Endometriosis and Pelvic Pain
What is Endometriosis?
It is a chronic disease that occurs when tissue similar to the lining of the uterus grows outside the uterus causing severe pelvic pain.
What does it do?
It can cause a chronic inflammatory reaction, in the form of scar tissue within the pelvis or other areas of the body.
Some examples are:
Superficial endometriosis: this is the most common form of endometriosis (~80% of diagnoses), which consists of shallow lesions along the lining of the abdominal cavity.
Cystic ovarian endometriosis: these are cysts that fill with menstrual blood which form on the ovaries. Approximately 17-44% of individuals diagnosed with endometriosis have this form.
Deep endometriosis (bladder, bowel, or recto-vaginal septum): this kind of endometriosis is only diagnosed in 1-5% of cases, and it occurs deep within the tissue or organs.
Endometriosis outside the pelvis: this is rare, but also due to the location being outside of the pelvic region, it can be hard to diagnose which can in turn delay the diagnosis.
There is no known cause, prevention or cure as of yet for endometriosis. However, the symptoms one experiences can be managed with medicines, surgery, therapy and other treatments.
Who is affected by Endometriosis?
Typically women are affected by endometriosis from the first onset of their period until menopause. Although rare, endometriosis can also affect men, in which case it is found in the bladder, lower abdominal region and inguinal region. Endometriosis is dependent on estrogen. If estrogen levels fluctuate, inflammation can increase and so can the growth of tissue associated with endometriosis which can lead to increased pain.
Endometriosis can potentially develop for the following reasons:
It is possible stem cells give rise to the disease, spreading it throughout the body through blood or lymph vessels.
Retrograde menstruation - when the blood containing endometrial cells flows back into the pelvic cavity. This can then be implanted and grow outside of the uterus
Cellular metaplasia (which is when cells change form) - the cells on the outside of the uterus can change into endometrial-like cells which can then also start to grow outside the uterus.
What are the symptoms?
Typically endometriosis can cause severe pain in the pelvis, which can be worsened during menstrual periods. However, there can also be pain when using the bathroom, during intercourse, or even can lead to complications when trying to get pregnant.
It is also possible for an individual to have no symptoms and be diagnosed with endometriosis.
Some other symptoms of endometriosis are:
Chronic pelvic pain
Heavy bleeding during periods (or between)
Issues getting pregnant
Bloating/nausea
Fatigue, depression or anxiety.
Do symptoms ever improve?
They can after menopause, but like any other disease, it is unique to everyone.
What is the impact of endometriosis on my life?
Unique to each individual, it can decrease the quality of life due to the severity of the pain experienced and it can also lead to fatigue, depression, anxiety, and infertility. Depending on the severity of pain, it can obstruct your regular workday or day-to-day activities.
What kind of treatment is there?
As mentioned before, there is currently no cure for endometriosis. However, it is possible to manage the disease through different forms of treatment. The method of treatment can be different for each individual as it depends on how severe the symptoms are, as well as whether trying for pregnancy is a factor for the individual.
For those who are trying to get pregnant, it is possible that you can be prescribed fertility medications and advised of specific procedures. It’s important to talk to your doctor to discuss what your options are.
Why does endometriosis cause difficulties during pregnancy?
Endometriosis can cause infertility because the growths can block your fallopian tubes (which is where the eggs need to travel to get to the uterus) or form scar tissues making pregnancy harder to obtain.
To treat the pain associated with endometriosis, individuals can be prescribed painkillers such as ibuprofen or naproxen (which are common in treating pain). It is also possible to be prescribed birth control to help control the pain (this points to the connection between estrogen and endometriosis). Some birth control or contraceptives that can help are pills, IUDs, implants, patches and injections. It is important to talk to your doctor about which method might be best for you.
Depending on your situation, surgery might be the best option but it depends on the severity of your symptoms, level of pain, and location of endometriosis within your body.
How can therapy help with endometriosis?
While therapy might not be able to provide the same level of pain relief as some prescribed medication, it can help relieve some of your mental stress towards your health issues. For example, Maria, a therapist here at the Mind Collective, said, “In therapy with me, I’ll highlight ways that you can become more compassionate toward yourself, provide coping tools and empower you so you can face your struggles with awareness and courage”.
While endometriosis is a physical disease, like any other health concern, it can weigh heavily on your mental health. But through therapy, you can begin to work on improvements with your therapist. You can open up to them about how the illness may be affecting you in your day-to-day life, and how it may be affecting you in specific situations as it is unique to you.
It’s important to remember that you don’t have to live through the struggles of endometriosis on your own. You can find support in your therapist and feel comfortable discussing the difficulties you are experiencing. Your therapist will help you with self-compassion and other ways to cope with the challenges that endometriosis can pose. Endometriosis lasts for the majority of your life so it is important to have the proper support.
Conclusion
It is important to spread awareness of the effects and impact of endometriosis as it can lead to underdiagnosis preventing timely treatment of this condition. Seeking help for the physical and mental barriers that can come with having endometriosis will allow you to better cope and navigate living with this condition. Feel free to talk about your concerns with your therapist, and/or healthcare provider, to find the right treatment plan for you!
