Endometriosis is a serious, chronic disease that affects millions of women around the world. It is characterized by severe pain, can lead to infertility and significantly reduces quality of life. It is estimated that about two million women in Poland struggle with it, and in many of them the diagnosis is made too late. What are the symptoms of endometriosis? What treatments can help? And why is prompt diagnosis so important for women planning to become mothers?

What is endometriosis?

Endometriosis is a disease in which cells of the endometrium (uterine lining) grow outside its natural area. Outbreaks of the disease can appear on the ovaries, fallopian tubes, bladder, intestines and even in distant organs such as the lungs or brain. As a result, it leads to chronic inflammation, the formation of adhesions and cysts, and severe pain.

Symptoms and consequences

The disease often develops over a period of years, and its symptoms are sometimes nonspecific, so that diagnosis is delayed. The most commonly reported complaints include:

Severe menstrual pain,
pain during intercourse,
Abdominal, back and leg pain,
Flatulence, diarrhea, constipation, nausea,
frequent urination,
Fatigue, lowered mood, depression.

In 96% of cases, endometriosis causes reduced fertility. The changes in the body can lead to obstruction of the fallopian tubes, hormonal disorders, as well as hinder embryo implantation and increase the risk of miscarriage.

In one in two-thirds of women presenting to an infertility clinic, endometriosis is already diagnosed, suspected or diagnosed at the stage of diagnostic testing.

Diagnosis and treatment

The basis of diagnosis is a medical history and gynecological examination, supported by imaging studies - ultrasound and MRI. It is now recommended to avoid invasive methods such as laparoscopy if there are other options for diagnosis.

- The treatment of endometriosis depends on the stage of the disease and the complaints reported by the patient, says Joanna Jacko, MD, specialist in obstetrics, gynecology and gynecological oncology, an expert in the diagnosis and treatment of endometriosis from Medicover Hospital. " Every patient with endometriosis should use an appropriate diet in the treatment, implement physical activity and physiotherapy. Sometimes these changes can already reduce inflammation and, consequently, pain. The next step we can suggest is hormone therapy. In the absence of a therapeutic effect or in very advanced stages of endometriosis, surgical treatment is a necessary solution. A very important aspect in the management of patients with endometriosis is fertility preservation. This applies both to patients managed conservatively and those qualified for surgery. The quality of oocytes is affected by the age of the patient and the duration of the disease, i.e. the earlier the oocyte is retrieved, the better quality it will be.

Treatment depends on the severity of the disease and may include:

Lifestyle changes (diet, physical activity, physiotherapy),
hormonal treatment,
surgical treatment for severe forms of the disease,
Fertility preservation procedures, such as oocyte freezing.

Modern methods, such as in vitro fertilization (IVF), give women with endometriosis a better chance of motherhood.

- Endometriosis doesn't have to mean giving up on motherhood - what's important is a quick diagnosis and implementation of appropriate treatment - says doctor. Jaroslaw Kaczynski, gynecologist-obstetrician, endocrinologist, Medical Director of Invimed Warsaw Mokotow.

Patient's story

Ms. Margaret struggled for years with pain and fruitless efforts to have a child. It wasn't until she got to a specialist that she was quickly diagnosed and successfully treated with surgery. As a result, she was able to start fertility support therapy, giving her a real chance at the desired motherhood. - I found out I had endometriosis in 2020. Fruitless efforts to have a child had already been going on for a year. In the meantime, during gynecological appointments, despite reporting a problem with getting pregnant and symptoms that might have suggested endometriosis, no broader diagnostics were implemented beyond basic blood tests. After a long time and unsuccessful attempts at treatment, we ended up with the right endometriosis treatment specialist. At the very first visit, he made the diagnosis and I was referred for another surgery. Thanks to this, my husband and I regained hope for parenthood, and I stopped living in pain.

Early diagnosis gives chance for better life

Endometriosis is a disease that is still diagnosed too rarely and too late. Women suffer in silence for years, not knowing what is causing their discomfort. Meanwhile, a quick response and the implementation of appropriate treatment can significantly improve patients' quality of life and increase their chances of motherhood.

- The modern approach to treating infertility in a couple struggling with the inability to achieve pregnancy in practice means treatment in an in vitro fertilization program. Through controlled stimulation of ovulation, we obtain several-odd follicles that contain a mature egg cell. After fertilization of the oocytes, we monitor the development of the embryos until the fifth-sixth day in order to cryopreserve (freeze) them at the blastocyst stage. In this way, the embryos obtained can be transferred to the uterine cavity, previously prepared for this in hormone therapy dedicated to patients with endometriosis or adenomyosis," adds Dr. Jaroslaw Kaczynski of the Invimed Clinic - Such planned therapy gives a very high percentage of pregnancies, allows us to shorten the waiting time for the desired child and bypass all those problems in human procreation that a diagnosis of endometriosis brings. If a patient with endometriosis is not currently considering motherhood, it is reasonable to secure her oocytes for the future, for in the course of a disease process such as endometriosis, oocytes undergo accelerated degradation and their quality is lower than the woman's biological age would suggest.

Source: press mat.