Endometriosis Causes Symptoms and Treatment Explained

• Severe, cramp-like menstrual pain
• Chronic abdominal pain, also outside of the period
• Pain during sex (dyspareunia)
• Pain with bowel movements or urination
• Heavy or irregular bleeding
• Unfulfilled desire to have children

The invisibility of the disease not only makes diagnosis difficult, but often leads to a lack of social understanding. On average, it takes between six and ten years in Germany before an endometriosis diagnosis is made. During this time, many sufferers repeatedly experience rejection, misdiagnosis or their symptoms being played down - both in their private environment and in the medical field.

But pain is not normal. Severe menstrual cramps, chronic abdominal pain or pain during sexual intercourse should never simply be accepted. They are an important warning signal from the body. Women who regularly suffer from such complaints should seek medical advice at an early stage.

During the menstrual cycle, the body undergoes complex hormonal regulation. It is thought that hormonal changes, particularly an imbalance between estrogen and progesterone, may promote the abnormal growth of endometrial tissue outside the uterus. This excess tissue can then colonize various sites in the body and cause inflammatory responses.

In addition to hormonal factors, genetic aspects also play a role in the development of endometriosis. There is evidence that certain genetic changes may increase the risk for endometriosis.

The immune system also plays an important role, as it should normally recognize and eliminate abnormal tissue. However, in women with endometriosis, there appears to be a malfunction of the immune system that results in the abnormal uterine tissue not being completely removed.

• Anamnesis: Detailed discussion about symptoms, menstrual cycle, family history
• Gynaecological palpation: During the physical exam, the doctor may palpate the lower abdomen to look for any changes or painful areas. Other tests may also be performed, such as a rectal or vaginal exam, to accurately assess the condition.
• Vaginal ultrasound: Visualisation of larger cysts (endometriomas)
• MRI or CT: If deep infiltrating endometriosis is suspected. Imaging tests such as transvaginal ultrasound can help visualize changes in the pelvic area. Other imaging techniques such as magnetic resonance imaging (MRI) or computed tomography (CT) may also be used to make a more accurate assessment.
• Laparoscopy: Minimally invasive laparoscopy with diagnosis and tissue removal - the gold standard. Definitive detection of endometriosis is often confirmed by a laparoscopy, medically known as laparoscopy. This involves a minor surgical procedure in which a thin tube with a camera (laparoscope) is inserted through a small incision in the belly button. The doctor can view the inside of the abdomen and look for signs of endometriosis. If needed, tissue samples can also be taken during the laparoscopy to make an accurate diagnosis.

Only by combining these methods can the disease be reliably diagnosed and an individual treatment plan drawn up.

• Painkillers (NSAIDs): e.g. ibuprofen for inflammation
• Hormone therapy: e.g. gestagens, GnRH analogues to inhibit tissue growth

• Laparoscopic removal of the foci
• Removal of adhesions
• In severe cases: Removal of the uterus

• Hormonal stimulation
• In vitro fertilisation (IVF)

• Dietary changes
• Acupuncture
• Phytotherapy (e.g. monk's pepper)
• Heat wraps, exercise, osteopathy
• TCM

• ‘It's just a heavy period’ - False. Endometriosis is a serious disease.

• ‘Only older women are affected’ - False. Teenagers can also get the disease.

• ‘Pregnancy cures the problem’ - Myth. Temporary relief is possible, not a cure.

• ‘You can't see anything, so it's psychological’ - Invisible does not mean imaginary.

Education is the first step towards acceptance and better care.

Endometriosis is a chronic disease that is physically, emotionally and socially stressful. However, with the right diagnosis, a personalised treatment plan and a supportive environment, a self-determined life can be possible.

Every woman deserves to be taken seriously and treated - before the pain takes over her everyday life.