2024-03-18 05:00:56
Around 10% of Brazilian women of reproductive age live with endometriosis. The disease leads to a dispersion of the endometrial tissue, the inner lining of the uterus, which should be eliminated during menstruation but ends up settling in other places in the body.
Endometriosis is painful (increasing menstrual cramps) and also reduces the patient’s chances of getting pregnant by up to 40%. Due to the pain and difficulties that women go through due to the condition, many opt for surgery to reverse the condition.
However, according to a study published in November 2023 in the scientific journal BMJ Open Quality, in Brazil, around 22% of women undergo surgery unnecessarily.
Avoiding unnecessary surgeries
The study was carried out by a group of gynecologists from the Albert Einstein hospital, in São Paulo, with 430 patients who had a medical indication to undergo the procedure between 2020 and 2021. The hospital implemented a council that would validate colleagues’ reports, which reduced the number of surgical indications by almost a quarter.
Within the program, all indications for endometriosis surgery are analyzed by two specialist nurses. They are responsible for evaluating each patient’s medical report, the reason for the surgery, the exams and the evidence. If all criteria are confirmed, then surgery can be performed.
The objective of the study was, initially, to evaluate the reduction in operational costs of the health system. Decisions were made with saving financial resources as a priority, but only so-called “procedures that bring minimal or no benefit to patients” were cut.
The surgery
Endometriosis can be treated in several ways. There are medications that regulate hormones and can reduce endometrial production and treatments that allow menstruation to be suspended. In cases of larger injuries caused by tissues that detach from the uterus, however, it is necessary to undergo surgery to prevent the tissue from leaking.
For gynecologist André Vinícius Florentino, from São Paulo, the best treatment alternative is one that combines surgery and hormonal blockades to achieve better results. “The disease returns in one in every three women who have surgery. It’s not that the procedure is bad, it can help patients a lot, but first we need to try other treatments,” he says.
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Endometriosis is a chronic disease of the female reproductive system. It arises when the endometrium, the tissue that lines the uterus from the inside, moves in the opposite direction during menstruation and can reach various locations in the abdominal cavity, such as the ovary, intestine and bladder Getty Images
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It affects women of reproductive age and has an unknown origin, although in some cases it has genetic influence. There is no evidence that the disease has a cure, however, there are treatments involving contraceptives or, in more serious cases, surgery Getty Images
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Endometriosis is a disease characterized by intense pain during the menstrual period, which can make women unable to carry out their usual activities. In addition, pain during sexual intercourse, difficulty getting pregnant, intestinal and urinary pain and bleeding are common Getty Images
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Unregulated and heavy menstrual bleeding, bleeding outside the menstrual period, tiredness, fatigue and pain in the lower back or lower abdomen during menstruation may indicate the presence of the disease Getty Images
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Endometriosis symptoms can begin days before menstruation and end days later. Pain can also vary from person to person, both in terms of intensity and frequency. In fact, the intensity of the pain may not be related to the extent of the disease. In other words, people who experience more pain may have less extensive disease and vice versa Getty Images
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The diagnosis of the disease is clinical, although it is not so simple to detect. Using imaging tests is the most common method, such as transvaginal ultrasound and magnetic resonance imaging of the pelvis Getty Images
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It is very important to be aware of the symptoms and urgently seek a specialist doctor if you suspect the presence of the disease. Delay in diagnosing disease outbreaks can lead to a more serious condition, when it is necessary to undergo surgical intervention Getty Images
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Another problem caused by the condition is female infertility. However, this does not mean that pregnancy is not possible. Women with endometriosis can become pregnant. In fact, everything will depend on the extent of the disease Getty Images
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Currently, according to the Ministry of Health, it is estimated that around 8 million Brazilian women suffer from this health condition Getty Images
Back Progress 0
Endometriosis improves a lot when the flow of hormones is regularized in the body. A healthy diet, a good sleep routine and regular physical exercise are factors that help to achieve balance.
“In addition, it is necessary to control stress. It releases a series of hormones in the body that lead to the oxidation of cells that trigger inflammation”, says the gynecologist.
Due to endometriosis
The endometrium grows in the uterus to create a favorable environment where eggs can grow. Therefore, endometriosis is connected to the female reproductive period and disappears with menopause.
The causes of the disease are not yet well established in science. There are hypotheses that the condition is linked to silent bacterial infections that end up leading to the growth of the endometrium, but it has not yet been possible to scientifically determine what triggers endometriosis.
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