Research

Here is a relatively short, yet thorough, all-encompassing description of what endometriosis is, who it can affect and why some women have it and others don't.

What is all this about?

Endometriosis still puzzles researchers and doctors because it is a mysterious disease. The name of the disease endometrium The endometrium thickens and detaches month by month in response to changes in the female hormonal cycle, and is then shed and expelled from the body in the form of menstrual bleeding. Normally, endometrial tissue covers only the inner wall of the uterus, but in endometriosis it can appear in other parts of the body, usually on the outer wall of the uterus, the ovaries, the uterine ligaments, the bladder, and can form adhesions on the peritoneal lining.In worse cases, the disease can also affect the intestines and, although rare, endometriosis has been described in the external genital organs, joints (e.g. knee joints), lungs and brain. That already sounds bad, right? Now imagine that these abnormally located tissues behave the same as if they were inside the uterine cavity, thickening every cycle and also bleeding. However, unlike menstruation, this blood cannot be evacuated from the body, causing severe pain, cramps and so-called strep throat in and around the affected organ.

Who can be affected?

In general, endometriosis can cause symptoms in women of childbearing age, i.e. from the onset of the first menstrual period (menarche) until the onset of menopause.If the disease is still present after menopause, it is most likely related to exogenous estrogen treatment from an external source. Today, more than 176 million women live with endometriosis, with one in 6-9 women said to be affected, depending on the statistics.

How does the endometrium get into these abnormal places? (Coronary artery)

This is the question that researchers still cannot give us a definite answer to. However, there is no shortage of theories, but none of them really explains all the cases. One of the first theories is the so-called retrograde menstruation that the menstrual secretions flow backwards, through the tubes and out into the abdominal cavity, where the cells attach and divide.

It has now been demonstrated that retrograde menstruation is quite common, but cannot be responsible for the development of endometriosis on its own, it requires some changes in immunity (More specifically, increased activation of peritoneal macrophages has been observed, with a concomitant decrease in the number of natural killer (NK) and T cells, which overall results in the inability of the immune system to clear abdominal endometrial cells. )

Some genetic backgroundand believe the disease is hereditary. In fact, familial accumulation has been observed. It is very likely that there are certain genes that predispose to the disease, so that women whose mothers or sisters have been affected are more likely to be affected themselves.

Others are independent of genesa birth defect they think. According to this theory, endometriosis nodules are present in the abdominal cavity and other abnormal sites from early on, even from foetal age, and when a woman reaches childbearing age, they start to cause symptoms in response to hormonal changes. According to this theory, endometriosis is a congenital condition that originates from embryonic, primitive female gametes that have not entered the uterus during development. In medical textbooks, this theory is metaplasia of cells of coelomic originwhich means that the embryonic cells undergo tissue transformation.

There are also some people who associate endometriosis with adverse environmental impacts is considered a disease. Some research, for example, reports a role for dioxin, but this possibility is not yet fully proven.Another possibility is the role of cellular implantation of in a place where there is tissue damage, for example in the scar after a perineal incision or caesarean section.

Some doctors argue that endometriosis can be found in virtually any woman, you just have to look hard. They base this assumption on the surprisingly large number of asymptomatic endometriosis cases they encounter during surgery for other reasons, as a side effect.

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