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10 Common questions about endometriosis

10 Common questions about endometriosis

The disease is recurrent among women because in addition to causing pain during intercourse, bowel changes during menstruation - such as diarrhea or pain to evacuate - is also associated with difficulties in getting pregnant after one year of unsuccessful attempts. Because menstrual cramps are common occurrences in a woman's life, it is recommended that research on the causes of pain should be done when women are reluctant to get better with medication or when they are unable to function normally. Because severe colic is the main symptom of endometriosis and leads to the suspicion that the disease is installed. Check out the most common questions about the disease:

What are the main symptoms of endometriosis?

What is endometriosis?

The vast majority have dysmenorrhea, ie menstrual cramps, the first and most important symptom. They are often severe cramps that make it impossible for women to exercise their usual activities. The pain may also manifest during sexual intercourse, when the penis touches the bottom of the vagina. This is the second symptom. In addition to these symptoms, difficulty in getting pregnant and bowel or urinary disorders during menstruation may be present.

How to differentiate a normal colic from the characteristic of endometriosis?

In fact, there is no very clear differentiation because there are patients with endometriosis and few cramps during the menstrual period. menstruation. However, the reasoning is always to guide women to seek a doctor when they have colic with some resistance to improve with medicines or that incapacitate to carry out their activities normally.

Symptoms of the presence of endometriosis can confuse and delay the diagnosis of the disease ?

Yes. And to identify it is important to know that the disease can affect women from the first to the last menstruation, with an average diagnosis around the age of 30. On average, the woman is 32 years old when the disease is diagnosed. In 44% of the cases, five years or more were spent until the disease was diagnosed. From 40% to 50% of adolescents who present with incapacitating colic. The clinical investigation, the well-made anamnesis followed by an adequate physical examination, the vaginal touch that allows to verify some characteristic aspects of the disease, all this is part of the normal and routine gynecological examination that does not aim at the diagnosis of the disease itself, may work as a primary prevention for endometriosis. The gynecological exam is the starting point to establish the diagnosis of endometriosis. If the disease is found in the ovary, the gynecologist may notice the increase of the ovaries by touch. It affects the region between the uterus and the intestine, a type of endometriosis that is called deep endometriosis, the touch allows you to perceive thickening behind the uterus and pain when the doctor touches that region. When the disease affects the peritoneum (tissue that lines the abdominal cavity), it becomes more difficult to establish the diagnosis by touch.

Does the disease present hereditary factors?

Some studies indicate that there is a hereditary factor that must be taken into account in cases of endometriosis. However, there are other risk factors that should always be taken into account, such as retrograde menses, which leads the endometrium into the abdominal cavity allowing the disease to develop locally. The patient's immunity should also be considered, such as stress and anxiety. This holds true for cancer and is worth for endometriosis. Finally, one should also consider the number of menses. Today, a woman menstruates on average 400 times in her life, whereas at the beginning of the last century she menstruated only 40 times, because the first menstruation occurred later, she became pregnant earlier, had more children and spent long periods breastfeeding.Can endometriosis become cancer?

The mechanism of the two diseases has many similarities. It is known, however, that the relationship between endometriosis and cancer is very small, around 0.5% to 1% of cases. In fact, although it does not characterize a malignant disease, endometriosis behaves similarly, in the sense that the cells grow out of their usual place. Although most of the time this growth has no lethal consequences, it causes many discomforts. Therefore, Swedish researchers presented a study where endometriosis was first associated with the appearance of several types of cancers, especially ovarian cancer. Experts from the Karolinska University Hospital in Stockholm, Sweden, analyzed data from 63,630 women who had been treated by the hospital with the diagnosis of endometriosis between 1969 and 2002. Scientists found 3,822 cases of cancer among women with endometriosis. According to the study, the disease increased the risk of women developing ovarian cancer in 37% of the analyzed group, a risk that is one third higher than the normal population of women without the disease. There was also an increase in the number of cases of endocrinological tumors (38%), renal cancer (36%) and thyroid cancer (33%). The researchers will investigate whether the hormonal or surgical treatment of endometriosis is related to the increased risk of cancer.

How can I diagnose and choose treatment?

The classification of endometriosis takes into account the extent of the disease. The most accepted one was elaborated by an American society and part of the procedure of visualization of the lesions, the next step after the diagnosis. Clinical examination, marker and ultrasound examination are the appropriate means to define women for whom laparoscopy should be indicated, an examination performed under anesthesia through small incisions in the abdomen through which an optical tube of approximately 10mm of diameter to visualize the areas of the abdominal cavity in which the implants were fixed - name that is given to displaced endometrial tissue. It is a minor surgical procedure that allows the identification of the size, extent and location of lesion involvement and initiate appropriate treatment immediately.

Diagnostic laparoscopy and the disease is treated?

After an analysis of the abdominal cavity, of the points with involvement by the disease, it is sought to resect whenever possible the foci that are found in the ovaries, fallopian tubes, uterus, peritoneum and intestine. Concerning cysts in the ovary and uterus, the concern is to remove them, but preserving these organs, since most of the time the patients are young and have a reproductive desire. Through laparoscopy, we have also been able to resect the foci existing in the tissue that lines the abdominal cavity (peritoneum) and other deeper ones located in the intestines, indicative of more severe cases and requiring effective treatment. Obviously, open surgery is also an alternative to remove endometriosis lesions, but laparoscopy is the most widely used method for diagnosis and treatment of this disease.

Does endometriosis cause changes in the menstrual cycle?

The relationship between endometriosis and female infertility may manifest itself in some cases. Patients in advanced stage of disease and obstruction in the uterine tube that prevents the ovum from reaching the spermatozoa have an anatomical factor that justifies infertility. In addition, some hormonal and immunological issues may be the cause for some women with milder endometriosis not being able to conceive. After treatment and generally laparoscopy, a good portion of the patients can become pregnant, especially the women in whom the tubas have not been obstructed. That is why at the end of the laparoscopy, it is usually injected contrast by the canal of the cervix to see if it leaves the tubas. The characterization of this tubal permeability is a point in favor of a pregnancy that depends, however, on other factors such as ovarian function or non-adhesion formation after surgery, for example.After successful laparoscopy, are there any risks of recurrence?

After laparoscopy, when the disease is at an advanced stage, it is usually indicated to temporarily suppress menstruation. They are usually medicines that block the ovarian function, during three or four months, for the patient to recover. Thereafter, there is a chance that the disease will re-exist, because the return of menstrual function may determine the reappearance of the lesions. Therefore, in some cases, you need to block menstruation longer and take care after gestations so that there are no recurrences. The cure of endometriosis depends on the good administration of the disease and does not always represent the eternal extirpation of the foci


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