The Endometriosis is a benign disease that involves the presence of endometrium outside the uterine cavity. Although its prevalence is not exact, it is estimated that one in ten women of reproductive age suffers from it. It is a chronic disorder, although it can go unnoticed if the implantation sites and the amount of endometrial tissue are small.
Signs and Symptoms
- Menstrual disorders
- Digestive involvement includes diarrhea, bleeding, constipation, and pain with defecation. All these symptoms get worse during menstruation.
- Having had a menarche (first menstruation) early, that is, before 12 years of age
- Having periods with heavy bleeding
- Having a short menstrual cycle
- Having first-degree relatives affected by endometriosis
- Having had a first late pregnancy or never having been pregnant.
Physical examination: With bimanual palpation (a technique in which the uterus and the ovaries are explored with one hand in the gut and the other in the vagina) pain can be demonstrated. The presence of a mass a level of the ovary, roughness of the ligaments of the sacrum, uterine fixation, and so on.
- The ultrasound is used mainly to see the cystic formation in the ovaries.
- The nuclear magnetic resonance is used in cases of endometriosis and deep involvement of the rectum.
- Laparoscopy is the test that will give the definitive diagnosis of endometriosis. This technique allows to see the inside of the abdomen through a pair of holes, observe the lesions directly, and take samples to analyze them with the microscope. Also, at the same time, surgical removal of the lesions can be carried out.
Treatment and Management
- The mechanism used for the treatment of this disease is to carry out an induction of menopause or a false pregnancy, that is, get a hormonal situation in the body similar to the one produced in these two circumstances.
- Non-steroidal anti-inflammatories or analgesics are used. It is also useful to administer oral contraceptives to delay the progression of the disease and avoid pregnancy if you do not want it.
- The different drugs that will be used are the following:
- GnRH analogues
- Levonorgestrel intrauterine device
- Conservative surgery
- Radical or definitive surgery