Let’s dive into the different treatment options available for those dealing with endometriosis.
You may remember that I mentioned that the gold standard for accurate diagnosis of endometriosis is biopsy through surgery.
However, the type of surgery that is recommended may differ depending on the provider. Some providers use ablation, where they cauterize or burn the endometrial tissue. With this option there is no possibility for a pathologist to look at the tissue and diagnose endometriosis. By burning the tissue and not removing it, not only is scar tissue left in its place but deeper rooted endometrial tissue could potentially be left and continue to cause pain.
Another surgical option is called an incomplete excision. This is where some, but not all, of the endometrial tissue is cut and removed.
Still other providers will offer surgical treatments like a hysterectomy (removal of the uterus) or oophorectomy (removal of the ovaries). These surgical treatments, unfortunately, do not treat endometriosis, nor do they stop the disease progression if any endometrial type of tissue is still left in the body.
This is why the gold standard of surgical treatments is to completely eradicate all the endometrial tissue throughout the pelvic, abdominal, and thoracic cavities. This is done via complete excision surgery, in which the surgeon cuts out all disease (endometrial tissue) while meticulously looking throughout the patient’s body. This takes a great amount of experience, skill, and patience on the surgeon’s part. And only a handful of skilled surgeons truly specialize in this. The goal with complete excision surgery is to restore normal anatomy and preserve the organs when possible. With this type of surgery recurrence rates are low.
Not every patient with endometriosis will undergo surgery.
For varied reasons, some will opt for other medical treatments that may not remove the diseased tissue. For those who are looking for other options, NSAIDS (non-steroidal anti-inflammatory drugs) or other pain-relieving medications may be needed to help relieve their pain. Some providers offer hormonal birth control medications given continuously to stop menstruation. Other providers may use hormonal medicines to induce a menopausal state. Different medications, however, may have significant long-term side effects. Ideally your provider will discuss these with you, so you can make an informed decision.
It is important to remember that those diagnosed with endometriosis often have a myriad of symptoms that affect other organ systems of the body, so it is crucial to identify and treat the other causes of pelvic pain as well.
Many find help with pelvic physical therapy, functional nutrition (aimed at decreasing total body inflammation) and pain management.
In pelvic physical therapy we address any musculoskeletal and fascial imbalances, restrictions and trigger points that are often a large factor in those with pelvic pain. We offer tools for patients to help manage their pain and to help calm their autonomic nervous system.
As pelvic health physical therapists we are trained to help normalize bowel and bladder function, including bloating, constipation, bladder urgency and frequency and so much more. We help patients regain the ability to enjoy their sexuality and connection with their partners in a pain free way. We educate patients on stretches, exercises, self-manual techniques to empower our patients to use their own tools to help their bodies heal and feel better.
Additionally, some physical therapists have learned about functional nutrition, which can help improve digestive function and decrease total body inflammation and can be a key factor in helping those with endometriosis heal and decrease their pain.
Although endometriosis can feel like a super scary diagnosis to receive, we are finding increasingly that we can help those carrying this burden to feel better. I hope your biggest take away is that if have or suspect you have endometriosis, you deserve to have a knowledgeable, skilled, multidisciplinary team of providers to help you.
If you have any questions about other experienced providers or would like to set up a physical therapy evaluation, please email us at info@itrphysicaltherapy.com.
In Kindness,
Jen