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Endometriomas - chocolate cysts - In the perspective of conventional medicine

I. Definition
Endometriomas - chocolate cysts definition as a condition of endometrial cells that are outside the ovaries, leading to endometriosis on the surface of the ovaries. It also reacts to stimulation hormone during the menstrual cycle, through the creation of tissue, breaks it and removed through menstruation that causes blood to spill into the abdominal cavity causing cramping and pain. Since chocolate cysts - endometriomas filled with a thick chocolate material type, are called chocolate cysts.

II. Causes of chocolate cysts - endometriomas
Endometriomas causes are still unknown, here are some tips and theories.
1. Retrograde menstruation
The retrograde menstruation theory suggests that during menstruation, blood flows backward instead of making out the menstrual blood pass through the fallopian tubes into the pelvic and abdominal cavity, resulting in the blood of fouling on the outside of the ovaries, causing endometriomas.

2. The weakening of the immune system
Normally, the immune system destroys the endometrial cells found outside the uterus. If the immune system weakened and no longer operate normally allow shed endometrial cells to attach and grow on the surface of the ovaries.

3. Stress and emotion
During stress and emotion, the adrenal glands produce cortisol, which affects the function of the body to clear toxins resulting in stimulation endometriomas growth.

4. Embryonic theory
This theory suggests that during the embryonic stage, some endometrial cells that normally grow in the uterus rather develops in the ovaries.

5. Hormonal imbalance
Endometriomas occur during the reproductive years of women when estrogen and progesterone are most active. At each stage of the menstrual cycle, estrogen and progesterone must be balanced by women to conceive. Any imbalance of hormones menstrual cycle causes the conversion of estrogen in estrogen and poor overproduction of prostaglandins, which leads the neck of the uterus to contract thus does not escape the period, causing cramping and endometriomas. Nutritional deficiency is also one of the causes of hormonal imbalance.

6. Hereditary
Genetic endometriomas can be passed through generations, or may be the result of genetic errors, causing some women more likely than others to develop the condition. A study shows that women are 5 times more likely to develop endometriomas if your sister has. Is a good idea for these women to have children early in their reproductive years.

7. Toxic environment
A study shows that exposure of our body toxins found in pesticides and other harmful waste products may have some hormonal and chemical influence, causing the activation of endometriomas at the time of the menstrual cycle. resulting in the proliferation of endo-ovarian tissue /

8. Xenoestrogen
Interaction of our body with certain chemicals cause an alteration of hormones in the body as a result of overproduction of estrogen make xenoestrogen for growth of endometriomas.

9. Sex during menstruation.
Sexual intercourse during menstruation causes endometriosis tissue to travel into the fallopian tubes after the ovary resulting in the development of ovarian endometriomas.

III. Symptoms of chocolate cysts - endometriomas
1. Gradually increased dysmenorrhea (cramps and menstrual pain)
They are caused by contractions of the muscles of the uterus as the result of more production of certain hormones in the family of prostaglandins from the endometriomas, and that their periods become more painful and the pain begins earlier or lasts longer time.

2. Pain during intercourse
The movement of the penetration of the penis can produce pain in an ovary bound by the endometrial implants or accession.

3. Period pain
This usually happens with excessive production of prostaglandins and leukotrient causing the cervix to contract as result of any escape for the period.

4. Trouble getting pregnant
If the cyst is presented in the ovary, which respond to changes menstrual cycle hormones causing cysts to get great monthly blocking the normal function of the ovaries resulting in infertility.

5. Increasing pain the end of the period room.
Because blood can not escape, that retents in our body causing damage to organs or body part that houses the endometriosis resulting in severe pain at the end of the period.

9. Pain on one side of the pelvis
The pain on one side of the pelvis during the menstrual cycle may be caused by endometrial implants or accession to the side of the ovary.

IV. Diagnosis
1. Physical examination
Usually, during the annual pelvic exam, if the mass of endometiomas are large enough, can be detected.

2. Ultrasound
Is defined as an imaging technique that uses high frequency sound waves to create an image of our internal organs, including tendons, muscles, joints, vessels. Diagnostic accuracy of endometriomas varies depending on the experience of the radiologist.
There are two types of diagnostic ultrasound
a) Ultra Sound
In order to evaluate the abdomen, including the uterus. You lie down with a full bladder for the procedure then a high-frequency waves pass through your body's abdominal region with a wave of new medical devices and forth in the abdomen with a thin gelatinous substance applied to the skin of your abdomen to improve body contact.
After taking the image, either the operator or physician in the office will explain what has been seen. You will be asked to take either the image with your doctor or sent.
If endometriomas or chocolate cysts, which are being captured in the image due to their dark forms other fluid-filled cysts.

b) Transactions vaginal ultrasound
Trans vaginal ultrasound is defined as the ultrasound scan taken with a transducer is inserted into the vagina (if discomfort with this procedure, ask the operator is going to make yourself the inclusion of the death of her discomfort.) Transvagina Ultrasound works well for measuring the thickness of the endomerium, endometrial hyperplasia, endometrioma and cancer.

3. Laparoscopy
Your doctor suspects the disease if you complain of severe menstrual cramps, or pain during intercourse, he Or she may suggest laparoscopy to look at the side of your uterus and ovaries, so he / she can visually confirm the presence of endometriomas and to measure its scope and most of the time, a small piece of tissue can be removed from the biopsy.

V. Treatments
A. Drugs
1. The creation of a state ongoing pregnancy
These types of medicines help stop or reduce the amount of corpus luteun stimulate the ovary to continue producing progesterone as continuous dose pill, Provera, and danazol.

2. Reducing the volume of blood flow
Beside the pill as mentioned above, progestogens are one of the conventional drugs used in the maintenance of pregnancy. High progesterone in your body, reduces blood flow during menstruation or tricks that your body thinks she is pregnant.

3. Create a state of menopause
It is necessary for increasing woman's estrogen body to start the menstrual cycle, drugs Estrogen inhibitors stop estrogen production by the ovary resulting trick your brain that are now in menopausal status. Without increasing no estrogen cycle. Such drugs include the full range of GnRH agonist drugs.

4. Stop the pain
During production of prostaglandins that control ovarian muscle contraction that cause menstrual pain. Such drugs include prostaglandin-inhibiting drugs, the pill, analgesic, etc.

5. Hormonal regulation of oscillation
These types of drugs used to treat endometriosis or menstruation symptomsof earlier in the menstrual cycle, such as depression, anxiety. Includes the pill, antidepressants, etc.

B. Side effects and risks
In general, taking the previous medication can cause the following side effects and risks.
1. Blood clots
2. Stroke and heart attack
3. Weight gain
4. hormonal imbalance
5. long-term loss for the period after leaving the pill in some women.
6. Nausea
7. Distension
8. Breast tenderness
9. male pattern hair growth and deepening of the voice
10 Indigestion
11. Etc.

B. Surgery
1. If fertility is a concern then
a) Laparoscopy
Most laparoscopies are completed in a hospital and generally is performed under general anesthesia.
Laparoscopy is a medical instrument used by a physician for the visualization and removal of tissue in the table. Through an incision in the abdominal wall, the slender instrument passes into the abdominal cavity. Laparoscopic hysterectomy is an operation involving the removal the current endometriomas during the course of laparoscopy. Today, many doctors insert a slightly larger telescope through the umbilical port, which allows use a carbon dioxide laser to destroy the endometriomas.

b) Laparotomy
As laparoscopy is a surgical laparostomy performed through a larger incision. You may need to stay in the hospital 1-3 days after surgery. If too large ovarian cysts, Ovarian cysts are found and suspected cancer.

c) Risks
1. The bleeding caused by medical instruments during surgery.
2. Damage adjacent organs also caused by medical instruments during surgery.
3. Infection
4. risk of anesthesia.

2. If you have more 40 and the fertility is not a concern
Then his gynecologists recommend the removal of both ovaries bilateral oophorectomy
General anesthesia is necessary and the operation is performed in the hospital.

a) In general, bilateral oophorectomy done with laparoscopic surgery. Laparoscope is a tube intestine that contains a small lens and a light that is inserted through a small incision in the navel with a camera at the other end that allows your doctor to see abdominal cavity on a video monitor. The two ovaries are removed through a small incision in the top of the vagina.

b) vertical incisions
Vertical incisions give the doctor a better view of the abdominal cavity, but will leave some scars remarkable. If cancer is detected abdominal incision vertical is required. After the incision the ovaries.

c) the horizontal incision
If the ovaries are removed by horizontal incisions that leave a scar less noticeable.

d). Risks and side effects
i) the heavy blood loss caused by medical devices used during surgery.
ii) up and bleeding during or after surgery
iii) The infection of the incision can be caused by bacteria or instruments physicians.
iv) necessary to stay in hospital for 2 - 5 days
v) The recovery time is longer. It may take 3-6 weeks to return to activity normal.

VI. Endometriomas and Fertility
Endomatriomas Some women can conceive naturally, but unfortunately for some, if endometriomas grow enough to block the extrusion of egg in the fallopian tube. Endometriomas is a test that also affect egg quality and jeopardize ovulation in some women.
1. Drug treatment
In the case of endometriosis interferes with egg production, fertility medication may be required to produce many eggs, resulting in increasing the probability of conception as Clomid.

2. Treatment with artificial insemination
a) In vitro fertilization (IVF)
In IVF, the sperm enters the egg outside the woman's body after fertilization is implanted again the woman's uterus.

b) Intrauterine insemination (IUI)
IUI fertility treatment is relatively simple. Put some sperm selected directly into the uterus.

c) Gamez intrafallopian transfer (GIFT)
If the endometriosis interferes with the function of the ovary, GIFT is useful to assist human reproduction by placing the egg and sperm in the fallopian tubes.

d) Intracytoplasmic injection sperm injection (ICSI)
For the same reason as above, technology ICSI a single sperm is injected directly into the egg, with a small needle and specialized.

I We hope this information will help. If you need additional insurance information or advice, please follow my series of articles by topic reference to my home page at:
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http://ovairancysts-endometriomas.blogspot.com/

I'm going back to anotherarticle "Endometriomas - chocolate cysts - In the perspective of traditional Chinese medicine", please bear with me. In the mean time enjoy reading.

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