Endometriosis is an often painful chronic condition that affects many individuals worldwide regardless of age or gender identity. In fact, it is so common that it is estimated to affect up to 10% of the population in the United States alone. That’s a lot of people! Despite how common endometriosis is, it is a woefully misunderstood and often misdiagnosed condition that can impact one’s ability to engage in physical activity, participate in school and/or work-related responsibilities, and reduce the overall quality of life. This week, we’re going to explore some of the common questions about endometriosis and the ways in which it can affect your pelvic health.
What Is Endometriosis?
Endometriosis is a condition in which tissue that is similar to the lining of the uterus begins to grow outside the uterine cavity. This lining is called the endometrium. The tissue growths that occur outside of the uterus are known as endometrial implants.
Endometriosis occurs when these implants form on the organs or tissue within the abdominopelvic cavities. These primarily include:
- Uterus
- Fallopian tubes
- Ovaries
- Ligaments that support the uterus
It can also spread to the bowels, intestine, bladder, and rectum – though this is less common. Most often, endometrial implants form near the reproductive organs listed above.
The start of one’s menstrual cycle brings about many changes in the body including changing levels of hormones (we’ll talk more about hormones in a future post!). Just like the tissue lining the uterus grows and sheds during the menstrual cycle, endometrial tissue growing outside of the uterus (endometrial implants) can grow and become inflamed and may cause pain. When this tissue begins to break down, scar tissue can form and restrict the movement of other tissues and structures, further contributing to pain.
Endometriosis Causes
Although there are several theories about the cause(s) of endometriosis, the exact cause is unknown.
One of the oldest theories, referred to as retrograde menstruation, suggests that endometriosis is caused by the tissue backing up into the fallopian tubes during menstruation. This kind of “reverse” menstruation allows the tissue to attach and grow outside the uterus.
Other theories include ideas about how cells can transform into endometrial cells or that the tissue may travel via blood cells.
Research is also investigating a possible genetic predisposition for the development of endometriosis; for some people, it appears to run in the family. Having a relative who has endometriosis doesn’t mean you’re guaranteed to have it too, but it’s may be helpful to explore any family history of pelvic pain or abnormal menstrual cycles if you or your doctors suspect you may have endometriosis.
We could probably fill a whole other blog post on possible causes of endometriosis. For now, we’ll leave it at it’s complicated!
What Does Endometriosis Feel Like?
Patients who have come to us for treatment for endometriosis have reported a wide range of symptoms. Some have mild symptoms, whereas others experience moderate or even severe symptoms.
It is worth noting that symptoms are felt differently from one person to the next. The intensity, frequency, and type of symptoms you experience do not necessarily correlate with the severity of the endometriosis. Symptoms may change over time, so tracking them might be helpful for understanding things that make them better or worse.
Endometriosis Stages
When someone is diagnosed with endometriosis, it is classified as one of four potential stages that from minimal to severe. How the stage is determined depends on the size, location, and the number of implants present.
- Stage 1 – Minimal: Someone diagnosed with stage 1 endometriosis is likely to have small, shallow implants localized to the ovary.
- Stage 2 – Mild: This stage is similar to the first stage, though there may be some small lesions that have spread to the pelvic lining.
- Stage 3 – Moderate: This stage involves larger, deeper implants on the ovary and pelvic lining compared to the earlier stages.
- Stage 4 – Severe: With this stage, there are often large, deep implants on the ovaries and lining of the pelvic cavity along with lesions on the fallopian tubes and bowels.
Common Symptoms
Most of the patients we treat report a feeling of general pelvic pain. Because endometriosis is affected by the menstrual cycle, intense menstrual cramps are one of the most common symptoms. These cramps are usually reported to be intense enough to be felt in the lower back or abdomen.
Other symptoms include heavy menstrual bleeding, painful sex (**LINK TO PAINFUL SEX ARTICLE ONCE LIVE**), uncomfortable bowel movements, and prolonged cramps.
Though rare, some people do not experience symptoms at all. This can make it challenging to diagnose and undoubtedly contributes to diagnosis occurring at later stages. For this reason (and a million others), it’s essential to have regular check-ups with your gynecologist and a pelvic health specialist.
If you are experiencing any of these symptoms, you can schedule an appointment online (Virtual Telehealth options available).
Treatment Options
Just as there is no known cause for endometriosis, there is also no cure (currently, that is!). While this may feel helpless, there is still hope to be had! There are numerous treatment options that are effective at reducing (and even resolving) symptoms. Though it may take a little bit of patience, your gynecologist and pelvic health specialists can help you find the best possible treatments.
Over-the-counter pain medications are usually the first thing people try; these can be helpful in some cases but don’t work for everyone. Hormone therapy is another option that has been used to help regulate the body’s hormonal changes that can agitate the condition. Progesterone is commonly prescribed when hormone therapy is being considered.
In some more severe cases, surgeries such as a hysterectomy or laparoscopy may be recommended by your doctor.
Pelvic Floor Physical Therapy For Endometriosis
Individuals who experience endometriosis may also experience pelvic floor dysfunction (PFD). Due to the pelvic and abdominal pain caused by endometrial implants, it is not uncommon for pelvic floor muscles to tighten up.
This tightness in the pelvic floor can continue even after the cause of the pain has subsided. When this happens, PFD becomes a chronic, secondary source of pain. Over time this can lead to scarring and pelvic floor spasms.
Alongside medical treatment for endometriosis, pelvic floor physical therapy has proven to be highly effective at reducing our patient’s symptoms. We work with them to reduce tension in, and restore balance to, the pelvic floor muscles.
**Never sure if this needs more elaboration every time**
How Grace PT Can Help
Admittedly, this just scratches the surface, so stay tuned for future posts as we dive even deeper into the topic of endometriosis. Endometriosis can be daunting to understand and face. That’s why our team at Grace Physical Therapy & Pelvic Health is always here to listen and help! We are committed to working with you to understand endometriosis and help you along the path to recovery.
If you think you have been experiencing symptoms of endometriosis, schedule a consultation today. We have in-person appointment options available at our three locations Raleigh, Durham, and Chapel Hill. We have telehealth consultation options available as well!
Until Next Time,
The Grace PT Team
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