Endometriosis

Endometriosis: An insidious disease

Endometriosis is one of the most common conditions found in gynecology. It is an "insidious" disease, as its diagnosis is often not easy. At the same time, its effect on women's health is significant.

What is endometriosis?

The disease is characterized by the presence of endometrial tissue outside the endometrial cavity. Although this tissue is morphologically and biologically similar to the endometrium, it is not normal for it to be located outside the uterus. When this happens, we are talking about endometriosis.

Where is endometriosis located?

The most common location is the ovaries, but endometriosis can be additionally localized in other organs of the pelvic cavity and not only. In fact, there are cases of its detection even in the lung. This ectopic tissue responds to ovarian hormones, making cyclic changes. Thus, it leads to the creation of endometrium’s or otherwise chocolate cysts that owe their name to their color.

Endometriosis: How common is it?

Endometriosis occurs mainly in women of reproductive age. The average age of women with this disease in recent years is getting younger and younger. Studies have shown that its percentage ranges from 40 to 60% for women with dysmenorrhea and 20 – 30% for women with infertility problems. Although difficult to estimate, it appears to be found in 6.2% of the wider female population. What are the symptoms?

The condition can manifest itself with several symptoms:

• The most common finding is dysmenorrhea, pain during menstruation. This pain is usually unbearable and is a major obstacle in a woman's daily life.
• Another symptom is chronic pelvic pain, a chronic feeling of heaviness and pain in a woman's lower abdomen. This feeling is usually confused with pain on period days. However, it is characteristic that chronic pelvic pain is noticeable regardless of the period.
• Also, many women with endometriosis complain of pain during their sexual contacts, i.e. they present dyspareunia.

Also, depending on the organ involved, the woman may present other kinds of problems. For example, there may be dysuric discomfort (if endometriosis foci are located in the ureter) or pain during bowel movements (if there is involvement of the intestine).

Endometriosis is responsible to a significant extent for cases of infertility, since it is associated with the formation of adhesions, while it can also lead to obstruction of the fallopian tubes.

Is endometriosis related to infertility?

It is very important to note that endometriosis is also responsible for cases of infertility. The onset of the disease may be associated with the formation of adhesions, and can also lead to obstruction of the fallopian tubes. At the same time, endometriosis may be related to immune mechanisms that are not completely known.

In these cases, the appropriate gynecologist – specialized in Infertility and Assisted Reproduction will help the woman cope with endometriosis. After all the necessary tests have been performed, she will discuss with her the various treatment options. In fact, depending on the case, and if the woman wishes to become pregnant, she may suggest the option of IVF.

Is there a cure for endometriosis?

Many efforts and studies have been done in order to find the most appropriate treatment for women suffering from endometriosis.

Over the years, various substances have been tested, such as nonsteroidal anti-inflammatories, immune modulators or hormonal preparations. In fact, there is evidence for the use of contraceptive tablets, progestin’s, androgens, agonists, but also gonadotropin releasing hormone antagonists or even aromatase inhibitors. However, none were found to completely fight endometriosis.

Of course, there is also surgical treatment with laparoscopy being the gold standard test for both diagnosis and fight of the disease. In this case too, however, relapses are often observed.

We conclude, therefore, that endometriosis is a common disease of young women, with many ways of manifestation that often make their daily lives difficult. Most importantly, it can also play a determining factor in fertility. Diagnosis and treatment remain another challenge for gynecologists.

In any case, it is advisable to contact the doctor if you have symptoms similar to endometriosis, in order to make the appropriate investigation.

Dr. Athanasios Papanikolaou is a Gynecologist – Assisted Reproduction & IVF Specialist with many years of experience in his field in Greece and abroad. The doctor belongs to the team of specialized scientists of the Institute of Life Assisted Reproduction Center, helping many couples to create their own family. Taking into account the personal needs of each woman, she undertakes to examine each case in depth and suggest the appropriate treatment for her.

Do not hesitate to contact him for a personalized approach!