ENDOMETRIOSIS

Endometriosis is a disease that affects multiple areas, when the tissue inside the uterus (Endometrial) adheres to the outside of the women or uterus. The frequency with which we see endometriosis in patients is very high, approximately 20% of women can have it, and on women with fertility problems or with pelvic pain it can be as high as 40 to 60%.

Lesions usually appear on the inside of the pelvic wall, ovaries (Endometriosis), Fallopian Tubes, as well as the rear part of the uterus; there can also be other unusual places where they can be found.

Most common symptoms of endometriosis is body pain during periods called dysmenorrheal (menstrual cramps), these pains increase. Pain during sexual intercourse (dispareunia), chronic pelvic pain for more than 6 months regardless of the day and with or without menstruation. Pain similar to a cramp in the intestines or intra-menstrual bleeding.

Infertility problems are very common with patients with Endometriosis. And it can be diagnosed in the following ways:

1. Clinical suspicion.
Pain or infertility

2. Lab tests
Ultrasound or MRI’s

3. Laparoscopy.

Laparoscopy is the most effective medical diagnosis (Gold Standard). Laparoscopy consists of small incisions in the abdomen through which a lens is passed through to inspect the interior of the abdomen; if there are lesions they can be extirpated, vaporized.

The treatment of endometriosis is one of the steps toward the diagnosis for infertility; generally, laparoscopy is suggested in cases where pain is unbearable. When it comes to infertility treatment, it would depend on how the disease has expanded or if it has damaged the pelvis or other internal organs. These treatments can include:

Medical treatments:

• Hormonal Anti
• Analgesics
• Agonists of GnrH (Zoladex)

• Laparoscopy

• Ovulation Induction
• Artificial Insemination
• In Vitro Fertilization
• ICSI (Intra-cytoplasmic Injection of sperm on the ovule)
• It is important to individualize the treatment of endometriosis and consider other factors like infertility, age, previous diagnosis as to have an appropriate treatment.