Endometriosis - is one of the most common and yet most unexamined diseases today. Controversy exists as to the reasons for its development, and treatment. In this regard, most physicians are inclined to that of endometriosis Endometriosis - a serious problem with serious consequences   It must be an individual approach to treatment.

General principles of treatment of endometriosis

It is believed that the need to treat endometriosis in the case where he somehow manifests itself. The inactive form of the disease just watch.

Endometriosis is genital (sexual organs) and extra (any other organs and tissues). Genital in turn divided into internal (uterus and fallopian tubes) and external (the rest of the genital organs). Today, it is believed that the outer endometriosis External endometriosis - a mysterious disease   subject to surgical treatment in combination with hormonal therapy. Internal endometriosis in some cases can be treated with the help of only about hormone replacement therapy, and if it does not work, carry out the operation.

Sometimes small endometriosis is not treated, if a woman wants to have a baby. During pregnancy, due to the fact that a long time does not occur cyclic changes of the mucous membrane of the uterus (the endometrium) may be an atrophy (decrease in volume) of endometriosis.

The same thing happens at the time of natural menopause - endometriosis may disappear by themselves.

Unfortunately, no, even the most modern methods of treatment can not guarantee complete cure from endometriosis. Very often hotbeds of the disease reappear. In order to maximize the development of their prescribed to suppress long-term hormone therapy.

Surgical treatment

Surgical treatment of endometriosis today typically carried out using a laparoscope - a special optical device that allows you to open access to the operative body without cutting the fabric. It is sufficient to make some holes for the introduction tube lighting and tools for operation. Image of the operated organ is transferred to the monitor, it allows you to carry out the operation under the control of, that is a very neatly and carefully remove endometirioidnuyu tissue, minimally damaging the surrounding tissue.

A special feature is the development of endometriosis in its tissue and adhesions around the nodes. Surgery, even with the use of a laparoscope, the process increases, which in itself may cause infertility.

Nevertheless, operation laparoskoopicheskie endometriosis are increasingly used, developed new methods for carrying out, improved combined (using hormone replacement therapy) treatment, which in some cases carried out, both before and after surgery.

Hormone therapy

Since endometriosis - is a consequence of hormonal disorders Hormonal disorders - oversupply and a lack of equally dangerous Only surgical treatment is usually not very effective. In this disease during their menstrual cycle, usually it generated a lot of estrogen and progesterone little, which leads to a dramatic proliferation of the endometrium, then its separating portions, accompanied by prolonged massive bleeding. This endometrial cells can be thrown into other tissues (muscle layer of the uterus wall of the fallopian tube, ovary) and spread through the blood and lymph systems to distant organs. Educated areas of endometriosis in other tissues grow and bleed during each menstrual cycle.

In order to suppress this process is now widely used drugs - analogues Riesling-hormones of the hypothalamus (Diferelin, Dekapeptil, nafarelin, buselerin, zolodeks depot). The mechanism of action of these drugs is based on the fact that the rate of release of their undulating stimulates the release of pituitary gonadotropins (TG). But if they are administered regularly and in large doses, TG secretion decreases. This leads to suppression of ovarian function, thereby comes persistent absence of cyclic changes in the genital organs, including the menses.

Assign these drugs are usually no more than three months, as they are capable of producing side effects such as osteoporosis (brittle bones increased). After treatment, the menstrual cycle is restored. During the application of such treatment areas of endometriosis it may be significantly reduced.

For small sites of endometriosis to suppress endometrial proliferation is sufficient purpose synthetic analogues of progesterone Progesterone - norm and pathology .

To prevent a recurrence of the disease after surgery are often prescribed by a special scheme hormonal contraceptives. Driving is not an ordinary assignment - 21 and 7 (21 days of taking the pills and 7 days interruption), 63, and 7 (63 days taking pills and 7 days last break). This leads to the suppression of the development of endometriosis.

Thus, the current treatment of endometriosis can only be individual. The choice of treatment is dependent upon the age and general condition of the patient, location and extent of the process.

Galina Romanenko

Bacterial vaginitis - a disorder caused by an imbalance of bacteria that form the vaginal microflora. In women with the disease vaginal bacteria (e.g., lactobacillus) begin to proliferate very rapidly, resulting in degraded natural microflora.

In the past, bacterial vaginosis was called nonspecific vaginitis or gardnerelleznoy. Last name is misleading, because it implies that the causative agent of bacterial vaginosis is caused by bacteria Gardnerella vaginalis (Gardnerella vaginalis). It is now known that bacterial vaginosis can be polymicrobial infection (that is caused by several different organisms).

Symptoms

The symptoms of bacterial vaginosis are:

• Watery, white or grayish vaginal discharge;
• A strong unpleasant odor from the vagina. (This smell is often compared with the smell of fish.)

About half of women who develop bacterial vaginosis, this violation does not cause any symptoms. It can run concurrently with other infections, including - with diseases transmitted sexually.

Causes of bacterial vaginosis

The exact cause of bacterial vaginosis is not set, however, it noted that it is most common among sexually active women. Sometimes, the symptoms appear soon after sexual intercourse with a new partner. Women who have sex with representatives of their sex, the risk of bacterial vaginosis is higher than that of women whose sexual partners are exclusively male. Scientists have not yet managed to identify a clear link between various sexual practices and the likelihood of bacterial vaginosis. However, they believe that the use of condoms (including - female) reduces the risk of infection.

Diagnostics

Bacterial vaginosis is diagnosed on the basis of gynecological examination Gynecological examination: an important component of women's health   and laboratory analyzes. During the examination the doctor pays attention to vaginal discharge and odor. Laboratory tests may show the decrease in acidity of the vagina - it can be seen, even if the patient does not have any other symptoms of vaginitis Vaginitis - symptoms that every woman should know .

Health care

In the absence of symptoms of treatment is usually not required - over time, the vaginal flora back to normal. Usually, treatment is given in the following cases:

• The presence of expressed symptoms of bacterial vaginosis;
• The patient will have a medical procedure in which bacteria from the vagina can enter the uterus - for example, the introduction of an intrauterine device or termination of pregnancy;
• Pregnancy - If signs of bacterial vaginosis pregnant woman be sure to see a doctor, so he picked up a safe for her and her child's treatment.

Normally antibiotics are prescribed for the treatment of metronidazole. It is administered twice a day for seven days. Take metronidazole should be after a meal - it reduces the likelihood of side effects such as nausea and upset stomach. Throughout the course of treatment should refrain from drinking alcohol.

If a woman for any reason can not receive metronidazole, administered her vaginal ointment, e.g., clindamycin. It is applied to the vaginal wall at bedtime Dreams: how to understand our dreams ; treatment also lasts for seven days.

Relapses

Approximately half of the women treated for bacterial vaginosis, this disease develops again within 6-12 months. This may be due to the fact that during the first course of treatment failed to fully normalize the vaginal flora The microflora of the vagina: purity ; cause of relapse can be re-infected. Infected women who practice homosexual sex, to prevent a recurrence, doctors advised to be screened and, if necessary, treatment, together with their partners.