Understanding Endometriosis: Part 1
MYTH: “It’s just a painful period”
The false narrative created by people about endometriosis can often leave women experiencing endometriosis feeling frustrated, hopeless, and misunderstood. The reality of endometriosis includes pain (often severe) during the menstrual cycle, pelvic pain, infertility, heavy bleeding, and/or bloating, nausea, diarrhea, fatigue, and more. The numbers say that 10% of women are diagnosed with endometriosis during their reproductive years - but the actual numbers may be much higher since it can only be diagnosed with an exploratory surgery of the abdomen, which many women do not choose to move forward with, and therefore do not receive the official diagnosis.
In part one of this two-part blog we are going to talk about what endometriosis is, and also how pelvic floor physical therapy can help. In the second part, we will be discussing the role of nutrition in managing the inflammatory process to help with endometriosis symptoms.
What’s really going on here? What is endometriosis? Well, endometrium is tissue that lines the inside of the uterus in women. It’s normal for the endometrium to thicken, break down, and then bleed - exiting the uterus through the vagina during a women’s menstrual period. When endometrial-like tissue grows anywhere outside of the uterus, that is what is called endometriosis. That tissue often adheres to the ovaries, fallopian tubes, or other organs within the pelvic cavity. The tissue can even adhere to organs in the belly such as the intestines, or even rarely as far away as the shoulder joint. Since the endometrial tissue will still go through the cycle of thickening, breaking down, and bleeding - it does so in other areas of the body without a way to “exit” the body like it does from the uterus. That bleeding occurring will create inflammation of the area and eventually leads to scar tissue formation and adhesions. The inflammatory process is often when pain is at its peak, but pain can persist beyond just the bleeding phase when scar tissue and adhesions begin to restrict mobility.
Well, if the bleeding is happening and is trapped in the body, it sounds like there is nothing we can do to help, right?? WRONG! While we aren’t necessarily going to stop endometrial tissue from growing in the wrong places (although some research may indicate that consuming Omega-3s in our diet may help with this), there are things we can do to help our symptoms! First we will talk about what Pelvic Floor Physical Therapists can do to help, and then we will talk a little bit about the role of nutrition in managing endometriosis symptoms.
Pelvic floor physical therapy - what is that? While all physical therapists have some knowledge of women’s health conditions, a pelvic floor physical therapist is specialty trained to provide a comprehensive assessment of the pelvic floor. Often women who are experiencing cyclical pain such as in endometriosis can experience secondary pelvic pain, which may cause pain during sexual activities or pain with urination, bowel movements, or use of tampons. A pelvic floor physical therapist is specialty trained to assess each pelvic floor muscle (there are actually 12+ muscles in that small area) for overactive or painful trigger points and treat those to relieve pelvic pain.
Perhaps you’ve experienced an abdominal surgery during your journey with endometriosis - a pelvic floor physical therapist can provide scar mobilization to improve your mobility. Women often experience lower abdominal pain and/or lower back pain during their cycles, and pelvic floor physical therapists can provide manual therapy (hands on care) to relieve tightness of muscles. They are also skilled in providing individualized stretches or strengthening as needed. Another tool they may be able utilize is electrical stimulation or TENS, which can be tried in the clinic as a pain relief tool. If it is successful for your symptoms, they can teach you how to set it up independently and even help you get a TENS unit to use at home as one of your pain management tools. If you’re looking for a pelvic floor physical therapist, remember to ASK whether the therapist you are seeing has specialized training in women’s health conditions. Not all physical therapists have the specialized training that is important for knowing your particular condition and your outcome will be much better when you see someone trained in your condition.
If you’re experiencing symptoms of endometriosis - reach out to us at Shift Physical Therapy. We are always happy to answer questions and provide education. We are passionate about helping women gain back confidence and control of their bodies! You can call us at 763-645-1113, email us at info@shiftptwell.com or find us on social media @shiftPTwell
Written by: Renee Hancock, Pelvic Floor Physical Therapist
