Understand the symptoms of endometriosis
Endometriosis is invisible, but the signs of his presence in the body are, in most cases, well perceptible, manifesting through the following symptoms:
Pain during intercourse, described in the depth of the vagina (deep in the vagina)
Changes in the intestine at the time of menstruation in cases of endometriosis involving the region (with symptoms such as diarrhea, constipated, anal bleeding)
Changes in bladder and urinary tracts at the time of menses in cases of endometriosis involves the urinary tract (perceived by the increase in volume of urination, pain when urinating, or bleeding into the urine, for example)
continuous pain, regardless of the period, particularly in more advanced cases of endometriosis, with lots of adhesions in the pelvic organs
It is important to remember that the amount of symptoms is not related to the volume and intensity of the disease. This means that not always women with many symptoms present the most severe endometriosis.
Considered one of the most common symptoms of endometriosis can be classified in different grades:
- Take: when the patient does not need to use medication to minimize symptoms
- Moderate: when the patient needs medicines, enough to improve pain
- Severe: when the patient has no improvement of symptoms, even consuming drugs
- Crippling:. When the patient has pain so intense that incapacitate to exercise daily activities, requiring hospitalization to alleviate uncomfortable or even to treat other symptoms
- such as nausea, vomiting, diarrhea, fever or headacheIt is important to note once more that the intensity of pain unrelated to the amount or degree of endometriosis.Regarding risk factors that could influence the degree of menstrual cramps, some studies have shown that early age at first menstruation, prolonged menstrual periods, smoking, obesity and alcohol consumption might be associated with more severe occurrences.Chronic Pain or Acyclic
- It’s a pain that persists for at least six months, not associated with the menstrual cycle. It is believed that the factors that cause pain are arising from outbreaks of disease or secondary to tissue changes, due to the aderenciais and fibrosis processes.The presence of pelvic adhesions and the number of surgical interventions contribute to worsen the discomforts of this symptom.
Pain Sexual Relations
Several scholars have pointed out this kind of pain as one of the most frequent in women suffering from endometriosis, affecting the utero-sacral ligaments, retrocervical region, rectovaginal septum and lower intestinal regions, such as the rectum and sigmoid. Others explained the association between the severity of pain during intercourse and the degree of infiltration of endometriosis.
Changes Urinary Cyclical
Urinary changes are primarily related to the menstrual period. Endometriosis that affects the urinary tract – reaching the bladder – often is characterized by lower abdominal pain, increased frequency of urination, painful urination, urinary bleeding or recurrent urinary infections. Symptoms can appear at any stage of the cycle, but it becomes more intense in the premenstrual and menstrual period.
Changes Intestinal Cyclical
Mainly related to the menstrual period. Generally, bowel symptoms increase in menstruation, being more intense when endometriosis involves regions such as the intestine (rectum and sigmoid), utero-sacral ligaments, retrocervical region and rectovaginal septum.
Clinically, the woman with deep disease may have pelvic pain complaints, pain during sex, and specific symptoms related to intestinal region, such as pain during bowel movements, diarrhea and bleeding cyclical proceedings. Such variations depend on the extent and depth of the disease.
Hypotheses that endometriosis causes infertility or decrease fertility are still controversial. Although there is evidence to show an association between the disease and infertility, a relationship of cause and effect has not been established. Issues such as the best treatment for infertility associated with endometriosis or if the disease actually has relevance when the main symptom is infertility, are also discussed.
In women under 35 years, the monthly fertility rate is about 12-15%. However, in patients with endometriosis, this number tends to decrease: 2% to 10%. The prevalence of endometriosis in women of reproductive age is estimated between 6% and 44%. Recent studies suggest that 25% to 50% of infertile women have endometriosis and 30% to 50% of women with endometriosis are infertile, which was attributed to immune, hormonal and systemic changes.
Several mechanisms may explain how endometriosis monthly decreases fertility rates. The most likely explanation is the pelvic anatomical damage, especially in advanced disease, and ovarian deficiencies, changes the peritoneal environment, implantation failure and higher early abortions rates.
Women with endometriosis have irregularities in the production of follicles in the body. They are carriers of abnormal hormone levels, changing and decreasing follicular growth, and registering follicular phase tends to be shorter.
Some patients are anovuladoras (no ovulation, the ovaries fail and do not release an egg) or suffering from some important degree of oligo-ovulia. Others may have regular menstrual cycles, normal levels of estradiol (predominant sex hormone present in females) and progesterone, therefore, folliculogenesis and luteinizing hormone (production corpus luteum, a structure that forms at the site of an ovarian follicle after liberaração a egg) normal, but the oocyte release phenomenon (female germ cells or gametes produced in the ovaries) from the dominant follicle does not occur even after the peak of LH (luteinizing hormone), constituting the so-called syndrome luteinized follicle non- roto (LUF).
In 60% of patients with endometriosis, the function of the corpus luteum is inadequate and may result in infertility or early abortion.