Endometriosis refers to one of the little-known and most insidious of gynecological diseases. According to statistics from chronic endometriosis ranks third after inflammatory processes of genital and uterine fibroids. The disease alternates periodic exacerbations and remissions. Get rid of the chronic endometriosis is almost impossible, mainly treatment reduced only to eliminate symptoms and slowing the progression of the disease process. A frequent companion of chronic endometriosis is infertility, and the fight against it as part of a complex therapeutic measures. Endometriosis Endometriosis - a serious problem with serious consequences   most women of reproductive age (30-40 years), but there were cases of the disease in young girls.

The definition of the term "endometriosis"

Endometriosis is a benign gormonalnozavisimym process in which organs in the sexual sphere, and it is growing and developing cells related to their morphological and functional features with the cells of the endometrium (lining of the uterus) .  These cells form endometrioid heterotopia (the centers) which are subject to the same cyclic changes occurring in the endometrium during the menstrual cycle .  Exacerbation of chronic endometriosis occurs during menstruation .  There are many classifications of disease, but so far there is no uniform classification of endometriosis, which would reflect all aspects of the pathological process .  In the place of localization of endometrioid heterotopias isolated genital (the process affects the organs of the reproductive system) and extragenital endometriosis .  In turn, genital endometriosis is subdivided into an inner (uterine endometriosis or adenomyosis) and outer .

The mechanism and causes of chronic endometriosis

The etiology and mechanism of the disease remains poorly understood problem. In the currently preferred implant theory. The basis of this theory is the mechanism of retrograde throw menstrual blood. That is, during menstruation, due to certain factors, blood enters the fallopian tubes Fallopian tubes: an important part of the reproductive system   and into the abdominal cavity where endometrial cells spread and take root (on the peritoneum, intestine, bladder, etc.). Another theory to explain the development of the disease, is considered to be immune. The immune system normally keeps track of all foreign cells and destroys them. If any failures in the defense forces of the organism endometrial cells remain undetected and continue to develop in atypical places for them. Hormonal theory explains the origin of endometriosis breach in the production of sexual hormones.

Factors increased risk of the disease:

• high levels of estrogen;
• stress, alcohol abuse, smoking;
• unfavorable environmental conditions;
• genetic predisposition (heredity);
• age 30-40 years;
• metabolic disease;
• endocrine disorders (thyroid disease);
• intrauterine interventions (abortion, curettage, cesarean section);
• malformations of sexual organs.

Clinical manifestations

Manifestations of chronic endometriosis depends on the location and extent of the process. Often the disease is asymptomatic, and endometrioid foci are accidental finding during laparoscopy or hysteroscopy Hysteroscopy - examination of the uterus inside . The main characteristic features of endometriosis Symptoms of endometriosis - can be very different   relate:

• Pain

Pain is usually constant, aching, and are located in the lower abdomen. Pain may enroll in the lumbar and sacral region, in the rectum and lower limbs. Characteristically increased pain before menstruation and during it.

• Dyspareunia

In chronic endometriosis patients complain of pain during sexual intercourse. Often, sexual intercourse is impossible.

• Menstrual irregularities

In chronic endometriosis there are various cycle disorders, characterized by the appearance of spotting before and after menstruation.

• Infertility.

Anna Sozinova

Endometriosis - a disease associated with hormonal and immunological disorders in the female organism. Therefore, for the treatment of endometirioza used drugs, corrective these violations, as well as painkillers, hemostatic agents, drugs for the treatment of iron deficiency anemia and bracing means.

Medications hormonal action

For the treatment of endometriosis, a variety of drugs that inhibit the action of female sex hormones estrogen. Action esrogenov necessary to suppress, as they cause a significant prolonged growth of the uterus mucosa (endometrium), and then its rejection accompanied by significant bleeding which occurs during the seized entering cells into other tissues to form therein regions of endometriosis.

For drugs that inhibit the action of estrogen, are synthetic analogs of Riesling-hypothalamic hormones (GnRH agonists), which include drugs such as Diferelin, Dekapeptil, nafarelin, buselerin, zolodeks depot, lyukrin depot et al. With prolonged use, they cause a decrease Education pituitary gonadotropins, which leads to suppression of ovarian function, that is, to a complete shutdown of their hormonal function and the absence of menstruation. Apply these drugs usually with common forms of endometriosis and relatively short (about three months) courses because they provide the side effect of osteoporosis (brittle bones).

A similar effect is produced and inhibitors of pituitary gonadotropins (e.g., danazol), which leads to a suppression of proliferation of endometrial atrophy and its sites in various tissues. Danazol also has side effects, in particular, it can cause in the woman's hormonal changes of male type: increased hirsutism, acne, increased body weight and so on.

In order to suppress the effect of estrogens used as synthetic analogs of female sex hormone progesterone Progesterone - norm and pathology   - Progestin or progestin, naprier, djufaston. Djufaston operates smoothly, preventing the growth of the endometrium, but without causing a negative impact on ovulation Ovulation - How to determine as accurately as possible? So it is often used for small forms of endometriosis in women who may still have children. This group of drugs is Mirena Spiral Mirena: advantages in the application   - Hormonal contraceptive, which contains only progestin, acting locally in the uterus, endometrial proliferation warning and reduce the degree of bleeding.

Combined oral contraceptives (COCs) are also used for the treatment of endometriosis, mainly in the final (post-operative) period. They are appointed by the scheme 63 +7 three menstrual cycles in a row, followed by one week apart for the rejection of the endometrium and menstruation. The big break between the rejection of the endometrium prevent proliferation of endometriosis.

Immunomodulators

Immunomodulators - a medication to correct the violations of immunity. Development of methods for the treatment of disorders of immunity in endometriosis today are mainly on the stage of development. However, it was found that the immune system has to develop endometriosis critical, since the immune system is responsible for the fact that the individual cells of tissues do not fall into other tissues, and did not develop there. The immune system destroys these cells.

Based on laboratory and clinical evidence has been found that the most effective use of drugs for endometriosis interferon and its inducers (drugs that stimulate secretion of interferon own cells).

These drugs include, for example, tsikloferon TSikloferon - restores the body's defenses Which blends well with other drugs for the treatment of endometriosis and not exert any adverse effects on the body. Most clearly the effectiveness of this drug can be seen in the appointment of his women with endometriosis, hormonal and immune to surgical treatment.

What other drugs used in the treatment of endometriosis

A characteristic feature of endometriosis are severe pain during menstruation, menstrual and intermenstrual bleeding that lead to the development of iron deficiency anemia. Therefore, the treatment of endometriosis and hemostatic prescribed analgesics and iron preparations for the treatment of iron deficiency anemia.

Treatment of endometriosis requires an integrated approach to the use of different groups of drugs.

Galina Romanenko