What is endometriosis? Why does it happen?
Endometriosis is a condition in which tissue similar to the lining of the uterus starts growing outside of the uterus. It is most commonly diagnosed in people assigned female at birth (AFAB) ages 25-40. This tissue mostly attaches to pelvic organs, but occasionally can grow to other visceral structures as well–it has been found as far away as the nasal passages. It affects about 1 in 10 people assigned female at birth. Common symptoms include pelvic pain, heavy and extremely painful periods, spotting between periods; and GI issues. Pelvic pain due to endometriosis is typically cyclical and is worse right before menstruation starts.
There are several theories about the cause of endometriosis, though more research is needed.
Endometriosis needs to be formally diagnosed through laparoscopic surgery, although ultrasound or MRI may give your doctor some initial insight.
What are my treatment options?
There is no cure for endometriosis, just management. Medical treatment options may include: hormonal management via oral contraceptives, GnRH-analogues, or progestins; laparoscopic surgery, a minimally invasive surgery used to remove adhesions and scar tissue; and NSAIDS/pain relievers.
If this is a medical condition, why can pelvic floor therapy help?
Pain neuroscience education and central sensitization-In chronic pain conditions, the autonomic nervous system can produce a hypervigilance that perpetuates pain cycles. This is called central sensitization, and it can make pain relief feel elusive. Pelvic floor therapy aims to educate clients about current research in pain science; this education can feel validating and empowering, and studies are suggesting that understanding pain science can help clients with pain reduction.
Self-care around menstruation-If you have endometriosis, you know that your menstrual cycle can be extra challenging. Your pelvic floor therapist will work with you to create a plan around your period pain, which might include brainstorming about lifestyle changes to support pain relief and relaxation; gentle stretches; or breathing exercises.
Pelvic floor relaxation-Many people with endometriosis experience pelvic floor hypertonicity, or overactivity in the fibers on the muscle. This may perpetuate some of the pain or discomfort they are feeling, and contribute to pain with sex. Your pelvic floor therapist will teach you tools for ongoing pelvic floor muscle relaxation.
Pain with sex-If you have endometriosis and you’re experiencing pain with penetrative intercourse, you’re not alone. Through the use of stretches, exercise, breathwork, and therapeutic tools such as a pelvic wand or dilators, your pelvic floor therapist can help address your pain with intimacy.
Endometriosis can be really challenging to manage. Working with a qualified pelvic floor therapist can help educate and empower you, mitigate some of the effects of the condition, and assist in the return to the activities you’ve always loved.
If you are interested in how Embrace can help you navigate your pelvic health, book an appointment with us!
This article was written by Mirah Sand OTR/L. They are a pelvic floor occupational therapist who is certified Pregnancy and Postpartum Corrective Exercise Specialist, and has received advanced pelvic health training through Herman and Wallace Pelvic Rehabilitation Institute.