endometriosis

Endometriosis is a disease associated with a woman's womb, which is influenced by sex hormones, especially estrogen. The disease can strike any woman of reproductive age in both existing and those not yet married, kekerapannya estimated at 1-10%.Some of them had the disease without symptoms, while others suffer severe pain when menstruation (dysmenorrhea), bleeding disorders of the womb and fertility problems (subfertility and infertility).
Endometriosis is also considered a career woman's disease.Especially with the current trends, many women who put careers and delay marriage and pregnancy period. Opinion was based on the theory that the female hormone system is prepared for the process of childbirth during reproduction, so women who delay pregnancy until the tip of her reproductive life (age 30s) showing a greater risk for experiencing hormone imbalance, especially estrogen. Upon this fact, some doctors consider pregnancy as a treatment option for endometriosis. It appears that 50% of patients with endometriosis who achieved pregnancy symptoms of endometriosis are missing, but at 50% again experienced a relapse after delivery.
What is endometriosis?
Endometriosis is a tissue-like membrane inner lining of the uterus (endometrium) grows outside the uterus, in a certain place and a woman's body. This network grew and attached to or referred susukan (implants) in places like the ovaries (ovaries), oviduct (fallopian Falloppii), the outer wall of the uterus, colon, bladder contents and the surrounding area. Or even in places farther from the stomach such as the eyes and lungs, although this rarely happens.


Growth and reactions of endometriosis tissue is very similar to the growth of tissue on the inner lining of the uterus (endometrium).Each month the ovaries release estrogen hormone that stimulates the growth of the endometrium to prepare the surface layer of the uterine lining (endometrium) to thicken and grabbed alley (secretion) to prepare a place the fertilized egg develops into an embryo. If the egg is not fertilized, the endometrial lining is going to escape and shed during menstruation.
So also happened in endometriosis, initially thickened with rising levels of estrogen, and when levels are decreased, the membrane was shed so that bleeding. This bleeding causes swelling and irritation in the area around it, so it will form scar tissue or adhesions. Extensive adhesions will result in the attachment of body organs to each other such as the ovaries with the small intestine (intestinum), which causes severe pain.
When estrogen levels decline, such as treatment or as natural as menopause, endometriosis complaints will subside or even disappear. During pregnancy, symptoms and complaints can also be reduced, because the growth of the endometrium and menstruation stops. However, symptoms that subsided only temporarily, because a few months after childbirth or childbirth, at least 50% of the symptoms will reappear.


What causes endometriosis?
Until now the exact cause of endometriosis is unknown. Some opinions have been advanced, one of which states that when menstruation endometrial fragments, there is flipped into the oviduct and continue into the pelvic cavity, and then becomes the attacker (the aggressor) to the stomach mucous membrane (peritoneum) to change the temperament and the shape becomesplants (such as parasites) that can menyusuk (implants) in the ovaries and the surrounding area. This process can continue to grow. Another opinion is that the endometrial tissue that move through blood vessels leading to the different parts or organs of the body and then attach and grow. In addition there is also suspected of congenital (hereditary) or offspring in the family for the gifted have to be a cell component of endometriosis, but this has nothing to do with the cancer (malignant tumors).
What are the symptoms of endometriosis?
Sometimes endometriosis have no symptoms at all. But more often provide a very diverse symptoms of pain during menstrual periods (dysmenorrhoea), because when pelepa-san endometriosis, bleeding and inflammation of the area sekitarya.Additional symptoms are often in the form of muscle spasms (cramps) uterus during menstrual periods are more arduous.Moreover, it can also arise painful urination (dysuria), painful intercourse (dyspareunia), painful bowel movements (diskezia), mid-menstrual cycle pain (mittelschmerz), and pain during ovulation (release of eggs).
Other impacts that are often found in people with impaired fertility endometriosis is so difficult to get pregnant (infertile). This is experienced by about 30-40% of women or two times the incidence in the general population. In the group of infertile women who went to the specialist was nearly 93% have endometriosis.
How to determine the presence of endometriosis?
The diagnosis of endometriosis is not always easy. The most precise determination is to do inspection endodkopi abdominal cavity, known as laparoscopy, which is an examination using a telescope (binoculars) that is inserted into the abdominal cavity and pelvis (pelvic) through a small surgery in the navel (umbilicus) .


What are treatment options?
While there has been no definitive treatment options to cure endometriosis. A number of medications available today just able to control the symptoms of endometriosis, pressed it as low as possible and provide temporary relief.
Appropriate treatment options will depend on age, degree and extent of disease, as well as the desire to have children factor.
Symptomatic (only eliminates the symptoms of the disease) If the symptoms of endometriosis is not too heavy, perhaps a combination of anti-pain medications such as aspirin, paracetamol, or / and anti-inflammatory drugs like ibuprofen is quite helpful in reducing pain and muscle cramps when menstruating uterus. But the drugs do not cure endometriosis, but only temporarily relieve suffering.
Hormonal treatment By administering hormones, menstruation stops, so that similar pregnancy or menopause. That is, the situation is similar to a natural event. With the cessation of menstruation, the symptoms would be reduced due to endometriosis.
Progesterone. Given synthetic progesterone drug will work as female hormone progesterone. At high doses, this hormone will inhibit the release of the egg and make the body 'believed' as if there has been a pregnancy. Consequently stops menstruation, uterine lining thins and the process stops endometriosis growth.Examples of drugs containing progesterone is norethisterone and medroxyprogesterone acetate (MPA). PMS is a syndrome side influences, such as water retention and emotional changes (mood swings). Actually, the more frequent side effect is bleeding occurred outside the menstrual period, weight gain and abdominal bloating. Oral contraceptives (birth control pills). Sometimes birth control pills also used to treat pain in patients with endometriosis. This drug should be used continuously for several months. During that period will stop. But oral contraceptives can not be used in all women, because it depends on the health condition and lifestyle. Danazol. This medicine contains the hormone androgen which is similar to testosterone in men. Its effect is to lower estrogen levels causing a state similar to menopause. Due to the growth of endometriosis tissue are influenced by estrogen then the result is the endometriosis will stop growing when estrogen levels decline.Side effects of this drug is acne and oily skin, hot flushes throughout the body, fluid retention and weight gain. Abnormal hair growth generally occurs in areas that are not supposed to become heavy and sound like a man. These side effects will go away when treatment is stopped. Danazol is usually given for 2-9 months.Other drugs are gestrinone that how it works and side effects similar to danazol. Usually used twice a week. GnRH agonist. This medicine is a relatively new type of hormone used for the treatment of endometriosis. Mimic the hormonal basis of his brain that controls release of the hormone estrogen with regularly. The effect of these drugs on body functions is to create a state similar to menopause due to decreased estrogen, and some make the endometrial tissue to die. GnRH agonist administered in various ways: Spraying through the nostrils (nasal spray) to be sprayed several times a day. In this way the important thing is not the occurrence of overdosing. Other drugs are still a class is given in the form of monthly depot injections. For example, is a small biodegradable pellets are placed under the skin and work releases the drug contained in it regularly for four weeks (28 days). Treatment is usually completed in approximately 6 months. GnRH agonists also cause side effects, similar to menopause.Symptoms include hot flushes, vaginal dryness and changes in emotion. Moreover, it can happen to lose a small amount of bone calcium, which recovered after treatment was stopped.
Aromatase inhibitor (aromatase inhibitors). This drug is the latest generation of anti-endometriosis drugs. Its use is based on recent findings, it turns out that endometriosis is a process in abnormal cells that can stand alone on the action of the enzyme atomatase.Because of the nature of the process, it can be explained now why endometriosis are also often found in women even after menopause. The advantage of this drug is the process of endometriosis can be cocked it without disturbing the process of developments in ovarian follicles. That is why during the administration of these drugs, pregnancy can occur. Once known to pregnancy, this medication should be stopped immediately.Giving these drugs can be carried out for 6 consecutive months. Surgery In addition to medication, surgery is also another option for the treatment of endometriosis. There are two kinds of surgery are:
conservative surgery radical surgery. At conservative surgery, performed only penghancu-bed removal or endometriosis tissue that looks alone. This surgery can be performed laparoscopically operative. With the help of tools that are very small, through binoculars, endometriosis tissue can be removed or destroyed. Sometimes used a laser beam. Compared with major surgery (laparotomy), the operative laparoscopy is less risky because the incision in the abdominal wall is made very small, so that the abdominal cavity is not visible to the outside.
In the radical surgery, in addition to removal of endometriosis tissue, also appointed one or more other reproductive organs including the uterus. This action is sometimes necessary in cases of endometriosis are very difficult to overcome, especially in women who already have children do not want anymore. As a result of this radical surgery, of course she will not be having periods again.
But now more women, if possible, choosing to maintain her ovaries and her uterus request is being named. But actually it is producing ovaries make estrogen and endometrial tissue of endometriosis grow. Therefore, removal of the ovaries will still need to think about. If appointed, then usually the hormone estrogen substitutes still needs to be given is known as hormone replacement. It is important to control the symptoms caused by the loss of early premenopausal ovary. Unfortunately, hormone replacement may also cause endometriosis tissue grows back so that hormone replacement may be performed after the network is considered dead.
More precise information
Selection of the proper treatment of endometriosis is very important that you specify with your doctor. Obstetrics and Gynecology Specialists specifically explore the problem of endometriosis will be happy to help you out of problems you face.