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Endometriosis and Physiotherapy

March was Endometriosis Awareness Month. Endometriosis effects 1 in 10 women in Ireland and is one of the most commonly seen gynaecological diseases. However, it is poorly understood and not commonly spoken about. And certainly not spoken about in conjunction with physiotherapy.

Symptoms of endometriosis can begin prior in early teenage years and persists throughout the life cycle. It can have a profound effect on the individual’s quality of life. Endometriosis is a long-term inflammatory condition where the tissue that normally grows inside the uterus, grows outside the uterus. The most common places where endometriosis can occur is the ovaries, fallopian tubes, the bowel and areas in front, back and sides of the uterus. It can also be found in the bladder and bowel and in some rarer occasions it is found outside the pelvis. These deposits of tissue cause an inflammatory reaction that can lead to pain which causes secondary muscle tension, scar tissue and adhesion formation. It is believed that the endometriosis tissue reacts to the same hormonal stimulation as normal endometrium which can lead to symptoms being worse at certain times of the month. As well as pelvic pain other symptoms include pain with opening bladder or bowel, painful sex, lower back pain, abdominal bloating, constipation, migraine, fatigue.

The exact cause of endometriosis is not known although most experts believe it is exacerbated by oestrogen normally produced in the body. Unfortunately, there are no treatments which fully cure endometriosis however there are lots of treatment options to help manage symptoms. The gold standard for diagnosing endometriosis is through a biopsy done by a specialist doctor.

The treatment options for endometriosis when it has been diagnosed includes medication, hormonal therapy, surgery. In addition, to these seeing a women’s health physiotherapist who specialises in treating problems related to the pelvic floor including issues with the bladder, bowel and sexual function can be a very beneficial adjunct to the more mainstream treatment options. Chartered physiotherapists who treat endometriosis work on the pelvis, spine and abdomen to release the tension in the muscles and stiffness in the joints caused by the body’s adaptation to endometriosis and therefore helps to improve quality of life. Physiotherapists can provide exercises to lengthen and strengthen the appropriate muscles as part of the treatment program customised to meet the person’s needs. Physiotherapists also liaise with the G.P. and specialist doctors to treat this somewhat invisible disease.