Leaving the gynecologist's office with «Mysterious» diagnosis «Endometriosis», Women often perceive the words of the doctor almost like a sentence. What is hiding behind this title, what are the symptoms of the disease, what is threatened with health, what are the causes of the occurrence and main treatment methods?
Content
As a rule, endometriosis occurs in women in the most active physiological period of life, most often from 30 to 45 years. In the body of a woman, a fabric is found, according to its properties, a very similar to the endometrium is a cloth, lining the inner cavity of the uterus. However, it is found there, where to be not at all should be. It is known that the main characteristic of the endometrium is the ability to be changed depending on the phase of the menstrual cycle. During the cycle, the endometrium is growing, and during menstruation, it turns out and goes out.
True, the endometrium fabric is somewhat different from the usual endometrium, but slightly, so we will not go deep into the details - this is the task of doctors and scientists. It is enough for the patients to know that the endometrium fabric has more than ordinary endometrium, vitality and, falling into other organs and tissues, growths and continues to lead «The usual way of life». It is as well as normal endometrium, passes all phases of its development: increases and menstruates, than violates the normal functioning of affected organs.
The reasons for the occurrence of this disease, despite the modern equipment and stubborn labor of scientists, and not studied to the end. There are many theories. Let us dwell on those that deserve the greatest confidence.
Let's start with the most common - Transplant theory. Its essence is that the endometrium from the uterus during menstruation can move together with menstrual blood and its microscopic pieces can penetrate the uterine pipes in the abdominal cavity. Maybe this happens and during the operation in the uterus.
But, of course, a healthy body has protection against such unauthorized resettlement. In the normal state, even if the cunning endometrium accidentally and found itself in the abdominal cavity, our immunity will not allow this tissue to settle and take care of neighboring organs or on the outer walls of the uterus. Therefore, to reduce the cause of the disease to chance and consider the cause of the disease purely transplantation difficult, must be present in the immunite, which ultimately become a trigger crochet.
There is I Embryonic theory The occurrence of endometriosis. It is believed that various defects of the development of urinary bodies in the fetus lead to the disease. Although this theory is considered obsolete, it is impossible to finally put the cross on it, since this disease occurs in adolescents and even children - the truth is extremely rare.
Currently, gynecology doctors converge on the fact that the most common cause of endometriosis is Genetic predisposition Combined with a hormonal imbalance in the body of a woman. This opinion confirms that endometriosis is manifested exclusively during the menstrual cycle. If the pregnancy or menopause comes, the development of a painful process is suspended and even its opposite development is observed up to full cure.
It is classified by this disease at the distribution site. Distinguish endometriosis of genital organs and endometriosis affecting other organs and fabrics. The endometriosis of the genital organs is divided into the outer, when the cervix is amazed, the peritoneum, which covers it, pipes, bladder and ovaries, and the inner, which captures only the uterus.
In this case, the endometrium tissue penetrates the uterus wall to different depth, and may partially capture the plots of peritoneum. The affected muscle wall of the uterus changes, the cavities in the form of nodes are formed in it, which are filled with blood. The damage to the muscular wall of the uterus is called adenomyosis.
In the case of external endometriosis, the most unexpected organs and tissues can be affected - for example, bladder, intestines, kidneys, lungs, bronchi and even eye conjunctiv. Single cases of endometriosis of conjunctivations are described when «menses» Sick as it would cry bloody tears.
Classical symptoms of endometriosis are driving pain, usually localized by the abdomen. They are enhanced during menstruation and can achieve such force that patient endometriosis falls into the hospital. In cases where endometriosis affects the rectum, pain occurs during defecation, and the bladder damage can manifest itself in the form of painful urination.
However, endometriosis can give and not such a bright clinical picture. He can wear not very pronounced or not to show himself at all. And it is even worse, as the cunning of the disease lies in the fact that, despite the visible well-being, minor cameras of endometriosis continue to do their black things. In such cases, endometriosis is revealed by chance when a woman appeals to a doctor about infertility.
Developing, endometriosis forms a plurality of adhesions, which are gradually doing uterine pipes with impassable, which leads to infertility. True, not always the obstruction of pipes caused by endometriosis is the true cause of infertility. There are cases when in women suffering from endometriosis, the uterine pipes are passable, and the pregnancy never comes.
Some scientists believe that infertility in patients with endometriosis is associated with hormonal and immunological disorders. There is also the theory that cells that suppress the movement of spermatozoa are activated in case of endometriosis. I will give example.
Patient A., 30 years old, addressed me about infertility. In 25 years she had a unwanted pregnancy, which ended with an abortion. After inspection, a woman was diagnosed: secondary infertility. The patient did not complain about the pain and disruption of the menstrual cycle, and only a suspiciously excited state of the patient pushed me to the thought of endometriosis.
To make sure of your guess, I appointed not only a standard inspection about infertility, but also recommended the patient to start it with ultrasound research. The results of the ultrasound gave an estimated diagnosis: adenomyosis, or internal endometriosis. The woman was treated, after 2 years she had a welcome pregnancy, the birth went fine, and a pretty boy appeared on the world. However, how many strength and money went to fight this disease!
That is why endometriosis prevention is so important. How to recognize this quiet and stop it before he makes trouble? Here are some useful tips. First of all, pay attention to your mood: if you often behave aggressively, break on your relatives and close on trifles, arrange hysterics or plaxive without a reason if you are tormented by headaches or you give away from sexual proximity because of the unpleasant sensations, it is likely that the cause of all this is endometriosis. Contact a gynecologist and express your suspicions.
Endometriosis can be suspected and on the failures of the menstrual cycle. If you have painful, abundant and long-lasting menstruation, their cyclicity is broken, shortly before and immediately after menstruation there are oscillations.
What every woman should pay attention to prevent the development of endometriosis? Here are some factors that increase the risk to get endometriosis:
- Hereditary predisposition. If your mom or grandmother hurt endometriosis, then you need to be particularly vigilant.
- Excessive level of estrogen (female sex hormones). Analysis should be made on their blood level, such analyzes are made in many commercial laboratories.
- Obesity. Try not to bloom, hold on to the form, enter the moving lifestyle, observe the diet.
- In addition, the risk of disease increases the abuse of alcohol and coffee, generic injuries of the cervix, bad ecology, frequent stress.
Separately, I want to stay on two risk factors: the inadmissibility of sexual life during the menstruation and the dangers of abortions. It would seem that the rules of hygiene of sexual life are well known, but in their practice I still meet with the blatant illiteracy of some patients. Women admitted that they consider sex intimacy during menstruation safe in terms of protection against unwanted pregnancy! I want supporters of this method «Prehips» to upset: during menstruation you can get pregnant, and in addition, in addition to get inflammation of the appendages, the uterus, and «to Kuchi» - and endometriosis.
How many doctors talk about the dangers of abortions, how much is happening the alarm, and our women (and men) continue to hope for Russian «AB». But abortion besides other harmful consequences, which I will not stop now, it is directly related to the topic of our conversation today's conversation.
And now we turn to the prevention. What factors restrain the development of endometriosis and are quite accessible to each woman? First, it is hormonal contraception. I foresee a philistine opinion: they say, harm one from these hormones! And in general - they get fat from them, yes what is there - almost covered with thick wool. In Western Europe, hormonal contraceptives use constantly, but I met the full there wherever we have. Yes, drugs can cause a slightly elevated appetite, but the power of the will to stick to the elementary diet, which is quite enough to stop the weight set.
Of course, there are certain difficulties in the reception of these drugs, not all of them fit. However, like any other medicinal drug, they have their own testimony and contraindications. Therefore, a gynecologist should appoint them, and not a girlfriend or neighbor.
Remember that with competent reception of these drugs, you are not only protected from abortion, but also reduce the risk to get endometriosis, and besides, breast cancer and uterus. Their reception, especially after 30 years, is the prevention and many other gynecological diseases. Curious, but smoking women are sick endometriosis much less. However, smoking has the mass of others, harmful health effects. And finally, what to do if you suspected endometriosis.
First of all - to go to a reception to a gynecologist. If the doctor suspects endometriosis, to clarify the diagnosis, it will definitely direct you to an additional examination. An experienced gynecologist in some cases and without additional analyzes with great confidence will establish diseases such as endometriosis of the cervix, an endometrioid ovary cyst or an endometrioid defeat of the processed space.
Confirm the alleged diagnosis will surely help Ultrasound. I would like to draw the attention of potential patients that the ultrasound should carry out a gynecologist, and not just an ultrasound specialist. And on modern equipment in a medical institution, and not somewhere at the metro station. For some reason, it is believed that the examination of the gynecologist is an updropic procedure, and the magical ultrasound is yes! This is a misconception, because only the amount of information obtained when examining and conducting an ultrasound can bring the doctor to an accurate diagnosis about endometriosis.
There are currently many other new tool methods of examination, which already confirm this diagnosis with one hundred percent accuracy. These methods include hysterosalpingography (and simply speaking, X-ray and appendages), which is carried out with the introduction of a contrast substance inwards with a special catheter. This study is simple and can be carried out on an outpatient basis for the 5-7th day of the menstrual cycle.
Another very informative operational study - Hysteroscopy. It is carried out exclusively in the hospital, and with mandatory intravenous anesthesia, with the help of a special optical device - hysteroscope. This device allows you to directly see what is happening inside the uterus, and thereby diagnose.
Laparoscopy - Operation, which is carried out in hospital under medication anesthesia. In the hands of a surgeon - laparoscope, a modern optical device. It penetrates the abdominal cavity, allows you to inspect the organs and identify endometrium changes in them. This study is very important to determine the localization of the process outside the genital organs. With a laparoscope, it is possible to immediately conduct operational treatment of endometriosis.
Recently, great popularity uses Blood research on oncomarkers, In which the blood is determined, the content of the CA125 is not exceeded. This analysis is not specific to identifying endometriosis: an increase in the amount of antigen occurs during the uterine mioma, as well as the uterus and ovarian cancer. However, the observation of the antigen dynamics is useful, as it allows you to evaluate the effectiveness of the designated treatment.
In a female consultation, with suspected endometriosis of the cervix or the wall of the vagina is carried out Colposcopy, or inspection of the cervix and vaginal walls under an increase with a special optical device - colposcope. This study allows you to better consider the vaginal part of the cervix and the walls of the vagina to reveal the visible foci of endometriosis.
In case of endometriosis, which is localized outside the genital organs, their special surveys are required. For example, if the divisions of the fat intestine and the rectum are affected, be sure to spend RectorOnososcopy - Study of the internal departments of the intestine to eliminate the germination of endometrioid tissue in them. And when localizing endometriosis next to the bladder is shown cystoscopy. This study makes it possible to eliminate or confirm the germination of endometrioid tissue through the wall in the bladder.
Is it necessary to treat endometriosis?
Is it worth treating endometriosis, if a woman is not going to acquire children or it does not bother with severe pain, but there are insignificant menstrual disorders?
I will answer unequivocally «Yes», because the process will definitely be progressing and even innocent initial symptoms of endometriosis can grow into a severe disease. But the main thing that should encourage any woman to go to the doctor, is the danger of rebirth endometriosis in cancer. Endometriosis patients belong to the group of high risk due to uterus cancer, ovaries, breast, colon and stomach.
What should be the treatment of endometriosis? First of all, it must be seamless to match the gravity and prevalence of the process. If the form of endometriosis is severe, then the treatment must be complex, combining both active hormone therapy and surgical treatment.
Often women during reception ask a question: «Is it possible to treat endometriosis by homeopathic agents or phytotherapy?». I am not a convinced opponent of non-traditional methods. However, according to my own observations of patients with endometriosis, which went on this path, the latter returned to me, but already with a more launched form of the disease. As a rule, non-traditional forms of therapy not only do not stabilize the process, but also lead to a more severe course of the disease. Time is missed. But, apparently, our person is so arranged that the miracle is eager.
But even modern methods, endometriosis is treated extremely difficult, the process of this long, requires patience and labor both by the doctor and the patient.
The main method of treating endometriosis is Hormonotherapy. Selection of drugs should conduct a specialist - a gynecologist. Given the clinical picture and the zone of distribution, its destination can be different, since the range of drugs is very wide. In addition, the doctor often appoints additional medicines that strengthen immunity.
With an extensive process and presence of nodal forms of adenomyosis, combination of adenomiosis with the uterine, the presence of endometrial ovarian cysts, bleeding is carried out Operational treatment. Before surgery, as a rule, hormonal therapy is used for 4-6 months. If there are no improvements, then resort to surgery.
