Endometriosis: The Most Common, Devastating Disease That Most People Have Never Heard Of.

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Pelvic floor physical therapy can significantly aid in the pain reduction of endometriosis. Scar tissue mobilization, visceral mobilization, internal pelvic muscle trigger point release, stretching, exercise modification, and education on the disorder itself are all ways that physical therapy can help.

What is Endometriosis?

Endometriosis is a painful disorder in which tissue that is similar to endometrial tissue (the tissue that lines the inside of the uterus) grows outside of the uterus in other areas of the body where it does not belong. This can cause severe pain, bleeding or spotting between menstrual periods, digestive issues and even infertility.

Endometriosis tissue may swell and bleed just like when you are menstruating. However, unlike normal menstruation which has a way to “exit” the body, endometriosis tissue will swell and then bleed into (most typically) the abdominal cavity which does not have an “exit”. This is why pain and dysfunction occur and why the pain can be so difficult to pin-point and describe.

Endometriosis can grow and expand causing other problems, such as:

  • Scar tissue or adhesion formation - this can cause abdominal organs to bind together as well as severe pain due to lack of needed mobility of the organs. Binding of organs and lost mobility will lead to pain and dysfunction.

  • Growth in the ovaries can trap blood and lead to cyst formation

  • Blockage of the fallopian tubes

What causes endometriosis?

The cause of endometriosis is unknown at this point but here are some common hypothesis:

  • Retrograde menstrual flow - some of the endometrial lining that is shed during a woman’s period flows backwards into the fallopian tubes and into other areas of the body such as the pelvis and abdominal cavity.

  • Genetic disposition

  • An immune system that fails to detect and destroy the endometrial tissue that is growing outside of the uterus

  • Hormonal irregularities - estrogen seems to play a vital role in the growth of endometrial tissue outside of the uterus. Research into whether endometriosis is an issue with the body’s hormonal system is occurring.

  • Abdominal surgery (such as a C-section or hysterectomy) can accidentally spread endometrial tissue to other areas of the body

Diagnosis and treatment of Endometriosis

As of now, the only way to know 100% if your abdominal symptoms are being caused by endometriosis is to have laparoscopic, exploratory surgery. A surgeon will look for the endometrial growths outside of the uterus and, if found, will remove or ablate the unwanted tissue.

A doctor can use symptom reports, pelvic exams, MRIs and ultrasounds to exclude other disorders and diseases that can cause similar abdominal pain . A diagnosis of endometriosis based on exclusion is not definitive but can allow you to get started with treatment and pain reduction. Often, if endometriosis is suspected and the patient is not actively trying to get pregnant, a doctor will start with prescribing hormonal birth control or an IUD. These will lessen or completely stop bleeding which can decrease pain. The addition of pelvic floor physical therapy, nutritionists and other pain-modulating therapies such as massage and acupuncture, will significantly aid in pain reduction and empower the woman to be a participant in reducing her own pain.