Status: 06/26/2023 10:48 a.m
Endometriosis is a growth of tissue in the abdomen that resembles the lining of the womb. Many women go through an odyssey before being diagnosed.
It is estimated that five to six million women in Germany suffer from the pain-related condition endometriosis. Many patients have gone through a medical marathon – on average, it takes almost ten years for the chronic disease to be diagnosed with certainty.
What is endometriosis?
In endometriosis, tissue similar to the lining of the uterus (lat. endometrium) grows freely in the abdominal cavity. These foci often appear on the peritoneum. However, they can also proliferate in the walls of neighboring organs such as the bladder or intestines. The growths are cycle-dependent active. Sometimes they can only go away after the menopause, but some women also have symptoms beyond that.
Because the blood cannot drain, adhesions develop that can cause severe pain. After a menstrual period, scars form, which reopen depending on the menstrual cycle. And: The immune system reacts to the proliferating tissue, inflammation occurs. Endometriosis is a chronic inflammatory disease.
Severe pain, nausea: Endometriosis symptoms are diverse
Since the endometriosis foci can spread to different parts of the body and organs, especially the pelvis, the symptoms of those affected are very different and difficult to interpret. Experts therefore also speak of a chameleon in gynecology. Women with endometriosis do not always or only have these symptoms, but many suffer from these strong symptoms every month:
Extreme cramps in the lower abdomen, which many of those affected practically knock out for days or can only be endured with strong painkillers, over-the-counter painkillers often do not help at all, nausea, circulatory weakness, rule-related pain in other parts of the body, such as the bladder, groin or shoulder, which can become chronic over time, severe pain during sexual intercourse, pain when urinating.
A particularly serious side effect of endometriosis can be infertility in women. However, the disease is often only discovered when the cause of the unfulfilled desire to have children is sought. About 20 to 40 percent of these women have endometriosis.
Diagnosis of endometriosis by laparoscopy
If endometriosis is suspected, a detailed survey of the medical history is essential: This involves possible endometriosis diseases in the family and the current symptoms, and questions about bowel movements, urination and sexuality can also be asked. Gynecological examinations including ultrasound follow.
Abdominal endoscopy (laparoscopy) is the only method to be able to diagnose endometriosis with certainty. During this examination, which should be carried out in one of around 50 specialized centers in Germany, doctors look into the stomach through the so-called keyhole technique (small incisions). This is then searched for endometriosis foci. If foci are discovered, they are removed, otherwise they continue to proliferate and can also attack other organs.
Causes of the disease unclear
The causes of the disease are not yet clear. Various theories are discussed. Statistically, endometriosis is more likely to develop in women who have any of these characteristics:
early first menstrual period short cycle and long period of bleeding uterine surgery late first pregnancy.
There could be a genetic component, as endometriosis runs in some families.
According to a recent Japanese study, certain intestinal bacteria, so-called fusobacteria, could also play a role in endometriosis. The connection must now be further explored. If bacteria are actually a cause, new treatment options could arise in the future, for example with antibiotics.
Treatment should be holistic
What helps which woman is very individual. The disease is multifaceted and not only affects individually different parts of the body, but also includes aspects such as the psyche, nutrition and pain memory. Therefore, a holistic approach should be taken during treatment.
Conventional endometriosis treatment: hormones or surgery
So far, endometriosis has been treated either hormonally or surgically. Hormones are designed to prevent new tissue from forming. This is done with progestogen monotherapy. But: The endometriosis is usually not cured. The growths can come back.
Even after an operation, the risk of recurrence for peritoneal herds is ten percent, for cysts on the ovaries it is 30 to 40 percent.
Nutritional therapy for endometriosis
Since histamines can increase the pain and quite a few of those affected are particularly sensitive to this, a cycle-dependent special elimination diet can help to alleviate the symptoms. In addition, a low-sugar, low-meat, anti-inflammatory diet is generally recommended to curb chronic inflammation. Endometriosis rarely occurs in isolation – intestinal problems due to intolerance or allergies are frequent companions. Avoiding gluten, for example, sometimes leads to a significant improvement in symptoms. You can find out exactly what to leave out by keeping a food diary. Professional support (medical nutrition or from nutritionists) can be extremely helpful here.
Physiotherapy and relaxation for endometriosis
TENS applications as well as yoga and osteopathy can relieve tension in the pelvic area and provide relaxation. Some sufferers benefit from acupuncture.
Pain therapy in endometriosis
Our body has a “pain memory” – and this is often very pronounced after years of discomfort. Pain therapy teaches those affected to deal with the dreaded symptoms differently and to perceive the body in a new way. This therapy can be a very useful addition to any measure for endometriosis.
Psychological support can also be useful. Another helpful offer are self-help groups – an important opportunity for patients with endometriosis to exchange ideas.
Further information
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