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When menstrual complaints make it impossible to live... A breakthrough in the diagnosis of endometriosis?

agnieszka Budzyńska, MA

You can read this text in 5 min.

When menstrual complaints make it impossible to live... A breakthrough in the diagnosis of endometriosis?

PantherMedia

Female pain complaints

Many women suffer during menstruation. It could be endometriosis. Polish scientists present the latest diagnostic method that will be able to confirm or exclude it.

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Table of contents:

  1. Endometriosis - what is it and who can get the disease?
  2. Why did it take doctors so long to diagnose endometriosis?
  3. What is the modern diagnosis of endometriosis?
  4. Where to get an endometriosis test and how much does it cost?
  5. What to do when diagnosed with endometriosis?
  6. What symptoms should prompt an endometriosis test?

Do you suffer during your periods? Do you have various complaints recurring at even intervals of your menstrual cycle and a basic gynaecological examination shows nothing? It could be endometriosis.

The good news for you, then, will be that you can now confirm or rule it out with a new diagnostic method - a simple test!

Endometriosis - what is it and who can get it?

Endometriosis is a hormone-immune disease characterised by the presence of tissue resembling the endometrium of the uterus in other places in a woman's body (outside the uterine cavity). This tissue most commonly develops in the ovaries and fallopian tubes, the ligaments surrounding the uterus, and the outer surface of the uterus, but these are not the only possible locations. Outbreaks of endometrium can also occur on the peritoneum or bladder, for example, and even occur in the lungs or brain.

Endometriosis, Infertility, Menstruation

Painful menstruation, photo by pantherrmedia

What is the difference between endometrial cells inside and outside the uterus? Well, the ones in the uterus flake off and are expelled during menstruation, while the others are not. This creates inflammation and the redundant tissue builds up with each cycle.

Despite the fact that, according to research, there are around one million endometriosis patients in Poland alone (other studies say three million), diagnoses have so far been very slow to be made, as the time taken has oscillated between 7-12 years!

During this time, patients patiently endured pain and other, not very pleasant, ailments accompanying endometriosis.

Why did the diagnosis take so long for doctors?

Firstly, as many as a quarter of the patients have no symptoms and therefore do not visit the doctor. Secondly - diagnosis has so far been difficult, with several stages, and symptoms and complaints confused, depending on the level of the disease and the details of the individual case. Thirdly - there was (and still is) a shortage of doctors specialising in this subject.

Endometriosis is usually impossible to detect in a basic gynaecological examination (even for a specialist), also during Medical US, if its degree is low or... if there are no characteristic elements in its course, such as ovarian endometrial cysts or adenomyosis.

In many cases, it is only exploratory laparoscopy, and therefore the placement of the patient in hospital, that allows the detection of fiery endometriosis, but does not treat it.

Endometriosis, Infertility, Menstruation

Endometriosis, photo by pantherrmedia

What is the modern diagnosis of endometriosis?

Anew way of diagnosing this intractable disease has been hailed as a breakthrough discovery, and its creators are Polish scientists Professor Jacek Malejczyk and Dr Ilona Kalaszczyńska, who discovered that with endometriosis there is an increased expression of mRNA - the FUT4 gene.

The test is a non-invasive method and resembles a coronavirus test, but a swab is taken from the uterine cavity. The marker in this case is a gene that is overactive in women with endometriosis.

The patient can receive the test result within a few days or so.

Where to have an endometriosis test and how much does it cost?

The endometriosis test can already be performed in infertility clinics, laboratories and gynaecological surgeries, so it is widely available.

On the basis of data collected in several clinics, in different cities in Poland, we have established that the price fluctuates around PLN 2,000. Unfortunately, the Ministry of Health has not decided to reimburse this test, due to insufficient data on this test, according to Ministry experts.

What to do when diagnosed with endometriosis?

There are currently two lines of treatment:

  • pharmacological.
  • surgical.

Endometriosis, Infertility, Menstruation

Abdominal pain during menstruation, photo by pantherrmedia

The choice of method is decided by the doctor. Pharmacological treatment uses hormonal drugs to suppress ovarian hormonal function, while surgical treatment gets rid of abnormal lesions, foci or endometrial cysts.

In the most difficult cases, a hysterectomy is also performed.

It is worth noting that surgical procedures are increasingly being carried out using laparoscopic technology, which is less invasive than traditional laparotomy.

According to Dr Mikołaj Karmowski, a specialist in endometriosis treatment, it is much easier to treat endometriosis in countries where reference centres focusing on the disease have been established. There, they have teams of specialists who take care of the patient as a whole - they carry out many multidisciplinary operations and even combine their care with setting a diet for the patient.

There are no such centres in Poland, so finding an endometriosis specialist is much more difficult, if not impossible. Not every gynaecologist will be able to guide the patient to recovery, as there is a lack of specialisation in this field.

Endometriosis, Infertility, Menstruation

Symptoms of endometriosis, photo: pantherrmedia

What symptoms should prompt an endometriosis test?

If you are suffering from menstruation, this may indicate the disease. Look out for symptoms such as:

  • menstrual disorders,

  • menstrual pain, perimenopausal pain, ovulatory pain,

  • pain with or after intercourse,

  • pain radiating from the pelvis to the lumbar region (and therefore resembling lumbar spine pain) and thighs,

  • complaints on passing stools, urination,

  • haematuria or flatulence

  • nausea, vomiting, diarrhoea, perimenopausal constipation,

  • pain during perimenopausal defecation,

  • abnormalities found during Medical US such as change in position of the uterus, restriction of its mobility or cysts,

  • a problem with getting pregnant despite frequent intercourse without the use of contraception, as well as in the case of unsuccessful IVF processes,

  • repeated miscarriages,

  • reduced ovarian reserve.