Endometriosis is the condition where the hormone-sensitive layer, which covers the inside of the uterus, called the endometrium, is in the outer regions of the uterus.
This hormone-sensitive tissue group, which is located where it should not be, can be seen especially in the membrane surrounding the uterus, tubes, ovaries (chocolate cysts), ligaments suspending the uterus, and in many parts of the body.
It is observed in approximately 10% of women of reproductive age in the population.
The most common complaints are:
- severe menstrual pain.
- painful intercourse.
- Persistent groin-back pain.
Endometriosis can sometimes only occur with infertility. It is difficult to make the diagnosis of endometriosis disease. Diagnosis can be made during laparoscopic surgery or by the presence of chocolate cysts.
Some hormonal drugs, birth control pills, progesterone, a coil with hormones, painkillers can be used to control the pain in endometriosis disease. Primarily painkillers and birth control pills are used especially in the early stage and mild pain. In advanced disease, suppressive hormone treatments are recommended.
In endometriosis, the tubes may be damaged or there may be problems with the attachment of the embryo. All of these may cause infertility. If these findings are present in married couples and they have difficulty in having a baby, a uterine film called HSG should be taken, and the quality of sperm should be controlled. The treatment plan is divided into 3 categories according to the ovarian reserve, HSG, and sperm status:
- Diagnostic laparoscopy
- Insemination treatment
- IVF treatment
In women with chocolate cysts, this disease is considered to be at an advanced stage. Especially if these cysts are large, unilateral, painful, and progressive, they should be removed laparoscopically. However, If there are bilateral cysts, poor egg reserve, previous similar operations, or advanced female age (over 37), direct in vitro fertilization is a more reasonable option instead of surgery. Egg reserve may decrease over time in women who have had surgery due to chocolate cysts.
Endometriosis is a progressive and insidious disease. The uterus, ovaries, tubes, abdominal cavity, membranes, intestines, bladder, and rectum may be affected. Endometriosis should be investigated, especially in pelvic pain that has existed for years.