Lower abdominal pain - start worrying about endometriosis?

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Painful periods? Do you feel lower abdominal pain during intercourse? Do you tend to experience convulsions in sports training or urinating? Just the belly hurts all the time? Perhaps these are completely unrelated things, but it could be endometriosis just as well. What is this disease and when a woman should start to worry about it, we asked gynaecologist Vija Plūme.

What is endometriosis?

Endometriosis can affect any woman of childbearing age. It occurs when the uterine inner layer - endometrial-like tissue begins to form in the uterine muscle (then called adenomyosis) or outside the uterus. For various reasons, endometriosis foci can enter the abdominal cavity, initially precipitating in the form of tiny foci, but over time, cysts (endometriosis cysts, chocolate cysts) or hard, scar tissue-like tissues that stick together the surrounding tissues and organs (adhesions). In these endometriosis foci, the endometrial-like tissues also menstruate (degrade), while the body tries to delimit the process with surrounding tissues, asserting its foci. This results in the formation of endometriosis cysts ("chocolate" cysts) or adhesions filled with old lysed blood. Often endometriosis foci causes abdominal pain. Endometriosis foci may occur in the peritoneum, other small pelvic organs (ovaries, bladder, intestine), seldom - outside the abdominal cavity (lungs, kidneys or other organs).

Pelvic abdominal pain, ovarian or retrocervical endometriosis?

Endometriosis of the pelvic peritoneum, endometriosis of the ovary and retrocervical endometriosis - the three most common localizations of endometriosis.

  • Pelvic abdominal endometriosis is the most common. During menstruation, the tissues of the uterine mucosa should be removed naturally from the woman's body, but a small part of the menstrual blood that remains in the body may not be absorbed, but attaches to the abdominal cavity and over time becomes adhesions. This leads to great pain during menstruation.
  • Ovarian endometriosis can begin to develop already at embryonic stage, when the future girl begins to develop female genitals. Likewise, it can appear during a lifetime. Over time, the ovarian surface cells are transformed and become similar to the cells of the uterine mucosa, only they have no place to release, so they penetrate into the ovarian tissue and eventually develop an endometriosis cyst. It is also called a chocolate cyst because its content looks similar to hot chocolate. This type is also characterized by very severe pain, especially before and during menstruation and during sexual intercourse.
  • Retrocervical endometriosis occurs when the uterine mucosa cells are located between the uterus and the rectum. The most pronounced symptoms are poor stools before the menstrual period - diarrhoea or constipation.

A lot of women of childbearing age may be ill with endometriosis and are unaware of it, but if you experience any of these symptoms - severe pelvic pain, real menstrual pain, abdominal cramps, irregular bleeding, pain during or after sexual intercourse, stomach and abdomen exit problems, urination disorders - go to the gynaecologist and do the necessary examinations. Discomfort and somewhat painful menstruation is one thing, but endometriosis that is not prevented in time, can also lead to infertility.

So apply for a gynaecologist and make sure you are healthy.