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What is endometriosis and how can it be treated?

Endometriosis – which in many cases manifests itself with severe menstrual pain, can in the worst case be the reason for an unfulfilled desire to have children. In recent years, the disease has increasingly appeared in the media, and celebrities have publicly reported on their suffering. Now a petition has been launched calling for concrete measures to combat the disease. Tikbow explains what it’s all about, what happens in the abdomen during the gynecological disease and what treatment options are available.

Did you know what endometriosis is? If not, you’re like many women. According to information from the Endometriosis Association of Germany e.V.1 around 15 percent of the female population is affected. And a large proportion of them are said to have only learned of the existence of the disease when they are diagnosed.

#EndEndoSilence petition.2 is now calling for a national strategy from the German government to deal with the disease. In concrete terms, this means an awareness campaign, funding for research and an action plan for gender-equitable medicine. The petition, which was launched by Theresia Crone, a student who is also ill, found many supporters within a very short time. Ex-GNTM contestant Anna Adamyan, formerly Wilken, is also one of the supporters. She has been campaigning for more visibility of the lower body disease for years.

What is endometriosis?

In endometriosis, tissue growths occur outside the uterine cavity, sometimes extending into the digestive tract. Particularly frequently, the inflammatory endometriosis lesions and cysts settle on the ovarian stalks and resemble the structure and behavior of the uterine mucosa. This means that the endometrial tissue is dependent on the estrogen level, i.e. it grows with the menstrual cycle and is also shed.

"There is periodically accompanying menstruation to a co-reaction of the mucosaähnlichen, in the abdominal cavity scattered tissue", explains us the Viennese womenärztin Univ. Prof. Dr. Doris Maria Gruber.3 This is the cause of the typical symptoms of endometriosis: tissue and blood remnants that could not be absorbed and metabolized by the surrounding tissue remain in the body. These are called "endometriomas" (= cysts or tissue remnants usually filled with blood, sometimes also called chocolate cysts because of their color), and these can settle on, for example, ovaries and fallopian tubes.

Symptoms and possible consequences

The disease makes itself felt differently from case to case and depending on the severity – and sometimes not at all. Depending on the exact location of the endometriosis lesions or cysts, bleeding from the bladder or bowel is also possible. They can be very painful due to hormones, especially before and during menstruation, but can also occur independently of hormones, for example in the course of medical examinations, when going to the toilet and especially during and after sex. This is the case, for example, with ex-GNTM contestant Anna Adamyan, who has already spoken very openly üabout her endometriosis disease in the Tikbow interview. The problem: endometriosis can usually only be detected at all by laparoscopy (often called laparoscopy or keyhole technology) über. The foci cannot be detected via ultrasound, CT or MRI.

(Unfulfilled) desire to have children with endometriosis

In many cases, endometriosis makes it difficult to get pregnant or even completely infertile. Affected women who want to become mothers are therefore often also patients of reproductive medicine. According to the Endometriosis Association of Germany, an unfulfilled desire to have children is the result of the disease in 40 to 60 percent of women. It is not known whether only severe or also milder cases of endometriosis affect fertility.

Treatment methods

Endometriosis only needs to be treated if there are symptoms or if there is a desire to have children.

Drugös

For extreme discomfort in the form of severe lower abdominal and abdominal pain, many doctors prescribe particularly strong painkillers for their patients. Furthermore, hormone preparations (e.g., certain birth control pills) are often used to try to keep estrogen levels low and thus prevent the (re)development or enlargement of existing endometriosis lesions. Gruber: "Some women are artificially induced into menopause by injection to suppress the violent hormonal reactions."

Holistic

Some (curative) practitioners try to alleviate symptoms by improving overall well-being, taking a holistic approach.

Surgical

The most common surgical method of treating endometriosis is laparoscopy. By means of a kind of laparoscopy, the cysts and foci of inflammation can be located and removed – ideally permanently. However, they come back in about half of the patients and require permanent treatment.

Who is at risk of getting the disease?

It is discussed that endometriosis is often genetically predisposed and related to hormonal fluctuations or a generally weak immune system. Otherwise, risk factors have not been sufficiently scientifically clarified. Für gewöhnlich the illness occurs only in the sexually mature age and exists only rarely übeyond the menopause", adds the Frauenärztin.

What can endometriosis be helped by?

Certain ingredients of cosmetics can cause the development of endometriosis – that suggests at least one Spanish study.4 from 2020 close. Scientists at the University of Granada and the San Cecilio de Granada University Hospital examined various cosmetic products and found that some of them contained endocrine disruptors, i.e. chemical substances that disrupt the natural action of hormones. These include parabens and benzophenones. The researchers found that the risk of endometriosis was higher when the study participants had higher levels of these substances. Accordingly, it is generally advisable to switch to cosmetics that are free of endocrine disruptors – a look at the list of ingredients can provide information on whether the product contains parabens or benzophenes.

Sources

1What is endometriosis?, Endometriose Vereinigung Deutschland e.V.
2#EndEndosilence – for a national endometriosis strategy, Change.org.
3with expert advice from Univ. Prof. Dr. Doris Maria Gruber, gynecologist in Vienna
4Cosmetic and personal care product use, urinary levels of parabens and benzophenones, and risk of endometriosis: results from the EndEA study, Sciencediret