In Italy they are at least three millions women with clear diagnosis of endometriosis but many they suffer from it and don’t know it: this chronic disease, in fact, still bears a burden diagnostic delay which is on average from 5 to 8 years. And it is one of the main known causes of infertility: in fact, it is found in approximately 30 to 50 percent of women who are unable to conceive. The good news is that, thanks to the timely recognition of symptoms and early diagnosis that allow appropriate treatments to be started, they can be done avoid physical and psychological suffering caused by the disease, but also prevent infertility. This is why it is fundamental know it to fight it.
Raise awareness of this affecting pathology The 10-15% of women of reproductive age, with a peak between the ages of 25 and 35, is the goal of world endometriosis day, which occurs on March 28th. Various initiatives organized in our country, including free gynecological visits in hospitals.
Starting from sunset, monuments, squares, institutional buildings – including the Ministry of Health, the Senate and the Chamber of Deputies – they light up yellow, color symbol of endometriosis.
What is endometriosis
Endometriosis is a chronic inflammatory disease, which can appear as early as the first menstruation (menarche) and accompany a woman until menopause.
L’endometrium – mucosa which physiologically lines the uterine cavity and every month flakes off and is renewed with menstruation – comes to be outside the uterus, in anomalous locations such as ovaries, fallopian tubes, bladder, intestine. The endometrial tissue, even when it is found in locations other than the uterus, retains the same characteristics, therefore every month under the stimulus of the hormones produced by the ovaries it thickens and then flakes off causing blood loss: a “false” menstruation which causes achesometimes very intense.
Symptoms
The most common symptoms of endometriosis are:
– pelvic pain, especially during the menstrual cycle;
– recurrent cystitis in conjunction with ovulation;
– menstrual irregularities (heavy periods and premenstrual blood loss); – intestinal disorders;
– sense of heaviness in the lower abdomen;
– pain during sexual intercourse;
– infertility.
As it turns out
Women who have a mother or sister with endometriosis have a seven times greater risk of developing it.
From an early age it is necessary to know that i menstrual pain and during intercourse Not I am normal is that they should not be silenced. It’s a good idea to talk about it with your doctor, who will evaluate whether to prescribe one gynecological examination which, together with thepelvic ultrasound, they are useful for timely diagnosis and adequate treatment. In case of more complex clinical conditions, the woman can be referred by the doctor to a reference center for endometriosis.
How to treat it
Depending on the symptoms, the stage of the disease and the clinical history of each individual woman, they may be indicated different types of treatment, as the experts of the National Agency for Regional Health Services (Agenas) explain on the portal dedicated to the pathology. The gynecologist will identify the right therapy.
Among the available treatments are:
– medical therapy (based on hormonal treatments, progestins or low-dose estrogen-progestins and supplements to relieve pelvic pain);
– the surgical therapy;
– the so-called «waiting behavior» (no medical or surgical therapy) with periodic checks.
Can you have children?
Endometriosis it is associated with infertility in 30-50% of cases.
In the early stages the causes of infertility seem to be linked to the chronic inflammatory state typical of the disease and to reduced quantity and quality of oocytesparticularly in cases of ovarian endometriosis.
In advanced stages, in addition to these causes, fertility can also be compromised adhesions caused by endometriosis, particularly when they involve the tubes, blocking them.
Early diagnosis of the disease and the initiation of timely treatments can prevent infertility.
What protections
If you suffer from stage endometriosis «moderate or III degree” or stage “serious or IV degree”, you have entitled to a series of free serviceswithout paying the ticket (here is the list, in the Ministry of Health database): since 2017, endometriosis, at advanced clinical stages, has been included in the Essential Levels of Assistance (Lea), in the list of chronic and disabling diseases .
There request exemption must be made to your local health authority of residence by presenting the certificate, issued by a public hospital or outpatient facility, which certifies the presence of the third or fourth stage pathology.
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