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What is endometriosis?
Endometriosis is a condition in which endometrial-like tissue grows outside the uterus, particularly on the ovaries, fallopian tubes and peritoneum.
This tissue responds to hormonal changes and repeatedly proliferates and bleeds with each menstrual cycle, but as it cannot be discharged from the body it causes inflammation, adhesions and pain. It occurs mainly in women of childbearing age and before menopause, and produces a variety of symptoms that can disrupt daily life, such as severe menstrual pain, pelvic pain and pain during intercourse. It is also well known as a major cause of infertility.
Main causes of endometriosis
The exact cause of endometriosis is not yet known, but one of the most widely accepted hypotheses is 'retrograde menstruation'.
Retrograde menstruation is a phenomenon in which menstrual blood that should normally be discharged through the vagina flows back through the fallopian tubes into the abdominal cavity, so that endometrial tissue implants on the ovaries, peritoneum and elsewhere.
In some women this tissue grows inside the body and can cause endometriosis.
Various other complex causes have also been proposed, including genetic factors, immune dysfunction and the stem cell origin theory.
Various other complex mechanisms have also been proposed, including immunological defects, genetic factors and the stem cell origin theory.
Symptoms of endometriosis
Symptoms of endometriosis vary from person to person, but the following are common
| Severe menstrual and pelvic pain | Pain is caused by bleeding and inflammation in endometrial tissue growing outside the uterus. Premenstrual syndrome and ovulation pain may occur together with it, and if the pain is not controlled by painkillers or worsens over time, endometriosis may be suspected. |
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| Painful intercourse and painful bowel movements | If endometrial tissue spreads around the vagina, to the pelvic ligaments or to the rectum, pain may occur during intercourse or bowel movements |
| Infertility and recurrent miscarriage | Adhesions in the fallopian tubes or the peritoneum can cause infertility through impaired ovulation or blocked tubes, and some patients also have difficulty maintaining a pregnancy, such as implantation failure. "It is important to check the health of your uterus through regular examinations." If the right time for testing or treatment of a uterine condition is missed, uterine function can be affected and a variety of symptoms may follow. We therefore recommend regular gynecological check-ups, and consulting a specialist whenever you have symptoms that are not usual for you. |
Treatment of endometriosis
Treatment for endometriosis is tailored to the patient's age, symptom severity and pregnancy plans.
The main treatments are as follows
| Hormone therapy | Drugs that suppress ovulation or the growth of endometrial tissue (oral contraceptives, progestins, GnRH agonists, etc.) are used. |
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If there is no response to drug therapy, or if the size or location of the lesion raises concern about infertility or organ damage, laparoscopic removal of the lesion is considered.
| Laparoscopic Surgery | For women who wish to become pregnant or to preserve fertility, surgery removes only the lesion. Minimally invasive surgery is usually performed laparoscopically, and may be converted to open surgery if necessary. |
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| Radical surgery | When pain cannot be controlled, when recurrence is repeated, and when fertility no longer needs to be preserved, hysterectomy with bilateral salpingo-oophorectomy, removing the uterus together with both ovaries and fallopian tubes, is carefully considered. |
※ After consulting a specialist, drug therapy and surgery may be combined or applied in stages, and continued management is needed to prevent recurrence.