March 5, 2025, 2:56 pm | Read time: 3 minutes
Endometriosis is one of the most common gynecological conditions, yet diagnosing it poses significant challenges for doctors. Many women suffer from symptoms for years without knowing the cause. Dr. Heidi Gösslinghoff, a gynecologist and reproductive medicine specialist, explains in an interview with STYLEBOOK what the condition entails, what treatment options are available, and why early diagnosis is crucial.
“Endometriosis involves displaced uterine lining cells outside the uterus,” explains Dr. Gösslinghoff. “These lesions are usually found in the pelvis but can also occur between the intestinal loops or—more rarely—in organs like the lungs.” A special form of the condition is adenomyosis, where endometriosis cells penetrate the uterine muscle.
Overview
Why Is Diagnosis So Difficult?
Endometriosis is a tricky condition because it can be completely symptom-free or cause severe discomfort. Affected individuals often complain of lower abdominal pain, especially before and during menstruation. But this is where the difficulty lies: “The crux is that endometriosis cannot be seen on an ultrasound,” emphasizes the expert.
The diagnosis of endometriosis is usually made through laparoscopy. “You actually have to look inside to definitively diagnose endometriosis,” says Dr. Gösslinghoff. During this procedure, the displaced tissue cells are identified and directly cauterized to alleviate symptoms. Endometriosis can have varying degrees of severity, ranging from one to five. It matters whether the lesions are confined to the pelvis or have spread further. The treatment varies depending on the extent of the condition.
Treatment Options for Endometriosis: Hormone Therapy or Surgery?
Endometriosis is hormone-dependent, meaning it mostly subsides on its own during menopause. But for women who wish to have children, this is not a solution. “You can induce a kind of artificial menopause with certain medications,” explains Dr. Gösslinghoff. “This stops the production of estrogens, which dries out the lesions.” However, this treatment is not indefinitely possible due to side effects like reduced bone density.
Alternatively, there are progestin preparations that do not contain estrogen and thus curb the growth of endometriosis. Lifestyle also plays an important role: “Women should focus on reducing inflammation in the body, for example, through a healthy diet with few artificial additives and plenty of omega-3 fatty acids.”
Endometriosis and Desire for Children
For many women, endometriosis becomes an issue when they want to become pregnant and it doesn’t happen. “After a successful operation where the endometriosis lesions are reduced, we often recommend trying to conceive naturally for three months,” says Dr. Gösslinghoff. If that doesn’t work, a fertility clinic can help.
The path to such a clinic is individual and depends on the severity of the condition and the woman’s age. “If I am older and have severe endometriosis, I would seek out a fertility clinic sooner rather than later,” advises the expert. Pregnancy is often particularly complicated with adenomyosis, as the uterine muscle is affected. “This can make embryo implantation difficult and cause problems later in pregnancy, which is why a planned C-section is often recommended for affected women.”
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More Attention Needed for Endometriosis
Endometriosis is a disease with many faces. It can be completely inconspicuous or lead to severe pain and infertility. Since it is often detected late, it is all the more important for women with persistent menstrual pain or unfulfilled desire for children to take their symptoms seriously and seek targeted examinations. “Endometriosis is a chameleon—the earlier it is diagnosed, the better it can be treated,” emphasizes Dr. Gösslinghoff.