Women of fertile age might suffer from endometriosis that impairs their quality of life and about a quarter of women with this disease can have problems with getting pregnant. This is an under diagnosed disease as in many cases a woman has no complaints.
The exact prevalence of the disease is unknown in the words of Dr. Alevtina Kamneva, a gynaecologist from the Eastern Tallinn Central Hospital, but it is assumed that approximately 2-10% of women of fertile age are affected by endometriosis. It is a chronic disease where tissue resembling uterine mucosa (endometrium) is located focally outside of the uterus. Most commonly, such lesions are located in the ovaries, uterus, uterine ligaments, oviducts, and inner surface of the small pelvis peritoneum, commented Dr. Kamneva.
In most of the cases endometriosis is not an aggressive disease, and about one quarter of the women with endometriosis do not have complaints at all. However, in three quarters of the cases the main complaint is pain in the pelvic region which occurs and increases in intensity cyclically 1-2 days before the menstrual period, and persists as a strong pain throughout the menstrual period, and in some women also a few days after the menstrual period. “If the disease takes an aggressive course, and new lesions and adhesions occur, the disease can get very serious and the patient has to use painkillers on a daily basis. It can completely ruin lives – the woman might not be able to bear children, relations with the partner are not good, and being frequently on sick leave does not assist working relations. Luckily such severe cases account for only about 1% of all cases. These are the most severe cases which usually require surgical intervention. Sometimes it is necessary to involve also other surgeons, for example when lesions are located in the intestine then intestinal resection has to be performed,” added Dr. Kamneva.
Endometriosis is also a serious concern in women who want to have a baby, but do not get pregnant. About 25% of women suffering from endometriosis have problems with getting pregnant. According to Dr. Kamneva it is associated both with adhesions in the region of the oviducts and ovaries, and also a persistent inflammatory process. “Frequently fertility treatment is needed to get pregnant.”
Now Estonian scientists are making the first successful steps to find the causes of endometriosis, although they are not yet known. “The most widely accepted theory today is that the cells of uterine mucosa or endometrial cells get into the abdominal cavity, for example during the menstrual period or after uterine surgery. In a normal situation the human body destroys these cells, but in some women they start to grow and function outside of the uterus. We do not know what exactly activates this disease,” Dr. Kamneva explained.
Endometriosis is treated medicinally or surgically throughout the world, it is not a new disease. The main concern is related to deep endometriosis where tumour lesions extend deep into the organs and cause strong chronic pain and infertility. “The only effective treatment in such cases is surgery, and these are very complicated operations,” Dr. Kamneva concluded.