Sunday, September 26

Endometriosis: the many effects of gynecological pain

Endometriosis: the many effects of gynecological pain

Endometriosis: the many effects of gynecological pain

Between 10 and 15 percent of Spanish women are affected by the endometriosis, a phenomenon that develops in a woman’s body when the tissue that lines the inside of the uterus (endometrium) appears in other areas. The main consequences of this scenario are heavy bleeding, intense pain, possibility of bleeding between one period and another … It can even cause fertility problems when it comes to getting pregnant.

Every March, World Endometriosis Day is celebrated. An article recently published in the Lancet journal breaks with the “classic” definition of endometriosis as a disease mainly restricted to the pelvic region and re-qualifies it as a systemic diseaseLancet. The research refers to the multitude of side effects in different organs of the female body, including liver, brain, spleen, lungs, and adipose tissue. The article, signed by researchers at Yale University (United States), insists that endometriosis has so many side effects, outside the pelvic region, that it can be defined as a chronic systemic disease.

The endometrium is affected by hormonal changes that govern the ovarian cycle also known as the menstrual cycle.. These hormones are what order the endometrial cells to develop, increasing the thickness of the tissue, also increasing its vascularity. In the last days of the menstrual cycle, there is a decrease in hormonal levels, the thickened endometrial tissue deteriorates and desquamation begins and its expulsion from the inside of the uterus (menstruation). But if a woman has this type of tissue in another place she will begin to have symptoms, in addition to long-term sequelae.

From the Federation of Associations of Midwives of Spain Women are recommended to see their reference midwife in the event of any of these symptoms.

The accumulation of the incidence of endometriosis in certain families attributed a genetic component to this disease. However, not a single responsible gene has been identified. According to the doctors Jan Tesarik and Raquel Mendoza-Tesarik, “it is more a question of a genetic predisposition that can be due to anomalies of several genes. Since 2010 it is known that the genes involved in endometriosis are mainly located on chromosome 1 and chromosome 7 of the human genome. But all cases of endometriosis are not necessarily linked to a genetic abnormality and the disease can occur in women without any family history”.

Most of the systemic effects are not caused directly by ectopic implants of the endometrial tissue, but rather result from the long-distance action of different substances produced by remote endometrial foci. These are primarily pro-inflammatory cytokines. These substances circulate freely in the blood and affect the function of different organs. In this way, a small focus located in the pelvis can cause a generalized state of inflammation.

Medications with antioxidant and anti-inflammatory effects are used to curb inflammation, for example vitamins C and E, acetylcysteine ​​or coenzyme Q10. “But the most suitable medicine is melatonin, since it combines a strong antioxidant and anti-inflammatory effect with a direct action against endometriotic cells”, emphasize doctors Tesarik and Mendoza. “In fact, oral treatment with melatonin is the only causal therapy that can slow the progression of endometriosis without blocking ovulation, which makes its use suitable for women with endometriosis seeking pregnancy,” add these specialists.

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