Endometriosis Awareness Month
Pain in the abdomen is known to many women as a common symptom of menstruation. However, a chronic disease can also be the reason for this pain: endometriosis.
Endometriosis and its symptoms
“In endometriosis, tissue similar to the lining of the uterus migrates into the abdominal cavity and settles in other places in the abdomen outside the uterus,” explains Alina Staikov, MD (bg), a specialist in gynaecology and obstetrics and head of a women’s health practice. Because these mucosal sites are hormone-sensitive and subject to the menstrual cycle, there is also monthly bleeding. This can result in inflammation and pain throughout the abdomen. Symptoms such as lower abdominal and back pain during menstruation, but also during sexual intercourse, urination or defecation, complicate the daily lives of those affected. In addition, these symptoms are sometimes accompanied by vomiting and circulatory collapse. Staikov elaborates: “Over time, chronic pain remains, which can also occur independently of the menstrual cycle.”
Endometriosis leads to a deterioration in quality of life and can have other consequences. Good treatment and extensive support are therefore strongly recommended. “This also applies to cases in which surgical treatment has already taken place and no pregnancy has subsequently occurred or in which no hormonal treatment has been initiated,” Staikov explains. All studies and experience show that endometriosis has a progressive course. In other words, there is always a worsening of the symptoms and the clinical picture. This can result in problems such as a reduction in fertility or, in rare cases, ovarian cancer. In addition, the clinical picture can also have consequences outside the reproductive organs: Intestinal obstruction, urin bladder disorders and kidney insufficiency are possible secondary diseases.
Diagnosis as the first step
The non-specific symptoms of endometriosis make it difficult to recognise suspicious signs and to make a quick diagnosis. Cases with few symptoms, for example, can easily be mistaken for a urinary tract infection because they only manifest themselves as painful urination. Severe menstrual pain that requires regular use of painkillers or a change in daily routine should be seen as a cause for suspicion.
The suspicion can be confirmed if there is also pain during sexual intercourse or defecation. Staikov recommends “consulting a specialist in case of suspicion or unclear complaints”.
Because endometriosis can only be suspected on the basis of the symptoms and complaints. The diagnosis can only be confirmed by laparoscopy (abdominal endoscopy).
Endometriosis is a chronic disease with a complex clinical picture.
Consequences for social life
Because of the non-specific symptoms of endometriosis and its relative unfamiliarity, it can be difficult for those affected to find appropriate help. For example, iron deficiency and dysuria are well-known symptoms with many possible causes, which is why endometriosis can go undiagnosed for a long time. Melanie Vogt, Endometriosis Care Nurse and sufferer herself, describes it like this: “Many sufferers run from doctor to doctor and feel that they are not taken seriously. Many doctors also don’t know much about endometriosis, or claim that you shouldn’t make such a fuss because menstrual pain is normal.” From her own experience, she would therefore also recommend seeing specialists for clarification if there is any suspicion.
Depending on the severity of the endometriosis, the disease also has an impact on the private lives of those affected. “Permanent abdominal pain, even if it is not cycle-related, often accompanies us – often together with digestive disorders. We affectionately call this belly ‘endo-belly’,” explains Vogt. In addition, fatigue and chronic pain are constant companions. These symptoms sometimes make it impossible to go through with appointments and plans. This makes it difficult to build relationships with friends or a partner, as the understanding of the disease in society is still very vague and the disease is still taboo. Vogt is also aware of this dynamic: “Many men can’t relate to endometriosis and simply want a healthy partner.”
Text Kevin Meier , Tagesanzeiger January 2021, Focus Modern Woman
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