Endometriosis: A traumatic event from her childhood is important

This text first appeared in December 2023.

A few years ago, a colleague sent me a young patient to the clinic and asked me to “look into her stomach.” She suffered from endometriosis: cells in the uterine lining spread outside the organ, grow with the monthly cycle and “bleed off”. They can cause inflammation and therefore severe pain. I became suspicious when the woman handed me a thick file folder and told her story. She was only in her mid-20s but had already had around 20 abdominal surgeries. It was clear to me that even further surgery would only relieve her symptoms for a short time. Every procedure traumatizes – i.e. injures – the tissue anew, triggering adhesions and scars.

Chronic pain like the one the woman experienced is very complex. They lead to a vicious circle of anxious anticipation, increased tension, increased pain, more fear and tension – and more pain. Scientific studies also show that the severity of endometriosis is independent of the extent of the disease: There are women who have many lesions but hardly any symptoms. And there are women who have severe pain, but you can hardly find any lesions. In other words: the same finding triggers something different in every person.

Such a young woman, so much pain, so many surgeries – I was sure there was more to it. I carefully began to ask the patient about her past. Was there an incident that could be related to the persistent symptoms? At first she didn’t understand what I was getting at.