5 “D” of the uterine lining

a Endometrial It is a benign and chronic female disease characterized by the presence of endometrial cells – the layer that lines the uterine cavity – outside the uterus. They generally develop in the pelvis and can affect the ovaries, tubes, intestines, diaphragm and even the abdominal wall.

According to data from the Brazilian Endometriosis Society, This disease affects 12% to 15% of women worldwide who experience menstruation (menacme).. Moreover, a correct diagnosis can take 8 to 12 years, which greatly affects the quality of life.

The cause of endometriosis is not completely understood, but it is thought that the origin may be due to retrograde menstruation – which comes from the tubes into the uterine cavity – and is associated with immune changes.

Among the most common symptoms of endometriosis are the five symptoms:

• Dysmenorrhea (menstrual pain)
• Pelvic pain
• Dyspareonin (pain during intercourse)
• Difficulty getting pregnant (infertility)
• Indigestion (pain when having a bowel movement)

This is in addition to urinary symptoms – and all of this can actually come together.

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a Dysmenorrhoea It is the term used for menstrual pain, is very common in endometriosis, and is disabling in nature. a Pelvic pain It can be like cramps or stitches that start during menstruation and get worse over time, and can even occur outside of menstruation.

actually Dyspareunia It is pain during intercourse, which can also worsen over time if endometriosis is not recognized and treated.

And the Difficulty getting pregnant? This is caused by the inflammatory state of the disease, which can prevent ovulation and even make fertilization difficult.

Finally, the Dyskinesia It is pain when defecating, especially during menstruation, and can also be accompanied by anal bleeding.

The diagnosis is made based on a person's history and clinical examinations, such as a vaginal or rectal examination. Moreover, imaging tests are very important to clarify endometriosis, such as pelvic MRI, transvaginal pelvic ultrasound with bowel preparation and colonoscopy.

Treatment can be clinical or surgical. It all depends on the symptoms and injuries found on clinical examination and imaging. On the surgical side, there is the emergence of minimally invasive procedures, such as video laparoscopy and robotic platforms, which provide excellent results.

It is also worth noting that a healthy diet, physical activity, perineal physical therapy and acupuncture can cooperate with treatment and improve the quality of life.

*Carlos Alberto Ortiz Teixeira, gynecologist specializing in robotic surgery at Hospital e Maternidad Santa Juana and Hospital e Maternidad Pro Matre Paulista