Endometriosis
Key information to understand what endometriosis is.
Definition of the disease
Endometriosis is a benign disease. It consists of the presence of endometrial tissue outside its usual location (which is the uterus).
This tissue grows and spreads, causing a significant inflammatory reaction wherever it is deposited. This results in a wide variety of symptoms.
Risk group and causes of appearance
It affects women of childbearing age, that is, while the ovaries are producing estrogen. This hormone stimulates endometriosis, and therefore, the disease ceases when menopause sets in.
It is present in 5-20% of women with chronic pelvic pain , and in up to 40% of women with reproductive problems.
The origin and mechanism of the disease are unknown. However, there are several hypotheses to explain its origin, although none are conclusive.
Alcohol and caffeine are risk factors, while exercise is a protective factor.
Symptoms caused by endometriosis
The main symptom is the pain caused by these implants, which are associated with an inflammatory component.
Diagnosing the disease is often delayed. The main reason is that the pain can lead doctors to believe it's another type of illness , primarily of digestive origin.
Pain may appear in the form of:
- painful periods,
- painful intercourse
- or significant discomfort when defecating and urinating, as most frequent locations.
- The appearance of ovarian cysts, known as endometriomas, as the initial form of the disease. These contain blood retained inside them, due to the 'menstruation' of this endometrial material.
Effects
As already mentioned, it can cause reproductive problems, due to the damage produced in the internal genital apparatus (ovaries, fallopian tubes , uterus and vagina).
Diagnosis of endometriosis
For diagnosis, the medical history and pain assessment are essential, along with the most common complementary tests.
For this purpose, we have gynecological ultrasound , preferably performed vaginally, to identify endometriotic cysts.
The measurement of a blood marker (CA-125) can also aid in the diagnosis , although it may be elevated, and false positives and negatives are possible. Therefore, a definitive diagnosis is made with a laparoscopy , although this is not always necessary. This procedure involves an endoscopic examination of the abdominal cavity under general anesthesia, which will reveal the endometriotic lesions.
What is the recommended treatment?
Treatment should be individualized for each patient, but will be aimed at :
- To the treatment of pain with anti-inflammatory analgesics.
- And to the decrease in the activity of tissue implants by hormonal treatments. For example, hormonal contraceptives (those containing Dienogest being preferable) and similar treatments, which will result in less menstrual flow.
In other cases, treatment must be surgical. Removal of ovarian cysts is generally performed with minimally invasive surgery (laparoscopy) or by repairing the pelvic anatomy damaged by the disease.
It should not be forgotten that a significant percentage of patients will need assisted reproduction treatments to achieve pregnancy given the harmful consequences of endometriosis on the internal female reproductive system.
Therefore, our strongest advice is to keep to your schedule of regular gynecological checkups. This way, at the first sign of any suspicion or symptom, an early diagnosis can be made and the best treatment implemented.
Article written by Dr. Ángel Lorenzo Álvarez
If you found this article interesting and would like to be seen by a specialist in Gynecology and Obstetrics, the Women's Unit at Ruber International Hospital has a specialized unit in this area. You can request more information by calling 917303673, schedule an in-person appointment , or book an online consultation if you prefer; always with top specialists.
