"Every month is a continuous death and rebirth.
My young body seems trapped in
to an elderly lady who is waiting for the arrival of death.
slowly die and then tried timidly to be reborn, but with
the disease progresses
I wonder if these are the key
I wanted for my life.
Sometimes the pain is so strong and prolonged
that I can no longer recover.
I feel like a helpless little cocoon
waiting, as if by miracle, the rebirth
finally free to live as
shining a butterfly with its colorful
remained unspoken for so long. "
Loria Orsato
of endometriosis is still not talking and there are few people who know a fund, including the institutions that still Today in Italy do not recognize it as a debilitating and disabling disease that persists throughout life and requires constant monitoring, underestimating.
Today things are changing, thanks to a network of associations of patients spread throughout the world, which has promoted education, support and research, in collaboration with physicians aware and motivated to defeat it. Endometriosis is a
insidious disease, tenacious, and partly remains a mystery, but chronic disease affecting women of reproductive age worldwide. It is therefore not a rare disease
The name derives from the word "endometrium, the tissue that lines the inner surface of the uterus and grows and then breaks up each month during the menstrual cycle.
endometrium is localized to the endometrial-like tissue outside the uterus, in other areas of the body.
In these locations the endometrial tissue develops into "lumps", "cancer", "injury", "plant" or "growths." These formations can cause pain, infertility and other problems.
They are located most frequently abdomen involving the ovaries, fallopian tubes, uterine ligaments, the rectovaginal septum (area between the vagina and rectum), the outer surface of the uterus and peritoneum (lining of the peritoneal cavity) . Sometimes these lesions are also found in abdominal post-surgical scars, the intestines or rectum, on the bladder, kidneys, ureters (which are protruding from each kidney into the bladder), vagina, cervix and vulva (external genitalia). Endometriotic lesions were also found outside the abdomen, lung, arm, thigh and other areas, although these cases are rare.
As the lining of the uterus, including endometrial lesions are usually sensitive sex hormones produced by the ovaries and in particular to estrogen. Therefore, training endometriosis undergo a cyclical development, flaking and therefore of bleeding. Unlike the inner surface of the uterus, however, the endometrial tissue outside of it has no way to escape outside of the body. The result is an internal stagnation of blood, tissue decomposition flaked from injury, inflammation of the surrounding areas and formation of scar tissue. The outcome is inflammation
inevitable
inflammation in fact is the response that our body puts into action each time undergoes a trauma. It is a convenient way of react, because it is immediate and does not depend on the type of trauma. Conficcatasi a splinter in your finger, or a viral or bacterial attack, such as endometriosis, when abnormal blood: the body has developed a system of rapid attack on the enemy, whatever form it takes. The inflammatory process, however, just as fast if not defused, it tends to become chronic. The inflammatory cells in the field also put the so-called cytokines, molecules released into the environment surrounding the point of attack of the enemy, which serve as mediators of inflammation. Cells and molecules give rise to an inflammatory mechanism autoamplificazione message. If the inflammation (= inflammation) is not brought under control in time, its final outcome is a chronic inflammatory stimulus that damages healthy tissue.
The body's response to injury and damage the healing tissue is the production of fibrous tissue that is less elastic and less functional than the original one. Often this repair mechanism produces the adhesions between the different organs of the abdominal cavity, hampering movement and proper functionality.
All this produces pain. The non-synchronization of the response to estrogen in the endometrium eutopia (ie, that physiologically plays the uterine cavity) el'endometrio ectopic (that is misplaced, that of pathological lesions) account for at least part of chronic pain related to endometriosis, ie in this many days of the month or even every day. The formation of adhesions is the cause of pain.
Other complications, depending on the location of the lesions may be the breaking of such lesions (which may be due to dissemination of endometriotic cells in other areas), intestinal obstruction (if the lesions are localized in the intestine or nearby) , bladder disorders (if the growths are the bladder), stenosis (= reduction) of the ureters with possible pain in the kidney and other problems. The teams do not endometriotic are usually malignant or cancerous: this is a normal tissue located in an abnormal site. In recent decades there has been an increase observation frequency of malignant lesions have developed or endometriotic lesions were observed in conjunction with them. However, studies are still conflicting order to reach a clear conclusion in this regard.
spoken instead of adenomyosis endometriosis when the cells are located in the myometrium, the muscular wall of the uterus.
against the pain, which can range from mild to extremely intense until it was unbearable, are prescribed NSAIDs (nonsteroidal anti-inflammatory) or the most common analgesics. Very often the treatment of pain at the time of occurrence is low because the pain tends to become drug resistant, is used then a more powerful narcotics, a medical prescription.
progestogens type compounds are used contraceptive pill administered for long periods. In addition, medications are used to contain only progestin that induce a state of pseudopregnancy. For shorter-term therapies are in use analogues of hypothalamic hormones that induce a state of pseudomenopausa. These drug treatments have heavy side effects, are therefore very tiring to bear because they create imbalances hard for a young woman and substantial effects on the body. In
are removed during the laparoscopy endometriosis formations (diagnostic laparoscopy in order to become operational). In fact, the diagnosis can only have a surgery that allows the removal of tissue for analysis. Laparoscopy is an invasive operation on average in which, thanks to fiber-optic instruments, the surgeon is aware of the abdominal and pelvic part of the patient. Sometimes laparoscopy is not possible and opted for a cut of the abdomen with laparotomy. Although we try to make the most conservative possible interventions of the internal genital organs, in severe cases should get the removal of the uterus (hysterectomy) and / or ovaries (annessiectomia) often unacceptable given the young age of the patients. Surgery is sometimes necessary to reach the bowel resection, the removal of a kidney, etc.., When the endometriosis has affected those organs already heavily compromised in their functionality and quality of life of women.
Unfortunately, chronic disease, because it almost always persists and needs of new treatments.
It is estimated that in 20-25% of cases of endometriosis are asymptomatic, that does not produce any obvious symptoms.
In most cases (75-80%) but the symptoms may present with a very wide variability in both the type and intensity. The
Symptoms of endometriosis can be divided into two categories: pain and infertility / infertility.
part of the painful symptoms, those most frequently found in cases of endometriosis are pain before and during menstruation (dysmenorrhea), ovulation pain, pain during or after sexual intercourse (dyspareunia), pain on defecation (dischezia) pain on urination (dysuria), pain radiating to the rectal area, pain in the lumbar region. You can also check: spotting (bleeding in between menstruation and the other one), blood in the stool or bleeding from the rectum (proctorragia), blood in the urine (hematuria), nausea, diarrhea and / or constipation and other intestinal disorders, headaches, tiredness and fatigue.
The intensity of pain is not related to or an extension and / or size of lesions or the severity of the disease. Small groups (called petechial) proved to be more active in the production of prostaglandins. Prostaglandins are substances synthesized in the body, involved in many functions and considered responsible for most of the painful symptoms as mediators of inflammation: this could explain the significant symptoms that often accompanies the presence of small plants.
painful symptoms due to endometriosis appear to have intensified over time, although in some cases we have cycles of remission and recurrence.
Infertility affects 30-40% of women with endometriosis and is a common outcome with the progression of the disease. It talks about infertility
what has prevented fertilization, so that the two gametes (egg and sperm) are not able to come together to form the zygote (the fertilized cell).
infertility when he left, although the fertilization took place, there is no continuation of the pregnancy with implantation of the pre-embryo in the inner cavity of the uterus.
The diagnosis of endometriosis, in general, is not considered reliable until it is proven by biopsy, that analysis tissue removed during surgery.
However, the doctor may use many tools that allow him to make a diagnosis with high probability of being confirmed by tissue histology. First
scrupulous collection of data on personal and family history of the woman (history), the accurate record of all the signs and symptoms that the patient can offer during the interview allows the clinician to focus its attentions to a diagnostic classification correct.
The pelvic examination - to be performed by the vaginal route, when possible, and always through the rectum - allows manual palpation of major injuries. A visit can be carried out properly identify painful areas by reproducing the same painful symptoms of the disease.
Among the instrumental analysis, U.S. - transvaginal when possible - is by far the most common and least invasive. Allows detection of ovarian cysts el'adenomiosi (endometrial tissue that lurks within the muscular wall of the uterus).
In the presence of bowel symptoms may be useful MRI, barium enema, the ecocolonscopia.
If you suspect involvement of the urinary tract, cystoscopy allows an exploration of the bladder, the IVU ol'uroRMN analyze channels abdominal ultrasound can detect ureteral dilatation and renal or ureteral.
CT and X-rays may also be support for a correct diagnosis.
may be useful to investigate the value of certain blood markers such as CA 125. But this is not always a measurement indicative of endometriosis because this protein can increase its concentration in the blood in the presence of other inflammatory conditions or certain forms of cancer. Moreover, it is said that rises in the presence of endometriosis. Therefore it is not in itself a significant prognostic value.
In Italy, in operation since 1999, the Italian Association Endometriosis Onlus (AIE), which was founded and from women with endometriosis and is recognized as an organization of volunteer non-profit society on the whole Italian territory (Decree dir. No MI 115). It is based in Nerviano (Milan) and participates in the international circuit of the International Endometriosis Association, International Association present in 66 countries worldwide. The IEA is a founding member of the European Endometriosis Alliance formed in October 2004.
The IEA, the first group of patients in Italy to deal with endometriosis in the perspective of women who are affected, has the following objectives:
emotionally support women
solicit informed about the disease
institutions
promote scientific research in Italy to collect signatures because we protect the rights of women with endometriosis.
Source: Italian Endometriosis Association
Information:
Italian Endometriosis Association Onlus
PO Box 114 20014 Nerviano (Mi)
Infoline 800 031977 - Fax 0331 589 800
info@endoassoc.it
www.endoassoc.it
Oral contraceptives reduce painful symptoms such as dysmenorrhea and pain inter-menstrual and effectively prevent the recurrence of endometriotic cyst after their surgical removal.
Unfortunately, the effect is symptomatic and not curative, that is, the benefit is obvious as long as you use the pill, but prohibiting the resumption of symptoms is very likely. Consequently, the concept of medical treatment involves prolonged periods of employment, some for years and still cover the time lag between diagnosis and the search for a pregnancy.
Many women taking "the pill" for contraception for a long time without any worries. However, when oral contraceptives are used for therapeutic purposes, are often burdened with the most diverse concerns, including the effect on fertility and future health.
The data concerning the effect on fertility are very reassuring, as well as those relating to the future health of the woman. Indeed, studies indicate that the pill may actually represent a protective factor.
Loria Orsato
