Comprehensive understanding of endometriosis

When endometrial tissue with growth function appears outside the mucosa covering the uterine cavity and causes a chronic inflammatory reaction, eventually generating scar adhesion-like lesions, causing patients to suffer from a series of clinical problems such as dysmenorrhea, pelvic masses and infertility, it is called endometriosis. This is an omnipresent disease, just like cancer can spread to all parts of the body. So for ordinary people, how should endometriosis be understood? How to avoid its existence? How to manage it? In response to these issues, I will lead everyone to understand them together!

The picture comes from the Internet

1. What is endometriosis?

The picture comes from the Internet

Endometriosis refers to the appearance of endometrial tissue with growth function in other parts of the body outside the uterus, referred to as endometriosis. These ectopic endometrium can invade any part of the body, most of which are pelvic organs and parietal peritoneum, so this disease is also called pelvic endometriosis. In layman's terms, it means that the endometrium grows in an abnormal position. These ectopic endometrium will bleed periodically with the changes in ovarian hormones, and the surrounding fibrous tissue will proliferate and cysts and adhesions will form, resulting in a series of clinical phenomena. The most common sites of endometriosis are the ovaries and peritoneum in the pelvic cavity. If the lesions invade below the peritoneum, deep endometriosis will occur. During the non-menstrual period, due to inflammatory reactions, mechanical stimulation or nerve involvement, endometriosis may also cause long-term chronic pelvic pain. If the sciatic nerve is involved, it will also cause radiating pain in the lower limbs. Severe adenomyosis and a large uterus may also cause lower abdominal pain during the non-menstrual period.

The picture comes from the Internet

2.Why does endometriosis exist?

The cause of endometriosis is still unclear. Related studies have shown the following theories: 1. The leading theory is that menstrual blood retrogrades and implants. The endometrium that retrogrades to the pelvic cavity needs to undergo adhesion, invasion, and vascular formation to implant, grow, and develop lesions; other pathogenesis mechanisms include coelomic epithelial metaplasia, vascular and lymphatic metastasis theory, and stem cell theory. 2. Abnormal expression and regulation of related genes, immune inflammatory response, and abnormal expression of sex hormone receptors are closely related to the occurrence of endometriosis. 3. Endometriosis has a familial clustering. Women with first-degree relatives with endometriosis have a 7- to 10-fold increased risk of developing endometriosis.

3. How should endometriosis be treated?

The picture comes from the Internet

(1) The long-term management of endometriosis should maximize the role of drug treatment. The treatment drugs for endometriosis are mainly divided into five categories: non-steroidal anti-inflammatory drugs, progestins, combined oral contraceptives, gonadotropin-releasing hormone agonists and traditional Chinese medicine. Because endometriosis cannot be cured, drug treatment must be effective and safe and continued until menopause or planned pregnancy. After the planned pregnancy is completed, patients should resume medication as soon as possible. Long-term management of drug treatment aims at long-term persistence, and drugs with good efficacy and good tolerance should be selected. (2) Surgical treatment: This includes conservative treatment to preserve the patient's reproductive function. The surgery tries to remove the ectopic lesions visible to the naked eye, remove the ovarian endometriotic cysts, separate adhesions, restore the anatomy, and relieve compression or even obstruction. Hysterectomy: remove the entire uterus and retain the ovaries. It is mainly suitable for those who have no fertility requirements, severe symptoms or recurrences that are ineffective after conservative surgery or drug treatment, but are young and want to preserve the ovarian endocrine function.

4. How to prevent the occurrence of endometriosis

The picture comes from the Internet

As the saying goes, "preventing disease before it occurs" is the highest level of medical and health care development, that is, preventing disease before it occurs or curbing it in its infancy. However, the pathogenesis of endometriosis is not yet fully understood. Therefore, there is no clear life guidance to prevent the occurrence of endometriosis, and the preventive effect is limited. The following points should be paid attention to: (1) Prevent menstrual blood from flowing backwards, and promptly detect and treat diseases that cause menstrual blood retention, such as congenital reproductive tract malformations, atresia, stenosis and secondary cervical adhesions, vaginal stenosis. Avoid strenuous exercise and sexual intercourse during menstruation; avoid gynecological pelvic examinations during menstruation unless there is a special condition or emergency. (2) Oral contraceptives may have a preventive effect on endometriosis. The principle is that they can inhibit ovulation and promote endometrial atrophy. Pregnancy and childbirth are also protective factors for endometriosis. We women are a very delicate and sensitive group of people. There is no need to be particularly panic about a single symptom, nor do we need to affect our normal life and work. Routine gynecological examinations every year, timely medical treatment if any symptoms occur, as well as a positive, optimistic and healthy attitude and lifestyle, without avoiding or doubting illness, are enough!

Conclusion

Endometriosis is known as a benign disease with the biological behavior of a malignant disease. It is a very difficult and headache disease for obstetricians and gynecologists. Doctors need to have superb gynecological surgical techniques, a solid foundation in gynecological endocrinology, and the ability to formulate individualized treatment plans for patients of different ages, different symptoms, and different fertility requirements, as well as the ability to communicate and implement these treatment plans that require patients to have good compliance. They also need to have the affinity to ensure long-term follow-up of patients without loss of follow-up. I hope that all patients with endometriosis can find a specialist who specializes in this disease, adhere to treatment, relieve pain, improve quality of life, protect fertility, reasonably arrange their own fertility plans, prevent recurrence, and strictly prevent cancer.