Endometriosis is a debilitating disease that impairs the quality of life in adolescent and adult females. We don’t know what causes endometriosis (there are several theories), and often, endometriosis is linked with infertility. Sorry – not exactly the best new of the day. So what is endometriosis? Endometriosis occurs when the inner lining of the uterus implants outside of the uterus and cervix, causing scarring, adhesions, and pain within the abdominal and/or pelvic cavity. It has been known to affect 10-15% of all women of reproductive age, with the age of 13 being the median age for onset of initial symptoms. Commonly reported symptoms include dysmenorrhea (painful periods), pelvic pain between periods, dyspareunia (painful intercourse), dysuria (painful urination), and GI complaints (including chronic constipation and IBS-type symptoms). These symptoms closely mimic other conditions, making the diagnosis of endometriosis difficult. It is known as an “invisible illness”, as there is currently no minimally-invasive testing to determine the presence of the disease. The only definitive and most accurate assessment available is laparoscopic surgery.
While rehabilitation cannot stop or cure the disease process, rest assured rehabilitation can help women in managing symptoms in hopes of improving their quality of life. Here a few ways a pelvic health physical therapist can help with conservative management:
- Embrace a Team Approach Ensure the female has the right medical providers on board, including but not limited to a primary care physician, gynecologist, acupuncturist, functional medicine doc, massage therapist ,and especially a reproductive endocrinologist. Hormone and medical management are vital to promote reproductive health and fertility. Pelvic health physios are happy to connect patients with the right provider(s).
- Pain Management Soft tissue work done by the therapist can help reduce pain and tension holding patterns within the muscles of the abdomen, low back, and pelvic floor. Teaching home techniques for the female to be independent with is important for long term benefits. After all, empowering her is the gift that keeps on giving.
- Downtrain the Pelvic Floor Muscles & Nervous System Often with endometriosis the pelvic floor muscles (PFM) tighten up, which facilitates pain patterns. The PFM rarely go off duty when there’s pain. Pelvic health physios help women to more successfully lengthen and relax their tightened, painful PFM. It’s almost like helping the pelvis breathe again.
- Hormone Regulation Endometriosis is an estrogen-dominated condition, meaning that progesterone & estrogen levels need re-balanced. Both hormones play a key role (more on this later) in overall in a woman’s health. Medical providers can help women struggling with symptoms associated with endometriosis get their hormones in check.
- Exercise Get the body moving but in the right amount. Too much exercise can ramp up the stress response. Keeping the abdomen and body gliding, moving, and grooving via various stretches and deep breathing techniques can help maintain mobility and reduce pain. Encouraging the female to be successful in basic exercise is helpful, especially when pain is a limiting factor. As the saying goes, “motion is lotion” and all parts of the body require healthy movement.
- ACOG fact sheet: https://www.acog.org/about_acog/news_room/~/media/newsroom/millionwomanmarchendometriosisfactsheet.pdf
- Endometriosis: epidemiology, diagnosis, and clinical management. Parasar P., Ozcan P., Terry K. (2017) Curr Obstet Gynecol Rep. March; 6(1): 34–41.