What is endometriosis?
- Endometriosis is a progressive and chronic condition that affects approximately 10% of women of reproductive age.
- It specifically refers to when the endometrium (the tissue that normally lines the inside of the uterus) is found growing outside of the uterus.
- Endometrial tissue has been found in many parts of the body including the bladder, bowels, vaginal wall and pelvic floor muscles.
What is adenomyosis?
- Adenomyosis is where cells that are like those that line the uterus grow in the layer of muscle in the uterine wall.
- Around 1 in 5 women have adenomyosis and this condition is often associated with endometriosis.
- Adenomyosis needs the female sex hormone oestrogen to For this reason, it mainly occurs in women aged between 30-50 years.
Signs and symptoms
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Pain
- Pain immediately before or during a period (called dysmenorrhea)
- Pain during or around ovulation
- Pain during or after sex (called dyspareunia)
- Abdominal, lower back and/or pelvic pain
- Vaginal discomfort due to pelvic floor muscle spasm or tightening
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Bleeding
- Heavy bleeding or irregular bleeding
- Bleeding longer than normal or before a period is due
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Bladder and bowel problems
- Increased urinary frequency, difficultly emptying your bladder, pain when emptying (called dysuria)
- Diarrhoea and
- Pain
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Bloating
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Fatigue
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Mood changes
- Anxiety and depression due to ongoing pain
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Reduced quality of life
- Needing to take days off work, study or school
How can physiotherapy help?
- Treatment to manage endometriosis and adenomyosis is usually provided by a team consisting of your gynaecologist, physiotherapist and sometimes a dietician or
- Physiotherapy treatments usually address two main concerns associated with endometriosis – managing your pain and managing symptoms of worsening muscle dysfunction leading to bladder, bowel and sexual dysfunction.
What the evidence says
- TENS machine
- Retraining of the pelvic floor muscles and nerves
- Lubricant and vaginal moisturisers
- Relaxation strategies and down regulation of the central nervous system drivers
- If indicated, manual techniques to desensitize the nerves and muscles of the pelvic floor which can include self-massage, pelvic trainers and/or wands
- A musculoskeletal assessment of your posture, breathing, thorax, abdomen and pelvis
- Bladder and bowel retraining
- Low to moderate exercise can help manage your symptoms by;
- Reducing and managing pain by reducing muscle tension
- Increase blood flow to the uterus which can reduce cramping pain
- Exercise induced endorphins help balance and lower excess oestrogen
- Increase the bodies anti-inflammatory and anti-oxidant markers