Endometriosis – what is important for you


They often have severe pain in the abdomen? You just can’t get pregnant? One possible reason for this may be the disease Endometriosis its.

This information is to help you learn about the disease. It also gives you advice and help on how to deal with it.

At a glance

In women with endometriosis, tissue similar to the endometrium grows outside the uterine cavity, for example in the abdominal cavity.

There are several signs: severe menstrual or lower abdominal pain, pain during or after sexual intercourse, unfulfilled desire to have a child.

Treatment options are: Surgery, hormones, painkillers.

The disease

Endometriosis is a common disease. According to estimates, about 40,000 women in Germany get endometriosis every year. In them, endometrium-like tissue grows outside the uterine cavity, for example in the abdomen, ovary or fallopian tubes, and less frequently on the bladder or intestines. These endometriosis foci can increase in size and spread. But they are benign. Like the mucous membrane in the uterus, they are subject to monthly hormonal changes: They grow up and are rejected again. However, the detached mucous membrane cannot flow out through the vagina as it does during menstruation, but remains in the body. This can lead to inflammation and adhesions. Sometimes blood-filled cavities form in the ovary (cysts). Sometimes affected organs can no longer work properly as a result. Why endometriosis foci form in the first place, and why some cause severe symptoms and others hardly any, is as yet unclear.

Signs and symptoms

The complaints begin mostly at the age between 20 and 30 years, often already with the first monthly bleeding. How endometriosis manifests itself varies from woman to woman. Many have no or only minor complaints. Others are so impaired by severe pain that they can hardly go about their work or everyday life.

Signs of endometriosis include:

    severe pain during menstruation

Signs may also indicate other medical conditions. It takes an average of 10 years before it is clear that endometriosis is present. Some women seek medical advice because they do not become pregnant. The disease is then often detected by chance.

The treatment

Endometriosis is a permanent disease. It can only be cured in individual cases. The symptoms usually disappear by themselves after the last menstrual period.

If you have no symptoms, no desire to have children, and all organs are working normally, treatment is not necessary.

There are several effective treatment options. Which treatment is right for you depends on your symptoms and your life situation. Since endometriosis often recurs, repeated treatments are often necessary.

Surgery can be used to remove endometriosis lesions. The pain has been shown to decrease in most women. You will usually have a laparoscopy: a camera and instruments are inserted into the abdomen through small incisions to remove the foci.

Hormones may also be an option for you. Luteal hormones, for example, are a good way to do this. Birth control pills can also be used. However, the "pill Not approved in Germany for the treatment of endometriosis. Hormones can relieve symptoms by weakening or suppressing menstrual bleeding for a longer period of time. This also immobilizes the endometriosis foci. Ask about side effects and the advantages and disadvantages of hormones before taking them.

There is scientific evidence that treatment with hormones does not improve fertility. In cases of unfulfilled desire for a child, surgical removal of the endometriosis lesions can increase the prospect of pregnancy. If you still do not become pregnant, fertility treatment can help, such as artificial insemination. Pregnancy can be achieved in many women with endometriosis.

Painkillers are often used in the case of endometriosis. However, no conclusive studies were found showing how effective they are for pain from endometriosis. Depending on your needs, you can receive specialist pain treatment as well as psychological and social support. Medical rehabilitation ("rehab") is often recommended after major endometriosis surgery or if you have permanent pain.

What you can do yourself

  • It is good to talk openly with your doctor about your symptoms. There are also endometriosis centers where specialized gynecologists work. They are well acquainted with the disease.
  • Physical exercise is good for you. It is best to choose something that brings you pleasure. Some affected women find Nordic walking, pelvic floor training or exercise in warm water pleasant, for example.
  • Learn to relax and cope with stress. Relaxation exercises such as yoga can be supportive to reduce pain, anxiety and tension.
  • You may also find acupuncture, Chinese herbal medicine or physiotherapy helpful.

It is advisable to observe yourself. As an aid, you can note down your complaints in a diary. Here’s how to find out what works for you and what doesn’t.

You are not alone with your condition. It can help to talk openly about it. You can also share your experiences with other sufferers, for example in a self-help group.

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