What is endometriosis?

Endometriosis is a benign disease, chronic that is manifested by the appearance of endometrial tissue (inner layer of the uterus) out of its normal anatomical place. This tissue is implanted anywhere in the abdomen, such as the ovaries, the fallopian tubes, the vagina, the ligaments that support the uterus, the organs of the abdomen such as the intestines, the bladder, the abdominal wall and more rarely in organs further away like the lung.

Why is it produced?

The misplaced endometrium can form implants, which are small non-raised plaques, nodules if they are larger, or endometriomas if they form cysts in the ovaries. These cysts are also called chocolate cysts because of the chocolatey appearance of their contents. East out of place endometrial tissue responds to the menstrual cycle causing bleeding coinciding with menstruation. The places where it is implanted are not prepared for bleeding so an inflammatory reaction occurs that would explain the symptoms and complications of the disease. When endometriosis settles on the uterine wall it is called adenomyosis and can cause heavy menstrual bleeding, called hypermenorrhea.

The causes of this disease are unclear, There are studies that point in several different directions, but all agree on a genetic factor involved since there is a higher incidence in daughters of mothers who have endometriosis. By not knowing its origin, the treatment can only be aimed at improving its symptoms and consequences, but without being able to eliminate its appearance.

What are the symptoms of endometriosis?

Symptoms are highly variable from one woman to another, being able to be totally asymptomatic or present one or more of the complaints characteristics.

• Dysmenorrhea or pain with menstruation, especially in women who had no previous menstrual pain. It can be very intense preventing normal life, accompanied by nausea and vomiting.
• pain with intercourse
• pain on gynecological examination
• Chronic pelvic pain
• Rectal pain and urinary discomfort.
• Some women the only symptom they present is sterility.

How is it diagnosed?

• The diagnosis is made based on the clinic history.
• The vaginal examination It can reveal sore spots, the presence of tumors due to endometriotic nodules and difficulty in the mobility of the internal sexual organs due to the presence of adhesions.
• The ultrasound It is the basic technique for diagnosis. It can detect ovarian cysts with a typical ultrasound pattern and that do not disappear spontaneously after a while.
• Diagnostic confirmation is made by laparoscopy, which is a technique that allows the visualization of the abdominal cavity and the taking of samples for analysis. To carry it out, a short stay in the hospital is required as it requires general anesthesia.
• The CT or MRI they can help on some occasions.
• blood tests are not definitive but can be indicative in certain cases.

Treatment for endometriosis

The treatment of endometriosis requires a personalization of each case according to the characteristics of each woman.

• Can be administered anti-inflammatory treatments qIn addition to their own analgesic effect, they reduce uterine contractions during menstruation.
• The oral contraceptives they leave the ovaries resting, which seems to slow down the progress of the disease and its relapses.
• Analogs of the GnRH it is a widely used treatment in cases of endometriosis. They produce a state of reversible menopause whereby the ovaries remain at rest and slow down the progression of the disease.
• Finally the surgical treatment, frequently laparoscopically, its objective is to eliminate all endometriotic tissue and preserve as much healthy tissue as possible.