Endometriosis affects 10-20% of women who are of childbearing age. Dr. Elena Zannoni, Gynecologist and Member of the Conservative and Endoscopic Surgery Service in Reproductive Age at Humanitas, discussed the endometriosis as a guest of the Tempo e Denaro studio at Rai Uno.
What is endometriosis?
“We talk about endometriosis when the presence of endometrial tissue, which normally coats the uterine cavity, appears in abnormal sites outside the uterus. The most common site is the ovary, but endometriosis may also be present in the pelvic peritoneum, intestine, in the rectum-vaginal septum, bladder and even in extra-pelvic regions”, explains Dr. Zannoni.
What causes endometriosis?
“The most accepted cause is the retrograde menstruation, or a condition in which the menstrual flow runs through the tube and colonizes the peritoneum and adjacent areas of the uterus and ovary. However, retrograde menstruation cannot account for all cases of endometriosis. Immune and inflammatory factors as well as genetic predisposition also come into play. In addition, there are cases of endometriosis that return due to a certain type of metaplasia or a change in the endometrial tissue that turns into endometriosis”, says the doctor.
What are the symptoms that manifest it?
“The symptoms are linked to the process of endometriosis. The manifestations behave like the menstrual flow. Typical symptoms of endometriosis, when present (since the disease can be asymptomatic) are pain in the menstrual period, premenstrual period, when defecating and during intercourse. It is a chronic pain that becomes a debilitating factor for some women. Endometriosis can also be associated with infertility and menstrual irregularities as the inflammatory process that occurs can affect the proper functioning of ovulation”, says Dr. Zannoni.
How to treat endometriosis?
“The diagnosis is made by a careful anamnesis, complete gynecological examination and a transvaginal ultrasound.
Therapy can sometimes be observational and therefore there is no need to intervene, especially if the woman is not particularly symptomatic or is trying to conceive. Then there are medical therapies designed to relieve pain, such as birth control pills and progesterone-based formulas.
When necessary, we resort to surgery, such as in the presence of debilitating symptoms or particularly large cysts that create an obstruction in the pelvis”, concludes Dr. Zannoni.