Symptoms
The cells of the uterine mucosa that are scattered in the body follow the same cyclical changes as the uterine mucosa. They are influenced by the same hormonal fluctuations and react according to the normal female cycle. In this context, the mucous membrane is also built up hormonally in the area of the endometriosis foci to prepare for the possible implantation of a fertilized egg.
If a fertilized egg fails to implant, the hormone level changes again and the mucosal layers are rejected. Due to this connection, the typical symptoms of endometriosis are mainly seen during menstruation. However, since the removal of the scattered parts of the uterine lining is only possible to a limited extent, subsequent symptoms may occur.
For this reason, affected patients often develop endometriosis cysts on the ovaries. However, both the occurrence and the intensity of the symptoms in the presence of endometriosis vary considerably from woman to woman. It is generally assumed that approximately 20 to 30 percent of affected women remain completely symptom-free.
If symptoms are caused by the scattered endometrial cells of the uterine lining, they too are often very variable. Among the most common symptoms in the presence of endometriosis are In most cases, the affected patients do not suffer permanently from the typical symptoms. Rather, the symptoms occur cycle-dependent or are subject to enormous fluctuations during the cycle.
In general, the symptoms are particularly pronounced in the days before and during menstruation and decrease in intensity once the bleeding has subsided.Over the years, however, the development of tissue scars, adhesions and/or inflammatory processes can lead to a permanent persistence of the symptoms.
- Severe menstrual cramps
- Chronic or recurrent lower abdominal pain
- Pain during sexual intercourse
- Pain when urinating or during bowel movements
- Cycle dependent back pain
- Bleeding disorders, irregular bleeding, spotting
- Fertility disorders, infertility
In some cases, the diagnosis can be made by describing the typical, cycle-dependent symptoms. During the routine gynecological examination, the suspicion of endometriosis may be confirmed.
This way, the affection of the vagina and the cervix can be seen directly, and painful pressure at special points during the examination also provides the doctor with an indication. An ultrasound examination through the vagina can also sometimes provide initial findings. However, a reliable diagnosis can often only be made by laparoscopy. This involves inserting a viewing device (endoscope) through the navel, with which the organs of the small pelvis, i.e. the uterus, fallopian tubes and ovaries, can be viewed. Sometimes a bladder or colonoscopy is also necessary if there is a fear of these organs being affected and they could be injured during a laparoscopy.
