Endometriosis – What is it?

Endometriosis is a benign but chronic condition. In endometriosis, tissue resembling the uterine lining grows outside the uterus.

The Chameleon of Gynecological Conditions: Endometriosis is a Benign Condition That Primarily Affects Women of Reproductive Age

Endometriosis is a condition in which tissue similar to the lining of the uterus grows in locations outside the uterus, such as the ovaries, in the abdominal and pelvic areas, on the intestines, or on the abdominal lining. Occasionally, this tissue can also occur outside the abdominal cavity. These tissue displacements lead to the formation of cysts and inflammation, which can cause significant pain.

Normally, the uterine lining (endometrium) regularly builds up and sheds during the menstrual cycle. Endometrial cells located outside the uterus also respond to the hormonal cycle and can bleed. However, the blood and the shed tissue have no way to exit the body and accumulate as endometrial lesions. From these lesions, endometriosis cysts, often called chocolate cysts, can develop. These processes lead to chronic inflammation, scarring, and adhesions in the affected tissues, resulting in intense pain that is not limited to the menstrual period. Endometriosis can have serious complications, including infertility. In 40 to 50% of cases of infertility, endometriosis has been identified as the cause. 

Age-Specific Frequency and Prevalence of Endometriosis

Even adolescents can experience symptoms of the disease from the onset of their first menstruation. The highest likelihood of developing endometriosis occurs between the ages of 35 and 45. Experts estimate that between 6 and 10 percent of all individuals assigned female at birth (AFAB) between puberty and menopause are affected by endometriosis. This equates to approximately 190,000-280,000 individuals in Switzerland. Intersex or non-binary individuals can also develop endometriosis.

How does endometriosis develop?

The mechanisms behind the development of endometriosis are still not fully understood today.

Currently, three theories are being discussed:

  • During the development of the reproductive organs, endometrial cells may settle in locations other than the uterus.
  • During the menstrual cycle, endometrial cells are typically shed through the vagina. However, according to one theory, these cells can “wander” through the fallopian tubes into the pelvic cavity. In individuals with a specific genetic predisposition, it’s possible for these cells to implant in the abdominal cavity. There, they may bleed monthly during menstruation into the abdominal space, leading to adhesions.
  • Another way for endometrial cells to spread is through transport via the lymphatic or circulatory system to distant organs, such as the lungs.

The Symptoms of Endometriosis: An Overview

The symptoms of endometriosis are highly diverse, making diagnosis challenging. A common sign of this condition is severe pain during menstruation. These pains can occur both in relation to the menstrual cycle and independently of it. Moreover, it’s possible for endometriosis to cause pain throughout the entire body.

Frequently reported complaints and symptoms include: 

  • Abdominal and back pain before and during menstruation, which can also radiate to the legs
  • Heavy and irregular menstrual bleeding
  • Pain during and after sexual intercourse
  • Pain during gynecological examinations
  • Pain during bowel movements or urination
  • Cyclic bleeding from the bladder or rectum
  • Unintended infertility

Associated with these symptoms may be:

  • Fatigue and exhaustion
  • Mental health conditions, such as depression and anxiety disorders
  • Increased occurrence of allergies and other autoimmune diseases
  • Heightened susceptibility to infections during menstruation

Treatment Methods: Insights into Current Approaches and Therapies

The choice of treatment method for endometriosis depends on the extent and nature of the symptoms, as well as the associated limitations in the affected person’s daily life. Since endometriosis can manifest very differently in individuals, the therapy must be tailored to the specific needs of each person. A crucial factor in this regard is the selection of a suitable doctor or healthcare provider.

The treatment options for endometriosis are diverse. Before initiating therapy, the goal of treatment should be established through a comprehensive discussion with the doctor. In many cases, interdisciplinary collaboration among experts in the fields of gynecology, pain management, psychology, and holistic medicine can be beneficial.

Common treatment approaches include: 

  • Diagnostic laparoscopy (with tissue sampling) and removal of endometrial lesions
  • Hormone therapy to prevent the buildup of uterine lining
  • Pain management (medication-based pain management, multimodal pain therapy)
  • Complementary treatments (nutrition, exercise, physiotherapy, stress reduction, acupuncture, traditional Chinese medicine, homeopathy, herbal medicine, etc.)
  • Medical cannabis

Medical Cannabis Therapy for Endometriosis?

Medical cannabis can be an effective treatment option for conditions like endometriosis. The use of medical cannabis can provide significant relief from lower abdominal pain, improve gastrointestinal symptoms, and elevate mood. A cannabinoid-based therapy also offers the possibility of reducing the use of conventional pain medications.

In the treatment of endometriosis, pain relievers or hormone medications are often used. However, these do not always lead to a noticeable improvement in symptoms, which can worsen the quality of life for patients, even with medication. In cases where endometrial lesions affect the intestines or bladder, surgical intervention may be considered. However, many patients experience the recurrence of endometrial lesions after surgery. If there is no desire for pregnancy, the removal of the uterus may be considered as a surgical measure.

Medrosan Pharmacy offers a contemporary consulting approach and collaborates with a physician specialized in cannabis. Consultation appointments can also be conducted via telemedicine, in accordance with generally accepted professional standards, if medically appropriate. We are happy to provide you with personal advice at our pharmacy near the Kunsthaus in Zurich. Alternatively, you can contact our partner physician, Nicolai Berardi, to inquire about alternative treatment with medical cannabis for endometriosis.

Valuable Support – Endo-Help Association

Endometriosis affects various aspects of daily life. For those affected, it can be very helpful to connect with others and share experiences. In Switzerland, the Endometriosis Association Endo-Help serves as an umbrella organization and offers various support groups that facilitate the exchange among those affected.

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