Sometimes, living in marriage for several years, women come to the gynecologist with a single complaint - the absence of pregnancy. And with surprise, they will find out that they have endometriosis. After all, infertility is sometimes the only clinical manifestation of endometriosis...
Content
One day, this thought comes to the head of a woman and, racing to incredible sizes, eclipses others. Now all actions and aspirations are aimed at achieving the cherished goal. And God forbid something will prevent the Holy Dream!
What a huge shock is tested by the one, which as a result of long and unsuccessful attempts to conceive a kid hears from the doctor frightening conclusion: «Infertility»... Unfortunately, there are many such cases. Some of them cause endometriosis. An obstetrician-gynecologist-endocrinologist, a specialist in the treatment of infertility and non-leaving pregnancy Elena Yuryevna Pechnikova, is talking about this disease.
Endometriosis - extremely common disease. And it is characteristic of women precisely reproductive age. The word itself comes from the name of the uterus oral mucosa - endometrium. This fabric obeys hormones that are produced by ovaries and cause menstruation.
The fact is that endometrium is developing cyclically, and in the middle cycle is 28 days. If in the uterine after ovulation did not fit the fertilized egg, that is, there was no pregnancy, then after a certain time, the endometry is brazed. And this process manifests itself, as you have already guessed, bleeding. That is, menstruation begins.
The essence of the disease is that endometrium is growing outside the uterus mucosa, in different organs and tissues. Currently, this phenomenon is not sufficiently studied, and there are several theories of its development. For example, endometriosis of the abdominal cavity is explained as follows: fragments of endometrial, very viable tissue, can with reverse blood flow during menstruation in the fallopian tubes to fall into the peritoneum, «Suggest» There and grow up.
Born outside the uterus fabric behaves actively. It still depends on the female sex hormones produced by ovaries. As a result, in the abdominal cavity, a process resembling menstruation. It looks like a plurality of internal hemorrhages of varying severity.
Symptoms and consequences of the disease depends on which the endometrium will germinate. If this is an ovary, then with time the cyst is formed in it. It is usually determined during the ultrasound. Make Ultrasound Woman Make Periodic Pulling Pain With Belly. But endometriosis may not give any pain. Some women live with him all their lives, nothing suspect.
If the cyst is small, then it is most likely to conceive a child, it will most likely hurt. However, most often doctors, finding Endometrioid cyst During the examination, they insist on its removal surgically, because the ovary is a quick and permanent body. To avoid «Women» There are further problems, it is better not to have any neoplasms in it, the more growing - such as endometrioid cyst.
The infertility of the ovarian endometriosis can only lead in extreme cases - when the cyst fills in itself the entire organ and purely mechanically prevents the fertilization of the egg. Or there is endometriosis and in other places.
Disease variation - Surface endometriosis, In particular, peritonean endometriosis. In this case, its foci is growing in the pelvic peritoneum - fabric, lining the cavity of a small pelvis from the inside. Symptoms in this case are similar: the woman feels pain at the bottom of the belly. Often, doctors mistakenly suspect the inflammatory process and prescribe antibiotics. If they do not help, it is most likely talking about the wrong diagnosis: in fact, a woman suffers from endometriosis.
Only sometimes it is possible «felt» endometriosis during palpation, when the doctor's touch causes the woman pain or decister the tubercles. Confirm or disprove the guess in most cases, you can only with Laparoscopy. The foci of the endometrium at the same time is clearly visible on the peritoneum and succumb to surgical removal.
This form of the disease is most often the cause of infertility, the so-called unclear form. When a woman has no complaints, and the desired pregnancy does not come in any way. The thing is that peritonean endometriosis sometimes causes the strongest adhesions in the peritoneum itself, between the ovary and the uterine pipe, around the pipe and in other places.
Spikes purely mechanically interfere with the fertilization of the egg. In order for the desired pregnancy, it is necessary to carry out laparoscopy: an operation to remove endometry tissue from peritoneum by excision or burning - coagulation. To prevent the growth of foci of endometriosis, as a rule, follow the subsequent hormonal or physiotherapy.
Internal endometriosis (adenomyosis) quite often detect when ultrasound. With this form of the disease, the foci of endometriosis germinate into the thickness of the muscular layer of the uterus itself. In some cases, this is due to thinning of the basal membrane, which suffers from abortions, instrumental scraps, chronic inflammatory processes of endometrial.
As a result of the growth of endometrial in the uterus wall, multiple intermushny hemorrhages occur, which cause a woman pain. Over time, the muscle tissue of the uterus becomes rude, loses elasticity and ceases to shrink. This leads to the fact that menstruation does not end in time. Permanent blood loss entail anemia.
The loss of the elasticity of the walls of the uterus is fraught with the fact that upon the occurrence of pregnancy, it cannot stretch, as it comes from a healthy woman as the fetus develops. Although after conception, the monthly women stop, endometrium tissues, sprouted into the wall of the uterus, are engaged, and the elasticity of the organ is partially restored.
One of the heavy forms of endometriosis - Retrocervical. In this case, the space between the cervix and the rectum is filled with foci of endometriosis. Symptoms of this form of the disease - pain during sexual intercourse and defecation, which are given to the lower back and the rectum. Painful seal diagnoses a gynecologist when inspection.
Some specialists to see the borders of the growth of foci of endometriosis, do ultrasound. And in order to establish how much fabric has spread to neighboring organs (ureters, rectum), it makes sense to make computer tomography (CT) or nuclear magnetic resonance research (MRI).
Operation to remove foci of endometriosis - with this form of the disease - the most appropriate. Sometimes it lasts up to 6 hours, because the process includes many neighboring organs. And, unfortunately, even among Moscow laparoscopists, gynecologists will have a few who will hold it on the highest category.
In addition to these forms of the disease, the endometrium can grow into the vagina, in the lumen of the uterine pipes, the cervix, on the scar after operations and, in principle, any other organs and tissues. Even on mucous eye!..
Since endometriosis - the disease is not fully studied, and, alas, there are no absolutely effective ways to treat. To date, two methods of struggle are known: with the help of hormonal drugs and by surgical intervention. It is known that the growing of foci of endometriosis outside the mucous membrane of the uterus depends on the menstrual cycle. As already mentioned, with the cessation of menstruation, for example, during pregnancy, endometrium moves are engaged and the growth of the tissue stops naturally.
The essence of drug treatment is to «Siemet» pregnancy. For this, a woman is prescribed hormonal monophasic contraceptives, pre-adaggent drugs that cause artificial menopause. When drugs do not help, resort to surgical intervention.
Summing up, it should be noted that endometriosis is optional infertility. The disease only in some cases leads to the formation of adhesions, scars and cysts, which purely mechanically hampered the fertilization of the egg. In addition, the growth of foci of endometriosis outside the mucous membranes of the uterus can be accompanied by immunological and (or) endocrine disorders in a woman who are able to bring to infertility or reduce the likelihood of pregnancy. Sometimes the fault of endometriosis occurs an early abortion of pregnancy.
There is an assumption that endometriosis, like some other «Women» Diseases may be associated with the emotional and psychological side of life. Cause - Serious, Internal Changes. Perhaps the woman is not satisfied in something, feels unprotected, undervalued. She lacks attention, caress, care. She does not feel a woman in the full sense of the word. In such patients, gynecologists often observe the clinical shape of endometriosis. Treatment in this case should not be limited by drug and operational methods.
