{"paper_id":"790648cc-7d9c-4701-bf8a-8189d7f2a4da","body_text":"Zusammenfassung\nEndometriose ist ein häufiges Krankheitsbild mit großer Auswirkung auf das gesamte Leben einer Frau. Derzeitig besteht keine Aussicht auf Heilung, es gibt lediglich symptomatische Therapieansätze; umso wichtiger ist es, die Pathogenese und die Auswirkung dieser Erkrankung auf den Organismus besser zu verstehen. Kernproblem der Endometrioseentstehung scheinen gestörte Kontraktionsabläufe in der Gebärmutter zu sein, die zu einer Mikrotraumatisierung der Junktionalzone (Archimetrose) mit Aktivierung von Stammzellen führen, die transloziert werden und dann die Grundlage für ektope Läsionen bilden (Epithel‑, Stroma- und Muskelzellen), entweder in der Gebärmuttermuskelwand (Adenomyose) oder im kleinen Becken (Endometriose) bilden. Andere Faktoren, wie genetische und epigenetische Veränderungen, Immunreaktion und Mesothelveränderungen, können das Geschehen weiter beeinflussen. Die typischen Beschwerden dieser Erkrankung wie schwere Dysmenorrhö, zyklische und azyklische Unterbauchschmerzen (UBS), zyklische Dysurie und Dyschezie, Dyspareunie, sowie Infertilität sind hinlänglich bekannt und trotzdem wird die Erkrankung im Mittel erst 10 Jahre nach Einsetzen der Beschwerden diagnostiziert. Die Schmerzentstehung ist komplex. Sowohl periphere also auch zentrale Sensitivierung von Schmerzmechanismen, aber auch hormonelle, psychische und muskuläre Veränderungen spielen im Schmerzgeschehen eine große Rolle. Bei ausgeprägter Endometriose scheinen vor allem auch die anatomischen Veränderungen zu mechanischen Funktionsstörungen der Genitalorgane zu führen, dennoch gibt es viele Hinweise, dass auch die Inflammation, die ovarielle Funktionseinheit (Eizellreifung und -qualität, sowie die Eizellreserve) und der adenomyotische Uterus multifaktoriell die Fertilität der betroffenen Patientinnen beeinflussen können.\nAbstract\nEndometriosis is a common medical condition that has a significant impact on the lives of women suffering from it. Symptomatic therapeutic approaches are currently the only option available since there are no causal treatments for this disease. This makes it all the more important to better understand the pathogenesis and impact of endometriosis on the body in order to develop future treatments. The core problem of endometriosis development appears to be disturbed contraction processes in the uterus, which lead to the microtraumatisation of the junctional zone (archimetrosis) with activation of stem cells that translocate and then form the basis for ectopic lesions (epithelial, stroma and muscle cells) either in the uterine muscle wall (adenomyosis) or in the pelvis (endometriosis). Other factors such as genetic and epigenetic changes, immune response and mesothelial changes can further influence what happens. Typical symptoms of this disease are severe dysmenorrhoea, cyclical and non-cyclical pelvic pain, cyclical diarrhoea and dysuria, dyspareunia as well as infertility. Due to its complex symptoms, endometriosis is usually not diagnosed until on average 10 years after the onset of symptoms. The origin of pain is complex. Both peripheral and central sensitization of pain mechanisms, as well as hormonal, psychological and muscular changes, play a major role in the pain process. In the case of severe endometriosis, it is in particular the anatomical changes that appear to lead to the mechanical functional disorders of the genital organs. Nevertheless, there is much evidence that not only inflammation and the ovarian functional unit (egg cell maturation and quality, as well as the egg cell reserve), but also the adenomyotic uterus can have a multifactorial influence on the fertility of affected patients.\nSimilar content being viewed by others\nLiteratur\nAbrao MS, Podgaec S, Dias JA Jr et al (2006) Deeply infiltrating endometriosis affecting the rectum and lymph nodes. Fertil Steril 86:543–547\nAkande VA, Hunt LP, Cahill DJ et al (2004) Differences in time to natural conception between women with unexplained infertility and infertile women with minor endometriosis. 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Gynäkologe 53, 645–657 (2020). https://doi.org/10.1007/s00129-020-04665-5\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00129-020-04665-5","source_license":"CC0","license_restricted":false}