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Endometriosis: Fulfill the desire for children with appropriate treatment

© leszekglasner / fotolia

An unfulfilled desire for children and severe menstrual pains - the cause is often endometriosis. The Endometriosis Center at the Medical Center - University of Freiburg specializes in its treatment and offers special pediatric consultations.

More than 30,000 women contract endometriosis every year. It is estimated that 10 to 15 percent of all women of sexually mature age suffer from it. That's between two and six million women in Germany. To help those affected as quickly as possible, Professor Dr. Gerald Gitsch, Medical Director of the Department of Obstetrics and Gynecology at the Medical Center - University of Freiburg, created the Endometriosis Center in 2015. In 2017 the Endometriosis Center was certified by the Endometriosis Research Foundation, the European Endometriosis League and the Endometriosis Association of Germany.

In endometriosis, the uterine lining (endometrium) locates outside the uterus which in most cases causes severe, cycle-dependent pain. Endometrial growths spread in the lower abdomen on the ovaries, fallopian tubes, intestine, bladder or peritoneum (abdominal lining) of the woman, and sometimes also in other organs. Endometriosis is a benign but often painful chronic condition. It almost always disappears on its own during menopause. The exact origin is still unclear.

Endometriosis usually remains undetected for years

"On average it takes six years for an affected woman to get the right diagnosis," says Professor Gitsch. That's how long women often suffer from pain during menstruation, intercourse, back pain and, less commonly, pain when urinating or defecating. "Typical of endometriosis is that the symptoms increase with the menstrual cycle and then subside again. But half of the women with endometriosis have no symptoms," explains private lecturer Dr. Michaela Bossart, Senior Physician in the Department of Obstetrics and Gynecology at the Medical Center - University of Freiburg. Together with Dr. Jörg Woll, also a Senior Physician there, she heads the Endometriosis Center.

"About one out of every two women with an unfulfilled desire for children has endometriosis" Dr. Jörg Woll, Head of the Endometriosis Center, Department of Obstetrics and Gynecology, Medical Center - University of Freiburg.

The only reliable way to make a diagnosis is via surgery under general anesthesia. In a laparoscopy, a tissue sample is removed and examined. In addition, the position, severity and growth type of the endometrial lesions can be determined by the laparoscopy. If endometriosis is confirmed, endometriosis surgery may already be begun during the procedure.

Pediatric consulations at the Endometriosis Center

For many women, fulfilling the desire to have children is at the forefront. "About one out of every two women with an unfulfilled desire for children has endometriosis," explains Dr. Woll. "That's why we also offer consultations on fertility therapy when endometriosis is diagnosed, for which the women or couples affected can make an appointment."

Good treatment results

There is currently no treatment that can cure endometriosis, that is eliminate its causes. However, several treatment options can help to temporarily or permanently relieve the symptoms. In most cases, laparoscopic surgery followed by medicinal treatment with hormones or painkillers brings freedom from symptoms. "It's a great joy every time, when many of the women who were involuntarily childless become pregnant after treatment," says the specialist Dr. Bossart.