The number of women hospitalised for endometriosis in Germany has risen sharply over the past decade — up 50.1 percent from just over 25,100 cases in 2014 to around 37,700 in 2024, according to new figures from the Federal Statistical Office. More than nine in ten patients were between 20 and 49 years old. Authorities say growing awareness among patients and doctors may be partly behind the dramatic increase.
Endometriosis is a chronic and typically painful condition in which tissue similar to the lining of the uterus grows outside the uterine cavity. Its consequences range from bleeding outside the uterus, inflammatory reactions, and lower abdominal pain to scarring, chronic pain, and reduced fertility. The causes can vary from case to case and have not yet been fully established. It is one of the most common gynaecological conditions, often going undiagnosed for years as its symptoms are frequently mistaken for normal menstrual pain.
A separate report published on Wednesday, the Barmer Arztreport, based on data from around eight million insured individuals per year between 2005 and 2024, paints an even broader picture. The number of women diagnosed with endometriosis more than doubled over the past two decades, rising from around 230,000 in 2005 to just over 510,000 in 2024. Women with the condition suffer from pain, nausea, and vomiting.
Experts attribute this sharp increase primarily to advances in diagnostics, endometriosis is now being detected far more frequently and at an earlier stage than before. The average age at first diagnosis fell by almost four years between 2015 and 2024.
"Just a few decades ago, endometriosis often went undetected," said Barmer chief Christoph Straub. "Endometriosis has become much more present in public awareness, and for women, years of uncertainty are now being avoided." However, Straub noted that even today the condition is still mistakenly attributed to normal menstrual pain in numerous cases.
Women diagnosed with endometriosis have significantly higher rates of accompanying conditions than would be expected for their age. Abdominal and pelvic pain were documented more than twice as frequently as average. Migraine and musculoskeletal conditions were also diagnosed at above-average rates among those affected. In addition, women with endometriosis more frequently suffered from depressive episodes and anxiety disorders.
Place of residence also appears to play a role. Thuringia recorded first diagnoses around 20 percent below the national average, while the Saarland was around 20 percent above it. Endometriosis is also diagnosed more frequently in densely populated regions than in sparsely populated areas.
Guidelines updated last year now recommend a less invasive approach to diagnosing endometriosis. Rather than laparoscopy with tissue sampling, non-invasive imaging procedures are now to be given preference. According to the Barmer report, this shift is likely to result in a decline in the number of hospital cases in the coming years.
While endometriosis cases climbed, other gynaecological inpatient treatments fell over the same period. Around 48,700 women were treated in hospital for uterine fibroids in 2024, a decline of 26.6 percent compared to 2014. Inpatient treatments for uterine prolapse also dropped by 4.6 percent to around 46,100 cases. In the case of uterine prolapse, almost three quarters of patients were over the age of 60.
The most common reason for hospital admissions among women in 2024 was cardiovascular disease, accounting for 12.8 percent of all cases. This was followed by injuries and poisoning at 10.4 percent, and pregnancy, childbirth, and the postnatal period at 9.4 percent. Cardiovascular disease also dominated as the leading cause of death among women, accounting for 35.4 percent of all female deaths, a total of 178,742 women. Cancer was the second most common cause of death, responsible for 21.1 percent of female fatalities, or 106,774 deaths.
The average life expectancy at birth for women in Germany stood at 83.5 years in 2024, 4.6 years higher than for men, whose average life expectancy was 78.9 years. Differences in life expectancy between the sexes are attributed in part to varying health habits between men and women, including differences in tobacco consumption, physical activity, diet, risk-taking behaviour, and working conditions.
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