Endometriosis is a disease where endometrial-like tissue (similar to the lining inside the uterus) develops on other pelvic organs like the ovaries, fallopian tubes, pelvic and low back ligaments, bladder, and colon. Endometriosis tissue has also been found in rare cases in non-pelvic organs such as the diaphragm or brain. This new, hormone-sensitive tissue behaves much like the uterine lining, by thickening and shedding each month. However, unlike uterine tissue inside of the uterus, which is shed each menstrual cycle, this hormone-sensitive tissue promotes scarring and inflammation which can lead to the formation of cysts, adhesions and pain.
Endometriosis affects 1 in 10 Canadian women (and those with a uterus); the root cause often being misunderstood and taking years to diagnose. Symptoms can include severe pelvic cramping, painful menstrual cycles, heavy bleeding and/or spotting between periods, pain with intercourse, back pain, leg pain, painful bowel movements, bloating, and chronic fatigue. Living with endometriosis can impact daily life and well-being; by understanding how the condition works can be a helpful first step to finding appropriate support and treatment options.
Recently diagnosed? See a pelvic health physiotherapist.
How endometriosis affects the body
During a menstrual cycle, the endometrium (the uterine lining) grows and sheds each month under influence of the rise and fall of hormones. Endometriosis is when tissues similar to the endometrium (also influenced by the rise and fall of hormones) grow in other parts of the pelvis including the reproductive organs, muscles and ligaments supporting them, as well as the bowel and bladder. Tissues growing on organs where it shouldn’t be leads to inflammation and scaring which contributes to pain.
The impact of endometriosis extends far beyond period cramps and physical discomfort. It can cause severe dysmenorrhea (painful periods), dyspareunia (painful intercourse), and chronic pelvic pain at anytime during the cycle. Many individuals also experience bowel and bladder symptoms, as well as debilitating fatigue. The chronic nature of these symptoms can significantly affect work productivity, social life, intimate relationships, and mental health. Notably, the severity of symptoms doesn’t always correlate with the extent of the disease; some people with substantial endometriosis may even be asymptomatic, adding to the diagnostic challenge.
The journey to diagnosis: understanding endometriosis symptoms
For many, the path to an endometriosis diagnosis is long and frustrating. In Canada, the average length of time to receive a diagnosis is about five years. This delay often stems from the varied and sometimes subtle ways endometriosis can present itself.
What does endometriosis feel like? Common symptoms explained
The most common complaint people experience is increased or abnormal pelvic pain during their period. This can manifest as unmanageable cramps that start days before a period and persist longer than usual. Many also report excessive, heavy bleeding with large clots; also known as adenomyosis, which occurs in 50% of endometriosis cases.
Beyond period pain, endometriosis can affect other bodily functions
While painful or heavier periods may indicate endometriosis, they may not be present in all cases, and symptoms can be present throughout the entire cycle. As endometriosis can affect multiple organs, other symptoms can include:
- Bowel and bladder. You might experience painful bowel movements and urination, especially during your period. Endometriosis can also cause constipation and bloating because inflammation and scar tissue in the pelvis can affect nearby organs.
- Back pain. The inflammation and scar tissue in the pelvis can also contribute to back pain, often felt in the lower back, legs, or pelvic region.
- Sexual health. Pain with intercourse, or even an inability to have penetrative intercourse, can occur due to muscle spasm or scar tissue affecting the pelvic organs.
- Fatigue. A deep sense of tiredness that isn’t related to activity is also a common symptom.
If you suspect you have endometriosis, it is crucial to consult your primary healthcare provider to discuss your symptoms and pursue a formal diagnosis.
Help find relief: how pelvic health physiotherapy can help with endometriosis
While there is no known way to prevent endometriosis or a definitive cure, we do know that it is a full body systemic inflammatory disease and managing its symptoms to help improve quality of life is possible. This is where specialized care, like pelvic health physiotherapy, can help.
Pelvic health physiotherapy uses hands-on treatment to help reduce pain and improve movement in people with endometriosis. Scar tissue and tight muscles in the pelvis can limit movement and cause the muscles to tighten even more, which can make the pain worse.
A dedicated pelvic health physiotherapist can help by:
- Minimizing scar tissue pulling. A physiotherapist can use gentle hands-on treatment, both outside and inside the body, to help ease tightness and pain from scar tissue. Physiotherapy can also help prevent new scar tissue from forming after surgery by using hands-on care and simple movement exercises.
- Addressing sexual dysfunction. For those experiencing pain with intercourse, a pelvic health physiotherapist can provide guidance and support. This may involve the use of dilators, specific stretching techniques, mindfulness, and pelvic relaxation strategies. The goal is to help you regain control over pain and enable pain-free activities, including intimacy.
- Improving overall pelvic function. By releasing tension and improving mobility in the pelvic floor muscles, abdomen and hips, physiotherapy can also help manage symptoms like painful urination, bowel discomfort, and chronic pelvic pain, which are common in endometriosis.
A large degree of pain experienced by those with endometriosis (even after surgery or medication to manage the disease) is related to the body’s learned protective response. This is when the muscles (of the abdomen, hip, and pelvic floor) are in the chronically guarded and tightened position, which can cause a lot of residual pain. A pelvic health physiotherapist can help relax these muscles to reduce discomfort.
Working with a pelvic health physiotherapist empowers you with strategies and tools to manage your pain and improve your daily function. They understand the complexities of endometriosis and can provide a supportive, knowledgeable environment for your healing journey.
Living well with endometriosis: your next steps
Understanding endometriosis symptoms and exploring endometriosis treatment options can feel overwhelming, but you don’t have to navigate it alone. While the question of “why is endometriosis not taken seriously?” Can arise due to diagnostic delays or dismissing symptoms; dedicated healthcare professionals are here to listen and help.
Taking proactive steps towards managing your condition can make a significant difference. If you are experiencing symptoms consistent with endometriosis, reach out to your doctor for a proper diagnosis. Once diagnosed, specialized support, like pelvic health physiotherapy, can play a key role in helping you manage pain and feel more in control.
Key takeaways
- Endometriosis involves uterine-like tissue growing outside the uterus, causing pain and inflammation.
- Common symptoms include severe period pain, heavy bleeding, painful intercourse, and bowel/bladder issues, often leading to a delayed diagnosis.
- Pelvic health physiotherapy is a key treatment option that helps manage pain by releasing tight muscles and fascia and addressing issues like sexual dysfunction.
- Understanding your symptoms and seeking professional guidance are helpful steps toward managing endometriosis and improving your quality of life.
FAQs
What is endometriosis?
Endometriosis is a chronic disease where tissue similar to the lining of the uterus grows outside of it, typically on pelvic organs, leading to pain and inflammation.
What are common endometriosis symptoms?
Common symptoms include severe period pain, heavy bleeding, painful intercourse, chronic pelvic pain, and bowel/bladder issues like painful urination or constipation.
How long does it take to diagnose endometriosis in Canada?
The average length of time for an endometriosis diagnosis in Canada is about five years.
Can pelvic physiotherapy help with endometriosis pain?
Yes, pelvic health physiotherapy can help manage endometriosis pain. Treatment may focus on reducing muscle tightness, improving movement, and easing pain during activities such as intimacy.
Can endometriosis cause constipation or back pain?
Yes, endometriosis can affect the bowel and cause pain, constipation, or bloating. Inflammation and scar tissue in the pelvis can irritate nearby organs and make bowel movements painful or uncomfortable. It can also contribute to lower back pain.
To schedule an appointment, contact a pt Health clinic near you or book an appointment online.
This blog originally appeared on Lifemark.ca and was written by Alana Lazareck-Devlin, PT, BMRPT, CAFCI.