Endometriosis – The Chameleon Of Gynecology

Approximately 4-12% of women develop endometriosis between puberty and menopause. What exactly endometriosis is, where it occurs, what the symptoms are, and how to treat it, I address in this article. I also clarify what the diagnosis means for the desire to have children.

What Is Endometriosis?

Endometriosis is a benign, common, but unfortunately often painful chronic disease in women. Affected women have the problem of tissue resembling the lining of the uterus (endometrium) forming outside the uterus.

Where Does Endometriosis Occur?

Usually, the foci of endometriosis occur in the abdominal and pelvic areas. Cysts and inflammation settle there, mostly on the ovaries, uterus, and fallopian tubes. But peritoneum or intestine can also be affected.

In rare cases, endometriosis foci have also been found outside the abdominal cavity, e.g. in the lungs.

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What Are The Symptoms Of Those Affected?

  • Severe, often cramping pain during menstruation.
  • Increased menstrual bleeding or bleeding between periods.
  • Abdominal & back pain that can even radiate to the legs.
  • Pain during or after sex.
  • Recurrent pain in the lower abdomen (especially in the 2nd half of the cycle).
  • Pain during gynecological examinations.
  • Pain or problems with bowel movements.

Of course, all these symptoms can also have other causes and the complaints can differ depending on where the mucosa has mistakenly settled.

However, what is really characteristic is the recurrent abdominal pain, the intensity of which varies during the cycle. The maximum pain appears just before or during the period.

How Can Endometriosis Be Treated?

Since the cause of endometriosis is not yet known, there is, unfortunately, no specific therapy that could cure the disease. If endometriosis does not cause major problems and does not get worse, there is usually no need to treat it. However, it is advisable to have regular check-ups with your gynecologist.

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Despite the lack of therapy, there are treatment options. Which one is chosen should be individualized to the woman based on age and family planning.

Surgery For Endometriosis

In order to diagnose the disease with certainty, a laparoscopy must be performed. During this small operation, it is possible to remove or sclerose affected areas. The surgery is absolutely necessary if mucosal tissue is deposited on the ureter, as this can damage the kidney.

Removal of the tissue is recommended in case of involuntary childlessness because it increases the chances of pregnancy.

Apart from laparoscopy, surgery can also be performed through the vagina if the endometriosis foci are conveniently located.

Only in very severe cases, the uterus is removed. The consequence of this radical surgery is that it is no longer possible to become pregnant. However, this option is used only when no other treatment method is possible.

Medications For Endometriosis

Pain and antispasmodic medications can be used as needed. However, it is not a permanent solution, and taking it should be discussed with the doctor!

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Certain hormonal contraceptives, such as the hormonal IUD or a progestogen-containing pill, dampen the influence of the female sex hormones on the endometriosis cells and additionally suppress menstruation. This allows the disease to be put on hold for a while, so to speak, and hopes that the defective tissue will regress during this phase.

Unfortunately, the effect is temporary and the disease may return after the therapy is stopped. Side effects such as mood swings or hot flashes may also occur.

Relaxation Therapy

The proof of the pudding is in the eating! Some women try complementary therapies such as relaxation methods or change their diet. Their effect has not been scientifically proven, but it is worth trying them out. One study suggests that acupuncture may help with the pain.

Pregnancy With Endometriosis – What Does The Disease Mean For The Desire To Have A Child?

When endometriosis foci are misplaced in the abdomen, they can upset the interaction of the reproductive organs. Tissue lodged in the ovary disrupts the cycle and hinders egg maturation and rupture.

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If the tangled mucosa becomes lodged in the fallopian tube, it hinders fertilization and transport of the egg. Tissue in the uterus has negative effects on the implantation of the affected egg.

It is said that there is a close connection between endometriosis and infertility – so the more severe the endometriosis, the more difficult it is to get pregnant. However, it also depends on where the tissue is deposited.

As mentioned above, the chances of pregnancy are better after the tissue is removed. It is true that not every person suffering from endometriosis will become pregnant. If it does not work out naturally, one can try artificial insemination.

Women who have become pregnant despite endometriosis can even hope for improvement after pregnancy. Pregnancy can also cause endometriosis to dry up.

So what does all this mean for pregnancy? It means that although it is not easy, it is very possible to get pregnant despite endometriosis.

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