Endometriosis

With this disease, the cells of the uterine endometrium are also found outside of the uterine cavity. This can lead to pain and destruction of tissue. Several stages of the disorder are recognized, depending on severity and distribution. The diagnosis is usually made via abdominal imaging (laparoscopy).

Endometriosis is a common disorder in women and manifests between puberty and menopause. Since the symptoms are not always immediately assigned to the disease it can be several months to years before endometriosis is confirmed.

Causes of this disease are cells and cellular islands found in the immediate vicinity of the uterus, i.e. around the ovaries, tubes, bladder and the intestine.

These cells are probably flushed into the abdominal cavity during menstruation. However, it is also possible that immature cells develop into uterine endometrium cells in the affected places.

Because these patches of cells react strongly to hormones the disease occurs during a woman’s fertile time, as soon as there is regular hormonal activity. When the hormone production declines with the menopause, the endometriosis also subsides.

 

Common symptoms

  • strong convulsive pain during menstruation
  • pain during intercourse
  • pain during defecation or urination

The patients require increasingly strong pain killers, to the extent that only infusions at the doctor’s office or in the hospital can help during menstruation. The disease can lead to an inability to conceive.  Inflammation of the lesions or spatial claims by the cell patches can lead to an occlusion of the tubes.

Read more on the stages of endometriosis

  • Stage I: the lesions are found in the lesser pelvis or uterine neck and are smaller than 5 millimeters, both tubes are navigable
  • Stage II: the lesions are found in the lesser pelvis, the uterine neck or the bladder ceiling, both tubes are damaged
  • Stage III: the endometrious lesions are located in the muscular layer of the uterine wall. One can also find endometrial cysts on the ovaries or the uterine ligaments.
  • Stage IV: the endometriosis is present on other organs, such as intestine, lung and liver

Diagnostics and treatment options

A systematic interview on typical complaints, particularly pain, can assist with diagnosis. Ultrasonic diagnostics can provide help as well. Nevertheless only a laparoscopy and the collection of a small sample can deliver the ultimate proof.

During the surgery it is tried to remove as many spots as possible. In order to treat smaller spots as well, it is often necessary to start a hormone therapy right after the surgery. During this process it will be tested whether the spots can be starved out hormonally. It might be necessary to use preparations that shift the body into a menopausal kind of state. There will be side effects, for instance hot flushes, night sweats, dry skin or a tense, depressive mood.
An alternative is the treatment with birth-control pills or medication that contains the hormone progesterone.