Since last January, endometriosis has been included in the LEA, the essential levels of assistance. The inclusion in the LEA gives endometriosis greater visibility, ensures that this pathology is treated in a more serious and concrete way, thanks to standardized protocols. The costs are covered by the National Health System, so the patient pays only the cost of the ticket.

This disease, which affects 10-20% of women of childbearing age, was reported by Dr. Elena Zannoni, gynecologist and Referent for Conservative and Endoscopic Surgery Service of reproductive age in Humanitas, a guest on Time and Money on RAI Uno.


What is endometriosis?

In cases of endometriosis we speak of the presence of endometrial tissue, which normally covers the uterine cavity, in abnormal locations, therefore out of the uterus. The most frequent site is the ovary, but endometriosis can also be found in the pelvic peritoneum, intestines, rectum-vaginal septum, bladder and even extra-pelvic sites,” explains Dr. Zannoni.


What are the causes of endometriosis?

The most accredited cause is retrograde menstruation, i.e. a condition in which menstrual blood flows through the tubes and colonizes the peritoneum and the surrounding areas of the uterus and ovaries. Retrograde menstruation, however, is not enough to explain all cases of endometriosis; immune, inflammatory and genetic predisposition factors also come into play. There are also cases of endometriosis that is born from a kind of metaplasia, or change, of endometrial tissue, which transforms in endometrial sense “, the doctor points out.


With what symptoms does it manifest itself?

Symptomatology is linked to the process of endometriosis, because the outbreaks behave like menstrual blood. The characteristic symptom of endometriosis, in cases in which it is present because the disease can also be asymptomatic, is pain: menstrual and peri-menstrual pain, pain during defecation and sexual intercourse. This is chronic pain, which for some women becomes a disabling factor. Endometriosis can also be associated with sterility and irregular menstrual cycle, because the inflammatory process that is established could affect the proper functioning of ovulation,” explains Dr. Zannoni.


How do you treat endometriosis?

Diagnosis is carried out by means of accurate medical history, in-depth gynecological examination and transvaginal ultrasound.

The therapy can sometimes be observational and therefore there is no need to intervene, especially if the woman is not particularly symptomatic or is attempting pregnancy. There are also medical therapies to relieve pain, such as the contraceptive pill and preparations based on progestin.

Surgery can be used under strict indications, for example in the presence of disabling symptoms or particularly large cysts that create a pelvic clutter,” concludes Dr. Zannoni.