What is endometriosis?

What is endometriosis? Endometriosis refers to the presence of endometrial tissue outside the uterus, also known as endometriosis. Ectopic endometrium can invade any part of the body, such as the umbilical cord, bladder, kidneys, ureters, lungs, pleura, breasts, and even arms and thighs, but most of them are located in the pelvic organs and parietal peritoneum. The ovarian ligament and uterosacral ligament are the most common, followed by the uterus and other visceral peritoneum, vaginal rectal diaphragm and other parts.

Endometriosis is a hormone-dependent disease. After menopause, ectopic endometrial lesions can gradually shrink and absorb. Pregnancy or the use of sex hormones to suppress ovarian function can temporarily stop the development of the disease.

Endometriosis has clinical manifestations similar to those of malignant tumors, such as implantation, infiltration, and distant metastasis. Continuous aggravation of pelvic adhesions, pain, and infertility are important clinical manifestations.

The symptoms of endometriosis vary from person to person and also vary depending on the location of the lesion. The symptoms are closely related to the menstrual cycle. 25% of patients have no symptoms. The main symptoms of endometriosis are lower abdominal pain and dysmenorrhea, infertility and sexual discomfort.

1. Lower abdominal pain and dysmenorrhea

Pain is the main symptom of endometriosis. The typical symptoms are secondary dysmenorrhea or progressive dysmenorrhea. The pain often occurs in the lower abdomen, lumbosacral and middle pelvic cavity. Sometimes the vagina, anus and thighs also hurt. It often occurs during menstruation and lasts throughout the menstrual period. A small number of patients may experience persistent lower abdominal pain and aggravated menstruation.

2. Infertility

The infertility rate of patients with endometriosis is 40%. The main causes of infertility are: changes in the pelvic microenvironment affect the combination and transport of sperm and eggs, abnormal immune function leads to an increase in anti-endometrial antibodies, which destroys the normal metabolism and physiological function of the endometrium, and abnormal ovarian function leads to ovarian dysfunction, poor corpus luteum formation, etc. In moderate and severe cases, the transport of fertilized eggs may be affected by adhesions around the ovaries and fallopian tubes.

3. Unharmonious sexual life

Most of them are located in the depressions of the rectum and uterus, with ectopic lesions or local adhesions that cause the uterus to be retroverted and fixed. Collisions or uterine contractions during sexual intercourse cause pain, usually manifesting as deep pain during sexual intercourse, especially before menstruation.

4. Menstrual abnormalities

15%-30% of patients with endometriosis experience excessive menstrual flow, prolonged menstruation, irregular menstruation, or premenstrual spotting, which may be related to ovarian parenchymal lesions, anovulation, corpus luteum insufficiency, or the combination of adenomyosis and uterine fibroids.

The treatment of endometriosis should be selected according to the patient's age, symptoms, location and extent of the lesions, and fertility requirements, in order to reduce and remove the lesions, relieve and control pain, treat and promote fertility, and prevent and reduce recurrence. The lesions can be surgically removed or controlled with drugs.