The Nu Guide: Understanding Endometriosis — Causes, Symptoms, and Treatment Options

Endometriosis is a complex and often painful condition that affects 1 in 10 women worldwide.

Endometriosis is a chronic condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterus. This tissue can be found on the ovaries, fallopian tubes, outer surface of the uterus, and other organs within the pelvis. During each menstrual cycle, these abnormal tissue growths respond to hormonal changes, causing inflammation, scarring, and pain.

It is a difficult disease to diagnose and can take many years to get a definitive diagnosis.

The symptoms of endometriosis can vary widely among individuals and may include:

• Chronic pelvic pain/abdominal pain

• Painful menstrual periods (dysmenorrhea)

• Pain during intercourse (dyspareunia)

• Heavy menstrual bleeding

• Infertility

• Fatigue

• Gastrointestinal issues such as diarrhoea, constipation, or bloating, especially during menstruation

Working with your GP, Gynaecologist, Pelvic Physiotherapist and Dietitian is an ideal “gold” standard holistic way to manage symptoms and improve quality of life. Sometimes accessing pain therapy, counselling or other health pracititioners can also help along the journey of living with a chronic health condition.

As a pelvic health physiotherapist, the approach I often take involves talking about:

1. Physiotherapy techniques such as manual therapy, myofascial release, pelvic floor release, movement and breathing techniques which are are all incorporated into a plan on an individual basis

2. Pain with intercourse. This is one area not always discussed. If painful intercourse is an issue we work with you to re-train the pelvic floor to improve movement and teach relaxation of the pelvic floor muscles

It's important to differentiate pain with intercourse versus pain with arousal, during or after intercourse. Pain can be superficial (on the outside of the vulva and at the entrance of the vagina), or with deep penetration. Post intercourse pain can vary from vulva pain to deep abdominal cramping.

Here are some things you might like to think about if you suffer from Endometriosis, or you think you may have some of the symptoms:

1. Sex and intimacy can affect relationships, and painful intercourse is not talked about enough for young women who are suffering with this condition

2. Using an oil based lubricant like Nu Balm and dilators (a wand to do your own pelvic floor release) are often incorporated at certain times to assist with your self management of the condition

3. Dietitians can work closely with you to manage bowel and gut symptoms

4. Pain Medication: Over-the-counter pain relievers such as ibuprofen or prescription medications may help alleviate pelvic pain and discomfort

5. Hormonal Therapy: Your gynaecologist will discuss birth control pills, hormonal patches, or hormonal intrauterine devices (IUDs) which can help regulate menstrual cycles and reduce the growth of endometrial tissue

6. Surgical Intervention: For some women, when conservative treatments fail to provide relief, laparoscopic surgery may be recommended. If pelvic floor tone and dyspareunia is present, there are nerve blocks and botox that can also be administered to alleviate symptoms, while also working with your Physiotherapist and Dietitian.

Endometriosis is a complex and often debilitating condition that requires comprehensive management tailored to each individual’s symptoms and needs. Early diagnosis and intervention are crucial in minimising the long-term impact of Endometriosis on reproductive health and overall wellbeing. If you suspect you may have Endometriosis or are experiencing symptoms suggestive of the condition, consult with your healthcare provider for an in depth assessment.

Some useful websites which also discuss this topic are Endometriosis NZ and Endometriosis UK.