Endometriosis of the uterus – one of the most common pathologies of the female reproductive system, which is faced by women of different ages. According to statistics, this disease is diagnosed in every tenth woman of reproductive age.
The endometrium is the inner mucous membrane of the uterus, rich in blood vessels. This tissue is sensitive to hormonal changes, so it changes monthly in women of childbearing age.
In the last phase of the menstrual cycle, it thickens significantly in preparation for embryo attachment. If fertilization does not occur, the functional layer of the endometrium is rejected during menstruation. Menstrual irregularities are often the first sign of a developing disease. After the end of menses, the process of restoration of the uterine mucosa begins.
It is important to realize that endometriosis is not just endometrium that grows outside the uterus. It is an endometrium-like tissue that is outside the uterine cavity and has a slightly different structure. This tissue can be present in the body from birth or occur during life. The exact causes of endometriosis are still a matter of scientific research.
Causes
At the heart of the development of endometriosis is a violation of the ratio of hormones: an excess of estrogen and a lack of progesterone. Factors that increase the risk of hormonal imbalance with the subsequent development of endometriosis may be:
- heredity;
- inflammatory diseases of the genital system, promiscuous sexual intercourse;
- excessive physical activity during menstruation, changes in the menstrual cycle;
- late first pregnancy, low number of births, repeated abortions, operations on the reproductive system;
- use of intrauterine devices longer than the recommended period;
- endocrine disorders, overweight or underweight;
- prolonged stress, weakened immune system, intoxication;
- poor environmental conditions;
- liver disease.
Main symptoms of endometriosis
What symptoms of endometriosis should alert every woman? We present a checklist of the main signs of the disease:
Pain syndrome:
- Chronic pelvic pain (especially during menstruation)
- Pain during sexual intercourse (dyspareunia)
- Painful urination or defecation during menstruation
- Unsubstantiated pelvic pain
Menstrual disorders:
- Heavy periods (hypermenorrhea)
- Irregular menstruation
- Intermenstrual bleeding
- Menstrual disorders of different nature
Reproductive problems:
- Infertility in women or difficulty conceiving
- Prematurity
General symptoms:
- Chronic fatigue and decreased ability to work
- Abdominal bloating
- Nausea during menstruation
- Decreased immunity
It is important to note that the intensity of symptoms does not always correspond to the stage of the disease – sometimes even the initial forms of endometriosis can cause severe pain.
Modern methods of treatment of endometriosis
Treatment of endometriosis requires a comprehensive approach and individual selection of therapy. Modern medicine offers several effective treatment strategies depending on the stage of the disease, the age of the patient and reproductive plans.
First-line drug therapy
The first line of treatment is drug therapy for endometriosis, which includes hormonal medications:
- Hormonal spiral (effective for up to 5 years)
- New generation combined oral contraceptives
- Long-acting progestins
Properly selected drug therapy of endometriosis can significantly improve the quality of life of the patient and prevent the progression of the disease.
Modern hormone therapy
- GnRH agonists and antagonists (treatment course 6-24 months)
- New generation aromatase inhibitors
- Selective progesterone receptor modulators
According to a study published in Reviews in Endocrine and Metabolic Disorders, hormonal drugs are the basis of drug treatment of endometriosis, affecting the key pathogenetic mechanisms of the disease – estrogen dependence and progesterone resistance. Modern hormonal therapy regimens demonstrate high efficacy in controlling the symptoms of the disease in 70-85% of patients.
Surgical treatment of endometriosis
Complex cases require surgical treatment of endometriosis, which helps to eliminate the foci of the disease. Indications for surgery include:
- Endometrioid cysts of 3 cm or more with ineffective conservative therapy
- Infertility in women associated with endometriosis
- Deep infiltrative endometriosis
- Chronic pelvic pain not amenable to medical treatment
Modern surgical treatment of endometriosis is carried out mainly by laparoscopy for endometriosis, which allows to minimize the traumatic nature of the intervention and reduce the rehabilitation period.
The latest treatments for endometriosis
- Targeted immunotherapy (blocking inflammatory pathways)
- Use of antifibrotic drugs
- New generation estrogen receptor modulators
- Combined treatment regimens with non-steroidal anti-inflammatory drugs
Practical tips for symptom relief
In addition to medical treatment, there are self-help methods that can help relieve endometriosis symptoms at home:
Control of pain syndrome:
- Heat treatments (heating pad on the lower abdomen)
- Warm bath with relaxing oils
- Non-steroidal anti-inflammatory drugs (as recommended by your doctor)
- Light abdominal massage
- Special exercises to relieve tension in the pelvic area
Dietary recommendations:
- Increase intake of omega-3 fatty acids (fish, flaxseed oil)
- Decrease consumption of foods that stimulate inflammation (red meat, trans fats)
- Incorporating turmeric, ginger, green tea into the diet
- Limit caffeine, alcohol and refined sugar
- Control of the glycemic index of consumed foods
Stress Management:
- Regular practice of yoga and meditation
- Breathing exercises
- Adequate sleep (at least 7-8 hours)
- Progressive muscle relaxation techniques
These techniques are not a substitute for professional medical treatment, but can significantly improve quality of life and complement mainstream therapy.
Prevention and lifestyle
The following recommendations can help maintain reproductive health and reduce the risk of endometriosis progression:
- Regular preventive check-ups with a gynecologist (at least once a year)
- Balanced diet with sufficient omega-3 and vitamin D intake
- Moderate physical activity
- Stress control
- Avoidance of bad habits
- Maintaining a normal weight
It is impossible to completely prevent the development of the disease, especially in the presence of genetic predisposition, but a proper lifestyle and regular follow-up with a specialist will help to identify the problem at an early stage.
