Apesar de não ter cura, o problema pode ser tratado para que as mulheres tenham uma melhor qualidade de vida
Você sabe o que é a endometriose? É um dos distúrbios ginecológicos que mais comprometem a saúde da mulher em idade reprodutiva. A doença acomete mulheres no período reprodutivo por estar associada à presença dos hormônios femininos, que são fundamentais para o desenvolvimento do endométrio. Vários estudos indicam aumento na incidência da endometriose nos últimos anos.
Caracterizada pelo crescimento fora do útero da camada que reveste internamente a cavidade uterina, chamada endométrio. Manifesta-se com mais frequência nos ovários e na cavidade peritoneal, mas pode ser encontrada em cicatrizes cirúrgicas, no intestino, na bexiga e até nos pulmões. É provável que não exista uma única causa e sim uma série de fatores atuando simultaneamente para o desenvolvimento da doença.
A participação de fatores autoimunes no desenvolvimento da endometriose é uma das hipóteses recentes mais aceitas. Outra teoria inclui o refluxo tubário ou fluxo retrogrado, verificado quando o endométrio sai pelas trompas e implanta na cavidade abdominal, ou seja, fora do seu lugar natural, que é o útero.
“Muitas mulheres apresentam esse fluxo retrógrado, mas não necessariamente desenvolvem a endometriose. Acreditamos que fatores genéticos contribuam para que as células da membrana, mesmo que fora do seu habitat natural, encontrem ambiente propício para o seu desenvolvimento. Cerca de 10% das mulheres em idade reprodutiva, no mundo, sofrem com a doença, ou seja, a doença acomete uma em cada dez mulheres em idade fértil.”, explica o doutor Júlio Cesar Rosa e Silva, ginecologista, professor da Universidade de Medicina de Ribeirão Preto (USP), diretor científico da Sociedade Brasileira de Endometriose e presidente da Comissão Nacional Especializada em Endometriose, ligada a FEBRASGO (Federação Brasileira das Associações de Ginecologia e Obstetrícia).
SINTOMAS
Os sintomas mais comuns da doença estão relacionados à dor, em alguns casos já na adolescência. São cólicas menstruais muito fortes, desconforto na hora da relação sexual, dores e sangramentos quando for urinar e ou evacuar. Muitas vezes essas dores tornam-se constantes, mesmo fora do ciclo menstrual, tornando a mulher incapacitada, comprometendo sobremaneira sua qualidade de vida.
“Outro sintoma pode estar relacionado à infertilidade ou dificuldade em engravidar, 50% das mulheres com endometriose apresentam esse problema. O diagnóstico é feito pelo que chamamos de suspeitas clínicas, que nada mais são que a constatação dos sintomas mais comuns. Temos o exame físico e os exames de imagem, com ultrassom e ressonâncias magnéticas”, fala Rosa e Silva.
O médico complementa que o tratamento, por sua vez, busca o controle desses sintomas, amenizando seus efeitos. “Podemos ter um tratamento clínico, baseado em hormônios e analgésicos, ou, em casos mais avançados, tratamento cirúrgico, quando se removem as lesões, geralmente encontradas na bexiga ou intestino, fazendo com que esses órgãos voltem a funcionar normalmente. A boa notícia é que de 70 a 80% dos casos são tratados com sucesso. A endometriose não tem cura, mas certamente pode ser controlada. Entretanto, temos que ressaltar, ela pode voltar, mesmo depois dos tratamentos”, fala Rosa e Silva.
DIAGNÓSTICO PRECOCE
Para o médico, a melhor forma de lidar com a doença é diagnosticá-la o mais rapidamente possível. “Assim que os sintomas aparecerem, procure um ginecologista. Essa conduta praticamente elimina casos mais avançados, e por consequência, mais graves da endometriose. E o tratamento não se limita ao ginecologista, ele é interdisciplinar. Envolve nutricionistas, psicólogos, terapeutas ocupacionais, fisioterapeutas e educadores físicos. Nos casos de infertilidade, é preciso procurar um especialista, o infertileuta. Ou seja, variáveis como uma boa alimentação, livre de gorduras, e a prática de esportes, por exemplo, certamente irão contribuir para a regressão da doença. Uma mudança no estilo de vida pode ser necessária e, convenhamos, a busca por hábitos saudáveis é sempre bem-vinda”, finaliza Rosa e Silva.
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