Stating that endometriosis with pain and infertility is a serious problem affecting one in 10 women of reproductive age, Obstetrics, and Gynecology, IVF specialist Prof. Dr. Erkut Attar pointed out that endometriosis may also be a precursor to some chronic diseases. “It could be the opposite. If there are other common diseases with endometriosis, endometriosis should also come to mind. ” Dr. Attar pointed out that in this case, the patient should be evaluated as a whole. He stated that both the evaluation and treatment of endometriosis patients should be carried out in line with this contemporary approach, otherwise, patients may not benefit from the given treatments sufficiently.
Endometriosis, which affects approximately 190 million women in the world, is a very important problem that occurs especially in women of reproductive age. Noting that the incidence of this problem, which manifests itself with pain and infertility, is increasing, Yeditepe University Hospitals Obstetrics and Gynecology, IVF Specialist Prof. Dr. Erkut Attar added: “The development and facilitation of diagnostic methods, together with environmental conditions, urban life, unhealthy food, and nutrition, has recently led to an increase in endometriosis patients.” 

“Endometriosis May Be a Precursor to Other Diseases” 

Stating that endometriosis may be a harbinger of other diseases, Prof. Dr. Attar: “It could be the opposite. If there are other common diseases with endometriosis, endometriosis should also come to mind. ” Drawing attention to the fact that endometriosis can be seen with malaria and allergic diseases other than restless bowel syndrome (IBS), migraine, interstitial cystitis (IC), fibromyalgia, vulvodynia, deep dyspareunia, sleep disorders and oscillological problems such as depression or anxiety, Prof. Attar pointed out that there may be an increase in cardiovascular diseases in endometriosis cases. In other words, while the presence of these diseases may be a precursor to endometriosis, endometriosis may also cause these chronic diseases." 

“Approximately 30% of Patients Have Infertility” 

Stating that infertility is one of the two main findings in endometriosis patients, Prof. Dr. Erkut Attar said, “Infertility is seen in about 30 percent of these patients. In other words, three out of 10 endometriosis patients have infertility problems. "
Prof. Dr. Erkut Attar said, one of the main symptoms of endometriosis is chronic pain. Especially in recent years, with the increasing recognition of the disease, endometriosis can lead to other pain syndromes. Dr. Erkut Attar continued his words as follows:
 “If a woman is in constant pain for 6 months or comes to us with constant menstrual pain, endometriosis is considered here. However, the most important difference in endometriosis is that the pain is chronic, not cyclical. In these patients, pain is experienced for at least three or six months in each menstrual period without a break, and there is no gap between them. However, endometriosis pains are often severe. It is not particularly localized, that is, there is widespread pain in the patient's abdomen, and it is difficult to pinpoint the exact location of the pain because it is not localized. ”

“The Presence of Chronic Diseases Increases the Severity and Prevalence of Pain!”

Reminding that endometriosis has 4 stages and sometimes pain may not be seen in the patient even in the most severe stage, Prof. Dr. Attar said, “This is the interesting part. Why some patients have pain while others do not is still an issue that is being investigated. Because some patients may experience very severe pain even in the early houses of the disease. In addition, if other chronic pain syndromes or psychological problems are added to endometriosis, gastrointestinal problems such as bloating in the abdomen, gas pains, which may also occur in relation to nutrition, on the other hand, frequent cystitis, widespread pain on the piss bag, pain during intercourse, pain in the vulva in the vagina without intercourse, or pains all over the body, which we call fibromyalgia, may be among the symptoms of endometriosis."

“We Need to Treat the Patient As a Whole.”  

Since endometriosis can be seen with some chronic diseases, it is extremely important to diagnose these diseases in treatment, Prof. Dr. Erkut Attar continued his words as follows:
“In these women, gastrointestinal disorders and painful chronic cystitis may sometimes come to the fore, while psychological problems may be at the forefront. Problems such as depression, anxiety, and sleep disorders are common in endometriosis patients. Therefore, the patient should be evaluated and treated together with these chronic diseases we call comorbidity. " 
Stating that laparoscopy is still the gold standard in the diagnosis of endometriosis, Prof. Dr. Attar also added: “Ultrasound, clinical examination, and the information we receive from the patient make a preliminary diagnosis for us, but the definitive diagnosis of the disease is made by a procedure called laparoscopy.”

Endometriosis Patients Can Have Babies

Stating that endometriosis patients can also have babies, Prof. Dr. Attar gave the following information about the treatment approach to be applied at this point:
 “Although endometriosis is usually treated like other infertility patients, surgery has an important place in the treatment of these patients. The ovarian reserve should be evaluated very well before making a surgical treatment decision. Existing chocolate cysts can seriously damage the ovaries; however, incorrect surgical treatments can cause more damage to the ovaries. This balance should be well understood and the treatment to be performed should be decided accordingly. We also make significant use of in vitro fertilization method to achieve pregnancy without resorting to surgical method from women with low reserves. "

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