THEMarch 28th of each year occurs World Endometriosis Daychronic and progressive pathology that affects women of childbearing age.
According to data from the Ministry of Health, in Italy people suffer from endometriosis 10-15% of women of reproductive age and about 30-50% of infertile women or who have difficulty conceiving. According to the numbers, women with endometriosis would be at least 3 milliona figure which however does not take into account the many undiagnosed cases.
Endometriosis: what it is
Endometriosis is one characterized chronic disease from the abnormal presence of the tissue that lines the internal wall of the uterusthe endometrium precisely, in other organs, such as ovaries, tubes, peritoneum and vagina. Every month, due to the hormones of the menstrual cycle, this endometrial-like tissue implanted in an abnormal location experiences bleeding. ANDexactly like that normally present in the uterus. Such bleeding involves an irritation of the surrounding tissues, that can cause formation of scar tissue and adhesionsamong the most widespread complications.
On possible causes different hypotheses have been put forward about this disease but still there is no single explanation. What is certain, however, is that i disorders caused by the disease – including pelvic pain, often very severe, abundant menstruation and last but not least infertility – often have a heavy impact on women’s daily lives.
Today we talk more about it
A crucial aspect of the disease is related precisely because of the diagnostic difficulty: it is estimated that they may pass up to 7/8 years before a woman manages to obtain a diagnosis precise of endometriosis.
There poor knowledge of the disease had a significant impact on the diagnostic delay: until recently, in fact, Very little was known and talked about this pathology. Today, fortunately, things are changing and this is also thanks to awareness-raising initiatives testimony of famous people who shared their experience and even TV series. In fact, the Prime Video series recently turned the spotlight on the disease.Antonia‘, with Chiara Martegiani and Valerio Mastandrea. The protagonist is a young woman who, at the age of 33, discovers that she has endometriosis.
Those underestimated symptoms
But why is the diagnosis of endometriosis so difficult?
“The instruments that we have available to make the diagnosis have improved today – explains the doctor Raffaela Di Pace, gynecologist, PhD in Physiopathology of Menopause and consultant sexologist. – But unfortunately Endometriosis is still a pathology that suffers from a considerable diagnostic delay. This because sometimes women underestimate the characteristic symptomswhich are the menstrual cramps (dysmenorrhea) e pain during intercourse (dyspareunia). Women often consider pain during their period to be normal, they try to control it by taking painkillers and thus end up underestimating the problem.”
Endometriosis: a difficult diagnosis
«However, we must also underline that the Clinical diagnosis of endometriosis is not easy – continues Dr. Di Pace. – Fortunately today, with the tools we have available, namely thetransvaginal pelvic ultrasound, especially if performed by expert personnel, we can trace diagnostic elements which can lead to the hypothesis of the disease, but it should still be remembered that for one certain and precise diagnosis one should be done laparoscopy. A real surgical operation.”
How is it treated?
To complicate the picture, the lack of definitive therapies for the treatment of endometriosis.
«Today we try to be increasingly less invasive and therefore of resort to surgery as little as possible – explains the specialist. – This is because we know that surgery, at the pelvic level, involves risks: it can create adhesions or lead to a reduction in the woman’s follicular heritage. Surgical intervention today is therefore only taken into consideration in selected and advanced cases of the disease.”
Pharmacological therapies
«On the treatment front, the birth control pill always remains the first choice and it is one of the most used methods in case of endometriosis – specifies Dr. Di Pace. – However, they are also used today progestin-only therapies which can be highly effective and they allow the patient a clear improvement in the quality of life. In very selected and more serious cases, inducing one may be considered pharmacological menopausea procedure that is often done even in the presurgical phase.”
Endometriosis and infertility
As mentioned, an important aspect also concerns the impact the disease has on fertility.
“The women with endometriosis have reduced fertility this is because sometimes the disease determines a significant adhesion picture what cause the imperviousness of the tubes – explains the specialist again. – Substantially land tubes are closed and therefore it is not possible to have a spontaneous conception. Beyond this, however, data on infertility rates indicate that, even when the tubes are open, the women with endometriosis often have fertility problems. In fact, there is frequently also a anovularity problem which accompanies cycle irregularities».
Awareness is important
To access treatments, limiting the progression of the disease and, consequently, its impact on quality of life and fertility, it is essential to obtain a timely diagnosis. And it is in this sense that the Raising awareness can still make a difference.
«The message to give to women, even the youngest, on the occasion of this day is certainly that of Don’t underestimate the pain – recommends the expert. – If a modest dysmenorrhea can be normal, in case of significant menstrual pain or pain during sexual intercourse, It is always good to undergo gynecological checks».
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