Endometriosis diagnoses are increasing significantly
Key Findings
Saarbrücken, May 28, 2026 – The number of women diagnosed with endometriosis in Saarland has increased significantly. This is shown by the BARMER medical report. According to the report, the number of affected women in the federal state grew from 734 per 100,000 women in 2005 to 1,260 per 100,000 women in 2024. This corresponds to an increase of 72 percent. According to projections by the statutory health insurance, the number of affected women in Saarland is estimated to have been 6,500 in 2024, up from 4,000 in 2005. "Endometriosis is a chronic, usually painful condition where tissue resembling the uterine lining grows outside the uterine cavity. Endometriosis has become much more recognized in society, leading to more frequent diagnoses and sparing affected women years of uncertainty," says Dunja Kleis, State Managing Director of BARMER in Rhineland-Palatinate and Saarland. For women with endometriosis, a tailored and long-term therapy is important, always oriented to their individual circumstances.
Endometriosis: Women in Saarland mostly between 30 and 34 years old
According to the medical report, endometriosis most commonly occurs in Saarland women aged 30 to 34. In this age group, in 2024, one in 31 women in Saarland was affected by the disease (3.2 percent). Across all age groups, Berlin had the highest rate of endometriosis diagnoses in 2024. Here, there were 1,618 affected women per 100,000 women. In Thuringia, by contrast, only 939 women per 100,000 were diagnosed with endometriosis in the same year, the lowest value among all federal states. The national average in 2024 was slightly below Saarland’s rate, with 1,212 affected women per 100,000. "The consequences of endometriosis range from bleeding outside the uterus, inflammatory reactions, and lower abdominal pain to chronic pain and reduced fertility. Treatment of endometriosis must not only address the symptoms but also possible organ damage, such as to the intestines or the fertility desire of affected women," demands Kleis. The goal must be to improve the patients' quality of life.
Recently significantly more initial diagnoses than expected in Saarland
It is striking that the number of initial diagnoses of endometriosis in Saarland was recently surprisingly high. According to the doctor report, the disease was diagnosed for the first time in the state 20 percent more often from 2022 to 2024 than expected based on the age structure of women in Saarland. "According to the medical guideline for the diagnosis and treatment of endometriosis updated last year, there is now a greater emphasis on imaging procedures in diagnosis rather than on tissue sampling via laparoscopy, which was previously the main method. In addition, psychosocial aspects and multimodal pain therapy are now given more consideration in treatment planning than before," reports Kleis. The multimodal treatment approach, which involves several medical specialties if necessary, is particularly important for endometriosis patients, as affected women have significantly more comorbidities than usual for their age.
Questions and Answers
What is endometriosis?
In endometriosis, tissue that is very similar to the lining of the uterus is found outside the uterine cavity. Such lesions are often detected on the peritoneum, but also on the ovaries or the intestines.
Why does endometriosis occur?
To this day, it is not fully understood why tissue growth, often painful, occurs outside the uterine cavity. Various medical studies identify, among other things, an immune system disorder, genetic factors, and hormonal influences as possible causes that interact to lead to the disease.
What symptoms does endometriosis cause?
This chronic condition typically develops only from or after the first menstrual period. The main symptom of endometriosis is lower abdominal pain. It often occurs together with menstruation, but also during or after sexual intercourse. The pain can vary in intensity and radiate to the lower abdomen, back, and legs. It is often experienced as cramping and may be accompanied by nausea, vomiting, and diarrhea. Over longer periods, the pain can become chronic. Endometriosis can negatively affect fertility.
How is endometriosis treated?
Treatment depends heavily on symptoms, age, desire to have children, and the extent of the condition. One option is medication-based, symptom-oriented pain therapy to alleviate symptoms. Additionally, hormone therapy can be administered to suppress the cycle or ovulation and thereby also reduce endometriosis lesions. A mostly minimally invasive surgery is also possible to remove or cauterize these lesions and to release adhesions. This can be advisable in cases of severe pain and desire to have children, or if organs such as the intestines are affected.
How were the data collected and evaluated?
The analysis is based on the anonymous billing data of BARMER insured persons from 2005 to 2024 for outpatient and inpatient treatments. In 2024, BARMER had 116,000 insured persons in Saarland. The results were standardized and extrapolated to the total population.
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