Endometriosis

The theory about retrograde menstruation is an outdated one and does a disservice to the patients because of its limitation to the uterus and inaccuracy in terms of pathology.  Often people are put on years of birth control because of it. 

 

Endometriosis is characterized by the presence of tissue similar to the lining of the uterus (endometrial-like) located outside the uterus.  These fragments are different structurally, and behave differently, from the normal endometrium which is shed during a period. This tissue causes pain, infertility, and organ dysfunction due to inflammation, invasion of structures in the body, and scar tissue.

 

Endometriosis impacts approximately 1 in 10 individuals assigned female at birth and is rare in individuals assigned male at birth. Symptoms are often dismissed as “bad cramps” leading to an average 10-year delay in diagnosis.

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Staging of Endometriosis is based on how it affects fertility and not based on symptom severity. The ASRM’s classification system “classifies the disease as minimal (Stage I), mild (Stage II), moderate (Stage III) or severe (Stage IV)” based on a point system for how deep lesions go, the number of lesions, if cysts are on the ovaries and adhesions.

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Myths about treatment:

Hormones, birth control pills, pain medicine, diet, and lifestyle do not cure endometriosis. We do not know the origin and what causes it and there are many theories about it.

The only way to diagnose it is Laproscopically.

Excision Surgery by a trained surgeon( please note that not all gyn are trained in this) is the best treatment to take the disease out and NOT ablation. 

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It is important to note that surgery will take the disease out but might not take all the pain away because there are many generators of pain. Pain can be coming from the pelvic floor and other muscles, nerves, and vessels, There can also be accompanying conditions like vulvodynia, interstitial cystitis, fibromyalgia etc. with endometriosis. 

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How can Pelvic PT help with endometriosis?

Pelvic PT trained or experienced in treating endometriosis can help with pelvic pain, abdominal pain that is caused by pelvic floor dysfunction or soft tissue or muscles in the abdomen, we can help with bowel or bladder symptoms like urgency/frequency, bladder pain, constipation again caused by pelvic floor muscles. Pelvic PT helps you to maintain an optimal level of strength and function and helps you maintain a good quality of life. 

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