Endometriosis briefly means the lining of the uterus settles into organs outside the uterus. It is most commonly located in the abdominal membrane, which we call peritoneum, ovaries (chocolate cyst), tubes and intestines, as well as many other intra-abdominal and extra-abdominal organs. These cysts, popularly known as chocolate cysts and located in the ovaries, are called endometriomas. Its name comes from the fact that the cyst contents really resemble liquid chocolate. Today, many treatment modalities have been developed for this strange disease, whose exact cause has not yet been found and is being tried to be elucidated with hypotheses. When you type endometriosis into the Google search engine, over 2,750,000 results have been reported, and it ranks first as the most researched, most common, and most frequently causing menstrual pain and intercourse pain, and is one of the most curious diseases of gynecology due to its complex pathophysiology (cause).
The most common complaints are menstrual pain, pain during sexual intercourse and difficulty in getting pregnant. But many women continue their lives without knowing that they have a disease such as endometriosis, without any symptoms. It is known that it is more common in women who have problems getting pregnant, as it is being researched to help them become pregnant. Treatment options vary depending on the severity of the disease, the degree of spread and involvement, and the desire for a child, so personalized treatment should be applied. In other words, not every treatment for endometriosis is suitable for every patient. Thanks to developing medicine, in recent years, the damage that occurs at the molecular level in endometriosis has become better understood and better treatment modalities and patient-friendly solutions have been developed. For example, the endometriosis treatment of a young expectant mother who wants to have children is completely different from the endometriosis treatment of a 35-year-old woman who has 3 children and has a lot of pain complaints. According to the degree of spread of endometriosis disease;
This disease, which we encounter on average in 10-20% of our young and fertile women, has a rate of 30-40% in the patient group who want to have children and have difficulties in this regard. rate appears. But the interesting thing is that many women are unaware of this disease.
As of 2010, although the equality of endometriosis = infertility has not been proven and no consensus has been reached on this issue, there is still a lot of evidence that it makes it difficult to get pregnant. There are two underlying effects of endometriosis preventing pregnancy.
1. Effect of anatomical damage to reproductive organs
2. Negative effects developing in the oocyte microenvironment
1. The most easily damaged reproductive organs are the tubes. The tubes provide the connection between the uterus and the ovaries and their function is to provide transmission and create the appropriate environment for the sperm to fertilize the egg (fertilization video). The tubes, which temporarily host the embryo formed during the 6-day period of fertilization and attachment to the uterus, nourish it, maintain its vital functions, and bring it to the uterus, appear to be a simple organ from the outside, but are one of the main players in the fertilization process, which is an extremely complex process. However, in addition to this functionality, it is easily damaged and can lose its functions due to many diseases, especially infections and endometriosis, and can prevent the woman from getting pregnant. For this reason, the tubes lose their functions due to the damaging effect of endometriosis and become the target of adhesions and endometriotic foci, becoming inoperable as a result of cicatricial (tissue recession) foci and leading to infertility.
2. Microenvironment damage is an issue that can only be detected through advanced cell level research and is still being researched. Roughly speaking, this damage, which starts from the egg shell, which we call shingles, is an abnormal shape and quality that disrupts the integrity of the egg. Negative effects of harmful by-products, which can cause deformations in the nucleus and cytoplasm of the pellets, have been reported. There is also evidence that it has negative effects on the adhesion of the embryo to the uterus. To summarize, depending on the severity of the disease, we may encounter poor quality eggs in endometriosis.
Treatment options:
A- Medication
1. Birth control pills
2. Progesterone supplement
3. Androgens: danazol, megestrol etc.
4. Suppression of menopause through medication with GnRh analogues
B- Surgical approaches
1. Laparospic
2. Open surgeries
In terms of this disease, which affects especially young and fertile women, regular check-ups should not be neglected and tell your doctor about the abnormalities and pain you are experiencing. You should be able to explain your problems well so that you can be protected from possible endometriosis and its harmful effects
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