What is endometriosis and what does it involve?
Endometriosis is a benign disease that is very common today and involves the presence of endometrial tissue outside of its natural location. The endometrium is the tissue that runs along the inner side of the uterus and that each month develops and flakes and leaves with the period but sometimes the endometrium in addition to being in that natural location is in other locations, mainly the ovary, the abdominal cavity and even in other locations. When this tissue is out of place we speak of endometriosis and it affects many women, in the general population we can say that one in 10 women can suffer from endometriosis and within certain groups such as those women who have fertility problems or pain problems more or less 40-50% can be said to have endometriosis. The 2 basic implications of this disease are pain and fertility problems, that is, these foci of ectopic tissue, outside their natural location, sometimes cause inflammation, adhesions and can cause pain, and the typical pain of endometriosis is menstrual pain, which we call dysmenorrhea, which can be increasing and therefore may need treatment. On the other hand, in some women, endometriosis can lead to the development of cysts and fertility problems.
What are the treatment options for endometriosis?
The goal of endometriosis treatment is either to inhibit the development of the ectopic endometrium by medical treatment that inhibits hormonal stimulation or to remove the ectopic tissue, the tissue that is outside its natural location by surgical excision. Therefore, we can apply both medical and surgical treatments mainly when endometriosis occurs with pain. Pain management, medical treatment and surgical treatment of pain associated with endometriosis are relatively highly effective.
How do the disease and treatments affect fertility?
The 2 general implications of endometriosis can be pain, as we have discussed, primarily menstrual pain, dysmenorrhea, and fertility problems. Endometriosis by different mechanisms can affect fertility through inflammation, adhesions, development of ovarian cysts, and on the other hand women with endometriosis have a higher frequency of fertility-related problems. Both medical and surgical treatment of pain associated with endometriosis is highly effective, with greater or lesser duration. The treatment of infertility associated with endometriosis from the medical or surgical point of view may not be as effective, and it is at this time when we have to try to achieve pregnancy in women who have gestational difficulties due to endometriosis, in addition to surgical treatment, assisted reproductive techniques can be applied. The option of surgery, assisted reproduction or a combination of both will depend on each case, each situation and each woman in particular.