Endometriosis: Causes, Symptoms, Reducing Pain
What is Endometriosis and How to Feel Better Without Surgery
What is Endometriosis?
Endometriosis or “endo” as many people call it, is a hormone-based disorder where endometrial tissue (uterine tissue) grows outside of the uterus. There are multiple types including ovarian, peritoneal, and deep infiltrating all specifying the location the abnormal uterine tissue is growing. Endometriosis can lead to many symptoms including chronic pelvic pain, painful periods (dysmenorrhoea), pain with sexual activity (dyspareunia), as well as infertility.
Endometriosis is not just painful periods.
There are many reasons a body may be in pain during the menstrual cycle – overactive pelvic floor muscles, endo, PCOS, ovarian cysts, fibroids. Regardless of the formal diagnosis, the muscles around the pelvic region often respond and lead to muscle cramping of the pelvic floor, abdominals, glutes, hip flexors, and many more.
How does one treat endometriosis?
The only way to fully receive a confirmed diagnosis of endometriosis is following a laparoscopic exploratory surgery. If abnormal tissue is found it is removed. It all appears “normal”, the surgeon will close up the incisions without further surgical interventions.
However, surgery is not the only option! Because this is a hormone-based disorder, hormone replacement therapy is an option although, similar to other medications, there can be serious adverse effects with long term use.
For those that wish to skip the surgical and pharmaceutical options, there are still plenty of ways to manage your endometriosis from the comfort of your home.
- Education – Whether that is through your pelvic floor physical therapist, online groups, or reputable research, it is important to understand what is going on inside of your body every month. Research has shown that those with chronically painful conditions see symptom improvement purely from education alone.
- Create Life Balance – Be honest with employers and discuss modifications during pain exacerbations. Listen to your body and give it rest when it demands it.
- Connect – The social support endometriosis groups bring is unparalleled and very helpful for the journey ahead. The advice given on these pages is from people who live and battle with this diagnosis every day and the tips and tricks given are extremely helpful.
- Exercise – After speaking with multiple endo clients, it can seem like exercise is the last thing they would like to do. However, taking a gentle and graduated approach can decrease pain and relieve the inflammation occurring in the pelvis.
- Practiced Relaxation – Personally, I have never looked at a woman, told her to relax and been successful (including myself). Through meditation, guided relaxation, or gentle yoga, a relaxed body of muscle is easier to achieve.
- Body Care – Heat. Ice. Anti-inflammatories such as ibuprofen or Advil. Sleeeeeeeep.
I’ve had the surgery…now what?
First of all, congratulations! The removal of the endometrial tissue is a first step in reducing your pain. However, after likely years of pain, there needs to be a bit of rewiring. I once read about this comparison online that said having endometriosis is like being hit in the stomach with a nail for years. After surgery, the nail stops but the brain is well adjusted to being in pain in the abdominal area and, in a strange way, continues the pain without the nail. This is called central sensitization.
As physical therapists, we work closely with both the nervous system and the muscles. Together, we are able to hit the reset button on the brain and allow for decreased pain. For a select few surgery may be the one-stop shop for no more pain. Yet for the majority, there is a recovery process.
In addition to the endometriosis, it is likely there were further reasons for the pain including overactive pelvic floor muscles and abdominal fascial restrictions. These are best addressed with hands-on therapy from a pelvic floor specialist.
Want to make sure you are healing appropriately? Schedule an appointment!
Endometriosis no longer gets to define you.