Unlike the past, Endometriosis now is a overtalked disease. I remember when,in an old article, I stated the importance to better understand this disease and the need to spread information about it in particular among women. Women awereness played an important part in the fight against Endometriosis and it led to a better understanding of the disease, to a more timely and early diagnosis and to a creation of many patients organizations.
Although the work made, in my opinion the situation in some countries is dramatic. Indeed, despite fund raising, events and demonstrations, Endometriosis like others important problems is underestimated and patients are left alone.
Advances in both surgical and medical therapy act as a counterbalance to the lack of preferential and codified healthcare protocols for a disease affecting reproductive system and quality of life in general even in young patients.
In addition, it is undeniable that the confusion and the proliferation of those who seem to have miraculous solutions are increased, even about a disease for which pathogenetic mechanisms (etiology and etiopathogenesis) are little known.
Now would like to illustrate two essential points:
– Endometriosis prevention: Does it exist?
– What is the best treatment for Endometriosis?
A “Primary” prevention, i.e. that avoid the disease onset, does not exist; I highly doubt those who suggest certain alimentary styles. There is a “Secondary” prevention: an early diagnosis based on the symptoms identification and the undertaking of routine tests as gynecological tests, pelvic and transvaginal ultrasound and CA 125 monitoring. It is a long time I advocate that Endometriosis must be controlled because it unfortunately is a very common disease. An early diagnosis lets effective therapeutic strategies and good chances of reproduction.
About treatment, this subject is very complicated. I need to clarify that it does not exist a therapy better than others but there is a better therapeutic synergy than others. A very significant and incontrovertible fact is that Endometriosis is susceptible to hormonal therapy and medical therapy (often endocrinological) is not absolutely antithetical to surgery and vice-versa.
Over the years highly effective drugs were successful used in the short-or long-term therapy against this disease like normal birth-control pills, GnRH Analogues (temporary menopausal condition drugs), progestinic pills and progestins androgenic hormones, modern progestinic molecules as dianogest and the access to intrauterine devices.
Thanks to surgical therapy development of a particular minimally-invasive laparoscopic surgery method, to the increasing awareness of excessive aggressions on small damages and to a greater attention to ovaries as endocrine-reproductive organs, the need of repeated and destructive surgeries has become sporadic.
Today, a good modulation and a good synergy between therapies could lead to excellent results of the problem even for women at a late stage of Endometriosis.