Lütje W, Brandenburg U
Frauenklinik AKH Viersen, Viersen.
Zentralbl Gynakol. 2003 Jul-Aug;125(7-8):281-5. doi: 10.1055/s-2003-42283.
Endometriosis is a varied and unspecific disorder, which can be detected by way of subtle diagnostics in almost every woman. In one case it is a minor accidental finding, in another case it is a cancer-like, mostly incurable, chronic painful a disease, which often has sterility and aggressive therapies as subsequence. For the origin of endometriosis many causes are discussed. The theory of retrograde menstruation through an hyperperistaltic-dystocic uterus presents on one hand an organic explanation-concept. From the psychosomatic point of view this unphysiological menstruation could also be seen as the result of an unsolved conflict, which might be connected with the gender-role or personal, familiar and social attitudes about menstruation. The exo- and endogenic supply with hormones in a time with less pregnancies and therefore more menstruation is also a contributing factor to the origin and development of this disturbance. Beside the theory of endometriosis as an autoimmune disease also implicates psychosomatic thoughts. Though there is always a repeatedly talk the "cancer of the career-woman", there are however very few psychosomatic research projects regarding endometriosis. Therefore it is a characteristic of this disease, that finding and feeling are very often controversial. This emphasizes the importance of psychosomatic, psychosexual, social and biographical aspects in connection with endometriosis. This point of view makes a relative plausible and comfortable explanation for the CPPS and sterility uncertain. Without question diagnosis and therapy of endometriosis followed on one hand by stigmatization and on the other hand by often restriction of quality of life leads to a lot of subsequent psychosocial problems.
子宫内膜异位症是一种多样且不具有特异性的病症,几乎在每位女性身上都可通过精细的诊断手段检测出来。在某些情况下,它是一个轻微的意外发现;而在另一些情况下,它则是一种类似癌症的、大多无法治愈的慢性疼痛疾病,常常会导致不孕以及后续的激进治疗。关于子宫内膜异位症的成因,人们探讨了多种因素。子宫蠕动亢进 - 难产导致的经血逆流理论一方面提供了一种器质性的解释概念。从身心角度来看,这种非生理性的月经也可被视为未解决冲突的结果,这可能与性别角色或个人、家庭及社会对月经的态度有关。在怀孕次数减少因而月经增多的时期,内外源性激素供应也是导致这种病症发生和发展的一个因素。除了将子宫内膜异位症视为一种自身免疫性疾病的理论外,也涉及身心方面的观点。尽管一直有关于“职业女性癌症”的说法,但针对子宫内膜异位症的身心研究项目却非常少。因此,这种疾病的一个特点是,检查结果和患者感受常常存在争议。这凸显了与子宫内膜异位症相关的身心、性心理、社会和个人经历等方面的重要性。这种观点为慢性盆腔疼痛综合征和不孕的不确定性提供了一种相对合理且令人宽慰的解释。毫无疑问,子宫内膜异位症的诊断和治疗一方面会带来污名化,另一方面往往会限制生活质量,从而引发许多后续的心理社会问题。