You may have seen the recent ABC online news article raising awareness of endometriosis. The article highlights how our health system is doing poorly when it comes to diagnosing and treating endometriosis, with many women waiting years for a correct diagnosis, and being made to feel they are “making it all up”.
Reported prevalence rates of endometriosis vary from 2-10%, but as under-diagnosis and under-reporting are quite common, actual rates may be higher.
Endometriosis involves cells like those in the lining of the uterus, appearing in other parts of the pelvis or elsewhere in the body. Typical symptoms include very painful and heavy periods, pain at ovulation or other times, bladder and bowel problems including urgency and frequency, pain with intercourse and fertility problems. However, symptoms can vary significantly between individuals, with not all women having all of these symptoms.
Many women with endometriosis also suffer from stress, anxiety and depression, with ongoing pain and poor diagnosis and management contributing to these problems.
Ultimately, women need laparoscopic surgery to diagnose endometriosis, although diagnosis can be suspected from the presenting symptoms. However, many doctors may not have a good understanding of endometriosis, and may dismiss teenage girls or young women complaining of “period pain” as just needing to “toughen up” a bit.
Treatment of endometriosis often involves managing symptoms, and their cascading effects, as best as possible, as there is no known full cure. Many women find laparoscopic surgery to remove their endometrial lesions can be helpful. Some women find having a baby helps, although for others it will get worse. Medical management with hormonal treatment and pain medications can also be important in overall care.
From a conservative point of view, a multi-disciplinary approach to endometriosis management is very beneficial.
Many women with endometriosis will have over-activity of their pelvic floor muscles, but weakness of other muscles around the hips and pelvis. A women’s health physiotherapist can teach women how to relax their pelvic floor muscles, which will often help to improve bladder and bowel pain and urgency, sexual pain and general pelvic pain.
They can also guide women into beneficial forms of general exercise, including gentle Pilates, yoga and walking for overall chronic pain management and to help provide more support for the pelvis, but without over-working the pelvic floor muscles.
Some physiotherapists or psychologists can also assist with teaching mindfulness, breathing techniques and stress management ideas, which helps with pain control and to deal with general stress and anxiety.
Improving your diet is also beneficial, and a nutritionist or dietician can recommend a number of anti-inflammatory foods, including whole foods, turmeric and leafy greens, while eliminating inflammatory foods such as highly processed carbohydrates and sugars.
You can find out further information about endometriosis from PelvicPain.org.au.
Jenny Phillips, a Titled Continence and Women’s Health Physiotherapist, can also assist you with managing your endometriosis.