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Marilyn Monroe also suffered from it, but most people don't know about this disease

2019-04-24
We speak of endometriosis if endometrial cells appear anywhere outside the uterine cavity, which follow the changes of the hormonally controlled menstrual cycle. These abnormally positioned cells create sterile inflammation around them, and adhesions and adhesions causing chronic pain may develop in their surroundings. We asked Dr. Zoltán Szakács, gynecologist and infertility specialist at the Duna Medical Center, about endometriosis. Few people know about a disease that affects approximately 200,000 Hungarian women, and 40-50% of those who go to the doctor for infertility problems suffer from it.
Marilyn Monroe also suffered from it, but most people don't know about this disease

Why is this disease so unknown?

In the case of endometriosis, "chronic ovarian inflammation" was a very common diagnosis even 15 years ago. The diagnosis was based on the fact that the patients suffered from lower abdominal pains that flared up from time to time, yet they did not have a fever, and the laboratory tests did not indicate inflammation either. Patients were typically given antibiotics but did not recover. And when it came to surgery, the surgeons found the lower abdominal organs severely fused together. Today, thanks to high-performance ultrasound machines, the origin and cause of pain can be determined much more precisely.

Why do many years pass before diagnosis?

If we identify the complaints retrospectively after the diagnosis, even in countries with a developed health culture, we get sad data. Comparing data from different countries, 4-14 years can pass between the onset of the disease and the diagnosis. However, this is not only the fault of healthcare systems. Since a definite diagnosis of the disease can only be made by histological examination of material obtained through surgery, in the case of patients who have not been operated on, we can only talk about suspicion of endometriosis, rather than a diagnosis. – emphasizes Dr. Zoltán Szakács.

Diagnosis of endometriosis

The appearance and nature of the pain already raises the possibility of the disease, just as the suspicion may arise in the case of bloody urine. If the cells are located near the uterus and vagina, the disease can even be discovered during a traditional gynecological examination. A cyst in the ovary, the enlargement of the uterus, becoming stuffed and bound, the mass and pain of the fallopian tubes or the ligaments holding the uterus can often be detected by palpation, but the lumps in the vagina can even be recognized with the naked eye. The most reliable diagnosis is provided by a modern, very high-quality ultrasound examination. With such a device, foci of a few millimeters on the wall of the intestines, the bladder, or the peritoneum can also be detected.

What about sex? And with having children?

If the endometriosis is located on the vaginal wall, the vaginal part of the uterus, the back wall of the uterus, or the deepest part of the abdominal cavity, intercourse can become extremely painful. The disease definitely makes conception more difficult, and spontaneous abortions are more common, but it does not make having children impossible. After surgical treatment of the disease localized only to the genitals, it is possible to conceive naturally, but in severe cases (e.g. the version that spreads to the bladder, ureter, intestines and/or causes severe abdominal adhesions) the "bottle baby" is recommended ” treatment, preferably within three months after surgery.

What is the solution?

There is currently no medical or surgical method available that would definitely lead to a permanent cure. The surgical solution is individualized in each case, and in the case of most patients, unfortunately, the intervention must be repeated several times. If the patient is still young and about to have children, the goal is definitely organ-preserving surgery, that is, if possible, only the lesion should be excised. If the patient is older, perhaps does not want to give birth, and the disease seriously interferes with her daily life due to constant pain, the complete removal of the ovaries and uterus may be considered. Thanks to the development of surgical techniques, most operations can now be performed with minimally invasive surgical methods, i.e. laparoscopy.

What can we do about it?

Unfortunately, there is no sure way to prevent endometriosis. However, a healthy diet and sports help prevent it, and relieve the symptoms even in the case of an already developed disease. Since the development of endometriosis is facilitated by an excess of follicular hormones, i.e. estrogens, the goal is to prevent the development of excess weight. Furthermore, it is worth reducing caffeine and alcohol intake, and it is recommended to banish the consumption of pre-prepared and preserved foods from our diet.

If you would like to apply for a gynecological examination, you can book an appointment via our telephone customer service at +36 1 790 7070 or online!

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Dr. Zoltán Szakács

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Prof. Dr. László Ungár