2024-03-01 13:43:08
Disease Awareness Month
Today, the first of March, is Endometriosis Awareness Day, as this month is designated every year to raise awareness, promote research to find a cure for this disease, and also to address the stigma that accompanies endometriosis in the form of infertility.
Endometriosis is an inflammatory condition that occurs in women when tissue begins to grow outside the uterus, and this tissue is the same tissue that lines the uterus internally.
A major cause of infertility
It is the world’s third leading gynecological cause of hospital admissions, and among the leading reasons for the estimated 600,000 hysterectomies performed each year in the United States (despite the fact that a hysterectomy cannot, in fact, cure endometriosis). . There is no cure for this disease, and its cause is not yet known, and awareness is a major problem.
Why is Endometriosis Awareness Day important? Dr. Muhammad Malak, a consultant in obstetrics, gynecology and infertility, answered this question by saying that the celebration of World Endometriosis Day began in 1993, and that the Endometriosis Association works to promote this issue by providing information and support to those who suffer from this condition. And by distributing yellow ribbons, a symbol and indication of the migrating lining.
He added that endometriosis is a disease that affects one in every 10 women in the United States, and an estimated 200 million women globally. Despite these staggering numbers, there is little awareness of this disease, and the condition is often misdiagnosed. According to the Endometriosis Foundation of America, a lack of awareness and education regarding the disease represents a major obstacle to its detection. These symptoms are often misdiagnosed. Through the efforts of participating organizations, the medical community, and civil society, more people are learning regarding this condition. However, there is still a need for better understanding, especially regarding early diagnosis and treatment.
Disease awareness
Awareness of endometriosis is extremely important because of the following considerations:
– A disease that requires awareness. According to the American Endometriosis Foundation, awareness is the biggest issue in combating endometriosis. The entire month of March is primarily dedicated to creating awareness.
Endometriosis leads to infertility. Endometriosis is currently the main cause of infertility, and managing symptoms is extremely important.
– Promoting research. Throughout the month of March, specialists, researchers and scientists in this field rely on the information collected to find better treatments for endometriosis. This will help more women globally.
Timely detection and intervention can give patients a chance to treat symptoms before they get out of control and require surgery. Women with endometriosis are also likely to have difficulty getting pregnant.
Interesting facts
Endometriosis is a disease that affects women around the world, mostly during their reproductive years (12-52 years).
– It has been proven that pregnancy may help relieve symptoms due to increased progesterone levels.
Genetics is important in contracting this disease, as studies have found a possible genetic component.
Chronic pelvic pain is a major symptom, especially outside the menstrual cycle.
Diagnosing the disease takes a long time, up to 8 years from the appearance of symptoms.
Symptoms and diagnosis
• Symptoms. People with endometriosis can experience lifelong symptoms throughout the body, including severe pain (especially pelvic pain) and during intercourse, organ dysfunction and failure, infertility, abnormal uterine bleeding, and frequent surgeries. Endometriosis is also closely associated with cardiovascular disease and hypertension, with patients with endometriosis being 40 percent more likely to develop ischemic heart disease and 19 percent more likely to develop cerebrovascular disease.
Other conditions more common in patients with endometriosis include: hypothyroidism, fibromyalgia, chronic fatigue syndrome, autoimmune diseases, allergies and asthma, systemic lupus erythematosus (SLE or lupus), rheumatoid arthritis, celiac disease, and multiple sclerosis (MS). ), and inflammatory bowel disease (IBS).
In addition, patients with endometriosis may experience immune and endocrine dysfunction, kidney failure, and damage to multiple organs and tissues, including the intestines, bladder, ureters, diaphragm, muscles, musculoskeletal structures, nerves, ligaments, lungs, and liver. Given the widespread potential for such chronic and severe symptoms, endometriosis is also one of the leading causes of school absence in adolescent and pre-adolescent girls.
Diagnosis. The diagnosis is confirmed by:
– Physical examination. To know if the condition is “endometriosis,” know the history of the disease, and where and when the pain is felt.
– Pelvic examination. To check for any unusual changes such as cysts on the reproductive organs, painful spots, irregular growths called nodules, and scarring behind the uterus. Often, large bags are needed.
– Ultrasound. Used to take pictures, transvaginal ultrasound may be used for better diagnosis.
– Magnetic resonance imaging (MRI). To take pictures of organs and tissues inside the body, it also helps in surgical planning. It gives the surgeon detailed information regarding the location and size of endometrial growth.
– Laparoscopy. It is performed by the surgeon by making a small incision near the navel, to check inside the abdomen for signs of endometrial tissue, and to know the location, extent, and size of endometrial growth. The surgeon may take a tissue sample called a biopsy for further testing. With proper planning, a surgeon can often treat endometriosis during laparoscopy in just one surgery.
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treatment
Treatment of endometriosis is often medical or surgical, depending on the severity of the symptoms and the extent of the desire to become pregnant and have children.
• First: Drug treatment:
– Pain treatment. Treatment begins with pain relievers, nonsteroidal anti-inflammatory drugs (NSAIDs), ibuprofen, or naproxen sodium to help relieve painful menstrual cramps.
– Hormonal treatment. Hormone therapy may be recommended along with pain relievers if you do not want to become pregnant, as it helps relieve or eliminate endometrial pain, slow the growth of endometrial tissue, and prevent the formation of new tissue. The rise and fall of hormones during the menstrual cycle causes the endometrial tissue to thicken, break down, and bleed. Hormone therapy is not a permanent cure for the disease, and symptoms may return following stopping treatment. These treatments include the following:
– Hormonal contraceptives. Birth control pills, injections, patches and vaginal rings help control the hormones that trigger endometriosis and may therefore relieve or eliminate pain in some cases. It has been found that the chances of relief increase with the use of birth control pills for a year or more without breaks.
– Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists. These medications prevent the menstrual cycle and lower estrogen levels, causing endometrial tissue to shrink, creating a state of “artificial menopause.” Taking a low dose of estrogen or progestin with Gn-RH agonists and antagonists may reduce the side effects of menopause. These include hot flashes, vaginal dryness, and bone loss. Menstruation and the ability to become pregnant return when you stop taking the medication.
– Progestin therapy. Progestin is a laboratory version of the hormone that plays a role in the menstrual cycle and pregnancy. A variety of progestin treatments can stop the growth of endometrial tissue, which may relieve symptoms. Progestin treatments include a small device placed in the uterus that releases levonorgestrel (Mirena, Skyla, others), a contraceptive patch placed under the skin of the arm (Nexplanon), birth control injections (Depo-Provera), or a progestin-only contraceptive.
– Aromatase inhibitors, this is a class of medications that reduce the amount of estrogen in the body and relieve the pain of endometriosis.
Surgical procedures
• Second: Surgery, which includes:
– Conservative surgery, to remove endometrial tissue in order to preserve the uterus and ovaries. This type of surgery may enhance the chances of a successful pregnancy, but the condition may return over time following surgery. Conservative surgery can be performed either by making a large incision in the abdomen to remove thick bands of scar tissue, or laparoscopically by making small incisions, and the surgeon places a thin viewing instrument called a laparoscope through a small incision near the navel. Surgical instruments are inserted to remove endometrial tissue through another small cut. Some surgeons perform laparoscopy with the help of robotic devices that they control. After surgery, your doctor may recommend hormonal medications to help relieve pain.
– Surgery to remove the uterus and ovaries, through:
A hysterectomy is performed when pregnancy is not desired, to treat symptoms associated with the disease such as heavy menstrual bleeding and painful menstruation due to uterine contractions.
The process of removing the ovaries leads to early menopause, and thus a decrease in the hormones secreted by the ovaries, and the result is an improvement in endometrial pain in some people. But for others, the uterine lining that remains following surgery continues to cause symptoms.
Removal of the uterus and ovaries was once thought to be the most effective treatment for endometriosis. Today, some experts consider it a last resort for pain relief when other treatments don’t work. Other experts instead recommend surgery that focuses on careful and comprehensive removal of all endometrial tissue.
• Community medicine consultant
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