THE‘endometriosis it is a chronic inflammatory disease that affects up to 10% of women of childbearing agebut which despite the incidence, still suffers from a diagnostic delay estimated between 8 and 10 years. Too long a time which represents not only a health and social failure, but one of the main causes of the chronicity of pelvic pain. On the occasion of World Endometriosis Day, which is celebrated on March 28let’s shine the spotlight on this pathology.
Endometriosis: when it occurs
Endometriosis often manifests itself already in adolescence with dysmenorrhea, or intense menstrual pain, which is too frequently underestimated or considered “normal”. But the pain can also appear outside of the cycle, during sexual intercourse, evacuation and be associated with gastrointestinal disorders. «Don’t give the pain time to become chronic. Play early. Take adolescents to a gynecological examination when pain is a disturbance to daily activities. Suffering for being a woman is not right and above all it is not normal. Putting out the fire of neuroinflammation allows you to avoid the pain becoming chronicto guarantee an optimal quality of life”, underlines the Professor Flaminia ColuzziHead of the Onco-Hematology Pain Therapy Center of Sant’Andrea Hospital of Rome and professor at the Department of Medical Surgical Sciences and Translational Medicine ofLa Sapienza University of Rome.
The alarm bells
«We need to make young women especially aware of the meaning of pain during the menstrual cycle, as the main “alarm bell” for endometriotic lesions. Most women diagnosed with endometriosis report dysmenorrhea in adolescence. There are criteria for distinguish primary dysmenorrhea, which physiologically accompanies menstruation, versus pain, with pathological significancewhich hides an underlying pathology. The gynecologist is the reference figure for framing the individual case and for making an early diagnosis, which avoids the unpleasant consequences of this disease. The gynecologist will identify the most suitable hormone therapy to control the pathology» explains Professor Coluzzi.
Endometriosis: what are the warning signs to pay attention to
Neuroinflammation and the sensation of “fire”
Scientific literature in recent years has underlined the crucial role played by neuroinflammation in central sensitization and chronic pain. «At each menstruation, part of the endometrial tissue debris seems to follow a retrograde path that leads them along the tubes, until they are deposited in the pelvic cavity. These would represent a powerful trigger that stimulates the activity of specialist cells, called mast cells, which physiologically have a sentinel role in defending the organism from possible external insults. When activated, mast cells release proinflammatory cytokines, which they sensitize small peripheral nerve fibers and trigger neuroinflammation processes» adds the expert.
Endometriosis: possible therapies
«Neuroinflammation is a natural protective process for our bodybut clearly it can transform into something pathological when continuous stimuli amplify its function. Nature, however, also comes to meet us with a therapeutic possibility to control neuroinflammation. The most extensively studied substance is palmitoylethanolamidewhich our body produces physiologically, but which can prove lacking in chronic conditions, such as endometriosis. Exogenous administration is an effective and safe strategy to control symptoms. Since it is not easily absorbable in our intestine, it is ultramicronized. In pelvic pain, the association with substances with anti-inflammatory and anti-angiogenic action may be usefulin particular in forms linked to endometriosis, dysmenorrhea and dyspaurenia (pain during sexual intercourse)”, concludes Professor Coluzzi.
