Vivian Ferreira do Amaral by Carlos Alberto Petta
Carlos Alberto Petta: Hello everybody. My name is Carlos Petta. I am from Brazil and a board member of ISGE. At this time, we are here in Sao Paulo, where we are having our joint meeting with ISGE and The Brazilian Society of Endometriosis. One of the things that is very concerned for everybody and our whole population is endometriosis in adolescents. This is a growing problem and we have here now Dr. Vivian Amaral, she works in Brazil, in the south of Brazil in the city of Curitiba. Dr. Vivian, how do you see endometriosis in adolescents, is it a real problem the symptoms are starting early in the life of a woman. How do you feel this problem?
Dr. Vivian Ferreira do Amaral: Well, hello, we have about six million women with endometriosis in Brazil, without saying that they are adolescents, but one important thing is prevention. Nobody focussed the dysmenorrhea since early menarche. So we should make some questions with them. Take care of the symptoms, early symptoms and give them some suggestions on changing lifestyles and start looking for the disease.
Carlos Alberto Petta: What is your impression and data on diagnosis delay on this population?
Dr. Vivian Ferreira do Amaral: They take about five to seven years to have the diagnosis. In adolescents, we believe, we have 60 to 80% girls having endometriosis, but they take 7 to 12 years to make diagnosis. So, when they are found out they have not the early stage, but you know, deep disease.
Carlos Alberto Petta: What would you have advise for those youngsters that have a relative with endometriosis and have some symptoms?
Dr. Vivian Ferreira do Amaral: They should go to gynecologists and say what they feel. They should change their lifestyles like having nutrition, adequate nutrition, so hard to do for adolescents, but they should do, exercises are important. If they have symptoms, they should be investigated.
Carlos Alberto Petta: Any special type of exercise, dieting, do you think is important?
Dr. Vivian Ferreira do Amaral: Aerobics is very important for pelvic pain physiologically they work and they should alternate. It depends on the age. Today, we have certain exercise for specific area and for specific age earlier and later like basketball for the young ones or even swimming and all the stuff.
Carlos Alberto Petta: What about laparoscopy in this woman, is it the first choice. Do you think the first choice is using oral contraceptive or non-steroidal anti-inflammatory drugs is done, what on imaging, how do you decide, what to do with dysmenorrhea?
Dr. Vivian Ferreira do Amaral: It depends on the symptom. Your clinical exam, your ultrasound and exams, laboratory exams, if you do not find anything, you should make on at least a therapeutic test, three to six months, it could be with oral contraceptive. If it does not get better, when you suspend it, you should think about endometriosis or you could get some marker like CA-125 and ultrasound suggests endometrioma or any type of deep endometriosis, they should be, we should plan before the therapeutic stuff. We should take it to the surgery and whatever.
Carlos Alberto Petta: How does it relate to emotional symptoms?
Dr. Vivian Ferreira do Amaral: They are very important because can you imagine a women, 5 to 12 years every single month with pain, a pelvic pain, five to seven days, each month. Can you imagine that? The family cannot support them. So they cannot work, it might be hard. So, depressive symptoms start to appear because everybody else around her looks at her like she is something strange because every single time she has got something different.
Carlos Alberto Petta: In fact, what we see is that endometriosis will cure in adolescents. So it is very important to think about this diagnosis, to be careful with these young women, we can prevent severe cases in the future or we can change their lifestyle and their life quality and probably to improve their quality of life and the control and treatment of a possible disease. I would like to thank Dr. Vivian Amaral from Brazil and we hope you will continue your research and looking forward in your research taking care of adolescents in your country. Thank you.
Dr. Vivian Ferreira do Amaral: Thank you. Bye-bye.
