Patient's question:
Please ask, in addition to the possibility of uterine fibroids causing irregular menstruation, are there any other serious consequences? Will it be an ectopic pregnancy during pregnancy?Doctor's answer:
Under normal circumstances, the endometrium covers the uterine cavity. If, due to certain factors, the endometrium grows in other parts of the body, it can become endometriosis. This ectopic endometrium, both histologically and functionally, not only contains endometrial glands but also endometrial stroma. Functionally, it shows significant changes with estrogen levels, varying with the menstrual cycle, but only partially under the influence of progesterone, which can produce a small amount of "menstruation" and cause various clinical phenomena. If the patient becomes pregnant, the ectopic endometrium may undergo decidual changes. Although this ectopic endometrium grows in other tissues or organs, it differs from the invasion of malignant tumors. The peak incidence of this disease occurs between the ages of 30 and 40. The actual incidence of endometriosis is far higher than what is clinically observed. If a laparotomy is performed for other gynecological diseases and the removed uterine adnexa specimens are examined carefully pathologically, it can be found that approximately 20–25% of patients have ectopic endometrium.【Etiology】
I. Implantation Theory The earliest theory (1921) proposed that the occurrence of pelvic endometriosis is due to endometrial fragments following menstruation backflow through the fallopian tubes into the pelvic cavity and implanting in the ovaries or other pelvic locations. Clinically, during laparotomy during the menstrual period, blood can be found in the pelvis, and endometrium can be detected in the blood. Post-cesarean scar endometriosis is a good example of the implantation theory.
II. Serous Membrane Theory Also known as Metaplasia Theory, it suggests that pelvic and ovarian endometriosis are derived from the metaplasia of the mesothelial layer of the peritoneum. The paramesonephric ducts are developed from the invagination of the primitive peritoneum and are related to the development of the ovaries.