Kinderwunschzentrum
Berlin
Ihre Spezialisten bei unerfüllter Kinderlosigkeit und Kinderwunsch für Berlin und Brandenburg

Dr. med. Reinhard Hannen

Dr. med. Christian Stoll

Landgrafenstr. 14
10787 Berlin/ Tiergarten

Web: www.kinderwunschzentrum.de
eMail: info@kinderwunschzentrum.de

Tel.: +49.(0)30.263 983 - 0
Fax: +49.(0)30.263 983 - 99
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Kinderwunsch Zentrum Kinderwunschzentrum Berlin und Brandenburg bei unerflltem Kinderwunsch
 
 

Endometriose

 

Endometriosis General:

Endometriosis is one of the most common gynaecological diseases to occur during the years of sexual maturity.  Around 10% of all women are affected between puberty and the menopause.  Nevertheless, it is diagnosed seldom and, often, very late (on average 7-10 years after the first painful symptoms).

 

Endometriosis can occur on the peritoneum, the fallopian tubes, the ovaries, the bladder, the intenstine and in the womb.  Just like the normal endometrium, the endometriosis changes during the menstrual cycle. The endometriosis is usually found in the lower abdomen / pelvic area and also commonly on the ovaries.  It is not unusual for endometriosis to spread into the vaginal wall and intestine and occasionally lesions have been found in the lungs and brain.  The associated pain can be attributed to the endometriosis lesions which bleed with the menstrual cycle, become inflamed and also scar.

 

Definition:

Endometriosis is a benign but painful and chronic proliferation of tissue which is similar to that of the endometrium, both outside the womb and within the womb`s musculature.

 

Causes:

Where does endometriosis come from?

There is not yet a definitive explanation
as to how the disease occurs.  During menstruation, all women bleed not only from the vagina but also experience so-called backward or retrograde menstruation, meaning bleeding through the fallopian tubes into the abdomen.  This period blood contains endometrium cells which are living and thus capable of implantation.  It is thought that these cells have a kind of stem-cell character, so that they are not broken down by the body but settle instead in another place which is foreign to them.  Endometriosis develops in these places.  Another theory is that endometriosis is a disease of the womb and that the endometriosis cells come from the deepest layer of the endometrium through a kind of unexplained hyperactivity of the womb muscle or through tiny wounds.  These cells then separate from the main body of cells and move into the abdomen, in that they accumulate. Finally, hormones and the immune system play a part which is not to be underestimated.  It is assumed that endometriosis is also hereditary as it occurs often within families.  The respective risks increase when a close relative (e.g. mother or sister) already has endometriosis.  Scientists also attribute the increase in occurrence of this disease to environmental hormones such as PCB, DDT or dioxide.  These substances have a similar effect to the hormone oestrogen and can thus confuse the endocrine system before the prenatal phase.

 

Who is affected?

Women in the childbearing years are mostly affected.  Generally, the disease first occurs between the ages of 23 and 27.  Cases of pre-pubertal endometriosis have been described but without scientific confirmation.  During the menopause, endometriosis usually always disappears.

 

Symptoms:

Which complaints are associated with endometriosis?  The endometriosis-tissue is, like the endometrium, dependent on the female sex hormones oestrogen and/or gestagen and is influenced by these.  This also explains why typical endometriosis symptoms mainly occur just before or during the woman`s monthly period.  Typical symptoms are: cramp-like to unbearable period pains, chronic abdomen and back pains, pain during intercourse and even pain during bowel movements or urinating.  Many endometriosis patients require painkillers.  Many endometriosis patients suffer from the unfulfilled desire to have a child (infertility).  Causes of this are the muscular hyperactivity of the womb which leads to a shortened period of residence of the sperm in the fallopian tube or the settling of endometriosis lesions in the fallopian tubes and the resulting reduction of the functioning of the fallopian tubes, reduced ovarian activity due to endometriosis cysts in the ovaries and, of course, knots in the lower abdomen related to endometriosis.  The immune system also plays a part.  An increased accumulation of “genetically foreign” sperm in the abdominal cavity and hyperactivity of the immune system can be a side-effect of the hyperactivity of the womb.  The immune system is also continually aggravated through the chronic inflammation.  Sometimes endometriosis is first diagnosed during research into the causes of undesired childlessness.  Endometriosis can be extremely painful but it is also possible that endometriosis goes unnoticed over the years and thus is only recognised later on.

 

Treatment of Endometriosis:

Operations:

Often, a laparoscopy has to first be carried out.  This serves the purpose of diagnosis and, at the same time, therapy, as endometriosis lesions and growths can often be removed during the operation.  In addition, the fallopian tubes of the patient who has a desire to have children can be examined for blockages.  Often, the operation leads to significant pain relief.  In the most serious cases, in which the patient has no desire to have children, the removal of the womb and, above all, the ovaries can lead to a definitive easing of pain.  This unfortunately results in an early menopause, with all the problems associated with this.
Hormone treatment
Sometimes, additional hormonal treatment has to be carried out, so that the remaining endometriosis lesions can dry out.  This therapy has to be very closely observed because it involves symptoms and problems of the menopause such as depletion of bone density (osteoporosis), hot flushes and sleep disorders.  In addition to removal through an operation the endometriosis lesions can be calmed through hormone therapy e.g. with gestagens such as the mini-pill and the 3-month-injection or the “normal” pill (taken without a break).
Additional treatment methods
Complimentary treatment procedures such as acupuncture or traditional Chinese medicine and/or natural healing practices can also greatly help the patient under stress.  These practices are in accordance with medical methods of treatment.  There is no validated study data on the subject of homeopathic treatment.  Relapse is not uncommon in all treatment methods.
Pain therapy
The pain can be treated symptomatically with acetylsalicylic acid, Buscopan, Diclofenac, Ibuprofen, Naproxen or other COX-inhibitors.
Dietary change
In the opinion of the British Endometriosis Society, the pain can be eased through a change in diet.  Milk, milk products and wheat should be avoided and plenty of fresh fruit and vegetables, cold-pressed oil such as evening primrose oil and linseed oil and oily fish (omega-3 fatty acids) should be eaten.

 

Procedure during Visit to Endometriosis Centre:

First of all, a detailed consultation with the doctor including a discussion of medical history takes place (Anamnesis).  A gynaecological examination follows.  An analysis of the typical symptoms leads to a suspected diagnosis.  An ultrasound examination or, if need be, other image-providing procedures such as computer tomography and MRT are employed to help in the diagnosis.  A definitive endometriosis diagnosis can only be made, however, through a laparoscopy and final examination of the tissue samples.

 

Our Aim:

As endometriosis is a disease of fertile women which can occur over decades and thus shows chronic progression, the endometriosis centre has to consider the life situation of each individual when devising a therapy concept.  Of course, the unfulfilled desire to have a child is taken into account but nevertheless, methods to improve quality of life must also be heeded.  It therefore makes sense and is, indeed, necessary, that the partner is involved in the diagnosis and therapy of endometriosis.  As a result of our extensive experience as gynaecological hormone specialists (endocrinologists) and fertility doctors (reproduction doctors), as well as our good cooperation with special operative endometriosis centres, level III, you can be assured that you are in good hands.  Please bring your doctor`s referral, copies of operation reports, doctor`s reports, reports of fine-tissue examinations (histologies) and, if possible, a short written summary of endometriosis treatment which has been carried out to date.  We will take care of you!

 

Endometriosis consultation times:

 

Our special endometriosis consultation session takes place every
Tuesday from 08:00-12:00 noon.

 

Contact information to make an appointment or to send medical results can be found here…

 

Further Contact Information:

 

Endometriose-Vereinigung Deutschland e.V.

Bernhard-Göring-Straße 152,

04277 Leipzig,

Tel.: 0341 / 306 5304

www.endometriose-vereinigung.de

 

 

Self-help group Berlin

Fehrbelliner Str. 92,

10119 Berlin-Prenzlauer Berg,

Tel.: 030 / 4434317

 

 

Stiftung Endometriose Forschung
(equivalent Endometriosis Research Foundation)

Lange Straße 38,

26655 Westerstede,

Tel.: 04488 / 503230,

Fax.: 04488- 503999

www.endometriose-sef.de

 

 

World Endometriosis Society

Southgate Road 89
London N1 3JS

Mrs. Lone Hummelshoj

www.endometriosis.org

lone@endometriosis.org

 

 

Our cooperation partners with: 

 

Endometriosis centre level III

Vivantes Humboldt-Klinikum
Klinik für Gynäkologie und Geburtsmedizin

Klinikdirektor Gynäkologie und Geburtsmedizin
(Vivantes Humboldt Clinic, Clinic for
Gynaecology and Birth Medicine)

Prof. Dr. Dr. Andreas D. Ebert
Am Nordgraben 2
13509 Berlin

 Tel.:+49 (30) 4194 - 2151

Fax.:+49 (30) 4194 - 1262

huk.gynaekologie@vivantes.de

www.vivantes.de/web/einrichtungen/huk_geb_gyn.htm

 

Endometriosis centre level III

Martin Luther Krankenhaus GmbH

Prof. Dr. med. Uwe Ulrich

Caspar-Theyß-Straße 27
14193  Berlin

Tel.: +49 (30) 8955-3311

Fax.:+49 (30) 89553366

u.ulrich@mlk-berlin.de

www.mlk-berlin.de

 

 

Cooperation with spa centres for endometriosis patients:

 

Staatsbad Salzuflen GmbH

Herrn Wilfried Stephan Geschäftsführer

Parkstraße 20

32105 Bad Salzuflen 

Tel.: +49 (5222) 1830;

Fax: +49 (5222) 183226;

s.nolte@staatsbad-salzuflen.de

www.frauenbewegungskur.de

 

 

Eisenmoorbad Bad Schmiedeberg-Kur-GmbH

Spa Director Dipl.-Ing., Dipl.-Jur. Siegfried Scholz

Managing Directo

Kurpromenade 1

06905 Bad Schmiedeberg

Telefon: (03 49 25) 6-0,

Telefax: (03 49 25) 6 29 00,

verwaltung@eisenmoorbad.de

www.eisenmoorbad.de

 

 

Treatment Methods

 

 

 

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