The focus of endometriosis on the cervix treatment. Methods for the diagnosis and treatment of endometriosis of the cervix

In healthy women, the lining of the uterus, or endometrium, is located within its inner cavity, and in endometriosis, parts of this tissue, which doctors call endometrial implants, appear outside the uterus. They usually grow on other reproductive organs. More often - on the ovaries and fallopian tubes, less often - on the cervix. AT last case the medical condition is commonly referred to as cervical endometriosis or cervical endometriosis.

Many women are unaware that they have cervical endometriosis because it usually causes no symptoms.

As part of this material, we will consider the symptoms of cervical endometriosis, as well as talk about the diagnosis of the disease and the available methods of its treatment. In addition, we will discuss the relationship of cervical endometriosis with fertility.

How common is cervical endometriosis?

The cervix connects the uterus to the vagina. In this area, endometrial implants rarely appear.

The prevalence of any form is difficult to assess due to the fact that a significant proportion of women with this condition do not experience symptoms and do not seek medical attention.

American scientists suggest that 6 to 10% of women have endometriosis. It is known that among the total number of patients complaining of symptoms, the largest proportion are women of reproductive age.

Cervical endometriosis is a rare condition. The study, published in 2011 by the Journal of Obstetrics and Gynecology, involved 13,500 women with endometriosis, and only 33 patients had cervical endometriosis.

Due to the fact that symptoms often do not appear, many women do not know that they have endometriosis until the next or delivery, the results of which show the presence of unusual formations.

Symptoms of cervical endometriosis

Symptoms of cervical endometriosis include the following:

• unusual vaginal discharge;
• pain in the pelvic area;
• or bleeding between;
• heavy, prolonged or painful menstruation.

When the cervix is ​​examined by a doctor, endometrial implants may be blue-black or reddish in color.

Causes of cervical endometriosis

The medical community does not know what causes endometrial implants to appear outside the uterine cavity, including on the cervix.

However, various medical procedures that can cause tissue scarring are known to increase the likelihood of developing endometriosis.

These procedures include:

• cryotherapy;
• biopsy;
• loop excision;
• laser therapy.

Pregnancy and fertility

Cervical endometriosis may not affect a woman's chances of getting pregnant

Endometriosis of the cervix does not directly affect the chances of conceiving a child.

However, any scar tissue on the cervix can block sperm from reaching the uterus, although this is very unlikely.

Endometriosis is more likely to cause Negative influence on fertility if endometrial implants are presented on other organs of the pelvic cavity, for example, on the ovaries.

If a woman is worried about having endometriosis, she can talk to her doctor about having her implants removed.

Diagnostics

If the doctor finds a mass on the cervix, he may suggest that the patient perform a Pap test. If the smear result indicates abnormalities, a colposcopy may be recommended for the woman.

This procedure involves using a binocular microscope to examine the cervix, vagina, and vulva for abnormalities.

If no abnormalities are found, the doctor may recommend a biopsy, which allows a sample of tissue to be examined under a microscope and more accurate diagnosis.

If the cervix was damaged during previous procedures, it will be more difficult for the doctor to remove the formations.

Treatment

If cervical endometriosis is not accompanied by any symptoms, then treatment may not be required. However, the woman will need to be regularly monitored by a doctor to monitor any dangerous changes by a specialist.

Treatment usually involves the removal of endometrial implants. To do this, doctors mainly use two methods.

• Electrocautery. The doctor uses electricity and heat to remove endometrial implants.
• Loop excision. This procedure involves the use of a looped wire instrument that removes tissue from the cervix.

It is important to understand that after removal, damage may reappear.

Complications

A biopsy may be required to more accurately diagnose cervical endometriosis.

Cervical endometriosis is such a rare condition that it can be misdiagnosed. Cervical masses can sometimes indicate cancer, but a qualified doctor can make an accurate diagnosis through a biopsy or other procedures.

Cervical endometriosis can also be confused with the following conditions:

• formations of smooth muscles on the cervix;
• cyst inflammation;
• cervical polyps;
• fibroids;
• melanoma or skin cancer;

Some conditions are associated with cervical endometriosis, such as:

• tissue defects of the cervix;
• human papillomavirus (HPV) infection;
• bacterial infections.

Conclusion

Cervical endometriosis is a rare disorder, and its characteristics resemble many other medical conditions, which is why it is not always easy to diagnose.

However, you need to understand that the correct diagnosis is extremely important. If a woman experiences symptoms that may indicate cervical endometriosis, she should see a doctor for a pelvic exam and follow-up diagnostic procedures.

Cervical endometriosis does not always require treatment. However, if a woman is concerned about pain or discomfort, surgery to remove endometrial implants can help relieve symptoms.

Endometriosis is a mysterious but increasingly common phenomenon. The tissue that forms the lining of the uterus, the endometrium, usually grows inside the uterine cavity (and responds to the monthly menstrual cycle). In the case of endometriosis, for some reason, this tissue begins to grow outward and affect other organs of the pelvic cavity or sometimes even outside it. (There are documented cases of endometriosis of the lining of the lungs and even of the brain.) The most common case of endometriosis is when tissue grows on the side walls of the pelvic cavity, which surround the internal organs that are in this cavity, and sometimes on the intestines.

Endometriosis is often accompanied by infertility and pain, but this is not always the case. Because fibroids and endometriosis often develop in women at the same time. Both fibroma and endometriosis are affected by nutrition and energy stagnation in this area of ​​the body.

Endometriosis is a disease caused by the conflict of rivalry. It develops when a woman's emotional needs run counter to the events and situations in her life. When a woman feels that her inner emotional needs are in direct conflict with surrounding reality, endometriosis is one of the ways in which the body tries to draw its attention to the problem.

Endometriosis has a different, historically established name - "the disease of female careerists." Women who postpone the birth of a child "for later" are the first at risk of getting this disease. AT last years women with endometriosis were told that if they stayed at home and had children, everything would be fine and healthy. This statement is very controversial and even offensive, since recent studies have shown that the percentage of endometriosis is the same for women who have given birth and who have not given birth. Pregnancy is not a panacea for endometriosis, but the real protection is a career and an adequate (contributing) personal life. The main thing is that business and personal life do not "tear a woman to pieces." But such a favorable prospect is still very far away, so for now, women should work on themselves on their own, first of all, listening to their body and the “signals” it sends.

Endometriosis is a benign condition characterized by functioning endometrium outside the uterine cavity. Symptoms depend on location and may include dysmenorrhea, dyspareunia, infertility, dysuria, and pain with defecation. It is diagnosed by biopsy, usually by laparoscopy. Treatment includes anti-inflammatory drugs, drugs to suppress endometrial growth and ovarian function, surgical ablation and excision of endometriotic implants.

Typically, endometriosis affects the peritoneal or serosal surfaces of the pelvic organs, typically the ovaries, broad ligaments, posterior Douglas space, and uterosacral ligaments.

Very rarely, ectopic endometrial tissue is localized in the vulva, more often it is detected on the cervix and in the vaginal wall. Most common cause vulvar ectopia of the endometrium is the implantation of fragments of the endometrium in the tissue of the vulva during operations on the perineum. Usually, the ectopic endometrium has the appearance of a small tumor-like formation with a bluish or almost black surface, but with a deep lesion, it may have a flesh color. At a section sometimes find a stagnant plethora. Treatment consists in excision of the ectopic endometrium with a histological examination of the drug to confirm the diagnosis. Endometriosis is also observed in the area of ​​the vulvar episiotomy.

This disease, as the name implies, is associated with the endometrium. But it nests not in the uterus, but outside it: with endometriosis, the cells of the uterine mucosa take root in other organs and host like at home. The fact is that in the first phase of the cycle, endometrial cells grow, and in the second phase they begin to secrete mucus. And if a fertilized egg enters the uterine cavity, then the endometrium will be ready to accept it. At the end monthly cycle If pregnancy does not occur, there is a sharp drop in the level of all hormones, and the endometrium is rejected - menstruation begins.

It is known that during menstruation, part of the menstrual flow is thrown upward by the reverse current. This is accurately recorded during laparoscopic surgeries, so the upward current theory is one of the most understandable explanations for where endometriosis comes from. If this theory is developed, it turns out that the behavior of a woman, which contributes to an increase in this current, provokes endometriosis. It's about about vaginal intercourse during menstruation. Then the jolts of the penis tell the reverse movement of the natural secretions, which can lead to endometrial reflux and the formation of endometriosis. Thus, scientists substantiate the implantation theory of endometriosis.

When the endometrium gets outside the uterus, where it does not belong, its cells still continue to behave as if they are in the uterus - that is, grow, then secrete mucus. And during menstrual bleeding, the epithelial cells of these screenings also react to a decrease in sex hormones: they exfoliate, try to be torn off, like the native endometrium in the uterine cavity. But they are in a closed space, from which they cannot leave, therefore they form chocolate cysts with brown contents.

Screenings are genital (in the body of the uterus, fallopian tubes, ovaries) and extragenital (in the peritoneum, bladder, rectum).

Is the countercurrent theory viable? Everything seems to be logical: there is a reverse current, there are dropouts. But why, then, do not all women suffer from endometriosis? There is also an immunological theory: endometrial cells that fall into the wrong place have certain properties and trigger immunological disorders in predisposed women. What is this predisposition?

Turns out it's a biochemical pregnancy. What happens in this case? Conception - the union of the egg and sperm to form an embryo - ends with implantation, that is, the onset of pregnancy. But a couple of weeks, while the embryo has not yet attached, and the changes have already begun, and there is a fatal period in which these immunologically functionally active cells are formed.

We can definitely only talk about women who want to get pregnant. They try, examine and monitor their condition until they get the coveted two strips - or continue to search for a magical remedy that increases the chances of conception.

But no one has ever looked closely at women who are not going to get pregnant and do not pay attention to their status. When scientific interest was shown to them, it turned out that among women who have an active sex life and do not plan to conceive, there are quite a few who still become pregnant, but this pregnancy does not develop further than biochemical and is interrupted with the next menstruation. Nevertheless, during the period when the fetal egg is functioning, there is a certain hormonal support (the level of chorionic gonadotropin, the so-called b-hCG, increases), and theoretically such a woman can be considered pregnant. Then something happens (for example, infectious, hereditary, hormonal or thrombophilic causes appear), the fetal egg dies and comes out with menstruation. But the endometrium, which functioned intensively at that time, is endowed with special properties. If cells of just such an endometrium enter different organs along the ascending path, this leads to the formation of chocolate cysts.

Symptoms and signs of cervical endometriosis

The clinical picture will depend on where the epithelium has landed and where the chocolate cyst has formed. And when during menstruation, with the contraction of the uterus, the epithelium begins to be rejected, the epithelium of the screenings also reacts, causing pain symptoms depending on its location. These can be serious pains in the lower abdomen, during urination, defecation, attempts to have sex. Often the pain is accompanied by a vegetative storm: constipation and diarrhea, reminiscent of cystitis, a sharp urge to urinate, accompanied by pain, cramps and increased frequency. How to distinguish endometriosis from cystitis? With cystitis, a general urine test confirms inflammation, and with endometriosis, chocolate cysts are clearly visible on ultrasound. Finally, the pain and drama of many women's destinies- infertility - often becomes the only symptom of endometriosis.

Endometriosis of various localizations is characterized by common manifestations. Long-term, often progressive disease may subside in the postmenopausal period. A long and severe course of endometriosis is characterized by pain after the end of menstruation, and pain is not characteristic of the lesion of the vaginal part of the cervix, and they are also poorly expressed in small foci of the endometrium on the peritoneum of the small pelvis. With endometriosis, infertility is often found, the causes of which are anovulation, inferior secretory function of the ovaries, adhesive processes in the small pelvis, changes in the endometrium of the uterus.

The classic definition links endometriosis to lower abdominal pain, menstrual dysfunction, and infertility. But the symptoms vary considerably depending on the patient's personality and history. Some patients with very advanced endometriosis had no symptoms at all. They did not suspect that they were sick until the doctor made a diagnosis. There are also patients with a slight overgrowth of tissues, but with constant severe pain and spasms in the pelvic area. Most often, endometriosis is localized in the area between the uterus and the rectum, called the “blind pouch of Douglas”. Endometriosis in this area can cause pain during intercourse, painful bowel movements, and painful bloating, especially before the onset of menstruation.

Diagnosis of endometriosis of the cervix

• Biopsy, usually by laparoscopy.
• Sometimes the use of imaging tools (to monitor the development of the disease), but the data obtained is not used to make a diagnosis.

Visualization tools do not provide definite and sufficient data for making a diagnosis. However, if done to rule out other disorders, they can show the extent of endometriosis and can also be used to further monitor the disease after diagnosis. Serological markers of endometriosis can help in monitoring the course of the disease, but these tests need further improvement for routine use. An infertility test may be ordered.

The final diagnosis of "endometriosis" can only be made by doing a laparoscopy, although I often diagnose this disease by the associated clinical manifestations, such as chronic pain in the lower abdomen and discharge between periods. In extremely rare cases, it can be felt during manual examination. This is possible only when the overgrown tissue has affected the cervix, vagina and vulva. Unfortunately, the statistics that exist today indicate that only the fifth doctor, to whom a woman addresses, makes a correct diagnosis. This is because many other diseases (for example, irritable bowel syndrome) give very similar symptoms to endometriosis.

stages

Staging helps doctors develop a treatment plan and evaluate response to therapy.

Gastroenterological complications in endometriosis

Rarely, endometrial lesions form outside the uterus. Such a deviation, most often asymptomatic, is found in 15% of women with a normal menstrual cycle. In women undergoing surgery for endometriosis, 30% of cases reveal involvement in the intestinal process, most often direct and sigmoid colon. The penetration of the endometrium into the lumen of the intestine causes its partial obstruction, accompanied by pain and constipation. Intestinal bleeding is rare - the endometrium usually does not penetrate the mucous membrane and develops only in the intestinal wall, leading to its hypertrophy and fibrosis. Only in half of these patients, the symptoms are activated and weakened depending on the phase menstrual cycle, but almost all women with this pathology have other foci of endometriosis in the pelvic cavity.

Diagnostics

Diagnosis of the considered pathology can be difficult. So, a rectal biopsy (as long as rectal bleeding does not appear) is normal. CT and MRI are also usually ineffective because the endometrial lesions are usually small in size. There is an effective intrarectal ultrasound, but it requires a very experienced specialist. The only effective diagnostic technique (allowing also to obtain tissue samples for research) is laparoscopy.

Differential diagnosis. Endometriosis, complicated by damage to the colon, should be differentiated from IBS; Crohn's disease, colon cancer. Diverticulosis is most common in older women, and colonic strictures due to radiation burns can be diagnosed by looking at the patient's history. Although ectopic endometrium is rarely malignant, such cases have been described. Very rarely, the process of endometriosis involves the mucous membrane of the colon, resulting in the formation of adenomatous polyps on it.

Treatment

With insufficient effectiveness of drug therapy with the use of hormones, surgical resection of areas of endometriosis is indicated. However, with intact ovarian functions, relapses of the pathology are very likely.

Most frequently asked questions

Why do so many women develop endometriosis?

There are a number of factors behind the significant increase in the number of women with this diagnosis. Firstly, with the advent of the laparoscopy method, it became possible to quickly and accurately determine whether there is an overgrowth of tissues and what nature they are. Laparoscopy It is done on an outpatient basis: a woman comes, undergoes the procedure and returns home the same day. The ability to look at the state of the pelvic organs without abdominal surgery has led to the fact that this study is very often offered to women suffering from pain in the lower abdomen.

Another factor in the apparent increase in the number of patients diagnosed with endometriosis is that today so many women are postponing the decision to give birth, and therefore their periods are not interrupted during pregnancy and lactation. If a woman already has children, then there are much fewer of them than before. Since endometriosis has a hormonal basis, a large amount of estrogen accumulates in a woman's body. This hormone is not produced during gestation and breastfeeding.

Is endometriosis hereditary?

Often in one family there are several women at once suffering from these diseases, so there is obviously some kind of connection with heredity. Of course, even if your sister has this disease, it is not at all a fact that you will also “earn” it, especially if you lead a completely different lifestyle. A genetic predisposition to endometriosis may not manifest itself in any way until a psychologically unfavorable situation develops at work or in the family.

Does endometriosis affect the ability to conceive?

Many of the patients diagnosed with endometriosis do not suffer from infertility: their the main problem- pain. Endometriosis as such does not cause infertility, but, apparently, is the main contributing factor. Currently, in 40-50% of women suffering from infertility, laparoscopy reveals the presence of endometriosis. Usually, endometriosis causes severe adhesive disease, which, in turn, leads to infertility. Dr. David Redwine writes, "Research on endometriosis in predominantly infertile women only adds to the complexity of the disease." Whatever causes endometriosis, it is somehow associated with infertility, but there is no direct interdependence between them.

So what causes endometriosis?

On this occasion, doctors have a lot of different theories, but none of them fully explains why today such a large percentage of women suffer from this disease. The classical version is that endometriosis is the result of the so-called retrograde menstruation, in other words, the partial absorption of menstrual blood and exfoliated endometrial tissue into the fallopian tubes. Then the endometriosis cells are implanted in the tissues that form the pelvic cavity, and begin to grow. Since almost all women experience retrograde menstruation to some extent, this does not fully explain why some people get the disease, while others do not. According to another theory, the tissues that form the pelvic cavity spontaneously turn into endometriosis, possibly due to a hormonal surge provoked by an unfavorable environmental situation - toxins such as dioxin, which acts on the body like estrogen.

It is not known exactly what causes the pain associated with endometriosis. But observations show that the hormones of the menstrual cycle stimulate the growth of endometriosis, and pain intensifies during ovulation and before menstruation. Since endometriotic tissues are similar in structure to those that form the lining of the uterus, it is clear that during menstrual bleeding, blood is absorbed into the walls of the uterus at a microscopic level. Some experts believe that tissues affected by endometriosis secrete some kind of Chemical substance, which provokes capillary absorption of blood into the peritoneum (the membrane of the pelvic cavity, where overgrown tissues are usually found). Over time, monthly reabsorption causes painful cysts and cicatricial growths, which, in the presence of adverse conditions, give a surge of painful sensations.

Endometriosis is a congenital disease, and every woman has pathogenic cells in a latent state. According to this version, endometriosis grows from the genital tissue of the female embryo, which never grows into the uterus. This explains the higher incidence in women who come from the same family, as well as the fact that some girls suffer from endometriosis-related pain from the very first onset of menstruation.

Accordingly, under certain circumstances, endometriosis can develop in every woman from the initially present defective embryonic cells.

Although most gynecologists consider endometriosis to be a progressive disease that gets worse over time, there is also an opposite opinion. Endometriosis may not grow over time (although its appearance changes), and also does not reappear if all affected tissues were removed during surgery.

During a laparoscopic examination for pelvic pain, doctors often do not notice endometriosis, especially on early stages because they were taught to look only for endometriotic adhesions. The characteristic black color of "burnt powdered sugar." But in fact, endometriosis scars come in a wide variety of colors - transparent, white, yellow, bluish and red. Often in the early stages they are very thin and difficult to distinguish without special equipment.

The color of endometriosis tissue may depend on the amount of blood leaking through nearby capillaries. Over time, they turn from transparent to black and thicken. The older the woman suffering from endometriosis, the greater the chance of finding just such “classic” “burnt sugar” adhesions and “chocolate”-colored cysts on the ovaries. (Ovarian endometriosis causes the growth of large cysts filled with stagnant blood. During surgery, the contents of such a cyst resemble chocolate syrup.)

The relationship of endometriosis with the state of the neuroendocrine-immune system

Subtle internal interactions of thoughts, emotions and immunity are the "key" to "decipher" the "message" that endometriosis "directs" to the consciousness of every sick woman. Studies of the immune system of women with endometriosis have shown that so-called autoantibodies are produced in their bodies. This means that at some deepest level, the “brain” of the pelvic cavity itself rejects defective cells.

Autoantibodies are involved in various reproductive processes, including sperm production, fertilization, and the normal course of pregnancy. Their presence explains the interdependence of endometriosis and infertility in those suffering from both diseases at the same time. Endometriosis undoubtedly affects the reduction of cases of egg fertilization, including during the procedure of artificial insemination (“in vitro”), and also increases the number of miscarriages.

Conventional medicine considers the creation of antibodies to one's own tissues as a characteristic feature of autoimmune diseases and considers this an insurmountable obstacle in their treatment. The immune system is extremely sensitive; our life depends on its ability to distinguish between self and non-self. What happens when the immune system gives the "command" to self-destruction? To heal ourselves, we must take for granted the fact that the immune system only "enforces" the decisions made by our brain.

Treatment of endometriosis of the cervix

• NSAIDs to relieve discomfort.
• Agents for suppressing ovarian function.
• Conservative surgical resection or ablation of endometrial tissue.
• Conservative surgery combined with medications.
• Total abdominal hysterectomy with bilateral salpingo-oophorectomy for severe disease, if pregnancy is not planned.

Symptomatic treatment begins with the appointment of NSAIDs.

Drugs and conservative surgery are symptomatic treatments; if ovarian function is not completely suppressed, most patients relapse after stopping treatment.

Drugs that suppress ovarian function inhibit the growth and activity of endometrioid implants.

GnRH agonists temporarily suppress estrogen production; however treatment is limited<6 мес.

Progestins should be given with estrogen because estrogen without progestin can cause residual endometrial tissue to grow.

Therapy

Women with symptomatic endometriosis are best helped by a complex, complex treatment regimen through maintaining the normal functioning of the immune system as a whole. But in parallel, they must listen to themselves and look for those aspects of their lifestyle that need to be changed.

Hormones

The traditional treatment regimen for diagnosed endometriosis is hormonal therapy - in the form of birth control pills, synthetic progestin, danazol (danocrine) or, more recently, gonadotropin-releasing hormone (GnRH) agonists - gonadotropin-releasing hormone "s agonists", such as sinaret (synaret) and lipron (lypron).These drugs act on the pituitary gland, which "gives the order" to temporarily stop menstruation, thereby giving the endometriosis the opportunity to resolve by stopping the cyclic hormonal replenishment.

All types of hormone therapy alter the levels of estrogen and other hormones in the body. endocrine system, thus "cutting off" the overgrown tissue from the "power sources". With a decrease in the amount of hormones, the symptoms disappear, and the disease itself enters a latent phase. Danazol and SHG agonists are also used to reduce the amount of diseased tissue before surgery so that it can be more easily excised. The negative side of such therapy is that it only relieves the symptoms, but does not eliminate the cause of the disease; the channel of receipt of hormones stimulating the growth of poor-quality tissue is simply temporarily blocked. In addition, some women do not tolerate the side effects that occur when taking hormonal drugs. Danazol is an expensive drug, and secondary male sexual characteristics may appear from it: hair on the body and face actively grows, the timbre of the voice becomes lower. Most women who take the drug gain weight. Treatment with SHG agonists causes hot flushes, thinning of the vaginal tissues, and bone fragility. However, for some women, such treatment provides at least a temporary respite from pain, and they go for it, even knowing that when the drug is stopped, the pain syndrome will return.

Natural progesterone is also very good at relieving the symptoms of endometriosis, which is why it is the second most important component of my treatment regimen after diet. I usually prescribe a 2% progesterone cream, such as progestin; Rub a quarter to a half teaspoon into the skin twice a day. Natural progesterone helps counter endometriosis due to its ability to mitigate the negative impact estrogen has on endometriotic adhesions. Natural progesterone has no side effects and is very well tolerated. Use the cream from the tenth to the twenty-eighth day of each cycle; some women are advised to rub the cream daily. Sometimes an increase in the dose of the drug is required, so instead of a 2% cream, you need to use a cream ordered by a doctor's prescription from a specialized pharmacy with a high content of progesterone. Natural progesterone can also be taken by mouth, usually in 50-200 mg capsules daily, from the tenth to the twenty-eighth day of each cycle.

Surgical method of treatment

Many still quite young women with severe endometriosis, treated for years with hormones and other drugs, decide to go for a complete removal of the uterus and ovaries. Although they themselves decide on the operation, many later realize that other, less radical treatments could be tried.

For example, a very positive effect is achieved after a sparing operation, in which only the endometriosis tissue is removed, leaving all the reproductive organs intact. More and more gynecologists today are able to do pelvicoscopy well and remove all growths formed by endometriosis. If this procedure is not done carefully enough, the adhesions that cause pain may grow back after the operation. After a successful pelviscopy, the pain syndrome remains only in 10% of cases. But this percentage includes women whose pain is not caused by endometriosis, but by fibroids, scars or adenomyosis. If a woman intends to go for a gentle removal, she should contact a surgeon who specializes in this particular area.

Restoration of energy balance

Everything that improves the activity of the immune system and normalizes the energy balance of the body is very conducive to the treatment of endometriosis.

Ask yourself the following questions and answer them honestly:

• What emotions do you miss?
• What needs to change in your work or personal life in order for you to get full satisfaction from it?
• Are you involved in any competitive process of any kind? Do you want to change anything?
• Are you getting enough rest?
• Do you believe that you will find the strength to change your life circumstances?

Three times a week for an hour, keep a compress of castor oil on the lower abdomen. Take a break if you have heavy menstrual bleeding. Pay attention to all thoughts, sensations and images that arise during the application of the compress. Consider taking a course of acupuncture at the same time as taking Chinese herbal medicines. For two months, at least once every two weeks of each cycle, do a full body massage. Pay attention to how you feel after the procedure.

Changing the power plan

Endometriosis is a disease whose symptoms are caused by excessive levels of estrogen in the body. Pain is also exacerbated by an excess of series 2 eicosanoids, such as P1T2-alpha, a hormone that also causes menstrual pain, and a lack of series 1 eicosanoids, which help prevent inflammation, open blood vessels, stimulating more fluid exchange in the body, and also contribute to normalization activities of the nervous and immune systems. Experiments have shown that in patients suffering from severe endometriosis pain, the percentage of series 2 eicosanoids in endometriotic cysts is much higher than in those who do not experience pain. Therefore, dietary change has two main goals: to reduce the production of estrogen and series 2 eicosanoids in the body. Quite often this brings considerable relief. To balance your eicosanoid content, consume enough essential fatty acids daily (see PMS section for details). Eliminate from the diet red meat and dairy products, supersaturated with arachidonic acid. For reasons that are not fully understood, dairy products stimulate pain in endometriosis. Also avoid all foods containing partially hydrogenated oils, such as margarine.

Foods that correct estrogen levels: cruciferous vegetables such as kale, mustard greens, turnips, cabbage, and broccoli. Try eating two servings of these vegetables a day. Soy foods like tofu, tempex, soy sauce, and miso also help a lot. Estrogen circulation is also inhibited by foods high in fiber. Try eating 25 grams of unrefined grains, legumes, brown rice, vegetables, and fruits daily. Keep in mind that refined grains contain high levels of carbohydrates that don't justify the amount of fiber. Eat oatmeal and crushed wheat grains.

Take enough multivitamin and mineral supplements. 100 mg of each B vitamin, 400-800 mg of magnesium, as well as vitamin E, zinc and selenium. London-based nutritionist Dial Millais, a former Trustee of the British Society for the Study of Endometriosis, announced the results of his dual study. As a result, those who took the supplement improved by 98% compared to those who received the placebo. He used supplements such as thiamine, riboflavin, pyridoxine, 100 mg each; zinc citrate 20 mg; magnesium aminochelate 300 mg.

Treatment with any supplements and diet changes only works after a three-month course.

Did you get scared? Do you feel sick, even if nothing bothers you? There is no need to demonize the action of sex hormones, you just need to take control of their unpredictable fluctuations and do everything so that the hormonal background is manageably even. There is no better way than oral contraceptives for this. Therefore, if you do not need pregnancy now, do not let the process take its course: keep your hormonal function in its original form for future motherhood!

Endometriosis of the cervix is ​​a very common pathology. It is not considered dangerous, but it can still bring trouble. What is this disease, what are its causes, symptoms and treatments?

Endometriosis of the uterus is the formation of foci of the endometrium outside the mucous layer of the organ. That is inside the muscle. If the disease affects the “exit” from the uterus, then doctors talk about endometriosis of the cervix, what is it and what does it look like?

Pathology is quite easily diagnosed during a gynecological examination using a mirror. On the neck, the doctor notices small red formations. Their size and color changes depending on the phase of the menstrual cycle. So, the symptoms of endometriosis of the cervix during menstruation are large, bleeding foci of purple color. Endometriosis can also spread to the cervical canal. After the end of menstruation, the lesions become noticeably smaller (2-5 mm). The woman herself may notice intermenstrual bleeding. Most often, there is no pain. Only if there are foci of the endometrium not only on the neck. With a common process, adhesions can form inside the cervical canal, which prevents spermatozoa from moving through it and is one of the causes of infertility.

If we talk about the reasons, then endometriosis of the cervix occurs after curettage of the uterine cavity, abortion, as a result of which the endometrial tissue enters the cervix and, if there is erosion on it, into the bloodstream. Another common cause is manipulation of the cervix, for example, endometriosis after conization, cauterization with electric current, etc. If the wound does not heal before the onset of menstruation, again, endometrial cells can penetrate inside, subsequently forming nodules and adhesions, cicatricial changes.

The question immediately arises - can endometriosis of the cervix and pregnancy coexist, will the disease negatively affect the development of the baby, will it provoke a miscarriage? Doctors say no. On the contrary, it is pregnancy that is the best “natural” remedy for endometriosis. Since there is no menstruation during pregnancy, it means there is no risk of the formation of new foci. Old foci cease to bleed and thereby provoke inflammatory processes.

Many women are interested in the treatment of endometriosis of the cervix with folk remedies. There are many reasons for this - this is the reluctance to go to the doctor, and beliefs about the harm of drugs, etc. Traditional healers recommend taking courses of treatment with various herbs that are used both locally (vaginal tampons, douching) and inside (for example, boron uterus with endometriosis). If you decide to be treated with “natural” means, then keep in mind that there may be various adverse reactions that you were not warned about (and not warned, because no one has studied the effects of herbs and is not engaged in) - severe allergies, the liver may suffer. And douching can provoke other diseases - candidiasis or bacterial vaginosis.

Is the game worth the candle, while there is an effective and safe drug treatment ... By the way, endometriosis should be treated only when there are symptoms, or the foci are large in area and interfere with the onset of pregnancy. Typically, lesions are removed using a laser, radio waves, or liquid nitrogen. But there is a small risk that this cauterization will only aggravate the situation. Another option is hormonal treatment.

Endometriosis of the cervix, according to statistics, is widespread in Russia and the CIS countries. And a significant role in this is played by unreasonable treatment - "cauterization" of cervical ectopia, which need only observation.

Therefore, every woman, especially those who have not given birth, should use reliable contraceptives in order to prevent abortions, and also undergo an annual examination by a gynecologist so as not to miss cervical diseases. In the case of the appointment of surgical treatment, in your opinion unreasonable, you need to consult with 1-2 more specialists.

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Endometriosis of the cervix is ​​a common gynecological hormonal disease in many women. In this article we will try to understand its intricacies and features.

What is endometriosis? His clinical picture

To understand what this disease is, let's talk a little about the structure of the uterus. The uterus is a hollow pelvic organ. The uterine cavity is lined with endometrial tissue. Tissues should not extend beyond the uterus. Otherwise, an anomaly called endometriosis develops.

The growth of the endometrium develops in the cervical canal, as well as in the cervix. Most often, the neoplasm is benign, but in rare cases a malignant form occurs.

Causes

It is worth noting that the final causes of the onset of the disease have not yet been established. Therefore, in medicine it is customary to call them theories or hypotheses. In this article, we will use the word "reasons" more often. There are several of them, namely:

In addition to the causes of the disease, there are also so-called "risk factors". These include:

• reproductive age;
• absence of pregnancy and childbirth;
• genetic disposition;
• unstable menstrual cycle and its violations;
• long wearing of the intrauterine device.

Varieties

In modern medicine, the disease is classified according to two indicators.

The first indicator is the spread of the lesion. The endometrium can grow along the cervix, its fundus or body.

On this basis, the following types are distinguished:

According to the severity of the lesion, there are four degrees.

• First degree. It is characterized by single foci located superficially.
• Second degree. It has several lesions that penetrate into the deeper layers.
• Third degree. These are multiple lesions located throughout the muscular layer of the uterus.
• Fourth degree. It is characterized by many deep foci that grow into nearby organs and tissues.

How to Diagnose Endometriosis in Women

From the point of view of diagnosis, pathology is not detected immediately. This is due to the fact that the symptoms of the disease often do not appear in women for a long time. In this case, the lesion can spread deep enough into the tissue. It also happens vice versa. Symptoms of the disease may be present, without significant pathology.

An objective diagnosis can be made only after an additional study. Let's see how this happens in practice.

During a visual preventive examination, the gynecologist detects changes in the cervix, the so-called endometriosis eyes. The uterus has a natural pale pink color. The eyes are painted dark blue. Having identified the pathology, the doctor prescribes an additional study using a calposcope. In addition, studies on histology and cytology are shown.

An additional examination can also be prescribed if a woman feels symptoms, but the pathology is not visually detected.

Here are some symptoms of the disease:

• pain during and after sexual intercourse;
• spotting a few days before the onset of menstruation, or prolonged spotting after they end;
• constant pain in the lower abdomen.

If the symptoms listed above are observed, calposcopy and additional tests are required. This is the only way to make a correct diagnosis.

Therapy

It is worth mentioning that treatment should be started only after the final diagnosis. This allows you to significantly reduce the time to eliminate the disease, as well as reduce the cost of it.

The main types of treatment are: conservative therapy and surgical intervention. Drug therapy includes the appointment of hormones and immunostimulating drugs. However, hormonal therapy is the main means of combating the disease. The following drugs are mainly used:

Therapy aimed at increasing immunity is appropriate only after an examination. Its purpose is to detect immune disorders. Thus, the treatment of the disease will be targeted and will bring long-term benefits.

It is worth mentioning that without local treatment, medication is ineffective.

It is imperative to remove the lesion. Various methods are used for this:

After complex treatment, constant systemic monitoring of the patient is necessary. It is recommended to observe during the year, in order to avoid recurrence of the disease and complications, among which is the endometrioid cyst of the cervix.

Treatment with folk remedies

Folk remedies can effectively treat even such a serious disease as endometriosis of the cervix.

However, alternative medicine can be used only in the early stages. A neglected disease must be treated in combination, as described above.

Folk remedies are: herbs, brewer's yeast, garlic, leeches, various decoctions, black clay. It is worth noting that the treatment with leeches, although listed along with folk remedies, is still used only under the supervision of a doctor.

Pregnancy and endometriosis

Endometriosis of the cervix can lead to serious complications, including infertility and ectopic pregnancy. This is due to the occurrence of adhesions and obstruction of the fallopian tubes due to the disease. Hormonal imbalance also negatively affects pregnancy.

However, the transferred disease is not a sentence for women who want to have children. Pregnancy is still possible with appropriate and timely treatment. Obstruction of the fallopian tubes, for example, is successfully eliminated by modern methods.

Pregnancy can also occur with the help of a progressive IVF method. Carrying and giving birth to a child is realistic even for women who do not have fallopian tubes.

Pregnancy significantly improves the condition of women with endometriosis. This is due to hormonal changes in the body, namely an increase in progesterone. In some cases, pregnancy contributes to the complete disappearance of the disease.

However, it is worth mentioning the dangers of endometriosis during pregnancy. These can be such pathologies as: placental abruption, increased placental, as well as the threat of miscarriage in the early stages. However, early detection of the disease and appropriate treatment will help to minimize the risks.

Endometriosis is a pathological process associated with excessive growth of tissues of one type or another. It occurs in the reproductive system and can be of various types, depending on the type of localization. Often found, for example, endometriosis of the cervix, which will be discussed in detail in this material.

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Definition

What it is? Endometriosis is a process of pathological growth of endometrial tissues, as a result of which it not only thickens, but also penetrates into other functional layers, in particular, into the myometrium. The cervix is ​​covered with this type of tissue, so endometriosis can also occur on it, although this occurs less frequently than in the uterus. For such a disease, it is characteristic that atypical cells (at the beginning of the process) are absent, extra cells have a standard structure for this type of tissue.

Sometimes this disease occurs on its own, in other cases it is formed as a result of the active development of such a process in the uterus and its spread to the cervix.

Degrees

There are four stages in the development of this disease. They are isolated depending on how much the sources of inflammation have grown.

• The first - at this stage, the symptoms of the disease are completely absent. There are only small isolated foci, their depth is small (within the thickness of the endometrium). This stage, like all endometriosis of the cervix, is well diagnosed, as it is visible to doctors even with an ordinary preventive examination using mirrors;
• The second is that the symptoms during this period are also very weakly expressed or may be completely absent. The foci increase in size, can connect with each other. Penetration into the myometrium is minimal or absent;
• Third - the first obvious symptoms of the disease appear. The penetration of the endometrium into the myometrium is obvious, but not more than 50% of its thickness. The affected areas are large, sometimes the entire visible part of the neck can be affected at this stage;
• Fourth - the symptomatology is obvious, severe, causes discomfort. Penetration of the endometrium into the myometrium by more than 50% of its thickness. Almost the entire area of ​​the cervix is ​​covered with foci of endometriosis. At this stage, atypical cells may appear, therefore, for diagnostic purposes, doctors often take scrapings.

Due to the subtle symptoms, the disease is often diagnosed only at the third or fourth stage in women who do not undergo regular gynecological examinations. Therefore, it is very important to undergo such examinations at least once every six months or a year. This will allow the doctor to notice in a timely manner that endometriosis of the cervical stump is developing, and prescribe treatment. The sooner it is prescribed, the lower the likelihood of developing unpleasant consequences and the sooner a complete cure for the disease will come.

The reasons

The reasons for this phenomenon are always associated with fluctuations in hormonal levels. A short-term or long-term increase in the level of estrogen in the blood leads to the development of pathology. Provoking factors are also surgical interventions (for example, cauterization of erosion), inflammatory processes in history, abortions, and more. Also, genetic predisposition and the presence of bad habits, especially smoking, play a role.

Occurrence

Although endometriosis itself is very common, its localization on the cervix is ​​​​rare. It occurs only in 0.1-2.4% of all women undergoing examination by a gynecologist. These are European statistics, but there is reason to believe that this figure is higher in the Russian Federation due to outdated methods of treating many gynecological diseases.

Symptoms

The symptoms and treatment of these diseases are related, as part of the therapy is symptomatic. With endometriosis of the cervix, the following symptoms occur:

1. Spotting spotting a few days before menstruation;
2. Abundant discharge during menstruation;
3. Lower abdominal pain;
4. Acyclic bleeding;
5. Discomfort during intercourse.

Other symptoms may also occur, but this is considered the most typical for this type of course of the disease.

Diagnostics

In order to diagnose subepithelial endometriosis of the cervix, the doctor needs to conduct a series of studies. Among them:

1. Inspection using mirrors;
2. Colposcopy to assess the condition of the uterus;
3. Hysteroscopy for the same purpose;
4. Ultrasound to assess the thickness of the endometrium;
5. MRI to determine the area and degree of development of foci;
6. Diagnostic laparoscopy is not always performed;
7. Diagnostic curettage in case the doctor suspects an oncological process.

After the diagnosis is made, treatment is prescribed, corresponding to the patient's condition and the degree of development of the pathology.

Treatment

This disease can be treated in several ways. Both radical and conservative treatment and their combination are used. You should not particularly rely on alternative treatment, but it can be used as an additional method in the fight against the disease.

Surgical methods

Surgical treatment of endometriosis of the cervix, the symptoms of which were discussed above, can be carried out by one of two main methods:

Surgical treatment is prescribed only after medical treatment has been ineffective.

hormone therapy

The goal of hormone therapy is to stop the increased production of the female sex hormone, which will positively affect the growth rate of the endometrium. For this, hormones are prescribed that normalize the hormonal balance or cause an artificial drug-induced menopause. These are the drugs of the following groups:

1. Estrogen-gestagen preparations for the normalization of hormonal levels;
2. Gestagens in their pure form, with the same purpose;
3. Antigonadotropic drugs to reduce the effects of estrogen on the body and the formation of an artificial menopause;
4. Gonadotropic-releasing hormone agonists for the same purpose.

Hormone therapy is a rather aggressive method of treatment, therefore it should be prescribed exclusively by a doctor.

Sedative therapy

Sedatives are often prescribed, but not all patients need them. The state of stress also has a negative effect on hormonal balance, so the level of stress must be reduced. This is done with the help of drugs such as Motherwort, Novo-Passit, Persen.

Physiotherapy

Physiotherapy is carried out using various methods. Acupuncture, laser treatment of lesions, pulsed currents and magnetotherapy are used. Doctors do not recommend relying too much on this type of treatment, but it is sometimes prescribed as an additional measure (or as a preventive measure after a cure). The negative side of this approach is its rather high cost, combined with unproven effectiveness.

Combined treatment

This is the most commonly used approach to therapy. Often, it consists of a combination of several methods. For example, sedatives are often prescribed at the same time as hormones. Also, physiotherapy can be prescribed as an additional treatment for various types of treatment. And some doctors even recommend trying folk recipes.

Folk remedies

Traditional medicine offers the following methods:

• Pour two tablespoons of dry calendula with a glass of boiling water. Drink this composition in half a glass three times a day, before meals. You can soak tampons with the composition and inject them for an hour;
• Mix a teaspoon of honey with a teaspoon or more of aloe juice. Add a few drops of propolis there. Soak tampons with the mixture and inject them daily, once a day, at night.

You can use folk methods only after consulting a doctor.

Effects

Endometriosis of the cervix, the photo of which is in the material, can lead to unpleasant consequences. It causes changes in the endometrium and the formation of adhesions. Thus, the likelihood of pregnancy is quite low. The disease can even lead to infertility.

Like any process associated with tissue growth, this one has the potential to degenerate into cancer. The appearance of atypical cells becomes the first signal of the onset of a precancerous condition.