Darci L. D. Janarelli

A chronicle sexual disease, the endometrioses is characterized by endometrial tissue-internal lining of the uterus functioning out of its place of origin, producing inflammatory reaction in places where it plant itself.

The most common places of endometrioses focus are the ovaries, fallopian tubes, uterus, bladder and peritoneum- a membrane that covers the entire abdominal cavity. Places less usual like the intestines and the rectum, the vagina, the vulva and the lungs amongst others, may receive endometriotic implants as well.

It's estimated that around 20% to 40% of women aren't aware of onsets of endometrioses for not showing any type of symptoms.

Several are the theories that try to explain the occurrence of endometrioses, but none of the postulated hypothesis had been totally accepted by the medical community.

The symptoms of endometrioses are quite variable and likely to depend on the place of lesions and the stage which it is at, although more often than not there's no relation between the intensity of symptoms, amount of implants or its growth pattern. It means that, for example, a woman at advance stage-IV grade may show milder symptoms than the initial stage-I grade.

Seemingly, usually is pain the main symptom and generally progresses throughout time, beginning, by rule, in the menstrual period in form of intense cramps that might irradiates to the back and thighs. In some women nagging pain remains even so the menstrual cycle ended, remaining so throughout the cycle, as variations of intensity may occur.

Quite common are the cases of deep pain in the sexual relations, due to endometriotic vaginal implants and outer-vaginal.

The diagnosis of endometrioses undertakes a good chat with respects to the patient's symptoms, alongside the gynecological exam to be undergo preferably close to the menstrual cycle and it's bound to be quite painful. On top of that, a blood work up called Ca 125, which is an endometrioses spotter. It's rather helpful such as when at lower rates therefore exclude the likelihood of disease. The pelvic ecography may show ovarian cists characteristics- endometrioms and should be conducted preferably after menstruation.

Such triad- gynecological exam, Ca 125, pelvic ecography- enables a diagnostic in most of times.

Nonetheless, the sure way diagnostic is the Laparoscopy, whereupon the direct view of the implants besides allowing to classify the stage of disease also ensures treating it, in part at least, through the cauterization of observed focus. As a key element, a biopsy of lesion would confirm the diagnosis certainty.

The treatment would depend on the stage of disease, age and desire for furthering. The clinical approach for endometrioses treatment tries to mimic a state of Pseudo menopause, Pseudo gestation or chronicle ovulation through hormonal replacement, i.e.., basically the idea is to make that patients stop and remain without menstruating.

The surgical treatment may be invasive or conservative. If patient already has a steady offspring and no longer wishes to procreate, the extirpation of uterus, ovaries and tubes seem the best next option alongside the cauterization of remnant focus. A more conservative treatment includes the destruction of adherences-typical formation of endometrioses and which usually modifies the anatomy of skin. Further, resection of endometrioms, the cauterization of implants and endometrial ablation- extirpation solely of the endometrium through Hysteroscopy.