Endometriosis can be a scary and sometimes debilitating diagnosis that affects roughly 10% of menstruating women. Many women suffering with endo have pain for years before they receive a formal diagnosis, and often have difficulty finding a treatment that works for them. So, what exactly is endometriosis anyway?
What is Endometriosis?
Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus, causing pain and/or infertility. Symptoms associated with endometriosis can include painful periods, pain during and/or after sexual intercourse, painful bowel movements, painful urination, abdominal bloating and nausea. These chronics symptoms can often contribute to fatigue, depression and/or anxiety.
Some places that endometriosis can often be found, but are not limited to:
- The Fallopian tubes
- The ovaries
- The rectum and/or intestines
- The bladder
- Various positions of the abdominal cavity
The Effects of Endometriosis
Endometriosis can lead to chronic pelvic pain, pain with intercourse, constipation and pain with bowel movements, difficulty and pain with urination, and infertility. According to the NIH, between 30 and 50% of women with endometriosis also experience infertility. While the exact correlation between endometriosis and infertility is not known, it is believed to potentially be due to abnormalities in pelvic anatomy, endocrine function, abnormal ovulation, and how the endometrial cells are affected by hormonal changes. Many patients’ symptoms are considerably more severe during their period leading them to take time off work, school, or other daily activities.
Symptoms of Endometriosis
Some of the symptoms endometriosis patients may experience include
- Excessive bleeding during menstruation, or bleeding between periods
- Extremely painful periods
- Bloating or nausea
- Painful intercourse
- Painful bowel movements or urination (more significant during menstruation).
How to Get a Diagnosis
If you are reading this and feel you might have endometriosis, you might be asking yourself “How do I know? How do I get a diagnosis?” Unfortunately, many women go years before getting a diagnosis. However, there are certain tests that can be helpful in diagnosing endometriosis. While none of these tests on their own can diagnose endometriosis, when bundled together they can be helpful in ruling out other conditions and can be utilized in preparation for surgery. These tests include:
- Pelvic exam- this can be utilized to palpate anatomical abnormalities, cysts, and scar tissue present from endometriosis
- Ultrasound (often abdominal and transvaginal)- this test alone cannot be used to identify endometriosis, but can be used to locate/identify cysts on the reproductive organs that may be resultant of endometriosis.
- MRI- this test can be used to identify the size and location of endometrial implants, and therefore can be helpful with surgical planning.
- Exploratory laparoscopy- this is where a surgeon uses a small camera that is surgically inserted into your abdomen to locate endometrial implants. This procedure can also be used to biopsy the tissue to determine if it is in fact endometriosis.
Risk Factors for Endometriosis
Some other information your doctor might take into consideration when diagnosing you include any risk factors you might have. While none of these risk factors alone point to endometriosis; when they are present in addition to positive findings with the above testing, they often make diagnosis a bit easier. These risk factors include:
- Beginning your period earlier than 12 years of age
- Heavy periods that last longer than 7 days
- A menstrual cycle that is less than 27 days
- A family history of endometriosis
- Having high levels of estrogen
- Abnormalities of the reproductive tract.
Check out the second post in this series on Endometriosis for tips on how Pelvic Physical Therapy can help.
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