Endometriosis

As the origin of the word suggests, endometriosis is a disease of the uterus, and surrounding area. Endometriosis tissue resemble s the endometrium and is able to grow and bleed along with the hormonal cycle. Even though endometriosis tissue is usually categorised as being benign , it can metastasize and cause permanent damage to the affected organs.

Endometriosis tissue can affect the ovaries, the intestines, and/or the peritoneum . Because the tissue builds up during the menstruation cycle like the endometrium itself but cannot flow out, cyst s develop. Rarely, endometriosis tissue might occur outside the abdomen, for example in the lungs.

Endometriosis is a wide-spread female disease. It affects about 8 to 15% of all German women between puberty and the climacteric period (i.e. peri-menopause, menopause and post-menopause). At up to 40.000 new cases annually, endometriosis is the second most common gynaecologic disease. Only people with a uterus are affected. There is no age limit to when endometriosis might occur (earliest with the first menstruation), however, the highest probability is between the ages of 35 and 45 years.

Which symptoms does it cause? Strong pain during menstruation is the most common symptom. However, the pain can also occur independently of the menstrual cycle. Often occurring symptoms include:

Stomach and back pain

Heavy bleeding during the menstruation

Irregular menstruation

Pain during or after penetration or gynaecological examinations

Pain during urination or defecation

Endometriosis is a systemic disease that may impair the hormonal balance, as well as the immune system.

Consequences of endometriosis may comprise: chronic inflammation s, scarring , adhesion s, haemorrhage in the peritoneal cavity and (often) infertility . Endometriosis causes infertility in about 40 to 60% of women who are involuntarily without children.

What causes endometriosis? The causes of endometriosis have not yet been cleared. However, there are several scientific theories about the reasons for the development of endometriosis (e.g. implantation theory, coelomic-metaplasia-theory).

How is it diagnosed? Presently, the only diagnostic method is laparoscopy . Laparoscopy is a minimally-invasive surgery where a tissue sample is extracted for laboratory examination. Beforehand, the abdominal cavity is filled with carbon dioxide to prepare the field of examination and improve visabillity. Prior to a laparoscopy, gynaecologists examine the area with a speculum and palpation .

How is the disease treated? Since symptoms range from no discomfort at all to severely impaired quality-of-life, the necessary treatment varies as well. Sometimes, treatment is not necessary.

Doctors may prescribe medication such as painkillers to alleviate the symptoms, as well as anti-inflammatory drugs that can also help prevent chronic pain. To mitigate the pain, yoga and relaxation exercises may be helpful.

Hormonal therapy, for example with progestagen compounds, may be useful to reduce the level of the hormone estrogen, which appears to be responsible for the growth of endometriosis tissue.

Often, the endometriotic tissue is removed laparoscopically. Only rarely, a laparotomy is required. Permanent treatment is required in about half of patients. Due to the high recurrence rate, once one endometriosis tissue is removed, another may form. This can lead to chronic pain and other impairment s.

Additionally, it may be useful to check blood nutrient values, especially vitamin D, as this seems to worsen some cases. Some supplements can be beneficial.

As a systemic disease, endometriosis should be treated in an interdisciplinary manner. Therefore, treatments are often combined.

How does society perceive it? Although endometriosis is a very common disease, relatively little is understood both medically and in public. This may be due to the taboo surrounding menstruation and menstrual cramps in our society. One could argue that making it easier to take paid leave from work for menstrual cramps could help to lift this taboo. This, along with more education about endometriosis, may lead to fewer women suffering from endometriosis undiagnosed.

EXERCISE:

1. In some endometriosis cases, a hormonal therapy is indicated. A) True B) False

2. What symptoms do endometriosis patients experience? A) Heavy bleeding during menstruation B) Irregular menstruation C) Headache D) Stomach and back pain E) Burning feet syndrome

3. Currently, endometriosis can only be diagnosed with laparoscopy. A) True B) False

You’ll find the answer below.

BIBLIOGRAPHY 1. www.bayer.com 2. http://dict.leo.org 3. www.dict.cc 4. www.endometriose-vereinigung.de 5. www.nhs.uk 6. www.webster-dictionary.org 7. www.who.int

CARMEN LOBITZ Carmen Lobitz ist freie Trainerin, Lehrerin und MTA. Sie gründete 1998 in Berlin lobitz seminare, die unter anderem Englischseminare für Health Professionals anbieten. Kontakt: mail@lobitz-seminare.de www.lobitz-seminare.de

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Lösung für Exercise:

1. A)

2. A), B), D)

3. A)

Endometriosis

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