关于内野痛和您的时期的真相

Endometreosis occurs when tissue similar to one lining your uterus starts growing outside of it, usually in the pelvic area. Every month, this tissue thickens, breaks down and bleeds, which over time causes inflammation, scarring (a.k.a. lesions) and pain. For some women, the pain or the bleeding (or both) is so bad they can’t leave the house, says Kristin A. Riley, M.D., a physician and surgeon at Penn State Health Obstetrics and Gynecology, in Hershey, PA. “Sometimes patients will say, ‘I miss two days of work or I miss two days of school every month.’ That's not acceptable,” she says.

“Often endometriosis can run in families,” says Dr. Riley, adding that patients will sometimes admit that their moms or sisters have had bad periods, too. Doctors suspect there’s a genetic component to endometriosis, although it’s still not entirely clearly which genetic mechanisms are at play, or how these genes or variants are passed down. But scientists may be narrowing it down. After analyzing the genetic profile of women who had close relatives with endometriosis, British and American researchers think they’ve found the particular gene, known as NPSR1, that could up the risk of endo pain.

Riley博士说，有些患者的疼痛急切，刺伤或不良抽筋。她说：“其他人有很多腹胀和很多胃肠道症状。”这些胃肠道症状可能包括便秘或腹泻或大量气体。在您期间，胃肠道症状也很常见。原因：内托组织可以在身体的其他部位生长，包括直肠，腹膜和结肠，从而导致那里的病变。这些症状与肠易激综合症（IBS）或其他胃疾病非常相似，以至于女性可能被诊断出患有这些疾病而不是子宫内膜异位症。

“The classic presentation of endometriosis is pain that worsens around the time of your period,” says Dr. Riley. But while that’s true for most patients with endometriosis, “there are other patients who don't fit that description and end up having endometriosis as well.” Some women have pain while having sex, peeing, or pooping. Painful BMs or urination (or bloody stools or pee) mean you have lesions near your rectum or on your bladder. That’s why it’s good to spell out where and when you have pain or blood to your providers, as it’s a good clue as to where you might have endo tissue.

Sometimes what looks like endo might be a condition known as adenomyosis, says Jeannie Kim, M.D., associate professor of obstetrics and gynecology at Columbia University Medical Center in New York City. That’s when the wayward uterine tissue grows deep inside the muscles of the uterus. One symptom is heavy bleeding or irregular bleeding during ovulation. It might be adenomyosis—or you might have endometriosis along with adenomyosis, says Dr. Kim. Complicating matters, adenomyosis is rarely picked up on ultrasound or MRI, meaning it is usually only diagnosed at the time of a hysterectomy.

For some, the longer they have endometriosis, the more issues they’ll have. The pain can get worse, and sometimes goes hand in hand with other issues, like abdominal wall or pelvic floor pain along with GI and bladder issues. Says Dr. Riley, “It’s not directly endometriosis causing that, but it's a downstream effect of inflammation and untreated pain.” Your body’s response to pain causes the muscles in your abdominal wall or pelvic floor to contract involuntarily. “Then that can cause things like bladder dysfunction or severe pain with intercourse, because those muscles are squeezing all the time,” she explains.

子宫内膜异位症以截然不同的方式影响人们。例如，一些骨盆病变很少的患者可能会出现严重的疼痛，而其他患有非常晚期病例的患者可能会出现轻度的症状。Kim博士解释说，这个谜团背后的理论是子宫内膜异位症是一种中心神经性疾病，它意味着您的大脑和脊髓过程的疼痛以一种过敏性的方式，这可能会因一个女人而异。她说，另外，骨盆病变可能只是系统的一部分，这也可能影响您的胃肠道，膀胱和肌肉。

子宫内膜异位症is a chronic inflammatory condition, meaning you’re in it for the long haul. On the other hand, sometimes you can catch a break from your symptoms, says Dr. Riley. “People can have a long period of time where they have bad periods or bad pelvic pain, but sometimes it goes quiet,” she explains. Then after a while, without warning symptoms can come roaring back. What gives? “There are a lot of factors that we don't understand still,” she admits. “Environmental factors, genetic factors, does stress play a role? Nobody really understands all those things yet.”

尽管女性对子宫内膜异位症的症状变得越来越直言不讳，但您可能仍然不愿意与提供者提出任何问题。“有时人们害怕说话，他们只是处理很长时间。但是，您不应该错过对您重要的事情，也不应该有那么严重或痛苦或严重的出血，以至于无法过自己的生活。”赖利博士说。不感受到您的初级保健提供者的爱吗？将您的担忧转移到子宫内膜异位症专家或中心，在该专家中，OB/Gyns与其他专家合作，提出解决所有症状的治疗方法。

Kim博士指出：“子宫内膜异位症是一种复杂而困难的病，也需要大量支持。”因此，您想要一个真正听您的提供商，并且可以与您建立开放的关系。她补充说：“这是您护理的重要组成部分。”同样至关重要：查找特定于特定的支持小组（IRL或在线）或您所在地区的其他患者可以提供提示和建议。是的，每个女人的内部经历都是独一无二的。但是，当您与其他人分享您的旅程的人时，您会发现挑战的共同点，并在提出问题时感到很自在。在您附近找到一个支持小组子宫内膜异位症.