Endometriosis refers to a benign disease that is characterized by the proliferation of endometrial tissue beyond its normal location in the uterus. Endometriosis has a hormonal dependence, and its foci undergo monthly cyclic changes in the phases of the menstrual cycle.
Genital and extragenital endometriosis
In the place of distribution of foci of the endometrium, endometriosis is divided into genital and extragenital. The genital form of the disease is most common and accounts for more than 90% of all cases, ecstagenital endometriosis is much less common.
In turn, genital endometriosis is internal flow (adenomyosis - proliferation of the endometrium from the mucous layer in the muscular wall of the uterus) and external, which includes such forms:
- endometriosis of the cervix;
- endometriosis of the vagina;
- endometriosis of the ovaries;
- tubal endometriosis;
- retrocervical endometriosis .
Causes of genital endometriosis
Risk factors for the onset of endometriosis proliferation are heredity, hormonal disorders, too early or too late onset of menstruation, late delivery, complicated labor and abortion, obesity, prolonged wearing of the intrauterine device. Endometrial cells fall outside the uterus are also facilitated by medical manipulations within the uterus, gynecological operations.
Symptoms of genital endometriosis
Endometriosis begins and develops gradually, with an increase in the severity of symptoms. At the beginning of the disease, the pain syndrome may be absent, and then acquire a more prominent character. The peculiarity of pain in genital endometriosis is their dependence on the menstrual cycle. The pain intensifies on the eve of the menstruation and during them, and then subsides. Soreness can be felt at other times, especially with sexual acts, since endometriosis causes foci of inflammation and adhesions in the lesions.
Genital endometriosis in most cases is accompanied by violations of the menstrual cycle and leads to such manifestations as menorrhagia , metrorrhagia, intermenstrual bloody discharge. The premenstrual syndrome becomes pronounced.
Women of childbearing age with genital endometriosis, as a rule, have difficulty with conception and bearing pregnancy. Endometriosis is characterized by infertility, ectopic pregnancies, miscarriages, problems with the placenta.
Treatment of genital endometriosis
In the asymptomatic course of endometriosis, the need to preserve the possibility of pregnancy for a woman, treatment is carried out conservatively. First of all, it is hormonotherapy aimed at stopping the progression of the disease and suppressing the foci. As ancillary measures, soothing agents, vitamins and immunomodulators, resorptive drugs, physiotherapy, hirudotherapy are used.
Surgical treatment of genital endometriosis consists in performing an organ-preserving operation (laparoscopic or laparotomic) to remove foci of endometriosis or, if this is not possible, complete removal of the uterus with appendages.
The most effective is combined treatment, when with the help of hormonal medications an artificial menopause is called, against which surgical excision of endometriotic growths with subsequent postoperative hormonal therapy is performed.