endometriosis disease about women 10 percentIt is actually a very common health problem that affects the endometriosisIt is a problem that occurs when the tissues that should normally be in the inner cavity of the uterus are moved to other parts of the body and settled there.
This tissue can be found in the organs inside the abdomen (ovaries, uterine canal, inner abdominal membrane, intestines, urinary bladder) as well as outside the abdomen. Along with the bleeding that occurs in the lining of the uterus during menstruation, bleeding-like symptoms occur in the areas where these endometriosis foci are located and cause many complaints. The most common complaint is painful menstruation. Endometriosis most commonly occurs in the abdominal cavity. Tissues accumulating outside the uterus are constantly damaged in later periods. groin pain and Infertility It may cause some problems such as:
The exact cause of endometriosis is still unknown. The most widely accepted theory on this subject is that during menstrual bleeding, the tissues in the uterus pass through the woman's tubes and settle in the abdominal cavity and continue their development there. It is thought that the immune system also differs from normal in a way that allows this. Since hereditary predisposition to endometriosis is thought to be an important factor, having endometriosis in the mother or another relative will increase the likelihood of endometriosis. Cysts sometimes occur if endometriosis occurs in the woman's ovaries. (chocolate cysts) can occur and if they grow too large, they can cause serious problems. Chocolate cysts can be seen with ultrasonography, although this is not always definitive. Definitive diagnosis can only be made through laparoscopy or open surgery. Laparoscopy is a useful procedure in diagnosing the disease and also gives an idea of the severity of the disease. This process will also help the doctor prepare the best treatment plan for you. While the diagnosis is made, surgical treatment of endometriosis foci can be performed simultaneously. 
Common symptoms of endometriosis include:
* Painful menstruation
* Painful sexual intercourse
* Abdominal pain before menstruation
* Back pain
* Pain when passing the toilet.
All of these symptoms may have other causes. Although there are no other symptoms of the disease, endometriosis is frequently encountered in some women who have difficulty getting pregnant.
How does endometriosis affect fertility?
The risk of endometriosis increases in women who have difficulty getting pregnant. In some of these women, especially those with advanced endometriosis, the damage caused by endometriosis causes blockage in the Fallopian tubes (uterine canals).
However, the reasons why endometriosis affects fertility in most women are not yet fully known. Other theories on this subject are: Endometriosis:
* It forms in the ovaries, affects ovulation development and disrupts the ovulation pattern.
* It produces toxins that kill sperm.
* It prevents the embryo from attaching to the uterus.
* It has a toxic effect on the embryo
The duct obstruction caused by endometriosis is sometimes not a complete obstruction and may allow sperm to pass through, but ectopic pregnancy may also occur when embryos get stuck in the partially destroyed ducts.
For more detailed information about ectopic pregnancy, please Click here.
Treatment of endometriosis
The main purpose of the treatments applied is to relieve pain, eliminate infertility and enable pregnancy. For this purpose, different medical and surgical treatments can be applied. Apart from pain relief, medical treatments are based on the principle that endometriosis is a disease dependent on estrogen (female hormone). Pregnancy and menopause are two natural conditions that prevent the formation of endometriosis. The aim of hormonal treatments is to imitate these two natural conditions. In both cases, since the effect of estrogen on the inner lining of the uterus (endometrium) will disappear, endometrial tissue located in the wrong place is expected to be suppressed. Of course, the problems should first be tried to be resolved with medical treatments, but if there are problems such as large chocolate cysts or pain that cannot be relieved by medical treatment, surgical treatment should be considered.
Medical treatment
* Mild painkillers (paracetamol and various non-steroidal painkillers, etc.)
* Hormone treatments (birth control pills, etc.)
hormone treatments
Hormone treatments are applied to stop or slow down the formation of endometriosis by preventing normal menstrual periods. The simplest method to achieve this is to use “birth control pills”. There are also other hormone treatments that have been found to be effective in reducing pain from endometriosis.
In recent years, there are monthly or 3-monthly depot injections called analogues, which are very effective but suppress the ovaries and therefore endometriosis by temporarily putting the person into menopause. Since these drugs, which are known to be very effective in relieving pain, are not used for more than 6 months, it is necessary to take additional precautions, especially to protect the bones, if they need to be used longer than this period. It should not be forgotten that none of the medical treatments have the effect of increasing a person's chance of getting pregnant. In fact, since the person enters menopause during the period when depot injections are used, it is not possible for the person to become pregnant or even menstruate. Hormone treatments may also cause some side effects in some women. However, these side effects are generally manageable.
Surgical Treatment
The severity of the disease, the woman's infertility history, her desire to become pregnant, and her age determine the type of surgical treatment. Unfortunately, even removing the woman's uterus cannot relieve pain in 30% of patients. Generally, the initial surgery is quite effective, while repeated interventions are less effective. The most common surgical procedures performed with laparoscopy are cutting the adhesions surrounding the ovary-tube-uterus, removing endometriotic foci and chocolate cysts in the ovary, burning them, or destroying them with laser.
Burning and cutting the nerve leading to the uterus (LUNA) is useful to a certain extent in relieving pain. Endometriomas in the ovaries are definitely in this regard. experienced and careful It must be removed by a surgeon by peeling off the membrane. The chance of pregnancy in women who apply to us to have children and who have previously undergone endometriosis-chocolate cyst surgery is not very high, even with in vitro fertilization treatment. We often see that in these women, the technique applied in the previous operation or operations damages the ovarian reserve. Therefore, this issue is very important for pregnancy. If there are chocolate cysts smaller than 3-4 cm in diameter, perhaps taking the person to insemination or in vitro fertilization treatment without touching them may increase the chance of pregnancy. In this regard, the other ovary, the patient's age and some other factors must be carefully evaluated by the surgeon.
The most important issue in the treatment of endometriosis is whether there is a desire for children..!
If pregnancy is desired, it is most rational to leave aside medical and surgical treatments and directly engage in treatments aimed at pregnancy. Because it has not been fully proven that medical and surgical treatments increase the chance of pregnancy.
Therefore, if there is no chocolate cyst in the ovaries that is large enough to make pregnancy treatments difficult and the ducts are known to be open, it is necessary to start child (infertility) treatment with vaccination as soon as possible.
If a mentioned chocolate cyst If there is, your doctor will first discuss with you whether it should be removed or not.
If spontaneous pregnancy does not occur following surgical treatment, this chance can be increased by stimulating ovulation and injecting sperm into the uterus. However, in advanced endometriosis and in the presence of additional factors such as the woman's age of 35 and above or a sperm problem that may cause infertility, direct treatment is not possible. IVF Seeking treatment should not be delayed.