Endometriosis is a subtle, not easily diagnosed disease that affects about ten percent of women of childbearing age. It affects the endometrium, or that small tissue that lines the internal surface of the uterus. The same one that tends to flake off during the menstrual cycle. Here are the characteristics, symptoms, diagnostic methods and treatments for endometriosis. What is endometriosis
Endometriosis is characterized by the presence of endometrium or similar tissue in uncommon areas of the body. These include the fallopian tubes, ovaries, uterine ligaments, the rectus vaginal area, the peritoneum and the outside of the uterus. More rarely they form in the bladder, intestines, vulva, cervix and post surgical lesions. There are even cases in which portions of endometrial tissue have been found in the arms, legs and lungs. The consequences of endometriosis
The main problem that affects people with endometriosis is that the tissue can develop lesions, growths, nodules and even tumors instead of forming normally, as happens in the case of the inside of the uterus. Depending on their location, they can cause various ailments including infertility (affects about 40 percent of women with endometriosis), chronic pelvic pain, painful sexual intercourse, bleeding. The role of inflammation in endometriosis
The most natural consequence is inflammation. It is nothing more than a physiological – and protective – response to an anomalous situation that occurs inside or outside the organism. While the inflammation aims to improve the condition quickly, on the other hand, if this condition does not resolve, the process becomes chronic. And this is how the famous – and feared – inflammatory cytokines are produced which greatly increase inflammation. The risk, if not treated in time, is that the body will produce fibrous tissue in response to increased inflammation, causing problems with movement, function and pain in the affected areas. The various types of endometriosis
Endometriosis can be internal or external. In the first case it could be in the right place – the uterus – but not in the common position: often between the perimetry and the endometrium. This condition is called adenomyosis. This is a very common phenomenon, often detected through excessively abundant menstrual cycles. In the case of external endometriosis, the endometrium is always located in areas of the body outside the uterus. And, as we have said, in more rare cases it can also affect the gastrointestinal viscera. Endometriosis generally disappears with the arrival of menopause
. Endometriosis rarely continues into the postmenopausal period. However, cases in which it persists for a long time are more likely in subjects taking replacement hormones.
EndometriosisThe causes of endometriosis
Unfortunately, the real causes of endometriosis have not yet been ascertained. There are, however, several theories regarding this. One of the most recent – all Italian – is the one conceived by Professor Signorile. His research has shown that there may be extrauterine endometrial tissue cells in some human fetuses. According to his study, this happens due to the contamination of female embryos following endocrine disruptors. These seem to modify the expression of some genes responsible for the formation of the genital system. Another possibility is that endometriosis is a consequence of retrograde menstrual flow. This is a condition in which some endometrial debris that commonly forms during the menstrual cycle, they rise – through the fallopian tubes – into the abdominal cavity instead of being expelled. However, it should be said that this theory has never been verified.Among the causes of endometriosis also familiarity and hormones
Others hypothesize that at the base of endometriosis there are estrogens: an excess of them could promote the onset of the disease. Genetic familiarity could also be at the basis of everything. In these cases it seems that the immune system is unable to recognize the endometrial cells that are outside the uterus. But the hypotheses do not end there. Doctors and professors believe that there is a possible dissemination. That is, endometrial cells are able to reach unlikely areas of the body by moving through the blood and lymphatic vessels. Finally, one cannot fail to mention the problem of unhealthy lifestyle. Hormone-pumped meats, air pollution and industrial food could predispose women to endometriosis. Symptoms of endometriosis
Symptoms are not common to all women and could also occur in old age. Generally, already in childbearing age, you can have severe pain during sexual intercourse that could suggest endometriosis. It must be said, however, that many doctors do not investigate as they believe that pain is common even in subjects not affected by this pathology. It can also be noticed during sexual intercourse that they could also become very painful. Finally, depending on the place where it occurs, you may have too abundant menstruation, intermenstrual losses, blood in the urine, pain and blood loss during the evacuation phase. The diagnosis of endometriosis
Diagnosis is usually made through laparoscopy. In this case, the laparoscope is introduced into the abdominal area through a micro incision. The instrument allows you to examine the entire abdomen and detect any tissue abnormalities. In some cases, even the gynecologist can detect endometrial cell formations outside the uterus during a normal visit. If, on the other hand, it is suspected that endometriosis affects other areas, an MRI scan (nerves of the lower limbs), a cystoscopy (urinary tract) or colonoscopy (intestinal tract) may be required. Treatment for endometriosis
There are still no truly effective treatments for endometriosis. There are mostly treatments that reduce the most common symptoms. These include birth control pills which inhibit ovulation – and consequently the spread of endometrial cells. In some cases, only pain relievers are used to reduce pain – especially during the menstrual cycle. If the problem disturbs the patient’s life a lot, surgery can be done. However it must be said that it does not completely resolve the pathology. In fact, endometriosis often forms again after some time.
