What is Endometriosis?
Endometriosis is characterized by endometrial-like tissue outside the uterus. It affects 5-10% of all women and some men too. It can affect most areas in the body like the pelvis, bowels, bladder, reproductive organs, appendix and thorax. The only organ it hasn’t been found on is the spleen! Since it can affect so many different areas every person can report a different presentation of the disease. Commonly, we hear about endometriosis affecting our menstrual cycles such as causing pain 1-2 days prior to the menstrual cycle, during the cycle and at other points in the cycle.It can impact fertility, lead to constipation and painful bowels, fatigue, back pain, abdominal pain, pelvic pain with things like intimacy or pelvic exams, and pain with urination.It can cause significant disruption in people’s lives leading to taking time off from work or school, limiting social activities and disrupting our interpersonal relationships. It can be associated with IBS, IC and chronic pain such as fibromyalgia. The pain can be progressive, starting in people’s teen years with onset of the period and progressively worsens over the years.
How is Endometriosis Diagnosed?
Endometriosis is diagnosed through a laparoscopic surgery that confirms the endometrial tissue outside of the uterus. Some providers will use Ultrasound or an MRI to help diagnose plus a thorough history and physical exam but those methods can’t truly confirm if a person has endometriosis.Treatment Options for Endometriosis
The goal of treatment is to catch it early so the disease doesn’t progress. However most people experiencing pain from endometriosis usually have it years before having treatment. The different treatment options include surgery, suppression medication, and physical/occupational therapy.Surgery
Excision surgery is a laparoscopic surgery using energy like a laser to cut out the endometriosis tissue all the way down to the “root level”. This surgery is considered the gold standard for treatment and leads to the lowest recurrence rates. The surgery needs to restore normal anatomy and remove all of the disease. Success rates greatly depend on who your surgeon is and his/her expertise. Ablation surgery is another surgery that is a common treatment in the world of endometriosis. This surgery is laparoscopic and burns the endometrial tissue but does not remove the “roots”. Ablation surgery has a higher recurrence rate.Management with Medication
Suppression medication like birth control is another common option for treatment. This does not get rid of the disease and may not help slow down the disease process but can help manage symptoms.
Physical and Occupational Therapy
Pelvic health Physical and Occupational Therapy is another form of management that can treat the musculoskeletal ramifications of Endometriosis. Pelvic health therapy can help treat bowel dysfunction, low back pain, painful intimacy and pelvic exams, abdominal pain by addressing the adhesions that can occur in abdomen and pelvis, pelvic floor muscle guarding, low back mobility, posture control, scar management, regulate the nervous system etc. Pelvic therapy can be helpful at every stage of the endo journey, including for those trying to avoid surgery, those trying to prolong the time prior to surgery, and those who have undergone surgery.Pelvic therapy can be helpful at every stage of the endo journey.If you suspect or have endometriosis we would love to chat through how pelvic floor therapy can be a part of your journey of healing!
Cheers to good health!
Resources
- Nancy’s Nook Facebook group or website: https://nancysnookendo.com
- Endometriosis research center: https://www.endocenter.org/
- For thoracic endo – extrapelvic not rare group: https://www.facebook.com/ExtrapelvicNotRare/
- Endometriosis and Me: https://www.facebook.com/groups/endometriosisandme/
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- Free Pelvic Floor Screens
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- Chronic Pain Management
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Written by Dr. Jesse Rapp