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Endometriosis: Diagnosis, Therapy, and Self-Help

Every year, 40,000 women are diagnosed with endometriosis. Are you one of them, or are you looking to learn more about what endometriosis is? What forms of therapy can help with this painful condition? This article is based on an interview with Prof. Dr. Med. Sylvia Mechsner, head of the Endometriosis Center at the Charité Women’s Clinic in Berlin.

What is Endometriosis?

Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterine cavity. This lining is called the endometrium. Endometriosis occurs when endometrium-like tissue grows on the ovaries, intestines, and the tissue lining the pelvis. It’s rare for endometrium-like tissue to spread beyond the pelvic region, but it can happen. Such tissue growing outside the uterus is called an endometrial implant.

Prof. Mechsner emphasizes the importance of not dismissing abdominal pain as general menstrual pain, but seeking medical support early. “Early treatment can influence the severity of pain in the long term,” explains Prof. Sylvia Mechsner, who has treated thousands of women in her Berlin practice for endometriosis.

What Causes the Pain in Endometriosis?

The hormonal changes of the menstrual cycle affect the misplaced endometrium-like tissue, causing inflammation and pain. This means the tissue grows, thickens, and breaks down. Over time, the degraded tissue has nowhere to go and becomes trapped in the pelvis.

Prof. Mechsner explains that this trapped tissue in the pelvis can cause severe pain during the menstrual cycle, fertility problems, irritation, scarring, and adhesions that connect your pelvic organs together.

What Are the Symptoms of Endometriosis?

The symptoms of endometriosis vary. Some women have mild pain, while others may have moderate to severe symptoms. The severity of your pain does not indicate the degree or stage of the disease. You can have a mild form of the disease but experience excruciating pain. It’s also possible to have a severe form of endometriosis with very little discomfort.

Pelvic pain is the most common symptom of endometriosis. You may also experience painful periods, cramps for 1 or 2 weeks around menstruation, and heavy menstrual bleeding or spotting. Pain during sexual intercourse, discomfort during bowel movements, or back pain that can occur at any time during your menstrual cycle are also symptoms. Prof. Mechsner notes that these pains and discomfort significantly affect the lives of affected women, making informed treatment important for quality of life.

It’s important to undergo regular gynecological examinations, so your doctor can monitor all changes. This is especially important if you have two or more of these symptoms.

What Causes Endometriosis?

“The exact cause of endometriosis is not known. There are several theories about the cause, although none have been definitively proven,” explains Prof. Mechsner from the Endometriosis Center in Berlin. Some scientists believe the condition can occur when small areas of your abdomen transform into endometrium-like tissue. This can happen because cells in your abdomen grow from embryonic cells that can change shape and behave like endometrial cells. It is not known why this happens.

These displaced endometrial cells can be found on your pelvic walls and the surfaces of your pelvic organs such as the bladder, ovaries, and rectum. They continue to grow, thicken, and bleed during your menstrual cycle in response to the hormones of your cycle.

It is also possible for menstrual blood to leak into the pelvic cavity through a surgical scar, such as from a cesarean section. Another theory is that endometrial cells are transported from the uterus through the lymphatic system. The development of endometriosis could also be linked to genetics or even environmental toxins.

Risk Factors for Developing Endometriosis

Endometriosis usually develops years after the onset of your menstrual cycle. If you know the risk factors and symptoms, you can determine if you are more likely to develop the condition and when to talk to your doctor. Prof. Mechsner from the Charité Women’s Clinic in Berlin highlights the following risk factors:

Age

Women of all ages are at risk for endometriosis. It most often affects women in their 30s and 40s, but the first symptoms of endometriosis can begin in puberty. Some endometriosis centers already focus on adolescent women to start pain therapy early.

Family History

Talk to your doctor if women in your family have had endometriosis. This may increase your risk of developing the disease.

Menstrual History

Talk to your doctor if you have problems with your period. These issues may include shorter cycles, heavy and prolonged menstruation starting at a young age.

Treatment of Endometriosis

Every woman understandably wants quick relief from the pain and other symptoms of endometriosis. This condition can lead to challenges in daily activities if left untreated and painful. Endometriosis is not curable, but its symptoms can be treated.

There are medical and surgical options available to alleviate symptoms and manage potential complications. Each body is individual and reacts differently to treatment options. Together with your doctor, you can try different therapy approaches and determine the best treatment for you. Prof. Sylvia Mechsner also considers whether there is a desire for children or not.

Treatment options include:

Pain Medication: You can try over-the-counter pain relievers like ibuprofen. Hormone Therapy: Hormone therapy helps your body regulate the monthly hormonal changes that promote tissue growth that occurs with endometriosis. Taking additional hormones can sometimes alleviate pain and stop the progression of endometriosis. Hormonal Contraceptives: These reduce fertility by preventing the monthly growth and build-up of endometrium-like tissue. Birth control pills, patches, and vaginal rings can alleviate or even eliminate pain in less severe endometriosis.

Surgical Procedures

Surgery is typically used in women who want to become pregnant or have severe pain and hormone treatments are not effective. The goal of conservative surgery is to remove endometrial growths without damaging the reproductive organs.

Laparoscopy

A minimally invasive surgery is used to diagnose endometriosis. It is also used to remove abnormal or displaced endometrium-like tissue. A surgeon makes small incisions in the abdomen to surgically remove the growths or burn or vaporize them. Lasers are now commonly used to destroy this “misplaced” tissue.

Hysterectomy

Your doctor may recommend a total hysterectomy as a last resort if your condition does not improve with other treatments. During a total hysterectomy, a surgeon removes the uterus and cervix. They also remove the ovaries because these organs produce estrogen, and estrogen can cause the growth of endometrium-like tissue. Additionally, the surgeon removes visible implant lesions.

Diet / Supplements

In general, it is highly advised to take additional magnesium (400 mg morning and evening) for endometriosis. Anti-inflammatory substances are also important. These include omega-3 fatty acids, turmeric, green tea extract, or probiotics. A histamine-free diet is also recommended from time to time. Prof. Mechsner emphasizes how important an anti-inflammatory diet is for endometriosis-related complaints.

It is important to know with endometriosis that you are not alone and do not have to go through difficult moments alone. Consider whether a support group would be good for you, providing emotional support and helping you learn more about the disease. These steps can help develop a balanced approach to treating your condition.

Exchanging experiences in a group of affected women provides support and emotional stability. You know that you are not alone with your complaints and that many women like you face endometriosis every day. Together, with good treatment, you can gain a lot of quality of life!

The ENDOGREET Study: Advancing Endometriosis Treatment Research
with tigovit green tea extract

The ENDOGREET study is a significant step forward in the scientific exploration of green tea extract for treating symptoms associated with endometriosis. This rigorously structured, randomized, double-blind, and placebo-controlled study aims to determine the efficacy of green tea in treating endometriosis-related symptoms. It includes women aged 18-51, either with a confirmed diagnosis or suspected presence of endometriosis, who experience menstrual or chronic pelvic pain. Green tea extract has shown promising effects in preliminary studies on cultured endometriosis cells. The study’s purpose is to assess the effectiveness of green tea extract in relieving symptoms associated with endometriosis-related pain (including pain during menstruation and non-menstrual lower abdominal pain). As we await the results from the ENDOGREET study, recognizing the potential of natural remedies like green tea in managing endometriosis is crucial. The journey towards effective endometriosis treatment continues, with green tea potentially paving the way for innovative, natural solutions.

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