Endometriosis is a benign disease that is characterized by the presence of endometrial tissue, that which is inside the uterus, outside the uterus. Endometrial tissue can appear in the ovaries, in the peritoneum and even, less frequently, in places such as the bladder, bowel or stomach. In the case that the disease manifests itself through symptoms, the most common are dysmenorrhea (menstruation more painful than usual), dyspareunia (pain during or after sexual intercourse), infertility and chronic pelvic pain.
Detection is essential to prevent future complications, the most important of which is infertility. "The diagnosis can be made in the gynecological consultation with such basic methods as an examination or ultrasound", explains Dr. de Santiago. Treatments used when dealing with this pathology are divided into analgesics, hormone treatment and surgery. "Naturally, treatment should be focused on preserving or improving the fertility of the woman, but the most common are hormone treatments, which cause atrophy of the endometrium or anovulation, when no egg is produced in the menstrual cycle," he adds. With anovulation and atrophy of the endometrium, pain and dyspareunia are considerably alleviated, which is why these treatments are the most prescribed in combating endometriosis.
The great advances in the approach to endometriosis have their origin in laparoscopic surgery, which has great advantages for patients because it is minimally invasive. In this case, the approach must be multidisciplinary and carried out by an expert team as it is a complex, delicate procedure.
Although the incidence of the disease is high, there is still much to discover about endometriosis. "We do not know the exact mechanism by which endometriosis occurs, although genetic, immunological or environmental factors may be involved," explains the doctor. Furthermore, there are some histological types of ovarian cancer that are associated with endometriosis. "Although the increased risk of developing this tumor is low in patients with endometriosis, it must be taken into account and monitored constantly," he adds.