Endometriosis

Table of contents:
1- What is endometriosis?
2- What are the causes?
3- Risk factors
4- Symptoms of endometriosis
5- How is the diagnosis?
6- Complications of endometriosis
7- What does the treatment consist of?

What is endometriosis?

Endometriosis is a painful condition in which endometrial-like tissue, tissue that usually lines the inside of the uterus, grows outside the uterus. It usually occurs in the ovaries, fallopian tubes and pelvic tissue. However, although rare, it can also develop in the bladder, bowel and lung.

This tissue, like the endometrium, thickens and bleeds with each menstrual cycle. However, because it has no way to leave the body, it becomes trapped.

What are the causes of endometriosis?

The origin of this pathology has not yet been established. However, there are some theories: one theory is that endometriosis is due to a process called retrograde menstruation, as the blood flows through the fallopian tubes into the pelvic cavity, instead of being expelled through the vagina.
The other theory is known as the “induction theory” and implies that hormones transform cells outside the uterus into cells similar to those lining the inside of the uterus. Another similar hypothesis involves embryonic cells, which would be transformed into endometrial-like cell implants at puberty.
On the other hand, in many cases there could be a surgical origin and endometriosis could develop as a result of surgery, hysterectomy or cesarean section.

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Risk factors

There are aspects that could imply a higher risk in the development of endometriosis:
– Early onset of menstrual period
– Menopause at an advanced age
– Short menstrual cycles, i.e., shorter than 27 days
– Periods longer than 7 days
– High estrogen levels
– Low Body Mass Index (BMI).
– Family members with a history of endometriosis.

Symptoms of endometriosis

Symptoms of endometriosis can vary, as some women are affected more than others. However, pelvic pain associated with menstrual periods is one of the most common.
Symptoms associated with endometriosis are:

  • Menstrual pain that is not relieved by painkillers.
  • Heavy menses
  • Infertility
  • Pelvic pain: this may occur just before the period or all the time.
  • Pain during or after intercourse
  • Pain when going to the bathroom
  • Blood in the stool
  • Fatigue
  • Gastrointestinal disorders: diarrhea, constipation, and nausea.

The most common symptom is pelvic pain associated with menstrual
associated with menstrual periods

How is endometriosis diagnosed?

There are some tests to determine if this pathology exists:
– Pelvic examination: consists of palpating the area to evaluate if there are abnormalities such as cysts.
– Ultrasound: can indicate if there are cysts associated with endometriosis.
– MRI: allows to know the location and size of endometrial implants.
– Laparoscopy: looks for tissue outside the uterus, its size and location. It also allows a sample of the tissue to be taken.

Complications of endometriosis

Most commonly, endometriosis is present in the ovaries, which generates endometrioma cysts. When this occurs, the tissue can become irritated and produce fibrous bands that cause the pelvic organs to stick together.

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However, the main complication of endometriosis is usually loss of fertility. In fact, more than one-third of patients diagnosed with endometriosis have difficulty becoming pregnant.
Weak fertility is due to the fact that endometriosis may make it impossible for the egg and sperm to unite through a blockage in the fallopian tube. In addition, this disorder can affect fertility in indirect ways, such as damaging the egg or sperm.

On the other hand, in some cases endometriosis is related to ovarian cancer. However, the risk is relatively low.

Treatment of endometriosis

It generally includes medication or surgery, which will depend on the level of severity of the disease.

  • Analgesics: seek to improve symptoms such as severe pelvic pain.
  • Hormone therapy: may help slow tissue growth and prevent new ones. That is to say, the modification of hormones in the organism can generate thickening or decomposition of the endometrial implants. In this case, the specialist may prescribe hormonal contraceptives, gonadotropin-releasing hormone agonists or antagonists, progestin therapy or aromatase inhibitors.
  • Surgery: in the case of patients who are pregnant or wish to become pregnant, it is important to preserve the uterus and ovaries, and therefore conservation surgery is usually performed. This can be done laparoscopically or by abdominal surgery. In the past a hysterectomy was performed, which is surgery to remove the uterus, but now it is possible to focus on tissue removal and avoid removal of the ovaries or uterus.

On the other hand, in some cases it is important to carry out fertility treatment, which can be ovarian stimulation or in vitro fertilization.