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Endometriosis is an extensive combination of clinical manifestations. It occurs when the cells of the endometrium (the mucous membrane that lines the inside of the uterus) encroaches on sites outside the endometrial cavity. Such sites may be the ovaries (endometrioma), the uterus walls (adenomyosis), the fallopian tubes, the intestine or anywhere in the abdomen, and also on more distant organs, such as the lungs and brain.

This is a frequent disorder that affects 10% of the female population but is not life-threatening. The exact cause of this disorder is not known and it is associated with disorders of the immunobiological system. Endometriosis is characterised by the development of ectopic endometrium, usually in the peritoneal cavity, which affects the woman’s fertility mechanically (development of haemorrhagic cysts or adhesions) or biologically (immunobiological disorders in the abdominal area).

The diagnosis is made after laparoscopy, during which the sites of the endometrial tissue are identified and the extent of the damage is assessed. The surgery may be combined with treatment manipulations, such as destruction of the endometriosis sites with diathermy or treatment of any eventual adhesions.

Symptoms include abdominal pain, painful and occasionally heavy and irregular menstruation. It can cause pain during or after sexual intercourse. Often, the pain is associated with the intestine, the bladder, the waist and the inside of the thighs. The pain may be continuous or may appear (and/or worsen) before or during menstruation. However, it does not always manifest with pain; there are many “silent” cases with no symptoms.

Unfortunately, endometriosis may cause infertility in several different ways, depending on its severity. It can affect ovulation or egg quality; cause blocking of the fallopian tubes; prevent embryo implantation (adenomyosis). Endometriosis does not cause an increase in miscarriages.

 

Beyond reproduction, there are several treatments to relieve the pain and improve the quality of life of women with endometriosis. As was mentioned, there are surgical interventions and also hormonal therapy, treatment with analgesics, or alternative treatments.

Endometriosis tends to get worse over time. For this reason, women who wish to have children should accelerate the process and consult with a doctor who specialises in reproductive issues in order to get diagnosed and, if necessary, treated. So far, IVF is the most effective method to achieve pregnancy, despite the low success rates compared to women without endometriosis. In young women who will be submitted to the laparoscopic removal of emdometriosis cysts, it is now recommended to freeze healthy ovarian tissue for future use, in case the endometriosis presents rapid worsening in future.

Η εξωσωματική γονιμοποίηση είναι προς το παρόν η πιο αποτελεσματική μέθοδος για την επίτευξη εγκυμοσύνης παρά τα χαμηλότερα ποσοστά επιτυχίας σε σχέση με γυναίκες χωρίς ενδομητρίωση. Σε νεαρές γυναίκες που πρόκειται να υποβληθούν σε λαπαροσκοπική αφαίρεση ενδομητριωσικών κύστεων, προτείνεται πλέον η κατάψυξη τμήματος υγιούς ωοθηκικού ιστού, για μελλοντική χρήση, σε περίπτωση που η ενδομητρίωση παρουσιάσει ταχεία επιδείνωση.

Εκτός από την αναπαραγωγή, υπάρχουν πολλές θεραπείες για την ανακούφιση από την πόνο και τη βελτίωση της ποιότητας της ζωής των γυναικών με ενδομητρίωση. Όπως αναφέρθηκε, υπάρχουν οι χειρουργικές επεμβάσεις αλλά και ορμονική θεραπεία, με αναλγητικά ή εναλλακτικές θεραπείες.

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