Gynecologist and fertility specialist, François-Xavier Aubriot explains on Europe 1 the symptoms and treatment of endometriosis, a widespread disease in women of childbearing age, but whose diagnosis is still far from systematic.

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In France, one in ten women has endometriosis. However, this disease has long been ignored, and its diagnosis is still far from systematic. How to recognize the symptoms? What treatments should be considered, given the age and lifestyle of the patients? Is it transmitted from mother to daughter? François-Xavier Aubriot, gynecologist and specialist in fertility, publishes this autumn Endometriosis (Mango Editions), a simple guide to explain this complex disease. He answered this Monday the questions of Mélanie Gomez.

Endometriosis, what is it?

Endometriosis is an endometrial disease, the lining of the uterus. "The cells that compose it migrate to implant abnormally to the belly and ovaries," says François-Xavier Aubriot. These cells remain sensitive to hormones, and therefore bleed like the rest of the endometrium during the menstrual period. But since it is not in the womb, this blood can not be evacuated naturally. This causes lesions, causing pain sometimes very intense.

Where does this disease come from?

The origins of this disease are still unknown. Some factors may, however, favor its appearance. "There is a little hereditary character When endometriosis is found in the family history of the first degree, the risk of developing it is about six times greater," observes François-Xavier Aubriot. A girl whose mother suffers from endometriosis therefore has every interest in talking to a doctor to be supported as soon as possible.

Other factors: endocrine disruptors, present in our diet, or in fertilizers for example. "This disease is an estrogen-dependent disease, and it's possible that these elements increase the estrogen levels in the body."

What are the symptoms ?

The main symptom of endometriosis is pain. "Having pain during your periods is not normal," says François-Xavier Aubriot. "You have to learn not to trivialize this symptom, and to look more systematically behind endometriosis." According to him, 50% of women with painful periods have endometriosis. Pains can also appear at other times in the cycle, especially during ovulation.

In case of pain, it is necessary to turn without hesitation towards a general practitioner or a gynecologist. Additional examinations can then be performed. "One can practice ultrasounds or MRIs, knowing that these examinations find mostly signs of deep endometriosis.The so-called superficial endometriosis, in the form of small lesions inside the belly, is not necessarily noticeable. "

What are the treatments to consider?

"At each age treatment because at each age his concern," says François-Xavier Aubriot. "In adolescence for example, the main concern is often at the level of pain." In this case, the contraceptive pill remains the most effective way of soothing patients. And for those who do not want hormone treatment, the pain can be relieved by a set of anti-inflammatory, analgesic and anti-spasmodic.

Endometriosis can also affect women's ability to conceive. "In case of infertility, endometriosis is found in nearly 35% of cases, and conversely, a woman who suffers from endometriosis risks infertility in 30 to 50% of cases." But beware, infertility does not mean sterility.

"Endometriosis lowers fertility, but in most cases, it does not prevent women from conceiving naturally." Medical assistance to procreation can be offered to patients. In general, the time of pregnancy is a moment of respite in the disease. And in some cases, the improvement persists in the months that follow. "It is not uncommon for a first child to be conceived with medical help and a second child to be born naturally.

Surgical treatment of endometriosis is also possible. it helps to eradicate the lesions that cause pain. "It helps to treat a lot of endometriosis, especially cases where they are not too deep." Because the greater the number of organs affected by endometriosis, the greater the potential for sequelae. "We must carefully weigh the pros and cons before considering an operation," says François-Xavier Aubriot. At menopause, endometriosis generally regresses significantly. "We still have to watch these women, because some people continue to have pain."