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Endometriosis: symptoms, causes, diagnosis, and treatment methods

Endometriosis occurs in 10% of women of reproductive age. Doctors call it one of the main causes of infertility and miscarriage. Read about why it occurs and how to deal with it in the article Passion.ru
What is endometriosis?
The name of this disease is associated with the word endometrium – an internal mucous membrane lining the body cavity of the uterus, and abundantly supplied with blood vessels. The growth of cells of the uterine mucosa beyond its limits, for example in the ovaries, fallopian tubes, rectum, bladder and other organs, is called endometriosis. Very rarely, but it happens that endometriosis spreads to the skin, lungs, and even the brain.

There are various ways to measure the severity of endometriosis. The most widely used scale of the American society of reproductive medicine. Doctors evaluate its manifestations on a point scale, depending on the area of endometrial tissue spread and the depth of its penetration into the affected areas of the body.

Stage 1-minimum
It is digested in cases of a small number of single foci of endometriosis on the muscular surface of the uterus, without penetrating deep.

Stage 2-weakly expressed
Lesions increase in size and begin to grow deeper into the abdominal tissues.

Stage 3-moderate
Lesions begin to actively spread to the deeper layers of tissues, causing their scarring and contributing to the formation of small cysts on one or both ovaries.

Stage 4-severe
This is the most widespread stage of endometriosis, when its multiple foci spread not only to all layers of the uterus, but also to nearby organs, causing massive adhesions and cysts.

According to experts, endometriosis does not always begin with the first stage and ends with the last. The insidiousness of this disease is that its signs and symptoms can both get worse and get better, regardless of whether you treat it or do nothing.
Symptoms
The main symptom of endometriosis is pelvic pain, very similar to what some women experience during menstruation. Many describe it as spastic pain, the intensity of which increases and decreases.

It is important to remember that the intensity of pain is not a reliable indicator of the stage of endometriosis. For example, in some women, weakly expressed endometriosis can manifest itself in unbearable pain, while in others, the first stage of this disease can be almost asymptomatic.

Common symptoms of endometriosis include but are not limited to the following:

Painful menstruation. It usually manifests as pelvic pain and spasms that can begin before and last for several days during menstruation.
Pain during or after sexual contact
Causeless chronic pain in the pelvic area during defecation and urination. In rare cases, small blood clots may appear in the stool or urine.
Heavy monthly and intermenstrual bleeding
Intestinal irritation syndrome. This symptom often accompanies endometriosis and completes the picture of its clinical manifestation.
Reproductive problems .Despite the fact that with a diagnosis of endometriosis, conception is quite problematic, with a competent approach and the help of specialists, many women still manage to get pregnant and carry a healthy baby.
Causes of endometriosis
Despite the fact that there is no clear answer to the question about the causes of endometriosis, experts find several explanations for its appearance:

Retrograde menstruation – the flow of menstrual blood back into the tube. In retrograde menstruation, menstrual blood containing endometrial cells is thrown back through the fallopian tubes and into the pelvic cavity instead of leaving the body. These endometrial cells stick to the walls and surfaces of the pelvic organs, where they grow and continue to thicken and bleed during each menstrual cycle.
Transformation of peritoneal cells. Under the influence of hormones or immunological processes in the body, peritoneal cells that line the inner surface of the abdomen are transformed into endometrioid cells, causing disease
The transformation of embryonic cells usually occurs during puberty, when hormones such as estrogen turn embryonic cells into endometrioid cells.
Implantation of endometrial cells in a postoperative scar. This often happens after operations such as cesarean section and removal of the uterus, when endometrial cells are attached to the area of the surgical incision.
Transfer of endometrial cells to other organs and parts of the body using blood vessels and the lymphatic system.
Disorders of the immune system, when the body is not able to recognize endometrioid tissue growing outside the uterus.

Risk factor
No one is immune from endometriosis, it can develop in any menstruating girl or woman. But still, most often this disease affects women aged 30 to 40 years.

Among the main risk factors for endometriosis, doctors distinguish the following:

Absence of children
Heavy menstruation lasting more than 7 days
A short menstrual cycle – 27 or less days.
Heredity. A woman has an increased risk of endometriosis if her mother, aunt or sister suffers from this disease
Health problems that block the normal flow of menstrual blood from your body during your period
Diagnostics of endometriosis
Because of the similarity of symptoms, endometriosis can sometimes be confused with diseases that cause pelvic pain, such as pelvic inflammation, polycystic ovaries and irritable bowel syndrome.

The diagnosis of “endometriosis” can only be made by a doctor after a thorough examination.

The first stage of endometriosis diagnosis is a gynecological examination, during which the doctor probes the vagina for the presence of large cysts and scars outside the uterine cavity.

Since small areas affected by endometriosis are not always palpable, the doctor may prescribe one of the types of visual diagnostics, such as ultrasound or MRI.

In some cases, visual diagnosis is not possible, then the only way to confirm or exclude endometriosis is laparoscopy. This is a minimally invasive surgery that allows doctors to see the affected endometrium. In some cases, they need only one look at the tumor to make a diagnosis; in others, they need to take a tissue sample for a biopsy.

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