ENDOMETRIOSIS AND FEMALE REPRODUCTIVE HEALTH

A. L. Unanyan
In: Акушерство, гинекология и репродукция, Vol 4, Iss 3, Pp 6-11 (2016) · 2016 · vol. 4(3) , pp. 6–11 · W3020025532
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Endometriosis, characterized by endometrial-like tissue outside the uterus, causes pain and infertility and is treated with surgery or hormonal therapy aimed at suppressing estrogen.

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This paper reviews endometriosis as a pathological process in which endometrium-like tissue grows outside the uterine cavity, emphasizing that more than 10 proposed theories of its origin exist but none fully explain its diverse manifestations and localizations. It highlights that the main clinical presentations include pain syndrome (such as dysmenorrhea, dyspareunia, and dyschezia) and infertility, while noting that surgical treatment—especially low-invasive approaches—may be insufficiently radical for young reproductive-age patients and can lead to “castration syndrome,” with low efficacy regardless of surgical tactics. It further describes the principle of hormonal therapy as suppression of ovarian estradiol secretion, outlining that progestagens, anti-gestagens, and gonadoliberin (GnRH) agonists form the basis of hormonal treatment. This paper is centrally about endometriosis — it reviews mechanisms, clinical manifestations, and surgical and hormonal treatment approaches relevant to endometriosis.

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Abstract

Endometriosis is a pathological process which is characterized by growth and development of tissue resembling the endometrium by its structure and function, while localizing beyond its normal site within the mucous membrane of uterine body. Endometriosis is one of the most topical issues of modern medicine. Regarding mechanisms of endometriosis occurrence, there are various, sometimes mutually exclusive points of view. Thus, over 10 theories of endometriosis origin are known, though none of those can comprehensively explain the multiplicity of manifestation and localization of endometriosis. The lead clinical manifestations of endometriosis are pain syndrome (dysmenorrhea, dyspareunia, dyschezia, etc.) and infertility. One of the main endometriosis treatment methods is surgery, particularly the low-invasive surgery. Surgical methods of treatment are often extra radical for young females and leads to castration syndrome in patients of reproductive and pre-menopausal age, and may well be of low efficacy regardless of surgical tactics. The main principle of medicinal therapy using any hormonal agent is the suppression of estradiol secretion by ovaries. The basis for hormonal therapy is formed by application of progestagens, anti-gestagens and gonadoliberin agonists
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Акушерство, гинекология и репродукция (Sep 2016) ENDOMETRIOSIS AND FEMALE REPRODUCTIVE HEALTH Abstract Endometriosis is a pathological process which is characterized by growth and development of tissue resembling the endometrium by its structure and function, while localizing beyond its normal site within the mucous membrane of uterine body. Endometriosis is one of the most topical issues of modern medicine. Regarding mechanisms of endometriosis occurrence, there are various, sometimes mutually exclusive points of view. Thus, over 10 theories of endometriosis origin are known, though none of those can comprehensively explain the multiplicity of manifestation and localization of endometriosis. The lead clinical manifestations of endometriosis are pain syndrome (dysmenorrhea, dyspareunia, dyschezia, etc.) and infertility. One of the main endometriosis treatment methods is surgery, particularly the low-invasive surgery. Surgical methods of treatment are often extra radical for young females and leads to castration syndrome in patients of reproductive and pre-menopausal age, and may well be of low efficacy regardless of surgical tactics. The main principle of medicinal therapy using any hormonal agent is the suppression of estradiol secretion by ovaries. The basis for hormonal therapy is formed by application of progestagens, anti-gestagens and gonadoliberin agonists

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endometriosisdysmenorrheadyspareuniainfertility

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