SHEREE DIBIASE, PT: Endometriosis: What you need to know

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Susie woke early one morning with a cramping, pulsing pain in her pelvic and lower abdominal region. She assumed it was her menses starting, but she noticed it seemed like this pain continued to progress each time she had her period and often throughout the days of her cycle. Sometimes she had constipation or diarrhea and other times her period was so heavy and irregular that she wasn't sure what was going on. She often felt pressure, tugging and pulling when she moved and there went her exercise regime right out the window. She felt like as time went on she struggled to function effectively with her home and work schedule during this time of the month. She wanted to get pregnant, but it had been a year of trying and she was getting frustrated. Everyone told her to just relax, but how could she just relax, she didn't feel good, most of the month.

Endometriosis affects more than 5.5 million women in North America and it is one of the most common gynecological diseases. It occurs when the endometrium, which is the lining in the uterus that is shed during a women's menses, grows similar cells outside the uterine cavity, often in the abdominal cavity, called endometrial implants. This growth can occur outside of the uterus, ovaries, Fallopian tubes or intestines. These implants can grow even farther from the uterus and have been sited in the lungs and brain, however this occurrence is very rare.

Endometrial cells are shed during menstruation, however these cells are not located in the uterus, so they have no way to be expelled from the body in the normal fashion. Therein lies the problem. These endometrial cells grow, breakdown and attempt to shed but have no where to go. They then cause a chemical breakdown in the region where they are attached and this chemical reaction can cause pain locally and in the surrounding tissue. Often there can be large areas of scarring that happens in the abdomen due to the chemical changes that occur in the tissue. When any movements are made a tightness or restriction can be felt especially during the menses cycle. The amount of pain a women feels does not coincide with the amount of endometriosis she has. She can have a small amount with a lot of pain and vice versa.

One of the common side effects of Endometriosis is infertility. This does not mean you won't ever conceive. If the endometriosis is mild or moderate in nature up to 70 percent of the population will take up to 3 years to get pregnant. This as you can imagine, can be a huge frustration for women because often they are unaware they even have the disease. Some women will never have any symptoms and don't know they do until they are trying to conceive.

Endometriosis is most often diagnosed between the ages of 25-35 and can start at the onset of puberty. After menopause, generally the symptoms decrease in nature,however scarring and tissue changes can remain.

Endometriosis is a chronic disease. There are a variety of treatments that include the use of hormone therapy ie birth control pills, hormone blocking therapy and surgical interventions. There are different surgical interventions, and depending on a woman's age and their desire for children, these interventions need to be discussed extensively with your MD, prior to surgery, to determine what surgery is best for you.

Endometriosis and it's side effects can be helped with physical therapy. The abdominal pain and scarring pre and post surgery can assist a patient in pain reduction and interventions can be established for a better quality of life. Learning how to live with this disease is part of the wellness See your MD today and start your journey towards healing.

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Sheree DiBiase, PT, is the owner of Lake City Physical Therapy and she and her wonderful staff specialize in women's health issues, along with women athlete performance. Please come see us in our Hayden office, 208-762-2100; Coeur d'Alene office, 208-667-1988; and in our Spokane Valley office, 509-891-2623.

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