Endometriosis care in Munich

In endometriosis, tissue similar to the lining of the uterus grows outside the uterus. Typical sites are the peritoneum in the pelvis, the ovaries and the ligaments behind the uterus, sometimes also the bowel or bladder. When it grows into the muscular wall of the uterus, this is called adenomyosis. The lesions respond to the hormones of the cycle. They can cause inflammation, adhesions and cysts. Cysts on the ovaries are often filled with old blood, hence the name chocolate cysts. Endometriosis is benign but often takes a chronic course. It is a common condition in women of childbearing age. How severe the symptoms are does not necessarily depend on the extent of the lesions.

Many women have a long road behind them before endometriosis is recognised. Period pain is often dismissed as normal, and symptoms vary greatly. Not every lesion is visible on ultrasound. Clues come from the detailed conversation, the physical examination and the vaginal ultrasound. A definitive diagnosis often only comes through keyhole surgery (laparoscopy), in which tissue is taken and examined. With typical symptoms, however, current practice allows hormonal treatment to begin even without prior surgery. A pain and cycle diary helps to recognise patterns. Please feel free to bring it to your appointment.

Treatment depends on your symptoms, your age and any wish to have a child. Anti-inflammatory painkillers relieve acute symptoms. Hormonal treatments, for example with progestins – hormones similar to the one produced by the corpus luteum – can dampen the growth of the lesions and reduce pain. For cysts, adhesions or when you are trying to conceive, keyhole surgery (laparoscopy) may make sense. Because endometriosis can recur, longer-term support is often necessary. Many women also want approaches that involve the whole person: exercise, warmth, relaxation, nutrition and naturopathic methods. We see these as a complement, not a replacement.

Endometriosis is an oestrogen-dependent condition: the lesions grow under the influence of oestrogen. An imbalance between oestrogen and progesterone can therefore play a role. For many years, Prof. Dr. Schulte-Uebbing has been looking into how environmental factors influence this balance. Some substances in the environment act in a hormone-like way; they are called endocrine disruptors. These include certain plasticisers and heavy metals. On this topic he has published, among others, “Advanced endometriosis – the role of endocrine disruptors and inflammation” (umwelt medizin gesellschaft, 2011). Another article is “Endometriosis and environmental factors” (Gesundheit Hessen, 2013). At the consultation, we include such factors in the assessment.

Prof. Dr. Schulte-Uebbing has described in several specialist articles how acupuncture and laser therapy can be integrated into a holistic concept. These include “A holistic treatment concept for endometriosis including traditional Chinese acupuncture, ear acupuncture and phytotherapy” (journal of physicians for naturopathy, 2013). Likewise “Integrative therapy of endometriosis: laser acupuncture and intravenous laser therapy” (ZAA, 2014). In 2024 he published several articles on PLACU therapy (Platelet Acupuncture Therapy) in the Journal of Applied Complementary Medicine, one of them on endometriosis. These methods belong to complementary medicine. Their effectiveness has not been proven in large studies. Whether they are an option for you, we discuss openly.