Endometriosis is a pathological process of benign growth in various organs of tissue, similar in structure and function to the endometrium – the inner lining of the uterus that is shed during menstruation. Endometrial growths undergo cyclic monthly changes, have the ability to penetrate into the surrounding tissues and form extensive adhesive processes.
How does endometriosis develop?
During each menstrual cycle, the endometrium (the inner lining of the uterus) matures and is shed along with the menstrual flow. This is normal. But for reasons that have not been clarified so far, endometrial cells can begin to travel throughout the body. Through the fallopian tubes, they enter the peritoneum, sit there on neighboring organs or sink into the thickness of the uterine wall, taking root and starting to function like a normal endometrium inside the uterus. Each menstrual cycle, the impostor focus increases in volume, weaving something like a web in the tissues, swelling and bleeding. At the same time, the fluid produced by the cells of the endometrium does not go outside – hence the pain. In response to irritation, adhesions form in the abdominal cavity, obstruction of the fallopian tubes develops. If endometriosis affects the ovary, cysts are often formed there – cavities, filled with liquid content. The existence of such a cyst, of course, disrupts the functioning of the ovary: there is a threat of infertility.
Currently, the cause of endometriosis is explained by a genetic predisposition, the theory of hormonal development of the disease, according to which the origin of endometriosis is associated with a violation in the body of a woman of the content and ratio of hormones. This is confirmed by certain changes in the foci of endometriosis during the menstrual cycle and the reverse course of the development of the disease during pregnancy and postmenopause. The implantation theory suggests that the rejected particles of the endometrium settle on the ovaries, tubes, peritoneum and give rise to the development of the disease. However, the most important are the negative changes in the neuroendocrine system due to stress, malnutrition, general somatic diseases, dysfunction of the endocrine glands, infection of the genital organs.
Depending on the localization of the process, genital and extragenital (located outside the genital organs) endometriosis are distinguished. Genital, in turn, is divided into internal (damage to the body of the uterus) and external (damage to the cervix, vagina, ovaries, fallopian tubes, pelvic peritoneum, etc.).
As a rule, endometriosis has the appearance of separate or merging with other tissues of small foci (nodes, nests) of a round, oval and irregular shape, the cavities of which contain a dark thick or transparent liquid. Endometrioid formations can consist of many small cystic cavities (cellular structure) or acquire the character of a cyst (for example, an ovarian endometrioid cyst).
Manifestations of endometriosis
All localizations of endometriosis are characterized by:
- long progressive course of the disease;
- pain, especially pronounced in the premenstrual period or during menstruation, associated with the accumulation of blood in the endometrioid formations. With a long course of the disease, pain sensations can be constant, which is due to the transformation of the mechanisms of perception of pain sensitivity as a result of the appearance of endometrioid tissue in uncharacteristic places (in the uterine muscle, on the peritoneum, etc.), shifts in the activity of the nervous autonomic system;
- an increase in the size of the affected organ or extragenital foci on the eve and during menstruation;
- failure of menstrual function, the signs of which are most often painful heavy menstruation, lasting more than the prescribed period, a violation of their periodicity, the appearance of spotting at the beginning and at the end of menstruation.
Infertility is the most frequent and formidable companion of this insidious disease. It affects approximately 46-50% of women diagnosed with endometriosis. The reasons for the improbability of becoming pregnant in this case are different: a violation of the ovulation process (maturation and release of the egg), the formation of adhesions in the pelvis as a result of the activity of endometrioid foci in the ovaries and fallopian tubes, and endometrial inferiority due to changes in the menstrual cycle.
A certain negative role is played by prostaglandins – substances, the number of which increases due to the inflammatory reaction in the tissues surrounding the endometriotic lesions. Moreover, in the focus of inflammation, the number of macrophages increases – cells that have the ability to absorb tissue decay products, bacteria and, most importantly, spermatozoa.
The classic picture of endometriosis is pain that intensifies before and during menstruation. They can be so strong that doctors are more likely to think about appendicitis or an ectopic pregnancy. With the germination of endometriosis in the rectum, pain appears during defecation, and if endometriosis has penetrated the bladder – during urination. But there are also so-called small forms of endometriosis, when its foci do not make themselves felt, nevertheless doing their job: leading to the formation of adhesions, obstruction of the fallopian tubes and, ultimately, to infertility. Patients are characterized by irritability, imbalance, tearfulness. Women often complain of dizziness and headache, unpleasant painful sensations during intercourse. Not often endometriosis is accompanied by other diseases of the genital organs: fibroids, inflammation, anemia.
The causes of endometriosis are still a mystery. But it is well established that if the mother was sick, and even more so the grandmother, and the daughter is likely to have signs of endometriosis. Among the risk factors are abortions, curettage of the uterus, since such procedures are the strongest hormonal and mechanical stress for the reproductive organs. Birth injuries of the cervix, and any inflammatory processes in this area can lead to the spread of endometriosis to the cervix. It is known that stressed women are more likely to suffer from endometriosis. This is due to the close relationship between the nervous and hormonal systems, as well as the fact that stress reduces immunity – that’s why the traveling endometrial cells take root in the wrong places.
When making a diagnosis, clinical test data are taken into account, special examination methods are also used, such as gynecological examination, ultrasound, hysteroscopy, hysterosalpingography, laparoscopy, and a blood test for special tumor markers (tumor markers).
It should be remembered that with any intrauterine interventions, primarily with surgical abortions, the risk of this disease increases. Therefore, after a surgical termination of pregnancy, it is strongly recommended to carry out a complex of rehabilitation measures, regular monitoring by a gynecologist-endocrinologist for the purpose of timely prevention and treatment of endometriosis and related complications, especially infertility.
In official medicine, medical and surgical methods are used to treat endometriosis. For drug treatment, hormonal products are used. Courses of treatment, as a rule, are long and ineffective, and relapses of the disease are frequent. In some cases, surgical treatment of endometriosis is performed. Surgical removal is mandatory for endometrioid ovarian cysts. Currently, the standard method of surgical treatment of endometriosis is laparoscopy.
Until recently, women suffering from endometriosis tried to help drugs containing sex hormones. Such products really “work” well for many gynecological diseases, but, as practice has shown, they are sometimes ineffective for endometriosis. Later, a new class of hormonal products was discovered that destroy the regulation of the reproductive system at the level of the brain, as a result of which artificial menopause begins, cyclic processes in the ovaries are turned off and the endometrium stops growing. Its foci, having lost hormonal stimulation, gradually atrophy. Termination of treatment means the resumption of the menstrual cycle. But the widespread use of this method is hampered by the high cost of products.
Another method of diagnosing (and at the same time treating) endometriosis is diagnostic laparoscopy. With the advent of laparoscopic methods, women have ceased to be afraid of operations: they are carried out through a minimal incision (0.5 cm). After the operation, treatment continues. Means that normalize the menstrual cycle, physiotherapy are used. If a woman no longer plans to have babies, and endometriosis has affected a significant part of the body of the uterus, the entire uterus is removed.
Many women are alarmed by the low effectiveness of hormonal products, their side effects (impaired fat metabolism, osteoporosis, hair loss, hormonal dysfunction, obesity, etc.), and you always want to postpone surgical treatment for “later”. In order to eliminate this rather formidable disease, non-traditional methods of treatment come to our aid – these are medicinal herbs, acupuncture and leeches.
Phytotherapy is aimed at balancing the hormonal background, which is always disturbed, with all this disease, without the use of chemicalized hormonal products, at increasing immunity and body defenses, relieves inflammatory processes, and normalizes the activity of many organs and systems.
The most effective of the methods of traditional medicine is hirudotherapy, based on the therapeutic effect of medical leeches.