Women with statutory health insurance in Germany have increasingly been diagnosed with endometriosis. Doctors diagnosed the chronic gynecological disease in 9.5 out of 1,000 women in 2022, an increase of 65 percent compared to 2012. This emerges from a study by the Central Institute for Statutory Health Insurance in Germany (Zi), which was reported to the German press agency is available. The experts write that the increase tends to be due to increased awareness of the disease among patients and doctors and not necessarily to a change in risk.
The study was based on cross-health insurance billing data from more than 35 million legally insured girls aged ten and over and women in Germany. According to the analysis, the diagnosis of endometriosis was documented in almost 340,000 patients in 2022, with a median age of 40. The study shows that it is likely that there will be a considerable delay before the disease is diagnosed. On average, the first symptoms appear at around 21 years of age.
According to Zi, endometriosis is considered one of the most common gynecological diseases in girls and women. In the disease, tissue similar to the lining of the uterus also grows outside the uterus. It also builds up and down regularly over the course of the cycle, but cannot drain away. Depending on the location in the body affected, these so-called endometriosis foci can cause different symptoms due to adhesions, adhesions and inflammation. Possible symptoms include cramps and severe pain during periods and during sex. The diagnosis is sometimes only made when the desire to have children is unfulfilled and the causes are searched for. But it also happens that affected women have no symptoms.
The number of unreported cases is still high
Despite evidence of increased awareness, the study shows that the frequency of diagnosis in this country is still below epidemiological estimates. This can mean that many women still do not know about their illness and live with the symptoms untreated for a long time.
According to the study, the high suspected number of unreported cases can have several reasons. Patients may only seek treatment late. Complaints during periods are often trivialized and accepted as normal. On the doctors’ side, this could be due to insufficient billing options and the high effort required to record the relevant information. The study shows that a laparoscopy is necessary to definitively confirm the diagnosis.
Hinnerk Feldwisch-Drentrup Published/Updated: , Recommendations: 8 Thorsten Winter Published/Updated: , Recommendations: 9 Johanna Kuroczik Published/Updated: , Recommendations: 5 Carla König Published/Updated: Recommendations: 21
As the professional association of gynecologists writes on its website, it is unclear how endometriosis occurs. Several factors seem to play a role, including genes. According to experts, one of the risk factors could be that women today go through many more menstrual cycles – and thus inflammatory processes – than in earlier times. Among other things, because of the younger average age at the time for the first pregnancy and significantly more pregnancies overall.
According to the Association of Gynecologists, medication, hormonal and surgical treatment options are available to alleviate symptoms. The increase in diagnoses observed in the study does not mean that more women were operated on. “The proportion of patients who received surgical services was constant over the entire period,” the study says. However, the type of interventions varied.