One in ten women suffer from endometriosis. While this is a disorder that involves the reproductive organs, a pelvic floor physiotherapist is a good member to have on your health team to help cope with your symptoms.

What is Endometriosis?
Endometriosis is a condition where cells that are very similar to the ones that line the uterus, grow outside of the uterus. They can grow on the outside of the uterus, the ovaries, the fallopian tubes, the outer lining of the rectum… normally they stay contained in the pelvic cavity. These cells act very much like normal endometrial cells – they thicken and then bleed with every menstrual cycle. Not fun. In fact, this can irritate surrounding tissues and lead to adhesions – sticky, fibrous bands or sheets of tissue that can bind surrounding organs.

Symptoms include painful periods – this can be very painful… leading to missed school days or work days. Sometimes, the pain can become more chronic…lasting longer than your periods. Pain can occur at other times too, like pain with vaginal penetration – including having sex, using tampons, or under-going a medical pelvic exam. Some women feel pain with urination or bowel movements too. There can also be more bleeding associated with your periods, periods lasting longer than usual, or spotting between periods. Women with endometriosis can also experience a variety of gastro-intestinal issues like nausea, diarrhea, constipation, and bloating (sometimes called Endo-belly). Some women report fatigue and tiredness too. Finally, infertility is also a symptom of endometriosis. It doesn’t mean that you can’t get pregnant, but you might have difficulty. For all of these reasons, it is best to seek medical treatment as soon as you can. And this is why we need women to know that painful periods are not normal.

Diagnosis is often based on symptoms. Sometimes pelvic ultrasounds are done, but this doesn’t always show endometriosis. A diagnosis is best confirmed with a laparoscopic surgery – though some physicians try to avoid surgery until necessary. If you think that you have some of the signs of endometriosis, contact your doctor.

Medical treatments include pharmaceuticals and surgeries. Different strategies or combinations of treatments are used for each individual and depends on symptoms.

How Does Pelvic Floor Physiotherapy Fit In?
A pelvic floor physiotherapist can’t treat the endometriosis tissues, but they can help to treat the surrounding muscles and help address some of the secondary symptoms:

• Pelvic floor and abdominal muscle pain
• Painful sex (tampon use, pelvic exam)
• Constipation
• Pain with urination
• Difficulty exercising
• Pain coping strategies

If you think that you could benefit from pelvic floor physiotherapy, discuss your options with your doctor.

Katie Kelly, Physiotherapist
Bsc., MSc. PT