Straight off the back of Women’s health week is the perfect time to discuss endometriosis. What is it? What are the common symptoms? And what can a Pelvic Health Physiotherapist do to help?
What is Endometriosis (or Endo)?
§ According to the World Health Organization (WHO) endometriosis is defined as a disease in which tissues similar to the lining of the uterus grows outside the uterus. It is thought to affect roughly 10% of women and girls of reproductive age globally.
§ There is no known cure for endometriosis and management is usually aimed at Symptom management
§ Endometriosis can only be diagnosed with Laporscopic surgery but researchers are currently working to create less invasive, bed side techniques of diagnosis.
Symptoms
Symptoms of endometriosis can vary quite a bit from person to person because the emerging evidence is suggesting that Endo and Endo symptoms are more systemic in nature, so it can affect much more than just the pelvic region.
But common symptoms can include (but are not limited to) (WHO 2023):
§ Irregular and or heavy periods
§ Pelvic pain including pain with sexual intercourse, bowel movements and/or urination.
§ Abdominal bloating
§ Nausea
§ Fatigue
§ Issues with conception
§ Depression/anxiety
Endometriosis related pain
- Endometriosis-associated pain (EAP) syndrome is defined by the 2023 European Association of Urology Guidelines on Chronic Pelvic Pain as ‘chronic or recurrent pelvic pain in patients with laparoscopically confirmed endometriosis’ the term is used when the symptoms persist despite adequate endometriosis treatment. (APA 2024)
- While endometriosis is thought to initially arise due to local inflammation, lesions and hormonal effects (Zondervan et al 2020), the persistent nature of EAP is due to a more widespread response in the body and it is proposed that endometriosis is a systemic disease (Taylor et al 2021)
Management
- When people hear Pelvic/Women’s health physiotherapy they tend to picture them treating ante or postnatal women or women with incontinence issues. However, Physiotherapy can play a large role in endometriosis management. EAP can be of a result of musculoskeletal and nervous system response to pain, which leads to ongoing or persistent pain even after the endometrial tissue has been removed. (APA 2024)
- Physiotherapy can address pain related to nervous system dysregulation and secondary musculoskeletal pain as a result of increased “danger” messaging from the area.
- Women who suffer with endometriosis benefit from a multidisciplinary or team approach to management. The team will obviously include a good GP, a Gynecologist and may also include a naturopath or dietician and/or a psychologist depending on symptoms.
So please make an appointment with one of our Women’s Health Physiotherapists to discuss a personalized, endometriosis management plan.
Written by Caitlyn Smith, Physiotherapist