What is endometriosis and how is it treated? Endometriosis. Causes, symptoms, modern diagnostics, effective treatment of the disease

The term "endometriosis", from the Latin "endometrium", refers to the tissue in the inner lining of the uterus. The disease occurs when tissue that looks and functions like endometrial tissue ends up outside the uterus, usually inside the pelvic cavity.

This is a chronic disease that affects a woman's reproductive organs. This happens when the endometrium, which normally lines the inside of the uterus, begins to grow on the outside. It often affects organs abdominal cavity, including the ovaries and pelvic area. In some cases, endometrial tissue is found in other areas of the body.

According to various estimates, about 176 million women in the world face this problem. medical problem aged 15 to 49 years.

Endometrial tissue, which is found outside the uterus, behaves during menstrual cycle much like the tissues inside the uterus. At the end of the cycle, when hormones influence the detachment of the lining tissue in the uterus, the endometrium outside it begins to disintegrate and bleed. But while menstrual fluid comes out of the uterus with menstruation, the blood of the disintegrating endometrium has no way out. The tissue around the affected area becomes inflamed and swollen.

These abnormal areas of tissue can grow into what are called “focal lesions,” also known as “implants,” “nodules,” or “growths.” The most common location for growths is a woman's ovaries.

Endometriosis according to its location is divided into genital and extragenital. Genital affects the reproductive organs of women - the ovaries and uterus. With extragenital endometriosis, other organs of the body suffer from the growing endometrium, for example bladder or intestines, and even lungs.

Mild forms of endometriosis are the most common; they can be asymptomatic and sometimes do not require treatment. But you should know that this disease can be a source of moderate or severe pain during menstruation, as well as painful sexual intercourse, and even an obstacle to a desired pregnancy.

Signs of endometriosis

The biggest problem is that any signs of illness on early stages seem natural reactions body at the beginning of the menstrual cycle.

The main symptom of endometriosis is pain in the pelvic area, which in women is often associated with menstrual cycles.

Although a large number of women constantly experience menstrual cramps, with the lining of the uterine wall shedding monthly, many women with endometriosis experience more pain than usual. According to doctors' observations, patients usually complain that the pain intensifies over time.

Some signs of endometriosis:

• Painful periods. Pelvic cramps and uterine cramps can occur before and for some time after your period begins.
• Painful sensations during coitus. Pain during or after intercourse is often a sign of internal appearance.
• Urination or defecation is painful. This often appears during menstruation.
• Heavy bleeding.
• Difficulty conceiving. There are many cases where uterine endometriosis is diagnosed in women who initially went to the clinic for infertility treatment.

It is worth considering that the intensity of pain is not always a sure sign of a late stage of the disease.

Some people with less severe endometriosis may experience severe pain and cramping, while some women with advanced endometriosis experience little or no pain.

Symptoms of endometriosis

A significant number of women with endometriosis do not report pronounced symptoms. Even as symptoms develop, they may vary, even among women in at different ages There are different symptoms.

In general, it is believed that the larger the lesions, the more symptoms.

About one third of women with uterine endometriosis discover they have it because they were unable to conceive and went to see a specialist, or endometriosis was discovered during surgery for another reason. Therefore, the severity of the disease and the number of symptoms are likely to be related to the location of the tissues rather than their size and number.

You can select following symptoms endometriosis:

The patient may also have a feeling of fatigue and lack of strength, anxiety, worry frequent shifts moods. Such symptoms may be manifestations of premenstrual syndrome, but together with the other listed symptoms they may indicate ovarian endometriosis.

Symptoms of endometriosis disappear as pregnancy begins. This, doctors believe, is due to the progesterone produced by the body. After the birth of the child, the consequences of the disease remain unclear.

Causes of endometriosis

The exact causes of the disease cannot be determined. Some experts believe that pieces of the endometrium move through the fallopian tubes back and exit into the pelvic cavity, where the reproductive organs are located. Tissue cells settle on the surfaces of the genital organs. When menstruation begins, the tissue bleeds, just like the tissue in the uterus. Blood from these areas irritates the surrounding tissue on the organs, which becomes inflamed and swollen.

Since doctors probably don't know what causes endometriosis, possible reasons or factors different women may vary.

1. Heredity: In women whose close relatives have endometriosis, the likelihood of the disease increases by 7-10 times. In addition, in the case of twins, there is a high probability of endometriosis in both, especially if they are identical twins.
2. Retrograde menstruation. When women have their period, blood flows from the vagina, but also in the opposite direction - into the pelvic cavity. In 90% of women, blood with endometrial tissue simply disintegrates or is absorbed and does not cause any symptoms; In women susceptible to endometriosis, endometrial tissue begins to grow.

Other possible risk factors for endometriosis include:

• menstruation lasting more than 5 days;
• heavy bleeding during menstruation;
• first menstruation before age 11;
• the interval is less than 26 days between menstruation;
• early pregnancy;
• underweight;
• alcohol consumption.

In some cases, endometriosis is misdiagnosed because its symptoms are similar to some other diseases of the ovaries or pelvic organs. The disease may be similar to irritable bowel syndrome, which may be accompanied by endometriosis, which greatly complicates its detection.

To diagnose this disease, the doctor, first of all, will find out the patient’s symptoms, specify the location of the source of pain and the time when it began.

A physical examination for endometriosis often consists of the following:

1. Examination by a gynecologist. A gynecological examination gives the doctor the opportunity to palpate areas in the rectum and vagina and determine
   presence of anomalies. For example, there may be cysts on the reproductive organs.
2. Ultrasound. The ultrasound transducer is either pressed against the skin on the abdomen or inserted into the vagina. An ultrasound cannot be 100% sure whether a woman has endometriosis, but it can detect cysts.
3. Laparoscopy. This is a procedure performed by a surgeon and is most commonly used to identify and treat endometriosis. While the patient is under general anesthesia, a small incision is made in the navel area, where an instrument called a laparoscope is inserted. With it, the doctor is able to find tissue located outside the uterus. Laparoscopy helps to obtain information about the location, distribution and size of endometrial implants so that the doctor can decide on optimal options treatment.

Endometriosis is difficult to recognize and detect because pelvic pain, the main symptom of the disease, is often an integral part of the menstrual cycle. And yet, a timely visit to a gynecologist when any of the symptoms appear will help diagnose the disease at an early stage of development and begin treatment on time.

Treatment of endometriosis

There are no specific medications that are used to treat the disease. The emphasis in treatment is on reducing pain and
cure for infertility. Treatment depends on the extent, symptoms and impact on subsequent ability to become pregnant. If a woman suffers from severe pain, then it is possible to use hormone therapy to reduce estrogen levels in the body. If the patient wants to become pregnant, the doctor may prescribe fertility treatment or surgery.

Medicines

If you complain of severe pain or heavy bleeding, if you are not planning a pregnancy in the near future, then birth control or anti-inflammatory drugs may help control the pain. Birth control hormones can keep the tissue from growing further. If a woman has severe endometriosis, or if these remedies do not help, stronger hormonal therapy may be tried.

"Duphaston"

The most commonly used drugs in the hormonal treatment of endometriosis include Duphaston. It is a progestogen or so-called synthetic progesterone. Its action is similar to that of progesterone, which is produced by women's ovaries. It is certainly not known how Duphaston eliminates endometrial implants, since, unlike other drugs used in the treatment of endometriosis, at a relatively low dosage it does not stop menstruation and does not affect ovulation. Presumably, Duphaston suppresses the growth of abnormally located endometrial cells, causing them to gradually die.

The dosage of the drug will largely depend on the gynecologist’s technique. A visit to this specialist during treatment with Duphaston will require 6 to 8 weeks after the start of the course, since the doctor must monitor how the treatment progresses.

Many women prefer to treat various diseases with folk remedies, but is it possible to treat endometriosis at home?
conditions?

Of course, it will not be possible to completely cure this disease with folk remedies, however, in order to control the severity of the disease and
relieve the main symptoms of pain and heavy bleeding, you can try some natural remedies.

1. Castor oil helps the body get rid of excess tissue and toxins. It should be used at the beginning of menstrual period
   cycle when the spasms are just beginning.
2. Massage the pelvic area and lower abdomen with essential oil Lavender or sandalwood will help you relax and soothe minor pain.
3. Turmeric. This spice contains a natural constituent known as curcumin, which has a strong anti-inflammatory effect and hence can be used for home treatment of the disease.
4. Chamomile has anti-inflammatory properties that help reduce inflammation as well as swelling.
5. Dandelion. Dandelion infusion helps regulate hormonal levels.

In addition to using various natural remedies, it is also necessary to monitor your lifestyle. For example, reduce the consumption of fatty foods, pay enough attention physical activity, walking and swimming. And also give up alcohol and smoking, avoid stressful situations.

It is worth remembering that not all women with endometriosis feel pain. And the severity of the disease does not always worsen over time.

After menopause and during pregnancy, the condition usually improves. If women over 40 years of age have barely noticeable pain, there are no plans for future pregnancy, or menopause is expected, then there is no urgent need for treatment.

At-home treatment may help relieve the pain, but the problem may remain. But even when visiting a gynecologist, the decision always remains with the patient.

Read more about endometriosis treatment

Not all women know what endometriosis of the uterine body is, but meanwhile, the disease can occur without pronounced symptoms and is very difficult to detect during a routine gynecological examination.

Endometriosis of the uterus is a disease characterized by the growth of the endometrium in unusual places. The endometrium is the mucous layer of the uterus; its structure contains many glands and vessels. The endometrium consists of:

• outer layer - it changes depending on the phase of the menstrual cycle;
• deep layer - it is not subject to changes due to hormonal surges.

In the first menstrual phase the outer layer actively grows, and in the second, if fertilization has not occurred, it is rejected. If we translate the name endometriosis into accessible language, it will mean the appearance of tissues similar in structure to the endometrium outside the uterus.

The exact causes of endometriosis have not yet been established. There are several theories about the occurrence of the disease:

• Implantation version – with hormonal disorders, endometrial cells increase their ability to adhere (stick) to various places. If there is high uterine pressure, then the cells can migrate to other tissues and continue their active growth there. Migration to neighboring organs (ovaries, tubes) can also occur during menstruation;
• Genetic theory. The occurrence of endometriosis in women can occur in several generations of the same family. Scientists identify a specific genetic marker that indicates susceptibility to the disease;
• Immune theory. The body's defense systems remove any tissue and neoplasms that appear in the in the wrong place. When immunity decreases, endometrial cells outside the uterus do not die, but take root and function normally;
• Theory of metaplasia. Many scientists suggest that some tissues can transform when exposed to various reasons to endometrioid.

Most common reasons

There are several causes of endometriosis:

• after incorrect gynecological instrumental manipulations on the genitals, for example, cauterization of cervical erosion, endometrial cells can migrate into the vagina and take root there, or during a cesarean section endometrioid tissue can enter the peritoneum;
• frequent abortions and other mechanical damage to the inner layer of the mucosa make its structure loose, thanks to which the cells penetrate deeper muscle tissue and continue to actively grow and change according to the phases of the cycle;

• taking it can also cause endometriosis. All women with this disease have low level, but increased estrogen content, and;
• in case of various diseases of the liver, which is involved in the regulation of estrogen levels, their excess in the body may be observed, which provokes hormonal dysfunction;
• intrauterine device can also cause the development of endometriosis. An inflammatory process forms at the site of its attachment in the mucosa. The mucosal tissues become loose and through the pores, during menstruation, the endometrium penetrates beyond the uterus.

Classification of the disease

Having found out what endometriosis is, you can consider its varieties. The disease is classified according to the location of the endometrium:

• genital;
• extragenital;
• combined form.

The most common form is genital, when the tissues are localized on the tubes, the outside of the uterus, and the ovaries. Most often, lesions are observed in the muscular walls of the uterus, and manifests itself in the form of strong menstrual bleeding with different intensity and duration.

Extragenital endometriosis is characterized by damage to the abdominal organs, urinary tract, and lungs. This type of disease is much less common and very difficult to diagnose.

The combined form is diagnosed when the genitals and internal organs.

Endometriosis of the uterus manifests itself in three forms:

• focal, when small islands form in muscle tissue;
• nodular, when the tissue takes the form of a node similar to fibroids;
• diffuse, when the endometrioid tissue is located in a chaotic manner, there are no clearly defined boundaries.

Often diffuse endometriosis of the uterine body is combined with other forms, for example, nodular.

Prevalence and development of endometriosis

In gynecology, uterine endometriosis is divided according to the degree of development and prevalence:

• The disease is classified as first degree if foci of occurrence are detected at a depth of less than one centimeter;
• if the lesions are localized in muscle tissue to approximately half its thickness, then a second degree is assigned;
• when endometriosis has spread throughout muscle wall, they state the third degree;
• if the lesions have spread through the entire muscle, come out and are localized on the abdominal organs - this is the fourth degree.

If endometriosis is extragenital in nature, then it is classified according to the degree of prevalence:

• small forms - when the lesions are single, shallow, and affect a small surface of the ovaries and the abdominal cavity;
• moderate severity, when the lesions spread to both ovaries and form adhesions in the retrouterine space;
• severe form - in which endometrioid tissue is localized on all internal organs of the abdominal cavity, including the rectum.

If endometriosis spreads only to the ovaries, doctors distinguish three stages of its development:

• the first is several small pinpoint lesions on one ovary that do not contain cystic cavities;
• second – cystic cavities are formed from several foci, but they do not exceed 6 cm;
• third - cysts up to 6 cm in size appear on both ovaries;
• fourth - cysts exceed 6 cm in volume and spread not only to the ovaries, but also to neighboring tissues.

From the second stage, adhesive processes begin to develop and gradually spread to the pelvic area.

Symptoms of endometriosis

The very first signs of uterine endometriosis are changes in the menstrual cycle and the intensity of bleeding, accompanied by severe pain. Depending on the stage of development of the disease, the following symptoms may occur:

• heaviness in the lower abdomen;
• a feeling of fullness;
• nausea;
• vomit;
• painful sexual intercourse;
• In the first days of menstruation, body temperature may rise.

The course of the disease is accompanied by heavy bleeding, which can lead to anemia. In this case, the following will be added to the symptoms of uterine endometriosis:

• weakness;
• drowsiness;
• fast fatiguability;
• fainting conditions;
• dizziness.

The main thing that makes endometriosis dangerous is that its symptoms coincide with many other diseases, so women often attribute such manifestations to painful menstruation and do not attach much importance to them.

Diagnostics

Endometriosis of the uterus is very difficult to detect during a routine examination; often the disease is asymptomatic, it is detected by chance, during routine or comprehensive examinations.

Diagnosis of endometriosis can be carried out in various ways:

• hysteroscopy;
• lab tests;
• gynecological examination.

One of the most effective diagnostic methods is transvaginal ultrasound. With such an examination, the doctor can diagnose endometriosis based on the following signs:

• heterogeneous thickness of the uterine walls;
• the uterus is changed in size, it becomes like a ball, enlarged as at 5–8 weeks of pregnancy;
• heterogeneous myometrium containing cystic cavities.

The nodular form of the disease is very similar to fibroids, so the doctor should prescribe additional examination.

Hysteroscopy is the most The best way diagnosing diffuse endometriosis. During the procedure, the localization of endometrioid cells can be detected. By using ultrasound examination ovarian endometriosis is clearly visible.

Laparoscopy is the most reliable way to detect external endometriosis. It allows you to establish an accurate diagnosis with almost 100% probability. Laboratory diagnostics may indicate change hormonal levels in a woman, identify the presence of inflammatory processes, the development of anemia. But this is only an intermediate stage of diagnosis.

Treatment

Like all women's diseases, vaginal endometriosis must be treated. But it is unlikely to completely get rid of the problem. When diagnosing the first and second stages of endometriosis, treatment is not prescribed, but it is necessary to undergo regular examinations and monitor the extent of tissue spread. Modern methods diagnostics make it possible to determine the development of the disease in the early stages, so the number of patients with this diagnosis has sharply increased.

If local endometriosis is detected, patients are not recommended to use intrauterine devices, but they should take a responsible approach to the issue of protection from unwanted pregnancy, since abortion can give a big impetus to the development of the disease.

Endometriosis most often occurs in women reproductive age. If the disease is detected in the premenopausal period and is asymptomatic, then drug treatment is not prescribed, but constant monitoring is necessary.

There are two ways to treat diffuse and nodular endometriosis:

• conservative – taking medications;
• surgical – removal of tumors.

Medication involves taking hormonal drugs, their action is aimed at reducing the secretion of estrogen. At the same time with hormonal treatment symptomatic therapy is provided to reduce painful sensations. Can be used:

• antispasmodic tablets;
• anti-inflammatory drugs;
• vaginal suppositories;
• anal suppositories.

Surgical intervention is indicated when diagnosing the following forms of the disease:

• Endometrioid cysts on the ovaries;
• Endometriosis of the uterus 3 and 4 degrees;
• Extragenital endometriosis, when large areas of internal organs are affected, resulting in their normal functioning being disrupted.

If drug treatment does not bring positive changes or it is contraindicated for the patient, then they also resort to the surgical method. For surgical removal tissues, laparoscopy is most often used. When symptoms are identified and treatment is prescribed in a timely manner, long-term remission can be achieved and the patient can return to her usual lifestyle.

Prevention of endometriosis should be aimed at timely elimination of disruptions in the menstrual cycle, regulation of hormone production, and prevention of invasive procedures in the uterus. The likelihood of the disease occurring when women's reproductive function declines sharply decreases.

What consequences might arise?

If you do not pay due attention to the disease, its development can lead to the following consequences:

• infertility;
• the risks of miscarriages during pregnancy increase;
• development of anemia;
• chronic diseases of the affected internal organs develop;
• endometriotic tissue can compress nerve endings, which can cause neurological problems.

Advanced stages of the disease can lead to removal of the ovaries and uterus, which will mean a complete loss of reproductive function.

Planning pregnancy with endometriosis

Endometriosis significantly reduces reproductive function due to:

• structural changes in the uterine walls;
• the ovaries are damaged, which leads to hormonal imbalance;
• adhesions develop in the genitals.

But if this diagnosis is made in time and all necessary treatment measures are taken, then pregnancy can occur within the first year after the course of therapy.

Endometriosis does not have any effect on the development of the fetus, but there is a high risk of premature birth, spontaneous miscarriage, and uterine rupture during childbirth. A pregnant woman with this disease should be constantly under the supervision of an experienced gynecologist. And after childbirth, treatment should be continued.

Bibliography

1. Gestagens in obstetric and gynecological practice. Korkhov V.V., Tapilskaya N.I. 2005 Publisher: Special Literature.
2. Intrauterine infection: Management of pregnancy, childbirth and the postpartum period. UMO stamp for medical education. Sidorova I.S., Makarov I.O., Matvienko N.A. 2008 Publisher: MEDpress.
3. Miscarriage, infection, innate immunity. O.V. Makarov, L.V. Kovalchuk, L.V. Gankovskaya, I.V. Bakhareva, O.A. Gankovskaya. Moscow, “GEOTAR-Media”, 2007
4. Atlas by ultrasound diagnostics in obstetrics and gynecology. Dubile P., Benson K.B. 2009 Publisher: MEDpress-inform.

Endometriosis is the cause of infertility in women. It is possible that the lesions may spread to other organs. Specific symptoms There are no signs indicating the appearance of this particular pathology. Painful sensations, as well as other unpleasant manifestations of endometriosis, are characteristic of the most various diseases internal genital organs. It is usually discovered only when a woman comes for a gynecological examination. The success of treatment depends on the degree of neglect of the disease.

The body of the uterus consists of 3 layers: the endometrium, the myometrium (muscle fibers) and the outer (serous) membrane. The endometrium has variable thickness, since one of its layers (superficial, it is called functional) peels off during menstruation and is brought out. After this, it grows anew from the cells of the second (inner basal) layer.

Endometriosis is diagnosed when the endometrium grows into the adjacent layers of the uterus (adenomyosis occurs) or endometrioid lesions appear in other organs. The disease is usually detected in young women of childbearing age who have not reached menopause, which indicates the hormonal nature of the pathology. After menopause occurs and an age-related decrease in the production of sex hormones occurs, the development of endometriosis stops, and the manifestations of the disease disappear without treatment.

A feature of endometriosis is that in the early stages obvious signs There are no pathologies. The reasons for the rapid development of the disease are:

1. The ability of endometrioid cells to easily leave the lesion, since it does not have a membrane separating the affected tissues from healthy ones.
2. Ingrowth of cells into neighboring tissues and rapid growth of the lesion (infiltrative growth). This is what endometriosis is like cancerous tumor, however, it is a benign disease.

The similarity with a malignant tumor is also that endometrial cells with blood and lymph can enter other, even distant, organs.

Types and forms of endometriosis

Depending on the organ in which the lesions are located, several types of such pathology are distinguished.

Genital endometriosis is a disease associated with the growth of the endometrium in the body of the uterus, its tubes, cervix, as well as in the ovaries and external genitalia. Extragenital endometriosis is a pathology that occurs in other areas of the body (lungs, bladder, etc.). When the genitals and other organs are simultaneously affected, a mixed type of disease occurs.

Endometriosis exists in 3 forms:

• diffuse - individual areas of endometrial growth are scattered over the entire surface and in the thickness of the organ;
• focal - there are several separately located clusters of endometrioid cells;
• nodular - a dense ball of overgrown endometrioid tissue is formed.

There are 4 degrees of organ damage.

1st degree– this is when lesions are found only in the endometrium (no deeper than 1 cm from the surface).

2nd degree– pathological foci grow in muscle layer up to about ½ of its thickness.

3rd degree– this is a lesion of the muscle layer to its full depth.

4th degree– the endometrium grows through the serous membrane, enters the abdominal cavity and spreads to the pelvic organs.

Possible consequences of endometriosis

A feature of the disease is that its development and damage to the deep layers of the uterine wall and peritoneum leads to infertility with approximately a 40% probability. The reason for difficulties with conception is, firstly, the formation of adhesions in the abdominal cavity. They prevent the mature egg from moving into the fallopian tubes, where fertilization is possible. Secondly, most often there is a narrowing of the lumen of the tubes due to the proliferation of endometrial cells. And thirdly, a pathological change in the structure of the wall contributes to the rejection of the embryo, the impossibility of its fixation and development in the uterine cavity.

Women who manage to become pregnant with endometriosis are at high risk of miscarriage or premature birth due to increased tone of the uterine muscles. Damage to the wall can cause it to rupture during childbirth. Endometriosis is accompanied by uterine bleeding and anemia in women. The spread of the disease to the intestines and urinary organs leads to disruption of their functioning and the occurrence of severe pain.

The development of ovarian endometriosis, the formation of endometrioid cysts and tumors may occur. In this case, there is often a need to remove them, after which irreversible infertility occurs and signs of deterioration appear. general condition woman's health.

Video: Is pregnancy possible with endometriosis?

Causes of endometriosis

Factors that provoke the appearance of endometriosis are hormonal disbalance and damage to the uterine wall. The cause of disruption of the endometrial structure can be:

• performing operations (curettage for diagnostic or therapeutic purposes), eliminating fibroids, removing the embryo during abortion;
• manual separation of the placenta during complicated childbirth;
• use of an intrauterine device;
• inflammatory diseases of the internal genital organs;
• the inability to completely remove the endometrium during menstruation due to narrowing of the cervical canal.

Warning: One of the reasons for the throwing of mucous particles into the pipes and abdominal cavity is considered to be an increase in intra-abdominal pressure. The cause of this phenomenon may be lifting heavy objects or having sexual intercourse during menstruation.

Women at risk of developing endometriosis are those who have puberty began too early or late, as well as those who did not have pregnancies and childbirth in adulthood. The likelihood of the disease is increased in women who become sexually active and become pregnant for the first time at 35 years of age or older.

Endometriosis is one of the possible complications thyroid diseases, diabetes mellitus, autoimmune pathologies. Endometriosis often occurs against the background of physical inactivity, stress, increased physical activity, regular UV irradiation in a solarium.

Obesity leads to hormonal shifts and an increase in estrogen levels, which provoke improper formation of the endometrium. The occurrence of symptoms of such a pathology in the organs of the reproductive system is caused by the impact of unfavorable environmental factors on a woman’s body. The presence of congenital abnormalities in the development of the genital organs and hereditary predisposition to endometriosis is of great importance.

Symptoms of endometriosis

Only after changes characteristic of 2 and subsequent degrees of spread of lesions occur do symptoms of uterine endometriosis appear. The first sign of the disease is the occurrence of menstrual abnormalities. Even the appearance of spotting a few days before the start of menstruation and after its end does not cause much concern. In the absence of other symptoms, the woman attributes them to stress, physical fatigue, and changes in weather.

But when uterine bleeding(sometimes heavy) between menstruation, a trip to the doctor is no longer postponed. Frequent bleeding leads to the appearance of symptoms of iron deficiency anemia (headaches, dizziness, weakness, pale skin and lips, circles under the eyes, decreased blood pressure, nausea, vomiting, rapid heartbeat, shortness of breath).

A woman's menstrual cycle shortens, her periods become painful (algomenorrhea occurs). Paroxysmal pain in the lower abdomen appears a few days before menstruation and continues for several more days after it ends. The cause of pain is stagnation of blood in the uterine cavity, the appearance of adhesions between its body, ovaries and other pelvic organs.

A symptom such as pain is felt in a specific part of the abdomen, depending on the location of the lesions. The pain may radiate to the groin area (if the lesions are located in the corners of the uterine fundus). When endometrioid tissue grows in the cervical area, the pain spreads to the rectum, lower back, and is felt in the vagina.

Sexual intercourse becomes painful (dyspareunia occurs). After them, bloody discharge appears.

Other symptoms of premenstrual syndrome increase (tension and tenderness of the mammary glands, swelling of the arms and legs, mental imbalance, frequent migraines). Possible causeless weight gain.

Video: Signs of endometriosis

Diagnosis of endometriosis

A doctor can assume the presence of uterine endometriosis based on the nature of menstrual disorders that the patient has. It turns out how enlarged the uterus is (its size can be comparable to the size of the organ at 6-8 weeks of pregnancy). During a gynecological examination, the mobility of the uterus is checked (it is limited due to the appearance of adhesions).

A colposcopy is performed. Using this method, small lesions of endometriosis can be seen on the vaginal wall. The surface of the uterus with endometriosis is uneven; sometimes the largest nodes are felt during external palpation.

An effective method is transvaginal ultrasound. The so-called ultrasound signs of endometriosis are detected:

• change in the shape of the uterus (it resembles a ball, enlarges before menstruation);
• heterogeneity of wall thickness due to the appearance of compacted nodes in them;
• the appearance in the myometrium of foci of endometriotic lesions resembling cystic voids.

Difficulties arise during diagnosis diffuse pathology, since small nodes are difficult to notice on ultrasound. Doubts also arise when a large knot is detected, which is sometimes mistaken for myomatous.

To obtain a reliable result, hysteroscopy is performed and the uterine cavity is examined. In this way, areas of insertion of endometrioid cells into the myometrium are detected. Diagnostic laparoscopy is performed to detect foci of endometriosis on the outside of the uterus and in the abdominal cavity. The condition of the uterine cavity is also studied by X-ray examination using a contrast agent or MRI.

The composition of the blood is studied to detect signs of inflammatory processes and anemia, and blood tests are performed for hormones and tumor markers.

Video: Symptoms and treatment features of endometriosis

Treatment of the disease

For endometriosis of the uterus, treatment is conservative or surgical. The technique is selected taking into account the degree of development of the pathology, the age of the patient, and her desire to preserve the ability to bear children.

Drug treatment

This treatment is carried out only in the presence of endometriotic lesions inside the uterine cavity.

Hormone therapy is mandatory. Its goal is to eliminate disturbances in the production of hormones.

Hormonal hormones are prescribed birth control pills. They contain estrogen and progesterone in a balanced ratio. With long-term use of these drugs (up to 1 year), reverse development (involution) of the endometrium occurs and its structure is restored. Synthetic analogues of progesterone (duphaston, primolut) are also used to suppress the production of excess estrogen and normalize their ratio.

Treatment is prescribed with drugs that accelerate endometrial dystrophy (gestrinone), estrogen receptor blockers (tamoxifen), as well as drugs that regulate pituitary hormones LH and FSH, which are responsible for the production of sex hormones.

Treatment with sedatives allows you to reduce the impact of stress, which helps improve hormonal levels and reduce the body's pain sensitivity.

Anti-inflammatory treatment. Usually the drugs are used in the form of suppositories. Eliminating inflammation helps reduce pain. At the same time, medications to strengthen the immune system and vitamins are prescribed.

Hepatoprotectors. Such drugs are prescribed during treatment to protect the liver from the toxic effects of long-term medications.

Surgical treatment of endometriosis

Indications for surgical treatment are the presence of grade 3-4 adenomyosis, the need for simultaneous elimination of fibroids, endometrial hyperplasia, and ovarian cysts. Surgeries are prescribed if treatment with medications has not given the desired result or the woman has contraindications to use hormonal drugs(vascular or endocrine diseases, depression).

Operations are carried out laparoscopic method. Endocoagulation (laser or thermal cauterization) of endometriosis foci is performed. The method of uterine artery embolization (cessation of blood supply to areas of the uterus affected by endometriosis) is also used.

Depending on the severity of the disease surgical treatment allows you to stop the spread of lesions and achieve a temporary improvement in the condition of the uterus, which often gives a woman the opportunity to conceive and give birth to a child. It is possible to completely rid a young patient of uterine endometriosis only by completely removing the organ. Women of menopausal age do not undergo this operation, since the pathology disappears spontaneously.

Endometriosis is a disease accompanied by ectopic proliferation of the mucous membrane, which is inner shell the uterine cavity, and other structures of the female body. The incidence of endometriosis is about 10% of all other gynecological diseases. As a rule, the pathology occurs in women of reproductive age from 20 to 45 years.

What kind of disease is this, what are the causes and characteristic symptoms, as well as how to treat endometriosis - we accessible language We'll tell you in this article.

What is endometriosis?

Endometriosis is a common gynecological disease, in which endometrial cells (the inner layer of the uterine wall) grow outside this layer. The growth of the endometrium can be within the reproductive system (then we talk about the genital form) and outside it (extragenital form). Internal endometriosis accounts for the vast majority of cases of the disease.

In most women, endometriosis develops as a result of a lack or, conversely, increased synthesis of estrogen - the main female hormone, which regulates the activity of the reproductive system, reproductive organs and is responsible for the appearance of skin, nails and hair.

Clinical manifestations depend on the localization of the process. General symptoms- pain, enlargement of endometrioid nodes, bloody discharge from external areas before and during menstruation.

Previously, this disease occurred mainly in women aged 30-50 years. Unfortunately, today it has become significantly younger; patients with endometriosis aged 20-25 years are becoming increasingly common.

Prevalence statistics:

• between the ages of 25 and 45, about 10% of women suffer;
• up to 30% are diagnosed with infertility;
• up to 80% with pain in the pelvic area of ​​a chronic nature.

Types and degrees

According to the localization of foci, endometriosis is divided into:

• Genital - lesions are localized within the woman’s reproductive organs.
• Extragenital - when pathological foci are detected outside the organs of the reproductive system.

There are 3 forms of uterine endometriosis:

• diffuse adenomyosis - proliferation of endometrioid heterotopias over the entire surface of the uterine mucosa with the formation of cavities in the myometrium;
• nodular adenomyosis - the proliferation of endometriotic foci locally with the formation of nodes that do not have a capsule;
• focal endometriosis - only certain areas of the uterine wall are affected.

Depending on volume pathological process, that is, depending on the depth of penetration of the endometrium, several stages of endometriosis of the uterine body are distinguished:

In particular, this is the minimum stage, easy stage, moderate stage and severe stage. The severe stage, as can easily be assumed, is the most painful for patients, and also the most difficult in terms of implementing measures aimed at treating endometriosis.

In case of prolonged illness and late stages course of the disease, endometriosis cells can even be found in the intestines, organs genitourinary system, in the lungs. But, fortunately, this happens quite infrequently and is not the norm.

Causes

Endometriosis is a polyetiological disease. This means that there are many reasons for its occurrence, and in some cases it is still not possible to establish the true cause.

The main theories of the development of pathology are:

• Implantation hypothesis. According to it, under the influence of hormonal and immune disorders, the ability of endometrial tissue to adhere (adhesion) and implantation (implantation) increases. Under conditions of increased intrauterine pressure, such functionally altered cells migrate to other structures, where they continue to grow and form endometriosis in the uterus.
• Metaplastic theory. It comes down to the fact that endometrial cells do not themselves take root in areas unusual for them, but only stimulate the tissue to pathological changes (to metaplasia).
• Heredity. This factor is relevant for many diseases that a person has to face, and endometriosis can also be considered as a disease associated with this factor.
• Immune theory. The body's defense systems remove any tissue and neoplasms that appear in the wrong place. When immunity decreases, endometrial cells outside the uterus do not die, but take root and function normally.
• Do not forget about the ecological microclimate in which a woman constantly finds herself. Thus, it is a scientifically proven fact that young women who live in places with high levels of dioxin suffer from endometriosis more than others.

Other possible factors leading to the occurrence of endometriosis include:

• history of abortions
• environmental impact,
• iron deficiency in the body,
• surgical interventions on the pelvic organs,
• obesity,
• inflammatory diseases of the female genital organs,
• wearing an intrauterine device,
• liver dysfunction, etc.

Today one of the most common reasons endometriosis are considered surgical interventions ever performed in the uterus. It's an abortion C-section, cauterization of erosion and other procedures. In view of this, after such operations you should undergo medical examinations with strict regularity.

Symptoms of endometriosis in women

About half of women with uterine endometriosis have no symptoms of the disease. Adenomyosis, when asymptomatic, is an incidental finding on ultrasound of the pelvic organs. But this only applies to those patients who have stage 1 endometriosis.

Symptoms and signs:

• The most specific symptom that is observed in most patients with endometriosis is pain in the pelvic projection. Pain with endometriosis is constant and intensifies a few days before the onset of menstruation.
• Spotting and spotting before menstruation. This symptom occurs in 35% of women suffering from endometriosis. A few days before the expected menstruation.
• Longer menstrual flow. Duration menstrual flow Many women suffering from endomntriosis exceed average values.
• Bleeding. The appearance of bloody discharge after sexual intercourse is one of the signs, regardless of the location of the nodes.
• Miscarriage, that is, in this case we are talking about spontaneous abortion/miscarriage. The reasons for this outcome are related to the big picture changes against the background of which infertility develops.
• Endometriosis of the uterus causes development of infertility, which is due to two factors. Firstly, implantation of the egg and gestation of the fetus becomes impossible in the altered uterus, and secondly, adhesive process in the small pelvis prevents the penetration of the egg into the fallopian tube.

Other possible symptoms endometriosis of the uterus:

• blood appears in the urine - hematuria;
• frequent urination, frequent urge at night;
• intoxication of the body - chills, general malaise, weakness, drowsiness.

Severity of symptoms in endometriosis depends on many factors: on the form, degree of spread of endometriosis, on concomitant diseases and even on the psychological mood of the woman.

Most women often confuse the symptoms of endometriosis with uterine fibroids, this is especially true for women who were once diagnosed with this disease. Some people do not pay attention at all to changes in menstruation, as well as the accompanying pain symptoms.

Complications

Endometriosis can be asymptomatic and not affect a woman’s quality of life. On the other hand, undiagnosed endometriosis and lack of adequate treatment can lead to complications.

If you do not pay due attention to the disease, its development can lead to the following consequences:

• infertility;
• the risks of miscarriages during pregnancy increase;
• development ;
• chronic diseases of the affected internal organs develop;
• endometriotic tissue can compress nerve endings, which can cause neurological problems.

Diagnostics

At the first suspicion of endometriosis, the doctor determines the composition of the examination, based on the medical history and various individual characteristics your patient.

On examination, foci of endometriosis can be found on the perineum and external genitalia, as well as on the cervix and vagina. The uterus is painful when displaced, can be tilted posteriorly and is tightly fixed in this position. Endometriotic ovarian cysts may be detected.

Examination and palpation alone are usually not enough to diagnose the disease, so the doctor must prescribe additional procedures.

The examination usually includes:

• Hysteroscopy is an examination of the uterine cavity using a special device - a hysteroscope. This device provides visual information on the monitor screen and allows you to directly examine the uterine cavity
• Laparoscopy is a highly informative microsurgical diagnostic method that allows you to diagnose any form of endometriosis and simultaneously carry out appropriate treatment;
• Ultrasonography. Is modern, fast, accurate and in a painless way determine the location, size, internal structure of the cyst, and, in some cases, give a prognosis;
• MRI. This study is 90% informative. But due to its high cost, tomography is rarely performed.
• study tumor markers CA-125, CEA and CA 19-9 and PO test, the levels of which in the blood with endometriosis increase several times.
• To reliably establish the presence of endometrioid tissue in certain organs, cytological and histological examination biopsy material, which is taken by colposcopy and laparoscopy with accompanying biopsy.

When is it necessary to see a doctor?

• For sudden, recurring severe pain in the lower abdomen.
• With a general increase in temperature, nausea and dizziness that appeared out of nowhere against the background of abdominal pain.

How to treat uterine endometriosis?

There are two ways to treat diffuse and nodular endometriosis:

• conservative – taking medications;
• surgical – removal of tumors.

At any clinic the attending physician the doctor must collect as much information as possible on these issues and only then prescribe a treatment method.

The doctor prescribes a comprehensive treatment, which includes:

• Diet (high-calorie foods with a decrease in the amount of spicy and spicy foods, irritating spices);
• Immunocorrection and vitamin therapy;
• Symptomatic therapy (pain relief, anti-inflammatory drugs);
• Normalization of the functions of the hypothalamic-pituitary system, individual endocrine secretion glands (thyroid).

Before prescribing a course of therapy and choosing a treatment method, the doctor takes into account the following factors:

• to which age category refers to a woman;
• prospects for further pregnancy;
• foci of spread and localization of pathology;
• clinical symptoms;
• nature of deviations;
• the state in which the immune system is located;
• duration of treatment.

Depending on the general indications Treatment can be medicinal, surgical (radical or organ-preserving), or combined.

Medications

• Non-hormonal drugs - non-steroidal anti-inflammatory drugs - as an effective means of combating pain.
• Hormone therapy involves long-term treatment, allows you to reduce the likelihood of relapse and achieve stabilization of the process after surgery.

Concerning drug treatment, then it is aimed at suppressing the growth/reproduction of endometrial cells. The following groups of drugs are mainly used for endometriosis:

1. In the early stages, the Mirena intrauterine device is successfully used. Her inner part filled with hormones that can replace female hormones, the lack of which provokes the growth of the endometrium.
2. combined action oral contraceptives (Marvelon, Femoden, Diane-35, etc.);
3. drugs representing the group of antigonadotropins (gestrinone, danazol, etc.). Danazol is used for 6 months. After 1–2 months of treatment with danazol, (cessation of menstrual flow) usually occurs. The menstrual cycle is restored 28–35 days after stopping use.
4. drugs representing the group of progestins (Depostat, Duphaston, etc.);
5. drugs of the agonist group (decapeptyl-depot, Zoladex, etc.);
6. antiestrogens (tamoxifen, etc.).

Other groups of drugs that help in the fight against symptoms:

• In addition to the main treatment, for the purpose of auxiliary therapy, anti-inflammatory, anti-spasm, sedative drugs can be prescribed: Novo-Passit, Ibuprofen, No-Spa, as well as vitamins;
• Sedatives (elimination of neurological manifestations);
• Immunomodulators (normalization of impaired immune status);
• Vitamins A and C (correction of deficiency of the antioxidant system);
• Iron supplements (elimination of the consequences of chronic blood loss);
• Physiotherapy.

Hormonal treatment should begin with the first menstrual cycle after surgery. The duration is 3–9 months, depending on the extent of the spread and severity of the process.

As mentioned above, determine the treatment regimen and control the effect Only your gynecologist can.

Self-medication for endometriosis hormonal drugs contraindicated due to many side effects of these drugs and the need to monitor the effectiveness of the treatment.

Surgical treatment of endometriosis

Surgery to remove the pathological focus, partial or complete resection of the affected organ is the main method radical treatment this female disease, endometriosis with genital and extragenital spread.

Indications for surgical treatment There are three main factors:

• Severe pain syndrome.
• The presence of individual tumor formations in organs.
• Infertility.

The type of operation depends on the following factors:

• patient's age;
• presence of concomitant chronic diseases;
• planning to replenish the family in the future;
• location of the focus of endometriosis;
• the degree of damage to surrounding tissues and organs;
• complications of the disease.

Depending on the type of endometrioid disease, the following types are possible: surgical interventions:

• uterine artery embolization, used for severe bleeding;
• removal of the uterus or resection cystic tumor ovary during abdominal surgery;
• hysterectomy via vaginal access;
• laparoscopic version of the operation.

Any type of operation requires full general anesthesia, both for abdominal and laparoscopic interventions. The main goal of surgical treatment is complete removal endometrioid lesions with maximum preservation of healthy tissue. This is especially important for women of reproductive age.

Recovery after surgery

• procedures using electrophoresis with the addition of zinc and iodine;
• therapeutic effects of ultrasound;
• baths with water enriched with radon;
• douching with medicinal anti-inflammatory compounds.

IN exceptional cases When neither the first nor the second methods help, surgery to remove the uterus may be required. Doctors are trying in every possible way to avoid this, and not only out of a desire to preserve the ability to bear children, but also because a woman’s entire life directly depends on hormonal levels, and the removal of the uterus and ovaries greatly changes it, and therefore changes the woman’s life.

Folk remedies

Traditional methods have been used for the treatment of endometriosis for a long time. folk remedies, but they are in no way a substitute for medication or surgery.

1. Dried and crushed cucumber shoots It is recommended to brew it like tea and drink without restriction.
2. Beetroot juice. You must take only freshly squeezed juice, and no more than 100 ml three times a day. You need to start treating endometriosis with this remedy with small dosages. If no allergic reactions occur, its amount can be increased to the above. However, remember: before drinking the medicine, it must first be left for 4 hours.
3. Infusion of boron uterus with endometriosis. It is prepared from 2 tablespoons of herbs. They are poured with boiling water (2 cups), covered with a lid and wrapped. Let it brew for 15 minutes, then strain. This infusion is taken in several dosages: either 4 times a day, half a glass half an hour before meals, or (a more gentle method) a tablespoon 3 times an hour before meals.
4. Castor oil Helps the body get rid of excess tissue and toxins. It should be used at the beginning of the menstrual cycle, when cramps are just beginning.
5. Chamomile has anti-inflammatory properties that help reduce inflammation as well as swelling.

Prevention

Preventive measures should be taken by all women of childbearing age, regardless of whether they have the disease or not. Particular attention must be paid if used intrauterine contraception, obesity or elevated estrogen levels are present.

To prevent endometriosis, it is necessary to:

• if severe pain appears before menstruation (dysmenorrhea), you must consult a gynecologist;
• after any surgical interventions in the uterus, it is necessary to be under the supervision of a gynecologist;
• successful treatment inflammatory diseases genital organs, even chronic ones.

The risk of developing endometriosis in the uterus is higher in the following groups of women:

• those who note a shortening of the menstrual cycle;
• suffering from disorders metabolic processes, obesity, overweight;
• using intrauterine contraceptives;
• after the age of 30-35 years;
• having increased level estrogens;
• those suffering from immunosuppression;
• having a hereditary predisposition;
• who have undergone uterine surgery;
• smoking women.

We examined in an accessible language what kind of disease this is, talked about the signs and methods of treatment. Endometriosis of the uterus is a recurrent chronic disease. Relapses after conservative therapy or organ-preserving operations within a year occur in 20% of cases; after 5 years of disease development, the number of relapses increases to 75%.

Remember, those women who use intrauterine contraceptives, those who are already thirty years old, should undergo regular examinations and consultations with a doctor. Be healthy and take care of yourself!

A woman's reproductive system is complex, but pathological disorders she can easily appear. It can be very difficult to regain your previous health. Today, a disease called endometriosis has begun to spread. After its appearance, a woman experiences subtle symptoms, which is why the pathology is so difficult to identify.

Once upon a time, this disease mainly affected women over 30 years of age, but today young girls also suffer from it. You should know the signs of endometriosis in order to identify the pathology in advance.

Classification of the disease

In gynecology, there is a classification of the disease according to its location. Endometriosis happens:

1. Genital.
2. Interior. The endometrium grows in the muscles of the uterus
3. Outer.
4. Peritoneal. Develops in the pelvis and ovaries.
5. Extragenital. Affects the bladder, intestines, lungs, kidneys.
6. Extraperitoneal. Appears externally on the genitals.

This pathology can be mild or severe. Sometimes it is difficult to determine the type of disease due to the size of the lesion. Most often, a severe form appears due to improper treatment.

There are 4 stages of endometriosis:

• minor;
• easy;
• moderate;
• heavy.

The latter form is difficult to treat and is more painful.

Causes of the disease

When a woman develops endometriosis, the causes are sometimes difficult to identify. Doctors today cannot accurately answer the question of why this disease develops. There are only theories regarding this. But there is no direct evidence.

Some experts say that retrograde menstruation can affect the development of pathology. In such a situation, in women, blood enters deep into the uterus and tubes. It contains endometrial particles that can stick to different places.

Endometriosis can be caused by procedures that involve invading the uterus. This may include:

• abortion;
• elimination of polyps;
• miscarriage;
• surgery, etc.

After the operation, the body recovers, but scars remain that are difficult to resist the appearance of the endometrium.

Hormonal imbalance can also affect the appearance of endometriosis. Studies have been conducted that have revealed that women who experience stress and strain their bodies both psychologically and physically are considered vulnerable.

There is also a theory that the development of pathology is influenced by hereditary predisposition. It is believed that the risk of developing the disease increases in those whose relatives already had endometriosis.

Some scientists are working on a test that will help a woman find out whether she may develop a pathology due to heredity. With such information, a woman will be able to carry out proper prevention so as not to receive negative consequences and not hear the diagnosis of endometriosis.

Signs of the disease

A huge number of women do not regularly visit a gynecologist for preventive examinations. For this reason, many representatives of the fair sex are not even aware of the development of endometriosis in their bodies. This happens due to the fact that the pathology does not initially manifest special symptoms, so it’s hard to guess about the disease.

But you need to carefully monitor your own condition, this is the only way to notice the signs of endometriosis. The following symptoms of the disease are identified:

• Menstruation lasts longer, painful sensations appear;
• after and before the onset of menstruation, women experience spotting;
• periodic appearance of internal pain in the pelvic area;
• women experience pain during sexual intercourse;
• feeling weak, tired, sleepy (by the way, such symptoms may indicate other diseases);
• in advanced stages of endometriosis, pain occurs during bowel movements and urination.

After your period ends, all pain disappears. This happens due to the fact that the condition of the mucous membrane is associated with the cycle.

Regardless of what signs of pathology there were, the diagnosis of endometriosis can only be made by an experienced doctor who will need proper diagnosis. The most top scores shows ultrasonography, with its help you can determine the diagnosis. The following echo signs are characteristic of this disease:

• the uterus enlarges;
• certain walls thicken;
• echo signs also include increased echogenicity of the myometrium;
• Before menstruation, a cyst opens.

The main thing is that the woman does not ignore the signs of pathology, otherwise she may get severe consequences. Her body needs proper diagnosis and then the required treatment. Not only the woman’s health, but also her future ability to have children will depend on this. This is especially important for those who plan to grow their family.

For treatment, the doctor often uses hormone therapy, this helps stop the development of the endometrium for a certain period. After completing the course, it can begin to continue to grow. For this reason, it is necessary to take medications that will maintain the condition.

Surgeries are also performed in cases of pathology, but the degree of the disease, the age of the women and the desire to have a child in the future must also be taken into account. Today, laparoscopy procedures are widely used. This way you can preserve the functions of the genital organs.

The danger of the disease for women's health

The consequences for women from the disease can be dire. First of all, it should be emphasized that endometriosis can ultimately lead to infertility. The study of this pathology continues to this day, but it has been noted that 60% of women who have suffered the disease face problems with conceiving a child.

This difficulty is believed to arise due to pathological changes uterine mucosa. This results in the egg that has been fertilized being unable to latch onto itself. Sometimes the uterine tubes close, and there have also been cases when a woman does not ovulate. It is these consequences that lead to problems with pregnancy.

A tilted uterus can also prevent conception. In most cases, women got rid of infertility when they were cured of the pathology. But there were also cases when the disease was in an advanced form, then doctors had to remove the uterus. Of course, in such cases the woman will not be able to get pregnant.

But it is also difficult for those who managed to get pregnant, as it becomes difficult to bear a child. Such women are more likely to have a miscarriage. For this reason, you should consult your doctor throughout your pregnancy. Also, a woman should monitor her lifestyle, diet, and not exercise.

Anemia

After experiencing an illness, a woman can suffer not only from infertility. Due to the fact that the patient has heavy periods, she may begin to develop anemia. After all, with the loss of blood in the body, the level of iron decreases. And with its help, all organs receive oxygen. As a result, there is not enough of it, and acid starvation occurs. This results in weakness and loss of strength. This feeling haunts a woman throughout the day.

In addition, pathology can provoke the development of uterine fibroids. This is due to being lost protective functions body. It's even worse if the diagnosis of endometriosis develops into cancer. The appearance of tumors due to this pathology was often observed. Therefore, timely diagnosis is also important.

Diagnosis of pathology

Actually initial stage developmental pathology is difficult to detect. Diagnosis is made from a gynecological examination. The doctor may also ask you to undergo proper tests and other research methods.

When a doctor examines a patient, she may notice for endometriosis that reproductive organs began to increase. Often the examination is complicated by the fact that the woman feels sharp painful impulses. Therefore, to determine endometriosis, the following diagnostics are performed in women:

1. Ultrasonography. With its help, the internal organs that are located in the pelvic area are examined. With this technique, pathology can be easily noticed.
2. Blood analysis.
3. Hysterosalpingography. This procedure requires a contrast agent. Using diagnostics in this way, you can determine the stage of the pathology.

Prevention of disease

Prevention of endometriosis is very important. Stick to simple rules should not only be for those who have previously experienced the disease, but also for all female representatives. This will help them protect themselves from health problems.

Every woman should visit a gynecologist in order to monitor the condition female organs. If the slightest problems appear, they should be treated and not put off until later. Doctors advise not to be sexually active during menstruation, as intimate intimacy often becomes the cause of endometriosis. You also need to protect yourself from stress.

If you follow these simple rules, you can reduce the risk of not only endometriosis, but also other pathologies.

But when the disease does appear, women often have to undergo surgery. In this case, the lesions are removed. There are the following ways to do this:

• vaporization using laser;
• resection;
• electrocoagulation.