Endometriosis is a chronic condition in which the endometrial tissue, which normally grows inside the uterus, grows outside of the uterus. This tissue continues to act as endometrial tissue; it thickens, breaks down and bleeds with each menstrual cycle. These can be found on the bowel, fallopian tubes, intensities as well as the ovaries. This is a debilitating condition that has an effect on the physical, mental, financial and emotional well-being of those affected.
In Australia 1 in 10 women have endometriosis, and it has been found to affect over 830,000 women Australia wide. Currently, there is no cure and it is an area where more research is needed. The following article will go over how it is diagnosed, common symptoms as well as why exercise is recommended as part of a treatment plan to help with Endometriosis. Our primary goal is to enable people to participate in activities of everyday lives.
Symptoms
Common symptoms of endometriosis are:
- Fatigue
- Pain in pelvic region, lower back or legs
- Pain with bowel movements
- Gastrointestinal distress
- Pain during or after sex
- Heavy bleeding or irregular bleeding
- Nausea
- Pain during or around ovulation
Diagnosis
If you had any of the previously listed symptoms, there could be a possibility that you have endometriosis and it is recommended that you go speak to your general practitioner or gynaecologist about it. The next step would be to have a laparoscopy, as this is the only way to diagnose endometriosis. This is where a camera is inserted to the abdomen region to determine if there is endometrial tissue outside the uterus. Due to a lot of these symptoms being related to a multitude of conditions and the fact that the only way to get diagnosis is through a laparoscopy, it has been found that on average it can take up to 7-12 years to diagnosis.
Treatment
Once you have been diagnosed it is important to take a multidisciplinary approach to help manage your condition. Below are a list of health professionals that can help you manage your condition.
- Dietitian can help with gastrointestinal distress symptoms
- Gynaecologist will help with diagnosis (laparoscopy)
- Pelvic Physiotherapist can help manage pain by reducing tightness in the surrounding muscles and connective tissues.
- Exercise Physiologist tailored exercise treatment.
Why Exercise Physiology
Looking at that list it can be clear as to why you would seek treatment from a whole range of different health professionals, and we all know exercise is good for us. So why should I see an Exercise Physiologist when I could just exercise myself? Well, one study found that self-managed exercises were associated 34.2% of women reporting an increase in pelvic pain, fatigue as well as an increase in flare-ups. Another study found that 15.9% had increased pelvic pain when performing Pilates. This is not to say that Pilate exercises are wrong, the important part to recognise here is that this occurred with self-management without education on what exercises are right and at what stage. Not one size fits all and it is for this reason why it is important to see an Exercise physiologist who is an expert on exercise for a multitude of conditions including endometriosis.
Benefits of Exercise
Exercise has been shown to have a whole range of benefits when it comes to Endometriosis as listed below:
- Analgesic Effect (pain relief): Exercise has been shown to have an analgesic effect. This is because when we exercise, we release feel good chemicals that assist in reducing our pain messages. One study in particular found that those who completed 2x 90 min of yoga per week for 2 months had a reduced level of daily pain as well as increase in quality in life compared to those who did not do yoga.
- Anti-inflammatory Markers: Endometriosis is an inflammatory conditions and when we exercises we increase our anti-inflammatory markers this is turn can help combat this inflammatory condition.
- Reduction in Estrogen: Moderate intensity exercise has been shown to reduce estrogen levels. Endometriosis tissue is fuelled by estrogen, therefore a reduction in estrogen can assist in the management of endometriosis symptoms.
- Pelvic floor spasms: Exercise can help improve mobility and assist with pelvic spasms which is a common symptom of endometriosis.
- Assist with Fatigue: Exercise has also been shown to help improve fatigue.
- Mental health: Often those with endometriosis struggle with their mental health. Exercise has been shown to have a positive effect on mental health.
Where do I start?
Remember that each person is different and will need a tailored individualised program to address their needs. However, in general because one of the main symptoms of endometriosis is pain, the muscles in the front of those body (chest, abdominal, hip flexors) are often very tight and the muscles at the back are very weak. This occurs when you are in pain and spend days curled up in foetal position as your pain management. For this reason, it is important to lengthens these muscles and then when they are ready to gently strengthen them.
For more information, feel free to contract your practitioner for further guidance and advice.
Disclaimer: This article is not intended to provide you with medical advice, but rather for educational purposes. If you yourself are unwell, please seek the appropriate medical attention. The readers should make his or her own evaluation of the accuracy and appropriateness of findings before applying to themselves. Optimum Health Solutions cannot accept any legal responsibility or liability for any errors or omissions that may be made.
REFERENCES
Award, E., Ahmed, H. A. H., Yousef, A., & Abbas, R. (2017). Efficacy of exercise on pelvic pain and posture associated with endometriosis: within subject design. Journal of physical therapy science, 29 (12), 2112-2115
Endometriosisaustralia.org. 2020. [online] Available at: <https://www.endometriosisaustralia.org/post/2019/10/27/move-to-improve-the-benefit-of-exercise-for-endometriosis> [Accessed 11 August 2020].
Endometriosisaustralia.org. 2020. [online] Available at: <https://www.endometriosisaustralia.org/> [Accessed 11 August 2020].
Goncalves, A., Barron, N., & Bahamondes, L. (2017). The practice of hatha yoga for the treatment of pain associated with endometriosis. Journal of alternate and complementary medicine, 23 (1): 45-52.
Health.qld.gov.au. 2020. Know The Signs And Symptoms Of Endometriosis. [online] Available at: <https://www.health.qld.gov.au/news-events/news/signs-symptoms-endometriosis> [Accessed 11 August 2020].
womenshealth.gov. 2020. Endometriosis | Womenshealth.Gov. [online] Available at: <https://www.womenshealth.gov/a-z-topics/endometriosis> [Accessed 11 August 2020].
