Endometriose - Wenn der Schmerz zum ständigen Begleiter wird  - Cellavent Healthcare

Endometriosis - When pain becomes a constant companion

Severe menstrual pain, unexplained abdominal cramps, and the feeling that no one really takes your symptoms seriously – this is how many women suffering from endometriosis feel. You are not alone! Endometriosis is one of the most common gynecological diseases, yet it often goes undiagnosed for years. In this article, you will learn what endometriosis is, what symptoms it causes, and what measures can help you better manage this condition.

Here you will learn...
What is endometriosis? What causes endometriosis? What are the symptoms of endometriosis? How is endometriosis diagnosed? What does treatment involve? What else can you do? Conclusion

The most important points in brief

Endometriosis affects approximately 10% of girls and women of childbearing age, but often goes undetected. It can cause severe pain and infertility.

The exact causes are not fully understood , however, retrograde menstruation, hormonal disorders and genetic factors play a role.

Treatment approaches include hormone therapy, surgical interventions, and multimodal pain management. An anti-inflammatory diet can also be helpful.

What is endometriosis?

Endometriosis is a chronic, benign condition in which cells similar to the lining of the uterus grow outside the uterus. These cells form lesions, which often occur in the ovaries or abdominal cavity.

The problem: These foci behave like the uterine lining during the menstrual cycle. They build up and are shed, but without the possibility of being expelled. The consequences are:

  • Pains
  • Inflammation
  • adhesions
  • Cyst formation, which can cause additional pain [2,3].

Endometriosis affects approximately 10% of women of childbearing age in Germany [1]. Unfortunately, the disease often remains undetected for a long time.


Woman holds hands on stomach
Model of the uterus

What triggers endometriosis?

The exact causes of endometriosis are not fully understood. However, experts suspect several contributing factors:

  1. Retrograde menstruation: The uterine lining is transported through the fallopian tubes into the abdominal cavity, which can cause inflammation [4,5].
  2. Hormonal disorders: Hormones influence the growth of endometriosis lesions.
  3. Genetic factors: The risk of endometriosis is increased by 50% if close relatives are affected [6].
  4. Other risk factors :
    • Early menstruation
    • Short menstrual cycle
    • Frequent bleeding [7]
Period calendar
Blood droplets made of paper

Did you know?

During menstruation, a woman loses about 30 to 80 milliliters of blood , which is roughly equivalent to two to five tablespoons or a small espresso cup.

What symptoms occur with endometriosis?

The symptoms of endometriosis are varied and range from mild to severely impacting daily life. The most common symptoms include:

  • Severe menstrual pain accompanied by abdominal cramps.
  • Pain during sexual intercourse (dyspareunia).
  • Problems with urination or bowel movements.
  • Spotting between periods and chronic abdominal pain.
  • Infertility: Approximately 40–50% of women with an unfulfilled desire to have children suffer from endometriosis [2,8].

However, some women have no symptoms whatsoever , and the condition is only discovered during infertility tests.


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Diagnosis & Therapy:
The long road to relief

Endometriosis often goes undetected for a long time – on average, it takes 7 to 10 years to receive a diagnosis. Many women feel they are not taken seriously during this time. The following diagnostic steps are common:

  1. Gynecological examination & ultrasound: First indications of endometriosis lesions.
  2. Laparoscopy : The gold standard for reliable diagnosis. The lesions can also be removed directly during the procedure.

If you suspect you have endometriosis, you should definitely get examined by your gynecologist and possibly be referred to a specialized endometriosis center [9,10,11].

Ultrasound images and model of the uterus

After diagnosis, therapy is the next step:

The treatment of endometriosis aims to alleviate symptoms and avoid complications such as infertility:

  1. Surgical removal of the lesions : This usually occurs during diagnosis via laparoscopy.
  2. Hormone therapy : Taking hormones such as the birth control pill suppresses the build-up of the uterine lining, which can relieve pain.
  3. Fertility treatment: Women wishing to have children should visit a specialized fertility center.
  4. Pain relievers : Medications such as ibuprofen help against acute pain, but should only be used for short periods [12,13].
Yoga group does breathing exercises

What else you can do

In addition to medical treatment, there are measures that can alleviate your symptoms and improve your quality of life:

1. Multimodal pain therapy

This therapy combines various approaches, such as:

  • Physiotherapy to loosen tension in the pelvic area.
  • Relaxation exercises such as yoga or mindfulness training.
  • Psychological support for pain management [14,15].

2. Anti-inflammatory diet

An anti-inflammatory diet can reduce inflammation and pain. Studies show that avoiding highly processed foods, sugar, grains, dairy products, and red meat can be helpful [16,17,18,19].
Instead, focus on:

  • Lots of vegetables and fruit
  • Omega-3 fatty acids from fish or flaxseed
  • Nuts and seeds
  • High-quality vegetable oils

Conclusion

Endometriosis is a common, yet often overlooked condition that significantly impacts the lives of many women. Although diagnosis can be lengthy, a variety of treatment options are now available that can alleviate pain and improve quality of life . It's important to seek medical help and not feel alone with your symptoms . Severe menstrual pain is not normal and should be investigated.

If you suffer from endometriosis or suspect you might have it, don't hesitate to consult a specialist or an endometriosis center. With the right support and a combination of medical therapy and lifestyle changes, you can make managing this condition easier.

Our expert

Portrait of Sharleen Omara

Sharleen Omara, MD

doctor

Key areas:
Gynecology | Nutritional Medicine | Public Health

What is endometriosis?

It is a chronic condition in which cells similar to the uterine lining grow outside the uterus. These growths cause pain, inflammation, and sometimes infertility.

How common is endometriosis?

Approximately 10% of women of childbearing age are affected. Nevertheless, the disease often goes undetected because it causes nonspecific symptoms and many doctors are not specialized in it.

What causes endometriosis?

The exact causes are unclear, but retrograde menstruation, hormonal imbalances, and genetic predisposition play a role. Women with a family history of endometriosis have an increased risk.

Can endometriosis be cured?

Currently, the disease is incurable, but the symptoms can be alleviated with hormone therapies, surgery, and pain management.

Can I get pregnant despite having endometriosis?

Yes, pregnancies are possible. Women wishing to have children should consult a fertility clinic, as sometimes more intensive treatment is necessary.

What kind of diet helps with endometriosis?

An anti-inflammatory diet can alleviate symptoms. Avoid sugar, dairy products, and highly processed foods. Instead, focus on vegetables, fruits, omega-3 fatty acids, and plant-based oils.

References for further reading:
  1. Endometriosis Research Foundation: Endometriosis – what is it? https://www.endometriose-sef.de/patienteninformationen/was-ist-endometriose/ (accessed on July 4, 2023)
  2. Institute for Quality and Efficiency in Health Care: Endometriosis https://www.gesundheitsinformation.de/endometriose.html (accessed on 04.07.2023)
  3. Gynecologists on the Net: Endometriosis https://www.frauenaerzte-im-netz.de/erkrankungen/endometriose/ (accessed on 04.07.2023)
  4. Vinatier D, Orazi G, Cosson M, Dufour P. Theories of endometriosis. Eur J Obstet Gynecol Reprod Biol. 2001 May;96(1):21-34. doi: 10.1016/s0301-2115(00)00405-x. PMID: 11311757.
  5. World Health Organization: Endometriosis https://www.who.int/news-room/fact-sheets/detail/endometriosis/?gclid=CjwKCAjw2K6lBhBXEiwA5RjtCWsYJh06ZQ40pHoG1lWV0lkDiigvJRWsrilWXIfu6y7I3SUHAUWQVhoCNvcQAvD_BwE (accessed on 04.07.2023)
  6. Rahmioglu N et al. The genetic basis of endometriosis and comorbidity with other pain and inflammatory conditions. Nat Genet. 2023 Mar;55(3):423-436. doi: 10.1038/s41588-023-01323-z. Epub 2023 Mar 13. PMID: 36914876; PMCID: PMC10042257.
  7. Wei M, Cheng Y, Bu H, Zhao Y, Zhao W. Length of menstrual cycle and risk of endometriosis: A meta-analysis of 11 case-control studies. Medicine (Baltimore). 2016 Mar;95(9):e2922. doi: 10.1097/MD.0000000000002922. PMID: 26945395; PMCID: PMC4782879.
  8. Endometriosis Association Germany e.V.: What is endometriosis? https://www.endometriose-vereinigung.de/was-ist-endometriose.html (accessed on July 4, 2023)
  9. Austrian Public Health Portal: Endometriosis: Diagnosis https://www.gesundheit.gv.at/krankheiten/sexualorgane/weibliche-sexualorgane/endometriose-diagnose.html#:~:text=Mit%20einem%20Vaginalultraschall%20lassen%20sich,Dieser%20Eingriff%20erfolgt%20unter%20Vollnarkose. (accessed on 04.07.2023)
  10. Endometriosis Association Germany eV: Diagnosis https://www.endometriose-vereinigung.de/diagnose.html (accessed on 04.07.2023)
  11. Hudelist G, Fritzer N, Thomas A, Niehues C, Oppelt P, Haas D, Tammaa A, Salzer H. Diagnostic delay for endometriosis in Austria and Germany: causes and possible consequences. Hum Reprod. 2012 Dec;27(12):3412-6. doi: 10.1093/humrep/des316. Epub 2012 Sep 17. PMID: 22990516.
  12. German Society for Gynecology and Obstetrics: Guideline Program for the Diagnosis and Therapy of Endometriosis https://endometriose-vereinigung.de/files/endometriose/artikel/Interdisziplinaere%20S2k-Leitlinie%20fuer%20die%20Diagnostik%20und%20Therapie%20der%20Endometriose%202020.pdf (accessed on July 4, 2023)
  13. German Medical Journal: Diagnosis and therapy of deep infiltrating endometriosis https://www.aerzteblatt.de/archiv/77157/Diagnose-und-Therapie-der-tief-infiltrierenden-Endometriose#:~:text=Die%20gesch%C3%A4tzte%20Pr%C3%A4valenz%20der%20Endometriose,48%20Prozent%20eine%20Endometriose%20nachweisbar . (accessed on July 4, 2023)
  14. Kempe, S. Early hormone and pain therapy prevents pain syndrome in endometriosis. Pain Med. 38, 18–19 (2022). https://doi.org/10.1007/s00940-022-3376-6
  15. German Pain Society (Deutsche Schmerzgesellschaft eV): Interdisciplinary-multimodal pain therapy https://www.schmerzgesellschaft.de/topnavi/patienteninformationen/netzwerke-der-versorgung/interdisziplinaer-multimodale-schmerztherapie (accessed on 04.07.2023)
  16. Uebel U. Anti-inflammatory diet. Uro-News. 2021;25(9):40–3. German. doi: 10.1007/s00092-021-4657-4. Epub 2021 Sep 10. PMCID: PMC8423505.
  17. Arab A, Karimi E, Vingrys K, Kelishadi MR, Mehrabani S, Askari G. Food groups and nutrients consumption and risk of endometriosis: a systematic review and meta-analysis of observational studies. Nutr J. 2022 Sep 22;21(1):58. doi: 10.1186/s12937-022-00812-x. PMID: 36138433; PMCID: PMC9503255.
  18. Liu P, Maharjan R, Wang Y, Zhang Y, Zhang Y, Xu C, Geng Y, Miao J. Association between dietary inflammatory index and risk of endometriosis: A population-based analysis. Front Nutr. 2023 Feb 27;10:1077915. doi: 10.3389/fnut.2023.1077915. PMID: 36923699; PMCID: PMC10008869.
  19. van Haaps A, Wijbers J, Schreurs A, Mijatovic V. A better quality of life could be achieved by applying the endometriosis diet: a cross-sectional study in Dutch endometriosis patients. Reprod Biomed Online. 2023 Mar;46(3):623-630. doi: 10.1016/j.rbmo.2022.12.010. Epub 2022 Dec 17. PMID: 36702643.
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