What is endometriosis?
Endometriosis is defined by the presence of endometrial tissue (gland and stroma) outside the uterine cavity.
Endometriosis in some cases is asymptomatic and is not detected, while in others causes pelvic pain, irregular bleeding, pain during or after sexual intercourse (dyspareunia), abdominal pain before and during menstruation, cramps, menstrual pain (dysmenorrhea), painful bowel movements and infertility.
How is it diagnosed?
Diagnosis is made by clinical symptoms, imaging methods (transvaginal ultrasound) or MRI (magnetic resonance imaging) and also by surgical procedures.
How does endometriosis affects fertility?
Infertility is mainly affected at three levels:
- At the level of the fallopian tubes by fixing them and impeding their permeability. In endometriosis, fallopian tubes, ovaries and intestines are stuck together as if glue had been spilled into the pelvis. Under these conditions, the release of the egg from the ovary and its way through distorted fallopian tubes is very difficult. In other cases, although the affectation is not obvious, the relation is well established.
- At the ovarian level the development of the egg is affected.
- At the endometrial level the implantation capacity is reduced.
What is the treatment?
Endometriosis can be treated by drugs or surgery. Treatment will depend on the patient’s age, wish for pregnancy and symptoms.
Drug treatment is directed, only, to relieve pain.
Surgical treatment should be evaluated carefully. This is the most frequent option for women with large endometriosis or for those where pain represents an important limitation in their daily activity. The procedure can be performed by laparotomy, that is, by an incision through the abdominal wall or laparoscopy, viewing the abdominal cavity by a camera. The selection of the technique used will depend on each individual case.