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Endometriosis is a condition where the tissue that normally grows inside the uterus grows outside the uterus. Not to be confused with adenomyosis in which the endometrial tissue breaks through the muscle wall of the uterus, but all the abnormally growing tissue is contained within the uterus. Scientists are unsure why this occurs, but it is suspected that approximately 10% of females worldwide have endometriosis.1

Symptoms of endometriosis include painful periods, heavy periods, painful ovulation, painful intercourse, pelvic pain and infertility. Symptoms can start as early as the first menstrual cycle of a girl and last beyond menopause. There are no definitive genetic links, however if a girl’s mother had endometriosis she is at higher risk. There are no direct correlations to increased risk of cancers.

There is no known “cure” for endometriosis, but there are many things women can do to help control symptoms. Commonly, endometriosis is treated with birth control pills or hysterectomy, however neither of those necessarily will get rid of the symptoms.

Birth control pills are often prescribed in order to stop the monthly hormonal cycle that increases symptoms, but often when girls choose to stop taking birth control pills their symptoms return. One hypothesis as to why periods are so painful is that the endometrial tissues both inside and outside the uterus are responding to the monthly hormonal cycles.

Endometrial tissue has been found on the uterus, bladder, ovaries, fallopian tubes, rectum, abdominal and pelvic cavity walls and as far away as the thorax.2 Because these tissues are not only found on the reproductive organs a hysterectomy will not necessarily get rid of the symptoms. If your doctor only offers you birth control pills or hysterectomy as your treatment options, find another doctor. I will give you some resources below.

Pelvic floor physical therapy can often help reduce symptoms significantly. A normal response to pain anywhere in our body is for the muscles around that area to tighten to protect the painful part. Endometriosis often causes the pelvic muscles to tighten in response to the pain and a pelvic floor physical therapist can help break that cycle. Pelvic floor physical therapy can help tremendously with the symptoms however it is not a cure.

I recommend to all my patients with endometriosis to seek nutritional guidance as well. Often women with endometriosis have too much estrogen in their system and certain foods can make symptoms worse. One example is soy and soy products. Soy has a significant amount of estrogen like properties and should be limited in anyone with endometriosis or adenomyosis. A registered dietitian, functional medicine doctor or Chinese herbalist can also recommend herbs or supplements to help balance the hormone levels and therefore control the symptoms.

If this combination of physical therapy and nutritional support do not control the symptoms well enough many women look to surgery. A hysterectomy will not cure symptoms of endometriosis!!! If you have adenomyosis a hysterectomy will likely cure your pain, but more common is endometriosis and a hysterectomy is not the solution. I cannot emphasize this enough because this is the most recommended procedure. A normal gynecological surgeon is also not skilled in treating endometriosis. It is a specialty within a specialty and I highly recommend you seek someone with the proper training to do your surgery.

A hysterectomy is not the cure and even a doctor who offers micro-surgery within the pelvis may not be the best surgeon for endometriosis. I am not trying to put down any surgeons or medical specialists, however I have seen many women who have had multiple surgeries without symptom relief and that is because they are not being treated by the surgeon with the proper training.

I highly suggest if you are considering ablation or excision surgery (which is what you should be having, not a hysterectomy) to join a Facebook group called Nancy’s Nook. There is a list of surgeons in that group who specialize in endometriosis excision surgery. Go to the proper surgeon and get proper treatment and you will avoid having multiple failed surgeries and years of pain.

I have no personal connection to any of the surgeons recommended by the group “Nancy’s Nook”. I only know among pelvic floor physical therapists who treat patients with endometriosis this is the recommended resource page.

If you want to know some of my recommended dietitians and herbalists whom I refer to please email me, and I would be happy to share their information. I do not have an exhaustive list, only a few I know personally and can vouch for their services.3

There is also a book that can help you understand some of what is going on in your body and which treatments can help. It is called “Stop Endometriosis and Pelvic Pain.” It is written by an endometriosis surgeon Dr. Andrew Cook.

If you have, or think you might have, endometriosis I would highly recommend starting with pelvic floor physical therapy and diet control. If you think you need surgery look for the recommended specialists, and then follow up with a pelvic floor physical therapist and someone who can guide your dietary needs.

As always, I love to hear your comments and questions below.

Please share this article with the woman you know who may have endometriosis or related symptoms.

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