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Endometriosis
Causes of endometriosis
The causes of endometriosis are not yet fully understood, but the theory of endometrial implantation is recognized by most experts and scholars. The main reason is that during menstruation, endometrial glandular epithelium and stromal cells can retrograde with menstrual blood, enter the pelvic cavity through the fallopian tubes, implant on the ovaries and adjacent pelvic peritoneum, and grow and spread there, forming pelvic endometriosis. Most clinical and experimental data also support this theory, indicating that approximately 70%-90% of women experience menstrual blood retrograde. Additionally, congenital vaginal atresia can also lead to endometriosis, as well as iatrogenic endometrial implantation, such as abdominal scar implantation after cesarean section or endometriosis at the perineal incision site after childbirth. These factors may also contribute to the development of endometriosis.
How is endometriosis diagnosed?
The gold standard for diagnosing endometriosis in women is laparoscopy. Under laparoscopy, the lesions of endometriosis can be clearly seen, the severity of the condition is understood, and it can also serve as a surgical treatment. However, generally speaking, this method of examination tends to be relatively expensive, so other methods are usually used for a comprehensive evaluation. For example, understanding the normal menstrual cycle, the duration of menstruation, and the presence or absence of dysmenorrhea. In addition, some related auxiliary examinations, such as vaginal ultrasound, can be combined to check for any abnormal cysts on the ovaries and the echo characteristics of the cyst content. Blood tests for CA125 can also aid in the diagnosis if a significant increase is observed.
Chance of pregnancy with endometriosis
When suffering from endometriosis, the likelihood of pregnancy in women decreases, with the chance of getting pregnant naturally being around 50%. The occurrence of endometriosis can lead to extensive adhesions in pelvic tissues and organs, hardening and stiffness of the fallopian tubes, affecting the movement of the fallopian tubes, thereby affecting the transport of eggs and fertilized eggs by the fallopian tubes. Severe adhesions around the fallopian tubes can also affect the release of eggs. Therefore, it is recommended to actively seek treatment for endometriosis before trying to conceive, which can be done through medication or surgical treatment. (The use of medication should be under the guidance of a doctor.)
Does endometriosis affect pregnancy?
Endometriosis is a common gynecological condition, which involves the implantation of endometrial tissue outside the uterine cavity. Endometriosis is a common cause of infertility: Firstly, when endometriosis occurs, it often affects the function of the ovaries. For example, ovarian chocolate cysts can affect the release of endocrine hormones in the ovaries, as well as cause ovarian ovulation disorders or premature ovarian failure. Secondly, endometriosis can cause inflammation in the pelvic cavity and adhesions within the pelvis. This will impact the function of the fallopian tubes, causing ovulation disorders in the tubes, as well as disorders in the transport function of the tubes. This can prevent fertilization, or after the sperm and egg have combined, the fallopian tubes may not be able to transport the fertilized egg to the uterine cavity, thus increasing the risk of ectopic pregnancy.
Endometriosis
Endometriosis means that the endometrial tissue, which normally lines the uterus, grows in other locations. It can grow on the ovaries, inside the muscular layer of the uterus, or in the pelvic cavity. The ectopic endometrial tissue responds to changes in the body's estrogen levels during each menstrual cycle, creating symptoms similar to menstrual bleeding. If it grows on the ovaries, it may form a "chocolate cyst" on the ovaries that gradually enlarges with each menstrual cycle. If it grows within the muscular layer of the uterus, it can lead to adenomyosis, causing significant pain during menstruation. If it grows in the pelvic cavity, it can lead to the formation of pelvic lesions. Therefore, it is recommended that patients with such conditions seek prompt medical treatment.
How is endometriosis diagnosed?
Endometriosis refers to the occurrence of endometrial tissue outside the uterine cavity, a common gynecological condition that often leads to painful menstruation, pain during intercourse, and infertility. Diagnosing endometriosis involves several approaches. First, inquire about the patient's clinical symptoms, including any painful menstruation and pain during intercourse. Second, a pelvic ultrasound should be performed to observe the situation inside the pelvis, assessing for any ovarian endometriotic cysts or pelvic endometriotic lesions. Third, a blood test for CA-125 can be conducted, as the levels of CA-125 tend to increase with endometriosis. Fourth, laparoscopy can be used to collect local tissue for pathological examination, which is the gold standard in diagnosing endometriosis.
How is endometriosis treated?
Treatment methods for endometriosis include conservative treatment and surgical treatment. If the patient's symptoms are relatively mild, the dysmenorrhea is not very severe, and there is no occurrence of excessive menstruation or prolonged menstrual period, conservative treatment can be applied. Common conservative treatment methods include oral contraceptive pills, and a levonorgestrel-releasing system can be placed inside the uterine cavity. If the patient has reproductive demands and the symptoms are more severe, or if there is a chocolate cyst on both ovaries, surgical treatment can be performed, but the recurrence rate after surgery is also relatively high. (The use of medication should be under the guidance of a doctor.)
How many days does the pain from endometriosis last?
Endometriosis refers to the condition where active endometrial cells implant outside the uterine lining. It is a relatively common gynecological disease. Pain usually begins one to two days before menstruation starts, is most severe on the first day of menstruation, and gradually lessens thereafter. The pain generally persists throughout the menstrual period. It is advised that patients with endometriosis seek timely treatment under the guidance of a clinical doctor, based on their individual conditions, to prevent the progression of the disease and serious health consequences.
Endometriosis Clinical Manifestations
Endometriosis is clinically most evident in dysmenorrhea, which tends to worsen progressively. The clinical presentation varies depending on where the endometrial tissue is located. If the tissue is located on the ovaries, it can form ovarian chocolate cysts. Generally, chocolate cysts can affect fertility, leading to anovulation and the appearance of ovarian chocolate-like cysts. Treatment typically involves surgical intervention, which is characterized by a high risk of recurrence after surgery. If there is no immediate plan for pregnancy, there is also a possibility of recurrence. Additionally, if endometriosis involves the uterus, it can lead to a uniformly enlarged uterus and uneven uterine wall echoes, resulting in adenomyosis. Therefore, the most typical clinical manifestation of endometriosis is progressively worsening dysmenorrhea.
What tests are done for endometriosis?
For patients with endometriosis, it is recommended that you undergo a gynecological ultrasound examination to observe the condition of the ectopic endometrial tissue in the pelvic cavity, whether it is present on the uterus or ovaries, and whether it has grown on the abdominal wall. Therefore, it is advised to have a gynecological ultrasound examination and a gynecological exam. Patients with endometriosis can also have a blood test for tumor markers. If you wish to undergo additional tests, you can also have a cervical cancer screening, which is also possible. The main recommendations are the first three: the gynecological exam, gynecological ultrasound, and tumor marker tests. These examinations are advisable. If the endometriosis is very severe and the pain is quite intense, treatment may be necessary.