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Endometriosis: symptoms, causes and treatment

20 Jan, 2023

Endometriosis: symptoms, causes and treatment

If you experience severe abdominal pain or pain during sex, these may be symptoms of endometriosis. The disease is widespread among women. Endometriosis symptoms are often very uncomfortable for those affected. Treatment for the condition may involve medication or surgery.

The most important facts about endometriosis at a glance

  • Endometriosis is a disease in which tissue similar to the lining of the uterus forms outside the uterus. 
  • Some estimates suggest that about 10 percent of all women may be affected by endometriosis.
  • The exact causes of endometriosis are not yet known, although genetics are likely to play a role, among other things.
  • Typical symptoms of endometriosis include severe menstrual pain and heavy menstrual bleeding.
  • Endometriosis can be treated with medication or surgery.

period knickersWhat is endometriosis?

The name endometriosis is derived from the term endometrium. The endometrium is the lining of the uterus. In women with endometriosis, tissue similar to the endometrium grows outside the uterus.

Just like the endometrium itself, this tissue changes during the menstrual cycle. It becomes thicker and is shed by the body during the period. Unlike the normal endometrium, however, it cannot be expelled from the body.

As a result, lumps and adhesions form over time. This causes pain and inflammation. In the long run, endometriosis can even lead to infertility in women.

Endometriosis is common in women

Endometriosis is a disease that is very common in women. Some estimates even assume that about 10 percent of all women are affected by the painful disease.

However, the numbers mentioned are partly quite different. This is partly because not all population groups are affected by endometriosis with the same frequency. In addition, endometriosis symptoms are sometimes only noticed after quite a while.

Causes: what causes endometriosis?

It is not yet clear why endometriosis occurs. There are different theories. It is possible that women get endometriosis when mucous membrane cells enter the abdominal cavity with the menstrual blood. But it is also conceivable that the mucous membrane cells form directly at the site of the later growths.

Irrespective of this, genetic factors certainly play a role. If close relatives are already affected, it is much more likely that women will develop endometriosis.

Other factors include, for example:

  • Very early menarche and late menopause, 
  • a particularly short menstrual cycle and a long period, 
  • operations on the uterus 
  • and being overweight

are among the known risk factors for the development of endometriosis.

Symptoms: How does endometriosis manifest itself?

Endometriosis can manifest itself through a range of symptoms. Women can develop the disease as early as puberty. However, it is also possible that endometriosis first manifests itself with symptoms at a later stage.

Typical endometriosis symptoms include for example

  • Very severe menstrual pain 
  • Severe abdominal pain outside of menstruation 
  • Pain during sex or immediately afterwards 
  • Noticeably heavy menstrual bleeding 
  • Pain when urinating or having a bowel movement

Some symptoms of endometriosis are directly related to the menstrual cycle. That is why they occur at the same time every month. How severe the symptoms actually are and what consequences they have depends mainly on where exactly the tissue has formed.

Does endometriosis always cause symptoms?

It is quite possible that endometriosis remains asymptomatic for a long time or that the symptoms that occur are simply not noticed. This is often because endometriosis develops at the same time as menarche. As a result, young women are used to the symptoms it causes from the very beginning and consider them to be something completely normal.

How is endometriosis diagnosed?

If you have any possible symptoms of endometriosis, you should of course contact your gynaecologist immediately. The gynaecologist will first ask you about the symptoms you are experiencing.

She will also carry out a gynaecological examination, during which she will feel your vagina and abdominal wall, among other things. In this way, she can localise possible hardening and pain, for example.

Ultrasound and biopsy

In addition to anamnesis and palpation, ultrasound examinations play an important role in the diagnosis of endometriosis. Larger adhesions can usually be easily detected.

period pantsIf the suspicion is confirmed, the gynaecologist will probably take a tissue sample. This will help to find out whether the growths are really endometriosis or whether they are caused by another disease, such as cancer.

Treatment of endometriosis

Treatment for endometriosis can vary. If it does not cause any symptoms and the diagnosis is an incidental finding, treatment may not be necessary.

However, if symptoms such as severe pelvic and menstrual pain occur, or if it is not possible to become pregnant despite the desire to have children, treatment of endometriosis is usually urgently recommended.

Basically, treatment can be either with medication, surgery or a combination of both. The factors that the gynaecologist takes into account when planning treatment include the exact location of the growths and the age of the patient.

Treating endometriosis with medication

To treat endometriosis with medication, hormone preparations can be used in addition to painkillers. While the painkillers reduce the pain associated with the disease, the hormone preparations are supposed to help curb the growth of the endometriosis lesions.

However, hormonal treatment of endometriosis is usually only suitable for women who do not want to become pregnant. This is because taking hormone preparations inevitably interferes with the body's own hormone production and thus suppresses ovulation, among other things.

Treating endometriosis with surgery

Depending on the severity of the endometriosis and the success of hormonal treatment, surgery may sometimes be necessary. The aim of such an operation is to remove the mucosal cells outside the uterus.

This can sometimes include the removal of parts of the affected organs. It may even be necessary to remove the ovaries or uterus during the operation. Because of the consequences involved, this procedure is of course discussed in detail with the patient beforehand.

What is the prognosis for women with endometriosis?

It is not possible to say in general terms how endometriosis will progress and how severe the symptoms will be. Sometimes existing growths regress on their own. However, it is also possible for the disease to spread and affect other organs over time.

It is not uncommon for the symptoms of endometriosis to reappear, both after stopping the medication used for treatment and after surgery. In most cases, however, the symptoms of endometriosis will eventually subside permanently, at least at the beginning of the menopause.