Endometriosis is a gynecological disease in which parts of the lining of the uterus (endometrium) are also located outside the uterine cavity. The disease occurs in women of childbearing age and is often the cause of infertility. Proper treatment of endometriosis can have a significant impact on the likelihood of becoming pregnant.

Parts of the endometrium in this disease can be found almost anywhere in the human body, most commonly in the small pelvis and abdominal organs. These endometrial deposits react to the level of sex hormones, causing them to bleed during menstruation and subsequently develop chronic inflammation. These tissue changes prevent conception; secondarily, adhesions also develop, mechanically preventing the egg from reaching the uterus and implanting.

Causes of endometriosis

Despite research, the exact cause of this disease is still unclear. As a rule, there is talk about a coincidence of several factors: genetic, immunological and hormonal. Various theories on the development of endometriosis are based on this. The oldest of them—the so-called implantation—claims that a so-called reverse menstruation occurs. In this case, the parts of the endometrium do not come out of the body, but enter the abdominal cavity. Another theory explains the disease as a result of the transformation of some cells into endometrial cells. The connection between endometriosis and the woman’s immune system is also being intensively researched.

Symptoms of endometriosis

Problems getting pregnant may indicate endometriosis. Pain in the lower abdomen, during menstruation or during sexual intercourse, is also a common symptom. Less commonly, there may be blood in the urine or stool. In some cases, endometriosis is completely asymptomatic and is discovered by chance during a laparoscopy.

Treatment of endometriosis

When treating endometriosis, we focus on two basic things: eliminating the problems of infertility and relieving the pain caused by endometriosis. It should be remembered that endometriosis cannot be completely cured, but its foci can be significantly reduced.

The therapy of first choice is conservative treatment, with hormone preparations and painkillers. This can reduce or regress the active endometriosis lesions.

The second option is the surgical route. This involves laparoscopic removal of unwanted endometriosis foci and simultaneous loosening of adhesions that have formed around the foci as a result of an inflammatory reaction.

Prognosis of endometriosis

Since endometriosis is a chronic disease, it must be expected that it may recur. Therefore, we also recommend that the woman should not delay family planning after treatment of endometriosis, as the chances of pregnancy may decrease again with the possible recurrence of the disease. After menopause, endometriosis disappears completely.

Our fertility experts

The article was prepared and provided by our partner clinic “FertiCare” in Prague, Karlovy Vary and Znojmo.

In FertiCare clinics we focus on holistic therapy of infertility and our target group is primarily clients from German-speaking countries.

MUDr. Petr Uher
Dr. Petr Uher

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