Endometriosis: A Hidden Disease
Endometriosis affects 1 in 10 women in the United States; it impacts 200 million worldwide. Yet it takes on average, 10 years to diagnose. Why?
Endometriosis Causes and Symptoms Explained
Endometriosis is a disease, in which tissue that is similar (but histologically different) to the tissue that lines the uterus (endometrium) is found elsewhere in the body. This can become quite painful, both during menstruation and otherwise. Endometriosis can occur anywhere in the body (even the brain and lungs!) but it very commonly occurs within the pelvis. Because the cells can be present anywhere, each person will have their own experience with endometriosis. Some individuals will have symptoms before they start menstruating, while others won’t have problems until later in life. Some people will complain of debilitating periods while someone else may find out while undergoing surgery for something else with no symptoms at all. Because this disease is so specific and unique to each person, it is important to know the array of symptoms. It is also important to recognize these symptoms can be constant or cyclical.
Someone with endometriosis may complain of one or more of the following:
Abnormal or painful periods
Back pain
Pain with sex
Pain with urination
Constipation or pain with BM’s
Chronic pelvic or abdominal pain
Stomach problems: indigestion, bloat, nausea
Infertility
Fatigue
How To Know If You Have Endometriosis
If someone suspects they have endometriosis, the only true way to confirm the diagnosis is through a diagnostic laparoscopy with a biopsy. Imaging can be helpful but it cannot be used to truly confirm a diagnosis. Laboratory tests do not confirm a diagnosis of endometriosis–although research is being done on different markers to test for endometriosis.
Treatments For Endometriosis
Surgery For Endometriosis
The “gold standard” treatment for endometriosis is minimally invasive laparoscopic excision surgery. Excision surgery ensures the entire lesion or root of the endometriosis tissue is removed. This is different than other forms of surgery like an ablation surgery, which only removes the tissue on a surface level and is often not specific enough to remove all of the disease, ultimately impacting long-term effectiveness. Historically, women with endometriosis were told they needed a hysterectomy to “cure” it. Unfortunately, there is no true “cure” and removing the uterus does not solve the problem of tissue growing elsewhere in the body.
Pelvic Health Physical Therapy Benefits
While surgery is often a mainstay of treatment for endometriosis, many individuals also benefit from working very closely with a pelvic health physical therapist. If a patient has a diagnosis, they may come in before surgery to help manage pain, improve their muscle function and mobility, and reduce flare ups. They may also come in because they are having bowel, bladder or sexual dysfunction and they want to address it before or after surgery. Pelvic PT helps prepare the body for surgery and recovery and can also be an integral part of someone’s healing journey. Additionally, some people with endometriosis may have had surgery in the past, or may not be wanting to pursue surgery at this time (everyone’s journey is unique!). In these cases, pelvic PTs can still work to improve bowel, bladder and sexual health; optimize myofascial function and tissue mobility; and improve pain levels to help people optimize their function in their daily lives. Learn more here.
Spreading The Awareness Around Endometriosis
The Importance of Education and Early Diagnosis
March was endometriosis awareness month; as we move into April, I think it is important to educate everyone about this disease. Parents, teachers, school nurses–all healthcare providers–should be educated in order to expedite the diagnosis and treatment journey. Early diagnosis is often key, and the more people know, the more we can make sure people get the treatment they need in a timely fashion. A film called, “Endo What?” was created to provide education on this disease and to continue spreading awareness around it. You can find the film and more, here.
As a pelvic PT, I have been the first person who talks to patients about endometriosis–sometimes, I am the one that suspects it and sends them to an endometriosis specialist. However, you don’t have to be a pelvic PT or a healthcare provider to recognize endometriosis. Sometimes, you just have to listen in order to put them in the right hands to get them the help they need. For more information on endometriosis, click here.
Resource For Pelvic Rehab Providers
If you a pelvic rehab provider, we actually have an incredible online mini-class on Endometriosis featuring Dr. Ken Sinervo, the medical director of the Center for Endometriosis Care, along with Dr. Jessica Reale, PT and Dr. Sara Reardon, PT. You can check out that course here!
Post Written By Brooke David PT, DPT, PRPC
Brooke and all the Southern Pelvic Health physical therapists are here for you!