Endometriosis Treatment Options
If you have been recently diagnosed with endometriosis, you might be wondering what treatments are available to you. This blog will walk through different treatment options and hopefully give you a little bit more information on where you can get started.
At our practice, we love helping people with endometriosis feel better in their day-to-day life, and we believe that the first step is having all the information that you need so that you can make an informed choice.
What Is Endometriosis?
Endometriosis is a chronic, inflammatory disease where uterine-like tissue grows outside of the uterus, causing lesions that produce their own estrogen.
These lesions can cause adhesions and the excessive estrogen can cause inflammation and pain. Endometriosis is commonly found in the ovaries, fallopian tubes, lining of the pelvic cavity, uterosacral ligaments (ligaments that attach the uterus to the sacrum), bladder and rectum.
Although rare, it is possible to find endometriosis on the diaphragm and the lungs. (REF: Bulun SE. Endometriosis. N Engl J Med. 2009;360(3):268–279.)
How Endometriosis Is Diagnosed
Currently, the gold standard for diagnosing is laparoscopic surgery in which biopsies of the tissues are taken.
However, more research is coming out on non-surgical options for diagnosing endo.
Unfortunately, it takes the average person 10 years to be diagnosed with endometriosis because of the wide variety of symptoms that endo causes.
Hormonal Treatment Options
Medication options for endo related pain include hormonal contraceptives/birth control pills, progestins, GnRH (gonadotropin releasing hormone) agonists/antagonists, and aromatase inhibitors.
These medications work by suppressing estrogen, which fuels endometrial lesion activity. They can reduce inflammation and pain associated with endo.
Although these medications may help to reduce endo symptoms, they do not eradicate endometriosis lesions, and they do not prevent the disease from progressing or recurring once treatment stops.
Surgical Options
There are a few surgical options for endometriosis, and one is far superior to the other.
Ablation:
Ablation is the burning or cauterizing of the surface of endometriosis lesions.
Ablation is not ideal because it does not cut deep into the root of the endometriosis lesions, which is necessary to remove endo.
Recurrence rate after ablation is high because it does not fully remove the disease.
No specialist training is required to perform an ablation, meaning many primary OBGYNs can perform it.
However, the best course of action for endo is to see an excision specialist-someone who is highly trained in removing the lesions.
Excision surgery:
Excision surgery is currently the gold standard for treating endometriosis.
This involves cutting out the entire lesion-getting deep to its root.
Many skilled excision specialists use robotic equipment to help with the precision of removing the lesions. Excision has higher success rates in reducing period pain, pelvic pain, and pain with bowel movements. Excision surgery also lowers the need for repeat surgeries.
We highly, highly encourage you to find an excision specialist if you are considering surgery to remove endometriosis.
Not all surgeons are created equal when it comes to endo, and choosing the right one can make a huge difference in eliminating your symptoms.
Pain Management Approaches
There are some non-invasive, non-medication options for treating the chronic pain associated with endometriosis.
The best option is to find a specialized pelvic floor physical therapist who is familiar with endo and how it can present itself.
Red light therapy is also a very helpful, non-invasive tool to promote oxygen flow and reduce inflammation in the body.
Other options include CBD suppositories which target inflammation and pain and help relieve symptoms (You can check out our favorite here: Medroots) and anti-inflammatory drugs (NSAIDs).
Pelvic Floor Physical Therapy for Endometriosis
One non-invasive pain management approach for endometriosis includes pelvic floor physical therapy.
Endo can cause abdominal and pelvic pain, and pelvic floor physical therapy via manual therapy and gentle exercise can be helpful at reducing this pain.
Pelvic Floor PT will not remove endo, but can be extremely beneficial in managing your symptoms.
For many patients, a pelvic floor physical therapist can actually help point you in the right direction regarding your symptoms and will usually have resources and specialists to refer you to.
Your pelvic floor PT will go over muscle and nerve relaxation techniques to help calm your body’s pain response, give you breathing exercises, examine your habitual routines, and work on reducing overall inflammation. And best of all, a pelvic PT will listen to your whole story and medical history as well as perform a pelvic exam (if necessary and consented to) to get the whole picture of your health.
Working With Your Healthcare Team
There are many components to consider if you have endo, and you should have a comprehensive health care team to help you navigate your options.
This team should at minimum include an endometriosis excision specialist, a pelvic floor physical therapist, and a mental health therapist.
It’s important that these team members communicate with each other effectively to help manage your symptoms.
These specialists are trained at dealing with endometriosis and can recognize symptoms more easily, refer you to appropriate providers, and provide you with evidence backed treatment options to help manage symptoms, reduce pain, and improve overall health.
The goal will be to improve your wellbeing with as little disruption to your life as possible.
Excision surgery, although technically invasive, can sometimes be your best option for treatment, though simultaneously working with both a pelvic floor physical therapist and a mental health therapist will maximize your healing and ease your recovery.
Be sure to discuss all of your symptoms with your providers so that they may determine the best options for you.
Where to Find Pelvic Floor PT for Endometriosis in Thousand Oaks
You don't have to navigate endometriosis alone.
Endometriosis is a complex disease that can impact so many aspects of your life. From pelvic pain and painful periods to bowel and bladder symptoms, pain with intercourse, and difficulty exercising, your symptoms deserve to be heard and understood.
At Cappuccino Physical Therapy, we are here to help you understand your body, address the musculoskeletal contributors to your symptoms, and work toward feeling more comfortable and confident in your everyday life.
Whether you have recently been diagnosed with endometriosis, are preparing for excision surgery, recovering from surgery, or have been living with symptoms for years, pelvic floor physical therapy may be an important part of your care.
You deserve care that is specific to you.
If you suspect you have endometriosis or are looking for support managing your symptoms, we would love to help.
Give us a call today to schedule your pelvic floor physical therapy evaluation.
