What is Endometriosis? (and how Pelvic PT can help)
Did you know that Endometriosis affects more people that inflammatory bowel disease?
Did you know that 10-15% of women suffer with endometriosis?
Did you know that patients often see 7+ physicians before being diagnosed with the condition?
Endometriosis is a common and very life-impacting condition. At Awake Pelvic Health & Wellness, we treat individuals with endometriosis, helping them with the musculoskeletal, neuromuscular, and chronic pain aspects of the condition. We also help our patient navigate the complexities of the healthcare system, helping them to build a strong team of healthcare providers so they can ultimately get the care they deserve.
So what exactly is Endometriosis?
Endometriosis is a condition in which the tissue similar to the lining of the uterus (endometrial-like) is located outside of the uterus. This tissue or “endo lesions” are different than the endometrium (lining of the uterus, which sheds during a period). The endo tissue can cause pain, organ dysfunction, and infertility due to inflammation and scar tissue. Endometriosis affect about 1 in 10 women and may take up to 10 years to get a proper diagnosis. Unfortunately, far too many healthcare providers still do not fully understand endometriosis and may dismiss a patients symptoms as “bad cramps” and unable to offer a full treatment plan.
Common Symptoms of Endometriosis:
Severely painful periods
Pelvic or abdominal pain not associated with menses
Low back and/or leg pain
Pain with sex
Painful bowel movements
Stomach problems like nausea, bloating, diarrhea and/or constipation
Fatigue
Infertility
Not everyone with endometriosis will present with the same symptoms, and can present with significant differences in severity. One primary issue that is common in folks with endo is significant pelvic floor dysfunction and tension into the abdomen and pelvic floor muscles. This is often due to the chronic pain aspect of endo and up-regulation in the musculoskeletal and nervous system, making muscles really tense and guarding.
How is Endometriosis Diagnosed and Treated?
It is important to work with a team of experts who can help address the unique aspects of endometriosis. For example, working with a pelvic floor physical therapist can be a significant step to helping reduce the chronic pain drives, tension at the pelvic floor muscles, improve pain with sex, and improve mobility of the muscles and fascia of the abdomen and pelvic floor.
Working with a dietician who is skilled in treatment of complex pain and hormone issues can be extremely helpful to reduce inflammation and food triggers that make your symptoms worse.
Working with a physician who has expertise in endometriosis diagnosis and treatment. Typically this will be gynecologist who is skilled in something called endometriosis excision surgery. Right now, the gold standard to diagnosis endo is through having a laparoscopic surgery and a biopsy of the tissue to confirm if there is abdominal endo tissue. Imaging such as MRI or Ultrasound is NOT able to fully rule-in or rule-out endo, so make sure your provider is not just relying on imaging.
It is also important that your provider evaluates you for other conditions that may be causing your symptoms such as:
Pelvic floor muscle pain or dysfunction
Interstitial cystitis/painful bladder syndrome
Adenomyosis
IBS
You and your physician (who is very skilled in treating endometriosis) may decide to try “conservative measures” first to help reduce symptoms and reduce the overall pain intensity with endometriosis. This might include working with a pelvic PT, acupuncturist, dietician, mental health therapy, chiropractor, etc. You and your physician may then decide that performing a laparoscopic excision surgery is the next right step, especially if symptoms continue to be significant.
When excision surgery is performed, your provider literally “excises” the endo lesions to help reduce and prevent further spread of the disease. However, just because endometriosis has been excised, does not mean that all pain will be eliminated. Patients will often continue with pelvic floor physical therapy and other treatments to help with the chronic pain aspect and improve overall musculoskeletal function.
I will often refer my patients to work with a gynecologic surgeon who is very skilled in endometriosis excision surgery for further evaluation to determine if surgery is a good next step or not, a dietician to help with food intake and sensitivities, and acupuncture/massage therapy/mental health therapy as needed.
How can Pelvic Floor PT Help with Endometriosis?
A pelvic floor physical therapist will be integral in helping treat pelvic and abdominal pain, as well as any related bowel, bladder, and sexual dysfunction associated with endometriosis. Pelvic Floor PT for endo may include:
Education on bowel, bladder, and sexual function
Manual therapy on the abdomen: fascial and visceral mobilization to help with connective tissue restrictions and scars
Pelvic floor internal release: release to tight muscles of the pelvic floor to improve function of these muscles
Pain science education
Home program: stretching yoga, exercises, journaling, self-care
Teaching of self-pelvic floor release with a wand or other methods
Listening to YOUR needs!
Are you or someone you know suffering with endometriosis or concerned that you might have endometriosis? Reach out, let’s chat, and make sure you are getting the care that YOU deserve!
Resources: there is a lot of misinformation and myths surrounding endometriosis. It is important to seek out the highest quality and latest evidence regarding endometriosis for best care. Nancy’s Nook provides excellent information and resources for individuals suffering from endometriosis.
https://nancysnookendo.com
