Is Your Pelvic Pain Caused By Endometriosis?


Written by: Dr. Jessica Papa, PT, DPT


Don’t let Endo be the End o’ Your World

One of my passions as a physical therapist is helping people discover the causes of their pain- whether it be back pain, joint pain, or pelvic pain. Some women may feel that they are cursed to endure pelvic pain as a part of womanhood, but not all pelvic pain should be treated as something like PMS. One prime example of a pelvic health disease that I treat is Endometriosis.

Endometriosis, or ‘endo’, affects 1 in 10 women between the ages of 15 to 49. It occurs when tissue that is similar to the lining of the uterus grows in other locations such as ovaries or fallopian tubes. Although less common, it can also grow in the vagina, cervix, bladder, or rectum. The cause of endo is unknown, so there is no way to prevent it. There are some people who are at higher risk: Another woman in your family such as your mother has it, your period started before you were 11, or if you have heavy menstrual cycles that last more than the usual 7 days.

Endo causes bleeding from the tissue outside of the uterus in addition to a normal period. This bleeding can cause inflammation and irritation which causes the pain that many women feel. You may also develop scar tissue which will add to the pain. Not all women will feel the same type of pain, but these are the most common kinds: painful menstrual cramps, chronic pain in the lower back or pelvis, pain during sex, painful bowel movements or urinating during periods, and pain in your intestines. Aside from pain, you may have spotting between periods, digestive problems especially during you period or even infertility.

Endometriosis is one of the top three causes of infertility.

Unfortunately, many women do not even know they have endo, or that they may be infertile until they try to get pregnant. There is still a lot unknown about this disease, but it is believed that infertility occurs from the damage to the fallopian tubes and from the inflammation that can affect the function of the reproductive system. Women with stage 1 or stage 2 endometriosis may be able to get pregnant on their own. However, with stage 3 or 4, other options should be discussed with your doctor.

If you believe you have endometriosis, you should discuss your symptoms with your doctor. Your doctor will do a pelvic exam to feel for cysts or scarring outside your uterus. Another option is to have an MRI or internal ultrasound to look for cysts. The only way to completely confirm the diagnosis is by laparoscopic surgery to see the growths or test the tissue. Before surgery, your doctor may try other treatments first to see if you respond. Limiting the estrogen in your body helps to control its symptoms, so birth control is often the first option. This will not cure endo as there currently is no cure, but it will help ease the pain.

There are other options that do not require medicine or surgery. A women’s health or pelvic floor physical therapist can help as well. This will help your pelvic floor muscles, help with tissue restrictions which will help decrease or eliminate the pain you feel during sex. Contact a pelvic floor therapist to discuss possible treatments to get you back to living a better life with endometriosis.

If you’re experiencing pelvic discomfort and are considering your options, I highly recommend seeking out physical therapy. A PT can help assess your situation and determine if further medical intervention is needed. If you have any questions about endometriosis, pelvic floor therapy, or if physical therapy is right for you, contact me for a phone consult to discover if I can help you find lasting pain relief.

Stay Well,
Dr. Jessica Papa, PT, DPT, Owner
Arancia Physical Therapy

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