Endometriosis, a risk of infertility

Endometriosis, a risk of infertility

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Endometriosis is a chronic disease whose main manifestations are pain and infertility. It affects in France 10 to 15% of women of childbearing age. The explanations of Dr. Chrysoula Zacharopoulou, gynecologist-surgeon.

What is the endometrium?

  • The endometrium is the inner mucous layer of the uterus whose main role is to receive the fertilized egg. This is called nesting. Under the influence of ovarian hormones, the endometrium changes in thickness according to the cycle phase.
  • When there is no implantation, the endometrium disintegrates to evacuate outside by the vagina. This phenomenon is commonly called the rules.
  • Endometriosis is a chronic disease of women of childbearing age, characterized by the presence of endometrium outside the uterine cavity.
  • Even outside the uterus, this endometrium behaves as if it were located in the uterine cavity and responds to hormonal fluctuations that occur during the menstrual cycle.
  • It forms, thickens and then tries to evacuate and bleeds. As it can not be discharged outside by the vagina, it gives to the places where it is nodules, cysts and inflammatory phenomena with formation of cicatricial tissue and adhesions between the neighboring organs.
  • This can cause significant pain as well as gynecological, urinary and digestive disorders depending on where the endometrium has been implanted.
  • It is estimated that endometriosis affects between 10 and 15% of women of childbearing age and it would affect 19% to 47% of adolescent girls with chronic pelvic pain. This figure tends to increase in recent years.

What is it due to?

  • This pathology could be due to the fact that at the time of menstruation, a small part of the cells of the endometrium, instead of evacuating to the outside by the vagina, would go up in the tubes to the abdominal cavity for s implant outside the uterus on different organs such as the ovaries, the tubes, the bladder, the intestine and the ureter.
  • However, reflux of endometrial cells by the fallopian tubes is a fairly common phenomenon and does not always result in endometriosis. Other unclear complex mechanisms also play a role in the development of this disease. Some risk factors have nevertheless been identified. The risk of developing endometriosis seems more important for:
  • Women who have had early first periods, short and regular cycles and abundant periods.
  • Women with a mother or sister with endometriosis. This risk is approximately six times higher for the sisters of the patients affected. There is also a strong concordance of endometriosis in homozygous twins.
  • Big and thin women.
  • In addition, exposure to dioxin or phthalates increases the risk of developing endometriosis.

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