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No programa “CheckUp Sod”, a história de Soraya, uma jovem diagnosticada com endometriose, é compartilhada. Após meses de dor intensa e testes médicos, ela descobriu a condição que afetou sua fertilidade. Com apenas 23 anos, Soraya passou por uma cirurgia e, após tratamento, conseguiu engravidar, trazendo esperança para muitas mulheres que enfrentam desafios semelhantes. A […]
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00:00Hello, good morning.
00:02Our health checkup is now starting,
00:04a program that puts you face to face
00:06with the greatest health experts in Espírito Santo.
00:15Soraya, young and starting a new life,
00:17had just moved to another state
00:19when she started making her first plans to get pregnant.
00:22I decided to stop taking birth control pills
00:25because I thought the pill could be the problem, right?
00:27And then, when I stopped taking birth control pills,
00:31my pains started to increase.
00:33And it didn't take long for them to become a constant nuisance.
00:37There was pain during intercourse, pain, pelvic pain,
00:40abdominal pain, paranasal pain, a lot of pain.
00:43The pregnancy didn't happen either.
00:45Soraya went to more than one specialist
00:48and underwent several tests
00:49until she received the diagnosis she had been waiting for.
00:52She had endometriosis.
00:54At just 23 years old, she underwent surgery.
00:58At least the result, the main objective,
01:01which is for you to have no pain.
01:02We have already achieved and preserved your beginnings,
01:05preserved your organs.
01:06The treatment continued after the surgery,
01:09but a month later she was able to resume her plans
01:11to have a baby.
01:13It wasn't quick, it wasn't easy,
01:15but just look at Serena's big smile
01:17and you'll know that this story had a happy ending.
01:20I didn't react because, like,
01:22I couldn't believe it was really happening
01:24because it had already been seven months.
01:26I kind of said in the seventh month,
01:28I said, oh, it hasn't come yet,
01:29it's because I don't think it's supposed to come.
01:31Quote,
01:31Well, guys, how cool is this story, right?
01:34After going through so many challenges,
01:37you can see Serena like this,
01:38look, healthy, playing around,
01:40giving you a little bit of work too, right?
01:43Of course.
01:45But do you think this story ended there?
01:48It didn't.
01:49That's because there's some news
01:51that I'm going to let Soraya tell you.
01:54Selena was promoted to big sister,
01:56right, daughter?
01:57We have baby due on the way.
01:59According to the Brazilian Endometriosis Society,
02:02one in every 10 women suffers from the problem in Brazil.
02:0630% of cases lead to infertility
02:09and 57% of women diagnosed with endometriosis
02:12experience intense pain.
02:16Medical monitoring is essential,
02:18but another secret to alleviating
02:20the discomfort of the disease is diet.
02:25Three foods that are really very common in Brazilians,
02:28consumption are white flour, red meat and sugar.
02:34We ask them to drastically reduce these.
02:37We eliminate them from the patient's routine.
02:39But of course, on the other hand,
02:41there are also practical examples of foods
02:43that are beneficial.
02:45For those who don't like them
02:46or can't adapt to them,
02:48supplementation can also be an option,
02:50such as
02:51sucking on grapes,
02:53eating the skin of purple grapes,
02:54which is where the source of resveratrol is,
02:57turmeric with white pepper,
02:59with black pepper,
03:00and including lots of vegetables,
03:02portions of vegetables.
03:04Why?
03:06Yellowish, red and orange vegetables
03:08are rich in antioxidants.
03:12So, making a salad isn't just a simple lettuce and tomato salad like we're used to.
03:17It's a really colorful salad.
03:20The Espirito Santo Health Department said that patients diagnosed with endometriosis are currently
03:26referred to specialized gynecology outpatient care.
03:30In addition, it has invested in technology and developed studies to update the line of care in the treatment of
03:36the disease.
03:3820 video surgery towers that promise to offer more precision to the procedures have already been purchased.
03:45There is a goal of creating a referral center for endometriosis with a multidisciplinary team that includes specialist doctors,
03:53surgeons, nurses, pharmacists, and also psychologists.
03:58Soraya still treats the disease today,
04:01but the example of her story brings hope to those facing the same problem.
04:05One woman shares it with another, right?
04:07Because otherwise we'd think it's just us.
04:09We'd think we're going crazy,
04:10because no one understands.
04:12You're in pain just because you're menstruating.
04:14How can that be, right?
04:15Like, everyone, everyone,
04:17for so many years,
04:18all women menstruate and you can't work.
04:20You can't do anything because you're menstruating.
04:31Welcome to Checkup Saad.
04:34Endometriosis is a chronic inflammatory disease that can affect several organs of the skin.
04:39By 2025, the Ministry of Health estimates that more than 7 million Brazilian women will have the disease.
04:47Singers Anita, Kelly Kay, and actress Larissa Manuela are some of the celebrities
04:52who have already revealed that they have endometriosis and talked about the difficulties they faced.
04:59Early diagnosis is one of the biggest challenges,
05:02and many women take up to 10 years to have their diagnosis confirmed.
05:06Poor thing.
05:08The hardest challenge was not playing a soap opera villain.
05:12If you want to stay here, work and pay me.
05:17Brenda had to suddenly face something that was still unknown to her.
05:24At first it was a shock because at that time it was a completely unknown disease
05:28and in my case it was already advanced.
05:31So my treatment was surgical.
05:35And it's not hard to find people who went through this pain.
05:39Other artists like Kel, Larissa Manuela,
05:42and Anita used their fame to raise awareness among their followers.
05:45It got worse, and over time it got worse, and worse, and worse.
05:50And then I reached a point where I was already feeling pain like this for no reason.
05:57The attitude of these artists made many people seek information about the disease
06:01and know that they are not alone.
06:06It is estimated that endometriosis affects around 180 million women worldwide,
06:127 million in Brazil alone.
06:15This information is useful for young people to get more and more tests to detect the disease.
06:22In today's health checkup, we spoke with gynecologist Dr. Laysa Borges
06:27and imaging diagnostic specialist Dr. Larissa Galvao.
06:32Welcome.
06:33Thank you, Alice, for your invitation.
06:35It is a pleasure to be here to talk about endometriosis, right?
06:38Which is a disease that I dedicate myself so much to.
06:43I think the most interesting thing, right, Dr. Laysa,
06:47is that sometimes it is a disease that presents symptoms, but it remains silent, right?
06:53So tell us how it develops in the body, what endometriosis is, these celebrities talk about it.
07:00Sometimes there are people at home with the same symptoms and have no idea that they have endometriosis.
07:07When we talk about endometriosis, we are talking about a disease characterized by the endometrium being out of place, right?
07:17The endometrium is the cavity, it is the layer that lines the uterine cavity,
07:21and it is the layer that peels off during menstruation.
07:27And because endometriosis is a very complex disease, there are several theories that justify it,
07:33but the most accepted one is that part of this endometrium,
07:36when it is externalized during menstruation,
07:39also has a part that flows back through the fallopian tubes and falls into the pelvic cavity.
07:47So, instead of the woman menstruating normally,
07:50this blood would be going to other places where it shouldn't,
07:53instead of the normal exit there during menstruation.
07:57And that is what would cause the problem.
07:59So it is a disease that only affects women, more or less.
08:03There are reports in the literature that endometriosis has already been found in men,
08:07which is why it is a complex disease and there are several theories to explain it, right?
08:14So, there are other theories that say that the origin of endometriosis is different,
08:19right, from stem cells.
08:21Anyway, from a series of other possibilities.
08:24But this is the most accepted and it is even a theory that we use to determine the treatment later.
08:31But, like, these women, when they menstruate,
08:34part of the endometrium flows back into the pelvis.
08:38And what we know is that this happens to all women,
08:41but not all of them develop endometriosis.
08:46And so what we have, right, in the literature,
08:49is that the women who will develop it are women who have receptors for these cells in their pelvis
08:53and this can be genetically determined.
08:57So if you are at home and have menstrual cramps,
09:00let's see if it is possible to determine whether all cramps are endometriosis or not.
09:04What are the symptoms?
09:06We'll tell you about it soon.
09:07And we want to know how this diagnosis is made.
09:10Doctor, tell us.
09:13Well, the diagnosis of endometriosis begins in the gynecologist's office
09:18with active listening to the patient's symptoms.
09:20What symptoms?
09:22It's the cramps, usually menstrual cramps,
09:25disabling, strong, pain during sexual intercourse.
09:28Today we know, Alice,
09:30that endometriosis is a systemic disease related to more than 40 symptoms.
09:36So, abdominal distension, leg pain, back pain, fatigue, right?
09:42These patients are more tired, more prone to depression.
09:46So, we have to pay attention to all of this.
09:50Well, once the diagnosis is made, which is clinical, right?
09:55According to the patient's symptoms,
09:57she will then receive a physical exam,
09:59which when performed by a specialist doctor,
10:02we can feel the focus of endometriosis by vaginal and rectal examination.
10:09And thirdly, she will receive an image that can be either a transvaginal ultrasound with bowel
10:14preparation, which is the method I use, or a pelvic MRI.
10:19The most important thing is to always have the exam performed by a specialist.
10:24And even if there are no findings in the imaging exam,
10:27we cannot say that this patient does not have endometriosis.
10:32We need to value her symptoms and treat this patient appropriately.
10:38This issue of pain is very subjective,
10:40and it seems that since menstruation,
10:42we women are led to believe that it is normal to feel pain when menstruating,
10:46that cramps are expected.
10:48Especially in young women who are starting, right,
10:51the process of their first menarche, their first menstruation.
10:56And living with this and understanding what is normal and what is not normal.
11:01When this pain, ah, the person at home listening to us can interpret that it is a pain that is
11:06not normal,
11:07that it could really be linked to, for example, endometriosis.
11:12Is it normal to feel pain every time you menstruate?
11:15No, it is not normal to feel pain.
11:19Well, what you said has a very important impact on the delay in diagnosis, right?
11:25Today, it takes us 7 to 12 years to diagnose endometriosis.
11:29And in this context, this saying, right, from our grandmothers,
11:33mothers, well, no, you will menstruate and it will hurt, that is normal.
11:39Well, I think we have to always individualize, but if that pain is bothering,
11:43ah, limiting the patient's usual activities,
11:46then that patient needs to seek help and needs to understand what is happening.
11:51Not everything is endometriosis, but it is an important diagnostic hypothesis that needs to be ruled out or not.
11:58And then, sometimes, this patient vomits, can't go to school.
12:03And the question that remains is,
12:05this endometriosis that she didn't have when she was young,
12:09can it develop throughout her life as well?
12:12The woman sometimes felt mild cramps or some type of cramp,
12:15but that diagnosis was not made.
12:18Can this come with age or will endometriosis occur from the first menstruation?
12:24Well, the patient won't always have symptoms during her first period.
12:28But do you know what happens very commonly?
12:31The patient who has had cramps since menarche, right, disabling pain, and stops going to school.
12:37This is a warning sign, even in young women.
12:40It's cramps accompanied by vomiting and fainting.
12:45So she goes to a gynecologist who prescribes birth control and,
12:49the patient doesn't investigate.
12:50And the patient is pain-free.
12:53And then, in her early 30s,
12:55when she's about to get pregnant and stops taking birth control,
12:58the pain starts to get worse,
13:00the symptoms start to get worse,
13:02and the investigation begins.
13:04And then her pelvis is already severely compromised.
13:08Can endometriosis cause ovarian cancer?
13:11I'll tell you more about it today on Checkup Sod.
13:14Dr. Larissa, in which cases is surgery indicated?
13:18An interesting question.
13:20Well, there are specific sites of the disease that indicate surgery, right, Alice?
13:25Like, for example, endometriosis affecting the appendix, right?
13:30Because we cannot tell from the image whether it is endometriosis or appendiceal cancer.
13:37Another situation is endometriosis affecting the hymne or a part of the intestine with a higher risk of obstruction.
13:47Or endometriosis affecting the ureter with a risk of obstructive disease and the patient ends up losing a kidney due
13:53to a focus of deep endometriosis.
13:57And last but not least, when the patient does not respond to conservative treatment.
14:04So, a patient who is following a diet suitable for someone with endometriosis and physical exercise,
14:10stress management, sleeping well, are all very important pillars in the treatment of this disease.
14:16Consider hormonal blockade and even so she has a lot of pain, she has a lot of symptoms.
14:22In this case, we also consider surgery.
14:26Doctor, and how does endometriosis affect the patient's fertility?
14:31Is it true that a person can lose the chance of getting pregnant because of this disease, if it is
14:36not treated?
14:37Yes.
14:38In fact, as a specialist in assistive reproduction,
14:42I see women every day who have difficulty getting pregnant and are not aware of the diagnosis of endometriosis.
14:50However, during the investigation, when we perform the tests that Dr. Larissa mentioned,
14:55we then diagnose endometriosis.
14:59And then, of course, it will depend a lot on the severity of the disease, right, and the age of
15:05the patient.
15:06But as a rule, the way in which endometriosis will affect fertility is based on this effect that we mentioned,
15:12of being an inflammatory disease and causing oxidative stress.
15:19So, the inflammatory mediators will make the pelvis weaker so that the egg can meet with the sperm,
15:25thus impairing fertilization.
15:29Furthermore, when the foci of endometriosis compromise the fallopian tubes,
15:34we can have anatomical changes, tubal obstructions preventing this meeting,
15:39and it can also compromise the ovary.
15:43In the ovary, it can cause changes in the quality of the eggs.
15:48Well, the endometrium itself, we now know that endometriosis also has an immunological role.
15:54So, when the embryo is implanted,
15:56the endometrium of a patient with endometriosis is different from that of a patient who does not.
16:02So, we have less endometrial receptivity.
16:05So, in fact, endometriosis acts on several points, right, in the reproductive system, impairing fertility.
16:15A study indicates that women with endometriosis have a 20% greater chance of developing cardiovascular diseases.
16:23So, let's see the report.
16:26The unbearable pain left Roberta Bedred and many times.
16:31It's
16:33A pain like having a knife stuck in it.
16:39It's a constant and intense pain.
16:43It's not a muscular pain, because since it's in places with nerve endings,
16:47it's a very strong pain, and it seriously compromises her quality of life.
16:54It took 15 years for her to be diagnosed with endometriosis.
16:59At the time, Roberta had surgery to remove the foci that were already in her intestine.
17:06I went to several doctors, gynecologists, gastroenterologists,
17:11and I was even hospitalized because I was passing blood.
17:15They even considered celiac disease, irritable bowel syndrome, and several other things,
17:21but nothing was discovered.
17:25Endometriosis is a chronic inflammation in which menstrual blood accumulates in the organs of the
17:29abdomen, especially near the intestines, bladder, and ovaries.
17:34Imagine that here is the uterus, fallopian tubes, ovaries, and cervix.
17:38Here is the vaginal canal.
17:40So when this patient menstruates and the blood comes out through the vagina,
17:44there is a retrograde flow and then this blood flows back here in the fallopian tubes,
17:48in the ovaries and falls here in the belly.
17:52In rarer cases, this blood can leave the abdominal cavity, reaching the brain.
17:58A year after the surgery, Roberta was diagnosed with endometriosis again.
18:05This time, the inflammation was in the liver and the diaphragm, the main muscle of respiration.
18:13Some days I am fine, I feel fine and other days I am in a lot of pain.
18:18And a very simple medicine.
18:20A painkiller does not work.
18:23In addition to pain, endometriosis can lead to infertility.
18:28Around 30% of patients are unable to get pregnant.
18:34Medicine cannot explain the cause of the problem,
18:37but there are studies that indicate that the combination of genetic, immunological, and hormonal factors
18:42can contribute to the development of endometriosis.
18:47It is estimated that 1 in every 10 patients of childbearing age has endometriosis.
18:54In Brazil, there are more than 7 million women who live with pain,
18:58difficulty getting pregnant and risk of heart problems.
19:03That's right.
19:05Scientists have concluded that women who have endometriosis are up to 20% more likely to
19:10have a heart attack or stroke.
19:14The study conducted in Denmark followed more than 300,000 women for 16 years.
19:22Scientists divided the patients into two groups,
19:25those with endometriosis and those without the disease.
19:29They focused on relating endometriosis to possible heart problems,
19:34such as arrhythmia, heart failure and heart attack, as well as stroke.
19:39Now, when we talk about the risk of heart attack or stroke,
19:42we are not thinking about clogging the blood vessels with endometriosis cells.
19:46We need to understand that because it is a systemic lesion, a systemic involvement,
19:51all the vessels in the patient's body, from head to toe,
19:54have a compromised, inflamed, oxidized inner lining.
19:59And this increases the chance of the blood having difficulty passing through there,
20:03becoming turbulent and then causing a thrombotic event.
20:07Therefore, women who suffer from endometriosis need more rigorous monitoring of their health.
20:15We need to measure some blood tests during routine appointments
20:19to assess how compromised this system is, how inflamed the patient is.
20:25I will definitely talk to the doctor to do the most specific tests possible.
20:30Dr. Laysa, but let's also bring hope to women who are going through this situation.
20:36What treatments are available today for patients who are trying to get pregnant and have endometriosis?
20:44When we talk about treatment, right, just as the diagnosis is complex, right,
20:49the treatment is not a cake recipe either.
20:53So, we always need to consider some criteria that are the main ones.
20:59So, first, whether or not this patient has
21:02EH, superficial endometriosis,
21:05deeper endometriosis and also what is the age of this patient.
21:11In addition, it is very important when we find a diagnosis of endometriosis,
21:16to remember that we are talking about a couple in this case.
21:20So, we need to investigate all the other possible factors
21:24that can also cause infertility in addition to endometriosis.
21:29We are going to take a break and I will be back in a moment to talk about myths and
21:33truths.
21:33Is all cramping a sign of endometriosis?
21:37Wait for me.
21:50We are back with the health checkup.
21:52We are going to talk about myths and truths in endometriosis.
21:56Dr. Every woman with cramping has endometriosis.
22:00Myth or truth?
22:01Myth.
22:02There are other diseases, right, that can also cause pain, EH, such as gastrointestinal alterations, EH,
22:09ovarian cysts, adenomyosis.
22:12The important thing is to consider this patient's pain and investigate what is happening.
22:16Dr. Laysa, endometriosis can cause infertility.
22:20Is this a myth or a fact?
22:22True.
22:23But not every patient with endometriosis is infertile, right?
22:27So, we have patients who have the diagnosis but are able to get pregnant.
22:31The pain is always proportional to the severity of the disease.
22:36It's true, doctor, that's a myth.
22:39In fact, we have a saying about endometriosis that goes like this.
22:43In endometriosis, size doesn't matter.
22:46So, very small lesions can cause a lot of pain and sometimes the patient with a pelvis
22:51completely affected by this disease doesn't feel anything at all.
22:56Can pregnancy cure endometriosis?
22:58Myth or truth?
23:00Myth.
23:02So, pregnancy can even stop the progression of the disease, because during the period when
23:07the patient's condition is serious, she won't menstruate, but the foci will remain there
23:12on the skin.
23:14Guys, pay attention to this important message for women.
23:18Anyone with symptoms of endometriosis should go to the nearest health center.
23:23That's where all care begins.
23:26Treatment is offered free of charge by the SUSE and it is the doctor who evaluates and defines
23:31the best treatment for each patient.
23:33Look for a health unit in your neighborhood.
23:36I'll be here.
23:37You can watch the program again on Folia Vitoria's YouTube channel.
23:41Next week there will be another health checkup at 10.30.
23:44I'll be waiting for you.
23:45Thank you, Dr. Lisa.
23:47Thank you, Dr. Larissa.
23:48Thank you, Alice.
23:49It was a pleasure.
23:51Have a good Sunday, everyone.
23:52Have a good Sunday, everyone.
23:52Have a good Sunday, everyone.
23:55Have a good Sunday, everyone.
24:02Have a good Sunday, everyone.
24:02Have a good Sunday, everyone.