The tissue around of the uterus is called endometrium. During each menstrual cycle there is an increase in volume of the endometrium, and a thickening, as it prepares for a possible pregnancy. If the woman does not become pregnant, the endometrium is eliminated in the menstruation.
Endometriosis is endometrial tissue growing outside the uterus (outside the normal location). It usually occurs in the ovaries, fallopian tubes, uterus, outside surface to the intestines or other abdominal organs. In rare cases it can affect other organs and body structures.
Although endometriosis does not heal, the recommended treatment can eliminate pain and solve infertility. Treatment depends on the severity of symptoms of endometriosis and the desire to become pregnant. Only for pain, it is recommended to follow any hormone therapy; once high levels of estrogen are reduced, it determines a decrease of endometrial proliferation and therefore reduces pain. To get pregnant it is recommended to follow both infertility treatment and surgical treatment associated with it.
If a woman has pain or bleeding caused by endometriosis and does not want a pregnancy in the near future, birth control pills are recommended, which are sufficient to control pain. Birth control pills cause regression of endometrial lining proliferation and remove the pain in most women. This also prevents worsening of endometriosis. Birth control pills reduce bleeding, inflammation and pain of endometriosis. Most women use these drugs safely, with few adverse effects taken a long time.
If symptoms are severe or pills are not effective, a stronger hormone therapy with gonadotropin releasing hormone analogues can be tried (GnRH), high doses of progesterone, progestin intrauterine device or danazol. Some doctors recommend a laparoscopy carried out first to see signs of endometriosis present in the pelvis. Although often not necessary unless there is a chance to have another problem.
Hormone therapy should be used to treat endometriosis?
If hormone therapy is not effective or if endometrial proliferation affects other organs, the next necessary step is surgery to remove endometrial proliferation and mucosal scars. It consists of one or more small incisions, called laparoscopy. After endometriosis surgery, hormone therapy may prevent restoration of endometriosis. Surgery removes the pain for a year or two years, although for 20% of women it still persists.
In severe cases of endometriosis treatment option is to remove the uterus and ovaries (bilateral oophorectomy and hysterectomy). Following this therapy early menopause is established. This radical therapy is reserved for women who had children and for which other treatments had little effect. However more than 15% of women continue to experience pain after surgery for endometriosis.
Fertility and endometriosis
In case of pain from endometriosis at a woman who wants to get pregnant, the first treatment option for pain control is laparoscopic surgery.
If infertility is associated with a milder form of endometriosis is considered necessary intrauterine artificial insemination or in vitro fertilization (laboratory), which increases chance of getting pregnant. If a moderate or severe endometriosis, laparoscopy will show the doctor to see and remove symptoms of endometriosis. Laparoscopic surgery can remove the pain of endometriosis and thus facilitate the woman to get pregnant.
After laparoscopy, the following therapeutic approach depends on the severity of endometriosis and the woman’s age.
treatment of endometriosis
Drugs that stimulate ovulation and intrauterine insemination
Moderate or severe / All ages:
Surgical removal of endometriosis and tissue affected, if pregnancy occurs it is recommended after in vitro fertilization
In women over 35 years is recommended in vitro fertilization instead of laparoscopic surgery.
Moderate or severe forms of endometriosis (stage III or IV), favors the occurrence of pregnancy and laparoscopy reduces pain and other symptoms of endometriosis.
A recent study shows an increased rate of pregnancy using laparoscopy in women with mild and moderate endometriosis.
Medications can be used before laparoscopic surgery to make it easier or after surgery to prevent recurrence of endometriosis. Drugs have not proved useful in treating infertility caused by endometriosis.
Treatment for endometriosis that can be performed at home:
– Administration of anti-inflammatory drugs after a set schedule. Should be checked with your doctor before taking medications. If there’s a chance that a woman be pregnant or become pregnant soon, she should not take any drugs. This causes an increased risk of miscarriage.- Applying something worm on the lower abdomen, like an electric blanket or hot water bottle. Heat improves blood flow and thus can remove the pain
– Stretching feet high, putting a pillow under your knees. When a woman is lying on the horizon, it is advisable to bring your knees above the chest to lower blood pressure.
– The use of relaxation methods and techniques
– Carrying out regular exercises. They improve blood flow, removing substances secreted by the body, endorphins, reducing pain.
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