What is endometriosis?
Endometriosis is a disease that affects about one in ten women of childbearing age worldwide. It is often masked by symptoms similar to menstruation, making it difficult to diagnose.
As explained by Professor João Luís Silva Carvalho, Clinical Director of CETI, “this pathology derives from the fact that the endometrium, which forms every month to allow for the implantation of the embryo and which is expelled every month during the menstrual period, when pregnancy does not occur, migrates out of the uterine cavity and implants itself in the pelvic cavity, namely in the ovaries, intestine and peritoneum”.
What is the endometrium?
The endometrium is the tissue that lines the inside of the uterus and its thickness varies throughout the menstrual cycle, being regenerated cyclically through a process of desquamation and regeneration. This desquamation allows the renewal of all the elements of the endometrial tissue.
In which organs is endometriosis located?
The normal location of endometriosis – a disease characterized by the presence of the endometrium – is, for example, the pelvic peritoneum, fallopian tubes, ovaries, bladder, appendix, intestines or even the diaphragm. In rarer cases, endometriosis can also manifest itself in more distant organs, such as the lungs or the brain.
In the various extra-uterine locations of endometriosis, the endometrial tissue undergoes transformations similar to those that occur in the uterus during the menstrual cycle, which most frequently result in pain and infertility.
It is important to note that endometriosis affects women from their first period and can last until their last.
Does endometriosis cause infertility?
According to international estimates, 50% of women with endometriosis have infertility and 25% to 45% of female infertility cases have endometriosis as one of the main causes.
The chronic inflammatory process of endometriosis, which consequently causes a spontaneous healing process, leads to the formation of pelvic adhesions, generating anatomical changes that can result in the obstruction of the fallopian tubes, responsible for the first events of fertilization, thus preventing their full functioning.
Additionally, inflammatory cells can affect egg and sperm quality.
What are the symptoms of endometriosis?
Symptoms vary depending on where the endometrial tissue is located, but the most common symptoms of endometriosis in the pelvic cavity are:
- Cramps;
- Abdominal pain;
- Hematuria (blood in the urine);
- Retorrhagias (rectal hemorrhages).
How is endometriosis detected?
Endometriosis is a disease that can be diagnosed clinically based on history and gynecological examination. Although to a limited extent, pelvic ultrasound and, in specific situations, magnetic resonance imaging or diagnostic laparoscopy can be helpful.
How is endometriosis treated?
According to Professor João Luís Silva Carvalho, there are three types of treatment, depending on the objective. Endometriosis treatment can be:
- Hormonal , which serves to prevent the progression of the disease;
- Surgical , by minimally invasive laparoscopic surgery, which is the main form of treatment for this disease. Surgical excision resolves the problem of endometriotic lesions and eventually the affected organs;
Using Medically Assisted Reproduction techniques to overcome the problem of reproductive failure (infertility).