Endometriosis; It is a chronic disease that is most common in women between the ages of 20 and 45 in the reproductive age group, and begins as painful menstrual bleeding that does not respond to painkillers, and disrupts the quality of life of the woman, leading to pain during intercourse and infertility.
The lining of the uterus, Endometriosis is the settlement of cells called endometrium in organs outside the uterus, which thicken and shed every month under the influence of estrogen and progesterone hormones, causing bleeding. Although it is most commonly seen in the ovaries, tubes, and abdominal membrane, it is also seen to settle in organs such as the intestines, bladder, stomach, lungs, eyes, nose, and sometimes in the cesarean section area. Since these cells thicken and shed under the influence of hormones every month and bleed like menstrual bleeding, the blood that accumulates in their location every month causes tissue damage and adhesion formation over time. As a result, it can lead to chocolate cysts in the ovaries, obstruction of the tubes, and adhesions between the abdominal membrane and the uterus, intestine, and ovaries.
Who should be reminded of endometriosis the most?
It should be considered that endometriosis may be present in those who have early menstruation and severe menstrual pain, those who suffer from recurrent and persistent lower abdominal pain, those who have painful sexual intercourse, those who have long periods with heavy bleeding and painful periods, those who complain of unreasonable infertility, and those who have relatives with endometriosis, such as mothers and sisters.
Endometriosis gives symptoms according to its location
- The most common (75%) are recurrent lower abdominal pain, painful menstruation, pain during sexual intercourse (ovarian uterus). When it settles in the ligaments that hold it in place and in the abdominal membrane)
- Infertility occurs in 25-50% (causing blockage in the tubes and affecting the ovaries)
- Painful, excessive and long-lasting menstrual bleeding (when it settles in the muscle of the uterus: adenomyosis)
- Constipation-diarrhea, abdominal pain (intestinal), eye and nose bleeding, bloody urine
Since endometriosis is a progressive and recurrent disease, it requires patience and continuous follow-up. . Various treatment options, including medical treatment, in vitro fertilization and surgical methods, are evaluated and applied depending on the person's complaint, the severity of the signs and symptoms, and the patient's expectations. in young ages While medical treatment is primarily preferred for pain, surgical treatment methods may be preferred in advanced cases and those who have completed their fertility.
Chocolate Cysts May Cause Infertility!
When endometriosis settles in the ovary, surgical treatment methods may be preferred. Cysts formed as a result of bleeding during the menstrual period are called chocolate cysts (endometriomas) because the color and density of the blood that accumulates and condenses inside them resemble chocolate. While simple cysts in the ovaries pass on their own over time, chocolate cysts do not go away, on the contrary, they gradually grow.
The priority treatment for those with chocolate cysts and infertility problems should be in vitro fertilization. It should not be forgotten that early and unnecessary surgery reduces the ovulation and pregnancy capacity in those who do not have children, but surgery should be considered when there is no other option.
Gynecology and Obstetrics Specialist Op. Dr. Leyla Ercan: "Although the causes of endometriosis are still not fully known, many reasons are thought to be such as reverse flow of menstrual bleeding into the abdominal cavity through the tubes, vascular spread of endometrium cells, weakness in the person's immune system and genetics."
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