- Danielle Khoury, DPT
March is Endometriosis Awareness Month

What is endo
Endometriosis is a disease where tissue similar to the uterine lining grows outside the uterus, causing adhesions, scar tissue and inflammation. This disease affects an estimated 176 million women worldwide, but this number has likely increased in the past few years. Most commonly it is found in the abdominal and pelvic cavity but can spread as far up to the diaphragm. Endometriosis affects the visceral organs, reproductive system, bowel and bladder. With 1 in 10 women being affected by this disease, it is likely you know someone who is affected. Unfortunately it takes the average woman suffering from endo 5-7 gynecologists prior to getting an actual diagnosis and the appropriate treatment.
Symptoms
Often endo is known for causing very painful periods. The truth is, a painful period is never normal. If you are confined to bed, over the counter medications, and to your heating pad while you are on your cycle it is worth having an appointment with your gynecologist. Other common symptoms are pain with intercourse, irregular periods, digestive problems such as IBS or “endo bloating” while on your cycle and unfortunately infertility.
Treatments
The gold standard treatment and diagnosis is excision via laparoscopic surgery. Excision surgery can temporarily help with symptoms, pain and scar tissue from adhesions however, there is no cure for endometriosis and follow up surgeries may be required. Some gynecologists recommend hysterectomy or birth control pills. Oral contraceptives or other forms of birth control can improve the symptoms of endometriosis but again there is no cure for the disease itself, even a hysterectomy is not a cure. Pelvic floor physical therapy can also be very helpful in managing symptoms. 97% of women with endometriosis are also experiencing pelvic floor myofascial pain and over-activity. This means the pelvic floor muscles become painful and tender and can lead to issues such as urinary frequency, urgency and dyspareunia (pain with sex). Pelvic floor physical therapy can help with these symptoms as well as working on abdominal-pelvic myofascial release, scar tissue, low back and hip pain due to the disease.
Raising awareness
Step one is talking about it. It’s important for women to not suffer in silence. If you suffer from severe bloating, IBS symptoms, painful periods or intercourse it is important to seek out your physician and preferably one who is experienced in treating pelvic pain conditions such as endometriosis. There are some helpful resources such as Nancy’s Nook Endometriosis Education Facebook Page and the Endo Summit Facebook page. Most women with endometriosis have to be advocates for themselves so it’s important to be well informed about your disease and show accurate information to your health care provider so you get the correct treatment. Nancy’s Nook Facebook page has a list of qualified surgeons and providers specifically trained in endometriosis excision, as well as extensive research articles to help educate.
References:
Beating Endo by Iris Kerin Orbuch, MD and Amy Stein, DPT
Nancy’s Nook Endometriosis Education Facebook page
Articles: Why Excision is Recommended
Painful Sex and Physical therapy by Sallie Sarrel
Recurrence of Endometriosis after Hysterectomy