Endometriosis and the absence of a man. Which doctor treats endometriosis. How relevant is the problem of endometriosis today?

Endometriosis is the appearance of cells of the inner layer of the uterus (endometrium) in atypical places: on the peritoneum, in the ovaries, fallopian tubes, wall and cervix, in the bladder, rectum and other organs and tissues.

This is one of the most mysterious female diseases. Despite the fact that this diagnosis is made quite often, the question - what kind of disease is it, why and how to treat it, often remains unanswered. But what if a woman with endometriosis is planning a pregnancy - is it necessary to do something in this case?

Statistics show that up to 30% of women of reproductive age suffer from endometriosis in one form or another.

What is it: causes

Why does endometriosis occur, and what is it? The cause of the disease has not been established and remains a matter of controversy. Numerous hypotheses for endometriosis have been proposed, but none of them has become definitively proven and generally accepted.

1. One theory points to the process of retrograde menstruation, when part of the menstrual tissue enters the abdominal cavity, grows into it and increases.
2. Genetic theory puts forward the point of view that the genes of some families contain the beginnings of endometriosis and, thus, members of these families are predisposed to endometriosis.
3. There is also a theory that explains the occurrence of endometriosis by the fact that tissue affected by endometriosis spreads to other parts of the body through the lymphatic system.
4. Others believe that remnants of tissue from the phase when the woman was in its infancy may subsequently develop into endometriosis, or that part of this tissue, under certain conditions, does not lose the ability to reproduce.

The likelihood of the disease increases with:

• frequent inflammation of the genital organs;
• tumors ();
• difficult childbirth;
• operations on the uterus;
• abortions;
• drinking alcohol;
• smoking;
• excessive "love" for products containing caffeine;
• disturbances in the functioning of the organs of the endocrine system (thyroid gland, adrenal glands, hypothalamus,
• pituitary gland, female gonads);
• reduced immunity.

Despite these studies, the actual frequency of endometriosis is unknown, due to the fact that in most cases the disease is asymptomatic and very difficult to diagnose.

Therefore, regularly undergo a preventive examination by a gynecologist. This is especially important for those who have had any operations on the uterus (abortion, caesarean section, cauterization of cervical erosion, etc.). Timely diagnosis is the key to successful treatment without consequences.

Can you get pregnant with endometriosis?

Endometriosis significantly reduces a woman's chances of getting pregnant, but it cannot harm the development of the fetus. If a woman with endometriosis does conceive a child, there is every reason to believe that the symptoms of the disease will become much weaker during the entire period of pregnancy.

If you have endometriosis, before you start trying to conceive a child, be sure to discuss with your gynecologist the possibility and risks of pregnancy in your particular case.

Symptoms of endometriosis

The symptomatology of this disease is so diverse that it can sometimes mislead even experienced professionals. Endometriosis of the uterus can be accompanied by both pronounced symptoms, and even their absence.

However, certain symptoms should definitely alert a woman:

1. Pain of varying intensity, up to acute. They can be localized, given to the inguinal region, anus, leg. Pain either occurs in the first days of menstruation, and disappears with its end, or does not leave the woman throughout the entire cycle, but at the end of menstruation they weaken.
2. Smearing dark spotting from the genital tract 2-5 days before and after menstruation, especially if these very menstruation is quite plentiful and prolonged;
3. Uterine bleeding in the intermenstrual period (metrorrhagia);
4. Spotting discharge can also be during sexual contact.

Menstruation with endometriosis becomes abundant, with clots, which leads to the development of chronic posthemorrhagic anemia:

• brittle nails,
• dyspnea,
• weakness, drowsiness
• dizziness,
• pallor of the skin and mucous membranes,
• frequent, etc.

Unfortunately, in some cases, the symptoms of endometriosis are very mild or absent. For this reason, you should visit the gynecologist's office every six months. Only timely diagnosis can protect against the development of undesirable consequences of endometriosis.

Endometriosis 1, 2 and 3 degrees

In the uterine wall, endometriosis foci are detected at different depths, so endometriosis of the uterine body can have four degrees of distribution:

• 1 degree . There are one or more small foci of endometriosis.
• 2 degree. There are several small foci of endometriosis that penetrate into the thickness of the affected organs.
• 3 degree. There are many superficial lesions and a few deep endometriosis lesions or a few cysts on the ovaries ("chocolate" cysts - the name comes from the characteristic dark brown color of the cysts, given to the cysts by decaying blood).
• 4 degree . Multiple and deep foci of endometriosis, multiple, large cysts on the ovaries, adhesions between the pelvic organs are diagnosed.

There is no linear relationship between the degree of spread of endometriosis and the severity of the symptoms of the disease. Often, advanced endometriosis is less painful than mild endometriosis, which has only a couple of small lesions.

Diagnostics

In the effective treatment of endometriosis, the most important point is timely and correct diagnosis. To determine the presence of endometrioid foci, you can use:

• radiopaque methods (hysterosalpingography)
• endoscopic examinations (for example, hysteroscopy),

However, the complaints and clinical symptoms listed above are of great importance. Sometimes endometriosis is also diagnosed during pregnancy - as a result, the treatment of such patients is ineffective due to difficulties in selecting a drug that minimally affects the fetus.

Prevention

The main measures aimed at the prevention of endometriosis are:

• specific examination of adolescent girls and women with complaints of painful menstruation (dysmenorrhea) in order to exclude endometriosis;
• observation of patients who have undergone abortion and other surgical interventions on the uterus to eliminate possible consequences;
• timely and complete cure of acute and chronic pathology of the genitals;
• taking oral hormonal contraceptives.

Complications

Endometriosis of the uterus can be asymptomatic and does not affect a woman's quality of life. On the other hand, endometriosis not diagnosed in time and the lack of adequate treatment can lead to complications.

Most likely consequences:

• adhesive process in the small pelvis;
• fertility disorder;
• anemia due to heavy bleeding;
• endometrioid cysts;
• malignancy.

How to treat endometriosis

Methods for the treatment of endometriosis have been improved for many years and are currently divided into:

• surgical;
• medical;
• combined.

Medicinal methods of therapy include the use of various groups of drugs:

• combined estrogen-gestagen preparations;
• gestagens, antigonadotropic drugs;
• gonadotropic releasing hormone agonists.

The earlier a woman is diagnosed, the more likely it is to use medication alone.

Conservative therapy

Conservative treatment is indicated for asymptomatic endometriosis of the uterus, at a young age, in the permenopausal period, with adenomyosis, endometriosis and infertility, when it is necessary to restore childbearing function.

The drug treatment path includes a fairly traditional therapy:

• hormonal;
• anti-inflammatory;
• desensitizing;
• symptomatic.

The main drugs with a proven effect for the treatment of confirmed endometriosis are:

• progesterone preparations;
• danazol;
• gestrinone (Nemestran);
• gonadotropin-releasing hormone (GnRH) agonists;
• monophasic combined oral contraceptives.

The duration of hormone therapy courses and the intervals between them are determined by the results of treatment and the general condition of the patient, taking into account the tolerability of drugs and the performance of functional diagnostic tests.

Other groups of drugs, "helpers" in the fight against painful symptoms of the disease:

• (anti-inflammatory therapy);
• antispasmodics and analgesics (pain relievers);
• sedatives (elimination of neurological manifestations);
• vitamins A and C (correction of deficiency of the antioxidant system);
• iron preparations (elimination of the consequences of chronic blood loss);
• physiotherapy.

Currently, research is underway around the world on the possibility of using immunomodulators for the treatment of endometriosis, especially for the treatment of infertility associated with it.

Surgical treatment of endometriosis

Surgical intervention is indicated in the absence of the effect of conservative therapy for 6-9 months, with endometrioid ovarian cysts, with endometriosis of postoperative scars and the navel, with ongoing stenosis of the intestinal lumen or ureters, with intolerance to hormonal agents or the presence of contraindications to their use.

Surgical methods for the treatment of endometriosis consist in the removal of endometrioid formations (most often cysts) from the ovaries or other lesions. Modern surgery prefers sparing operations - laparoscopy.

After removal of the foci of the disease, physiotherapeutic and drug treatment is indicated to consolidate the result and restore the cycle. Severe forms of endometriosis are treated by removing the uterus.

The results of treatment depend on the volume of surgical intervention, on the usefulness of hormonal therapy. The rehabilitation period in most cases is favorable: reproductive function is restored, pain during menstruation is significantly reduced. After treatment, dynamic observation by a gynecologist is recommended: gynecological examination, ultrasound control (1 time in 3 months), control of the CA-125 marker in the blood.

Prognosis for endometriosis

This disease often recurs. For example, the recurrence rate of endometriosis after surgery to remove lesions during the first year is 20%, that is, 1 out of 5 operated women during the first year after the operation will again have the same problems as before the operation.

Hormonal correction has a good effect, but the problem of this method of treatment is the disruption of the process of natural maturation of the endometrium of the uterus, and hence the impossibility of the natural conception of a child. When pregnancy occurs, as a rule, for the entire period of pregnancy, the symptoms of endometriosis disappear. With the onset of menopause, endometriosis also disappears.

Endometriosis is a disease whose incidence has increased in recent years. Doctors attribute this to a variety of hormonal disorders in women. A high amount of estrogen in the body contributes to the suppression of ovulation and the pathologically active growth of the endometrium inside the uterus, which is subsequently rejected, and its cells can migrate to other organs.

The most common form of the disease is internal genital endometriosis, when an overgrowth of endometrioid cells is observed in the uterus. Usually, the disease does not manifest itself in any way at the initial stage, and women learn about it only when they are planning a pregnancy or looking for the cause of existing infertility. Treatment of endometriosis can be conservative, in which the patient is prescribed hormones, and surgical - foci of endometrioid nodes are removed surgically. The surgical method is indicated for severe endometriosis.

Endometriosis in women

Endometriosis and pregnancy

Endometriosis and pregnancy - does one interfere with the other? Statistics say that half of women with this diagnosis are infertile. But if they are still lucky enough to get pregnant, changes in the hormonal background during childbearing and breastfeeding make it possible for endometriosis foci to decrease. Unfortunately, this effect lasts only until the menstrual cycle is restored, which often coincides with the end of feeding.

What if the disease prevents you from getting pregnant? Treatment usually begins with hormone therapy. Some resort to the treatment of endometriosis with folk remedies: beetroot juice, a special herbal collection, and clay applications are used. But it is important to remember that the use of traditional medicine can significantly aggravate the disease, if only because it takes a lot of time.

The most radical method of treatment is surgical. It allows you to remove large foci, but after a while the patient may develop new growths of the endometrium. Therefore, if a woman decides to have an operation, pregnancy should be planned as soon as possible, until the disease returns.

Endometriosis in breastfeeding mothers

Despite the fact that the nature of endometriosis is not fully understood, doctors have learned how to deal with it.

It is known that the best way to get rid of it is to normalize hormones. This can be achieved through childbirth and breastfeeding. A decrease in the amount of estrogen produced contributes to the fact that new foci of overgrown endometrium cease to form, and the old ones decrease. Symptoms of endometriosis in the form of severe or moderate persistent pain go away. Moreover, there is a high probability that after the end of breastfeeding and the restoration of ovarian function, the disease will not return again.

Endometriosis in nulliparous women

Symptoms of endometriosis are most often not pronounced, or they are confused with signs of other gynecological diseases. Therefore, the true diagnosis is not always established quickly. You can suspect the presence of endometriosis mainly by pain and prolonged painful menstruation. If a woman cannot get pregnant for a long time, this forces her to see a doctor and start being examined, because sometimes it is not possible to get pregnant precisely because of endometriosis.

Statistics show that after pregnancy and lactation, many women are completely cured of this disease. If it worries, and the state of health does not allow it to become a mother yet or it is not possible to get pregnant, women are offered hormonal treatment. It allows you to eliminate the signs of endometriosis and save the patient from chronic pain.

Can men have endometriosis?

The main cause of endometriosis, which all doctors agree on, is a hormonal disorder associated with increased secretion of estrogen. As a result, the endometrium grows stronger than expected, in the uterine cavity or outside it.

Does endometriosis happen in men? Indeed, normally they do not have tissues similar to endometrioid, which means that the appearance of the disease is impossible. In fact this is not true.

It is extremely rare, but still the disease can develop in men. This is due to the fact that in the body of a man there may remain the rudiments of the embryonic tissue of the genitourinary system, characteristic of the female. During pregnancy, during the formation of the fetus up to the 20th week, the cells of the genitourinary system continue to develop and acquire specificity for either the male or female reproductive system.

But sometimes the embryonic rudiments that form in women are preserved in men and can become a source of endometriosis. The likelihood of the disease increases even more if a man receives estrogen treatment (for example, with prostate tumors). In this case, the endometrial-like tissue can begin to grow very actively.

Endometriosis in children

Signs of endometriosis are characteristic primarily for women of fertile age from 20 to 45-47 years. But sometimes the disease occurs even in children. Scientists attribute this to the theory of the embryonic origin of the disease, when endometrial areas are laid even in the prenatal period. If a teenage girl starts menstruating, then the mechanism of the occurrence of endometriosis becomes the same as in women - pathological cells are captured by the bloodstream and spread through the genitals, abdominal cavity and other body systems.

Patients complain of painful heavy menstruation. Pain in endometriosis is concentrated in the lower abdomen and can last for months, appearing and fading. If the symptoms of the disease greatly impair the quality of life of adolescents, they are prescribed hormone therapy with oral contraceptives or surgery.

Symptoms of endometriosis are often non-specific and may be mistaken for signs of another disease. For this reason, the true incidence of endometriosis is not known for certain. How does the disease manifest itself?

• The main symptom is chronic, sometimes very intense pain. Mostly women complain of pain in the lower abdomen, sometimes it can intensify during intercourse and defecation.
• Prolonged menstruation with noticeable blood loss is characteristic of internal endometriosis (in the uterine cavity).
• Due to the strong and constantly recurring blood loss, anemia may develop.
• Primary or secondary infertility.
• Depending on where the endometrioid tissue is located, there may be a discharge of blood from the navel, a bloody tear (bleeding from the eyes), separation of blood with sputum, nosebleeds.

Pain with endometriosis

The main symptom that worries patients is pain with endometriosis. They accompany the life of the patient almost constantly, being localized in the lower abdomen, they can "give" to the groin and lower back. Such pain is called chronic pelvic pain and can be associated both with the presence of an ovarian cyst, irritation of the peritoneum (with an inflammatory process), spasm of blood vessels and muscles, and with an adhesive process due to endometriosis. Unpleasant sensations become stronger before menstruation, aggravated during intercourse or going to the toilet.

Forms of endometriosis

Endometriosis of the body of the uterus

One form of the disease is adenomyosis, or internal genital endometriosis. In this case, the mucous layer (endometrium) grows into the muscular layer of the uterus, and can reach the outer serous membrane. The danger of adenomyosis is that it contributes to large menstrual blood loss and causes anemia. In addition, the disease can be accompanied by severe pain and prevent pregnancy.

The symptoms and treatment of endometriosis of the uterus are well known to gynecologists, and therefore it is necessary to seek medical help from them. First, patients are offered hormone treatment. With pronounced symptoms of uterine endometriosis, treatment consists in a surgical operation, during which the foci are removed with a scalpel, cauterization with a laser or electric current.

In severe cases, when the disease manifests itself as frequent and heavy bleeding, the patient is offered removal of the uterus. Of course, for such a decision, it is necessary to weigh the pros and cons, because the deprivation of an organ leads to an early menopause and premature aging of the female body.

Endometriosis of the cervix

Endometriosis of the cervix is ​​a type of disease, which consists in the pathological growth of the endometrium in the cervix. It is believed that the increase in the number of cases of cervical endometriosis is directly related to the increased number of manipulations on the neck used to treat erosion. If they are done before menstruation, there is a risk of endometrioid cells being introduced into the wound, and then spreading into the thickness of the cervix.

A typical symptom of the disease is intermenstrual bleeding. During menstruation, there may be an increase in pain in the lower abdomen. Treatment of endometriosis of the cervix is ​​similar to the treatment of other forms of the disease - the appointment of hormones and the removal of foci by excision or cauterization.

Endometriosis of the ovary is a common form of the disease, which consists in the defeat of the tissue of the female ovaries. Most often, it manifests itself in the form of endometrioid cysts. Cysts have a negative impact on a woman's fertile health, because they disrupt the functioning of the ovaries and interfere with normal ovulation. If the endometriosis of the ovary progresses, it can lead to the depletion of its own reserve of follicles and infertility. In addition, cysts cause severe pain in the lower abdomen, especially worse during or after intercourse.

With endometriosis, an ovarian cyst is easily detected on ultrasound by distinct signs that are visible to the doctor during the study. To exclude the possibility that the cyst is still functional, and not endometrioid, it is better to repeat the study for several cycles. When the diagnosis is preliminarily established, patients are offered surgical treatment in the form of laparoscopy.

Peritoneal endometriosis

Unlike internal genital endometriosis, limited to the body of the uterus, there are other forms of the disease, which are called extragenital. They received this name for the localization of endometrioid foci outside the female genital organs. How can endometrial cells enter the abdominal cavity?

• With blood flow (retrograde reflux of menstrual blood).
• as a result of germination.

Damage to the peritoneum is called peritoneal endometriosis. It is manifested by pelvic pain, discomfort during defecation, painful menstruation. It is possible to detect abdominal endometriosis only with laparoscopy, which is also a method of treatment: during the operation, all available foci of growth are removed.

Vaginal endometriosis

Endometriosis of the cervix is ​​sometimes supplemented by the spread of the endometrium into the vagina. The cells enter the vaginal wall through wounds and then germinate and spread further. It is easy to detect this form of the disease due to the availability of the study area for gynecological examination. The study of the walls of the vagina with the help of mirrors and the study of the contents of the foci allows you to accurately establish the diagnosis. Patients suffering from vaginal endometriosis complain of pain shortly before the onset of menstruation, pain and spotting during intercourse. This form of the disease is treated with surgery and hormonal therapy.

Rectovaginal endometriosis

The opposite of internal endometriosis is extragenital, located outside the genitals. At the same time, there is a form of the disease that affects both the genital area and organs outside it (mixed form). We are talking about endometriosis of the body of the uterus and vagina, which is accompanied by the germination of endometrioid tissue in the rectum. This form of the disease causes great physical suffering to women. Rectovaginal endometriosis can be diagnosed with a rectal examination. Suspicion of the disease should be caused by the patient's complaints of pain during defecation and the admixture of blood in the stool during menstruation. Treatment of rectovaginal endometriosis is difficult, as complex surgical intervention is required.

Bladder endometriosis

Endometriosis of the body of the uterus and other reproductive organs is a fairly common phenomenon, but damage to the bladder is rare. How can endometrial cells be in it?

• Retrograde reflux of menstrual blood.
• Germination from the adenomyosis focus through the wall of the uterus.
• Contact with the surface of the bubble of cells from endometrioid cysts.

Often, endometriosis of the bladder does not manifest itself in any way, and can only be detected by chance during operations on the organs of the abdominal cavity and small pelvis. If the growths affect the back wall of the bladder or the mouth of the ureters, patients complain of difficulty in urination. Typically, patients complain of a feeling of heaviness in the lower and deeper abdomen, especially before menstruation. The act of urination may become more frequent and become painful.

Often, such patients are misdiagnosed as cystitis, but the treatment prescribed in accordance with the diagnosis does not bring relief. With the development of pathology, pain in endometriosis intensifies, blood appears in the urine. To establish the true cause of the appearance of such symptoms, the doctor must pay attention to the dependence of pain and the menstrual cycle and prescribe a cystoscopy, on which foci of endometriosis can be detected.

In medical practice, there are 4 degrees of endometriosis:

1. In the first degree, there are few foci, and they grow shallowly into the wall of the uterus (up to the muscle layer). Usually during this period there are no symptoms of the disease. Heavy menstruation is often the only symptom. If you consult a doctor at this stage, the disease is treated with hormone therapy.
2. The second degree of endometriosis means that the germination of cells has reached the deeper layers of the uterus (to the middle of the muscular layer). New foci of the disease do not appear, but the old ones quickly increase in size. Due to the strong germination of the endometrium, the patient may be disturbed by pain. At this stage of endometriosis, treatment is carried out not only with hormones, but also with surgery, if the doctor deems it necessary.
3. The third degree of endometriosis corresponds to an increase in the area of ​​\u200b\u200bdamage to the uterus (the entire muscle layer is affected up to the serous membrane). The pathological proliferation of cells continues at a rapid pace, as a result, the intensity of pain in a woman increases. In addition to the uterus, other genital organs are also involved in the process. A lot of adhesions are formed in the small pelvis. Treatment of the third degree of the disease is mainly surgical, followed by hormone therapy.
4. Grade 4 endometriosis is the most severe. It captures the entire pelvic area, including the gynecological organs and the excretory system. Multiple adhesions often lead to fusion of organs with each other. Stage 4 endometriosis can only be effectively treated surgically.

Causes of endometriosis

Menstruation and endometriosis

The causes of endometriosis have not been definitively established. For researchers, it is obvious that the disease most often occurs against the background of hormonal disorders. One of the ways that endometriosis spreads in the body is called retrograde menstruation. In this case, the particles of the endometrium with the flow of menstrual blood do not move along the usual path towards the vagina, but enter the abdominal cavity through the fallopian tubes. There, fragments of endometrioid tissue are able to take root on the surface of other organs and function, obeying the hormonal female cycle. Bleeding areas form foci of endometriosis. The likelihood of further development of the disease increases with a decrease in immunity.

Hormonal disorders

Hormonal imbalance is the main cause of endometriosis. An increase in estrogen production leads to the fact that endometrial cells actively grow and multiply, and some of them spread outside the uterus with blood flow. You can correct hormonal failure with the help of special therapy. The main drug is progesterone, produced under the name "duphaston" or "utrogestan". Duphaston with endometriosis compensates for the lack of its own progesterone, as a result of which the pathological growth of the endometrium is suppressed and the normal menstrual cycle is restored with the maturation of the dominant follicle and ovulation.

Often, one violation in the hormonal sphere entails several diseases. For example, a frequent companion of endometriosis is fibroids, in which the muscular layer of the uterus grows under the influence of excess estrogen. However, in this case, progesterone therapy (duphaston) is contraindicated, since it is believed that it provokes the development of fibroids.

Heredity

The cause of endometriosis may be heredity - up to 60% of patients note the family nature of the disease. In some families, endometriosis is passed down from generation to generation for a long time, and affects all women. Often diseases are accompanied by endocrine and immune disorders, which can also be inherited. Hereditary predisposition means that the risk of passing the disorder from mother to daughter is very high, therefore, in order to prevent endometriosis, it is necessary to take care of its prevention.

The cause of endometriosis may be disorders in the immune system. Normally functioning immunity, with the help of macrophages, destroys endometrial cells that have been torn away and gone beyond the usual location. In the event of a failure in the body's defense mechanism, torn cells are able to survive in atypical places for themselves, forming foci.

Therefore, the disease spreads to neighboring organs (endometriosis of the body of the uterus, cervix and vagina appears, endometriosis of the ovary), and then goes beyond the reproductive system. As a result, endometriosis can affect the abdominal cavity, bladder, germinate into the intestines. In fact, its spread is similar to the development of a tumor, when pathological cells are also not destroyed by the immune forces of the body.

Metaplasia

Metaplasia is the benign replacement of one type of tissue with another that is not characteristic of that location. Some scientists consider metaplasia as one of the causes of endometriosis. The fact is that the endometrium and the inner surface of the abdominal cavity are embryonic "relatives": they are formed from one germ. In the process of intrauterine development in the unborn child, the germ is divided into the endometrium and the epithelial layer of the peritoneum. During separation, under the influence of many reasons, an error occurs, and in place of the epithelium, areas of the endometrium appear, in which endometriosis can subsequently develop.

Diagnosis of endometriosis

The following methods are used to diagnose endometriosis:

• Usually the doctor begins with a survey and study of the patient's history. He is interested in the nature of pain, whether they increase before the next menstruation or during and after the act of defecation, the duration of the cycle and the nature of the discharge during and between menstruation, heredity for gynecological diseases, surgeries and diseases in the past.
• A manual gynecological examination is required to determine the size and position of the uterus, cervix and ovaries. Examination of the mucosa in the mirrors allows you to see signs of endometriosis in the vagina and on the cervix.
• If a disease is suspected, X-ray diagnostic methods (HSG, CT, MRI) are prescribed, with the help of which it is possible to detect foci not only with endometriosis of the uterine body, but also outside the reproductive system.
• Sometimes it is used on the CA-125 marker - an increase in its level indicates the possible presence of endometriosis (it can also indicate the presence of an oncological disease).
• One of the most reliable diagnostic methods is an endoscopic examination, in which a tube with a video camera is inserted through natural openings or laparoscopic incisions, and the doctor sees an image of the organs on the screen.

Another method of research is ultrasound. It is used most often, as it is minimally invasive (does not require punctures, incisions) and is quite inexpensive compared to endoscopy and MRI. Ultrasound has its drawbacks:

• It allows, basically, to see the disease in the uterine cavity and on the ovaries, and the foci in the abdominal cavity and intestines will go unnoticed.
• To increase reliability, the study should be carried out on certain days of the menstrual cycle (before the onset of menstruation, when the endometrium is saturated with blood and is better visualized).

On ultrasound, foci of endometriosis are areas with altered echostructure or seals. With localization in the ovaries, the doctor will see endometrioid cysts.

Laparoscopy

The "gold standard" for diagnosing the disease is laparoscopy. With this operation, endometriosis is diagnosed most reliably and accurately. Like all invasive methods, laparoscopy has a significant drawback - it is a full-fledged surgical intervention with anesthesia, after which time is required to restore the body.

At the same time, the study allows not only diagnosing endometriosis, but also simultaneously treating it by surgical removal of all available foci. During the operation, the surgeon can diagnose and treat endometriosis of the uterus, detect and remove endometrioid ovarian cysts, cauterize the foci in the abdominal cavity.

Biopsy

It is possible to reliably diagnose endometriosis when suspicious cells are examined by a specialist morphologist under a microscope. To obtain these cells, you need to perform a biopsy - excision and sampling of tissue. If the disease is localized in an accessible area where sampling can be performed without surgical intervention, it is done on an outpatient basis. When the disease has affected the internal organs, surgery may be required.

So, with endometriosis of the ovary, the surgeon receives cell samples during the operation and sends them for research. Then he removes suspicious areas and removes the cyst. With endometriosis of the uterus, a pipel biopsy is possible, when the gynecologist takes tissue from the uterine cavity with a special tube. Pipel-study does not require anesthesia, it is performed quickly and almost painlessly. It is also carried out when there is a suspicion of myoma, and the doctor needs information about the state of the inner surface of the uterus. With endometriosis, fibroids are quite common, since both diseases are associated with hormonal disorders.

Endometriosis: treatment

How to treat endometriosis?

To date, two main methods are known - surgery and hormone therapy. Some doctors consider pregnancy and lactation as a method of treatment, which change the hormonal status of a woman and help reduce or even disappear the symptoms of the disease.

But it should be remembered that the improvement in this case is often temporary, and with the restoration of the menstrual cycle after pregnancy and lactation, endometriosis may return. In addition, not all patients have the desire and opportunity to give birth to a child in order to be cured. Therefore, modern medicine offers other ways to treat endometriosis:

• Hormone therapy is to suppress the secretion of estrogens, which affect the growth of the endometrium. For this purpose, contraceptives and drugs that compensate for the deficiency of progesterone are used.
• Surgical laparoscopic surgery is a radical method that allows you to remove most of the foci of endometriosis. The disadvantage of surgery is that it can only be performed on patients who do not have contraindications. After laparoscopy, hormonal treatment is usually prescribed to ensure that endometriosis does not reappear.

Pain management for endometriosis

With a pronounced degree of endometriosis, patients complain of severe pain. Depending on where the foci are located, pain may appear in the lower abdomen, radiate to the lower back, intensify during intercourse and after the toilet. Endometriosis is often accompanied by the formation of adhesions inside the abdominal cavity, which are able to hold organs together in an unnatural position. Because of this, and also because of the stretching of the adhesions themselves, women experience pain from movements or changes in body position. Treatment of endometriosis with the help of surgery is not always possible, but special drugs and procedures will help relieve patients from pain:

• Non-steroidal anti-inflammatory drugs with analgesic effect.
• Duphaston with endometriosis can have an analgesic effect due to inhibition of the production of prostaglandins.
• Gonadotropin-releasing hormone agonists that block the production of estrogen by the ovaries.
• Massage.
• TENS - electrical stimulation of nerve endings near the site of pain to reduce it.

How to treat endometriosis with hormones? There are several areas of therapy:

• The use of analogues of the hormone produced by the hypothalamus (GnRH) to immerse the woman's body in a state of artificial menopause. In this case, the foci of endometriosis atrophy in the absence of the production of sex hormones.
• Antiprogestins also suppress menstrual function and estrogen secretion by the ovaries.
• Complex oral contraceptives (gestagens and estrogen-gestagens) suppress ovulation and estrogen production. In the course of treatment, the drug is used without monthly breaks.
• Intrauterine systems (spirals) "Mirena" act only in the uterine cavity and reduce the manifestations of endometriosis due to the release of small doses of progestogen.
• Duphaston with endometriosis compensates for the lack of progesterone, reduces the production of estrogen and acts on endometrial receptors, inhibiting its growth.

Elimination of symptoms and treatment of endometriosis of the uterus and other reproductive organs can only be carried out as directed and under the supervision of a physician. You can not independently prescribe hormonal drugs, because they have serious side effects.

Endometriosis: surgery

In medicine, there are only two ways to treat endometriosis:

• Surgery.

Surgery to treat endometriosis is most often performed laparoscopically through small openings in the body. Filling the abdominal cavity with a special gas allows you to clearly see all the organs. With instruments inserted into the incisions, the surgeon cauterizes or excised the foci of the disease. If the patient has endometrioid cysts, they are emptied and removed.

With an extragenital form and a severe degree of endometriosis, surgery is often the only way to improve a woman's condition. Unfortunately, surgical treatment often brings only a temporary effect, and then endometriosis returns again. To prevent its development, patients after surgery are prescribed additional hormone therapy.

Endometriosis: treatment with folk remedies

Women turn to the treatment of endometriosis with folk remedies when they want to avoid hormone therapy or surgery. Sometimes such methods bring some effect, but still the best results are given by traditional treatment. Therefore, folk remedies are best used as an addition to the main therapy. What are the most popular home remedies for treating endometriosis?

• Phytotherapy.

Collections of medicinal herbs affect the hormonal background, helping to reduce the level of estrogen in the blood. Phytopreparations also raise immunity and help reduce the inflammatory process in the pelvis.

• Hirudotherapy, or treatment with leeches.

The substance secreted by leeches when bitten helps to relieve vasospasm and improve blood quality.

• Clay applications have an anti-inflammatory effect, improve cellular nutrition and metabolism.

Clay treatment should be carried out with caution, since applications have a warming effect, and heat treatment for endometriosis is prohibited.

• Special physical exercises.

Their effect is to normalize pelvic circulation and reduce adhesions.

• Reception of beet juice eliminates hormonal disorders.

It is also a good remedy for the prevention of anemia, which is very important for endometriosis of the uterus, accompanied by large blood loss during menstruation.

Infertility

Endometriosis and pregnancy in the minds of most people are mutually exclusive concepts. It is believed that getting pregnant with endometriosis is almost impossible. Why is the disease dangerous for women planning a child?

• Hormonal changes lead to disruption of ovulation.
• The appearance of foci of the endometrium in the fallopian tubes contributes to their obstruction. Adhesive and inflammatory processes in the pelvic organs that accompany endometriosis can also lead to blockage of the lumen of the fallopian tubes or their deformation.
• Violation of the process of implantation of a fertilized egg prevents the development of pregnancy in the short term.
• With endometriosis, a cyst formed in the ovary disrupts the maturation of dominant follicles and depletes the body's ovarian reserve.
• Foci of endometriosis release toxic substances dangerous to the embryo.

Problems during pregnancy

Up to 50% of cases of endometriosis are complicated by infertility, and if a woman still managed to get pregnant, complications and troubles may arise:

• In the earliest stages of pregnancy, the fetal egg runs the risk of not attaching to the wall of the uterus due to the pathological growth of the endometrium. In addition, the functioning of endometriosis foci is accompanied by the release of toxic substances harmful to the development of the embryo.
• Impaired estrogen secretion leads to the fact that in the 2-3 trimester the body lacks its own progesterone, and this increases the likelihood of miscarriage.
• In the last stages, in the presence of the uterine form of endometriosis, the risk of perforation of the uterine wall increases.
• The course of pregnancy can be complicated by fibroids - this is a benign formation that develops in the muscular layer of the uterus and can reach large sizes. Obviously, it is not useful for the development of the baby, because the myomatous node can occupy a large space inside the uterus. The node creates a problem in case of attachment of the placenta on it - there is a risk that the placenta may exfoliate. In addition, fibroids increase the contractility of the uterus, and this can lead to spontaneous miscarriage.
• With endometriosis, fibroids are very common, because the cause of both diseases is similar - pathological division and proliferation of cells.

Pathological childbirth

Despite the fact that endometriosis and pregnancy are little compatible concepts, sometimes women manage to conceive and bear a child. However, childbirth in the presence of the disease can be complicated by the following circumstances:

• Endometriosis doubles the risk of preterm labor.
• Attachment of the placenta dangerously close to the focus of endometriosis can lead to premature detachment.
• Endometriosis of the cervix, especially when combined with once cured erosion, can lead to poor opening of the cervix during childbirth due to scarring and mucosal damage.
• The uterine form of endometriosis with the germination of cells in the thickness of the wall can lead to rupture of the uterus.
• Endometriosis of the cervix, body of the uterus, or vagina can lead to heavy postpartum bleeding.
• If endometriosis proceeds in the form of an extragenital lesion, perforation and bleeding from the affected organ is possible.

Endometrial cysts

One of the forms of endometriosis is ovarian, when the foci are located in the tissue of the ovaries. Ovarian diseases are characterized by the formation of cysts - a thin-walled cavity with liquid contents. Their danger is that cysts interfere with the functioning of other organs, suppress ovulation, can fester and break into the abdominal cavity.

With endometriosis, the cyst actively grows and gives the woman pain. Its cavity is filled with clotted blood, so the formation is sometimes called a “chocolate cyst”. The walls of the cyst are sensitive to hormones, as they consist of the same cells as the uterine mucosa. For this reason, the disease can be treated with hormonal drugs. In the absence of effect, a laparoscopic operation is performed, in which the cyst is emptied and removed along with the capsule.

Anemia

One of the complications that accompany this disease is anemia. It is associated with increased blood loss during and between periods. Most often, anemia occurs with endometriosis of the uterus, when menstrual bleeding is especially heavy. It can be cured by eliminating the symptoms of the underlying disease.

For this purpose, hormonal therapy and surgical methods are used. Women who do not trust traditional medicine practice the treatment of endometriosis with folk remedies. Despite the fact that sometimes some success can be achieved in this way, remember: the elimination of symptoms and treatment should still be carried out by a gynecologist.

Peritonitis

Endometriosis under adverse circumstances can be complicated by peritonitis. Peritonitis is an inflammation of the peritoneum, accompanied by a serious condition of patients. It occurs when blood, urine, or intestinal contents enter the abdominal cavity. This can happen when the leg of the endometrioid cyst is twisted, the endometrium grows through the walls of the uterus and the surrounding tissues are destroyed, the walls of the bladder and intestines are damaged by foci of the disease. In this case, the typical pain of endometriosis increases, the patient's condition deteriorates rapidly.

Symptoms of endometriosis, complicated by peritonitis, are as follows:

• Acute abdominal pain that gets worse over time.
• Intoxication with nausea and vomiting.
• Temperature rise.
• Pain when pressing on the anterior abdominal wall
• Tension of the abdominal muscles when pressed (abdomen hard as a board).

Neurological disorders

Neurological symptoms appear in patients with damage to the nerves with foci of endometriosis. This is facilitated by a large number of nerve plexuses in the genital area and organs of the reproductive system. Germination of lesions in the nerve fibers leads to intense pain and decreased sensitivity in the pelvic area.

The neurological disorder of endometriosis may also be associated with the chronic pelvic pain syndrome that accompanies the disease. The pain is caused not only by the foci of the disease that affected the nerve endings, but also by the multiple adhesions that accompany endometriosis.

It is difficult to remain optimistic and cheerful if something constantly and strongly hurts. Therefore, patients are immersed in sad thoughts, nothing pleases them and is not interested. With long-lasting unpleasant sensations, depression gradually develops, and this is already a separate disease, and not just a bad mood, as many people think. How to treat it, and how to reduce pain? The biochemical processes of chronic pain and depression proceed in the same way, and this makes it possible to successfully use antidepressants in pain therapy.

Prevention of endometriosis

One of the ways to prevent endometriosis is an annual examination by a gynecologist. In this case, during a manual examination, the doctor may suspect the presence of a disease in the body of the uterus and ovaries, peritoneum and intestines, and examination in the mirrors makes it possible to see the foci of the disease located in the vagina and on the cervix. If the doctor assumes the presence of a disease, he directs the woman to additional studies - ultrasound, MRI, blood tests and laparoscopic diagnostics. An annual examination is also useful for detecting other diseases (for example, fibroids), because with endometriosis, fibroids are very common, which is associated with the same hormonal cause of these diseases.

Physical activity

It is known that endometriosis develops in women with disorders in the immune system. To strengthen the body's defenses and prevent the development of the disease, you need to strengthen:

• To refuse from bad habits.
• Eat properly.
• Lead an active lifestyle with adequate physical activity.

In addition to strengthening immunity, for the prevention of endometriosis, it is recommended to limit physical education during menstruation. This is due to the fact that active movements can lead to the reflux of blood, and with it endometrial particles, into the abdominal cavity through the fallopian tubes.

Choice of contraceptive methods

The cause of endometriosis, according to most doctors, is hormonal disorders combined with a malfunction in the immune system. Hormonal dysfunction is when the body produces excess estrogen, which causes endometrial growth. You can suppress the production of estrogens with the help of complex oral contraceptives (COCs) - this is one of the ways to treat the disease. If a woman has a hereditary predisposition to endometriosis, the appointment of COCs is a way to prevent the disease. Do not forget that endometrial cells can enter the surrounding tissues as a result of surgical intervention in the uterine cavity (for example, during an abortion). Taking COCs allows you to reliably protect yourself from unwanted pregnancy and unhealthy abortion procedures.

Prevention of intrauterine intervention

One way to spread endometriosis is surgery or any manipulation on the reproductive organs. During such an intervention, endometrial cells enter neighboring tissues, and then can begin to grow in them. Given the fact that the disease develops in the presence of immune disorders, which are widespread in women, the risk of disease as a result of the operation is high. After all, endometrial cells that have fallen outside the uterus, which are normally destroyed by macrophages, can actively develop in women with impaired immunity.

In order to avoid the spread of endometrioid tissue to the surrounding, care must be taken with all intrauterine interventions. This is especially true for abortion. Abortion injures the walls of the uterus, the surface of the vagina and the cervix, and such microtraumas are an easy way for endometrial cells to enter the surrounding tissues.

Endometriosis is a disease that affects a large number of women. The exact number of sufferers of the disease is unknown, but it is clear that it is the main cause of chronic pelvic pain. Endometriosis comes in several forms. Extragenital refers to localization outside the reproductive system, the genital form affects the uterus with the neck, vagina and ovaries. An unpleasant complication of the disease when the ovaries are involved in the process is a cyst.

With endometriosis, the cyst grows rapidly, causes severe pain and can be complicated by rupture. In addition to it, a woman can be brought to the surgical table by the germination of the endometrium in the peritoneum and the walls of the intestines, bladder. Damage to the surface of organs can cause organ perforation and the development of peritonitis.

How to prevent the development of such serious complications? First of all, patients are prescribed hormonal treatment with contraceptives or other means that suppress estrogen production. Duphaston for endometriosis is one of the options for hormonal treatment aimed at filling the deficiency of progesterone and limiting the growth of the endometrium. If hormonal therapy does not give the desired effect, they resort to surgical treatment. Sometimes surgery may be the only way to reduce or completely get rid of the symptoms of the disease.

The uterus is a hollow organ connected through the cervical canal to the vaginal cavity and through the fallopian tubes to the abdominal cavity and ovaries.

The innermost layer of the uterus is the endometrium. You can get an idea of ​​its appearance at each menstruation, when it is rejected and removed almost entirely from the uterine cavity.

Why is the endometrium removed from the uterine cavity at the beginning of each menstrual cycle?

The answer to this question is simple - it's all about that. That it is the endometrium that is that “fertile soil” that, having fallen on which, a fertilized egg can continue its development and give rise to a new life. Therefore, every time when fertilization did not occur during the menstrual cycle, the mucous layer of the uterus is rejected and a new one gradually forms - already during the next cycle.

With endometriosis, for unknown reasons, the endometrium of the uterus is in areas where it should not be (the muscular membrane of the uterus, ovaries, on the abdominal mucosa, in the vagina). Moreover, in the foci of the pathological spread of the endometrium (they are also called ectopic foci or heterotopias), as in the uterus, all stages of endometrial maturation (proliferation of endometrial cells, secretion and rejection) occur.

The growth of the endometrium is regulated by the hormonal system, namely, the sex hormones of the ovaries and hypothalamus. Therefore, these hormones equally affect both the basal layer of the normal endometrium of the uterus and ectopic foci, regulating their growth and development phases.

Risk factors and possible causes of endometriosis

Risk factors in the development of endometriosis:

• Abortions at different stages of pregnancy
• Diagnostic curettage of the uterine cavity
• Operations on the pelvic organs

Endometriosis of the body of the uterus

Symptoms of endometriosis of the body of the uterus (adenomyosis)

• Painful menses. The most intense pains are in the first days of menstruation, when there is an active contraction of the muscular membrane of the uterus and rejection of the endometrium, including in ectopic foci.
• Profuse menstrual flow with bloody discharge. Menstrual flow with endometriosis is characterized by a dark color, but there is also a significant part of the blood clots in the discharge.
• Longer menstrual flow. The duration of menstrual flow in many women suffering from endomniosis exceeds the average.
• The appearance of dark brown discharge 2-5 days before menstruation. Also, after the end of menstruation, dark brown discharge may go away for another 2-5 days. These secretions depart in the pre- and postmenstrual period from endometrioid foci, which can enter the uterine cavity when the myometrium contracts.
• Bloody discharge during the intermenstrual period. This symptom is quite common. It may indicate a hormonal imbalance.

Stages of endometriosis of the body of the uterus (adenomyosis)

Diagnosis of endometriosis of the body of the uterus

• Allows the gynecologist to determine the likelihood of a particular gynecological disease. Inspection in the mirrors allows you to examine the vaginal cavity and the outer part of the cervix.
• Ultrasound of the pelvic organs- this study reveals almost all forms of endometriosis in 90% of cases. However, in some cases, a more detailed instrumental examination is required. Ultrasound for the diagnosis of endometriosis is best done on the 23-25th day of the menstrual cycle.
• X-ray examination of the genital tract using contrast (hysterosalpingography) . Before this diagnosis, it is recommended to carry out curettage of the uterine cavity. The X-ray image is preceded by filling the uterine cavity with a special radiopaque substance.
• Hysteroscopy- This is an examination of the uterine cavity using a special apparatus - a hysteroscope. This device displays visual information on the monitor screen and allows you to directly examine the uterine cavity, as well as perform minimally invasive operations using special manipulators.

Endometriosis of the cervix

Symptoms of cervical endometriosis

• Dark spotting discharge from the genital tract on the eve of menstruation
• Pain for this form of endometriosis is not as characteristic as for other types of heterotopia.
• Brown discharge during genital intercourse, more often observed in the second half of the menstrual cycle.
• Discomfort and even pain during genital intercourse.

Diagnosis of endometriosis of the cervix

• Gynecological examination. When viewed in the mirrors, as a rule, foci of endometriosis of the cervix are detected.
• Cervicoscopy- this instrumental study allows you to examine the cervical canal and identify heterotopias in it.
• Separate scraping- allows you to identify endometrioid secretions in the resulting biomaterial.

All diagnostic measures for endometriosis of the cervix should be carried out in the second half of the menstrual cycle - on the 23-25th day of the cycle.

Endometriosis of the vagina and perineum

Symptoms of endometriosis of the vagina and perineum

• Severe pain that worsens shortly before menstruation
• Pain during genital or anal intercourse
• Brownish spotting that occurs more often in the second half of the menstrual cycle
• During genital intercourse, brownish discharge from the vagina may be observed.

Diagnosis of endometriosis of the vagina and perineum

• Gynecological examination. Inspection of the vaginal cavity in the mirrors and sampling from the foci of endometriosis of the contents allows you to accurately diagnose in most cases.
• Ultrasound of the pelvic organs- allows you to clarify the prevalence and size of endometrioid lesions.

ovarian endometriosis

Symptoms of ovarian endometriosis

• Soreness in the lower abdomen may or may not be related to the menstrual cycle. Persistent pain can occur as a result of inflammation of the peritoneum, irritated by endometriosis lesions.
• In some cases, there is an increase in pain in the lower abdomen during physical exertion or during sexual contact.
• An increase in soreness can occur as menstruation approaches, with a peak on the first day of menstruation.
• Pain can be given to the lumbar or inguinal region, as well as to the rectal region.

Diagnosis of ovarian endometriosis

• Ultrasound of the pelvic organs is the most informative of non-invasive diagnostic methods.
• Diagnostic laparoscopy gives the most accurate data on the localization, size of endometrioid lesions. Also, this method can be used for surgical treatment.

Fallopian tube endometriosis

Symptoms of endometriosis of the fallopian tubes

• Pain in the lower abdomen
• Soreness may increase a few days before menstruation
• Acute pain during exercise may indicate the formation of peritoneal adhesions.
• Soreness during intercourse, increasing with the approach of menstruation.

Diagnosis of endometriosis of the fallopian tubes

• Ultrasound of the pelvic organs allows you to determine the size of the focus and its approximate localization.
• Laparoscopic diagnostics allows you to make a direct examination of the surface of the fallopian tube and most reliably identify the localization of endometriosis.

Treatment of endometriosis

Surgery

Medical treatment

• Combined oral contraceptives (femoden, anovlar, ovidon, marvelon, rigevidon, diane-35)
• Preparations from the group of progestins (duphaston, norkolut, depostat)
• Drugs from the group of antigonadotropins (danazol, gestrinone)
• Representatives of gonadotropin-releasing hormone agonist preparations (zoladex, decapeptyl-depot, suprefect-depot)
• Drugs - antiestrogens (toremifene, tamoxifen)

As mentioned above, only your gynecologist can determine the treatment regimen and control the effect against the background of the ongoing treatment. Therefore, self-treatment for endometriosis with hormonal drugs is contraindicated due to the many side effects of these drugs and the need to monitor the effectiveness of the treatment.

Prevention of endometriosis

• It is necessary to avoid abortions, not to strive for childbirth through a Caesarean section, think a thousand times before agreeing to curettage and other procedures in the uterine cavity, and refrain from using intrauterine contraceptives.
• It is necessary to monitor the regularity of the menstrual cycle - its violation is the main symptom of hormonal changes.
• Immunity should be maintained at a high level - therefore, sports, rational nutrition and a competent distribution of work and rest regimen must be determined and observed for you.

Endometriosis and pregnancy

In some cases, the pain syndrome in endometriosis is so pronounced that the only way to get rid of this disease is to remove the uterus.

But what to do if natural conception against the background of endometriosis does not occur within 6 months?

Checking the patency of the fallopian tubes- this requires hysterosalpingography, diagnostic laparoscopy

Determination of the presence of ovulation(Ultrasound of the ovaries in the middle of the menstrual cycle, measurement of basal temperature and study of hormonal levels)

Diagnosis of the condition of the uterus(ultrasound of the pelvic organs, hysteroscopy, hysterography)
If during these studies the cause of infertility was identified, then the gynecologist will prescribe the necessary treatment:
In case of obstruction of the fallopian tubes - excision of the flocks of the abdominal cavity, removal of endometriotic foci that can mechanically compress the fallopian tubes.

With a disturbed hormonal background, ovulation is stimulated with hormonal drugs.
With endometriosis of the uterus, it is possible to perform an operation to remove the foci of endometriosis.

If pregnancy has not occurred within 6 months after the treatment, then the possibility of in vitro fertilization should be considered.

If conception has come, then we are doubly happy for you. From now on, regular premenstrual pain will disappear and there is every chance of having a healthy baby. The fact is that under the influence of hormonal changes occurring in the body of a woman during pregnancy, the activity of endometrioid foci drops to a minimum.

Prognosis for endometriosis

What are the complications and consequences of endometriosis?

Endometriosis can affect both the genitals ( with genitalia) and other body tissues ( with extragenital form) - intestines, lungs, liver and so on.

The consequences of the disease are determined by:

• the affected organ;
• the severity of the growth of endometrial tissue;
• timeliness and adequacy of the treatment.

• violation of the menstrual cycle;
• the formation of adhesions in the pelvis;
• the formation of endometrioid cysts;
• neurological disorders;
• rupture of the affected organ;
• violation of childbirth;
• malignancy ( transformation into a malignant tumor);
• infertility.

Formation of adhesions in the pelvis
The appearance of endometrial cells in organs in which they are not usually found leads to the development of an inflammatory process characterized by the migration of a large number of leukocytes ( cells of the immune system that provide protection to the body) to the site of inflammation. They surround "foreign" cells, trying to prevent their further spread throughout the body. As the disease progresses, special cells may appear in the focus of inflammation - fibroblasts, which produce a large amount of fibrin protein and collagen fibers. Of these, adhesions are subsequently formed, which are growths of the connective ( cicatricial) tissue. Growing adhesions can block the lumen of the fallopian tubes and uterus, with endometriosis of the intestine, squeezing of its loops and disruption of the passage of feces can occur. There may be "gluing" between the various organs of the small pelvis and abdominal cavity, which leads to a violation of their function.

Formation of endometrial cysts
If pathological growths of endometrial cells are located on the surface of the affected organ ( ovaries, uterus or other) then during menstruation, they are rejected, as a result of which they enter the abdominal cavity or are excreted through the vagina with menstrual blood. If the focus of endometrial tissue is located in the depths of the organ ( that is, it is surrounded on all sides by normal tissue), the rejected cells of the endometrium cannot stand out, as a result of which they remain in the resulting cavity ( along with a certain amount of blood flowing from damaged vessels), that is, a cyst is formed.

Such a pathological process will be repeated every month, when the woman begins her period, as a result of which the size of the cyst and the volume of blood contained in it will gradually increase. The cyst will gradually compress the surrounding tissues, leading to dysfunction of the organ. When the size of the cyst reaches a critical size, its wall may rupture and the contents will leak out. Sometimes this is manifested by profuse bleeding, which is observed during the next menstruation. If the contents of the ruptured cyst enter the abdominal cavity, peritonitis develops ( inflammation of the peritoneum - a thin membrane surrounding the internal organs of the abdominal cavity and small fold).

Neurological disorders
The growth of endometrioid cells in various tissues can lead to compression of the nerve structures passing in this area. As a result, intestinal motility may be disturbed, which will be manifested by constipation or frequent diarrhea, bloating, and so on. Dysregulation of the bladder can lead to frequent urination or urinary incontinence.

Rupture of the affected organ
The germination of endometrial cells in the walls of various organs violates their integrity and strength. The rupture of the wall of the large intestine can occur with an increase in the load on them, which is observed with constipation, intestinal obstruction, the use of rough and poorly processed food. The ingress of feces into the abdominal cavity can lead to the development of fecal peritonitis, requiring urgent surgery. Rupture of the uterine wall can occur at various stages of pregnancy ( depending on the degree of damage to the myometrium - the muscular layer of the uterus) and without urgent surgical intervention can lead to the death of the fetus and mother.

Birth disruption
During childbirth, the myometrium begins to contract, helping to push the fetus out of the uterine cavity. The germination of the endometrium in the tissue of the muscular layer of the uterus significantly disrupts the contractility of the organ, as a result of which there may be a weakness in labor ( that is, the uterus cannot contract with sufficient force to ensure the birth of a child). In addition, the load on the muscle fibers of the organ during labor pains increases several times, which, with endometriosis, can lead to uterine rupture.

Intestinal obstruction
Violation of the passage of feces can develop as a result of a pronounced proliferation of endometrial tissue in the intestinal cavity. In this case, a mechanical overlap of its lumen and the development of intestinal obstruction occur. Another cause of this complication may be the formation of adhesions in the abdominal cavity. As they grow, they squeeze the intestinal loops from the outside, as a result of which the passage of feces is also disturbed.

malignancy
One of the theories for the development of endometriosis is considered to be a tumor degeneration of ordinary cells of the organ. If we consider endometriosis from this point of view, then it refers to benign tumors, since the growing cells of the endometrium do not destroy, but rather push back the cells of normal tissues. However, sometimes malignant degeneration of endometrioid cells into cancerous ones can occur. In this case, the rate of development of the pathological process accelerates, cancer cells begin to destroy neighboring tissues and organs, and metastases appear - distant tumor foci that are formed as a result of the migration of cancer cells with blood and lymph flow.

Infertility
The most common complication of endometriosis is infertility, which is observed in more than 60% of women suffering from this disease. The cause of infertility can be adhesive processes, endometrioid cysts in the ovaries, as well as the development of inflammatory reactions in the uterine mucosa, which prevents the attachment of a fertilized egg and the onset of pregnancy.

It is worth noting that the onset of pregnancy at any stage of endometriosis stops the progression of the disease. This is due to the suppression of the secretion of female sex hormones ( estrogen), which are responsible for proliferation ( overgrowth) endometrial tissue. The longer a woman has endometriosis, the less likely she is to become pregnant.

Can you have sex with endometriosis?

Sex life with endometriosis is affected by:

• form of the disease. The most dangerous in this regard is endometriosis of the uterus and external genital organs. In this case, the proliferation of endometrial cells ( mucous membrane of the uterus) leads to functional disorders in the affected organ, and can also cause a number of complications. Endometriosis of other organs ( e.g. lungs) usually does not affect a woman's sex life.
• The severity of the disease. With endometriosis, endometrial cells appear in various organs. The larger the focus of endometriosis, the more the surrounding tissues are compressed and the more the function of the affected organ suffers.

• Bleeding. With endometriosis of the cervix or vagina, the affected tissue may be permeated with a large number of endometriotic lesions. During intercourse, their mechanical damage may occur, resulting in bleeding. The intensity of blood loss varies depending on the severity of the endometrioid process and the affected organ.
• Get sick. Acute stabbing pains are usually observed in endometriosis of the body and cervix, vagina, intestines. An inflammatory process develops around the endometrial cells, which is accompanied by increased sensitivity of the tissue of the affected organ. During sexual intercourse, the overgrown tissue of the endometrium is squeezed, which causes the onset of pain. Its intensity varies from mild to unbearable ( what can cause sexual intercourse). Another cause of pain may be vaginal dryness, often observed in the treatment of endometriosis with hormonal drugs, as well as the development of adhesions in the pelvis.

In milder cases, it is recommended to reduce the frequency of having sex in the first half of the menstrual cycle if possible. This is due to the fact that during this period, under the influence of female sex hormones ( estrogen) there is an increase in the endometrium in the uterus and in the foci of endometriosis, which may be accompanied by a deterioration in the condition of the woman and the development of more severe complications.

Can you sunbathe with endometriosis?

Endometriosis is the overgrowth of endometrial cells ( mucous membrane of the uterus) organs where they are not normally found. Under the influence of female sex hormones ( estrogen) there is increased growth of the endometrium ( both in the uterus and in the foci of endometriosis), as a result of which it compresses the surrounding tissues, leading to a violation of their functions.

Sunbathing with endometriosis can cause:

• Faster progression of the disease. Exposure to ultraviolet rays or simply high temperatures accelerates metabolic processes throughout the body, including in the foci of endometriosis. This is followed by accelerated division ( breeding) endometrial cells, which worsens the course of the disease. In addition, exposure to high temperatures can lead to the appearance of new foci of endometriosis in previously unaffected organs and tissues.
• Development of cancer. Endometriosis is essentially a benign tumor. Since cell division in the foci of endometriosis occurs very intensively ( especially in the first half of the menstrual cycle), with a high degree of probability, a mutation may occur in them, the result of which will be a malignant degeneration of the tumor and the development of cancer. Under normal conditions, this does not happen, since the woman's immune system quickly finds mutated ( tumor) cells and destroys them. However, when exposed to ultraviolet radiation, the rate and number of mutations increase several times, while simultaneously increasing the risk of developing a malignant tumor.

• live in countries with a hot climate;
• sunbathing during the hot part of the day from about 10-11 am to 4-5 pm);
• sunbathe for more than 30 minutes continuously;
• visit a bath and / or sauna;
• visit the solarium.

Can you get pregnant with endometriosis?

For pregnancy to occur, conception must occur that is, the fusion of female and male germ cells). The female sex cell ( egg) matures in the ovaries, after which it is secreted into the fallopian tubes, where it remains for several days. To fertilize it, the spermatozoon ( male sex cell) must pass through the cervix, uterine cavity and enter the fallopian tube. After the fusion of the egg and sperm, a new cell is formed - the zygote, which enters the uterine cavity and attaches to the endometrium ( mucous membrane of the uterus). Thus, the development of the fetus in the female body begins.

Endometriosis is characterized by the appearance of endometrial cells ( mucous membrane of the uterus) in various organs and tissues, where it is not normally found. Almost any tissue or organ can be affected ( uterus and ovaries, pelvic organs, thoracic and abdominal cavity and so on). The growing tissue of the endometrium compresses the affected organ, damaging it. In addition, endometrial cells outside the uterine mucosa are perceived as "foreign", as a result of which an inflammatory process develops in the affected organs, characterized by dilation of blood vessels and tissue edema.

If endometriosis affects the pelvic organs ( uterus and fallopian tubes, ovaries), developing complications can disrupt the process of conception at various levels, leading to infertility.

The cause of infertility in endometriosis can be:

• violation of the patency of the fallopian tubes;
• the formation of adhesions;
• change in the endometrium;
• endometrioid ovarian cysts.

Violation of the patency of the fallopian tubes
During the first phase of the menstrual cycle ( in the first 14 days after the next menstruation) there is an increased growth of endometrial tissue under the action of female sex hormones ( estrogen). Such changes affect not only the uterine mucosa, but also endometrial cells in the foci of endometriosis. If at the same time the fallopian tubes are affected, then their lumen may be completely blocked, as a result of which the spermatozoa will not be able to reach the egg and conception will become impossible.

Adhesion formation
Another cause of infertility may be the formation of adhesions in the pelvis. In response to the appearance of endometrial cells in various tissues, an inflammatory process develops. Special cells migrate to the focus of inflammation - fibroblasts, which are involved in the formation of fibrin ( blood plasma protein) and collagen fibers. Of these two components, adhesions are formed - connective tissue strands that can squeeze the fallopian tubes from the outside, disrupting their patency.

Endometrial change
If endometriosis affects the muscular layer of the uterus, fallopian tubes or cervix, then the developing inflammatory changes prevent the normal attachment of the zygote.

Endometrial ovarian cysts
A cyst is a closed cavity filled with fluid ( usually bloody). During menstruation, normal endometrial tissue is shed in the uterine cavity, as a result of which a small amount of blood flows out of the damaged vessels. In the foci of endometriosis, the same phenomena are observed, however, blood can remain in the affected organ itself, resulting in the formation of a cyst.

As the disease progresses, the cyst may enlarge and new cysts may appear, significantly reducing the amount of functional ovarian tissue. In addition, the process of normal maturation of the egg and its release into the fallopian tubes becomes impossible, as a result of which infertility develops.

Is IVF effective for endometriosis?

Endometriosis is characterized by abnormal growth of endometrial cells ( mucous membrane of the uterus) organs where they are not normally found. A number of factors lead to infertility in this disease, which must be taken into account and studied before IVF.

Endometriosis is characterized by:

• Violation of the patency of the fallopian tubes. With the growth of the endometrium in the fallopian tubes, their lumen overlaps, resulting in spermatozoa ( male sex cells) cannot reach the egg ( female sex cell) and fertilize it. Even if this process occurs, the likelihood that a fertilized egg will enter the uterine cavity and attach to its wall is also significantly reduced.
• Adhesive disease. In the organs affected by endometriosis, an inflammatory process develops, characterized by swelling of the tissues and the release of the liquid part of the blood from the vascular bed. Also, the development of inflammation is facilitated by bleeding, often observed in lesions of the pelvic organs ( ovaries, uterine wall, intestines, bladder). As the disease progresses, fibrin plaque is deposited on the walls of the organs ( specific plasma protein), which leads to the formation of adhesions, "gluing" the organs together. Adhesions can compress the ovaries or fallopian tubes, which disrupts the development and fertilization of the egg.
• Immune system disorders. Endometriosis is characterized by changes in the immune protective) systems of the female body. With extensive damage to the uterine wall, inflammatory changes in the mucous membrane of the organ can be observed, which can also be the cause of infertility.
• The formation of cysts in the ovaries. The endometrioid ovarian cyst is a cavity filled with blood, which is formed as a result of repeated bleeding observed in the foci of endometriosis during each menstruation. Since the blood has nowhere to be released, it accumulates in the tissues of the ovaries, leading to a violation of their function ( first of all, to disruption of the process of maturation of the egg).

Fertilized eggs are placed in a special incubator for 3-5 days, after which the transfer is carried out 2 ( in some cases - 4) embryos into the uterine cavity. This procedure is painless and takes only a few minutes. If the process of their attachment occurs normally, pregnancy will occur.

Indications for IVF for endometriosis are determined by:

• The prevalence of the disease. If the cause of infertility was a violation of the fertilization process ( with adhesive disease, ovarian cysts or obstruction of the fallopian tubes), IVF allows you to get pregnant in almost 90% of cases. In the presence of inflammatory changes in the uterine cavity and a violation of the hormonal background of a woman, the effectiveness of the method is significantly reduced.
• The effectiveness of previous treatment. If there are not many endometriotic foci and they have not caused serious functional and anatomical disorders in the uterus, fallopian tubes and ovaries, drug treatment of endometriosis is first provided. After that, the woman is advised to try to conceive naturally within a year. If she fails, IVF is assigned.
• The age of the woman. If a woman is younger than 35 years, before IVF it is recommended to carry out the treatment described above and adhere to expectant management for 1 year. If the patient's age is over 35 years, IVF is performed as early as possible ( after performing all the necessary studies and a short course of treatment with hormonal drugs).

Is there a special diet for endometriosis?

Endometriosis is a pathological condition in which endometrial cells ( mucous membrane that lines the uterine cavity) appear in other tissues and organs ( where they do not normally occur). The central link of this disease is the growth of endometrial tissue outside the uterine cavity. This is due to an increase in the concentration of female sex hormones ( estrogen) in the first half of the menstrual cycle. During the next menstruation, the endometrium is rejected, as a result of which a certain amount of blood flows out of the damaged vessels.

Clinical manifestations of endometriosis are due to:

• Location and size of endometriosis foci. This disease can affect almost any organ of the human body. The growing tissue of the endometrium puts pressure on the normal cells of the affected organ, which, as the disease progresses, leads to a violation of its function, the development of inflammatory processes and the appearance of pain of varying intensity.
• The amount of blood loss. During normal menstruation, a woman loses no more than 100 ml of blood. However, with endometriosis, bleeding develops in all foci of the disease, which in severe cases can lead to massive blood loss and severe anemia.

Is it possible to cure endometriosis with folk remedies?

Used to treat endometriosis:

• Herbal collection. Contains elderberry, chamomile and nettle flowers, as well as raspberry, mint and sage leaves. The collection has anti-inflammatory, antimicrobial and weak analgesic effect. To prepare the collection, you need to take 20 grams of each ingredient, chop and pour 2 liters of boiling water. Insist in a dark place for 4 - 5 hours, then strain and take 1 glass ( 200 ml) 4 times a day 30 minutes before meals. The course of treatment is 10 - 14 days.
• Plantain infusion. It has anti-inflammatory and antimicrobial action. Helps stop bleeding and activates regenerative processes in damaged tissues. To prepare an infusion, 50 mg of crushed plantain leaves must be poured with 1 liter of boiling water and infused for 1 hour. The infusion must be carefully filtered, then add another 500 ml of warm boiled water. Take orally 2-3 tablespoons 4 times a day, half an hour before meals. The duration of treatment is 10 days.
• A decoction of a boron uterus. It has anti-inflammatory and antimicrobial effects, contributes to the normalization of the menstrual cycle, and also reduces the risk of endometriosis degeneration into a malignant tumor. To prepare a decoction, 2 tablespoons of boron uterus grass should be poured with 1 liter of hot water and boiled in a water bath for 20 minutes. Strain thoroughly and take 100 ml ( half a glass) 3 times a day before meals.
• Infusion of celandine. It has antimicrobial and analgesic action. To prepare the infusion, 2 tablespoons of chopped celandine grass should be poured with 500 milliliters of boiling water and infused in a dark place for 3 hours. Then carefully strain and take 50 ml 4 times a day before meals.
• Beet juice. Helps to normalize hemoglobin levels and restore mucous membranes after bleeding. Freshly squeezed beetroot juice should be taken 50-100 ml 3 times a day before meals.
• A decoction of the bark of viburnum. Viburnum bark has an astringent and hemostatic effect, and also increases the tone of the muscular layer of the uterus, helping to stop bleeding as soon as possible. To prepare a decoction, 100 grams of chopped bark must be poured with 2 liters of boiling water and boiled in a water bath for 30 minutes. After that, cool at room temperature, strain and take 2 tablespoons 4 times a day before meals.
• Decoction of barberry root. This plant enhances uterine contraction, helping to stop bleeding. To prepare a decoction, 1 tablespoon of chopped barberry roots must be poured with 1 liter of hot water, brought to a boil and boiled for 20 minutes. After that, cool at room temperature, strain and take 50 ml 3 times a day before meals.

How to treat endometriosis with hormonal drugs?

The endometrium is a mucous membrane of the uterus, consisting of two layers - functional and basal. The functional layer under the influence of various sex hormones undergoes certain changes depending on the phase of the menstrual cycle, while the basal layer ensures its regeneration ( recovery) after menstruation.

Depending on the day of the menstrual cycle, there are:

• proliferation phase. This phase begins immediately after the end of the next menstruation, lasts about 12-14 days and is characterized by the growth of the functional layer of the endometrium, which occurs under the influence of estrogens ( female sex hormones). Estrogens are secreted by the cells of the follicle ( maturing egg) in the ovaries.
• secretion phase. Lasts about 14 days. During this phase, estrogen production and rate of endometrial proliferation) decreases, and the hormone progesterone secreted by the corpus luteum of the ovaries "prepares" the endometrium for the implantation of a fertilized egg ( the number of glands increases, the endometrium begins to produce various enzymes). If pregnancy does not occur, the functional layer of the endometrium is gradually shed.
• phase of menstruation. During menstruation, rejection and removal of the functional layer of the endometrium occurs, and under the influence of a newly increasing concentration of estrogen, a new phase of proliferation begins.

The action of hormonal drugs in endometriosis is aimed at blocking the proliferation of the endometrium at various levels, which significantly reduces the clinical manifestations of the disease.

Treatment regimens for endometriosis with hormonal drugs

Yes, and even more so, about a third of women who do not receive any treatment go away on their 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. There are three types of management of endometriosis in world gynecology:

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

Drug treatment: the most common treatment tactic. 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 disruption of the internal organs. Also, an operation may be required if it has developed as a result of endometriosis.

What medications are used to treat endometriosis?

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

Contraceptive pills (oral contraceptives, OK): Janine, Yarina

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

• Analogues of gonadotropins: Buserelin, Zoladex

Each of these groups of drugs affects the body differently.

Contraceptive pills (Zhanin, Yarina) and endometriosis

Your gynecologist may prescribe birth control pills (OCs) to treat endometriosis: Janine, Marvelon, Regulon, and others. These drugs contain different doses of hormones, so be sure to consult a gynecologist before starting the medication.

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

Utrozhestan, Duphaston and endometriosis

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

Danazol and endometriosis

Danazol is a synthetic hormone that, at the time of administration, suppresses the production of female sex hormones, helping to reduce the foci of endometriosis. For the appearance of the therapeutic effect of Danazol, it is necessary to take it for at least 3-6 months.

This drug was previously widely used in the treatment of endometriosis, but in some countries doctors are beginning 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 chest, excessive 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 at the same time devoid of its side effects.

Buserelin, Goserelin (Zoladex) and endometriosis

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

The course of treatment of endometriosis with these drugs is no more than 6 months. After the end of the medication, the ovaries begin their work again, so you do not have to worry that they will never "turn on" again.

Collapse

Endometriosis is a common disease that responds well enough to treatment if it is started in a timely manner. If left untreated, this disease can lead to a number of serious consequences, including infertility and the development of oncological processes. Therefore, it is important to start therapy in a timely manner. How to treat endometriosis? This is discussed in this article.

Methods

Endometriosis is a process in which endometrial cells are actively dividing in one or another part of the reproductive system, resulting in significant tissue growth. This process is hormone-dependent, it develops only under the condition of a high content of estrogen in the patient's blood. Therefore, the disease can be treated with medication (by affecting the level of hormones) or surgically (by removing directly the focus of active tissue growth).

Can endometriosis be cured? Usually, this disease responds well enough to drug therapy. Surgical methods are used extremely rarely. In addition, after 40 years, this disease is not treated at all, since during menopause, estrogen production stops, and the overgrown tissues degrade by themselves, the pathological process stops.

The occurrence of this disease after 50 years is a rarity. But it is in this case that it is most difficult to cure, since the effect of hormones is often already meaningless.

Medical treatment

How to treat uterine endometriosis with medication without surgery? For such therapy, hormonal drugs of one type or another are used. The appropriate type of medication and the specific remedy is selected by the doctor based on the current hormonal balance and its changes. Self-medication in this case is extremely dangerous, as it can further disrupt the hormonal balance, worsen well-being and accelerate the development of the disease.

COOK

Combined oral contraceptives or COCs are drugs that contain two main female sex hormones - estrogen and progestogen. When they enter the body in the recommended dosages, the hormonal balance normalizes, and the development of the disease stops. In addition, they protect against unwanted pregnancy. The following drugs are used:

1. Marvelon and its complete analogue, both in composition and in principle of action - Regulon (about 600 rubles);
2. Jeanine (about 800 rubles);
3. Yarina (about 850 rubles);
4. Diana (about 1100 rubles) and others similar.

How is uterine endometriosis treated in this way? You need to drink drugs, observing a few rules:

• Take one tablet a day, at the same time, preferably in the morning, time;
• If you miss a pill, take it as soon as possible, but if more than 12 hours have passed, then it is better not to take it at all;
• Do not stop taking the tablets abruptly, as this may cause bleeding;
• The duration of the course of therapy is at least three months;
• Take the tablets strictly in the order indicated on the blister, as they have a different hormonal composition;
• Take the first tablet from the package on the first day of the menstrual cycle;
• After the end of the package, take a break for the period of menstruation, and then start the next package.

Such drugs should not be drunk with impaired functioning of the liver and kidneys, diseases of the brain and central nervous system, and a tendency to form blood clots. Migraines, abdominal pain and mammary glands are highlighted as side effects.

Progesterone analogs

Drug treatment of endometriosis can be carried out with progesterone preparations. Such gels and tablets for endometriosis are prescribed with a low content of this hormone. Progesterone inhibits the growth of the endometrium. Used drugs such as:

1. Crinon gel (from 2000 rubles);
2. Duphaston (500 rubles);
3. Injesta (300 rubles);
4. Utrozhestan (403 rubles).

Some patients note an increase in the mammary glands while taking such drugs.

AGNRG

Gonadotropin-releasing hormone agonists cause an artificial menopause by completely stopping the production of estrogen. The most commonly used drug is Buserelin, which is injected. It can be entered once a month. Usually, 3-4 injections are enough. This method is not used very often. The cost of funds is 2500-3000 rubles.

Surgery

Such an intervention is prescribed in cases where other methods of treatment are ineffective. And also when endometriosis occurs in women after menopause, since in this case it may not have a hormonal cause. There are three types of interventions:

• Moxibustion with liquid nitrogen is suitable for all women. Such treatment is carried out for endometriosis with its focal course. In this case, the area of ​​growth is so small that it can be burned. This is a relatively simple and safe intervention, the recovery period after which is no more than three weeks. There is only one consequence - a scar can form;
• Curettage of the endometrium is carried out using access through the cervical canal. This procedure is only suitable for women who have given birth. It allows you to cure endometriosis of any type, but it is quite traumatic. May lead to scarring, adhesions;
• In the most severe cases and in the post-reproductive age of the patient, a complete removal of the uterus (or other affected organ) may be used. Such cases are extremely rare, since the intervention is quite severe, leads to the formation of adhesions, etc.

Methods for the treatment of endometriosis are selected by the doctor based on considerations of the least trauma and the greatest efficiency. Surgical treatment is rarely used. Is it possible to cure endometriosis of the uterus in this way completely? No, if the cause is not eliminated - while maintaining the hormonal imbalance, over time, the tissues will begin to grow again.

Laparoscopy for endometriosis

Folk methods

Non-hormonal drugs for endometriosis can be prepared independently. But keep in mind that such treatment must be agreed with the doctor, as it may have contraindications:

• Mix serpentine root, shepherd's purse (grass), cinquefoil, calamus, knotweed and nettle in equal amounts. Pour two teaspoons of the mixture with a glass of boiling water and boil for five minutes. The treatment regimen for endometriosis is simple - drink a glass of the drug a day half an hour before meals, divided into three doses;
• Copper sulphate is also used. One tablespoon is diluted with a liter of boiling water, waiting for the sediment to settle. And then the dining room of the diluted composition without sediment is poured with one liter of boiled water. Make the composition of the bath for about 30 minutes, periodically adding hot water. The duration of treatment is one month. This medicine for endometriosis of the uterus is poisonous, and its use must be agreed with the doctor.

Such drugs are good as additional means, but they cannot be the main treatment.

Tampons

Tampons are indicated for endometriosis of the cervix and vagina, as they have a positive effect, acting directly on the affected areas. Some pharmacies sell Chinese tampons with herbal extracts. They must be inserted into the vagina at night and removed in the morning. This is an alternative medicine, therefore, it is necessary to use such drugs for the treatment of endometriosis with caution and after consulting a doctor.

Safer homemade tampons with aloe. A gauze pad must be soaked in juice and inserted into the vagina. Use the same as Chinese.

Diet

Both hormonal and non-hormonal treatment of endometriosis involves careful adherence to the diet. It is necessary because some foods contain phytoestrogens and can affect hormonal balance. In addition, a strong immune system can reduce the rate of tissue growth, so you need to eat food rich in vitamins and minerals. The following foods that increase estrogen content should be excluded from the diet:

1. Pomegranates and juice from them;
2. Lentils, wheat, corn;
3. Beer, bourbon, red wine, green tea.

1. Breakfast: porridge, chicken egg, weak tea;
2. Second breakfast: fruit, kefir or fermented baked milk, or tea;
3. Lunch: vegetable or meat soup, a small piece of baked (not fried) meat with a vegetable or cereal side dish;
4. Afternoon snack: cottage cheese with tea and or fruit and kefir;
5. Dinner: Vegetable salad with boiled fish and tea.

The doctor will describe the diet in most detail. How to get rid of endometriosis? Diet alone will not help to heal, but it can significantly speed up recovery, make treatment more effective.

Physical exercise

Sports with this diagnosis is not contraindicated. Moderate exercise is recommended. Yoga, intensive walking, dancing (without jumping) are especially shown. This does not have a direct effect on the course of the disease, but it can prevent the formation of adhesions. In addition, when playing sports, endorphins are produced, which act as painkillers.

It is worth avoiding jumping, strength exercises, and activities that increase blood flow to the pelvic organs.

Mud therapy

Mud therapy can be carried out at home. For this, clay is used. Pure clay without sand is dissolved in water and infused overnight. In the morning, the mixture is stirred and brought to a boil on the stove. As soon as it boils, remove from heat and place on cling film. Cool the composition and put it on the lower abdomen. Keep it this way for two hours.

Talk to your doctor before using these medicines to treat endometriosis.

Acupuncture

Acupuncture for endometriosis is a controversial method of alternative medicine, the principle of which is to install needles on acupuncture points - projections of internal organs. It is believed that this method speeds up the cure, increases the likelihood of getting pregnant, etc. It activates the blood supply to the pelvic organs, which is not very good for such a diagnosis. On the other hand, it relieves blood stasis, which can also cause this disease. It is also possible to normalize the work of the ovaries, and as a result, the normalization of hormonal balance.

Alternative treatment should be carried out strictly by a professional. Its purpose and beginning must be agreed with the gynecologist. It is important to remember that such funds can cause significant harm, they are not safe.

Hirudotherapy

Another controversial method of oriental medicine, which is sometimes used for endometriosis of the uterus. Leeches, like needles, are installed on acupuncture points - projections. The principle of operation is approximately the same as that of needles. But the secretion of leeches additionally thins the blood, improves the functioning of blood vessels. As in the case of needles, leeches should be prescribed by a gynecologist, since an unauthorized start of a course can be harmful to health. The procedure for installing leeches should be performed by a specialist.