Do you have painful menstrual cycles? Do you have to miss school or work due to your period discomfort? 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 it?
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 it 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. This condition can cause periods so painful women have to miss school or work. It often causes severe pelvic pain as well.
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
This condition 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 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 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 this condition. 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 trans-vaginal)- 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 floor physical therapy can help and read below for some FAQs!
Frequently Asked Questions About Endometriosis
Does Dry Needling Help?
Yes, dry needling can help with endometriosis. A woman in my clinic presented with endometriosis and secondary constipation. I used needling to help decrease tissue restriction, increase blood circulation, release trigger points and improve scar mobility. Please keep in mind this is different from acupuncture. The needle is a tool, just like my hands are, to work on muscles and tissues. Inquire with your healthcare provider if dry needling could help you.
Can It Cause Back Pain?
Endometriosis can cause back pain due to dysmenorrhea. Dysmenorrhea is painful menstruation accompanied by painful cramps, lower back pain, and abdominal pain. Natural pain relief remedies are recommended for pain during periods caused by endometriosis. However, the pain can often be severe.
How Can You Relieve Back and Hip Pain due to Endometriosis?
Below are my top three exercises to help relieve back and hip pain from endometriosis.
- Shoulder blade squeezes
- Transverse abdominus contractions
- Child’s pose
Can Endometriosis Cause Constipation, Diarrhea, Nausea, etc?
Endometriosis can cause constipation, diarrhea, nausea, bloating, and other gastrointestinal issues. An anti-inflammatory diet may help with these issues, including a plant-based diet. Check with your healthcare provider or a registered dietician to see if diet can improve your endometriosis. Cramps caused by endometriosis may induce nausea and vomiting.
Can It Cause Bloating (endo belly)?
Yes, bloating of the abdomen is known as endo belly. Endo belly can be extremely painful and can impact the individual emotionally as well.
Can Endometriosis Cause Leg Pain?
Endometriosis can cause leg and back pain.
Can It Cause Bladder or Bowel Issues?
Endometriosis can cause bladder and bowel movement issues. Endometriosis can cause bowel issues such as gas, bloating, constipation, and more.
What about Hemorrhoids?
Endometriosis isn’t likely to cause hemorrhoids. Hemorrhoids are swollen veins around your anus and rectum that can either be painful or painless and present internally or externally.
Can Endometriosis Cause Tailbone Pain?
Yes, tailbone (also known as coccyx) discomfort is literally a pain in the butt! You may notice that simple, everyday activities become bothersome. For example, sitting can be extremely irritating, and you may constantly need to change positions or even avoid hard surfaces. Pooping may become painful and more difficult, and you may even notice increased discomfort with intercourse. However, even movements like transferring from sitting to standing can improve your symptoms. Tailbone pain isn’t serious. However, endometriosis can be the source.
What About Vulvar Pain?
Vulvar pain from endometriosis is rare but can happen.
Can it Cause Dyspareunia?
Endometriosis can cause dyspareunia. Painful sex, also known as dyspareunia, is a common diagnosis with up to 18% of the worldwide population (and affects ALL genders). Individuals who have dyspareunia often don’t know how to seek treatment. Unfortunately, it is taboo, and discussing symptoms might be difficult. Lastly, medical providers may not take the reports of these symptoms seriously. People are not getting the help they need, leading to mental health issues, relationship challenges, and an overall decreased quality of life. Fortunately, when diagnosed appropriately, dyspareunia can be managed and treated by a team specializing in pelvic health.
Interested in more tips on how to prevent or overcome Pelvic Floor Problems?
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