Find out why uterine endometriosis is dangerous. This is a pathological hormone-dependent growth of glandular uterine tissue outside this organ - in the fallopian tubes, ovaries, in the thickness of the uterus, on the peritoneum, in the bladder, in the intestines, and also in more distant organs. At the same time, heterotopias (endometrial fragments), sprouting in other organs, also change cyclically, like the endometrium located directly in the uterus, that is, in accordance with the menstrual cycle. Such changes are manifested by pain syndrome, an increase in the volume of the affected organ, bloody discharge from the structures of heterotopias, menstrual dysfunction, infertility, pathological discharge from the mammary glands.
Description
The disease is characterizedbenign proliferation of tissues that are functionally and morphologically similar to the endometrium of the uterus. What is accessible language? This is the tissue lining the inner mucous membrane of the body of the female reproductive organ (mucosal layer). The clinical manifestations of this disease directly depend on the localization of the pathological process. The disease can cause the formation of ovarian cysts and menstrual irregularities.
Many patients wonder if it is possible to get pregnant with uterine endometriosis. We will talk about this below.
This disease in women is the third most common gynecological pathology, after uterine fibroids and various inflammatory processes. In the bulk of cases, endometriosis occurs in women of reproductive age - 25-40 years (approximately 27%), is observed in 10% of girls during the formation of menstrual functions and in 2-5% - in menopausal age. What is dangerous endometriosis of the uterus, it is important to find out.
Disease classification
Manifestations of the disease depend on the localization of foci of endometriosis. In this regard, it is divided into extragenital and genital forms. With the genital form, heterotopias are located on the tissue of the genital organs, with the development of the extragenital form - outside the structures of the reproductive system.
In the genital form of the disease differ:
- peritoneal endometriosis, which is characterized by damage to the ovaries, fallopian tubes, pelvic peritoneum;
- extraperitoneal endometriosis, which is localized in the lower parts of the reproductive system - in the vagina,external reproductive organs, rectovaginal septum, cervix, etc.;
- internal endometriosis, developing in the muscular layers of the uterus.
Localization of endometriosis is mixed, which often occurs when the pathological process is neglected. In the extragenital type, foci of heterotopias are noted in the intestines, lungs, navel, kidneys.
Degrees of disease
Depending on the spread and depth of germination of focal growths of the endometrium, 4 degrees of endometriosis of the uterus are distinguished:
- I degree - single and superficial foci;
- II degree - multiple foci;
- III degree - deep multiple foci, cysts on the ovaries, adhesions in the peritoneum;
- IV degree - deep multiple foci of endometriosis, large endometrioid ovarian cysts (on both sides), germination of cells in the walls of the rectum and vagina, pronounced adhesions.
In addition, there is also a generally accepted classification of internal uterine endometriosis, in the development of which four stages are distinguished according to the level of damage to the muscle layers:
- I stage - initial germination of myometrium;
- II stage - lesions extend to half of the uterine muscle layer;
- III stage - germination through the entire thickness of the uterus;
- IV stage - sprouting to the abdominal cavity.
Pathological foci may differ in shape and size: from rounded formations of a few millimeters to growths of severalcentimeters with shapeless outlines. They are distinguished by a dark cherry color and are separated from the surrounding tissues by whitish connective tissue scars.
The lesions become more noticeable before menstruation due to their periodic maturation, depending on the cycle. Spreading to the peritoneum and other organs, endometriosis sites sometimes grow deep into the tissues or are located superficially.
Causes of uterine endometriosis
In medicine, there is still no consensus on what causes the development of endometriosis. Most scientists adhere to the theory of retrograde menstruation. In accordance with it, in some women, menstrual blood with particles of the endometrium enters the abdominal cavity and fallopian tubes - retrograde menstruation. There, particles of the endometrium of the uterus are attached to the tissues of other organs and continue to function cyclically. What is it, we have already told in an accessible language.
If a woman does not become pregnant, the endometrium during menstruation begins to be shed from the uterus, while microbleeding is observed in other organs, provoking the development of an inflammatory process.
Increase the likelihood of developing the disease as factors such as heredity, features of the structure of the fallopian tubes, immunosuppression. The role of genetic predisposition to the development of the disease and its transmission by inheritance is very high.
Contribute to the development of this pathological process are also surgical interventions in the uterus: caesarean section, artificialabortion, cauterization of erosions, etc. Therefore, after surgical interventions of this type, medical supervision is necessary to identify abnormalities in the functioning of the reproductive system.
Other theories of endometriosis are not widely accepted. As the reasons for its development, they consider gene mutations, dysfunction of cellular enzymes and receptor reactions to hormones.
Symptomatics
The course of the disease can be varied, but there are some reliable symptoms that indicate the development of endometriosis:
- Pelvic pain - occurs in 16-24% of cases. It has a clear localization or is characterized by spillage throughout the pelvis, may intensify before menstruation.
- Dysmenorrhea - observed in 40-60% of patients. This symptom is most pronounced in the first 3 days of menstruation.
- Painful intercourse.
- Pain when urinating or having a bowel movement.
- Menorrhagia - long-term and heavy menstruation. Occurs in approximately 2-16% of women.
- The occurrence of post-hemorrhagic anemia.
- Infertility.
Can I get pregnant with uterine endometriosis?
In the presence of this pathology, one should not talk about absolute infertility, but a low probability of pregnancy. Endometriosis sharply reduces the chances of safely bearing a child and can provoke spontaneous miscarriages, therefore, pregnancy management with such a disease should be carried out under constantcontrol of specialists. The probability of conception after treatment of the disease varies from 15 to 56% in the first 6-12 months.
Possible complications and consequences
Many women are concerned about the question: why is uterine endometriosis dangerous? Cicatricial changes and hemorrhages cause the formation of adhesive processes in the pelvic and abdominal cavity. Another common complication of this disease is the formation of endometrioid ovarian cysts, which are filled with old menstrual blood. Both of these complications can cause infertility in women. Compression of the nerve trunks leads to various neurological disorders. Significant blood loss during menstruation causes the development of anemia, weakness, irritability and tearfulness. In some cases, malignant degeneration of pathological foci is observed. So the complications and consequences of endometriosis should always be remembered.
Diagnosis
In the process of diagnosing this pathology, other pathologies of the reproductive organs that occur with similar symptoms should be excluded. It is also necessary to collect an anamnesis and complaints, the most indicative of which are pain, information about past diseases, operations, and the presence of gynecological pathologies in relatives.
Follow-up examination may include:
- gynecological examination (rectovaginal, vaginal, in the mirrors) which is most informative before menstruation;
- hysterosalpingoscopy and colposcopy for clarificationlocalization and form of the lesion, tissue biopsy;
- Ultrasound of the pelvis and abdomen;
- CT or MRI to clarify the nature of endometriosis, its relationship with other organs, etc.;
- laparoscopy, which allows you to visually examine pathological foci, assess their number, activity, degree of maturity;
- hysterosalpingography and hysteroscopy, allowing to diagnose the disease with an accuracy of 83%;
- laboratory study of oncological markers CEA, CA-125 and CA 19-9, as well as the RO test, the presence of which in the blood in this disease is significant.
Whether uterine endometriosis is treated, find out below.
Treatment methods
When choosing a method of treating an ailment, doctors are guided by such indicators as the number of births and pregnancies, the age of the patient, the prevalence of the pathological process, its localization, the intensity of pain, the presence of concomitant diseases, the need for pregnancy.
Therapy methods are divided into surgical (laparoscopy with removal of foci and preservation of the uterus or its complete removal and oophorectomy), medical and complex.
What drugs are prescribed for uterine endometriosis?
Medicated treatment
Indications for conservative treatment are asymptomatic endometriosis, young age, the need to restore or preserve childbearing functions, premenopause. The main in drug treatment is hormone therapy with such groupsMedicines:
- Complex estrogen-gestagenic agents. These medicines contain small doses of progestogens that suppress ovulation by reducing estrogen production. Such remedies are shown in the initial stages of endometriosis, since they are not effective when the endometrioid process is neglected and in the presence of ovarian cysts.
- Gestagens ("Norethisterone", "Gestrinone", "Progesterone", "Dydrogesterone"), which are indicated at any stage of the pathology, continuously - up to 8 months. Taking these drugs may be accompanied by bleeding in the middle of the cycle, a depressive state.
- Antigonadotropic drugs ("Danazol" and others), which suppress the production of gonadotropins in the hypothalamic-pituitary structure. They are used continuously for 6-8 months and are contraindicated in women with hyperandrogenism (an excess of androgenic hormones).
- Gonadotropic-type releasing hormone agonists ("Goserelin", "Triptorelin", etc.) The advantage of drugs in this category is the possibility of using once a month and the absence of pronounced side effects. Such drugs cause suppression of ovulation and estrogen levels, which leads to inhibition of the progression of endometriosis foci.
In addition to the above medications, immunostimulants are also used in the treatment of endometriosis, and in symptomatic therapy - analgesics, antispasmodics, anti-inflammatory drugs.
Folk treatment
With endometriosis in folk medicine, the use of a variety of herbs is proposed. All medicinal plants used in the treatment of this disease are divided into two categories:
- Anti-inflammatory herbs for uterine endometriosis: chamomile, coltsfoot, calendula, St. John's wort, celandine. Decoctions and infusions of these herbs help fight the progression of the inflammatory process, have antiseptic properties.
- Specific: burnet, upland uterus, round-leaved wintergreen, red brush. Such plants fight directly with diseases of the female organs - the uterus and appendages.
Propolis is often used in treatment, there are also recommendations for the use of leeches.
We found out why uterine endometriosis is dangerous.
