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Endometriosis
Endometriosis is a benign
invasive process characterized by the existence of endometrium (tissue of
the internal layer of the uterine cavity) outside the uterus.
There are different theories about what originates it, but the reason is not
certainly known. It is supposed that, due to a congenital alteration, groups
or nests of endometrial cells are found in other parts of the body,
generally in the pelvis, although they can be placed somewhere else, even at
distance. The most frequent location in the abdominal area is in the ovaries
in a bilateral way.
From then on, these cells which form a tissue follow the typical changes in
each cycle, due to the hormonal influence as well as the own uterine
endometrium. However, each month the endometrium first proliferates, then
grows and finally it is released to the exterior, in a process known as
menstruation.
On the contrary, the cells located in the ovaries’ interior do not have an
exit to the exterior. Consequently, the desquamation is accumulated forming
cysts called chocolate cyst because of the blood they contain.
From the clinical point of view, the most curious characteristic of
endometriosis is the lack of correlation between the intensity of the
symptoms and the severity of the lesions.
The clinic of endometriosis is characterized by pain and infertility but
many times it doesn’t present any symptoms.
The pain can be manifested during menstruation (dysmenorrhea) or during
sexual intercourses (dyspareunia) or either as a pelvic pain. Its
physiopathology is not totally clear, but in certain patients it can even be
disabling with direct consequences on the patients’ personality and
relationships.
It is considered that recent lesions produce more prostaglandins resulting
from pain and old lesions produce fibrotic infiltrators generating scars
with the consequent pain.
The breakage of a cyst produces acute pain because of chemic peritonitis or
chronic pain if the release of the cyst content is slow. Adherences, scars,
retractions and consequent fibrosis are also cause of pain.
Among 30% to 60% of sterile couples in which the woman is subdued to a
laparoscopy, endometriosis is diagnosed. This illness is believed to be the
responsible for the ovular dysfunctions as well as the uterine hemorrhages
from pre-menstrual spotting to hypermenorrheas or very abundant
menstruations.
CLINICAL EXAMINATION
Many times it is asymptomatic, but we must always think about it when the
symptoms arise or are exacerbated in the pre-menstrual period.
The gynecological exploration in women with endometriosis can be completely
normal. Some other times, the signs of exploration can be pain to pelvic
palpation, adnexal mass, uterine fixation, and pain when the uterus is
moved.
DIAGNOSIS
The presumptive diagnosis is made through gynecological scan.
The tumor marcs such as the carcino – embryonal antigen Ca 125, are usually
augmented, but the certain diagnosis is provided by a biopsy through
laparoscopy.
TREATMENT THROUGH TRADITIONAL MEDICINE
A) Hormonal: provoking hyperestrogenism or pseudo pregnancy (absence of
menstruation) from analogues to GnRH to Tamoxifen (antiestrogenic).
All of them provoke a medical castration and only manage to put a transitory
stop to the progression of the illness. They don’t guarantee the decrease of
relapse rate once the treatment is finished.
B) Surgical: The treatment should be as conservative as possible attempting
to extirpate all the abdominal focuses while trying to conserve the most
possible amount of ovary tissue.
It can be done through:
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Laparoscopy
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Conventional surgery through laparotomy
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The surgical treatment does not guarantee new lesions not to appear
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TREATMENT OF THE PAIN: *Anti-inflammatory drugs
*Anovulatory drugs (contraceptive pill)
*Analogues with GnRH pre surgical
TREATMENT OF STERILITY ASSOCIATED WITH ENDOMETRIOSIS:
It is proved that hormonal treatment neither improves nor reverts sterility.
Surgical treatment is indicated in endometriosis of level III and IV with
lesions which distort the anatomy, but in previous stages the improvement
has not been proved. What we do know is that during the first months after
the operation the possibility of getting pregnant increases. Assisted
reproduction techniques can also be considered a possible therapeutic
resource.
HOMEOPATHIC MEDICINE
Even though homeopathic medicine will take the diagnosis of endometriosis
into account first, as well as the localization of the lesions, it will act
not only on them but also on the person as a whole.
As it is an energetic medicine it won’t act eliminating symptoms but trying
to reestablish the equilibrium which, when lost, causes the illness. The
symptoms which show the evolution of the illness appear in the body, but
they are correlated with the emotions or the psyche.
The homeopathic medicine will be prescribed mainly taking into account the
aspects and psychical structure of the patient, apart from their current
historical moment. This is what makes the following statement valid: “there
are no illnesses but ill people”.
Modern medical schools agree with this Hippocratic aphorism, but it is
homeopathy the one that gives sense to this statement through the
homeopathic medicine meant for the patient as a whole, integrating the
symptoms of the psychical, functional and organic sphere.
The patient is a subject resulted from the personal history, immersed in the
current moment.
Observing this will help as know:
Why does an illness, which in the case of endometriosis is congenital, start
or is manifested “now”?
Why is the pain worse now?
Apart from acting over the whole subjective component of that pain, the
homeopathic medicine acts on the psychical, functional and organic spheres
since they are ruled by the Vital Energy which makes us get sick or get over
an illness. There is where homeopathy acts, driving it to reestablish the
equilibrium.
If through the homeopathic treatment the pain of the patient with
endometriosis doesn’t cease, or it urges to get pregnant in that period, or
the control scans show that the illness is moving forward, we can always
count with the surgery as a resource. However, we shouldn’t forget that most
of the times the surgery is palliative and doesn’t prevent a relapse of the
illness in the future.
Improving the patient’s subjectivity, will improve the patient’s present in
any case, being
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