The Gist: What Is Endometriosis?
Also known as: pelvic pain, adenomyosis
Endometriosis is a disorder where tissue similar to that found in the inner lining of the uterus (endometrium) is found outside the uterus, often on the lining of the pelvic cavity, ovaries, or fallopian tubes. This can lead to adhesions, scarring, and severe pain. This tissue may also swell and bleed during menstruation. Studies show it may affect more than 11% of women between the ages of 18 and 44.
The Anatomy Of Endometriosis
The endometrium is the inner lining of the uterus. Each month, it thickens to prepare for pregnancy, but, if pregnancy doesn't occur, it sheds itself during menstruation (your period).
The exact cause of endometriosis is not certain. Some factors may include genetic components, retrograde menstruation (blood flowing back into fallopian tubes/pelvic cavity instead), or surgical scar implantation.
Who Gets Endometriosis? When Does It Occur For Women?
The exact cause of endometriosis is not fully understood, however some widely accepted risk factors include:
- If your first period was before the age of 11
- Short menstrual cycles
- Heavy periods that last more than 7 days
Surgery can also lead to endometriosis. After a c-section or hysterectomy, endometrial cells may attach to the incision.
The Origin Way: Physical Therapy For Endometriosis
At Origin, we look at your entire history and take a comprehensive approach that includes not only addressing the pelvic floor but also the way you move, your abdominal mobility, and even your breath. You and your Physical Therapist will create a plan of care that moves at a pace that is comfortable for you.
A typical plan of care involves breathing and relaxation training, as well as mobility and lengthening exercises to improve your pelvic floor and abdominal range of motion.
Strengthening exercises for the core and pelvic girdle may also be indicated. Manual therapy techniques may also be used, but they will be used according to your plan of care. It may involve manual therapy to the abdominal fascia or the pelvic floor, but you and your Physical Therapist will discuss all manual therapy techniques prior to them being introduced. Our goal is to never cause more pain by moving too quickly.
How Long Does It Take?
Because we are not treating the endometriosis but rather the associated symptoms, a plan of care can take anywhere from 2-12 months to provide some symptoms relief and arm you with the appropriate tools and strategies to use once your course of physical therapy is over.
What To Expect In The Future
Endometriosis is a lifelong condition. In physical therapy, we are not treating the endometriosis but rather the subsequent pain and symptoms. So, you will likely have continued symptoms in some capacity even after physical therapy. However, you will have the tools, exercises, and strategies to manage those symptoms when and if they flare up again.
Additional Reading And Sources
Wurn, Belinda F., et al. "Decreasing Dyspareunia and Dysmenorrhea in Women with Endometriosis via a Manual Physical Therapy: Results from Two Independent Studies - Belinda F. Wurn, Lawrence J. Wurn, Kimberley Patterson, C. Richard King, Eugenia S. Scharf, 2011." SAGE Journals, journals.sagepub.com/doi/abs/10.5301/JE.2012.9088
Buck Louis, Germaine M, et al. "Incidence of Endometriosis by Study Population and Diagnostic Method: the ENDO Study." Fertility and Sterility, U.S. National Library of Medicine, Aug. 2011, www.ncbi.nlm.nih.gov/pubmed/21719000
Treloar, Susan A., et al. "Early Menstrual Characteristics Associated with Subsequent Diagnosis of Endometriosis." American Journal of Obstetrics and Gynecology, Mosby, 22 Dec. 2009, www.sciencedirect.com/science/article/abs/pii/S0002937809019802?via=ihub
Peterson, C Matthew, et al. "Risk Factors Associated with Endometriosis: Importance of Study Population for Characterizing Disease in the ENDO Study." American Journal of Obstetrics and Gynecology, U.S. National Library of Medicine, June 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC4114145/
Common & Treatable
Roughly 12% of women have PCOS and 10% have endometriosis. Physical therapy has been shown to reduce pelvic pain with endo and can support physical activity to improve PCOS.