Endometriosis is a diagnosis that is known to many women firsthand, and even more of the fair sex is not even aware of the presence of this anomaly in their body. The disease is very insidious, in particular due to the fact that it disguises itself as other ailments, and may not manifest itself at all. One of its most unpleasant consequences can be infertility. In this article we will talk about the problems, diagnosis, what hormones are given for endometriosis and modern methods of treating the disease.
What is endometriosis?
The inner walls of the uterus are covered with a special layer of cellular tissue called the endometrium. In the event that structural units of this type spread to parts of the body outside this organ, they begin to divide abnormally there and increase in size, a disease develops. Such formations are most often found in the pelvic area, including the bladder and intestines.
Rarely, abnormal tissue growth is diagnosed in the liver, brain, lungsand on scars after operations. Most pathologies are benign and do not develop into cancer. The main problem is that as the size increases, the formation begins to put pressure on the surrounding organs, and being inside them can lead to obstruction. Also, obeying the female monthly cycle, the mucous membrane inside the uterus begins to exfoliate at some point, leading to bleeding. The result is cysts, scarring, and adhesions.
The exact cause of this disease is unknown. There are several theories associated with the appearance of pathology, including retrograde menstruation and coelomic metaplasia, but none of them have been proven.
Changes and disruptions in the body associated with hormones in fibroids and endometriosis are very similar. In addition, the two diseases may have identical causes, such as sexually transmitted infections; getting rid of an unplanned pregnancy. As a result, in both cases, he althy cells begin to divide abnormally, growing and causing a lot of trouble.
Endometriosis mainly occurs in women of reproductive age and is very rare after menopause. This is the main factor causing pelvic pain. Studies show that a significant number of women undergoing fertility treatment actually suffer from the condition. Risk factors for developing the condition include having a mother or sister with the disorder, not having children, starting periods at an early age, and irregular periods.
Symptoms and stages
Most women suffering from this disease do not actually experience any discomfort and do not even realize that there is some kind of anomaly inside them. The most common symptoms of endometriosis are:
- pain (usually pelvic) that occurs just before a period and decreases after it;
- painful intercourse and convulsions after intercourse;
- cramps and pain during bowel movements or urination.
The disease is classified into four stages (I-minimal, II-mild, III-moderate and IV-severe). The majority of cases are considered as minimal or weak. Complications contribute to the formation of cysts or scars in the last two degrees.
Endometriosis can also be associated with fertility problems. From 30% to 40% of women with this diagnosis have problems conceiving. The reason is not entirely clear, but it is believed that scars in the reproductive tract or malfunctions of the gonads and hypothalamus may be involved. In patients with this disease, an imbalance of sex hormones in the body was revealed, for example, the permissible norm of luteinizing and follicle-stimulating hormones, estrogen and prolactin is exceeded. What hormones are lacking in endometriosis? Accordingly, male, namely progesterone, which decreases significantly. Therefore, in the treatment, doctors use various means that can normalize these disorders.
Diagnosis
May be complicated due to many diseases with similar symptoms and long studies. From the onset of the disease to an accurate diagnosis, unfortunately, it can take several years.
Research begins with a thorough history, including patient complaints, collection of information about hereditary factors, as well as an initial examination by a doctor.
Followed by a transvaginal ultrasound, where the reproductive organs are imaged using sound waves generated by a probe placed in the vagina. It is considered one of the best ways to diagnose endometriosis.
Unfortunately, symptoms and physical examination cannot be used to make a definitive diagnosis. These methods are used to exclude other diseases of the pelvic organs.
Blood tests are often used to detect endometriosis. Which hormones you need to take for endometriosis is decided by your doctor. These hormones are the main way to find out if a woman is susceptible to the disease. Tests may be needed for: LH, FSH, testosterone, progesterone, prolactin and estradiol, among others.
Since the level of substances is constantly changing, depending on the monthly cycle and other factors, only a professional has the right to decipher the test results and prescribe treatment.
The only definitive way to diagnose endometriosis is to take a sample of endometrial tissue from the found formation. For this, a special method is used, which is called laparoscopy. Atduring its implementation, the patient is given general or local anesthesia, and then the operating doctor makes a small incision in the lower abdomen and inserts a special device (laparoscope) inside. With its help, specialists can directly examine the areas of interest of organs and notice mutations and changes in tissues. In the event that any are found, a biopsy is performed (a piece of material is plucked off) for the final stage of the study.
Treatment options
When your doctor confirms the diagnosis based on the results of hormone tests for endometriosis, he will discuss with you possible scenarios.
Treatment is necessarily carried out taking into account the individual case, the severity of the symptoms and the presence of any complications. Women with the first stage of the disease may not need special drugs.
For more serious conditions, there are medical and surgical solutions to the problem. The first involves taking one or more drugs that will help not only relieve pain, but also reduce the growth of pathology. Surgical intervention is used in case of treatment failure or severe cases.
NSAID use
Since endometriosis is finally detected only after a biopsy, anti-inflammatory drugs are prescribed for that period of time until an accurate diagnosis is made or as an auxiliary component already in the treatment of endometriosis. What hormones you need to take and how long the course will last, the gynecologist will explain everything.
This group appliesdrugs with mild symptoms of the disease, that is, at a mild stage. As a rule, drugs such as Ibuprofen or Nimesil are offered, which can not only reduce pain and spasms, but also affect the inflammatory process.
Unfortunately, this method has no effect on the mutated tissues themselves.
Hormone Therapy
This type of treatment can be a good choice if pain medication doesn't work. Of course, this method is very popular and really brings good results, however, it can lead to side effects and is not used during attempts to conceive or pregnancy.
Treating endometriosis with hormones can cause side effects such as:
- weight gain;
- depression;
- acne;
- increased hair growth on the body and face;
- irregular periods.
You should talk to your doctor about the risks and benefits of this method. In addition, if a woman stops taking such medications, all symptoms may return.
The simplest remedies that gynecologists prescribe for endometriosis include: birth control pills, patches and vaginal rings containing sex hormones in varying proportions.
Most often, gestagens are used in the treatment, and after the course, birth control pills are offered.
Combined oral contraceptives (COCs)
In most cases, these hormones are used for endometriosis. The list of funds is:
- "Dienogest";
- "Levonorgestrel";
- "Marvelon";
- "Jess"";
- "Diecyclen".
The last drug is most often prescribed by gynecologists.
When taking hormones of this group (duration is 6-9 months), the production of gonadotropes is blocked, which directly affect the production of estrogen in the ovaries. Due to such changes, the size of the pathology begins to decrease, as a result of which estrogen synthesis and tissue growth slow down.
Continuous medication artificially stops menstruation, causing irregular cycles, headaches and breast discomfort.
Oral contraceptive pills are generally well tolerated by patients with abnormal endometrial growth. Their use helps to get rid of pain, inhibits the growth of formations and prevents them from bleeding.
Gestagens (progesterone analogues)
These include pills, injections and the intrauterine device. Gestogens reduce pain and, at the same time, delay menstruation while taking.
Progestins (drugs containing the corpus luteum hormone) are more effective than previous remedies and are prescribed for more severe symptoms, severe pain. These include:
- "Check";
- "Dufaston";
- "Norethisterone";
- "Linestrenol";
- "Norkolut";
- "Orgametril";
- "Laktinet";
- "Visana".
These funds are prescribed for those who cannot use oral contraceptives in the treatment of endometriosis with hormones (for medical reasons). However, they also have limitations. Side effects include:
- constant mood swings;
- nausea;
- edema;
- headaches and dizziness;
- intestinal problems.
Also, progestin preparations are contraindicated for those who wish to have offspring in the near future, because during the reception and for a long time after them, there is no menstruation, and, accordingly, conception becomes impossible.
"Visana", according to many women, is recognized as the most effective means. However, the decision on which hormones to take for endometriosis should be agreed only with the attending physician, since the progestogen in their composition has a huge number of contraindications.
GnRH agonists
Doctors usually recommend limiting their use to six months due to the many problems that drugs can bring to your body.
Analogues of gonadotropin-releasing hormone of the hypothalamus (GnRH) - for example, Buserelin, Diferelin, Leuprorelin, very well help relieve pain, spasms and have a beneficial effect on reducing the size of overgrown tissues.
Drugs belonging to this group. able to stop the production of LH in the pituitary gland, which leads toa gradual decrease in estradiol in the blood, a decrease in the tissues of the mucous membrane (including in the uterus) and inhibition of the maturation of follicles in endometriosis. We found out which hormones are elevated during illness - the balance between progesterone and estrogens is disturbed. The absence of the female hormone in the body leads to a situation identical to that which occurs during menopause, which lasts while taking GnRH. Side effects due to lack of sex hormones include metabolic disturbances, sexual disturbances, hot flashes, headaches, psychosis and joint pain.
The use of a combination of progesterone and GnRH in treatment is considered quite successful. Their combined use avoids the unwanted side effects of single therapy.
"Zoldex", according to women, is considered one of the best hormones for endometriosis in its category. It is used by introducing a depot capsule subcutaneously into the navel area. The number of injections depends on the severity of the condition, but it is not recommended to use it for more than six months. Of the minuses - a rather high price (from 9,700 for a 3.6 mg syringe) and many side effects. According to patients, not every doctor will agree to inject this injection due to the complexity of this procedure.
Danazol
A synthetic drug that inhibits the production of gonadotropins in the body, that is, the release of hormones in the genitals, and increases androgen levels, thereby lowering estrogen levels.
The negative side is considered to be a hugethe number of side effects that begin to appear as they are taken. A woman can recover dramatically due to edema throughout her body. The amount of hair on the face increases, the skin becomes oily and covered with an unpleasant rash, the voice becomes coarse. Menopausal symptoms (lack of sexual desire, hot flashes, and hysteria) may also begin to bother you.
Of course, after the course of treatment ends, the body recovers and all unpleasant moments disappear, but gynecologists still try not to prescribe the drug due to the many restrictions in its use.
Aromatase inhibitor and reviews about it
Another type of hormone in endometriosis. Doctors' comments suggest that these are quite promising remedies that can significantly alleviate symptoms and prevent mutating cells from developing further. Drugs such as "Anastrozole" or "Letrozole" have the ability to interrupt the production of a special enzyme, which, according to scientists, is one of the culprits for the appearance of endometriosis. Due to this, the level of estrogen in the body falls, which allows male hormones to increase naturally.
Like all other similar products, aromatase inhibitors are not recommended to be used for too long due to calcium leaching. Doctors rarely use the drug for this diagnosis, but if they do, it is in combination with other therapies.
Surgery
If after the treatment with hormones for endometriosis, there is no improvement,have to have an operation. After it is done, the gynecologists again prescribe a course of medications to prevent the remaining mutated cells from growing again.
Also, a surgical method is offered to the patient in the case when the formation begins to compress the organs, leading to their deformation, or when, with an internal location, it contributes to obstruction.
Types of operations are divided into conservative, in which the reproductive organs are left, or final, with the removal of one uterus or together with the ovaries. After carrying out such manipulations, drugs are also used for safety net.
Influence of food
Since the decrease in the level of sex hormones in endometriosis in the body directly affects the well-being and symptoms of the disease, along with medications, you can use a special diet that can enhance their effect. Naturally, you should limit your consumption of foods and drinks that contain natural estrogens (for example, coffee, beer, legumes), and red meat.
Extensive studies have shown that a diet rich in vegetables such as cucumbers, pumpkins, zucchini, peppers, tomatoes, eggplants, as well as melons and watermelons has a beneficial effect on the he alth of patients.
We found out what stages and methods of examination exist for endometriosis, which hormones are elevated, and also learned about a variety of options for dealing with the disease.
Unfortunately, modern medicine has not yet fully learnedcure the disease, but timely diagnosis and well-prescribed treatment can significantly improve the quality of your life, and also help to give birth to a he althy baby.
