Remarkable:

• After all, this disease affects 5 to 10 percent of the female population.
• And there are 40,000 new cases every year.

This includes all women who are not yet or no longer in the menstrual phase of life. This is because endometriosis is closely linked to the menstrual cycle.

This is particularly significant for women with an unfulfilled desire to have children: up to 60 percent of these women have endometriosis. Endometriosis also has a strong impact on the experience of sexuality. This is because pain during sexual intercourse is a serious complaint. And if no cause can be found, this very quickly has an impact on relationships. Women with undiagnosed endometriosis very often suffer from a lack of understanding from those around them in addition to the actual pain. "Don't act like that!" There is therefore an urgent need for education.

What is behind the unpronounceable term "endometriosis"?

The term is derived from the Latin name for the uterus: endometrium.

• In the uterus, the endometrium is built up anew every month as a possible nesting place for a fertilized egg.
• If fertilization does not occur, the endometrium sheds and is expelled with the next menstrual period.
• The whole process starts all over again in the next cycle.

This mucous membrane may also be found outside the uterus. The space between the rectum and the vagina and the bladder wall seem to be the least likely to cause problems. However, if the mucous membrane is located in the fallopian tubes, sterility can be a consequence. In this case, anyone wishing to have children should consider artificial insemination.

On the ovaries we find the chocolate cysts mentioned above, which fill with blood. Such a cyst can be removed by laparoscopy. If the mucous membrane between the rectum and the uterine orifice grows, it can lead to adhesions and adhesions of the intestines. This can cause severe discomfort: Pain during bowel movements, during sexual intercourse, during menstruation. In this case, surgical removal of the diseased tissue is recommended.

However, endometriosis is not limited to the abdomen. This mucous membrane can also develop in the lungs, diaphragm, navel or even the brain.

Why is the disease so difficult to diagnose?

Affected women often have a veritable odyssey from doctor's surgery to doctor's surgery behind them. Of course, one can rightly get upset about this and ask why a single doctor cannot make a diagnosis immediately.

1. One reason is certainly that the symptoms are so diffuse. An important clue is the accumulation of most symptoms at the time of menstruation. However, those affected do not always notice this regularity themselves. And not all symptoms occur in this context. If you suffer from the symptoms described above, problems urinating, low back pain or similar, pay attention to when exactly this pain occurs and keep a record of it. This will help to establish a connection to possible endometriosis.
   
2. Another problem with the diagnosis is the difficulty in visualizing the disease. Foci are rarely visible directly in the vagina during a gynecological examination. While a fibroid can be detected relatively easily by ultrasound, a chocolate cyst has to be quite full before it is noticeable. And even then, it is not necessarily clear that these are endometriosis cysts. Less experienced doctors may not even recognize possible thickenings and lumps. Ultimately, a laparoscopy is required to examine the tissue safely.

Where does the disease come from and what can be done?

The question of where endometriosis comes from can be answered quickly: we don't know. There are various theories: From genetic inheritance, which does indeed seem to play a major role, to changes in the immune system. We have also already seen that it can spread to different parts of the body. This is why it is so difficult to develop suitable treatment methods.

Here you can find

• Painkillers
• operations
• Traditional Chinese medicine
• Acupuncture
• Osteopathy
• Change of diet

As endometriosis is caused by sex hormones - the influence of oestrogen leads to the spread of the disease, while a lack of oestrogen leads to regression - hormones are also prescribed.

Endometriosis affects more than just the physical symptoms

Imagine you have pain during sex over a long period of time. However, your gynecologist cannot diagnose anything. Then you are quickly told that the cause is psychosomatic. You may be told that you are not open enough, have hidden fears or a problem with your partner. That may actually be the case. At some point, you will at least believe it yourself. But this doesn't change the fact that you are in pain.

At first, your partner reacts with understanding, but over time they become completely annoyed. You may even feel pain at the mere touch of your abdomen. Your partner may therefore think that you are just trying to avoid him and sex. Endometriosis can actually break up relationships.

From an economic point of view, the disease is not a trifle either. In the USA, the damage caused by absenteeism is estimated at around 22 billion dollars. The damage caused by depression in Germany is on a par with this figure. But we only have a quarter of the population here. Okay. If we roughly break that down, we are left with just under five billion dollars' worth of damage. That's still quite a lot. On average, those affected are unable to work for 45 days a year. And yet the disease is largely unknown.

One more reason to look forward to the menopause

Endometriosis is a difficult to recognize and often not even known disease that affects women of childbearing age. Once fertility is over, in most cases endometriosis also disappears. Now this is only a faint glimmer of hope if a woman is just 30 years old and suffering from the pain.

It is important to find out the cause so that nobody can say "it's just in your head". The pain is there and in this case has a very clear physical cause. This knowledge alone and the feeling that the illness is being taken seriously relieves a lot of anxiety. "There really is something there, I'm not imagining it". And then treatment can be tackled together with the doctor. Sport, relaxation exercises, acupuncture and a change in diet cannot cure this chronic illness, but they can alleviate the symptoms. And by the time the menopause arrives at the latest, things will have calmed down again.

Anja Drews - qualified sex educator for ORION

Sources: Wikipedia, Frauenärzte im Netz, Klinikum Bielefeld & Ärzteblatt