What is endometriosis?
Endometriosis is a chronic disease that occurs when cells similar to those that line the female uterus grows in other parts of the body including the abdominal cavity and the internal organs inside the pelvis such as the ovaries, fallopian tubes, bladder and bowel.
What are the symptoms?
This disease is highly individualised and the symptoms range significantly from person to person. However, some common symptoms include:
- Pain that stops you on or around your period
- Pain on or around ovulation
- Pain during or after sex
- Pain with bowel movements
- Pain when you urinate
- Pain in your pelvic region, lower back or legs
- Having trouble holding on when you have a full bladder or having to go frequently
- Heavy bleeding or irregular bleeding
Interesting myths and facts about endometriosis
(The National Action Plan for Endometriosis 2018):
Myth: Period pain is normal – you must have a low pain threshold.
Fact: Severe pain (dysmenorrhea) with menstruation is not normal and can be caused by endometriosis or other related conditions.
Myth: Everyone who has endometriosis has severe period pain.
Fact: Many individuals have no symptoms at all.
Myth: Having a baby will ‘fix’ endometriosis.
Fact: Endometriosis symptoms can appear to improve during pregnancy due to changes in hormone levels. These effects may only be temporary and symptom recurrence can occur.
Myth: If you have endometriosis, you can’t have children.
Fact: Although it can be more difficult to conceive, most women with endometriosis are still able to have children.
Myth: A hysterectomy will cure the disease.
Fact: There is no cure. For some women, it is a suitable option to alleviate some symptoms, but symptoms can return.
How is endometriosis diagnosed?
Endometriosis is diagnosed by undergoing laparoscopy and having a biopsy taken. This biopsy will be sent to a lab to determine the diagnosis. Sometimes with a collection of your symptoms, a doctor may suggest you have endometriosis and will discuss the best course of action for you to take.
What are the treatments for Endometriosis?
Various treatments for Endometriosis exist, most commonly:
- Surgical treatments (involving an operation)
- Complementary medicine
How does endometriosis cause the above symptoms?
Pain is common and many women find they spend a lot of time with a curled-up posture due to pain. Spending a lot of time in a flexed position can make the muscles and tissues around the abdominal, pelvic and back area very tight. There can be scar tissue from endometriosis and the surgeries used to help manage the disease. This scar tissue can also contribute to the pain. On top of these issues, many women experience bladder, bowel and issues with intercourse which can be addressed by a Women’s Health Physiotherapist.
Many women are de-conditioned due to not being able to exercise because of pain, starting a gradual exercise approach with a health professional, such as clinical pilates with a physiotherapist, can help to reduce pain flare-ups
How can a Women’s Health Physiotherapist help?
Our number one goal is to help you reach your goals, so with endometriosis for many women, it is to help reduce pain and improve function.
How we do this, is to have a very holistic approach, looking at all aspects of your life. This includes:
- Assessing pelvic floor activity – are they overactive and contributing to pain
- Looking at bladder and bowel habits
- Treating any symptoms of painful intercourse
- Assessing your bodies protective response to pain and changing the input into your system to relieve pain.
- Introducing exercise (including clinical pilates) and stretches which will help your body relax during painful periods
- Trigger point release or acupuncture to reduce muscle tension around painful areas
- Manual therapy and myofascial pelvic and abdominal massage to release scar tissue, adhesions, spasms, facial and muscle tightness
- Work in conjunction with your specialist who may be managing your endometriosis