VERIFIED CONTENTConsultation: dr Tadeusz Oleszczuk, gynecologist-obstetrician
Endometriosis is one of the few diseases whose causes are unknown. Although it most often affects people of childbearing age, it can also affect postmenopausal women and even teenagers. We talked about endometriosis with an expert, Dr. Tadeusz Oleszczuk.
Patrycja Pupiec: Aggressive forms of endometriosis are often compared to the aggressiveness of cancer. Why?
Taduesz Oleszczuk:Endometriosis is a disease in which the epithelium from the uterine cavity begins to appear within the pelvic organs. We don't know the reasons why this happens. This results in the formation of gradually growing inflammatory foci of endometriosis in the fallopian tubes, ovaries, peritoneal epithelium covering the bladder, uterus and intestines.
This causes chronic pain. Endometriosis affects 5-30 percent. women of childbearing age, but recent years show that this number is increasing and also applies to 5 percent. adolescents and postmenopausal women. Even 50 percent. women treated for infertility suffer from endometriosis.
The problem, however, is that it usually takes 6-8 years for a correct diagnosis to be made and treatment to begin. In 30 percent women with chronic pain are diagnosed with endometriosis. Of course, it's not like there were no problems today and they will arise tomorrow - it takes time.
Apart from pain, the symptoms of this disease include diarrhea, intestinal problems, constipation, but also symptoms appear from completely different systems - just like in the case of cancer, therefore each disturbing symptom should be carefully analyzed. This condition develops gradually. Initially no symptoms.
You have repeated in your interviews more than once that pregnancy is a specific condition that regulates various other states in the body, such as minor hormonal disorders. Why is pregnancy considered a cure in endometriosis?
Often in the treatment of endometriosis, pregnancy is "used". During it, as well as after childbirth and breastfeeding, the body "rests" from menstruation, so there is no monthlyexpanding the uterine epithelium. If a woman became a mother and gave birth to several children, even if there is endometriosis in the family, the use of pregnancy may prove to be an effective preventive measure.
Pregnancy is protective. Likewise, a reduction in symptoms is observed during the menopause, when the physiological production of estrogens ceases and the uterine epithelium is atrophied. The same goes for endometriosis. Similar effects of controlling epithelial growth and reducing pain can be obtained pharmacologically.
The mechanism of the treatment depends on the nature of the disease. Treatment is about taking control of this disease, but of course there are different stages of advancement - in some the disease progresses very aggressively, and in some more painful inflammatory changes occur more slowly.
Why is endometriosis diagnosed so long? The women indicate that it sometimes lasted for years, even though they consulted their symptoms with different doctors.
Unfortunately, sometimes during a medical interview I often hear from patients "the doctor told me that this is my beauty", "you will have menopause, it will disappear" or "the gynecologist says that it is normal that I experience severe pains during menstruation" . Pain should never be ignored as it is a symptom of inflammation or other ailments. Early treatment is important in endometriosis.
Women are often able to function with various problems, e.g. intestinal disorders (diarrhea, constipation), hormonal disorders (breast pain) or recurring pain in the lower abdomen for several days a month, returning for years. It is worth observing the symptoms, their severity and the time they appear. Endometriosis can also be accompanied by immunological disorders or chronic infections.
Endemetriosis has been associated with pain before and during menstruation, but it does not always have to come. There are such cases, right?
Of course, that's why in such cases a laparoscopy should be performed to check whether it is definitely endometriosis, because the interview itself is one diagnostic criterion, and only the result from the sample taken during the examination confirms the diagnosis. Additionally, in a woman trying to become pregnant, obstruction of the fallopian tubes can be diagnosed and appropriate treatment may be initiated.
In the case of endometriosis, is it that if the mother was sick, the daughter should be careful, because she may also be sick?
Yes, because due to our connection we have a similar body morphology, metabolic and hormonal structure, intestinal microflora, food intolerances, susceptibility to disordersimmunological. Diseases such as thyroid disorders, for example, are also inherited. It is worth having an ultrasound of the thyroid gland if there are family problems with this largest gland.
Endometriosis affects many women who have problems with fertility. Does this mean that it is only then diagnosed?
Yes, because in case of problems with getting pregnant, tests for the diagnosis of endometriosis are carried out, for example by checking the patency of the fallopian tubes. It turns out that the partner is he althy, the woman has no hormonal problems, and the pregnancy is not. After the tests, it turns out that there are adhesions in the fallopian tubes causing obstruction, and there is an endometrial cyst in the ovary. This should be treated.
Untreated endometriosis can progress and the problems will increase. Sometimes, during the procedure of the ovarian endometrial cyst, you can see endometriosis foci in the form of small spots on the walls of the smaller pelvis. The treatment is supplemented by administering appropriate hormonal drugs.
The statements of women who suffer from endometriosis show that in Poland this disease is treated mainly privately. What is the support from the National He alth Fund in the treatment of this condition?
If there is already a specific diagnosis, i.e. histopathological confirmation based on biopsies or lesions excision, the National He alth Fund reimburses the hormonal drug. It allows to effectively block the growth of endometriosis foci and reduce pain.
Often women suffering from endometriosis complain of pain in the joints. Why?
As already mentioned, endometriosis is an inflammatory reaction and is related to immunity. The increase in the amount of circulating inflammatory mediators and disorders of the immune system may occur with the appearance of an inflammatory reaction in the joints. The very state of irritation of the intestinal mucosa can lead to a build-up of fluid in the pelvis, which can also cause pain in the lower abdomen.
Regardless of how we approach it, we always come across associations with immune disorders. For some, it will show as skin lesions, for others, you may notice a deterioration in mood, and some will develop joint changes. Hence, women who suffer from endometriosis often have problems with their joints.
You should evaluate your he alth holistically and the impact of your diet is usually greatest.
Treatment of endometriosis includes, in addition to pharmacology and surgery, diet and physical therapy, right?
During the several months of hormonal treatment of endometriosis, women getvague recommendations, for example, "take care of yourself". What does that really mean? After all, there are no specific guidelines, so I always follow what causes disease - 20 percent. these are the genes I have already mentioned, and the rest is the lifestyle we lead, the way we eat.
How much stress we have and whether we are active enough - it all affects our immune system, which is why some people get sick more often and others less often. If we eat junk food, processed foods, large amounts of sugar, we unfortunately kill the good bacteria in our gut, and only feed the pathological ones that cause and exacerbate inflammation. Once upon a time, food was not as processed as it is today and did not contain as much sugar, chemical additives, antibiotics or pesticides.
In any case, the general condition of the body and the efficiency of the immune system are important.
gynecologist-obstetrician Tadeusz OleszczukGynecologist-obstetrician with over 30 years of experience. Author of the books "What the gynecologist will not tell you" and "Calm your hormones".
www.tadeuszoleszczuk.pl
fb.com / drtadeusz
Read other articles from the StrefaKobiety series:
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- Ignorance or maybe ignorance? Why do women die of cancer?
- 20 percent couples deal with infertility. Mostly not the fault of the woman
- Last menstruation and menopause. How to prepare for it?
- A woman must be he althy before starting contraception
- How to take care of intimate hygiene to avoid infections?
- Allergies - where do they come from? Allergy to semen and condoms
- Gynecologist banning abortion: Let's not condemn women to suffering at risk of losing he alth and life
- Pain in the intimate areas. Is it normal to feel pain?
- Sexually transmitted diseases. How to take care of your safety?
- Polycystic Ovary Syndrome (PCOS), or when the body and mind suffer
- Gynecological visit during a pandemic. What has changed?
- Breasts. What about their appearance should worry us?
- Are you pregnant and afraid to vaccinate against COVID-19? Expert explains why it is worth doing this
- Endometrial cancer, i.e. a cancer in which lifestyle is important
- Why are uterine fibroids mostly only monitored?
- Gynecologist: People are afraid to name the basic elements of the reproductive system, let alone know what the physiology of the cycle looks like