Endometriosis is the abnormal growth of cells outside of the uterus. Endometriosis is a chronic disorder that may be painful. Exactly how many women have endometriosis is unknown because it can usually be diagnosed only by directly viewing the endometrial tissue. The percentage of women who have endometriosis is higher among women who are infertile (25 to 50%) and women who have pelvic pain (75 to 80%). It can be a painful and stressful condition to have, but there is a hope, as many different types of treatments are available which can help to have a better living.

Cause of Endometriosis

The cause of endometriosis is unknown. One theory is that the endometrial tissue is deposited in unusual locations by the retrograde flow of menstrual debris through the Fallopian tubes into the pelvic and abdominal cavities. The cause of this retrograde menstruation is not clearly understood. These lesions are most commonly found on the ovaries, the Fallopian tubes, the surface of the uterus, the bowel, and on the membrane lining of the pelvic cavity (i.e. the peritoneum).

It is also likely the direct transfer of endometrial tissues at the time of surgery may be responsible for the endometriosis implants occasionally found in surgical scars (for example, episiotomy or Cesarean section scars).

Finally, there is evidence that some women with endometriosis have an altered immune response in women with endometriosis. They are less commonly found to involve the vagina, cervix, and bladder. Endometriosis sometimes runs in families and is more common among first-degree relatives (mothers, sisters, and children) of women with endometriosis. It is more likely to occur in women with the following characteristics:

· Have their first baby after age 30

· Have never had a baby

· Started to menstruate earlier than usual or stopped menstruating later than usual

· Have short menstrual cycles (less than 27 days long) and have heavy periods that last more than 8 days

· Have certain structural abnormalities of the uterus

· Have mothers who, when pregnant, took the drug diethylstilbestrol (DES), prescribed to prevent miscarriage (in 1971, the drug was banned in the United States)

Endometriosis seems to occur less often in women with the following characteristics:

· Have had several pregnancies

· Started to menstruate later than usual

· Breastfeed a long time

· Use low-dose oral contraceptives

· Exercise regularly (especially if they started before age 15, exercise more than 4 hours a week, or both)

Signs and symptoms

Some women experience mild symptoms, but others can have moderate to severe symptoms. Pelvic pain is the most common symptom of endometriosis. You may also have the following symptoms:

Possible symptoms by location include

· Large intestine: Abdominal bloating, pain during bowel movements, diarrhea or constipation, or rectal bleeding during menstruation

· Bladder: Pain above the pubic bone, pain during urination, urine that contains blood, and a frequent and urgent need to urinate

· Ovaries: Formation of a blood-filled mass (endometrioma), which sometimes ruptures or leaks, causing sudden, sharp abdominal pain

· painful periods

· pain in the lower abdomen before and during menstruation

· cramps one or two weeks around menstruation

· heavy menstrual bleeding or bleeding between periods

· infertility

· pain following sexual intercourse

· discomfort with bowel movements

· lower back pain that may occur at any time during your menstrual cycle

· bloating and distention

Physiotherapy Treatments

Pelvic health Therapist in Curezone physiotherapy Mississauga will evaluate the alignment, musculature, fascial systems, and movement patterns in the pelvis and body for issues that activate your pain and decrease your quality of life. Changes to your exercise and relaxation routines, and maintaining a balanced diet to stay healthy, may help you to manage the symptoms of endometriosis.

They develop a treatment programme according to your specific needs. There is also a build up of scar tissue from the endometriosis or from the surgeries to remove endometriosis. This tightness in the muscles and connective tissue (fascia) in the area can then cause further pain. Endometriosis severely impacts the pelvic floor, and more often than not, women who suffer from endometriosis also suffer from a hypertonic, overactive or tight pelvic floor. PTs can help to manage the symptoms of endometriosis such as painful menstrual cramping, abdominal discomfort, pelvic floor pain, and painful intercourse by:

treating connective tissue dysfunction treating myofascial trigger points “Visceral manipulation therapy” mobilizing viscera (gentle manual therapy techniques aimed at releasing adhesions scar tissue, adhesions, spasms, fascial and muscle tightness, and to restore the correct alignment of the bones, soft tissues and the pelvic and abdominal organs. Restoring the proper mobility of the internal organs, such as the uterus, bladder, colon and small intestine) Correcting postural and movement dysfunction (often when we are in pain not only does it change our muscle tone but it causes us to move and posture ourselves differently than we typically would. Providing patients, the correct postural techniques.Pelvic floor coordination exercises to help learn how to contract, hold, and relax the pelvic floor correctly and on demand. The focus is usually on learning how to relax the pelvic floor.

Medications

Hormone-based therapies can be used to manage endometriosis related symptoms, and may involve combined hormonal contraception, progesterone-like medications, or gonadotropin releasing hormone (GnRH) agonists with ‘add-back’ therapy. Reducing estrogen levels may help manage pain related to endometriosis.

Alternative treatments

Many women with endometriosis report that nutritional and complementary therapies such as acupuncture, traditional Chinese medicine, following a macrobiotic diet, herbal treatments and homeopathy improve pain symptoms. In fact, exercise may actually improve endometriosis symptoms. Daily exercise (about 60 minutes each day) such as walking, swimming, dancing, or other activities will help you maintain a healthy weight and give you energy.

If you are interested to know more about your problem and discuss to find out if there is a solution meet our specially trained Pelvic Health Physiotherapists standing by to help you. Call today to get started on your recovery from Endometriosis!