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Updated: Mar 9, 2023

Endometriosis affects 1 in 10 females. 10% is a high percentage of the population! You probably know at least 10 females, so that means likely at least a few women in your life have endometriosis.

Endometriosis is when the tissue that is similar to the tissue that lines the inside of the uterus grows outside of the uterus. Normally women shed this lining with their monthly menstrual cycle, but if this tissue is growing outside the uterus it is never being shed from the body.

Endometriosis can occur in the pelvis or abdomen. It is commonly found on the outside of the uterus, ovaries and fallopian tubes. It is also common in the rectum, appendix and other parts of the pelvic cavity. It has been found as far away as into the diaphragm and tissue lining the lungs, although not commonly that far away.

Endometriosis is often very painful. It has a spectrum of severity from mild to debilitating, often associated with how much endometriosis has grown in the body.

Some classic signs of endometriosis are long, heavy, painful periods. This is the most common complaint. Some other signs and symptoms can be pain with sex, lower back and abdominal pain, bleeding between periods, pain or difficulty with bowel movements and urination and extreme fatigue.

Some common medical treatments are hormonal birth control, pain medications and other hormone medications. These can control the symptoms, but not treat the cause. Often it will be suggested to have a hysterectomy or surgery to remove the endometriosis tissue.

The limitations of surgeries are that often a hysterectomy is not removing all the endometriosis tissue, and there are other reasons having a uterus is important, even if you don't want children or are past childbearing age. The uterus not only holds babies but the ligaments that hold up the uterus are intertwined with the ligaments that hold up the bladder and if you remove the uterus their is a higher likelihood of bladder issues in the future.

Endometrial tissue that is abnormal, but inside the uterus is called adenomyosis, so a hysterectomy might "cure" adenomyosis but not endometriosis.

Another surgical intervention is ablation surgery where the doctor will go in laparoscopically (small incision) and burn off the endometriosis tissues. This is ok, however often some endometriosis cells are left behind and will continue to grow again in the future.

Excision surgery is the gold standard of endometriosis surgeries. These need to be done by a specialist, and there aren't many of them trained in the world. The Facebook group "Nancy's Nook" has a list of surgeons trained in excision surgery. It's free to join and the best resource for endometriosis education. Use it for its resources.

Excision surgery is where a specially trained surgeon will also go inside laparoscopically and excise, or cut away, all the endometriosis. This is a tedious surgery! This has better outcomes because the surgeon can see the edges of the endometriosis tissue and send samples to the lab to make sure they get all the cells so there is less likelihood of endometriosis growing back again in those areas.

Surgery is for those with severe symptoms and it can be life changing! I've seen women after excision surgery and they do well.

For those whose symptoms are not as severe they may choose to do things naturally, they may choose birth control to decrease the monthly symptoms or to take pain medications as necessary.

Pelvic floor therapy can also be extremely helpful for women with endometriosis. Therapy doesn't actually take away the endometriosis tissues, however it can help break up adhesions in the muscles, ligaments and other tissues. It is also highly recommended after surgery to go to pelvic floor therapy. I have seen pelvic floor therapy help with pain in areas the surgery couldn't fix.

If you think you have endometriosis talk to your doctor, join Nancy's Nook FB group and advocate for yourself. It is often a condition that is missed and brushed off by medical professionals, unfortunately. If you don't want to be on birth control or hormones or have surgery do your research and advocate for yourself. Also, try pelvic floor therapy to help with the pain, I've seen women not need other medications and surgeries after going through pelvic floor therapy.

Share this with the girls and women who you think might have endometriosis. Also, share this with your doctor and nurse friends because the medical education is severely lacking for this disease.

If you have endometriosis or similar symptoms, give pelvic PT a try. And know that you will always be heard and believed that your pain is real and it's physical when you come into our office.

Call 562-285-3449 or email to schedule a free phone consult to see if pelvic floor therapy can help you.

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