From adolescence to menopause, follow-up is essential. It provides contraception, replacement therapy and cancer screening.
Endometriosis is characterised by the abnormal presence of menstrual tissue outside the uterus, most commonly in the pelvis. It starts a chronic inflammatory process. This condition affects 5% to 10% of women of childbearing age.
Different scientific theories have been suggested, including retrograde menstruation, spreading through the bloodstream or lymphatic system, and coelomic metaplasia, but none of these theories fully explain the origin and behaviour of this enigmatic condition.
Many women who have endometriosis are asymptomatic (they have no symptoms), and the presence of lesions (tissue injuries) is discovered by chance, during surgery for another reason.
On the other hand, a large number of women present clear symptoms. The pain associated with endometriosis may take one of the following forms:
It is very important to note that the intensity of the pain is not directly related to the severity of the endometriosis. For this reason, patients with small lesions may experience severe pain and vice versa.
Your gynaecologist will carry out a standard clinical vaginal examination to exclude or confirm the presence of a mass or sensitive area, by palpation.
The first examination that is carried out when endometriosis is suspected, is an intravaginal ultrasound.
Certain additional examinations may prove necessary, such as:
The diagnosis is carried out using direct visual examination at the time of surgery, and the pathological findings of the biopsies (examinations of tissue removed from the body).
However, pelvic pain is not always related to endometriosis.
The first treatment option is often medication; it is non-specific and aims to alleviate the symptoms. It is not always necessary to carry out surgery.
Hormonal contraceptives ideally taken without interruption should be the first line of treatment.
Another more complex treatment (with a GnRH agonist) is hormonal castration, which should be considered as a secondary line of treatment.
Sometimes surgical treatment may be necessary. Your doctor will decide if it is needed and will explain its intended purpose.
It is true that endometriosis may reduce fertility. However, there are many options available to help patients if this is the case.