WHAT IS ENDOMETRIOSIS?
Endometriosis; It is a disease that affects women of reproductive age and whose cause is not fully understood. It takes its name from the word endometrium, which is the tissue that develops and sheds during menstrual bleeding every month and lines the inside of the uterus. In endometriosis, endometrium-like tissue is found in other parts of the body outside the uterus. Endometrial tissue develops in these areas outside the uterus. These growths can cause pain, infertility and other problems.
The most common places where endometrial growths are found in the abdomen are; It is between the ovaries, the ovarian canals, the ligaments of the uterus, the outer surface of the uterus and the abdominal membrane. Sometimes these developments; It can be found in the incision site of surgeries performed in the abdomen, in the intestines, on the bladder, vagina, cervix and vulva. Endometrial developments also outside the abdomen; It can be found in the lung, arm, hip and other locations; but they are not common. Endometrial developments are generally not cancerous tissues. It is the presence of normal tissue outside of where it should be. Just like in the uterus, endometrial developments respond to menstrual hormones. Every month, tissue multiplies, sheds and causes bleeding.
Unlike the normal tissue lining the uterus, endometrial tissue outside the uterus has no way to leave the body. After all; Bleeding into the abdomen, tissue and blood changing properties as a result of growth, changes in the surrounding areas, and hard connective tissue develops. Other complications depend on the location of the growths. Growths may burst (endometriosis may spread to new areas), if the growths are in or near the intestines, adhesions may develop, bleeding or obstruction may occur, and if they are on the bladder, they may interfere with urinary functions or cause other problems.
SYMPTOMS
The most common symptoms of endometriosis are; Pain before and during the menstrual period (usually more severe than normal cramps), pain during or after sexual activity, infertility, excessive or irregular bleeding. Other symptoms; fatigue, painful bowel movements, periodic lower abdominal pain, diarrhea and/or constipation, and other bowel disorders. Some women with endometriosis have no symptoms. Infertility occurs in 30-40% of women with endometriosis and occurs due to the progression of the disease.
The severity of the pain is not related to the volume or size of the growths. If the small growths are overactive in the production of a substance called prostaglandin, symptoms can develop severe. Prostaglandins are substances produced by the body that have various functions and are thought to cause the symptoms of endometriosis.
THEORIES ABOUT THE OCCURRENCE OF ENDOMETRIOSIS
The cause of endometriosis is unknown. Although many theories have been put forward, none of them seem to explain all cases.
The possible reasons suggested are the settling of endometrial tissue in the abdomen as a result of menstrual bleeding, the spread of endometrial tissue from the uterus to other parts of the body via lymph or blood, and the carryover in the genes of some families.
DIAGNOSIS
Before the invention of laparoscopy, the diagnosis of endometriosis could not be made with certainty. Laparoscopy also determines the location, volume, and size of the growths, giving the doctor and the patient more information and making decisions about pregnancy and treatment in the long term.
TREATMENT
Treatment for endometriosis has changed over the years, but no definitive cure has yet been found. Hysterectomy (removal of the uterus) and removal of the ovaries may be considered definitive treatment.
Painkillers are often prescribed for endometriosis pain. Treatment with hormones aims to stop ovulation for as long as possible and sometimes puts endometriosis in remission during treatment and for months or even years after treatment. Hormonal therapy includes birth control pills, progesterone hormone derivatives, and GnRH agonists. For some women, the side effects of hormonal therapy can be problematic.
Women with endometriosis are often advised not to postpone pregnancy, as pregnancy often provides temporary remission and is believed to result in infertility in the long term.
However, there are many problems in the treatment of endometriosis to achieve pregnancy. The person may not have made the decision about “having a child”, which is one of the most important decisions in his life. It may not have the elements (partner, financial livelihood, etc.) that are important for having and raising children.
Other factors can make the pregnancy process more difficult. The rate of ectopic pregnancy and miscarriage is increased in women with endometriosis, and one study found that they had a more difficult pregnancy and birth. This study also showed a familial transmission and link to endometriosis. The risk of endometriosis and related health problems is increased in children of women with endometriosis.
Organ-preserving surgery—which involves removing and destroying implants by laparotomy or laparoscopy—may be performed and, in some cases, may relieve symptoms and allow pregnancy to occur.
Surgery with laparoscopy (called operative laparoscopy) has rapidly replaced major abdominal surgery.
Radical surgery, hysterectomy (removal of the uterus), removal of all foci and ovaries (to prevent subsequent hormonal stimulation) may be necessary in some cases of chronic and severe endometriosis.
No matter how the treatment is done, the probability of re-activation of the disease is high until menopause. Research in postmenopausal women is scarce, as menopause is believed to be the end of mild or moderate endometriosis.
The content of the page is for informational purposes only, be sure to consult your doctor for diagnosis and treatment.
Content Update Date: 26.12.2022