Endometriosis: diagnostics and treatment options
Dr. med. Dimitrios Chronas
November 6, 2024
6 min
At the recent public event at Zollikerberg Hospital on the topic of endometriosis, Dr Dimitrios Chronas, Chief Physician and Head of the Women's Clinic, and PD Dr Daniela Paepke, Senior Physician mb Women's Clinic, ZIMT, BreastCentre Zurich, Bethanien & Zollikerberg, provided insights into the diagnostics and treatment options of medicine and integrative medicine. Our experts summarise the most important findings of the event here.
What is endometriosis and what complaints and symptoms can be associated with it?
Endometriosis is a hormone-dependent disease in which tissue that resembles the lining of the uterus grows outside the uterine cavity. It mainly occurs in the abdominal cavity, usually on the peritoneum or ovaries. If the endometriosis tissue grows in the muscle wall of the uterus itself, it is called adenomyosis. Endometriosis causes various complaints and symptoms, including
- Pain: This often occurs during menstruation, but also during sexual intercourse, urination or defecation.
- Chronic pain: Over time, the pain can become a constant companion.
- Infertility: Many affected women have difficulties getting pregnant.
- Non-specific symptoms: Endometriosis can also cause a variety of non-specific symptoms that cannot always be clearly categorised. These include, for example, digestive problems or diffuse pain outside the abdomen in the sense of pain radiating outwards.
At what age are women no longer affected by endometriosis?
Endometriosis usually affects women of childbearing age, i.e. from puberty to the menopause. With the menopause, hormone levels drop sharply, which usually stops the growth of endometriosis tissue. Therefore, women are usually no longer affected after the menopause.
How common is endometriosis and what are the risk factors?
Around 10 to 15 per cent of women of childbearing age are affected by endometriosis. In women who experience pain or have difficulty getting pregnant, the proportion can be as high as 50 per cent. It is not yet clear how endometriosis develops, but there are certain risk factors:
- a very early first menstruation
- short menstrual cycles
- heavy menstrual bleeding
- Family history, such as relatives who are also affected
- hormonal imbalances
Public event on endometriosis
Missed the lecture? Watch the recording.
In October, the well-attended public event "Endometriosis in Focus" took place at Zollikerberg Hospital. Dr Dimitrios Chronas, Chief Physician and Head of the Women's Clinic, and PD Dr Daniela Paepke, Senior Physician at the Women's Clinic, ZIMT, BrustCentrum Zürich, Bethanien & Zollikerberg, provided fascinating insights into the topic in their presentations and answered a wide range of questions from the audience. You can find the entire recording of the event on YouTube.
How can endometriosis be diagnosed?
Various tests are available to diagnose endometriosis:
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Our endometriosis consultation
Severe menstrual cramps, lower abdominal pain, pain during sexual intercourse, involuntary childlessness and bloody urine or faeces are typical symptoms of endometriosis. Individual counselling and treatment is crucial for affected patients. We are happy to support you on your personalised treatment path for endometriosis.
What treatment options are available in medicine and integrative medicine?
Painkillers are used to alleviate the pain. However, they do not directly affect the endometriosis centres themselves, but only have a symptom-relieving effect.
Hormone treatment is often used to stop the growth of endometriosis tissue. As oestrogen stimulates the endometriosis tissue, progesterone acts as an antagonist and inhibits growth.
If the symptoms are severe, hormone therapy is not effective, desired or tolerated, or organs such as the kidneys or intestines are impaired in their function, it may be advisable to surgically remove the endometriosis tissue. For women who wish to have children, careful consideration is given to whether and when an operation is the right step.
Integrative medicine can also make a major contribution to the treatment of endometriosis and pain. The most important pillar here is lifestyle counselling and, if necessary, changes to your own lifestyle. It is recommended to reduce inflammation-promoting foods such as alcohol, sugar, animal fats, trans fats and gluten. On the other hand, an abundant intake of inflammation-reducing foods such as pulses, vegetables, oils rich in omega-3 fatty acids, fish and fish oil is recommended.
Warmth and relaxation are also important topics and can be treated with the help of external applications such as rubs or wraps and with the help of meditation or mind-body medicine. MBSR courses (mindfulness-based stress reduction) are recommended here.
Phytotherapy, homeopathy and anthroposophic medicines can also be used to reduce pain. These should be individually prescribed or recommended by a doctor with appropriate training.
Our experts answer two additional questions from the audience.
"Can you start trying to get pregnant straight after a laparoscopy or should you wait for the next cycle?"
After a laparoscopy in which endometriosis has been removed, there is no fixed rule to wait for the next cycle to get pregnant. However, it is often advisable to recover briefly and talk to your doctor about the best time. In many cases, women who wish to have children are advised to try to get pregnant soon after the operation, as the chances are often best directly after the removal of endometriosis foci.
"How long should I take hormone treatment after a laparoscopy?"
The duration of hormone treatment after a laparoscopy depends on several factors, such as the severity of the endometriosis, the symptoms, the patient's life situation or age. Hormone treatment is often continued for at least six months to a year to prevent the endometriosis tissue from growing again. In many cases, however, long-term treatment can also be useful, especially if the risk of recurrence is high. It is important to regularly discuss with your doctor how long the treatment should be continued.
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