Endometriosis of the uterus – what it is, the reasonssigns, symptoms and treatment of endometriosis in women

Endometriosis is a disease that is accompanied by ectopic
overgrowth of the mucous membrane, which is internal
shell of the uterus, in other structures of the female body.
The incidence of endometriosis is about 10% of all
other gynecological diseases. As a rule, pathology
occurs in women of reproductive age from 20 to four5 years.

What is this disease, what are the causes and
characteristic symptoms as well as how to treat endometriosis – we are available
language will tell in this article.

What is endometriosis?

Эндометриоз uterus

Эндометриоз — это распространенное гинекологическое
a disease in which endometrial cells (the inner layer of the wall
womb) grow outside this layer. Sprawl
endometrium can be within the reproductive system (then they talk about
genital form) and outside of it (extragenital form). To share
internal endometriosis accounts for the vast majority of cases
diseases.

Most women endometriosis develops as a result of
lack of or, conversely, increased synthesis of estrogen – the main
female hormone that regulates the activity of the reproductive system,
reproductive organs and responsible for the appearance of the skin, nails and
hair.

Клинические проявления зависят от локализации process. Are common
symptoms – pain, increase in endometrial nodes, bloody
discharge from the outer areas before menstruation and during
her.

Previously, this disease occurred mainly in women in
age 30-50 years. Unfortunately, today it is significantly
younger, more and more patients with endometriosis 20-25
years old.

Prevalence statistics:

  • between the ages of 25 and four5, about 10% of women suffer;
  • up to 30% are faced with a diagnosis of infertility;
  • up to 80% with pain in the pelvic area of ​​a chronic nature.

Types and degrees

According to the localization of foci, endometriosis is divided:

  • Genital – foci are localized within the reproductive
    органов women.
  • Extragenital – when detecting pathological foci of
    outside the reproductive organs.

There are 3 forms of endometriosis of the uterus:

  • diffuse adenomyosis – proliferation of endometrioid heterotopias
    over the entire surface of the lining of the uterus with the formation of cavities in
    myometria;
  • nodular adenomyosis – the proliferation of endometrial foci locally
    with the formation of nodes that do not have a capsule;
  • focal endometriosis – only certain areas are affected
    uterine wall.

Depending on the volume of the pathological process, that is, from
endometrial penetration depth is divided into several stages
endometriosis of the uterus:

Stage 1
  • the mucous membrane is affected up to the layer of myometrium (to medium,
    muscle layer, as mentioned earlier);
2
  • several lesions capable of penetrating into the circular layer
    myometrium;
3
  • multiple foci of endometriosis localized throughout
    muscle layer of the uterus;
four
  • pathological endometrium affects even the serous
    shell.

In particular, this is the minimum stage, the stage is easy, moderate
stage and stage is heavy. Hard stage, as it is easy to assume
is the most painful for patients as well as the most
complex in terms of the implementation of measures aimed at treatment
endometriosis.

With prolonged illness and in the later stages of the course
diseases, endometriotic cells can even occur in
intestines, organs of the urogenital system, in the lungs. But fortunately,
it happens quite infrequently and is not the norm.

The reasons

Endometriosis is a polyetiological disease. It means,
that the reasons for its occurrence are many, and still
пор  в некоторых случаях не удается установить истинную
reason.

As the main theories of the development of pathology
are considered:

  • Implant hypothesis. According to her under the influence
    hormonal and immune disorders increases the ability of the tissue
    endometrium to adhesion (adhesion) and implantation (implantation). AT
    conditions of increasing intrauterine pressure such functionally
    modified cells migrate to other structures where they continue
    their growth and form endometriosis in the uterus.
  • Metaplastic theory. It comes down to the fact that the cells
    endometria do not take root themselves in unusual areas, but only
    stimulate tissue to pathological changes (to metaplasias).
  • Heredity. This factor is relevant for many
    diseases that a person has to face, and
    endometriosis can also be considered a disease, with this
    related factor.
  • Immune theory. Body defense systems remove any tissue.
    and neoplasms that appeared in the wrong place. With
    lowering endometrial cells outside the uterus does not die, and
    take root and function normally.
  • Do not forget about the ecological microclimate in which
    constantly there is a woman. So, a scientifically proven fact is
    that young women who are in places with elevated
    content of dioxin, most others suffer from endometriosis.

To other likely factors leading to occurrence
endometriosis include:

  • history of abortion
  • environmental impact,
  • iron deficiency in the body
  • surgery on the pelvic organs,
  • obesity,
  • inflammatory diseases of the female genital organs,
  • wearing intrauterine device,
  • abnormal liver function, etc.

Today, one of the most common causes of endometriosis
considered to be surgical interventions ever conducted in
uterus. These are abortion, caesarean section, cauterization of erosion and others.
procedures. ATвиду этого после подобных операций следует с четкой
regularly undergo examinations at the doctor.

Симптомы эндометриоза у женщин

Поражение эндометриозом

Withмерно у половины женщин с эндометриозом uterus, симптомы
no diseases. Adenomyosis in asymptomatic
is a random finding on the pelvic ultrasound. But this
applies only to patients with endometriosis grade 1.

Symptoms and signs:

  • The most specific symptom that occurs in
    most patients with endometriosis is pain in the projection
    small pelvis. Endometriosis pain is permanent and
    worse several days before the onset of menstruation.
  • Blood spotting before menstruation. This symptom
    have 35% of women suffering from endometriosis. A few days before
    estimated menstruation.
  • Longer menstrual flow. Duration
    menstrual flow in many women with endomtriosis
    exceeds average.
  • Bleeding The appearance of bloody discharge after intercourse
    – this is one of the signs, regardless of location
    knots.
  • Miscarriage, in this case we are talking about
    spontaneous abortion / miscarriage. The reasons у такого исхода связаны с
    overall picture of the changes against which evolves
    infertility.
  • Endometriosis of the uterus causes the development of infertility, which is connected
    with two factors. ATо-первых, имплантация яйцеклетки и
    Fetal bearing becomes impossible in the altered uterus, and
    secondly, adhesions in the pelvis prevents the penetration
    ovum to fallopian tube.

Other possible symptoms of endometriosis of the uterus:

  • blood appears in the urine – hematuria;
  • frequent emptying of the urea, frequent urge at night;
  • intoxication of the body – chills, general malaise, weakness,
    drowsiness.

ATыраженность симптоматики при эндометриозе зависит от многих
factors: the shape, degree of spread of endometriosis,
concomitant diseases and even from the psychological mood
women.

Most women often confuse the symptoms of endometriosis with
заболеванием миомы uterus, особенно это характерно для женщин,
who once made this diagnosis. Some are not at all
pay attention to changes in menstruation, as well as the accompanying
pain symptoms.

Complications

Endometriosis can be asymptomatic and not affect quality.
жизни women. On the other hand, time is not diagnosed
endometriosis and lack of adequate treatment can lead to
complications.

If a не уделять заболеванию должного внимания, то его развитие
can lead to the following consequences:

  • infertility;
  • the risk of miscarriage during pregnancy increases;
  • the development of blood anemia;
  • develop chronic diseases of the affected internal
    organs;
  • endometriotic tissues can squeeze nerve endings that
    provokes neurological problems.

Diagnostics

With первом же подозрении на эндометриоз врач определяет состав
surveys based on history and various individual
features of your patient.

With осмотре очаги эндометриоза могут быть обнаружены на
perineum and external genitals, as well as on the cervix and
in the vagina. The uterus is painful at displacement, can be rejected
posterior and firmly fixed in this position. Can be detected
endometrioid ovarian cysts.

Single examination and palpation to diagnose the disease as
usually not enough, so the doctor must prescribe
дополнительные procedures.

AT состав обследования обычно входят:

  • Hysteroscopy is an examination of the uterus with a special
    apparatus – hysteroscope. This unit provides visual information.
    on the monitor screen and allows you to directly inspect the cavity
    uterus
  • Laparoscopy – highly informative microsurgical method
    diagnostics that allows you to diagnose any form
    endometriosis and at the same time to conduct appropriate treatment;
  • Ultrasound procedure. Is modern, fast,
    precise and painless way to determine the location, size,
    the internal structure of the cyst, and, in some cases, give a forecast;
  • MRI This study is 90% informative. But because
    its high cost, tomography rarely carried out.
  • study of tumor markers CA-125, CEA and CA 19-9 and
    RO-test, whose indicators in the blood during endometriosis increase
    several times.
  • To reliably establish the presence of endometrioid tissue in
    cytological and histological
    a biopsy study that is collected by colposcopy and
    laparoscopy with concomitant biopsy.

When you just need see a doctor?

  • With sudden, recurring severe pains in the lower part
    belly.
  • With a general increase in temperature, nausea and
    dizziness in the background of abdominal pain.

How to treat uterine endometriosis?

There are two ways to treat diffuse and nodular endometriosis:

  • conservative – taking medication;
  • surgical – removal of tumors.

In exceptional cases, when neither the first nor the second methods
help, may require surgery to remove
uterus. Doctors do their best to avoid this, and not only from
desires to preserve the ability to bear children, but also because the whole
A woman’s life is directly dependent on hormonal levels, and removal
uterus and ovaries greatly changes it, and therefore changes life
women.

In any clinic, the attending physician should collect as much information as possible.
on these issues and only then assign a method
treatment.

The doctor prescribes a comprehensive treatment, in which
enters:

  • Diet (high-calorie foods with a decrease in the number of spicy and spicy
    dishes, annoying spices);
  • Immunocorrection and vitamin therapy;
  • Symptomatic therapy (analgesia, anti-inflammatory
    drugs);
  • Normalization of the functions of the hypothalamic-pituitary system, individual
    glands endocrine secretion (thyroid).

Before you assign a course of therapy and choose a method of treatment,
The doctor considers the following factors:

  • what age category does a woman belong to;
  • prospects for further pregnancy;
  • centers of spread and localization of pathology;
  • clinical symptoms;
  • nature of deviations;
  • the condition in which the immunity is located;
  • продолжительность treatment.

Depending on the general indications, treatment may be
medication, operational (have a radical or
organ-preserving character), as well as combined.

Medications

  • Non-hormonal drugs – nonsteroidal anti-inflammatory
    means – as an effective means of dealing with pain.
  • Hormone therapy – involves long-term treatment,
    reduces the likelihood of relapse, stabilize
    process after surgical intervention.

As for drug treatment, it is focused on
suppression of growth / reproduction of endometrial cells. Mostly with
endometriosis uses the following groups of drugs:

  1. The intrauterine device is successfully applied in the early stages.
    Mirena. Its interior is filled with hormones that can
    replace female progesterone, the lack of which provokes
    endometrial growth.
  2. combined oral contraceptives (marvelon,
    femoden, diane-35, etc.);
  3. drugs representing the antigonadotropin group (gestrinone,
    danazol, etc.). Danazol is used for 6 months. After
    1-2 months of treatment with danazol, as a rule, amenorrhea occurs
    (cessation of menstrual flow). Menstrual cycle
    recovers 28–35 days after stopping.
  4. drugs representing a group of progestins (depressant,
    Dufaston, etc.);
  5. drugs of the agonist group (decapepl-depot, zoladex and
    etc.);
  6. antiestrogens (tamoxifen, etc.).

Other groups of drugs – helpers in the fight
с симптомами:

  • AT дополнение к основному лечению в целях вспомогательной
    therapies may prescribe anti-inflammatory, relieving cramps,
    sedatives: Novo-Passit, Ibuprofen, No-shpa, and
    also vitamins;
  • Sedatives (elimination of neurological
    manifestations);
  • Immunomodulators (normalization of impaired immune
    status);
  • Vitamins A and C (correction of antioxidant deficiency
    systems);
  • Iron preparations (elimination of the effects of chronic
    blood loss);
  • Physiotherapy.

Hormonal treatment must begin at first.
menstrual cycle after surgery. Duration is 3–9
months depending on the extent and severity
process.

As mentioned above, determine the treatment regimen and
контролировать эффект в состоянии лишь ATаш врач гинеколог.

Self-medication for endometriosis with hormonal drugs
contraindicated due to the many side effects of these drugs
и необходимости контроля за эффективностью проводимого treatment.

Surgical treatment of endometriosis

Surgery to remove a lesion, partial or
complete resection of the affected organ – the main method of radical
treatment of this female disease, endometriosis with genital and
extragenital proliferation.

Indications for surgical treatment are three main
factor a:

  • Severe pain syndrome.
  • The presence of individual tumor formations in the organs.
  • Infertility.

The type of operation depends on the following factors:

  • age of the patient;
  • the presence of concomitant chronic diseases;
  • family replenishment planning in the future;
  • location of endometriosis;
  • the degree of damage to surrounding tissues and organs;
  • complications of the disease.

Depending on the type of endometrioid disease are possible
The following types of surgery:

  • uterine artery embolization used in strong
    bleeding on the background of adenomyosis;
  • removal of the uterus or resection of a cystic tumor of the ovary with
    abdominal surgery;
  • extirpation uterine vaginal access;
  • laparoscopic surgery option.

Any type of surgery requires full general anesthesia, as for
abdominal as well as laparoscopic intervention. The main
the goal of surgical treatment is complete removal of endometrioid
foci with maximum preservation of healthy tissue. Especially this
important in women of reproductive age.

Recovery after surgery

After успешной операции рекомендуется восстановительное
treatment:

  • procedures using electrophoresis with the addition of zinc,
    iodine;
  • therapeutic effects of ultrasound;
  • baths enriched with radon;
  • syringing medicinal anti-inflammatory
    compositions.

In exceptional cases, when neither the first nor the second methods
help, may require surgery to remove
uterus. Doctors do their best to avoid this, and not only from
desires to preserve the ability to bear children, but also because the whole
A woman’s life is directly dependent on hormonal levels, and removal
uterus and ovaries greatly changes it, and therefore changes life
women.

Folk remedies

For the treatment of endometriosis, traditional
folk remedies, but they are by no means a substitute
medical or surgical method.

  1. Dried and shredded cucumber shoots recommended
    brew like tea and drink without restriction.
  2. Beet Juice It is necessary to accept only freshly squeezed
    juice, and not more than 100 ml three times throughout the day. Start to heal
    endometriosis with this agent is necessary with small dosages. If a
    no allergic reactions will occur, its amount can
    increase to the above. However, remember: before drinking
    medicine, you must first defend it for four hours.
  3. Infusion of boron uterus with endometriosis. It is prepared from 2
    tablespoons of herbs. They are poured boiling water (2 cups), cover
    cap and wrap. Let it brew for 15 minutes, after which
    filter. This infusion is taken in several dosages: or four
    half a glass twice a day, half an hour before meals, or (more
    sparing method) in a tablespoon 3 times an hour before meals.
  4. Castor oil helps the body get rid of excess tissue
    and toxins. It should be used at the beginning of the menstrual period.
    cycle when spasms are just beginning.
  5. Chamomile has anti-inflammatory properties that
    help reduce inflammation as well as tumors.

Prevention

Preventive measures should be taken by all women.
childbearing age, regardless of whether there is a disease or not.
Special attention should be paid if intrauterine devices are used.
contraception, obesity present or elevated
estrogen.

As prevention of endometriosis, it is necessary:

  • with the appearance of severe pain before menstruation (dysmenorrhea)
    it is necessary to consult a gynecologist;
  • after any surgical intervention in the uterus is necessary
    is under the supervision of a gynecologist;
  • successful treatment of inflammatory diseases of the genital organs,
    even chronic.

The risk of developing endometriosis in the uterus is higher in the following groups
women:

  • marking the shortening of the menstrual cycle;
  • suffering from metabolic disorders, obesity, excessive
    weight;
  • using intrauterine contraceptives;
  • after the age of 30-35;
  • having an increased level of estrogen;
  • suffering from immunosuppression;
  • having hereditary predisposition;
  • перенесших операции на матке;
  • women smokers.

We have an accessible language considered what this disease is, told
о признаках и методах treatment.  Endometriosis of the uterus is
recurrent chronic disease. Relapses after
conservative therapy or organ-preserving operations during
years occur in 20% of cases, after 5 years of disease
relapse increases to 75%.

Remember that examinations and consultations with a doctor should take place regularly.
those women who use intrauterine devices
contraception, those who are already thirty years old. be healthy
and take care of yourself!

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