Symptoms of endometriosis of the uterus in women. What are the complications and consequences of endometriosis? Prevention of intrauterine intervention

is a disease of the female reproductive system of a hormone-dependent type.

This disease is characterized by the growth of the endometrium - the mucous membrane of the uterus - in other parts of the female body.

According to experts, endometriosis of the uterus is a widespread gynecological disease, ranking third in terms of prevalence after uterine fibroids and various inflammations of the female genital organs.

Usually, this disease affects the body of women in reproductive age. The peak incidence of endometriosis occurs after the age of forty, mainly the disease manifests itself in women from 40 to 44 years. Endometriosis is more common in women who have not given birth. However, this disease today also manifests itself in girls who are in adolescence. Another feature of endometriosis is that in women who have had several births, the disease manifests itself less frequently than in nulliparous patients. The disease can also occur in women after a menstrual break.

pathogenesis (what happens)

At in the uterus there is the formation of nodes that resemble the inner lining of the uterus. Such nodes can be located both in the uterus and outside it. This ailment is a benign tumor-like disease and manifests itself in women due to atypical growth and further functioning of endometrial cells (the so-called inner lining of the uterus).

Classification of endometriosis

Specialists classify endometriosis according to the localization of this pathology. Considering this factor, allocate genital endometriosis , , external endometriosis , as well as peritoneal , extragenital and extraperitoneal endometriosis . With internal genital endometriosis, the endometrium grows in the cervix and uterine canal. With extragenital endometriosis, cells of the uterine mucosa grow in the kidneys, bladder, intestines, lungs, and also in scars after operations. With peritoneal extragenital endometriosis, damage occurs ovaries , pelvic peritoneum , fallopian tubes . With the extraperitoneal form of the disease, endometriosis grows in the external genital organs. Allocate "small" and severe forms of the disease. In severe forms, the disease develops if the patient does not undergo appropriate treatment on time. From how much great depth affected areas, there are four stages of the disease: minimum , light , moderate , heavy . The most difficult to cure the last stage of endometriosis.

Causes of endometriosis

To date, experts have made several assumptions regarding the causes of endometriosis. Today there is a so-called theory retrograde menstruation . According to this theory, the blood secreted during menstruation and containing parts of the endometrium quite often ends up in the fallopian tubes and the abdominal cavity. This is the so-called phenomenon of retrograde menstruation. When cells enter these organs, they can be cauterized. After that, the cells of the uterine mucosa begin to function as their purpose requires: they prepare for the implantation of the embryo. If conception does not occur, then the main part of the mucous membrane comes out of the uterus during menstruation. But from other organs, the exit of the endometrium is impossible. Consequently, a small hemorrhage occurs in the organs, causing inflammation. In view of this, women with retrograde periods are in risk group. To find out if retrograde menstruation is taking place, it is enough to undergo an examination and consultation with a gynecologist.

However, endometriosis of the uterus affects not every woman with a similar feature of menstruation. It is generally accepted that the main characteristics that significantly increase the predisposition to this disease are the following. First, it is a certain structure fallopian tubes , which is easy to detect during the examination. Secondly, the presence of a hereditary factor plays an important role. Thirdly, the appearance of endometriosis contributes to dysfunction immune system woman's body.

They started talking about the genetic factor after the research of scientists from Ireland. It has been proven that in women whose close relatives suffer from endometriosis, the likelihood of its manifestation increases five times. In view of this, during examination and consultation, specialists will definitely find out if there have been any cases this disease among the patient's family.

However, other factors mentioned also increase the likelihood of the disease. So, in case of violations in the work of the immune system, which maintains the normal state of tissues in the body, a similar one may occur. If the immune system is normal, then it can have a destructive effect on deviations in the functioning of the body, which include the growth of the endometrium outside the uterine lining. When the immune system fails, other systems also fail. To detect the development of the disease as early as possible will allow regular preventive examinations.

So, as the causes of endometriosis, doctors determine the tendency to a genetic disease, as well as a violation of the hormonal balance in the female body. However, there are also other theories, such as implantation theory . AT this case it is assumed that parts of the endometrium that have been sloughed off in some situations ( , childbirth,) can settle on the ovaries, peritoneum, tubes and provoke the onset of the disease. Also, as provoking factors, doctors determine , malnutrition, a number of diseases general, improper functioning of the glands internal secretion, genital infections.

To date, one of the most common causes endometriosis are surgical interventions ever performed in the uterus. it , , cauterization and other procedures. In view of this, after such operations, it is necessary to undergo examinations with a doctor with a clear regularity.

Symptoms of endometriosis

With endometriosis, a woman usually complains of very painful periods, regular pain in the lower abdomen, fatigue and weakness, headache, and sometimes nausea and vomiting. In this case, the patient often cannot become pregnant.

It is important to consider that the symptoms of endometriosis can be very different. Their manifestations are directly related to individual characteristics the patient's body. Very rarely, this disease is generally asymptomatic, therefore, it can only be diagnosed if you undergo a regular examination by a doctor. However, as a rule, certain symptoms of this disease still occur. Pain is the main symptom of endometriosis. In most patients, pain manifests itself in various forms. Another common symptom of the disease is this. Maximum this symptom manifests itself on the first or third day of menstruation. This symptom is associated with menstrual bleeding in cyst and, accordingly, an increase in pressure in the cyst. Also, dysmenorrhea can occur due to retrograde menstruation and irritation in the peritoneum. It can also manifest itself as a result of active production, causing vasospasm and strong contractions in the uterus. Pain during the days of menstruation is also manifested due to touching nearby organs with an endometrioid focus. In addition to the symptoms described, with endometriosis, discharge of dark Brown color, persisting for several days after menstruation.

A certain number of women complain of pelvic pain that is not related to the menstrual cycle. It occurs due to secondary inflammation in those organs that have been affected by endometriosis. Symptoms of endometriosis can also be painful during intercourse. Most often, a similar symptom occurs in women with affected endometriosis. vagina , rectovaginal septum , recto-uterine space . There are also pains in the lower back, menstruation is irregular, but they are especially plentiful.

Second unpleasant symptom of this disease impossibility of conception. manifests itself in 25-40% of affected women. To date, all the causes of infertility in endometriosis have not been fully elucidated. Obviously, there are changes in the fallopian tubes, ovaries, which provoked endometriosis, and ultimately does not occur. The second reason for the impossibility of conception with this disease is a malfunction of the immune system. Endometriosis can similarly affect the regularity of ovulation, and then pregnancy will not occur due to disturbances in the ovulation process that accompany this disease. Another symptom of endometriosis is menorrhagia . However, this feature disease is less common than the main symptoms.

Diagnosis of endometriosis

In the process of making a diagnosis, an examination and all the necessary procedures under the guidance of a doctor of a certain profile are very important. First of all, when diagnosing, you should undergo an initial examination by a gynecologist. Next, the doctor interviews the patient in detail to find out the nature of the pain, to find out what gynecological diseases she had before, whether the appropriate surgical interventions have ever been given. Also, the specialist should find out information about gynecological diseases of the patient's relatives.

Further, in the process of making a diagnosis, following methods: a gynecological examination is performed using a mirror, an ultrasound examination of the organs in the small pelvis, rectovaginal , rectal examination , colposcopy , laparoscopy , hysteroscopy . It is the last two procedures that are the most commonly used methods for the diagnosis of endometriosis of the uterus. They should only be carried out in clinical setting. Pelvic pain, which lasts for more than six months, is the main indication for the use of laparoscopy and hysteroscopy.

Most patients with this disease have an increase in the uterus, usually moderate. Also, in a certain part of the patients (in about 15-20% of cases), fixed and unfixed bending of the uterus . In the process of diagnosis, in some patients, the presence of nodules in the posterior fornix is ​​determined, provoking the onset of pain. To assess whether there are similar phenomena in the rectovaginal septum, a rectovaginal examination is performed. During a study aimed at examining the fallopian tubes and ovaries, the specialist determines whether these organs are enlarged, whether they are motionless, and whether pain occurs. During colposcopy and hysteroscopy, the specialist receives the material used for the biopsy. It is considered to be an effective addition to endoscopic methods examinations and contribute to the determination of the correct method of therapy.

Treatment of endometriosis

When selecting an adequate method of treatment, the specialist takes into account many factors, including the age of the patient, the presence of pregnancy in the past, the characteristics of the disease on this stage. The doctor should assess how severe the symptoms of endometriosis are, whether this disease is combined with other inflammatory processes, whether it is necessary to work on recovery reproductive function women.

There are currently several effective treatments for endometriosis. So, depending on the above points, experts suggest the use of a conservative medical method for the treatment of endometriosis, as well as surgical methods. During the operation, an organ-preserving method (laparoscopy and laparotomy) can be used, with the help of which only the foci of the disease are removed and the organs are preserved. In some cases, a radical method is shown in which the uterus and ovaries are removed. Used and combination specified methods treatment.

So, conservative therapy is used if the disease is asymptomatic, in the permenopausal period, with infertility , adenomyosis , endometriosis to restore fertility. For this, the patient is assigned a course hormonal , anti-inflammatory , desensitizing and symptomatic funds. However, the main component similar treatment it is considered hormone therapy . It is important to consider that only a long course of drug treatment guarantees the effect of such therapy. During treatment, regular monitoring by the treating specialist is indicated.

Treatment of endometriosis is carried out after a doctor's examination and the appointment of the funds necessary for the course of therapy. However, the treatment of endometriosis can also be used in parallel. folk remedies, after all, many years of experience in treating the disease became the basis for the emergence of a number of similar folk recipes.

The doctors

Medications

Treatment of endometriosis folk remedies

There is an opinion that endometriosis can be effectively treated with clay. For this, it is advisable to use blue or gray clay, because it is these varieties that have more pronounced healing qualities. It is important that the clay is clean, without impurities of sand or earth. Clay needs to be ground in a basin and pour a little water - it should only cover the clay. The basin should be left overnight so that the mixture becomes as soft as possible. In the morning, the liquid that remains above the clay must be drained, and the remaining clay must be kneaded until a homogeneous mass of sour cream consistency is eventually formed. Before that, a little bee venom can be added to the clay.

About half a kilogram of clay should be put in a saucepan and heated. It is advisable to do this in a water bath, because clay can overheat on fire. Transfer the mass to cellophane or oilcloth and make a cake, the thickness of which will be about three centimeters. This cake should be applied to the stomach in the place between the navel and the pubis. On top, you should wrap the body with a warm scarf or blanket and keep a warm cake for about two hours. After this time, the cake should be removed and the stomach washed well. After the session, it is recommended to make several rotational movements in the abdomen in both directions.

Sessions should be repeated every day, the course of treatment is from five to eight procedures. It is important to consider that every day you need to soak a new clay.

Beetroot juice can be used to treat endometriosis during painful periods. Squeezed juice, which must stand for four hours before drinking, should be drunk 50-100 ml twice or thrice a day. At first, you should use a smaller dose, gradually it increases. It should be noted that when taking large doses of juice in the early days, you can get indigestion. If desired, beetroot juice can be mixed with carrot juice.

For resorption endometriotic adhesions some exercises of physiotherapy exercises are recommended, in particular the “fish” exercise. To perform it, lie on your stomach and stretch your arms forward. In turn, you need to raise one or the other leg, alternating this with raising both legs. Ten lifts of each leg and both legs should be performed. Every day you need to do three sets. After a month of such exercises, the woman's well-being improves significantly.

With endometriosis, menstruation becomes especially plentiful, so large blood loss provokes iron deficiency anemia. To prevent it, it is important to adhere to , which involves the use of red meat, fish, pomegranate, buckwheat, rosehip broth. At the same time, coffee consumption should be limited.

The treatment of endometriosis with the help of manual therapy is also practiced. Treatment with leeches affects the woman's body in a complex way, correcting the functioning of all systems. The saliva of leeches has painkiller , anti-inflammatory , immunomodulatory impact.

Treatment of endometriosis with herbs

In addition, there is a practice of treating endometriosis with herbs. The use of herbal medicine helps to restore the hormonal balance in the body, increase immunity, stimulate defensive forces the female body, preventing the development of inflammatory processes, and also normalizes the activity of a number of organs and systems.

There are many herbs that can help relieve endometriosis. In this case, means are often used to restrain bleeding (horsetail, hare cabbage, wormwood, celery, tansy, oregano, yarrow). Women suffering from endometriosis are advised to consume as much variety of greens as possible - parsley, dandelion, spinach, celery, broccoli. In addition, infusions are useful oat straw and barley.

Herbal preparations are used to treat endometriosis. To prepare one of them, you should take one tablespoon of yarrow leaves, mint, chamomile nettle, medicinal beetle, raspberry and elderberry flowers. To the collection you need to add two tablespoons of marshmallow and sage herbs. A mixture of herbs should be poured with two liters of boiling water and the collection should be insisted for two hours. After straining the broth, you need to take it four times a day, one glass half an hour before eating. The rest of the decoction can be used in the process of douching. A similar course of treatment should be continued for two weeks, and after ten days it can be repeated. However, when preparing the collection, it should be taken into account that the bead significantly reduces . Therefore, sick hypotension it should not be added to the collection.

In the treatment of endometriosis with herbs, a decoction of stinging nettle is often used. To do this, two tablespoons of grass should be poured with one glass of boiling water and heated in a water bath for 15 minutes. It is necessary to add another glass of water to the broth and take half a glass of it before meals. The decoction should be drunk three to five times a day.

According to the same scheme, you can prepare a decoction of the mountaineer pepper ( ). However, this decoction should be taken one tablespoon three to four times a day. If the decoction turned out to be bitter and brown, then it is enough to drink it 30-40 drops three times a day.

Use for the treatment of endometriosis and shepherd's purse grass. To prepare the infusion, a tablespoon of chopped herbs should be poured with one glass of boiling water. Dishes with infusion should be wrapped and wait about one hour. You need to take the infusion one tablespoon before meals 3-4 times a day.

Both shepherd's purse and water pepper have the ability to increase the contractility of the uterus. Therefore, it is advisable to drink these infusions during menstruation. In addition, all of these herbs can be periodically added to food (in salads, soups). This should be done for several months, periodically changing the composition of herbs in order to eliminate the addiction of the body.

There are other recipes for treating endometriosis with herbs. You can take about 50 g of dry cucumber lashes, chop them and pour 0.5 liters of water. The mixture should be boiled for five minutes, after which it is infused for about one more hour. Means drink three times a day for half a glass.

To prepare another decoction, crushed viburnum bark is used, which should be boiled for ten minutes. For a decoction, one tablespoon of bark and one glass of boiling water are taken. The decoction is drunk two tablespoons three times a day.

In addition, the treatment of endometriosis with folk remedies involves not only taking them orally, but also douching. For this purpose, you can use a decoction of star anise root. It is prepared as follows: star anise root should be crushed, take three tablespoons of the mass and pour it into 500 ml of boiling water. Boil star anise for fifteen minutes, over very low heat, filter after twenty minutes. Add the same amount of water to the decoction and use it for douching.

For douching with endometriosis, an infusion of celandine is also used. To do this, pour one tablespoon of celandine herbs with 500 ml of boiling water and heat in a water bath for ten minutes. After straining, add the same amount of water. Similarly, a decoction of crushed oak bark is prepared, but the mixture should be boiled for twenty minutes.

In addition, traditional medicine recommends that women put tampons soaked in medicinal infusions. A tampon is made from a bandage: for this, the bandage is folded into several layers, rolled into a bag and tied, leaving a convenient tail for extraction.

Tampons with eucalyptus and calendula are considered an effective method. To do this, you need to prepare an oil extract of these medicinal plants. 100g of eucalyptus leaves need to be mashed and pour 200ml of warmed olive oil. Twenty more calendula flowers should be dipped into this solution. The container must be closed very tightly and put in heat for 20 days.

Another effective method of treating endometriosis is therapeutic baths. Twice a week it is recommended to take a bath with an infusion of oat straw. To do this, a full liter jar of oat straw is poured with five liters of boiling water and insisted for two hours. The infusion must be filtered and poured into a bath, which must be taken for half an hour.

Prevention of endometriosis

For the prevention of endometriosis, it is necessary to without fail undergo regular preventive examinations by a gynecologist. Particular attention should be paid to this rule for women and girls suffering from too strong menstrual pain which may be a symptom of endometriosis. It is important to undergo preventive examinations after an abortion or other surgical intervention in the uterus. To prevent the occurrence of endometriosis, all diseases should be treated promptly. inflammatory diseases genital organs, including chronic ones. Tests aimed at determining the level of hormones that directly affect the work of both the immune system and other systems in the body will also help prevent the disease.

Since the disease significantly affects the quality of life of a woman, all points should be taken into account to help prevent its occurrence. First of all, those women whose female relatives had endometriosis should be especially vigilant. Obesity should not be allowed: healthy eating and regular exercise reduces the risk of this disease. Regular stressful situations should be avoided, alcohol and coffee should not be abused, abortions should not be allowed, as a result of which endometriosis often develops. In addition, both folk and traditional medicine indicate that the most effective means of preventing endometriosis is and childbirth.

Women who experience contraction monthly cycle, metabolic failure and, accordingly, sharp set weight, should Special attention turn to preventive measures. Also, examinations and consultations with a doctor should be regularly carried out by those women who use intrauterine contraceptives, those who are already thirty years old, and also regularly smokers.

Endometriosis is an inflammatory process in which cells of the epithelial layer lining the inner surface of the uterus grow outside the organ. Doctors consider the main cause of pathology hormonal disorders. In most women, endometriosis develops as a result of a lack or, conversely, an increased synthesis of estrogen, the main female hormone that regulates the activity of the reproductive system, reproductive organs and is responsible for the appearance of skin, nails and hair.

To determine which hormone caused pathological changes epithelium, diagnostic curettage is performed. The resulting material is sent for histological examination, according to the results of which the woman is prescribed treatment. It is necessary to start therapy for this disease as early as possible, since a complication of chronic endometriosis can be various gynecological diseases, breakthrough uterine bleeding and infertility. To do this, it is important to know the symptoms and signs of pathology.

Endometriosis has no pronounced clinical symptoms, therefore, to diagnose the disease without special survey impossible. Even an examination on a chair with a gynecological speculum does not always allow you to determine the pathological growth of endometrial cells, so the symptoms of the disease must be treated very carefully. It is important to tell your doctor about all the existing disorders, because endometriosis is characterized by a combination of four signs that appear in almost every woman with endometriosis.

Infertility

The diagnosis of "infertility" is made if pregnancy does not occur after a year of regular intercourse without the use of contraceptive methods. The main reason for the lack of pregnancy in endometriosis is the anatomical changes in the endometrium, in which it becomes impossible to attach and maintain a fertilized egg. Hormonal disruptions that cause pathological growth and changes in the structure of the endometrium affect the synthesis of hormones necessary for the development of pregnancy.

If the cells of the epithelial layer go beyond the organ (into the ovaries, cervix, fallopian tubes, etc.), adhesions can form in the space of the fallopian tubes - compacted areas connective tissue that connect two or more organs. The adhesive process causes obstruction of the fallopian tube - one of the causes of infertility in internal endometriosis.

Note! Chronic endometriosis negatively affects the state of the immune system and inhibits its activity. Even if pregnancy occurs, the probability of its termination or fetal fading will be very high - more than 65%.

Pain syndrome

Pain associated with endometriosis can be different character, intensity and localization. Acute pain, usually cutting or stabbing, is localized in the lower abdomen. chronic pain can be dull, pulling. Their intensity is usually moderate, so most women do not pay attention to them, taking this symptom for manifestations of premenstrual syndrome or the result of increased stress.

Chronic pain in endometriosis can be aggravated by the following factors:

• intimacy;
• menstrual flow;
• weight lifting.

Important! Pain sensations when chronic endometriosis easily stopped by painkillers, so many ignore this symptom. The hallmark is a constant, chronic course, that is, the symptom weakens or disappears while the drug is in effect, after which the soreness returns.

Bleeding

In almost all cases of endometriosis, regardless of its location, a woman is concerned about contact spotting that appears after sexual intimacy. If the lesion has affected the organs of the genitourinary system or the intestines, drops of blood or blood streaks may be found in the urine or feces.

Not abundant bleeding with a pronounced pain syndrome is noted a few days before the onset of menstruation (about 4-5 days). Blood smearing usually lasts 1-3 days, after which it disappears, and after 24-48 hours the woman begins menstruation.

Menstruation may be accompanied by education blood clots dark scarlet or brown. Their size can reach several centimeters, and their appearance is somewhat reminiscent of a raw liver. By themselves, clots are not a symptom of endometriosis, as they can also occur with other pathologies (for example, endometrial hyperplasia), but in combination with other signs, pathological growth of epithelial cells can almost certainly be suspected.

Irregular menstrual cycle

Women with this disease always have menstrual irregularities. These include:

• constant cycle fluctuations;
• lack of menstruation for several months in a row;
• plentiful and prolonged menstruation(menorrhagia).

In case of any cycle failures, women should immediately consult a doctor, since in the absence timely treatment risk serious consequences and complications will be very high. Untreated endometriosis can lead to benign tumors, infertility, inflammatory processes.

Signs and symptoms of different types of endometriosis

The role of the psychological factor in diagnosis

Almost 80% of women with chronic forms of endometriosis have psychological problems. They are prone to depressive disorders, psychosis, they are disturbed emotional condition, there is a tendency to sudden mood swings. Some women may completely lose interest in the events taking place around. They stop looking after their appearance, reduce communication with friends and loved ones, avoid appearance in public places.

A distinctive symptom of pathology (subject to the presence of other clinical manifestations) is anxiety, unreasonable fear. In particular severe cases panic attacks may occur.

Important! Some women start taking drugs sedative effect to cope with emerging psychological problems. It is important to understand that such treatment will give a short-term result, since the cause of the pathology will not go anywhere.

How does the disease manifest itself in older women?

Some people mistakenly believe that endometriosis is a disease of women. reproductive age. Pathological growth of the endometrium beyond the epithelial layer can occur at any age, and in women over 45 years of age, the risk of developing the disease is several times higher, since progesterone production is blocked after menopause. Other factors that are often found in older women can also contribute to the occurrence of pathology. These include:

• excess body weight;
• diabetes;
• disorders in the thyroid gland;
• a large number of infectious diseases in history;
• transferred operations (regardless of the localization of the pathological process).

Elderly women with endometriosis often experience headaches, dizziness, and bouts of nausea. In severe cases, single vomiting is possible. The pain syndrome is usually mild or moderate in intensity, exacerbations are rare. Psychological condition women also differ from normal indicators: irritability, aggression towards others, tearfulness appear.

Important! A hallmark of the disease during menopause are spotting. They can be mild (blood smearing) or voluminous - in this case we are talking about bleeding. This clinical picture is typical for endometriosis of the uterus.

Endometriosis of the ovaries: signs

The result of endometriosis is the appearance of cystic formations. The main symptom in this pathology will be pain syndrome, which is most often permanent and intensifies after intense exercise or intimacy. Menstruation with endometriosis of the ovaries is painful, the use of drugs often does not bring significant relief.

You can distinguish ovarian endometriosis from other forms of the disease by the characteristic shooting pain in the perineum, rectum and lumbar region. There is a pain syndrome at any time of the day and does not depend on the physical activity of the woman. At night, when the muscles and ligaments are relaxed, the pain may be more intense.

Endometriosis of the cervix: the clinical picture of the disease

The defeat of the cervical part of the uterine body is the only form of endometriosis in which there is practically no pain (in rare cases, the pain can be slightly pronounced). This is due to the fact that there are no nerve endings and pain receptors on the neck. Pathology can be suspected by uncharacteristic spotting in the second half of the menstrual cycle. Blood smearing can also be observed before the onset of menstruation - it usually lasts 2-3 days and does not cause discomfort as opposed to internal endometriosis.

Symptoms of internal endometriosis

On ultrasound, the doctor detects nodular formations on the surface of the uterus, which indicate the development of pathology. During palpation of the uterus, severe pain appears. In the period between menstruation, the pain is localized mainly in the lower abdomen, has an acute character. The intensity of sensations intensifies during sexual contact and lifting heavy objects. If during this period to examine the blood of a woman, you can notice signs of anemia, which are associated with constant bleeding.

Symptoms of the disease after caesarean section

Delivery by caesarean section is considered a simple operation (in terms of technique), but it is important that it is performed by a qualified surgeon. It is also worth checking with the doctor what kind of material will be used for suturing, as some types of surgical threads can cause itching, discomfort in the suture area and increase the risk of gynecological pathologies.

Growth of epithelial cells in the suture area and postoperative scar occurs in 20% of cases. Pathological changes in the body of a woman after a cesarean section can be suspected by the following symptoms:

• poor healing of the scar surface;
• release of brown liquid from the seam;
• severe itching in the area of ​​suturing;
• palpation of nodules under the seams;
• strong nagging pain in the lower abdomen.

If these signs are found, a woman is advised to contact the antenatal clinic to the doctor who conducted the pregnancy. In some cases, hospitalization may be required to exclude suppuration and inflammation of the sutures, so pathological symptoms should not be ignored.

Diagnosis of the disease

Endometriosis refers to diseases that are difficult to diagnose due to a blurred clinical picture, since the pathology has signs and symptoms that are characteristic of most gynecological diseases. Even during the examination, it is not always possible to determine the presence of pathology. The doctor will be able to suspect endometriosis during palpation of the vagina and rectum if nodules or cysts are found.

As a rule, one examination and palpation is not enough to diagnose the disease, so the doctor will definitely prescribe additional procedures, for example, ultrasound of the pelvic organs. The examination can be performed abdominally (through the skin of the abdomen) or using a vaginal ultrasound probe that is inserted into the vagina. Ultrasound is not 100% informative method diagnosis of endometriosis, but with the help of this survey cystic cavities can be detected.

If in doubt, the woman will undergo a laparoscopy. This operation is performed under local anesthesia or general anesthesia and can be used not only for the purpose of diagnosis, but also for the treatment of pathology. Laparoscopy rarely causes complications, but to prevent the consequences, it is important to observe sexual rest after the procedure (at least 2-4 weeks).

Endometriosis is not a dangerous pathology, but it can have a very negative impact on a woman's reproductive health, so the disease should be treated as early as possible. Symptoms and signs of endometriosis cannot be called specific, therefore, it is necessary to consult a doctor in case of any deterioration. women's health. The totality of the triad of clinical manifestations - pelvic pain, menstrual irregularities, infertility - almost always indicates endometrial pathology, therefore, with an early visit to the doctor, the disease can be completely cured.

Video - Endometriosis: causes, symptoms, treatment

Endometriosis is a disease from the field of gynecology. A woman who has known all the charms of this disease will remember with tears those days of pain and torment that accompanied her throughout the course of the disease.

Previously, and more precisely until the 70s of the last century, endometriosis was literally treated with birth control pills. After the end of the course of treatment, every second patient became pregnant immediately after the first sexual intercourse.

Girls are probably aware of all the processes that occur during menstruation. The endometrium (the inner lining of the uterus) peels off and drains outward along with the blood. But sometimes there are cases when pieces of this same endometrium do not come out, but stick to the walls of the uterus and bring great inconvenience to their mistress. Among such inconveniences, gynecologists especially highlight severe pain in the pelvic area, as a result of which infertility may occur up to ovarian cancer or cervical cancer.

After the endometrial tissue adheres to the walls of the uterus, it begins to bleed and swell. The exit of blood to the outside is difficult, the accumulating blood accumulates, thickens and strongly presses on the nerve endings. A woman with endometriosis experiences severe pain and is at risk of getting adhesions between the endometrium and the uterus.

In old textbooks, you can find statements that endometriosis is a disease exclusively inherent in women of mature age from 30 to 50 years. Today, the disease occurs not only in the above persons, but also in young girls of 20 years old. In addition, the frequency of diagnosing this disease has increased significantly. If earlier endometriosis was a relatively rare occurrence, now, for example, ovarian endometriosis is diagnosed in every third woman. Surveys among women suffering from infertility have shown that 5 out of 100 diagnosed with infertility also have endometriosis of the rectum, ovary, bladder and other locations of this disease. In European practice, endometriosis of the cervix is ​​the least common.

The situation is worsened by special substances prostaglandins. They have a serious impact on the course of the disease and cause severe pain. In a small amount, they are always present in the organisms of both sexes. Prostaglandin is released at sites where inflammatory processes. The action of prostaglandins in our case leads to more intense contractions of the smooth muscles of the fallopian tubes and uterus. Normally, prostaglandin is always released into the walls of the uterus, causing them to contract evenly. The disadvantage of this substance is that it begins to stand out in huge quantities and in different places just when it is not desirable - in the case of endometriosis of the cervix. The increased level of prostaglandins and the scattered position of the foci of activity of the uterine walls cause severe pain, causing the cervix to contract more frequently, thereby increasing the interaction of the uterine walls with pieces of endometriotic tissue that begin to solder. In particular, prostaglandin has a wide range of uses in obstetrics - it is administered to women in childbirth, in whom childbirth is difficult and additional stimulation of the uterine muscles is required.

Symptoms of endometriosis

Among special symptoms, manifested during the course of the disease, can be distinguished:

• Irritability.
• Unbalance.
• Tearfulness.
• Frequent dizziness and headaches.
• Beginning signs of infertility (problems with fertilization).
• Severe pain during bowel movements (in case of germination of endometrial tissue into the rectum).
• Quite intense menstrual flow.
• Severe pain before and after menstruation.
• Cases of bleeding in the uterus before and after the onset of menstruation.

Treatment of endometriosis in general depends only on the stage of development of the disease. If the disease still touched the girl, then she would not know about it right away. The first symptoms will begin to appear only after a while. Detect endometriosis on the most early stage possible only by accidental diagnosis. But in most cases, sick girls already have adhesions of the endometrium with the uterus.

It is impossible to self-diagnose endometriosis at home. It is possible only in rare cases to guess about the disease only by special thick brown or dark red discharge before the onset of menstruation or during coitus.

But even if a girl has discovered the presence of the above symptoms, this is not a reason to make a diagnosis on her own. There are no specific methods for diagnosing an illness at home. Even in clinics, this is difficult. Only after examination by a gynecologist can one say about the presence of the disease. No one can determine the presence of the disease online or in gynecological forums.

Most hallmark The fact that a woman began to develop endometriosis can be caused by severe pain in the lower abdomen, in the scientific world called dysmenorrhea. Almost every second woman during the development of the disease is subject to such pain. A few days before the start of a new menstrual cycle, a woman may feel mild pain. The pain reaches its highest point only three days after the start of the menstrual cycle.

Pain can also occur during sexual intercourse with your partner. The cause of such severe pain in this case is the development of a cyst on the rectovaginal septum. Dyspareunia (that's how pain during intercourse sounds scientifically) is often the cause of rectal uterine space and damage to the sacro-uterine ligaments.

Infertility ranks second in trouble after pain. Approximately 40% of women diagnosed with endometriosis experience the depressing effect of not being able to have a child. Infertility in this case does not have precisely justified scientific point view of causes. The most popular theory is that the cervical canal is clogged with endometrial tissue and adhesions. Other theories talk about clogging of the fallopian tubes, which carry eggs from the ovaries to the uterus. This confirms the theory of endometriotic anovulation (disturbance of the ovulation process).

An equally popular theory of endometriosis is the assertion of a direct relationship heavy menstruation(menorrhagia) with hormonal processes in the uterus. To date, it is known that menorrhagia and endometriosis were diagnosed in only 15% of girls. In addition, often, in addition to menorrhagia itself, uterine myoma was also found in the body of a woman.

The absence of children and the discovery of signs of illness in oneself are serious reasons for going to the gynecologist. With endometriosis, you can not hesitate, delay can cost a lot.

Types of endometriosis

Gynecology textbooks list two different types of endometriosis:

• Genital, stationed only in the area of ​​\u200b\u200bthe uterus - its neck or canal. At the same time, genital endometriosis is divided into:

1. Internal genital endometriosis, mainly affecting only the inner parts of the uterus and often leading to fibroids.
2. External genital endometriosis affecting organs outside the uterus too (cervix, vagina, peritoneum, perineum, ovaries and fallopian tubes).

• Extragenital, which affects other organs adjacent to the uterus.

Stages of development of endometriosis

In gynecology, there are four stages in the development of this disease:

I. Small foci of adhering endometrium to the uterus.

II. One or more foci that have penetrated deep into the wall of the uterus.

III. A large number of foci that have penetrated deeply through the wall of the uterus. Relatively small cysts appear on one or both ovaries, adhesions in the abdominal cavity.

IV. There are a lot of deep foci, a cyst appears on both ovaries, adhesions appear between entire organs.

It is worth noting that the establishment of the stage occurs in conjunction with an examination by a gynecologist and an ultrasound check. Ultrasound in this case can only confirm the fears of the gynecologist and help him in establishing the diagnosis.

Reasons for the development of endometriosis

In fact, the cause of the disease is not clear until now. There are only theories of individual gynecologists, which all have the right to put into practice. So, some theories say that the cause of the disease are special viruses or errors in the genetic code. But many experts agree that endometriosis is caused by disorders in hormonal balance, in particular, in too high levels of the female hormone estrogen. Also, gynecologists have created a list of factors that can significantly increase the likelihood of endometriosis:

• uterine fibroids
• Difficult delivery
• abortion
• Anemia
• Inflammation of the genital organs
• Smoking
• addiction to alcohol
• Excessive consumption of caffeinated foods
• Violations in the functioning of the thyroid gland, hypothalamus, adrenal glands, pituitary gland, gonads of a woman
• Decreased immunity level
• Diabetes
• Hypertension
• Excess weight.
• iron deficiency in the body
• Intrauterine device
• Caesarean section, cervical erosion

Diagnostics

The diagnosis of endometriosis can only be made by a gynecologist. When diagnosing, he can use methods such as a verbal survey about the possible genetic predisposition of endometriosis, relatives transferred earlier serious illnesses, recent operations, and diagnosis by examining the uterus directly.

The gynecologist's tools may include a mirror, an ultrasound machine, and so on. The doctor may hesitate in making a diagnosis. In this case, he can apply the methods of vaginal examination, colposcopy, hysteroscopy, laparoscopy and rectovaginal examination.

An external sign of endometriosis, with which you can determine the presence of the disease visually, is an increase in the uterus. In 70% of the examined patients, at least a slight, but still an increase in the volume of the uterus was established.

Diagnosis of endometriosis is greatly facilitated if an ultrasound scan is performed two to three days before the onset of menstruation.

The theory of endometrial metaplasia has also recently emerged. According to scientists, endometrial tissue that has entered the abdominal cavity from the uterus turns into a completely different tissue. This is just a theory, rather a dubious hypothesis, because it is still not clear what tissue the endometrium turns into, and the principle of transformation itself is unclear.

A more likely theory about the occurrence of endometriosis is that the immune system is responsible for disruptions in the menstrual cycle. Scientists have found that under normal conditions, the dormant endometrial tissue will not be able to linger for a long time either on the walls of the uterus or anywhere else.

Relationship between endometriosis and pregnancy

The period of pregnancy is characterized by a low release of estrogen, which means that the likelihood of getting endometriosis is very small. But, as practice shows, this still happens sometimes.

Suppose a pregnant woman came to the gynecologist, and he diagnosed her with endometriosis. The woman is in a panic. Indeed, there may be huge problems, but we must set ourselves a single task - to bear fruit. There is a huge risk of miscarriage if the pregnancy started a couple of months ago. This threat can be made a little less if the doctor prescribes special hormones. The main thing is to wait for the moment of formation of the placenta, which is not affected by endometriosis and produces its own hormones. The placenta can significantly reduce the chances of a miscarriage.

However, after childbirth, when the placenta disappears and hormones cease to be released, endometriosis can again make its unexpected visit and continue to progress.

Treatment of endometriosis

The list of medicines should be compiled only by a gynecologist. The treatment plan for endometriosis depends on many factors. Most often, factors such as previous pregnancies, the age of the woman, the severity of the course, the localization and spread of the disease, the relative severity of individual symptoms endometriosis, fertility and infertility. Each case must be approached individually. Some criteria by which the type of drugs and their dose are determined are:

• Type of disease
• Desire to get pregnant
• Hormonal level
• The presence of adhesions

Conservative treatment, most often provided if the symptoms are mild, includes desensitizing, anti-inflammatory, symptomatic and hormonal therapy. Hormone therapy in this case acts as the main treatment for the symptoms and causes of endometriosis. Of the hormonal drugs, estrogen-progestin drugs stand out, in particular, two- and three-phase contraceptives (“pure progestogens”). The action of hormonal drugs based on estrogen-gestagen can be described as follows: the drug, penetrating into the organ that secretes the hormones of the menstrual cycle, blocks it, and thus menstruation stops and the further spread of the disease stops. However, it is worth noting that the drug will begin to have a full effect only after a long time. In addition, during the course of treatment, constant monitoring by the attending physician is necessary, since the side effects of estrogen-gestagenic drugs have not yet been fully studied.

Today, developments in the field of immunology and the associated “incomplete detachment of the endometrium” have become popular. As already mentioned, one of the reasons for the development of endometriosis may be a weak response of the body to certain infections that provoke disturbances in the hormonal balance of a woman's body.

If a woman has been diagnosed with endometriosis by a gynecologist, treatment will likely include medications containing hormones, antiandrogens, and uterine remedies. In rare cases, the doctor will insist on surgery or radiation therapy. Full course treatment can reach 4-5 months.

If adhesions have not yet formed, the doctor will prescribe courses of hormone therapy, which after a while will restore the menstrual cycle and stimulate the growth of new eggs. Among medicines, which have a big move in such cases, we can distinguish "Janine". It can significantly slow down and even stop the development of endometriosis and prevent the development of pregnancy (for those who do not need a child yet). But there are no absolute guarantees when taking Zhanin. If the symptoms of endometriosis still continue to bother, then the medicine is not suitable, and you need to look for other ways to solve the problem.

If adhesions nevertheless began to appear, the doctor prescribes a special resolving therapy, the duration of which is about two and a half months.

Already after a few weeks after intensive therapy, the probability of a successful pregnancy from the first time is very high. Girls should know this.

If the spikes do not disappear, then they resort to at least for laparoscopic surgery. A small incision is made in the groin area and adhesions are removed with a laparoscope. After a successful operation, special drugs are injected into the woman's body and appropriate procedures are carried out that temporarily stop menstruation. After laparoscopy, the disease raises a white flag in almost all cases. In the next six months, two stripes should appear on the pregnancy test. If not, then IVF (artificial insemination) is done.

If it is impossible at the moment to come to the doctor's office, use anti-inflammatory drugs. nonsteroidal drugs such as nurofen, ketanol, ketanal. They reduce the amount of prostaglandin and, accordingly, make the pain much weaker. Almost all antiprostaglandins effectively fight pain. Among the most effective antiprostaglandins, medipren and nuprin should be distinguished.

The following is a list of the most commonly prescribed medications for endometriosis:

1. Antiprogestins. Danazol, an antiprogestin, has a strong effect on the production of gonadotropins and the female hormones estrogen. While taking danazol, amenorrhea, or the complete absence of menstruation, is observed. The drug is strong, but has one big drawback - the woman becomes masculine. About 90% of women who used antiprogestins and its derivatives suffered from such hormonal and endocrine disorders as a decrease in the size of the mammary glands, elevated level hairline on the face (hirsutism), depression, edema, intense weight gain. In this regard, there is a heated debate in the scientific world about whether the game is worth the candle. Indeed, by correcting the hormonal situation in one area, antiprogestins upset the balance in another.
2. Gestrinone. Pretty too effective remedy, which is contraindicated in pregnancy and does not imply conception after the end of use for 3 months. Also contraindicated in lactation, diseases of the kidneys, liver, and heart failure.
3. Duphaston. Dufaston refers to drugs that change the hormonal balance, so you should be extremely careful in dosages. In fact, duphaston is a direct analogue of natural female progesterone, which ensures the normal flow physiological processes among women.

If the pains have stopped, and with the help of ultrasound it has been found out that endometrial growths are no longer observed, then we can confidently state victory over the disease.

Alternative treatments for endometriosis

In fact, folk remedies will not be able to cure endometriosis in any way. In most cases, treatment with folk remedies is only palliative and only relieves symptoms such as pain and discomfort. The attending physician, along with conventional drugs can also prescribe folk remedies.

The wisdom of the ages recommends using decoctions and tinctures of viburnum, barberry, St. John's wort for endometriosis. The most widespread was the upland uterus. Boron uterus treats endometriosis well, but in some cases it can cause side effects.

In addition, past generations have left us recipes for other folk remedies:

1. One tablespoon of viburnum flowers is poured into a glass of water and boiled for about ten minutes. Strain the resulting broth and consume three tablespoons three times a day.
2. One tablespoon of St. John's wort is taken. The decoction is prepared according to the same method as the recipe above. Only the dose has changed - instead of 3 tablespoons, you need to drink a quarter cup of strained broth from St. John's wort three times a day.
3. Grind the barberry root in the amount of two tablespoons and insist in half a liter of boiling water. The resulting broth should be drunk during the day.
4. The upland uterus is a strong herb, so it is measured in the amount of one tablespoon and poured with a glass of boiling water. Then the mixture is boiled for ten minutes on low heat and insisted in for three hours. Strain the broth and drink one tablespoon four times a day.

The above methods are useful during pregnancy and will not harmful effects to the fruit. However, this may seem difficult, and therefore, non-pregnant girls are prescribed "Upland uterus". It treats all the consequences of endometriosis: cysts, adhesions and so on.

Prevention of endometriosis

In the vast majority of cases, endometriosis is diagnosed by chance during preventive examinations or when the patient complains of problems with conceiving a child.

There are a few simple rules, which allow you to avoid the appearance of this disease:

• Be less nervous. Nerves cause many diseases, endometriosis is no exception.
• Stop using tampons or limit their use. As much as tampon advocates complain about the failure of arguments against the use of tampons, they remain a reason why endometriosis can manifest itself.
• Walk more. Walking fills the lungs fresh air and solve problems with nerves and stress.
• Sleep in the allotted age category time. Adults usually get 7-9 hours of sleep. During pregnancy lower bound can be raised a little.
• Don't do heavy physical activity. This is especially true during periods of menstruation.
• Exclude any sexual intercourse with a partner during menstruation.
• Enjoy life and be more active. Although this rule applies to all aspects of life, but in this case, such behavior can be quite useful in terms of prevention.

The danger of tampons lies in their obstruction of the free flow of the endometrium and blood to the outside. The endometrium, along with blood, returns to the uterus, and through the fallopian tubes penetrates to the ovaries and other organs. In general, tampons increase the chances of getting sick.

Fresh clean air and good sleep feed the brain with the oxygen it needs so much, in turn, providing the brain with enough conditions for the production of hormones.

Everyone knows that professional female bodybuilders acquire masculine facial features, voices, their breasts decrease (in the female sense). The whole reason is an increase in the number of male hormones and a decrease in female ones. You can use this fact in the prevention of endometriosis. By reducing the amount of estrogen, the risk of disease is reduced.

A run would be helpful. Only here you will need mathematical and computational skills. The number of heart beats per minute should be close to a certain mark, so as not to overload. To do this, subtract the number of age in years from 180. 5 minutes of running should not cause the heart rate to exceed 120 beats, and after 10 minutes - 100 beats.

Also, gynecologists and endocrinologists have developed special exercises that can help avoid or reduce the symptoms of endometriosis:

1. Normal walking in place. Continue for 2 minutes.
2. Walking in a half squat and cross step.
3. Sit on something hard and bring your legs together and apart several times.
4. Squats. Squat about 20 times.

Exercises that involve the vestibular apparatus or you need to throw your head back help very well.

In the prevention of endometriosis, various diets are often used. Almost everyone recommends including seafood in your diet. Indeed, they are natural antiprostaglandins. Seeds, nuts, cereals are also useful. As for coffee, it is not advisable to use it. Caffeine addiction in itself is not pleasant, and in the case of endometriosis, caffeine can increase uterine pain.

By using special analyzes in the laboratory, you can get a detailed picture of the work of the endocrine system and hormonal balance. So, checking for estrogen levels can increase the chances early diagnosis endometriosis

In addition to your own prevention, you can also take up the prevention of your daughters. To do this, they should be taken to a gynecologist for an examination from about the beginning of their first menstrual cycle. Such precautions almost completely exclude cases of advanced endometriosis.

Conclusion

He wants to save one thing: you don’t need to turn to forum girlfriends for advice if the symptoms described above were found. In any case, you need the help of a qualified gynecologist. On average, preventive examinations by a gynecologist should take place twice a year.

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, when known 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 (abortions, C-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 skin and mucous
• 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 prevent development undesirable consequences 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 cysts attached to 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 the timely and correct diagnosis. To determine the presence of endometrioid foci, you can use:

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

However, complaints are of great importance clinical symptoms listed above. 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) 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, undiagnosed endometriosis and the absence of adequate treatment may 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.

How before a woman diagnosed, the more likely using only medications.

Conservative therapy

Conservative treatment is indicated for asymptomatic endometriosis of the uterus, in young age, in the permenopausal period, with adenomyosis, endometriosis and infertility, when it is necessary to restore the 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 general condition the patient, taking into account the tolerability of drugs and indicators of tests of functional diagnostics.

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 endometriosis is treated by removing the uterus.

The results of treatment depend on the volume surgical intervention, from the usefulness of hormone therapy. The rehabilitation period in most cases passes favorably: childbearing function significantly reduced pain during menstruation. 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 good effect, but the problem of this method of treatment lies in 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.

The female reproductive system is very complex, and sometimes it is even too easy to disable it, but it can be much more difficult to restore it. One of the most common diseases in women today is endometriosis. It occurs, perhaps, even too often.

Unfortunately, it is difficult to give more accurate information, since the disease is often asymptomatic. Previously, this disease occurred mainly in women aged 30-50 years. Unfortunately, today it has become much younger, more and more patients with endometriosis are 20-25 years old.

How the disease progresses

Endometriosis is a serious disease associated with disorders in inner layer uterus - endometrium. With endometriosis, endometrial cells begin to grow outside the uterus. The disease is very dangerous, including because it is quite difficult to diagnose. On the one hand, it is not uncommon that it is asymptomatic, on the other hand, those symptoms that may still appear are characteristic of a number of gynecological diseases. Therefore, it is very important to undergo a complete examination at the first signs of endometriosis.

In this regard, I would like to emphasize the importance of regular preventive examinations by a gynecologist, which, unfortunately, many women neglect.

Types of endometriosis. Adenomyosis

Depending on localization pathological tissue and the degree of damage to endometriosis is divided into several types. Yes, allocate genital endometriosis , that is, affecting the organs of the reproductive system, and extragenital , that is, affecting neighboring organs: bladder, intestines, kidneys, peritoneal walls and so on.

Genital endometriosis is divided into external, developing in the vagina, vaginal-rectal wall, fallopian tubes and ovaries, and internal endometriosis uterus, or adenomyosis.

Let's talk about the last type in more detail. Adenomyosis is, in fact, endometriosis of the body of the uterus. AT normal conditions The endometrium develops cyclically: first it thickens, preparing for the implantation of the egg, then, at the end of the cycle, it is rejected and exits along with menstrual blood. At the same time, the endometrium grows only in the uterine cavity, and its muscular layer is under the reliable protection of a special membrane.

However, in some cases, the growth of the uterine mucosa changes, increases, and also finds weak spots in the protective membrane and grows into the muscular layer of the uterus. As a result, firstly, excess mucous tissues are not completely removed from the uterus, and secondly, muscle tissues are affected. Doctors allocate 4 various stages of this disease: endometriosis of the uterus of 1 or 2 degrees means that the endometrium has grown to about the middle of the myometrium. Grade 3 indicates that there is germination to the serous cover, but grade 4 means that the peritoneum is already affected.

Adenomyosis also differs according to the type of development. Perhaps the most difficult and unpleasant option is diffuse endometriosis uterus. With diffuse adenomyosis, the germination of the endometrium occurs evenly throughout the uterus, layer by layer. Treating this condition is very difficult.

However, more often it occurs focal adenomyosis when only certain parts of the uterus are affected: anterior or back wall. Another variant of endometriosis of the uterine body is nodular. It has a lot in common with focal, however, in this case, the muscle tissue begins to defend itself, to resist the "invasion". As a result, a seal, a small nodule, is formed around the foci of germination. This, in turn, leads to an increase in the size of the uterus. However, in terms of future treatment, there is simply no big difference between the second and third types.

Reasons for the development of the disease

Unfortunately, doctors and scientists still cannot say with certainty what exactly leads to the development of adenomyosis. There are several theories, none of which, in other matters, has been proven.

So, some scientists argue that the cause of the development of endometriosis is retrograde menstruation : a phenomenon in which part of the menstrual blood goes deeper into the uterus, into the fallopian tubes and sometimes into the abdominal cavity. Menstrual blood always contains particles of the endometrium. As a result, these cells can attach themselves to very unusual places for themselves.

Various factors can also lead to the development of uterine endometriosis. procedures and interventions into her cavity. Miscarriages, abortions, curettage, removal of polyps, any operations that can break the integrity of the membrane, including laparoscopy and caesarean section. Of course, after the operation, the membrane recovers quite quickly, but scar tissue appears at the site of damage, which is much less effectively able to resist the germination of the endometrium.

Undoubtedly, the development of the disease is influenced by hormones , so that any failures in this area, disruption of the glands, can also cause endometriosis. According to research results, women are at risk, often facing stressful situations, as well as undergoing constant.

Some scholars note the effect hereditary factor . According to their research, if a case of endometriosis has already been encountered in the family, then the woman's risk of encountering this disease also increases.

At the moment, there is even information that doctors are developing a special DNA text that will allow early detection of a woman's genetic predisposition to endometriosis. This will allow women at genetic risk to focus on preventive measures.

Symptoms and Diagnosis

Diagnosis of endometriosis of the uterus, unfortunately, is extremely complicated by a whole range of reasons. Firstly, in a number of cases, the disease is completely asymptomatic until the moment when serious complications begin. Secondly, most of the symptoms characteristic of endometriosis can signal many other diseases.

To make an accurate diagnosis, it is necessary to conduct a number of studies, including a routine gynecological examination with mirrors, ultrasound, colposcopy and laparoscopy.

Ideally, every woman should know the signs of endometriosis of the body of the uterus in order to be able to consult a doctor in a timely manner. Most of symptoms are somehow related to the menstrual cycle.

So, one of the most striking and common symptoms is painful menstruation. The pain begins to bother women 1-2 days before the onset of menstruation and reaches its greatest strength, as a rule, by the 3rd day of discharge.

The causes of pain during menstruation can be very different. In particular, it can be caused by an excess of prostaglandins, which cause muscle contraction. When the concentration of these substances in the tissues of the uterus is not uniform, pain occurs. Also, pain can be the result of contact of the affected areas of the uterus with other organs and tissues.

Pain can haunt a woman not only during menstruation, but also in the middle of the cycle. The cause may be inflammation that occurs against the background of pathological processes.

A symptom of adenomyosis is a violation of the menstrual cycle. Especially often this symptom occurs in cases where the disease itself is of a hormonal nature. Perhaps a change in the duration of menstruation or, more often, a change in the nature of the discharge. Often, periods become much more abundant.

If the lesion extends to the cervix or vagina, the woman may experience sharp pain during intercourse. Scanty spotting after sex is also possible.

Not infrequently, with adenomyosis, an increase in the size of the uterus and a change in its shape are observed. Of course, on her own, a woman will not be able to determine the size of her uterus. But it is clearly visible on ultrasound.

What is dangerous endometriosis of the uterine body

The consequences of endometriosis of the uterus can be extremely unpleasant and even dangerous. First of all, this disease often leads to infertility. The nature of this phenomenon is not fully understood, however, in 60% of cases, women with endometriosis experience difficulty conceiving and bearing children .

According to some versions, conception is complicated precisely by violations of the uterine mucosa. That is, a fertilized egg simply cannot be fixed. In addition, the overgrown endometrium can block the entrance to the fallopian tubes, which also interferes with conception. Last but not least is the hormonal background. In some cases, endometriosis does not ovulate at all.

The formation of nodules on the body of the uterus is fraught with a change in its shape. In some cases, a fixed bend of the uterus is formed. And it also prevents conception.

Fortunately, in most cases, infertility can be cured after the disease itself is eliminated. Although sometimes, when the uterine lesion reaches a critical point, and other methods of treatment do not help, the woman's uterus is removed.

If pregnancy does occur, then it will be extremely difficult to maintain it. miscarriage on early term in women with adenomyosis, it occurs many times more often than in healthy women. This means that a woman with endometriosis throughout her pregnancy will have to carefully monitor herself, avoid physical and emotional stress.

However, infertility is not the only danger of adenomyosis. Heavy periods can cause another serious disorder - anemia . Together with blood, a woman loses iron each time. However, during normal menstruation, no more than 80 ml of blood is lost; with adenomyosis, this amount can increase several times. At the same time, the supply of iron from the outside remains the same.

But iron is responsible in our body, primarily for the transfer of oxygen from the lungs to other organs. As a result of a lack of hemoglobin, less oxygen enters the organs, begins oxygen starvation. The woman begins to feel weakness, fatigue, constant malaise.

In some cases, endometriosis can cause development of uterine fibroids . It is connected with defense mechanisms. In more dangerous option development of events, we can talk about the degeneration of pathological endometrial cells into cancer cells. In this case, the removal of the uterus is likely to be avoided.

Treatment and prevention

From the foregoing, it becomes clear how important timely and qualified treatment of uterine endometriosis is. If you suspect that you have adenomyosis for any reason, do not delay a visit to the doctor.

There are three enough effective methods cures: conservative (medication), organ-preserving surgery in combination with medication and radical surgery. Which method is chosen in which case depends on the specific situation.

Before prescribing treatment, the doctor must conduct all necessary research. Only on their basis, depending on the degree of damage to the organ, the form of the disease, the age and general physical condition of the woman, and also taking into account her plans for the future, in particular with regard to childbearing.

As a rule, doctors try to get by with conservative methods. Medicines remove menstruation from a woman for up to six months. During this time, excess overgrown endometriosis tissue is excreted from the body. And the growth of the endometrium stops. Muscle during this time is also cleared.

Naturally, the treatment is carried out with the help of hormonal agents. As a rule, these are 2 or 3 phase contraceptives. Many women worry about the need for long-term use hormonal pills. In this regard, the development of more efficient and safe means. Now it is very important that, firstly, the doctor who treats you is aware of all latest developments. Secondly, it is necessary that throughout the course of taking the drugs your condition is constantly monitored.

If conservative methods do not help or the degree of damage is too high, a cleaning of the uterus may be prescribed. Of course, curettage can only be discussed in the case of focal or nodular adenomyosis. In the case of diffuse lesions of the uterus, the area of ​​​​the lesion is too large to make sense of scraping it. In such a situation, one has to rely only on drug treatment of endometriosis.

In addition to surgery, in this case, the use of hormonal drugs is also expected. In some cases, medications are prescribed in the preoperative period. This allows you to prepare the body for a stressful situation, as well as restore reproductive functions.

AT exceptional cases when neither the first nor the second methods help, surgery may be required to remove the uterus. Doctors do their best to avoid this, and not only out of a desire to preserve the ability to bear children, but also because the whole life of a woman directly depends on the hormonal background, and the removal of the uterus and ovaries greatly changes it, and therefore changes the life of a woman.

Unfortunately, it is rather difficult to talk about the full prevention of this disease, because the causes of the appearance of endometriosis are still a mystery in most cases. However, something can still be done.

First, try to avoid stressful situations. And in any case, excessive loads do not have a positive effect on a woman's health. Secondly, try to take care of your health. Abortions, curettage, miscarriages and, of course, various inflammatory processes and diseases lead to damage to the protective membrane, and scars at the sites of damage can later become those weak points through which endometriosis “breaks through”.

Perhaps this is all that can be done in terms of preventing endometriosis. The rest of the measures relate to ways of early detection of this disease. In no case should you neglect regular preventive examinations by a gynecologist. This will help to track unwanted processes in time and stop them in time.

Folk methods of treatment

Let's return to the issue of women's fears regarding hormonal drugs. Unfortunately, many patients reject doctors' prescriptions and try to get by with folk remedies in the treatment of endometriosis of the uterine body.

It can be various homeopathy, and some kind of semi-magical rituals, and various diets. Of course, some of these remedies, such as beetroot juice or properly selected homeopathic preparations, may lead to general health improvement body and, perhaps, even remove the external symptoms of endometriosis, but this does not mean a cure.

Adenomyosis will again go into an asymptomatic stage, the woman will decide that she is completely cured and will forget about her illness. The same will continue to progress. cure later advanced disease will be much more difficult.

So it is better not to get carried away with folk methods of treating endometriosis of the body of the uterus. It is best to just discuss the details of treatment with your doctor, find out what are possible side effects when you can wait for the result, and whether it is possible to pick up other drugs. This will help you understand the mechanism of the drug and understand how necessary it is at all.

Endometriosis of the uterine body is a serious and dangerous disease that needs to be treated promptly. Monitor your well-being, condition and do not forget to visit a antenatal clinic every six months. Otherwise, the disease can lead to infertility and removal of the uterus. And this is the hardest blow for any woman.

Of course, modern medicine allows you to cope even with fairly severe forms of the disease, but this is not a reason to let everything take its course.

Informative video: a specialist talks about the methods of treating endometriosis

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