Readers ask

How can you recognize endometriosis?

Many women suffer from abdominal pain during their period.

(Bild: thinkstockphotos.de)

Readers ask, experts answer on the most pressing health issues. Silvia M. (37): "How can I actually tell if I have endometriosis?"

Prof. Dr. Friedrich Gill, specialist in gynaecology and obstetrics from Vienna: " In endometriosis, the lining of the uterus settles in the small pelvis, on or in the ovaries, bowel, bladder and, in rare cases, in the lungs. Physiologically, it is normally located in the uterine cavity and is "bled" every month or so during menstruation to give a fertilized egg the opportunity to implant in the newly formed mucous membrane. If the endometrium is located atypically in the uterine musculature, this is referred to as adenomyosis.

The mechanism of development is still unclear. Among other things, the spread of the disease during menstruation via the fallopian tubes into the abdominal cavity and genetic causes are under discussion. What is certain is the possible spread of the mucous membrane during a caesarean section into the abdominal wall, a so-called scar endometriosis.

Recognition is not always easy, as many women suffer from menstrual pain and this masks the symptoms! The clear indications are pain a few days before the start of menstruation, increasing discomfort at the start of menstruation and only subsiding at the end of menstruation.

In contrast, adenomyosis usually only begins at the start of menstruation. Accompanying symptoms can also include pain when urinating in the bladder region or during bowel movements. During the gynecological examination, there is often severe pressure pain (also during sexual intercourse) in the posterior vaginal vault.

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Endometriosis cysts can sometimes be found on the ovaries during vaginal ultrasound. However, it can also happen that nothing is found during the gynecological examination that confirms the suspicion. In this case, the only remaining option is a laparoscopy, as very often a "discrete" endometriosis on the peritoneum causes more discomfort than a pronounced one with cyst formation! Adenomyosis can sometimes be detected by ultrasound, while magnetic resonance imaging (MRI) provides more reliable information.