What are the main signs of uterine endometriosis? This is a common question. Let's look into it in more detail. Endometriosis of the uterus is one of the most complex diseases of the genital area, which is difficult to diagnose and cure. This pathology is accompanied by the growth of the endometrium, which is the inner layer of the uterine wall. It can grow outside the uterus, as well as inside the organ itself.
Description
This disease is accompanied in women by the presence of sufficiently strong pain, and also entails a violation of the menstrual cycle. In addition, the disease in most situations leads a woman to infertility, in connection with this, its timely detection and treatment seems to be one of the urgent tasks in modern gynecology. In our article, we will study what are the signs of endometriosis, and also find out how the treatment is carried out.
What are the causes of pathology?
Today in medicine there are many versions, as well as theories regarding the causes of endometriosis, but there is still no singlean opinion about what serves as a fundamental factor for the formation of this pathology. Most doctors cite the hormonal factor as the main cause of endometriosis. This is explained by the fact that this disease is best treated with hormones. In addition, it has already been proven that fragments of the endometrium, which are found outside the uterine cavity, can respond to hormonal changes in the female body.
According to the hormonal version of the appearance of signs of endometriosis of the uterus, one type of tissue (coelomic epithelium) degenerates into another, which is called the endometrium. Often this happens in women who suffer from unstable hormonal levels or certain thyroid diseases.
Another common cause of endometriosis is a mechanical factor, or, as it is also called, an implantation prerequisite. According to this theory, endometrial cells travel outside the uterus in the opposite way when the so-called retrograde menstruation occurs. Most often, such a deviation develops against the background of normal menstruation after traumatic childbirth, as well as complicated abortions.
Once in the abdominal area, endometrial cells begin to implant in the ovaries and intestines. In addition, the ingrowth of endometrial cells into the muscular ball of the uterus is no less common. An important factor that affects the formation of an endometriosis focus is the presence of a genetic predisposition. Thus, those women who have the highest risk of getting sick havewhose mothers had the disease at one time. To date, the exact mechanism of inheritance is not known, however, scientists have already managed to detect defects in several genes that were involved in the formation of this disease.
Signs of endometriosis
The set of symptoms of the disease depends mainly on its immediate form, as well as on the stage of the disease. Depending on the position of the foci of pathology, endometriosis can be genital or extragenital. In the presence of the genital form, the organs of the genital area (ovaries and vagina) are affected, and in the extragenital form, the intestines suffer first of all, along with the omentum, navel, bladder, inguinal canal, and so on.
Common signs of endometriosis will be the presence of pain of varying degrees of intensity. Often the pain can be localized in the pelvic region. Unpleasant sensations intensify during menstruation, and also become especially noticeable during intercourse and during urination or defecation. In the event that we are talking about the presence of an extragenital form, the pain may have a clearer localization.
Signs of endometriosis in women don't stop there. The presence of an ailment can cause a violation of the menstrual cycle. Basically, we are talking about an increase in the total amount of discharge and increased menstrual pain. Also, an equally common sign of internal endometriosis of the uterus can be spotting, which begins a few days before menstruation.
Increased blood lossusually causes the body to decrease hemoglobin and cause anemia. In most situations, in the presence of a disease such as endometriosis, a he althy conception becomes impossible, in connection with this, women in this case still suffer from infertility. But, as practice shows, after a treatment course, fertility usually increases, and women still manage to bear a he althy child. Signs of endometriosis directly depend on the degree of development of the disease.
Degrees of disease
The following degrees of the disease differ in the level of damage to the walls and the severity of symptoms:
- First. Against the background of this degree of disease, one third of the thickness of the uterine wall is affected.
- Second degree is accompanied by a lesion of half the thickness of the wall.
- The third involves the germination of the endometrium throughout the thickness of the uterine wall up to the outer cover.
Often, signs of endometriosis of the cervix are recorded in several areas or immediately over the entire surface of the organ. Until now, a definite theory about the cause of the development of pathology, unfortunately, does not exist. Why does such a peaceful tissue, in which a child should be born, suddenly become aggressive and begin to grow through the wall of the uterus, making “rivers with lakes” in it?
The fact is that the endometrium transferred outside the uterus during menstruation also menstruates, bleeding and partially exfoliating. The appearance of bleeding in the pelvic area gives impetus to the formation of adhesions. Sometimes you can see adhesionsprocess of the fourth degree. As part of this process, the entire pelvic cavity is closed by adhesions. In this case, a serious tubal factor of infertility appears.
It's worth remembering how severe the symptoms and signs of endometriosis can be. In the photo in the article, you can see what kind of discomfort and soreness women experience with this disease.
Features of manifestation
During menstruation, the mucous membrane of the uterus is exfoliated, and together with the blood through the cervical canal and vagina, all excess contents flow out. In the event that menstruation is plentiful, and the pressure in the uterus increases, blood during menstruation with part of the endometrium through the tubes enters the abdominal cavity. This process is called retrograde menstruation. External endometriosis of the uterus can develop in cases where endometrial cells take root on its surface and remain on the fallopian tubes and ovaries, bladder, pelvic peritoneum, starting to grow and multiply. It sometimes happens that the endometrium begins to grow through the muscular wall of the uterus. A similar phenomenon can provoke an abortion and lead to diagnostic curettage.
The leading symptom of endometriosis and uterine fibroids, as already noted, is pain. The presence of severe pain during menstruation can cause you to call an ambulance. As for sexual life, the development of pathology makes intimacy unlikely for the same reason that painful and uncomfortable sensations appear. In addition to this, an examination by a gynecologist also turns out to be veryembarrassing.
Sometimes it can happen that it becomes impossible to sit on a chair, due to the fact that the perineum, which contains the endometrioid tissue, is tense. Some women may feel as if they are sitting on a hot nail.
Less significant symptoms and signs of endometriosis in women are the observation of two-stage menstruation. For example, the first three days of menstruation pass as usual, but end in the appearance of a brown daub, which looks like tar or dark chocolate. This manifestation can be observed in the last two days of menstruation. The fact is that in the last days of menstruation, the endometrium menstruates in the wall of the uterus. In addition to the external and internal appearance of endometriosis of the uterus, endometrioid ovarian cysts can also occur. It should be noted that they are nothing like a functional ovarian cyst.
Endometrioid sieving, which refers to the spread of the endometrium over the area of other organs, against the background of retrograde menstruation, fall on the ovaries, where the formation of cysts five to ten centimeters in diameter begins to occur. This phenomenon causes the standard symptoms of endometriosis, which is expressed by pain during menstruation, during sexual activity, and also as part of an examination by a gynecologist.
Diagnosis of pathology
Endometriosis belongs to the category of diseases that are quite difficult to diagnose, especially considering the fact that in some situations the pathologymay be almost asymptomatic. If endometriosis is suspected, a gynecological examination should be performed. As part of the examination, the doctor will be able to detect some tension in the area of \u200b\u200bthe appendages, as well as the uterus or Douglas area.
Ultrasound: signs of uterine endometriosis
In the nodular form, ultrasound may show the following echoes:
- changes in the structure of the uterine wall are most often rounded or oval;
- in some cases, cystic-like formations up to 30 mm in diameter are visible;
- education itself has no clear contours;
- also may show an endometriosis nodule that grows within the wall of the uterus (interstitial).
The focal form of the disease manifests itself as follows:
- in the process of conducting an ultrasound examination on one of the sections of the muscular wall of the uterus (myometrium), one can observe increased echogenicity, with the absence of a clear and even contour;
- with a more detailed examination, cystic formations from 2 to 15-16 mm can be detected;
- The walls of the uterus can have different thicknesses compared to each other.
The final diagnosis in case of pathology can be made only with the help of special procedures. For this, hysteroscopy or laparoscopy is performed.
Sometimes additional computed tomography and magnetic resonance imaging are also required. But as for ultrasound diagnostics, it is not in this situationis fully effective, since during the examination of small endometriosis nodes, they are almost never visible. It should be noted that laparoscopy today is the most successful method for diagnosing this disease. Also, in the presence of endometriosis of the cervix, endometrial regions are clearly visible during examination with vaginal mirrors.
Continue looking at the symptoms, signs and treatment of endometriosis.
Providing treatment
To date, surgical treatment is considered the most effective. This method is used in the presence of endometrioid ovarian cysts, as well as in the following cases:
- Presence of nodular endometriosis.
- In situations in which the disease is combined with the presence of fibroadenoma.
Surgical treatment of signs of endometriosis involves the complete removal of foci of pathological growth of endometrial cells. In some advanced cases, it becomes necessary to remove the entire organ.
At its initial stage, this disease responds well to hormonal treatment. In particular, gestagens are widely used in the form of drugs such as Dydrogesterone and Norethisterone. In addition to these medications, estrogen-gestagens are used along with antagonists. In most situations, hormone therapy is combined with surgical treatment. In addition, the treatment of endometriosis is directed to the elimination of pain. In this regard, it is considered appropriate to take non-steroidal anti-inflammatory drugs with analgesics. In addition, patients are givengeneral strengthening therapy, in which women take antioxidants along with vitamins and sedatives. In addition, diet therapy is carried out.
Treatment of symptoms and signs of endometriosis of the uterus must certainly be combined. Surgical treatment currently includes a variety of techniques, ranging from the excision of certain areas of endometriosis as part of laparoscopy and ending with the absolute removal of the uterus in especially complicated cases. Today there is also a wide range of drugs that are aimed at curing this disease. It is interesting to note that in some patients, endometriosis can go away on its own after childbirth, since the hormonal background in the female body changes during pregnancy. There are also cases in which physiotherapy with hyperbaric oxygen therapy is used.
What else should I know about uterine endometriosis?
Endometriosis is currently a very common gynecological disease, against which the cells of the inner uterine layer grow outside the organ. These areas can undergo absolutely all the changes that occur in the endometrium during the menstrual cycle.
Symptoms and signs of endometriosis are typical mainly for women who are in their reproductive age - from twenty to forty-five years. Today, only inflammatory diseases with uterine myoma are ahead of him in their frequency. Quite often, women meet genitalendometriosis, which occurs in ninety-four percent of cases. In this case, areas of the endometrium can be located on the genitals. In such a situation, doctors talk about the development of external genital endometriosis. Against the background of this form of the disease, pathological areas can also be located in the thickness of the muscular uterine wall. This disease also has another name - adenomyosis.
The development of extragenital endometriosis is different in the fact that the "lost" endometrium grows on other organs, such as the intestines or bladder. It can even be found on postoperative scars. True, this form of endometriosis is much less common - only six percent of all cases.
It is interesting to note that scientists are still confused about this disease. For example, there is an opinion that, together with the blood during menstruation, pieces of the endometrium enter the fallopian tubes, as well as into the abdominal cavity or towards the ovaries and are fixed there. In other organs, they are able to penetrate directly through the blood vessels. In this regard, the risk of developing endometriosis of the uterus is associated with operations that are performed on the internal genital organs. Doctors also associate this disease with abortions and difficult births.
According to another hypothesis, the entire pathological process is formed long before the first menstruation. That is, experts believe that this happens when the female body is still developing in the mother's womb. In suchcase, we should talk about deviations in development. Other experts blame various disorders of the immune system, along with changes in hormonal levels, for the appearance of endometriosis. Among other things, the role of heredity is possible along with the ubiquitous stress, bad ecology and overwork.
Prevention of uterine endometriosis
Prevention of endometriosis primarily involves regular visits to the gynecologist, because often the disease may not make itself felt for a long time. Preventive examination will help to identify the pathology at an early stage and exclude the recurrence of the disease. In addition, doctors recommend following the rules:
- It is essential for women to avoid strenuous exercise during their period.
- Never have intercourse during your period.
- Women should minimize their use of tampons.
- Always get a good night's sleep and try to be as stress-free as possible.
It is especially important to follow the preventive rules for young women who are of childbearing age. This pathology, which is in an advanced stage, can cause serious problems in the genital area. In addition, pathology entails the inability to have children.
How else can you avoid the appearance of signs of internal endometriosis? First of all, women should exclude abortions. As for various manipulations on the internal organs, they should be performed only strictly according to the indications, and it is best to avoid them too. It is also recommended to warn andtimely eliminate any tissue damage during childbirth. It is equally important to timely and correctly treat certain inflammatory diseases of the organs in the pelvic area. You should also deal with hormonal disorders.
Oddly enough, but according to statistics, women who smoke endometriosis are the least likely to suffer from endometriosis of the uterus, as well as those who take contraceptives. And of course, the first method should not be recommended to anyone for prevention purposes, but the second option is often considered by doctors as one of the methods to combat this pathology.
We looked at the symptoms and signs of uterine endometriosis.
