What is endometriosis? everything you need to know

No, you are not crazy, nor are you a complainer or lazy. Your painful period, the one that breaks you in half every month and leaves you out of the game, is not an excuse to attract attention or a way to get away from anything, but it can hide endometriosis, a benign gynecological disease, but that It can be very painful and disabling.

The big problem: misunderstanding

The woman who suffers it not only has to face the misunderstanding of many, but it can also take up to 10 years to be diagnosed because it is usually considered "normal" that menstruation is painful or that sexual relations are also painful.

You are not alone

It is estimated that there are about 200 million women of childbearing age in the world who suffer from this ailment, between 1 and 2 million in Spain. In other words, 10 out of every 100 women suffer from it. That it is underdiagnosed can only be due to the "normality" with which menstrual pain is assessed. And no, when the pain is disabling, it is not normal.

What is endometriosis?

The uterus or womb is made up of three layers. The internal one is the endometrium. This is the layer that is prepared with each menstrual cycle to accommodate the fertilized egg. If there is no pregnancy, this layer is shed.

Endometriosis occurs when this tissue that should only be in the uterus spreads to other areas of the body such as the ovaries, fallopian tubes, the bladder, it can even reach the abdomen or lungs or in even rarer places, such as the brain.

Because it hurts?

This endometrial tissue behaves like the one in the uterus, so when the bleeding arrives, there is also bleeding in these tissues that are out of place, with the aggravation that this bleeding cannot be expelled and is very painful.

But it does not hurt only with menstruation, it can do it throughout the cycle, since this endometrial tissue is sensitive to hormonal changes. It can also hurt when having sex, which is very upsetting for a woman and can seriously affect her self-esteem.

What are the symptoms of endometriosis?

Very bad menstrual pain
Abdominal pain outside the menstrual period
Pain during intercourse
Very heavy menses
Pain when defecating
Pain when urinating
Fertility problems
Nausea, vomiting
Dizziness
Fatigue

What are the types

In this disease there are three different types, but this does not mean that a woman has one of the three, but that she may have a combination of them.

Peritoneal endometriosis. It occurs when the endometrial tissue has reached the tissue that lines the abdomen on the inside.
Ovarian endometriosis. It is when it has reached the ovary and in this case it is made up of cysts that can have different sizes.
Deep endometrysis. The tissue has reached the rectum, the bladder, the ureters or the pelvic nerves … It is the type that is more serious. But gravity does not equal pain. There are times when it may have a development in which it does not cause discomfort but when it does, it does so in such a way that an organ such as the kidney can no longer be saved because by causing a urinary obstruction it has seriously affected kidney function.

How is it diagnosed?

The essential thing, before performing any test, is to think that the pain that the patient feels is not normal, a prejudice that is often difficult to overcome and that causes many women to be diagnosed after years of suffering.

The gynecological ultrasound is the most appropriate test for endometriosis.
In certain circumstances, nuclear magnetic resonance can also be used .
If we are talking about deep endometriosis, other tests can be performed, such as a colonoscopy, for example.
The laparoscope is, according to Harvard Medical School (EE. UU.), The best way to confirm the diagnosis of endometriosis.

Which is the treatment?

Analgesics. It is not a treatment of the disease as such, but of one of its symptoms, such as pain. They can be NSAIDs, non-steroidal anti-inflammatory drugs, such as ibuprofen, or if the pain is more intense, they can be derived from morphine such as codeine. It may even be necessary to resort to other more powerful ones.
Hormonal treatment. If endometriosis is not severe, oral contraceptives can be given. In other cases progesterone derivatives ( gestagens ) are recommended, which shorten or eliminate menstruation. And other drugs that prevent the production of the female hormones that regulate the female cycle may also be indicated.
Surgery. To remove endometrial tissue that has spread beyond the uterus, the patient is usually operated on with laparoscopy, a less invasive technique. It is important that those who perform the surgery are specialist surgeons, since the intervention can affect a woman's ability to become a mother.

These treatments can be applied in combination, because due to the variability of symptoms, each case must be assessed individually.

What are your causes?

It is not known for sure, but there are various theories. The most widespread speaks of a retrograde menstruation, that is, during menstruation, the blood, instead of being expelled to the outside, penetrates the pelvic organs. But there are other theories that speak of failures in the immune system and genetic inheritance.

Risk factor's

If your mother has endometriosis, you are more likely to suffer from it.
If you have had your first period very soon.
If you have never been pregnant or the first delivery has been after 30 years.
Malformations of the genital system.
According to Harvard Medical School (USA), being very thin also increases the risk of endometriosis.

Pregnancy and endometriosis

One of the main complications of endometriosis is that it makes it very difficult or even prevents pregnancy. But this depends on each case.

When the fallopian tubes are not affected and the ovarian cysts are not large, for example, there is no impediment to stopping the hormonal or contraceptive treatment that is followed and trying a spontaneous pregnancy, which can take up to a year to occur.

In other cases, the gynecologist may recommend that assisted fertilization techniques be used, techniques that between 30% and 50% of women who suffer from this ailment have to resort to.

What can you do

If you think that your pain is not normal, that it disables you from leading a normal life, despite what they tell you, insist. Get the appropriate tests done. And if you still think that they have not been correct in your diagnosis, go to an endometriosis unit. Here is a list of public hospitals that have it:

In Madrid