Cervical endometriosis is a gynecological, hormonal-dependent, non-infectious disease in which functional tissue (endometrium) is found on the mucous membrane of the cervical canal and vaginal cervix. This diagnosis is most often made to women of reproductive age. This pathology, if not treated in a timely manner, can lead to iron deficiency anemia, the development of malignant pathology and infertility.

Symptoms of cervical endometriosis

Clinical signs of endometriosis are:

1. Menstrual irregularities. With this pathology, women are most often bothered by bloody, dark red discharge. They occur 2-3 days before menstruation and a few days after it. Most often, the discharge is scanty and found on underwear. Some women experience metrorrhagia (bleeding not associated with the monthly cycle).
2. Drawing pain in the lower abdomen. It does not occur in all patients.
3. Discomfort during sexual intercourse (dyspareunia).
4. Signs of anemia. With uterine bleeding, hemoglobin drops and the number of red blood cells decreases. This leads to dizziness, weakness, shortness of breath, brittle nails, drop in blood pressure, pale skin and drowsiness.

Endometriosis often occurs latently (asymptomatically) and is discovered accidentally. In other cases, the only symptom is spotting.

Causes

Endometriosis can be caused by:

1. Mechanical damage to the cervical mucosa. This is possible during surgical interventions (during a cesarean section), curettage, manual assistance during complicated childbirth, the introduction of intrauterine contraceptives (spirals), hysterosalpingoscopy (instrumental examination of the uterus and tubes), induced abortions, removal of polyps and cauterization of tissues.
2. Hormonal imbalance in the body. The causes may be diseases of the thyroid gland, adrenal glands, ovaries, hypothalamus and pituitary gland. Hormonal imbalance often occurs due to uncontrolled use of hormonal medications.
3. Frequent childbirth.
4. Complications during childbirth. Promotes the entry of endometrial cells into the cervix of the organ.
5. Genetic predisposition.
6. Pseudo-erosions.
7. Inflammatory diseases (chronic endocervicitis).

Predisposing factors include stress, late childbirth, early or late puberty, decreased immunity, insufficient motor activity and narrowing of the cervical canal.

Classification

The following forms of the disease are distinguished:

• endocervical (the mucous membrane covering the neck of the organ is involved in the process);
• exocervical (the vaginal part of the cervix is ​​affected);
• diffuse;
• focal;
• nodal

There are 4 stages of disease development. At stage 1, endometrioid lesions are localized shallowly and spread no further than the muscle layer. At stage 2, less than half the thickness of the myometrium is involved in the process. At the 3rd stage, the functional epithelium of the uterus grows into the entire muscular layer of the cervix. At stage 4, neighboring organs are often involved in the process. Fistula tracts often form.

Diagnostic methods

Methods for diagnosing endometriosis include:

1. Examination using mirrors on the obstetric chair. The gynecologist examines the uterine cavity, cervix and vagina. Normally, the mucous membrane is pale pink. With endometriosis, red lesions up to 5 mm in size are detected. Before cyclic bleeding, they become purple-blue and enlarged.
2. Colposcopy (examination of the vagina and cervix with a magnifying device). The study is most informative in the week before menstruation.
3. Targeted biopsy. It is carried out to collect material from the mucous membrane of the cervix. The fragment is taken with a special needle under visual control. The procedure is performed with or without anesthesia on an outpatient basis.
4. Histological analysis. Allows you to identify areas of functional epithelium in atypical places.
5. Cytological examination (examination of cellular material under a microscope).
6. Diagnostic curettage. It is carried out to clarify the diagnosis according to strict indications.
7. Ultrasound of the pelvic organs. Detects pathological inclusions in the cervical area.
8. Computed or magnetic resonance imaging.
9. Metrosalpingography (x-ray examination). It is carried out after the cessation of menstruation. A dye is introduced, by the distribution of which the doctor judges the condition of the tissues.
10. Blood test for markers of endometriosis. Indirect signs of the disease are an increase in the level of cancer protein CA-125 and protein PP-14. This study does not allow excluding other pathologies (tumors and inflammatory diseases).
11. Analysis of smears from the vagina, urethra and cervix.
12. Bacteriological analysis.
13. Microflora research.
14. General clinical blood and urine tests.
15. Biochemical blood test.
16. Patient interview. In the initial stages, there are often no complaints.
17. Physical examination.

Differential diagnosis is carried out with tumors (myoma, fibroma, cancer), cervicitis, endometritis, cysts and polyps.

Course of the disease

The disease is characterized by a chronic, slowly progressive course. Even after removal of lesions, relapses often occur. Repeated tissue proliferation is caused by the reflux of the functional endometrium into the cervix from the body of the organ.

Treatment of cervical endometriosis

Treatment can be surgical or conservative (medication). Treatment tactics depend on:

• presence of complications;
• size of pathological foci;
• degree of tissue damage;
• age of the sick woman;
• reproductive plans (desire to have children in the future).

In the absence of complications, small areas of endometriosis and the absence of pronounced symptoms, dynamic observation (watchful waiting) is possible.

Surgery

Indications for removal of lesions are:

1. Ineffectiveness of drug therapy for 3-4 months.
2. Concomitant hyperplasia (proliferation) of the endometrium.
3. Nodular form of the disease.
4. 3rd and 4th degrees of the disease.
5. Associated endometrioid cysts.
6. Common retrocervical endometriosis.
7. Inability to use hormonal drugs. Many drugs are contraindicated for thromboembolism, thrombophlebitis, atherosclerosis, coronary heart disease, migraine, liver failure, bleeding of unknown origin, diabetes, jaundice, depression, migraine, high blood pressure and varicose veins.

For endometriosis, hysterectomy (removal of the organ along with the appendages) can be performed. This is an extreme measure that is required when the pathological process is very widespread. Most often, the following minimally invasive interventions are performed for endometriosis:

1. Laser coagulation(burning out pathological areas using a laser). This treatment is performed on an outpatient basis after local anesthesia. The advantages of laser therapy are low blood loss, low risk of complications, rapid tissue regeneration and the absence of rough scars.
2. Radio wave therapy.
3. Cryodestruction (tissue freezing).

Hormone therapy

For endometriosis the following may be prescribed:

1. Combined estrogen-progestogen agents.
2. Inhibitors of gonadotropin production (Danol).
3. Gestagens (Visanne, Duphaston, Nemestran).
4. Analogues of gonadotropin-releasing hormone (Zoladex, Buserelin).

Medicines are prescribed individually, taking into account contraindications.

Cervical endometriosis is a condition in which abnormal growth of endometrial cells (mucous membrane) occurs outside the reproductive organ. Endometrial tissue has receptors for hormones, so the same processes occur as in the normal state of the mucous membrane, that is, menstruation. Such bleeding can lead to inflammation of the tissue and cause: pain, the possibility of infertility, and an increase in the volume of the uterus. More often appears in women who are still capable of childbearing. Also, harmful cells can harm other organs.

You can also encounter a variety - subepithelial endometriosis of the cervix. It appears as a result of injuries after surgery. Develops due to the contact of cells with damaged surfaces. It is found most often in young and middle-aged women (cervical erosion is also a variety).

Forms of endometriosis:

• Genital – damage to the organs of the reproductive system;
• Extragenital – damage to organs outside the reproductive system;

Causes

Experts have still not been able to identify a number of exact reasons why it is possible to determine why its development began. Only by certain premises can one understand why the disease appeared.

Theories of origin:

1. Metaplastic - indicates that the appearance of inflammation, damage and hormonal imbalances provokes possible tissue degeneration. That is, diseases such as, for example, peritoneal mesothelium or vascular endothelium, can take the form of endometrium.
2. Embryonic – based on the possibility of pathology occurring during the formation of organs. With this pathology, an anomaly in the development of the human genital organs, gastrointestinal tract and urinary tract occurs, which leads to the disease.
3. Implantation - according to this theory, during menstruation, the rejected endometrial cells may not be completely released, as a result of which these cells remain in the body and have the opportunity to attach to the cervical canal, cervix or other organs.
4. Immunological - says that due to failures in the immune system, endometrial cells take root in unusual locations.

Psychological aspect

No matter how patients forget about this aspect, it is very important and has a great impact on the body. Psychiatrists believe that certain psychosomatic characteristics contribute to the development of endometriosis of the uterus and cervix, the symptoms of which begin to appear due to instability of the emotional state. What patients need to pay attention to is internal aggression and daily negative self-analysis. Women and girls who see themselves only from the negative side create predisposing factors for the occurrence of autoimmune reactions.

Symptoms

Symptoms can be quite varied, and the disease very often does not make itself felt at all and a diagnosis can only be made during a routine examination by a gynecologist. If you do not find out about the occurrence of such a violation in time, you can lead to serious consequences.

Common symptoms:

• Pain (the most common symptom);
• Spotting bloody discharge outside of menstruation;
• Unpleasant sensations during sexual intercourse (pain can appear not only in the vagina, but also in the lower back and rectum);
• Pain in the pelvic bones;
• Infertility;
• Menorrhagia (large loss of blood during menstruation that does not meet the norm);
• Dysmenorrhea (pathology in which severe pain occurs in the lower abdomen during menstruation);
• Enlarged uterus;
• Enlargement and immobility of the fallopian tubes;
• Weight gain;

Diagnostics

Diagnosis to identify the disease is carried out in different ways, but at the same time, diagnosing it is quite difficult, so only an experienced specialist should do this. Before taking any action or prescribing treatment, the doctor must analyze your medical history and find out about everything that worries you.

Diagnostic methods:

1. A complete examination by a gynecologist of the vaginal cavity and the outer walls of the cervix.
2. Ultrasound of the pelvic organs.
3. X-ray of the genital tract.
4. Biopsy (a test in which cells or tissue are removed).
5. Hysteroscopy (research method using a hysteroscope).
6. Laparoscopy;

Treatment

When prescribing treatment, a specialist must pay attention to many factors. Such as age, number of pregnancies experienced, level of severity of the patient’s disease, how pronounced the signs are and the possibility of complications. Therapy should be aimed not only at removing the causes of the disease, but also at preventing the possibility of development of these tissues in the future and preventing the consequences that can be expressed in the appearance of endometriotic cysts, adhesions, and painful bowel movements.

Treatment methods:

1. Medication (conservative) - before performing surgical interventions, they try to treat the patient with hormonal drugs in order to normalize the functioning of the hypothalamic-pituitary system. Hormones correctly act on the receptors that are located in the endometrial foci. This helps reduce the severity of the disease. Hormones used: oral contraceptives, progestins, drugs with antigestagenic properties, antigonadotropic drugs, anti-estrogenic drug, androgens, steroids.
2. Surgical - used only for severe forms. So severe that the removal of the uterus and ovaries is required. But this radical method cannot be taken under duress; all responsibility for the decision lies with the patient. The problem can be solved with the help of a gentle operation, which does not require removal of the reproductive organs and only the endometriotic tissue is removed. More and more specialists are now able to perform such an operation efficiently. After a successful procedure, only 10% of women may experience pain. But the pain will no longer be caused by endometriosis, but by scars, fibroma or adenomyosis. Usually the operation is performed using liquid nitrogen, laser or radio waves.

How is the operation performed?

Surgical intervention involves cauterization and removal of accumulated cells. The operation is performed using cosmetic punctures in the abdominal wall using laparoscopic access. Surgically, instruments and a camera are inserted through the internal cavity using a flexible rod. For removal, different techniques are used: resection, electrocoagulation, laser vaporization. Doctors most often prefer resection in order to immediately take materials for a biopsy. Laparoscopic access practically does not injure the patient and reduces the possibility of complications and relapses.

For complex cases, the laparotomy method is used, in which an incision is made in the abdominal wall. It is precisely in those cases when the removal of reproductive organs occurs that there is a struggle for a woman’s life.

Treatment of endometriosis - video

Frequently Asked Questions

Can it be cured with folk remedies?

There is no folk remedy for treatment. This is not inflammation or injury, which can be treated with compresses and decoctions. Endometrial clumps are the same tissue as the healthy cells that form the cervix. Therefore, this pathology can only be removed mechanically. After the operation, you should refrain from drinking alcohol, smoking, neuroses and psychosomatic disorders. As a preventive measure, you can drink herbal drinks. So that the already healthy cervix is ​​not endangered.

Can endometriosis be inherited?

There are often situations where several women in a family exhibit this disease, so there is a possibility of a genetic predisposition. But it is not necessary that at least one sign will appear in you, if, for example, you lead a different lifestyle than your relatives. The disease manifests itself only in a situation conducive to it.

Does cervical endometriosis and its treatment affect fertility?

Most people with this diagnosis do not suffer from infertility, but, unfortunately, it can contribute to it. Cervical endometriosis occurs in 50% of infertile women who have undergone laparoscopy. It often causes adhesive disease, which leads to the inability to have a child. But there is no direct connection between this disease and infertility.

Why do so many women get endometriosis?

When symptoms appear, the doctor performs a laparoscopy; in most applicants, specialists identify symptoms at an early stage, which does not mean that there were fewer sick patients before. Now experts know more about how to treat and how to stop the development of cells in the bud. But there is also a factor that may actually have increased female growth. Currently, female representatives are postponing the conception of a child, which can also lead to the development of unwanted tissue.

Pay close attention to your health so that cervical endometriosis does not occur in your body. To do this, you need to visit a gynecologist at least once every six months for preventive purposes. If a doctor discovers this disease in you, follow all his recommendations and carry out treatment in a timely manner so that serious consequences and serious complications do not arise. Do not forget that you should not escalate the situation and panic, because your body hears all the alarming messages and turns them not in your favor.

Cervical endometriosis is one of the most common gynecological diseases. This is a benign growth of the internal mucous membrane of the uterus (endometrium) beyond its boundaries.

In a healthy woman, the endometrium in the uterus changes during the menstrual cycle in preparation for conception. If the fertilized egg does not reach the uterus, the endometrium is shed and comes out along with the menstrual flow. Under some circumstances, remnants of the endometrium, which should grow only in the uterus, settle on other organs and begin to grow.

Endometriosis often affects the fallopian tubes, ovaries, bladder and nearby pelvic organs. In some cases, endometrial cells even reach the mucous membrane of the lungs or nose. Quite often, endometriosis is combined with anemia, fibroids and inflammation of various locations.

Cervical endometriosis is characterized by the settling of endometrial cells in this area, more precisely on the vaginal surface. It is noteworthy that endometriosis of the uterus is diagnosed much less often than endometriosis of the ovaries. However, the disease is no less dangerous.

Cervical endometriosis is a very painful and complex pathology that can cause infertility. Sometimes the disease provokes cervical cancer.

Although endometriosis of the cervix is ​​rare, in most cases it is complicated in the vagina and perineum. There is a diffuse form, which affects all walls, and a focal form, affecting specific areas.

The localization of endometriosis determines its types:

• genital (affects the genitals);
• extragenital (affects membranes and organs outside the reproductive system).

Genital endometriosis is divided into internal and external. Internal pathology affects exclusively the uterine mucosa, and external pathology affects the fallopian tubes, ovaries, cervix, and vagina.

Stages of development of endometriosis:

1. Cells penetrate into the boundary layer.
2. The pathology grows into the thickness of the muscle membrane.
3. Damage to the serous layer.
4. Deep lesions, the appearance of cysts and adhesions.

Causes of endometrial growth

The risk of developing endometriosis greatly increases during intrauterine surgery. Quite often the disease occurs after a surgical abortion. After termination of pregnancy, it is strongly recommended to undergo a rehabilitation course and be constantly monitored by a gynecologist.

The most common causes of endometriosis are instrumental manipulations in the uterus: biopsy, electrocoagulation of erosions, abortion. Trauma to the cervix during childbirth, miscarriage or abortion can also provoke endometrial growth.

The easiest way to form a focus of endometriosis in the cervix is ​​to attach pieces of the endometrium to fresh wounds in the mucosa. Naturally, such processes do not occur in all women, but the more precise reasons for the development of endometriosis have not yet been studied.

Symptoms of cervical endometriosis

The symptoms of endometriosis and the severity of the pathology depend on its stage and the characteristics of the female body. Often the disease does not manifest itself in any way, so a woman learns about its development only during a preventive examination with a gynecologist. Endometriosis is often detected during the diagnosis of infertility.

Endometriosis of the uterus is constantly progressing and has a long-term nature. During the development of the pathology, pain occurs during sexual intercourse, bleeding between menstruation, and painful discomfort in the abdomen. Women often report painful menstruation.

When the disease reaches the rectum, pain may occur during bowel movements, and in the case of the bladder, during urination. Mild forms of endometriosis are asymptomatic, but still harm a woman’s health. Often, patients report only irritability, dizziness, imbalance and headaches.

Many advanced cases of cervical endometriosis are due precisely to the fact that the pathology often does not manifest itself in any way. And if a woman does not carry out preventive medical examinations, the absence of symptoms is fraught with serious complications.

Characteristic signs of endometriosis can appear singly or in combination. You can suspect the disease by spotting after sex or spotting before and after menstruation. There is often no pain, except in cases where the disease affects the cervix and other organs.

How to diagnose cervical endometriosis

Diagnosing cervical endometriosis is not difficult. Even with a visual examination of the vagina using a speculum, the doctor may notice formations in the cervix. Differential diagnosis is also simple: the formations are similar in characteristics to the endometrium in the uterus.

During the initial period of the menstrual cycle, these formations grow and bleed during menstruation. After the end of the discharge, the formations decrease. If, after examination, the doctor suspects endometriosis, he gives the patient an appointment for colposcopy and, in some cases.

Treatment of cervical endometriosis

Therapy is prescribed only when the diagnosis is confirmed, otherwise the treatment may be harmful. There are two ways to eliminate endometriosis: hormonal and surgical. Often, foci of disease are removed with liquid nitrogen, laser or radio waves. Drug therapy is sometimes a much safer and more effective treatment method.

Medication method

Endometrial therapy is always individual and comprehensive. The doctor must take into account the patient’s age, the need to preserve reproductive function, the spread of the pathology, its duration and severity, as well as the presence of complications.

The effectiveness of conservative treatment is due to the role of hormones in the development of endometriosis. Progesterone, which is considered the pregnancy hormone and is produced by the corpus luteum in the second phase of the cycle, as well as androgens or male hormones secreted by the ovaries and adrenal glands, deform the endometrium and slow down its growth.

Estrogens, which are secreted in the first phase by the ovaries and adrenal cortex, on the contrary, provoke the growth of the endometrium. In endometriosis, estrogens are contraindicated, as they cause progression of the disease. Hormonal therapy is based on drugs with androgens and progesterone.

Hormonal drugs for endometriosis:

• non-steroidal anti-inflammatory drugs, which help with pain;
• male sex hormones are rarely used, as they cause side effects (excessive hair growth, clitoris enlargement, voice changes);
• combined oral contraceptives in a continuous course, but these drugs contain estrogens and gestagens;
• gestagens (duphaston, medroxyprogesterone, norkolut);
• synthetic derivatives of 17-alpha ethynyltestosterone (danazol);
• derivatives of 19-nortestosterone (non-mestran);
• analogues of gonadotropin-releasing hormones (, buserelin), which provoke the onset of artificial menopause (ineffective in case of a lack of gonadotropins, an excess of estrogens);
• antiestrogens ().

Surgical intervention

Surgical therapy is aimed at removing foci of endometriosis. This is often done using a laser or coagulation. Isolated treatment of pathology is rarely carried out.

Modern medicine often uses combined treatment of endometriosis, especially external endometriosis. Surgery supplemented with a course of medications is much more effective than surgical therapy alone.

Combinations can be different, but often they start with medications, then have surgery and resume taking the pills. The choice of surgical intervention depends primarily on the extent of endometriosis. Usually the choice is between laparoscopy and open surgery.

If the patient has been diagnosed with extensive endometriosis combined with fibroids, and there is no need to preserve reproductive function, you can choose extirpation (removal of the uterus and appendages). This treatment is considered extreme, so medications and organ-conserving surgery are most often prescribed.

Traditional methods

Many women turn to traditional medicine for endometriosis of any location. This is a natural phenomenon, because traditional methods seem safer and cheaper than official medicine.

Healers recommend using herbs for local and internal effects. Before starting such treatment, you should consult your doctor and analyze the risks, because natural remedies often cause side effects. Taking tinctures can cause severe allergies, and douching can provoke candidiasis or bacterial vaginosis.

Complications of endometriosis

If any symptoms occur, you should consult a doctor, since infertility is a common complication of endometriosis (almost 50%). Therefore, the disease is often diagnosed when there are unsuccessful attempts to become pregnant.

Without treatment, the disease becomes advanced; endometrial cells grow toward the cervical canal (cervical). This phenomenon leads to the formation of adhesions in this canal, which will impede the passage of sperm to the uterus. When the adhesive process is very advanced, the passage is completely blocked. Fertilization will not be possible. Infertility caused by endometriosis develops due to ovulation disorders, adhesions, underdevelopment of the endometrium in the uterus and disruptions in the menstrual cycle.

Inflammation greatly increases the level of prostaglandins, which negatively affects female reproductive capabilities. The inflammatory focus also includes many macrophages (cells that absorb toxins and dead deposits). But during inflammation, macrophages begin to process not only decay products, but also sperm, significantly reducing their number.

Prevention of endometriosis

Medicine has not yet determined the exact causes of endometriosis, so there are no specific measures to prevent the disease. A timely and healthy pregnancy is believed to be the best protection against endometriosis.

The main measures to prevent endometriosis: regular preventive examinations with a gynecologist, as well as the exclusion of surgical intervention in the uterus. You need to visit a doctor at least once a year. Just half an hour a year helps to avoid serious complications of the disease, such as infertility and cancer.

Cervical endometriosis is not a contraindication to having a child. Conception is considered a favorable factor, since during this period menstruation stops, and foci of pathology stop bleeding, inflammation weakens, without forming new mucosal lesions. Pregnancy is a natural way to self-treat cervical endometriosis.

Treatment of cervical endometriosis is a complex and lengthy process. No doctor can guarantee recovery. The patient should participate in the process of choosing treatment and individual drugs, as well as independently assess the risks and the possibility of complications.

Cervical endometriosis is a very common pathology. It is not considered dangerous, but it can still cause trouble. What is this disease, what are the causes, symptoms and methods of treatment?

Endometriosis of the uterus is the formation of endometrial foci outside the mucous layer of the organ. That is, inside the muscle. If the disease affects the “exit” of the uterus, then doctors talk about endometriosis of the cervix, what is it and what does it look like?

The pathology is quite easily diagnosed during a gynecological examination using a speculum. The doctor notices small red formations on the neck. Their size and color changes depending on the phase of the menstrual cycle. Thus, the symptoms of cervical endometriosis during menstruation are large, bleeding lesions of a purple color. Endometriosis can also spread to the cervical canal. After the end of menstruation, the lesions become noticeably smaller (2-5 mm). The woman herself may notice intermenstrual bleeding. Most often, there is no pain. Only if endometrial foci are present not only on the cervix. With a common process, adhesions may form inside the cervical canal, which interferes with the movement of sperm through it and is one of the causes of infertility.

If we talk about the causes, endometriosis of the cervix occurs after curettage of the uterine cavity, abortions, as a result of which endometrial tissue enters the cervix and, if there are erosions on it, into the bloodstream. Another common cause is manipulation of the cervix, for example, endometriosis after conization, cauterization with electric current, etc. If the wound does not heal before the onset of menstruation, endometrial cells can again penetrate inside, subsequently forming nodules and adhesions, scar changes.

The question immediately arises: can cervical endometriosis and pregnancy coexist, will the disease negatively affect the development of the baby, or provoke a miscarriage? Doctors say no. On the contrary, pregnancy is the best “natural” remedy against endometriosis. Since there are no periods during pregnancy, this means there is no risk of the formation of new lesions. Old lesions stop bleeding and thereby provoke inflammatory processes.

Many women are interested in the treatment of cervical endometriosis with folk remedies. There are many reasons for this - this is the reluctance to go to the doctor, and beliefs about the harm of drugs, etc. Traditional healers recommend taking courses of treatment with various herbs, which are used both topically (vaginal tampons, douching) and internally (for example, bog uterus with endometriosis). If you decide to be treated with “natural” remedies, then keep in mind that various side reactions are possible, about which you were not warned (and were not warned, because no one has studied the effects of herbs and is not doing so) - severe allergies, the liver may suffer. And douching can provoke other diseases - candidiasis or bacterial vaginosis.

Is the game worth the candle, when there is an effective and safe drug treatment... By the way, endometriosis should be treated only when there are symptoms, or the lesions are large in area and interfere with pregnancy. Typically, lesions are removed using a laser, radio waves or liquid nitrogen. But there is a small risk that this cauterization will only worsen the situation. Another option is hormonal treatment.

Cervical endometriosis, judging by statistics, is widespread in Russia and the CIS countries. And unjustified treatment plays a significant role in this - “cauterization” of cervical ectopia, which only needs observation.

Therefore, every woman, especially those who have not given birth, must use reliable contraception to prevent abortions, and also undergo an annual examination by a gynecologist in order not to miss cervical diseases. If surgical treatment is prescribed, which in your opinion is unfounded, you need to consult with 1-2 more specialists.

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Content

Endometriosis is a gynecological pathology, which means the process of growth of endometrioid cells beyond the mucous inner layer of the uterus. The exact causes of endometriosis have not been established. It is believed that the signs of the disease are caused by immune, hormonal and genetic factors.

The disease often occurs in women of reproductive age, which is why it is dangerous. Lack of treatment for the disease can affect general well-being, intimate life and reproductive function, which poses some danger.

Endometriosis progresses in two main forms.

• The genital variant involves the spread of endometrial elements to the organs of the reproductive system. The most commonly affected areas are the uterine myometrium, ovaries, tubes, vagina and cervix.
• Extragenital appearance refers to endometriosis of the lungs, intestines, bladder and other organs. This type is the most dangerous, however, it occurs relatively rarely.

The uterine body consists of the perimeter, myometrium and endometrium.

In endometriosis, the cells of the inner layer or endometrium extend to the myometrium and deeper layers.

Cellular reflux into the abdominal cavity through the pipes to neighboring organs and tissues may also occur. Quite often in gynecological practice, endometriosis of the cervix and the spread of the disease to the cervical canal can occur.

Reasons

The disease has not been studied enough. Scientists have developed several basic theories explaining the etiology and pathogenesis of cervical endometriosis.

• Endometrial. This theory is based on the phenomenon of retrograde menstruation, in which a reverse reflux of bloody discharge with endometrial cells may occur during menstrual periods. Under certain conditions, the spreading elements of the endometrium develop in tissues that are foreign to them. This is how cervical endometriosis can develop.
• Embryonic. Scientists say that in some cases, endometriosis occurs in girls with genital abnormalities as early as 11-12 years old. Both genital and extragenital forms of endometriosis are recorded with this development of the disease. The pathological change develops due to the intrauterine laying of endometrial cells in atypical places. This situation does not imply the reflux of endometriotic elements.
• Metaplastic. Some tissues can turn into elements of the inner layer of the uterus.

Endometriosis cells, like malignant elements, spread through lymphatic and blood vessels.

Cervical endometriosis occurs after trauma to the endometriotic tissue in most cases, especially after numerous births and surgical interventions on the cervix.

Risk factors for the development of cervical endometriosis include hormonal and immune imbalances. Women with endometriosis may experience impaired production of sex hormones, such as prolactin, progesterone and estrogens. The danger is that the disease is accompanied by an immune disorder, which makes it possible for endometrial cells to develop in an environment that is unusual for them.

Manifestations and symptoms

Many women with a history of pathology are interested in the dangers of cervical endometriosis. The danger of the disease is directly related to the symptoms of cervical endometriosis that a woman develops. With endometriosis of the cervix and cervical canal, various clinical pictures and signs are described.

The cervix is ​​a section of the female reproductive system, which is a kind of connecting link between the vagina and the body of the uterus. This physiological connection is achieved through the cervical canal. This cervical or cervical canal is characterized by anatomical narrowness. In addition, the cervical canal contains protective mucus. Gynecologists note that the narrowness of the cervical canal and the mucus produced prevent the penetration of pathogenic flora into the uterine cavity. However, under pathological conditions, the cervical canal is also susceptible to inflammation.

Infection of the cervix and cervical canal by endometriosis causes the development of signs and symptoms. As with any other disease, the manifestation of cervical endometriosis is individual and depends on the characteristics of the medical history.

Signs of cervical endometriosis include several manifestations.

• Pain syndrome. The most common symptom is pain of varying intensity and localization. Endometriosis is a disease in which the casting and germination of pathological cells in various organs and systems can occur. This is why endometriosis is dangerous.

Foci of endometriosis are subject to the same changes by day of the cycle as the normally located endometrium. In this case, the lesions menstruate simultaneously with the inner layer of the uterus. However, the rejected cells cannot be eliminated from the body. The danger is that over time, irritation and inflammation develop, which occurs with every form of endometriosis. A woman may experience pain that intensifies during her period.

• Changes in the cycle and nature of menstruation. With endometriosis of the cervix, spotting may occur, which occurs two to three days before and after menstruation. Another manifestation is the development of bleeding and heavy menstrual flow.

Manifestations and symptoms of the disease must be treated.

Endometriosis of the cervix is ​​dangerous because with excessive blood loss Anemia may occur. The danger of anemia in the development of a threat to life and health.

• Infertility. The inability to conceive is quite common with the disease. As a rule, cervical lesions and uterine endometriosis are combined. If the pathological condition is not treated promptly, endometrioid elements may spread to the tubes and ovaries. The danger is that not only pathological foci develop, but also adhesions and cysts. With these formations, disturbances in the functioning of the organs of the reproductive system may occur, preventing conception and implantation.

If the cervix is ​​affected, symptoms may not occur in the initial stage. As a rule, signs and manifestations of endometriosis develop when endometrioid elements are widespread, which is why it is dangerous. Symptoms and treatment are interrelated. The more severe the symptoms develop, the more intense the treatment will be.

Diagnosis and treatment

Symptoms of endometriosis on the cervix need to be treated after a detailed examination.

Since the disease rarely has manifestations and symptoms at an early stage, it is usually detected in an advanced form.

In gynecological practice, there are cases when a patient is examined for the development of infertility, and one of the types of endometriosis is detected.

Diagnosis of cervical endometriosis includes several main types of research.

• Collection and subsequent assessment of medical history data. Based on the characteristic symptoms, complaints and medical history of the patient, the doctor has the opportunity to suspect the development of a specific disease. The hereditary factor is of particular importance when a certain form of pathology can arise within the same family.
• Gynecological examination on a chair. Damage to the cervix has its own signs and manifestations, which are clearly visualized in the mirrors. In particular, the doctor determines the blue or red spots found in this variety. In addition, the patchy lesions usually bleed during menstruation. If the lesions are localized in the cervical canal, the doctor will not see any changes when examined in the mirrors.
• Colposcopy. This test accurately identifies visual symptoms, signs and manifestations of cervical endometriosis. The procedure helps to accurately determine the nature of tissue damage thanks to a colposcope, which works using lighting and magnifying systems. During the examination, a histological examination is also carried out, allowing a detailed study of the cellular structure.
• Separate diagnostic curettage allows you to verify damage to the cervical canal. Histological examination of the removed material from the cervix reveals endometrial cells.
• A blood test for certain tumor markers (CA-125) in cases of severe adenomyosis combined with cervical endometriosis will reveal an increase in this marker.

Based on the diagnostic results, the doctor prescribes treatment, which can be:

• conservative;
• surgical.

However, it is desirable that the treatment be comprehensive. This is due to the risk of relapses.

Conservative treatment is prescribed for the development of both severe symptoms and moderate manifestations. If significant symptoms develop, such as intense pain or infertility, conservative treatment is carried out before and after surgery. For moderate symptoms, conservative treatment is used as an independent method. The basis of conservative tactics is drug treatment.

Cervical endometriosis should be treated with hormonal and anti-inflammatory, hemostatic, immunostimulating drugs that:

• balance hormonal levels, reducing the production of estrogen;
• eliminate unpleasant symptoms associated with pain;
• protect against unwanted pregnancy during treatment;
• stop bleeding;
• eliminate inflammation.

Drug treatment is effective when the main hormonal component is present. In order to eliminate the symptoms, signs and manifestations of cervical endometriosis, the patient should be treated with the following drugs:

• gestagens;
• agents that suppress the production of sex hormones;
• progesterone antagonists;
• GnRH antagonists;
• androgens;
• estrogen antagonists;
• anabolic hormonal drugs.

Surgical treatment is quite common. The disease can be treated using the following destructive tactics.

• Cauterization using an electrocoagulator. It should be remembered that this treatment process can be dangerous when used in nulliparous women. Treatment by electrocoagulation is allowed in case of realized reproductive function.
• Cryodestruction. This treatment is not dangerous, since during the procedure the lesions are exposed to liquid nitrogen. The formation of rough strictures and scars is not typical.
• Laser or ultrasound removal. Like cryodestruction, these processes are not dangerous and are often found in gynecological practice as methods of treating women and girls who are planning to give birth.

With a combination of cervical lesions and other organs, it is possible to treat pathology through laparoscopy.

In some cases, it becomes necessary to consult other specialists.