What is internal endometriosis in women and how to cure it? Effective drugs for the treatment of endometriosis in women.

Yes, and even more than that, in about a third of women who do not receive any treatment, it goes away on its own. This is due to the work of the immune system, which can recognize the “unnecessary” endometrium and destroy it.

How is endometriosis treated?

Based on the above, endometriosis does not always need to be treated. In world gynecology there are three types of management of endometriosis:

Observation without treatment: this tactic is not suitable for everyone, but only if endometriosis was discovered by chance (for example, during an ultrasound or surgery for another reason), the foci of endometriosis are small and do not cause any inconvenience.

Treatment with medications: the most common treatment strategy. We will talk about it in more detail below.

Surgical treatment (surgery): usually prescribed if drug treatment has not helped or endometriosis has led to serious problems with the functioning of internal organs. Surgery may also be required if endometriosis develops.

What medications are used to treat endometriosis?

The main medications for endometriosis that gynecologists prescribe are hormonal and affect the level of the body's own hormones. We will talk about 4 groups of drugs that are most often used in the treatment of endometriosis:

Birth control pills (oral contraceptives, OK): Zhanin, Yarina

Medicines containing progesterone and its analogues: Utrozhestan, Duphaston, Visanne

• Gonadotropin analogues: Buserelin, Zoladex

Each of these groups of drugs affects the body differently.

Birth control pills (Zhanine, Yarina) and endometriosis

Your gynecologist can prescribe birth control pills (OC) for the treatment of endometriosis: Janine, Marvelon, Regulon and others. These medications contain varying doses of hormones, so be sure to consult your gynecologist before starting to take the medication.

Birth control pills help reduce pain associated with endometriosis shortly before and during your period. For successful treatment of endometriosis, it is necessary to take OCs for at least 6 months. If the effect is noticeable (pain disappears), then your gynecologist may advise you to take OK for another 3-6 months. As a result of this treatment, areas of endometriosis may noticeably decrease in size.

Utrozhestan, Duphaston and endometriosis

Preparations containing progesterone (female hormone) or its analogues, such as Utrozhestan, Duphaston, Depo-Provera, Visanne and some others, give a good effect in the treatment of endometriosis. These medications reduce the body's production of estrogen, which inhibits the growth of the endometrium (both in the uterus and in areas of endometriosis). It is better to prepare in advance for long-term treatment, since the course of taking these drugs can last for 6-9 months.

Danazol and endometriosis

Danazol is a synthetic hormone that, while taken, suppresses the production of female sex hormones, helping to reduce foci of endometriosis. For the therapeutic effect of Danazol to appear, it must be taken for at least 3-6 months.

This drug was previously widely used in the treatment of endometriosis, but in some countries doctors are starting to abandon Danazol for several reasons. First of all, these are the side effects of Danazol, which include increased blood pressure, menstrual irregularities, weight gain, swelling and pain in the breasts, excess hair growth on the face and body, acne, hair loss and others. Secondly, new drugs have appeared in the arsenal of gynecologists that are as effective as Danazol, but without its side effects.

Buserelin, Goserelin (Zoladex) and endometriosis

Analogues of gonadotropin-releasing hormones, which include Buserelin, Goserelin (Zoladex), Sinarel and others, suppress ovarian function and reduce the level of female sex hormones in the blood. During treatment, you will not have periods, and you may also experience symptoms of menopause (hot flashes, mood swings), but this can be corrected by taking additional small doses of hormones.

The course of treatment for endometriosis with these drugs is no more than 6 months. After you stop taking the medication, the ovaries start working again, so you don’t have to worry that they will never “start” again.

How can you win Endometriosis through proper nutrition, natural supplements and effective methods.

One of my close friends asked me not long ago if there were any natural ways to treat Endometriosis.

I heard and read about this disease, and the story that doctors treat this condition with hormones (at least) did not surprise me at all.

And I decided that this would be a good opportunity to not only study this topic further, but also write a separate post about it. Still, cases of Endometriosis are becoming more and more common and women should know how to, if not prevent, then at least try to cure the body of this disease without side effects and hormonal therapy.

What is Endometriosis?

Every month there is a special layer called endometrium thickens in our uterus to support a fertilized egg during pregnancy. If fertilization does not occur, the uterus begins, in simple terms, to “molt,” that is, to get rid of the thickened endometrium. This process is called menstruation. And this is a normal function of the female body.

Endometriosis is a condition where the tissue lining the uterus begins to grow outside of the uterus in other parts of our body. And the same hormones that provoke the onset of menstruation provoke the growth of the endometrium where it is completely unnecessary. The endometrium can “grow” in the fallopian tubes, ovaries, peritoneum, and intestines. Every month, this tissue, due to the action of hormones that regulate the menstrual cycle, grows little by little more and more.

Over time, this can lead to the formation of scars and adhesions inside the reproductive organs, pelvis, and intestines.

According to statistics, women suffering from Endometriosis have a 9-50% chance of infertility.

There are 4 degrees of Endometriosis:

• 1 - a few isolated endometrial particles outside the uterus and a minimal number of adhesions
• 2 - greater number and greater depth of growths, but less than 5 cm and a minimum number of adhesions
• 3 - multiple deep endometrial particles or cysts on one or both ovaries and several adhesions
• 4 - multiple deep growths, a large number of cysts, numerous adhesions, often on organs

Symptoms or how Endometriosis manifests itself

Endometriosis is very difficult to diagnose. Often its symptoms coincide with other diseases.

Symptoms:

• Chronic pelvic pain
• Pain during menstruation
• Pain during sex
• Chronic fatigue
• Infertility
• Heavy menstruation
• Lower back pain

Sometimes there are no symptoms at all.

Causes of Endometriosis

Scientists and doctors are still not 100% sure what can provoke the development of this disease. Naturopaths view this disease as chronic inflammation and autoimmune response.

Estrogen Overload

The natural function of this female hormone is to stimulate cell growth. But excessive amounts of Estrogen lead to unnatural cell growth.

Most often, excessive amounts of this hormone occur due to xenoestrogens or substances whose molecular structure is similar to Estrogen. Xenoestrogens have the same effect on the body as real Estrogen.

So where do these Xenoestrogens come from? These are pesticides, plastic, feminine hygiene products (pads, tampons), preservatives, unnatural cosmetic products, sunscreens, deodorants, air fresheners, washing powders, household chemicals. Therefore, I once again want to emphasize that it is very important to surround yourself with natural things!

Genetic predisposition

If your mother or grandmother had Endometriosis, then the chance that you will have it is quite high. Scientists say it may be a gene that causes inflammation.

Lymphatic flow theory

According to it, the endometrium spreads throughout the body through the lymphatic system. And overload or overcrowding with toxins leads to serious problems, including the development of Endometriosis.

Theory of Retrograde/Reverse Menstruation

This theory suggests that the endometrium ends up in the fallopian tubes and peritoneum due to improper blood flow during menstruation.

Immunological factors

In the early stages of the development of Endometriosis, increased levels of cytokines, lymphocytes and macrophages are observed. Over time, the immune system changes and the number of macrophages and antibodies increases, while the number of T cells decreases. This leads to decreased immune function, which allows the endometrium to grow uncontrollably where it is not needed.

Oxidative stress

Or cell damage from free radicals and the development of chronic inflammation. This theory is currently considered as the main factor in the development of Endometriosis.

How can you cure Endometriosis naturally?

The approach to any disease must be comprehensive and Endometriosis is no exception to the rule. The most important thing is to remove the factors that provoke its occurrence and development and fight inflammation.

Nutrition

To begin with, it will be very important to minimize exposure to Xenoestrogens. Stay away from, replace it with glass. Use only natural personal care products, cosmetics, and household chemicals. Replace tampons and pads.

Eliminate pro-inflammatory foods - and. The first causes inflammation of the intestines, and from there the whole body through development. The second contains a high concentration of Isoflavonoids, which lead to Estrogen dominance, which is not at all necessary even for a healthy person.

Healthy weight

The fact is that fat cells synthesize Estrogen. Now imagine if we have many such cells? It is logical that there will also be much more Estrogen then. Maintain a normal, healthy weight. If you can’t lose weight, I recommend paying attention to.

Omega-3

Since the disease is of the nature of chronic inflammation, it would be logical to fight it with the help of anti-inflammatory drugs. One of them is. They can be taken in capsules (such as these) or in the form.

Compresses with Castor oil

Indole-3-Carbinol

Helps balance hormones by breaking down excess Estrogen and removing it from the body. Since Endometriosis is a condition of Estrogen dominance, clearing excess estrogen effectively helps reduce endometrial growth. It can be purchased.

Pycnogenol

A strong antioxidant obtained from pine bark. Helps fight endometrial proliferation and improve egg health. Normalizes the function of the immune system and protects against free radicals and chronic inflammation. Take 1 capsule 2 times a day. You can find this supplement

Content

Endometriosis of the uterus is a disease of the reproductive system in women of a hormonal nature. The disease is otherwise called adenomyosis or internal endometriosis. With endometriosis of the uterus, endometrial cells migrate from the mucous layer into its muscular layer, which is called the myometrium. Under the influence of certain reasons, foreign cells begin to germinate, forming lesions that cannot be completely cured.

The uterus is an organ of the reproductive system consisting of three layers. The inner layer, called the endometrium, lines the organ cavity itself. The endometrium is the lining of the uterus. The middle layer or myometrium is the thickest. The myometrium is the muscle of the uterus. The third outer layer is the peritoneum, which envelops the body of the uterus. In another way, the outer area is called the serous membrane.

The endometrium performs an important function, ensuring the implantation of the fertilized egg and its development in the event of conception.

The mucous membrane is represented by two layers:

• functional, which grows and is rejected by the uterus during each menstrual cycle;
• basal or germinal, which ensures monthly growth of the functional layer.

Types and degrees

Endometriosis of the uterus is a fairly common disease in women of different age groups, which is very difficult to cure. If left untreated, serious complications may develop.

Endometriosis of the uterus is characterized by a variety of symptoms, types and degrees of disease.

Types of endometriosis.

• Diffuse. Endometrial cells grow over the entire surface of the mucosa, forming cavities in the myometrium.
• Nodal. Foci of endometriosis form nodes without a capsule.
• Focal. This type can be described as affecting certain areas on the wall of the uterus.

The progression of the growth is determined by the depth of the pathological process.

There are several degrees of development of endometriosis:

• distribution of endometrial cells to a shallow depth in relation to the muscle layer;
• germination of mucosal cells to half the muscle layer of the uterus;
• involvement of the entire thickness of the myometrium in the pathological process;
• spread of endometriosis to the peritoneum with the formation of fistulas in the pelvic area.

If there is no treatment at the initial stage, the pathology will progress over time.

Causes

It must be emphasized that there are no specific reasons for the development of adenomyosis. Scientists have proposed several options for its appearance. However, it can be noted that there is still no definite evidence of their reliability.

Theories of the occurrence of uterine endometriosis.

• Implantation. The appearance of a pathological process will be possible if endometrial cells are thrown out of the organ cavity during menstruation or surgical interventions.
• Embryonic. Within the framework of this version, it can be assumed that foci of endometriosis develop from the tissues of the germinal material that forms the genital organs.
• Metaplastic. Foci of pathology develop from the peritoneal mesothelium, which has undergone metaplasia.

Endometriosis of the uterus will develop if there are certain predisposing factors:

• trauma to the organ during surgical termination of pregnancy, curettage, difficult childbirth, surgical interventions;
• hereditary predisposition;
• early or late menstruation, childbirth;
• late onset of intimate life;
• excessive sun exposure;
• chronic stress condition;
• lifting weights;
• inflammatory processes of the reproductive sphere;
• hormonal and endocrine disorders;
• autoimmune diseases;
• overweight;
• reactions from the immune system, for example, allergies or frequent acute respiratory viral infections;
• environmental impact;
• sedentary lifestyle.

Despite the fact that there are many factors that cause endometriosis, there are no specific causes of the disease.

Symptoms and clinical picture

If the disease is in its initial stage, we can talk about the almost complete absence of signs of uterine endometriosis. In such cases, adenomyosis can be detected through pelvic ultrasound.

If the pathology is not treated in a timely manner, characteristic signs appear as it progresses.

• Changing the cycle duration. It may be noted that endometriosis of the uterus is characterized by a shortening of the menstrual cycle.
• Presence of spotting discharge. They typically appear within a few days before and after menstruation.
• Breakthrough bleeding. With adenomyosis, you may notice a discharge mixed with blood that is not associated with menstruation.

If the bleeding is intense and there is no way to eliminate it with medication, we can talk about the need for surgical intervention, which may include amputation of the uterus. Accordingly, a woman needs to remember to consult a doctor in a timely manner if alarming symptoms appear.

Pain intensity and location depend on where the lesions are located. If the isthmus is affected by endometriosis, pain will be felt in the rectum, lower back and vagina.

• Discomfort during sexual intercourse. The occurrence of pain is typical before and after menstruation.
• Infertility. If adenomyosis is not treated, infertility develops in most cases. The impossibility of conception is due to the lack of favorable conditions for implantation and development of a fertilized egg and an extensive adhesive process that makes conception impossible.

Symptoms increase as the disease progresses and if there is no adequate treatment for pathological signs.

Diagnostics

To effectively treat a pathology, it is necessary to accurately diagnose its stage, form and type.

Methods are used to determine uterine endometriosis in modern gynecology.

• Collection and study of anamnesis. Of particular importance are surgical terminations of pregnancy, difficult childbirth, various surgical interventions, and inflammatory processes in the past.
• Gynecological examination. Using palpation, the doctor determines whether the uterus is enlarged and painful. Lack of uterine mobility indicates the presence of adhesions.

• Ultrasound examination of the pelvic organs. Using this method, it is possible to visualize the increased volume of the uterus, increased echogenicity of the myometrium, and also identify foci and nodes of endometriosis.
• Hysteroscopy. This method allows you to determine whether there are holes in the organ, which are endometriotic ducts.

Hysteroscopy is a valuable method of diagnosis and treatment in modern gynecology. With its help, you can not only diagnose, but also treat many conditions of the female genital area.

• Metrosalpingography. The study is carried out using x-rays in the first half of the cycle. On x-rays, you can determine the location of the contrast agent, which indicates the spread of the pathological process.
• MRI. This method is one of the most accurate in diagnosing the disease. However, the study is not often used due to its high cost.
• Markers of the presence of endometriosis. To determine pathology, markers CA-125 and PP-14 are indicative.

Treatment

Many women suffering from uterine endometriosis are interested in the question of whether it is possible to cure the growth of the mucous membrane. Since uterine endometriosis is a chronic disease, it cannot be completely cured. Basic therapy is aimed primarily at stabilizing the disease, its transition to a latent form and getting rid of unpleasant manifestations. Such a consequence as the inability to conceive is also successfully treated.

Generally the disease can be treated conservatively and surgically.

The basis conservative therapy constitute medications with hormonal and non-hormonal action.

With conservative therapy, an integrated approach is important, to effectively treat the symptoms of the disease. As a supplement to the main therapy, diet, rational physical activity, folk remedies and physiotherapy are used.

There are many factors to consider before treating endometriosis:

• age;
• desire to have children;
• features of pathology;
• the presence of associated complications.

Endometriosis is often treated with sedatives, immunostimulating and anti-inflammatory drugs.

Hormonal drugs used to treat adenomyosis.

• Estrogen-progestin medications. These oral contraceptives can treat hormonal imbalances and slow down the growth of the endometrium. As a result, the foci of endometriosis gradually heal, and the signs of the disease disappear. Treatment with such drugs is necessary for at least six months.
• Progestogens. The drugs suppress the production of estrogen and progesterone in the body. In order to cure the manifestations of excessive production of these sex hormones, drugs are also used for a long time.
• Antiprogestins. The drugs can effectively treat endometriosis, causing atrophy of the overgrown endometrium.
• Antiestrogens. These hormonal therapy agents are used to cure the patient of the painful manifestations of the pathology.
• Gonadotropin inhibitors. The drug reduces the production of certain sex hormones, reduces pain, and prevents bleeding between cycles.
• Gonadotropin-releasing hormone agonists. In combination with other drugs, medications help cope with the manifestations of endometriosis and cure it.

Many medications are medical conservative therapy have side effects and are not always able to effectively treat uterine endometriosis.

There are certain indications for surgical treatment of the disease:

• concomitant endometrial hyperplasia or fibroids;
• nodular type of uterine endometriosis;
• adenomyosis stage 3 or 4;
• endometrioid cysts diagnosed in the ovary;
• ineffectiveness of conservative therapy or contraindications to it.

In modern gynecology they use organ-preserving operations to effectively treat the proliferation of endometrial tissue and localize foci of endometriosis.

• Laparotomy. The disease is treated by abdominal surgery.
• Laparoscopy. The intervention is performed through small incisions on the abdomen in the projection of the uterus.
• Laser and electrocoagulation. These treatment methods are minimally invasive methods.

Before treating the patient surgically, the doctor prescribes hormonal drugs. Immediately after surgery, physiotherapy and balneotherapy are indicated.

Despite the fact that endometriosis of the uterus in the initial stages can be successfully treated, he has a tendency to relapse. Doctors have not yet been able to completely cure the growth, however, thanks to combination therapy, a fairly lasting effect can be expected.

Symptoms of endometriosis may disappear even if the condition is not treated. As a rule, this occurs before and after menopause, when the physiological activity of the ovaries gradually fades away.

It is especially important to cure infertility, which occurs with endometriosis in almost every case. It should be noted that its causes for adenomyosis are different, which determines a differentiated approach to how the pathology is treated in a particular patient.

Factors leading to infertility in uterine endometriosis.

• Often, the inability to conceive occurs due to extensive adhesions that disrupt the function of the fallopian tubes.
• Changes in hormonal levels that occur with endometriosis of the uterus often lead to a lack of ovulation.
• When the endometrium grows, concomitant inflammation can be diagnosed, which causes excessive contractions of the uterus and, as a result, spontaneous abortion.
• Internal endometriosis is often accompanied by various autoimmune disorders that cause immunological infertility.

Infertility with uterine endometriosis can be cured only through combination therapy. If the growth is treated promptly, you can expect an increase in the chances of natural conception.

Pregnant women with endometriosis are at risk of miscarriage. Modern treatment regimens used in gynecology can cure many pathological conditions, while prolonging pregnancy.

Main symptoms:

Endometriosis is a gynecological non-tumor disease, accompanied by the growth of the inner lining of the uterus (endometrium) outside its cavity. Simply put, tissue that is found in the uterus of healthy women with endometriosis grows in other organs. Endometriosis, the symptoms of which women experience, develops for unknown reasons, although there is some evidence for the identification of immune, hormonal, hereditary and some other factors.

general description

So, in order to better understand what we are talking about when considering this disease, it is necessary to dwell on what the endometrium actually is, and also delve a little into the features of the organs of the woman’s reproductive system.

In women, the pelvis contains the uterus, a muscular organ connected on both sides to fallopian tubes that open to the abdominal cavity. The uterus is covered by three main layers, this is the inner layer endometrium, middle (muscle) layer myometrium, And perimetry- the outer serous thin shell of the organ, acting as a continuation for the layers of peritoneum from the bladder.

The layer we are interested in, the endometrium, includes two more layers, this is the functional layer and the basal layer. The functional layer includes a layer of cells that, in their own structure, resemble cylinders, which, in fact, determines their name - this is cylindrical epithelium. Between such cells there are glandular cells - due to them, the required mucus is produced, and there are also large numbers of terminal branches belonging to small spiral arteries.

Throughout the entire menstrual cycle, the functional layer is subject to constant changes due to the effects of female sex hormones. When menstruation occurs, it is rejected and finally released. Further, where the functional layer in the uterus has been rejected, the process of cell division of the basal layer begins. As a result, new cells are formed, replacing the rejected layer and forming a new layer.

Experts note that in terms of prevalence, endometriosis ranks third among gynecological diseases, following uterine fibroids and inflammatory processes affecting the genital organs of women. Most often, endometriosis is diagnosed in women of reproductive age, mainly between the ages of 40 and 44 years. According to various data, the average incidence of endometriosis in this category is about 12%. In infertile women, endometriosis is diagnosed more often - they account for approximately 30-40%, while multiparous women encounter this disease somewhat less frequently - about 27%.

Interestingly, teenage girls can also develop this disease. For example, it is known that about 50% of patients in this group who underwent surgery due to pain arising in the pelvic area were diagnosed with endometriosis. The premenopausal period also does not exclude women from developing this disease - here its frequency on average is about 2-5%. We would like to add that after menopause, women in similar age groups can also develop endometriosis, which, however, occurs somewhat less frequently.

At the same time, it is impossible to determine the true incidence of the disease in question, due to the difficulties associated with its diagnosis, as well as the fact that in some cases endometriosis occurs without symptoms at all. On average, about 70% of cases of patients seeking medical help due to pain in the pelvic area result in a diagnosis of endometriosis.

These data, if readers approach them properly, are a strong argument in favor of regular preventive visits to a doctor such as a gynecologist. This especially applies to those women who experience certain embarrassment associated with seeing this specialist, as well as those women who completely ignore such recommendations and do not visit the gynecologist at all.

Endometriosis: causes

The disease we are considering is polyetiological, which, in turn, indicates the presence of many different probable causes that determine it. However, as has already been highlighted, the true cause of endometriosis has still not been determined. Let's look at some of the options that are currently considered as the main ones.

• Retrograde menstruation. Or, as it is called, “reverse” menstruation. This phenomenon is determined by the following process: a certain amount of menstrual blood released during menstruation is directed into the abdominal cavity through the fallopian tubes. Menstruation according to a similar “scenario” is not uncommon; moreover, it often occurs in healthy women. The only difference from patients with endometriosis is that in healthy women the immune system restrains the endometrium, preventing it from growing in the area in which it ends up, that is, in the abdominal cavity.
• Heredity. This factor is relevant for many diseases that a person has to face, and endometriosis can also be considered as a disease associated with this factor. Accordingly, it is believed that the risk of developing the disease in question increases if it is present in close relatives.
• Immune system disorders. This reason is also considered as a putative factor leading to the development of endometriosis. If the immune system is weakened, then finding itself in the abdominal cavity during the already considered option of “reverse” menstruation, endometrial cells not only are not destroyed, but also attach to the tissues and organs located here, thereby forming foci of endometriosis.
• Surgical intervention in gynecology. Any kind of surgical intervention, such as curettage (curettage), abortion, cesarean section, cauterization of erosion, etc. - all this is usually considered as significant predisposing factors to the development of endometriosis.
• Hormonal changes. This factor is also believed to contribute to the development of endometriosis. The fact is that the endometrium is quite sensitive to the effects of female sex hormones, and foci of endometriosis react to them in a similar way. The growth of such lesions, for example, is promoted by female sex hormones and estrogens.
• Endometrial metaplasia. This factor implies a transformation in which one tissue is transformed into another. There is a theory according to which the endometrium, once outside the uterus, can transform into another tissue in a similar way. Meanwhile, the causes of metaplasia are currently unclear; moreover, any assumptions about it give rise to a lot of controversy among researchers.

In addition to the factors listed, there are some other factors, and they also cannot be excluded when considering the connection with endometriosis. In particular these include:

• iron deficiency in the body;
• environmental impact;
• urinary tract infections, as well as STDs;
• dysfunction of the liver organ;
• obesity;
• use of an intrauterine device, etc.

Endometriosis: forms and types

Classification of endometriosis is made in gynecology in accordance with the area of ​​localization of its foci. In particular, they highlight genital And extragenital endometriosis. Genital endometriosis can be internal (this is adenomyosis) or external, extragenital, in turn, can be extraperitoneal or peritoneal.

Internal genital endometriosis refers to the growth of endometrial foci in the area of ​​the muscular uterine layer, namely in the cervix and in the uterine canal.

As for extragenital endometriosis, it mainly develops in the environment of the kidneys, bladder, intestines, lungs, and in the area of ​​some postoperative scars.

Extragenital peritoneal endometriosis primarily affects the fallopian tubes, ovaries and pelvic peritoneum.

The localization of extraperitoneal endometriosis is concentrated on the side of the external genitalia. The main forms of this variant of the disease are endometriosis of the vaginal part of the cervix, endometriosis of the vagina, retrocervical endometriosis, endometriosis of the rectovaginal septum.

Endometriosis can occur in so-called “minor” forms or in severe forms. In the latter variant, the localization of lesions may correspond to a mixed form, which is why endometriosis is sometimes not subject to a clear classification at all. In addition, severe forms of endometriosis, according to the observations of specialists, develop as a result of ignoring therapeutic and preventive measures at the stages necessary for this.

Based on the depth of the lesions, the corresponding stages of endometriosis are distinguished. In particular, these are the minimal stage, the mild stage, the moderate stage and the severe stage. The severe stage, as can easily be assumed, is the most painful for patients, and also the most difficult in terms of implementing measures aimed at treating endometriosis. In internal endometriosis, the lesion according to specific stages is as follows:

• Stage 1 - the mucous membrane is affected up to the myometrial layer (up to the middle, muscular layer, as stated earlier);
• Stage 2 - the myometrial layer is affected to the middle;
• Stage 3 - the lesion reaches the serous (peritoneal) lining of the uterus;
• Stage 4 - here the parietal peritoneum is affected.

Thus, we can distinguish a group of abdominal and pelvic organs (namely, they are most often affected by lesions), which will determine the types of endometriosis:

• Endometriosis of the uterine body (aka adenomyosis);
• Ovarian endometriosis;
• Peritoneal endometriosis (also known as peritoneal endometriosis);
• Vaginal endometriosis;
• Cervical endometriosis;
• Rectovaginal endometriosis;
• Bladder endometriosis;
• Endometriosis affecting other organs (at this point the disease is much less common): diaphragm, pleura of the lungs, the lungs themselves, intestines, eyes, stomach, skin, etc.

Endometriosis of the uterine body: symptoms

Endometriosis of the uterine body, or, as we previously designated, adenomyosis, is one of the main forms of endometriosis, in which the myometrium is affected by foci of endometrioid tissue. The symptoms of this form of the disease are as follows:

• Painful menstruation. This symptom also has its own medical definition - aldismenorrhea. The intensity of pain does not correspond to the severity of pain, in general. The appearance of pain is caused by the fact that fluid begins to accumulate in the tissues, which occurs due to the actual adhesive process affecting the uterine cavity, the accumulation of menstrual blood in the foci, and the inflammatory process.
• Cycle disorders. This symptom is quite characteristic of adenomyosis, although, however, not only for it - many gynecological diseases and disturbances in the functioning of the body are accompanied, as is known, by such “failures”. With adenomyosis, cycle disorders are mainly reduced to bleeding. A fairly important symptom for this case is the appearance of brownish or bloody discharge; they appear 1-2 days before the start of menstruation and last the same, 1-2 days after it. An important signal is also a change in the nature of menstrual flow. So, if before menstruation proceeded normally, then with adenomyosis they can become, for example, excessively abundant. This is also often accompanied by severe exhaustion of the patient.
• Dark color of menstrual discharge. A characteristic feature of the manifestation of endometriosis during menstruation is also the presence of blood clots.
• Prolonged menstrual flow. Often, menstruation with endometriosis lasts longer, exceeding the average duration.
• Infertility. Infertility is caused by two main reasons, namely the fact that there is no possibility of implantation of the fertilized egg and its further gestation due to the prevalence of the process, and also the fact that the adhesive process is developed in a pronounced form, which is accompanied by damage to the uterine cavity. In both cases, the result is the same - all this leads to infertility. At the same time, this is not the final verdict on the disease, because in at least 20% of cases in practice, pregnancy is recorded among patients even with a severe form of the disease in question.
• miscarriage, that is, in this case we are talking about spontaneous abortion/miscarriage. The reasons for this outcome are related to the general picture of changes against which infertility develops.
• Endocrine disorders. This symptom is mainly relevant for extragenital endometriosis, although it may also be present during adenomyosis. It manifests itself in particular in hypothalamic-pituitary insufficiency of the ovarian system. Due to hormonal imbalances, spotting may appear in women between menstruation, which occurs quite often with endometriosis.

In most cases, the disease progresses. Without treatment for six months, approximately 47% of patients experience a worsening of their condition, while spontaneous improvement occurs in approximately 30%. What is noteworthy is that during pregnancy, patients experience some regression of the disease, and even a significant improvement in their general condition. The fact is that pregnancy is a condition in which a decidual reaction begins to develop in the formed lesions, as a result of which they begin to decrease.

Decidualization consists of changes in the endometrium during pregnancy in which a special type of cellular layer of the endometrium is formed - decidual tissue. During pregnancy, decidual changes occur quite intensively: cells accumulate fat and glycogen, and the size of these cells increases. At the same time, the growth of blood vessels in the endometrium is enhanced.

As for the role of this decidual tissue, its role has not been fully determined. Meanwhile, it is generally accepted that due to this tissue, control is exercised over the introduction of the fertilized egg into the wall of the uterus, where it acts as a kind of layer, first between the trophoblast, and then the wall of the uterus and placenta. We also add that the decidual reaction acts as an integral stage of implantation.

Ovarian endometriosis: symptoms

Ovaries with endometriosis can be affected due to the introduction of endometrial cells into them through the lumen of the fallopian tube, which occurs with the flow of lymph and blood. The causes of ovarian endometriosis are also not completely clear at the moment; foci of endometriosis can be located both externally on the ovary and directly in it. Symptoms of ovarian endometriosis may manifest differently in each case, depending on the size of the lesions and the specific area of ​​their localization. Let's highlight the general symptoms:

• Lower abdominal pain. Such pain is not necessarily associated with a specific period of the menstrual cycle, that is, it can appear at any time. Constant pain in the lower abdomen can be caused by inflammation of the peritoneum due to irritation due to the formation of endometriotic lesions.
• Pain in the lower abdomen during physical activity and sexual intercourse.
• Increased pain in the period before menstruation, especially severe pain on the first day.
• Spread of pain to the groin or lumbar region, to the rectum.

Peritoneal endometriosis: symptoms

Peritoneal endometriosis (peritoneal endometriosis) is characterized by the fact that in its development a significant role is played by the interaction of endometrial elements with peritoneal mesothelial cells. The “reverse” reflux of menstrual blood, which we have already discussed earlier, can contribute to the development of this form of the disease, which is caused by certain disturbances in the functioning of the immune and endocrine systems.

Peritoneal endometriosis can be of two types. Thus, the first type is characterized by a limited extent of damage - only the peritoneum is affected. The second type, accordingly, is characterized by the fact that damage to endometrioid foci occurs not only within the peritoneum, but also behind them, that is, the uterus, ovaries and fallopian tubes are affected.

With minor forms of endometriosis, there may be no clinical symptoms for a long time - the disease occurs in a latent form. At the same time, infertility with such a course of the disease, even in a small form, often exceeds 90%. If foci of endometriosis have spread beyond the peritoneum and “taken root” in the rectum and its muscular layer, also affecting the perirectal tissue, then a similar course is accompanied by the appearance of pelvic pain, painful sexual intercourse (which is more pronounced before the onset of menstruation, as well as after it) .

Endometriosis of the vagina and perineum: symptoms

Basically, the perineum and vagina are affected by endometriosis as a result of germination from the side of the retrocervical lesion, somewhat less often this occurs due to the appearance of endometrial lesions in the area of ​​​​the area affected during childbirth.

The leading complaint for this form of the disease is pain that occurs both in the vagina itself and in the depths of the pelvis, and the severity of pain in this case varies from moderate to quite pronounced, often painful and exhausting. Increased pain is observed during sexual intercourse, as well as a week before and after menstruation. Severe pain appears particularly if the anterior perineum, as well as the external sphincter of the rectum, is involved in the process.

There are also certain kinds of difficulties in the act of defecation, which is accompanied by excruciating pain during those periods during which endometriosis worsens. The nature of the pain is pulsating and burning (analogy with an abscess). When menstruation occurs, patients detect swelling, nodes or a cystic type of formation when palpated.

After the end of menstruation, the detected formations either decrease in size or completely disappear, after which scars remain in their place, they are painful, and have areas of brownish pigmentation. If in this case the diagnosis is made erroneously and unreasonably (sphincteritis, rectitis) on the basis of damage to the external sphincter of the rectum, and thermal procedures are prescribed (including warm sitz baths), then the pain only intensifies.

Pain in the vagina can also be combined with local itching. Some patients experience brownish and bloody discharge coming from the vagina, both spontaneously and during sexual intercourse. Such discharge appears during the almost standard period for endometriosis for this symptom - a few days before menstruation and a few days after it.

Cervical endometriosis: symptoms

This form of the disease is also quite common, and the reason for this is the location of the affected area - the cervix most often “comes under attack” during various manipulations in gynecology (abortion, curettage, etc.).

Some symptoms of cervical endometriosis, in general, can be said to be common to other areas affected by this disease. These include:

• spotting brownish discharge that appears before menstruation;
• pain and discomfort during sexual intercourse;
• the appearance of brownish discharge during sexual intercourse (this symptom mainly occurs in the second half of the cycle).

As for other pain sensations (in the lower abdomen, for example), in this form of the disease they are not so characteristic of the overall clinical picture.

Rectovaginal endometriosis: symptoms

Rectovaginal endometriosis can be deep (or internal), which is accompanied by the development of pathological foci in the uterus characteristic of endometriosis, as well as external, which is accompanied by damage to the fallopian tubes, wide uterine and intestinal ligaments, ovaries, pouch of Douglas and peritoneum.

The symptoms of this form of the disease are similar to other forms: there are also pain sensations that occur during sexual intercourse, as well as pain in the lower abdomen before and after menstruation.

Bladder endometriosis: symptoms

Some time ago, endometriosis in this form was considered to be a rare disease; any information about this disease in the medical literature flashed in a rather meager volume. Meanwhile, now cases of this disease are diagnosed more often, and this is most likely due to the past insufficient familiarization of urologists and gynecologists with it, rather than the rarity of its occurrence. A role in this is also played by the fact that often specialists, in attempts to establish such a diagnosis as endometriosis of the bladder, adhere to the direction of another pathology - cyclic hematuria, which in any case is incorrect, moreover, the last specified diagnosis is rarely relevant for patients for whom it was delivered.

The bladder with endometriosis can be affected in different ways. So, for example, it is possible that the contents that are in the endometrioid ovarian cysts get on its surface, as well as the ingress of menstrual blood (according to the “scenario” of retrograde reflux), which includes viable endometrial particles, or the growth of the endometrium from the isthmus and the anterior uterine wall to the bladder. An important role is also played by the isthmus left during supravaginal amputation of the uterus, which is affected by endometriosis, as well as the gentle surgical effect on the uterus during certain manipulations. Caesarean section plays some role. An acceptable option is the hematogenous entry of endometrial elements into the wall of the bladder organ.

The features of the clinical picture of endometriosis in this case are determined by the features of its genesis. Thus, foci of endometriosis formed during the implantation of endometrial particles on the surface of the bladder organ may not manifest themselves for a long time, in other words, there are no symptoms. Detection of lesions occurs accidentally, for example, during the process of abdominal dissections for actual diseases of certain pelvic organs, as well as in the area of ​​the lower abdominal cavity. Naturally, the detection of pathology is allowed by those specialists who are familiar with it.

When endometriosis spreads to the posterior wall of the bladder from the uterine stump or from the isthmus, it leads to the occurrence of quite severe dysuric phenomena in patients. If we are talking about a pathology such as congenital endometriosis of the bladder, in which the location of the lesions is concentrated on the side of the orifices of the ureter, then the picture of the disease can also be quite severe.

Most often, symptoms of endometriosis of the bladder include complaints of a feeling of heaviness that occurs in the depths of the pelvis and lower abdomen. It intensifies before menstruation, as well as after it. At the same time, urination in patients becomes more frequent, in some cases it is accompanied by pain. The severity of pain can vary; accordingly, it can be either moderate or quite severe, up to the loss of normal ability to work during such a period. During urological examinations and repeated urine tests, no reasons are found to explain the patients’ suffering, which is why the diagnosis of “cystalgia” is established. The therapy used to address the manifestations of symptoms determines the lack of sufficient effectiveness. During thermal procedures, the pain intensifies. At the same time, experts do not attach due importance to the relationship determined between the menstrual cycle and complaints.

Gradually, painful urination is complemented during menstruation by hematuria (blood in the urine), the severity of its manifestation may vary. At this stage of disease progression, a diagnosis such as recurrent hemorrhagic cystitis can be established. Therapy to address the manifestations of actual symptoms is still ineffective.

Soon the disease becomes chronic. According to some data, about 3-5 years pass from the onset of such a symptom as painful urination until the onset of hematuria. What is noteworthy is that many patients experience some relief from pain when urinating from the time the hematuria began to appear. In most cases, the listed symptoms lead to fear in patients that they may have a tumor in the bladder.

Let us add that blood in the urine with endometriosis of the bladder, according to some observations, is a symptom that occurs in 25% of patients with this disease. If we are talking about extensive endometriosis, in which the bladder neck is captured by the lesion, then a symptom such as a problem with urinary retention (incontinence) may also make itself felt.

Endometriosis and pregnancy

If we consider this disease in combination with infertility, then we cannot unequivocally assert equality between them. In other words, pregnancy is not impossible with endometriosis. Another thing is that pregnancy with endometriosis significantly reduces the chances of pregnancy. In practice, there are cases of conception with this disease, but it is important to understand that the success rate of conception in this case is lower, and, of course, that with endometriosis there is a certain risk to the fetus, which consists of spontaneous miscarriage. If you still succeed in conceiving a child, then it is imperative to see a doctor, strictly following his recommendations.

As for the cause-and-effect mechanism in the “endometriosis - infertility” scheme, there is no clear clarity here yet. Meanwhile, there are certain assumptions regarding the factors that provoke infertility in endometriosis:

• Immunological and endocrine disorders that are relevant in parallel with endometriosis. These factors negatively affect ovulation, fertilization and subsequent implantation of the egg into the uterus.
• Mechanical disorders causing obstruction of the fallopian tubes; pathology of ovarian anatomy; adhesions that make it difficult for the egg to be released.
• Processes accompanying local inflammation.
• Luteinized follicle syndrome.
• Frequent miscarriages in the early stages.
• Pathology of the transport function of the fallopian tubes, caused by an increase in prostaglandins against the background of endometriosis.

Interesting in its own way and, at the same time, important is such a factor as unfavorable conditions for the future fetus in the body (womb). More precisely, the essence of this is as follows: the body independently decides whether a woman can now bear (and then give birth to) a healthy baby.

At the same time, new studies show that the majority of women with endometriosis, regardless of the nature of the menstrual cycle (even normal and regular), there is no true ovulation as such, that is, we are talking about anovulation. Let us add that without ovulation, pregnancy is in principle impossible.

Data from some sources indicate that after treatment and organ-preserving surgical interventions, pregnancy occurs on average in 15-56% of cases - such a significant gap in rates is determined by the characteristics of the pathological process and the severity of the disease. Basically, gynecologists note that after treatment carried out in the right direction, pregnancy occurs within six months to a year. Accordingly, the wait for pregnancy can last from 6 to 14 months.

At the same time (albeit rarely), in practice, such cases are not excluded in which successful treatment of endometriosis does not result in the onset of a long-awaited pregnancy after six months or more. In this case, you will need to undergo additional examination, which will allow you to identify other factors involved in the problem of infertility.

Complications of endometriosis

If treatment of endometriosis is ignored as a necessity or it is initially implemented illiterately, then you may subsequently encounter a number of complications:

• infertility;
• development of adhesive processes in the abdominal cavity and small pelvis;
• development of posthemorrhagic anemia in patients against the background of heavy chronic blood loss accompanying menstruation;
• neurological disorders caused by compression of nerve trunks;
• formation of endometrioid ovarian cysts;
• transformation of endometrioid tissue into a malignant tumor formation.

Diagnosis

In order to establish a diagnosis of endomketriosis, it is necessary to obtain the results of certain studies, these include in particular:

• Ultrasound of the pelvic organs using a special vaginal sensor;
• hysterosalpingography is a method in which a contrast agent is used, due to which one can assess how widespread the process of formation of lesions turned out to be, as well as understand how much the patency of the fallopian tubes has been affected by this, which is especially important if the patient is experiencing infertility;
• hysteroscopy - this method makes it possible to examine the features of the surface of the uterus, endometrioid ducts and the mouths of the fallopian tubes (on the pale pink mucous membrane they look like dark red dots);
• laparoscopy is a microsurgical procedure that makes it possible to diagnose any form of the disease, and with the simultaneous possibility of treatment during it;
• blood test to detect endometriosis markers;

In general, the need for one or another version of the study is determined by the attending physician; depending on the characteristics of the pathological process, the diagnostic scheme may vary.

Treatment

Treatment of endometriosis is carried out in two main directions, and this is surgical elimination of foci in areas affected by endometriosis (or removal of organs with them completely), as well as drug treatment, aimed at providing hormonal correction of activity characteristic of the endometrium.

Surgical treatment often has no alternatives due to the fact that the patient’s condition often rapidly deteriorates and there is a threat to subsequent infertility. In many cases, the pain that accompanies endometriosis becomes almost unbearable; in addition, the pain is accompanied by the rapid growth of lesions, which causes an unfavorable prognosis.

Surgical intervention can be performed in different ways, this is determined based on the location of the lesions, the possibility of access to them through one or another technique of the required effect. If we are talking about endometriosis of the vagina, cervix or perineum, then the preferred option is endoscopy (excision of lesions and cauterization is carried out either through the vaginal cavity or from the outside). If the lesions are located in the uterine cavity, then an option such as removal of the uterus (the question of whether or not to remove the appendages) or hysteroscopic surgery, which provides access through the vagina to the affected organ of the uterus, can be considered.

If endometriotic lesions are located in the area of ​​the fallopian tubes, ovaries or peritoneum, then laparoscopy can be performed - several small holes are made in the abdomen in certain areas for subsequent access to the affected areas.

As for drug treatment, it is aimed at suppressing the growth/reproduction of endometrial cells. The following groups of drugs are mainly used (only the attending physician can decide on their prescription!):

• combined action oral contraceptives (Marvelon, Femoden, Diane-35, etc.);
• drugs representing the group of antigonadotropins (gestrinone, danazol, etc.);
• drugs representing the group of progestins (Depostat, Duphaston, etc.);
• drugs of the agonist group (decapeptyl-depot, Zoladex, etc.);
• antiestrogens (tamoxifen, etc.).

Information on these groups of drugs is provided for general information only! Self-medication with them is unacceptable; use is possible only on the basis of the testimony of the treating gynecologist!

Endometriosis: prevention measures

Prevention of endometriosis is an equally pressing issue both for those women who suffered from this disease and were cured of it, and for those women who encountered this disease only through certain information sources. We highlight the following recommendations for prevention:

• regular visits to the treating gynecologist, at least once every 6 months;
• sexual abstinence during menstruation;
• timely treatment of gynecological diseases;
• fighting excess weight (doing exercises, dieting, etc.);
• avoidance of stressful situations as such, as far as possible;
• exclusion of abortions, selection of optimal solutions for contraception.

Endometriosis: some facts about this disease

Some women ignore this disease, believing that it will go away on its own, some believe that it is only “their problem,” and some even believe that it will not affect them at all. Is it so? Let's look at some established facts related to endometriosis.

• Endometriosis is a disease of active and business women

A number of studies in this area and their results, in particular, indicate that endometriosis is more often diagnosed in women in large cities, as well as in women whose professional activities are associated with increased mental stress. Basically, we are talking about socially successful business women, as well as women whose activities are supplemented by systematic changes in climatic conditions due to business trips, etc. Here we are talking about the desire for self-realization while postponing motherhood for “later.” Those women whose sex life is “excessively active” are also at increased risk, especially if it is combined with frequent changes of sexual partners (which, as we know, is not very rare). It is quite possible that in addition to treating endometriosis, we will have to take care of some restructuring of consciousness, which is also an important part in this matter.

• Endometriosis negatively affects the sexual partners of women with this disease

Relatively recently it became known that the problem of endometriosis is not only a purely female problem, but also a problem of a woman’s sexual partner. There are two substantiated statements on this matter:

Seminal fluid contains certain molecules (such as estradiol, prostaglandins, etc.), due to which a stimulating effect is exerted on the endometrium. During sexual intercourse, seminal fluid ends up in the uterine cavity or in the abdominal cavity through the posterior and anterior vaginal fornix. Prostaglandins enhance cell proliferation and also lead to the suppression of apoptosis (that is, a protective mechanism that acts as part of the development of endometriosis), while inducing the production of certain enzymes, due to which endometriosis develops with greater intensity. Accordingly, it can be summarized that when sperm enters the body of a patient with endometriosis, it acts as a factor supporting the development of this disease.

Endometriosis negatively affects the quality characteristics of sperm. It has also been proven that hypoxia acts as one of the trigger mechanisms for endometriosis. In other words, women with endometriosis are always in a state of oxidative stress, in which cells are damaged as a result of oxidation. At the same time, there is an accumulation of oxygen free radicals in their body, which, as it has become known, are characterized by a toxic effect on sperm - in particular, cell membranes are affected, incl. and DNA, apoptosis (cell death) is also triggered. That is, those processes that “control” the disease in women negatively affect the general condition of sperm. Accordingly, in case of infertility, it is extremely important to begin treatment, thereby eliminating the negative impact for both partners that leads to such a result.

• Endometriosis and IVF

In particular, on this point, patients are interested in whether the IVF procedure for endometriosis will be effective. There are also certain facts about this:

Common forms of the disease negatively affect the ovarian reserve, reducing the number of eggs obtained during stimulation; why this happens is still unclear;

Endometriosis itself acts as a basis for including patients in the appropriate risk group regarding the possibility of developing an ectopic pregnancy after the embryo transfer has been performed;

Internal endometriosis (i.e. adenomyosis) helps to reduce the possibility of successful embryo implantation within the framework of RVT programs in the same way as with the usual (natural) method of conception.

Let us summarize that the only correct solution in the treatment of endometriosis is laparoscopy (surgical intervention) with the addition of certain drugs of conservative therapy.

Joseph Addison

With the help of exercise and abstinence, most people can do without medicine.

Which doctor should I contact?

If you suspect a disease such as Endometriosis, you should consult a doctor:

When a woman's normal hormone levels are disrupted, endometriosis can develop. Endometrial hyperplasia today is the most pressing pathology in gynecology, which accounts for 10% of other female diseases. The main danger of the disease is that if it is not treated, then over time there is a risk of cancer.

What is endometriosis

The gynecological disease endometriosis is the growth of the endometrium in the uterine cavity in women of reproductive age. The disease can also develop in young girls, but most people get sick after 40 years. The cells of the mucous membrane of the female organ contain receptors that respond to sex hormones and crypts (spiral glands). A healthy woman no longer has endometrial cells in any tissue of her body.

If pathology develops, they begin to migrate to different organs. The peculiarity of endometrial cells is that during relocation they do not lose their menstrual function. Pathology most often develops in the abdominal cavity or pelvic area (genital form). Depending on the location, endometriosis can be external or internal.

Internal endometriosis

This is a gynecological disease that affects the body of the uterus and the inside of the fallopian tubes. More often, the pathology has the nature of a diffuse process, and the growths resemble fibroid nodes. Internal endometriosis is classified according to stages of manifestation.

1. First degree. There is only one focus of inflammation. A small area of ​​mucous membranes is affected.
2. Second degree. At this stage, a larger area is affected, and inflammation begins to actively progress and reaches the middle of the myometrium.
3. Third degree. The pathological process is characterized by damage to the deep layer of the myometrium and foci of different localization.
4. Fourth degree. The most dangerous for the body, since hyperendometriosis affects not only the mucous membranes of the organ, but also the area of ​​the parietal peritoneum.

External endometriosis

This pathology is characterized by the growth of the endometrium onto tissues and organs located outside the uterus: fallopian tubes and cervix, vagina, genitals, ureters, bladder, ovaries. External endometriosis also has four degrees of development from one small lesion to large cysts and multiple adhesions that appear between the pelvic organs. There is also an internal-external form of endometriosis, when the endometrium grows into the myometrium, and damage to the peritoneum and organs of the reproductive system is observed.

Causes

What is uterine endometriosis is already clear, but for what reasons does the disease occur? The pathology has no established origin to date. The most likely causes of endometriosis:

1. Immune disorders. Protection in the body is aimed at getting rid of any foreign tissue. When immunity is impaired, endometrial cells are not destroyed, but take root and function outside the uterus.
2. Heredity. There are familial forms of the disease, when women in the same family suffer from the same pathology for several generations.
3. Hormonal dysfunction. In women, examination often reveals high levels of estrogen and low levels of progesterone, which provokes the growth of the endometrium.
4. Menses. During heavy periods (menorrhagia), endometrial cells sometimes travel retrogradely outside the organ, and then spread to the ovaries, cervix, tubes, walls of the small intestine, navel and other tissues.

Symptoms

A typical sign of the disease is painful menstruation (dysmenorrhea), heavy bleeding during menstruation, and infertility. At the first stage, the disease can be completely asymptomatic and can only be diagnosed during a gynecological examination or ultrasound. Even if pain occurs during menstruation, after it stops the pain ends. When the endometrium grows, other symptoms of endometriosis occur:

• irregular menstrual cycle;
• bloody issues;
• pain during sexual intercourse;
• painful defecation, urination;
• severe premenstrual pain;
• increased body temperature during menstruation;
• pelvic pain.

Diagnostics

Since there are no laboratory signs for this pathology, doctors, after a vaginal examination, refer the patient to a transvaginal ultrasound to diagnose uterine endometriosis. The study is carried out using a vaginal sensor. This method is widely used to assess the dynamics of treatment and identify adenomyosis. Additional diagnostics of endometriosis:

• CT or MRI;
• laparoscopy;
• hysteroscopy;
• hysterosalpingography;
• colposcopy;
• blood test for tumor markers.

Find out more about how the operation is performed.

Endometriosis - treatment

There is an opinion that endometrial growth can be treated with pregnancy. This statement is partially true, since the period of waiting for a child has a beneficial effect on the condition of the uterus. However, signs of improvement will be temporary - only until the onset of the first ovulation. Treatment of endometriosis is carried out with therapeutic methods or surgery. The choice of therapy depends on the depth of endometrial growth and the number of lesions.

For the first and second degrees of damage, conservative treatment is chosen. If this does not produce results, the patient is offered surgery. In modern medicine, several surgical methods are used to get rid of endometriosis. During laparoscopy or laparotomy, the organs are preserved and the affected area is removed. During radical abdominal surgery, the uterus or affected organs are completely removed (in the case of extragenital form).

Folk remedies

Our ancestors also knew what endometriosis was, so they used herbal decoctions and infusions for this disease. The most popular treatment is boron uterus grass. You need to pour 15 g of dry plant with hot water (2 cups) and leave in a water bath for 15 minutes. This infusion should be drunk daily in three doses for two weeks. Another effective alternative treatment for uterine endometriosis:

• combine herbs in equal quantities: eleutherococcus, elecampane, chamomile, licorice, plantain;
• add 2 tsp to the mixture. chaga and badyagi powder;
• three tbsp. l. pour the mixture with a glass of water;
• heat on fire for 5 minutes, then leave for 40 minutes;
• douche with warm, strained infusion in the morning and evening for 10 days in a row.

Drugs

In the early stages, the Mirena intrauterine device is successfully used. Its internal part is filled with hormones that can replace female progesterone, the lack of which provokes the growth of the endometrium. It is also necessary to use medications to stop the growth of endometrial cells and reduce the high concentration of estrogen in a woman’s body. Main medications for endometriosis:

1. Antiprogestins (Mifepristone, Danazol). The drugs cause suppression of ovarian function in order to inhibit foci of endometrial spread.
2. Hormonal contraception (Zhanine, Pharmatex). Suppresses menstrual flow, which leads to good therapeutic effects.
3. Analogues of natural progesterone (Visanne, Duphaston). A lack of female hormone can provoke endometrial growth, so replacement therapy is indicated.

Prevention of endometriosis

Preventive measures should be taken by all women of childbearing age, regardless of whether they have the disease or not. Particular attention should be paid if intrauterine contraception is used, obesity is present, or estrogen levels are elevated. Prevention of uterine endometriosis includes:

• regular visits to the gynecologist;
• fight against excess weight;
• sexual abstinence during menstruation;
• refusal of abortion;
• stress prevention;
• moderate exercise;
• fight against smoking.

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