Endometriosis

Your contact person

Professor Dr. med. Dr. phil. Dr. h.c.mult. Andreas D. Ebert
Specialist for Gynecology and Obstetrics

Please bring the following to your appointment:

What is endometriosis?

Endometriosis is the occurrence of tissue similar to the uterine lining outside the uterus. Endometriosis is a benign, but often chronic disease that affects mainly women of childbearing age. However, we also see endometriosis tissue in elderly women, which can be attributed to hormone intake in recent years. The benign disease endometriosis can develop in the peritoneum, the Fallopian tubes, the ovaries, the bladder, or the colon. The symptoms arise because the endometriosis lesions may bleed, become inflamed, or form scar tissue depending on the menstrual cycle.

There is thus far no clear explanation for how endometriosis develops. Today, specialists assume that for all women, menstrual blood flows not only out of the vagina, but that there is what is called retrograde menstruation, i.e. bleeding into the abdominal cavity. This menstrual blood contains living cells from the uterine lining, which can then grow in the abdominal cavity.

Some scientists suggest that these cells are a kind of stem cell, which would explain why they are not absorbed by the body, but can grow in a “foreign” enviroment. Active endometriosis lesions are then formed at these sites, e.g. the peritoneum, the ovaries, the colon, or the bladder, which are also controlled by nerves and can thus cause pain.

Today we assume that endometriosis is actually a disease of the uterus and its tissues, and that the endometriosis cells arise from the deepest layer of the uterine lining. Due to estrogen-induced hypermobility of the uterine muscle or due to micro-trauma, these cells are sloughed off and can reach the abdominal cavity via the Fallopian tubes.Thus, hormonal changes, but also many other factors such as cyclooxygenase (COX-2) or aromatase and changes of the immune system might play an important role. Although no actual endometriosis gene has been found, there can be a familial predisposition. The individual risk of developing endometriosis increases if a first-degree relative, i.e. mother or sister, has endometriosis.

What problems does endometriosis cause?

The uterine lining goes through cyclical changes during a woman’s childbearing years. Like the uterine lining, endometriosis tissue is also dependent on the action of female sexual hormones,  Estrogens and Gestagens, which affect it via special receptors. This explains why many typical symptoms of endometriosis occur mainly shortly before or during menstruation.

Typical symptoms of endometriosis are:

Note:

Menstruation that causes very severe pain in the lower abdomen resulting in bed rest, illness, or excessive drug intake is not normal!!!

Endometriosis can also reduce fertility, and this disease is often not detected until laparoscopy is conducted due to failure to concieve. 

Endometriosis is considered to be a very common disease, although no precise data are available. According to estimates, approx. 10 to 20% of all women of childbearing age are affected by endometriosis. In around half of these women, endometriosis causes symptoms that require diagnostic tests and individual treatment.

Could you have endometriosis?

The keys for diagnosing endometriosis are an extensive consultation with the physician and a gynecological examination. The typical symptoms often lead directly to the suspected diagnosis. A thorough gynecological examination provides additional evidence. 

Imaging methods such as ultrasound are very valuable for diagnosing ovarian cysts or changes in the uterus (adenomyosis).

Additional methods such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are used in special cases. However, a definitive diagnosis of endometriosis is possible only by laparoscopy (minimally-invasive Surgery) with corresponding examination of tissue samples.

How is endometriosis treated?

At the center of endometriosis treatment is diagnostic and surgical laparoscopy, which is also a treatment approach in which all endometriosis lesions or adhesions are removed. This procedure also frequently leads to a sharp reduction of pain and improved pregnancy rates. After the procedure, treatment can be supported with hormones that effectively reduce pain, reduce any residual microscopic tissue, and prevent the spread of new endometriosis tissue. Additionally, it is possible to jointly develop effective treatment approaches for persisting pain.

The laparoscopic removal of endometriosis lesions can considerably improve fertility in women who fail to concieve. Endocrine treatment (with Hormones) is not recommended for infertility, as the women will not become pregnant during these treatment. In addition, we recommend complementary treatment methods such as acupuncture, Traditional Chinese Medicine or Natural Medicine. Many women have had good experience with these approaches, as these treatment methods will support the treatment of classical medicine. Some exxamples are: Green Tea Extract (Epigallocatechin-Gallat, EGCG), red wine extract (Resveratrol), ginger extract, and honey extracts.

Where else can I get information?

ENDOMETRIOSE-VEREINIGUNG DEUTSCHLAND e.V.
Bernhard-Göring-Strasse 152, 04277 Leipzig
Tel. (0341) 306 5304
www.endometriose-vereinigung.de