What is endometriosis?
Endometriosis is a gynecological condition in which the tissue that normally lines the inside of the uterus, called the endometrium, grows outside the uterus, mainly in the pelvic region of women (between the navel and the groin).
Symptoms
The symptoms of endometriosis are diverse and include:
- Dysmenorrhea (menstrual cramps): main symptom of the disease in 62.2% of cases
- Chronic or constant pelvic pain: may occur intermittently throughout the menstrual cycle. It presents various characteristics, such as discomfort, throbbing pain, and often worsens over time
- Pain during sexual intercourse: mainly related to deep lesions in the vagina
- Bowel changes: abdominal bloating, blood in the stool, constipation, and anal pain during the menstrual period
- Infertility: difficulty getting pregnant after one year of trying
Although most women with endometriosis exhibit some of the above symptoms, others may have the disease without experiencing any of them.
Additionally, these symptoms are often found in other conditions, which should always be investigated. Thus, medical attention for diagnosis clarification and follow-up is essential.
Causes
The causes of endometriosis are not fully understood, although there are different hypotheses to try to explain its onset:
- Theory of retrograde menstruation: a phenomenon common to most women, which causes menstrual blood, instead of exiting through the usual place, to flow through the fallopian tubes into the abdomen, allowing endometrial cells (which are shed with the blood) to implant and develop endometriosis in predisposed women, for some still unknown reason
- Theory of coelomic metaplasia: transformation of cells from another origin into endometrial cells, growing in an inappropriate place
Diagnosis
The diagnosis is usually made by a gynecologist, through an adequate clinical evaluation (patient's history and physical examination) and there are some complementary tests that can be useful, such as blood tests and ultrasound, for example. In the suspicion of endometriosis, it is possible to clinically monitor the case's evolution or indicate surgery through videolaparoscopy (a surgical technique performed with the aid of a camera in the abdomen).
The average time between the first symptoms and the diagnosis is approximately seven years and, sometimes, the identification is made during the infertility investigation process.
Treatment
Endometriosis should be approached as a chronic disease and requires follow-up during a woman's reproductive life (the entire period in which she can have children), as this is when the disease manifests its main symptoms.
The treatment should be directed towards the patient's complaints, as well as the location and extent of the disease. The use of medications can be effective in controlling pelvic pain and should be the treatment of choice in the absence of absolute indications for surgery.
The procedure should be performed by a qualified healthcare team, through hormonal and analgesic medications and, when necessary, include complementary therapies such as physical activity, physiotherapy, acupuncture, and psychological support.
Prevention
Although it is not possible to prevent endometriosis, some strategies can help reduce the risk of developing it or worsening the symptoms:
- Healthy diet: maintaining a balanced diet rich in fruits, vegetables, whole grains, and fiber can be beneficial for people with endometriosis
- Regular exercise: regular physical exercise can help reduce inflammation and alleviate the disease's symptoms, such as pain
- Stress management: chronic stress can worsen the symptoms of endometriosis. Therefore, stress management strategies such as meditation and yoga can help reverse the situation
References
You may also like to read about:
Adenomyosis: disease that occurs when the tissue lining the inside of the uterus (endometrium) develops in the muscle of the uterus (myometrium), causing heavy menstrual bleeding
Cervical cancer: type of cancer that arises in the lower region of the uterus when cells multiply in a disordered manner. Its symptoms include abnormal vaginal bleeding and discharge
Vaginismus: condition in which the muscles around the vagina close involuntarily, causing pain during attempts at penetration