What if the endometriosis is left untreated

Endometriosis - A hormone-related disease

What is endometriosis?

In the course of a woman's natural monthly cycle, the lining of the uterus initially builds up, is then shed again during menstruation and excreted from the body via the vagina together with the menstrual blood. In the case of endometriosis, on the other hand, it occurs benign growths of the uterine lining (the endometrium) inside and outside the uterus, which can lead to severe adhesions in the tissue in the abdomen and pelvic area. These growths and adhesions can affect the uterus, fallopian tubes, ovaries, vaginal wall, intestines, bladder or peritoneum, and very rarely they also affect the lungs or brain.

Outwardly, this disease is neither recognizable to the physician nor to the patient herself. Even during regular preventive examinations by the gynecologist, it is usually not recognized.

Overview of possible symptoms and types of treatment

Treatment options

  • A laparoscopy and sclerosing or lasering the growths is necessary
  • In addition, there is hormone therapy with estrogen-progestin preparations
  • Half of the women affected develop endometriosis again, so recurring growths are possible
  • Early treatment can increase the chance of conceiving
  • Symptoms usually come to a standstill during menopause
  • Can not be detected for years if there are no symptoms
  • However, symptoms such as: heavy menstrual bleeding, pain during sexual intercourse, pain in the abdomen, digestive problems and urinary obstruction can also occur
  • Fertility can be permanently impaired
  • Symptoms of illness can vary over the years

What are the causes of endometriosis?

The full causes have not yet been clearly clarified. Various theories name autoimmune processes, environmental toxins, disorders of the autonomic nervous system and many other possible factors, all of which are conceivable but not proven. But you know that the Disease dependent on hormones is. This means that it rarely occurs before puberty or after the onset of menopause.

The diagnosis is usually made between the ages of 25 and 35, often when the woman is having trouble getting pregnant. It is directly related to the hormone estrogen, which plays an important role in the menstrual cycle.

It could a familial accumulation to be watched. Twin studies have shown that genetic predisposition can trigger endometriosis in 51% of cases. The sister of a sick patient has a two to nine times higher risk than the rest of the population. If the sick sister has a particularly severe form of the disease, the risk is even 15 times higher.
In addition, medicine now knows that late births, obesity and previous operations on the uterus can significantly increase the risk of disease.

How is endometriosis diagnosed?

Women who experience severe pain during intercourse should always have this checked by their doctor. Women who do not use hormonal contraception and who observe exceptionally severe pain, cramps and bleeding during their menstrual period should also have this checked out by a doctor.

Women who wish to have children and who do not become pregnant within a year despite regular intercourse should also seek medical help, as fertility can be permanently impaired. Based on this information the attending physician will an individual medical history create, consider endometriosis to be possible and possibly advise the patient to have an operation.

The only way to be able to diagnose or rule out endometriosis with certainty is a so-called laparoscopy. It belongs to the field of so-called keyhole surgery, which means that only three to four tiny surgical instruments are inserted through the abdominal wall. These consist of a camera probe, a probe that inflates the abdomen with a special gas for better visibility, a gripping instrument and one or two surgical instruments with which growths can be obliterated or lasered.

This minimally invasive procedure is therefore considered to be comparatively gentle and can usually be carried out on an outpatient basis. In more complicated cases, hospitalization makes sense. The gynecologist may refer his patient to a special endometriosis center for diagnosis and treatment. These centers are now all over Germany.

Common questions about endometriosis

It is a chronic disease that is incurable in half of the cases. If left untreated, the endometrial foci lead to more and more adhesions. Even after the surgical removal of the adhesions as part of a laparoscopy, the success is usually only temporary. Depending on the severity of the disease, the success of the treatment only lasts a few months to five years. 20-40% of the patients treated surgically then develop the typical symptoms again.

Patients who wish to have children are therefore advised after such treatment to work towards a pregnancy with their partner in the following months. With the onset of menopause, the disease usually comes to a standstill. This is related to estrogen production, which decreases during menopause.
As a rule, men cannot develop endometriosis. For some diseases that are treated with estrogen preparations (e.g. prostate cancer), men can also in very rare cases develop this suffering. This disease can even be detected well in mammals, which is why primates in particular have proven useful for researching female fertility problems.
The need for therapy depends on the patient's complaints. Many women do not know that they are ill and therefore do not seek treatment. Especially not if there are no complaints. In the event of such a diagnosis, surgical therapy is advised for those women who are undergoing examinations for a lack of pregnancy. But even patients who suffer from this disease can become pregnant in about half of the cases without help.

Individual advice from the treating physician is advisable here. Since every intervention carries the risk of injuries to the abdomen and thus of further adhesions and scarring, it is advisable not to intervene too frequently.

How is endometriosis treated?

If the laparoscopy shows changes in the tissue, the examination can flow into the surgical removal of the endometrial foci pass to the uterus, fallopian tubes, ovaries, intestines or urinary bladder. If possible, the foci are removed during the procedure. Since the operation is carried out under general anesthesia, the patient must give her written consent in advance. A second operation can be avoided in many cases.

If the growths have already affected large parts of the abdominal cavity, this procedure often has to be followed by further operations, especially if the growths cause urinary congestion. Surgical intervention is the most important treatment option, particularly when it comes to the treatment of fertility disorders.

However, there is also the option of drug treatment, usually in the form of hormones. Painkillers can also be used for severe pain expressions. In the case of hormone therapy, for example with estrogen-progestin preparations or pure progestin preparations ("the pill"), a decline in the growth of the uterine lining was observed, which leads to subjective alleviation of the condition, but cannot eliminate the cause.

The herd persist. A currently popular form of treatment is Combination or three-phase therapy, in which the laparoscopy is used together with a form of drug therapy. After the first laparoscopy, the patient takes medication for a few months. This is followed by another laparoscopy to check the success of the treatment and, if necessary, to surgically remove any remaining tissue. In the case of particularly large operations, subsequent rehabilitative measures in combination with psychotherapy are conceivable, as the painful illness that has lasted for years can be perceived as very stressful.

What can happen if the disease is left untreated?

Untreated endometriosis can be caused by adhesions in the abdomen, on the internal sexual organs, such as the ovaries Female sterility to lead. The later the disease is recognized, the worse the chances of being able to have children are.

If the disease progresses with pronounced symptoms, the patient has to live with severe cramps and pain without therapy. Due to the progressive growth of the endometriosis tissue in the entire abdominal cavity, an operation should always be considered sooner or later. In the event of urine congestion, an operation must be performed in any case.

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