Endometriosis – Causes, Symptoms & Treatment


Endometriosis is an overgrowth of the lining of the uterus that only affects women due to the symptoms and limitation of disease in the uterus based on the underlying anatomy.

What is endometriosis?

In women with endometriosis, there is an overgrowth of tissue that manifests itself in the mucous membrane outside the uterus. Endometriosis affects the endometrium, the lining of the uterus.

Endometriosis is caused by benign growths on the mucous membrane that do not cause metastases to form. Endometriosis is characterized by sometimes quite severe painful impairments. Endometriosis is not only typical of the areas around the uterus.

Endomeriosis can also develop on the peritoneum in the small pelvis, on the so-called retaining ligaments of the uterus and on the ovaries. Endometriosis is also quite common in the Douglas space. This area is the deepest part of the abdomen behind the uterus. Endometriosis is a proliferative abnormality characterized by continued growth if left untreated.


Despite extensive research, the causes of endometriosis are not yet clearly known. Only numerous risk factors can have a direct influence on the development of endometriosis. It is believed that endometriosis is an expression of secondary tumors from another cancer focus.

In addition, it is acknowledged that cells from the inside of the uterus reach the outer mucous membranes and contribute to endometriosis there.

The processes in the ovaries known as retrograde menstruation can possibly contribute to the promotion of endometriosis by the discharge of cells from the endometrium. A weakened or altered immune system can also be a causal trigger for endometriosis.

Symptoms, Ailments & Signs

Only half of all affected women have symptoms of endometriosis. The symptoms experienced by the other half of those affected depend on the location of the endometriosis in the body. Just like the regular mucous membrane of the uterus, the endometriosis foci are subject to cycle-related changes. Accordingly, complaints mainly occur depending on the cycle.

Whether and how pronounced the symptoms are varies from case to case and is not necessarily related to the size or number of the lesions. A large proportion of the patients are completely symptom-free and the endometriosis is merely an incidental finding. The main symptom of endometriosis is in the second half of the cycle, during and after the period, sometimes very severe, cramping pain. This is known as dysmenorrhea .

In addition, the menstrual period can be increased or there can be bleeding between periods. Depending on the location of the mucosal foci, there are other very different symptoms. These include pain during intercourse and pelvic exams, painful bowel movements or pain when urinating , menstrual bleeding from the bladder or intestines, nausea and circulatory problems .

Women suffering from endometriosis are much more likely to be infertile than healthy women. During a medical examination, patients may find cysts, adhesions, and scars in the affected tissue. Due to the large number of possible symptoms and the different severity of the symptoms, the diagnosis is difficult and the disease is often discovered late.

Diagnosis & History

Due to the diverse and sometimes severe symptoms and symptoms of endmetriosis, women go to a specialist who can perform a laparoscopy to confirm the assumption. In addition, due to the relatively unspecific symptoms of endometriosis, further diagnostic information such as observing menstruation in relation to a painful course, pain in the small of the back and during sexual contact as well as disturbances in the menstrual cycle are useful.

Laboratory examinations of blood and stool as well as the control by the gynecologist can partially represent steps in the diagnosis. So-called imaging techniques such as ultrasound or computer tomography serve as diagnostically relevant options for clarifying endometriosis. In addition, the tissue samples obtained during the laparoscopy are examined.

The progression of endometriosis varies from person to person. Basically, in the majority of cases, endometriosis must be removed in order to create freedom from pain and symptoms and to eliminate the symptoms that occur. Left untreated, endometriosis can lead to infertility .


Since endometriosis is a chronic disease, the symptoms keep recurring. Without treatment, the symptoms usually get worse. Scattering of the lining of the uterus can increase both with and without treatment. As a result, the symptoms increase and other parts of the body can also be affected.

In addition to the cyclically recurring pain, the possible connection to female infertility is a complication. Even if there is no scientific confirmation, studies show that the fertility rate of women suffering from endometriosis is significantly reduced. Without treatment, an existing desire to have children may remain unfulfilled.

Most of the treatment is done with hormones. Complications can occur in many ways, since the hormones control all bodily functions. The administration of estrogens can lead to weight gain and skin reactions. The risk of thrombosis in the affected women also increases. Hot flashes and sweating as well as reduced bone density are also possible side effects of hormone administration.

If parts of the lining of the uterus are spread over a large area, an operation is carried out. Complications can include problems during or after the anesthetic, the risk of infection is increased, and scarring occurs. The adhesions at the interfaces can also cause pain. Alternative medical, supportive measures such as mud packs, massages and implementation of relaxation techniques such as yoga proceed without complications.

When should you go to the doctor?

Women who have severe menstrual pain or suffer from other menstrual problems should consult a doctor. If you experience low back pain or pain during intercourse, this indicates a serious condition that needs to be investigated. The doctor can determine whether it is endometriosis and, if necessary, initiate treatment immediately. If there is an unfulfilled desire to have children, this must also be clarified. Possibly a previously undetected endometriosis is present, which has led to infertility.

Prompt treatment may resolve the growth and restore fertility. People who have had cancer before are particularly susceptible to endometriosis. A weakened or altered immune system can also promote proliferation of the uterine lining. If these risk factors are present, the gynecologist should be consulted quickly with the symptoms mentioned. Other contacts are internists or – in the case of a medical emergency – the emergency services. Infertility may need to be worked through with a therapist.

Treatment & Therapy

Various methods and procedures are available to doctors for the treatment of endometriosis. However, treatment is not mandatory for every woman.

The two pillars of endometriosis therapy are drug and surgical treatment. With the operation, women affected by endometriosis are finally free of symptoms. The surgical intervention against endometriosis is based on a laparoscopy or laparoscopy. This procedure can enable laser-assisted excision of endometriosis.

In some cases, endometriosis can be removed through the vagina. An abdominal incision is usually justified when the endometriosis cannot be reached in any other way. This method is carried out only after family planning is completed, since the abdominal incision mostly includes the removal of the ovaries at the same time.

For the treatment of endometriosis with drugs, progestins and drugs known as GnRh antagonists are administered. The prescribed drugs usually have to be taken over a longer period of time, usually over half a year, to achieve the intended effect.

Outlook & Forecast

According to the current medical status, endometriosis cannot be completely cured and difficulties can therefore arise again and again in the course of an affected patient’s life. There are also some cases of endometriosis in which the affected woman has no symptoms for the rest of her life.

If an endometriosis focus spreads or a new focus develops, new symptoms or an aggravation of existing symptoms must first be expected. Depending on the severity and level of suffering of the patient, surgical removal of the endometriosis focus may be necessary, which eliminates the symptoms. However, this only lasts until another problematic focus occurs in the body.

Problems also arise when women with endometriosis want to become pregnant. Fertility is limited by endometriosis; in some cases natural fertilization is even impossible. Affected women still have the option of artificial insemination , but it is also possible that no pregnancy occurs or that the pregnancy is terminated in the first few days and weeks.

If, on the other hand, the pregnancy persists and the child is born, it is possible that the endometriosis improves after the birth and the woman then has to deal with less severe symptoms or no symptoms at all.


There are no known ways to prevent endometriosis. This would only be possible if the causal triggers could be narrowed down sufficiently. However, within the framework of targeted self-observation, women are able to realize early detection of endometriosis. In the event of irregularities in menstruation, such as persistent and recurring symptoms during or between menstrual periods, it is advisable to talk to your gynecologist.


Many women who have endometriosis have to undergo surgery to remove the painful growths in the lining of the uterus. Under certain conditions, these can spread throughout the body. Depending on where the knots were removed, an adhesion bulge can develop. Alternatively, there may be other postoperative consequences. Both may require follow-up care.

When cells from the lining of the womb become lodged in the body, it causes pain. These are not always given to an acceptable extent. Endometriosis can also lead to infertility. Nevertheless, there is no need for treatment if the endometriosis causes no or only minor symptoms. In this case, there is no follow-up care.

The situation is different, however, when the lining of the uterus settles on the intestinal wall, on organs or even in the eye. In this case, surgical options must be discussed. In addition, the resulting pain can be treated psychotherapeutically and thereby alleviated.

Treatment with painkillers or hormone preparations should be closely monitored in terms of aftercare. Both can lead to consequences such as addiction and dependency or an increased risk of thrombosis or embolism. The age of the woman therefore plays a decisive role in the treatment and aftercare measures chosen. In old age, a hysterectomy may be indicated. As a rule, this operation is followed only by postoperative follow-up care.

You can do that yourself

With endometriosis, the uterine lining forms outside the uterine cavity, which is often associated with enormous pain for the women affected. The patients cannot take any self-help measures that combat the root cause of the problem.

The most important step towards self-help is to work towards a speedy diagnosis and adequate medical treatment. Women who suffer from severe pain during menstruation should by no means accept this as “natural”, but should consult a gynecologist in any case. If endometriosis is actually diagnosed, there are a number of treatment options.

Patients should then seek comprehensive information from an expert about all possible therapy options. Gynecologists specializing in the treatment of endometriosis can be researched on the Internet, and the medical associations and health insurance companies also provide information on this.

During an acute attack, affected women should rest if possible and spend a day in bed. A hot water bottle on the stomach often provides relief. Chemical hand warmers, which can be placed discreetly under clothing, help on the go and at work.

Naturopathy recommends intestinal cleansing with subsequent change in diet to a largely plant-based diet with a high proportion of raw food for endometriosis There is no scientific research on the effectiveness of this treatment method for endometriosis. However, since a balanced, plant-based diet is beneficial to overall health, there is nothing wrong with trying it.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.