Have you ever thought that endometriosis may be the cause of menstrual pain, failure to conceive, painful intercourse, or any of these symptoms?
The endometrium is “in the wrong home”
Statistics show that the incidence of endometriosis among women of childbearing age in China is 10% to 15%, with a high incidence among women aged 25 to 45. In layman’s terms, endometriosis means that the endometrium is “in the wrong home”. If the endometrium grows outside the endometrial layer, it is called endometriosis; if the endometrium grows in the myometrium, it is called adenomyosis. Why does the endometrium grow and develop outside the uterus? There are many reasons for this. One explanation is that the cells of the body will shake off into another kind of cells after some stimulation. When menstruation occurs, if menstrual blood enters the abdominal cavity, it stimulates the cells on the surface of the ovaries, turning them into endometrium and causing ectopic disease. There is also a “planting hypothesis” that states that if the menstrual blood containing the endometrium flows through the fallopian tubes on both sides of the uterus to the pelvic cavity, if the conditions are right, it will settle there and reproduce, causing disease.
These “misplaced” endometrium can interfere with the normal functions of the reproductive organs and are often accompanied by various symptoms of menstrual disorders, such as prolonged periods, excessive menstrual bleeding, premenstrual spotting, and secondary dysmenorrhea. If a woman finds that her menstrual flow gradually increases and her dysmenorrhea worsens day by day; if she can obviously feel severe discomfort or even unnamable pain when making out with her lover; if she finds that she is just in her prime, but her efforts to get pregnant repeatedly fail are to be alerted to whether she is suffering from endometriosis.
Endometriosis itself is a benign disease, but has some characteristics similar to malignant tumors. For example, it can infiltrate and grow into the surrounding tissues and organs and interfere with their normal functions, and can even metastasize to other parts of the body, such as the lungs and belly button, just like cancer. Symptoms such as menstrual pain and painful intercourse can also worsen as the local lesions worsen. Moreover, patients have a very high chance of infertility or miscarriage. About 40% of the infertility patients have endometriosis.
Treatment: Surgery + medication Endometriosis treatment requires different approaches that take into account the patient’s condition and requirements for fertility. Laparoscopic diagnosis and surgery combined with medication is currently considered the gold standard for the treatment of this condition.
Surgery can usually be performed laparoscopically. In young women who still have a need for fertility, ovarian endometrioid cyst debulking can be used to preserve fertility but has the highest recurrence rate of up to 50% after surgery. More severe cases or those with adenomyosis may be treated with a procedure that preserves ovarian function and may recur in 1/4 of patients after surgery. Radical surgery with removal of both ovaries may be used at the discretion of older patients or those with severe dysmenorrhea.
There are also many medications available for this group of patients, including gonadotropin-releasing hormone analogs, androgen derivatives, short-acting oral contraceptives, and highly effective progestins.
Gonadotropin-releasing hormone analogs are more commonly used clinically. They are the most potent, but also have the most pronounced side effects. Androgen derivatives, such as danazol suppositories, are administered topically in the vagina with greatly reduced side effects, and are particularly useful for internal heterogeneous foci in the vagina and the cervix and posterior fornix. Short-acting oral contraceptives are used in the first-line treatment of dysmenorrhea in endometriosis and for consolidation therapy. It also has the effect of reducing the risk of ovarian cancer. However, it is contraindicated in people who are obese, smoke, have breast cancer or venous thrombosis, or have liver disease. Highly effective progestins are used as oral medications and can be added to intrauterine devices that are placed in the uterine cavity to significantly relieve dysmenorrhea and inhibit endometrial growth while providing contraception.
This method has been used earlier in foreign countries and is effective for moderate to severe dysmenorrhea. In China, many women have some concerns due to the decrease in menstrual flow and amenorrhea in a small number of patients after its use. The trend of its application has also been increasing in recent years. Of course, Chinese medicine also plays a very important role in the treatment of this disease. Due to its mild side effects, it can be used for a relatively long time in some patients with chronic diseases.
It should be reminded that endometriosis has a significant impact on fertility. Six months after surgery is the prime time to get pregnant. Patients with endometriosis with infertility should seize the opportunity to take active treatment measures, including the use of “IVF” to conceive.
There are numerous risk factors that can trigger endometriosis. Based on several studies, medical experts have summarized seven “prescriptions” for early prevention.
Exercise prescription: Exercise can improve uterine congestion during menstruation and shorten uterine contraction time. Women of childbearing age should do physical training three times a week and one moderate intensity full body activity. One study found that yoga is the best exercise to relieve menstrual cramps.
Hygiene prescription: do not have sex during menstruation. Intercourse during menstruation increases the chances of menstrual blood reflux. During this special period, women should also avoid heavy physical work and do not overexert themselves. If the menarche is early and the cycle is shorter than 27 days, but each period is long (more than 7 days), the possibility of menstrual reflux is higher.
Family prescription: Pay attention to family history. Studies have shown that women with endometriosis, such as mothers or sisters, have a 7-fold increased risk of the disease in their immediate female family and should be taken seriously. Such women should seek early medical attention if they have significant dysmenorrhea when they have their periods at puberty.
Dietary prescription: Quit smoking. A balanced diet with plenty of fresh vegetables and fruits is good for general health. It is also crucial to quit smoking, limit alcohol and restrict the intake of cream, lard and animal oils. This is because eating more of these foods can cause prostaglandin levels in the body to rise and induce menstrual cramps. When you have your period, you also have to stop “cold food”, do not eat cold drinks, less touch too acidic and spicy food.
Emotional prescription: optimism first. Negative brain activity will weaken the body’s immune system, giving a variety of diseases to take advantage of. The high level of mental stress, work tension, too much mental work, will make people in a long-term state of stress, but also change the internal environment of the body. Women should be open-minded, not to take the bull by the horns, to maintain an open-minded, positive mental state.
Beauty prescription: when buying toiletries and various skin care products, be sure to pay attention to the label and ingredients list. Too fragrant skin care products, home air fresheners, etc., will contain a lot of additives, may also be harmful to health.
Fertility prescription: the birth of a child, less abortion. This is especially important to remind the workplace “white” people, do not be busy with work and delayed life events. Studies have shown that 21-29 years old is the prime period for childbirth. Giving birth at full term can improve the ectopic endometrium, strengthen the immune system and alleviate problems such as cervical stenosis. Late marriage, late childbearing, infertility or multiple abortions can elevate the risk of endometriosis.