Endometriosis is gradually becoming a more widely known, diagnosed and understood condition. It affects around 1 in 10 women, and of Women experiencing persistent pelvic pain 7:10 have endometriosis. The symptoms of Endometriosis are not limited to pain, they can include any of the following: Nausea, bloating, fatigue, bowel and bladder dysfunction, heavy bleeding during periods, Pain with sexual intercourse, and in some cases, it impacts fertility. Physiotherapy plays multiple roles in the management of endometriosis, most commonly clients seek pain relief strategies and treatment for associated low back pain. Currently, there is no evidence to suggest exercise reduces the occurrence or progression of endometriosis, however, it is beneficial at mitigating side effects of medication used to control the disease and reduces the risk of associated health complications. Physiotherapists such as our team at Mount Lawley Physiotherapy and Podiatry are skilled at providing exercise advice for many different medical conditions including Endometriosis. We also screen for associated symptoms that are best treated by Women’s health specialist Physiotherapists and can refer on as required. As Endometriosis is so common it is unsurprising a member of the Mount Lawley Physiotherapy and Podiatry team has first-hand experience of this disorder. I have kindly asked Aimee to answer a few questions that might provide some personal insight into the impact and management of endometriosis. Aimee’s perspective is interesting as she has been studying Human biology at Curtin University and therefore now understands a lot more about the condition than at the time she was diagnosed.
What age were you when you started experiencing symptoms that prompted you to seek medical investigation? What were these symptoms?
I first started experiencing symptoms in my early/mid-teens. It first started to really impact my daily life when I was about 15, I remember my periods becoming so heavy that I would need to change pads at school between every class and would often still bleed through. I was very shy to talk about it and assumed that everyone else went through the same experiences so just dismissed and never really spoke up. I first saw my GP about this when I was 17 and was put on a combination pill in hopes that it would help reduce the bleeding and help the pain. This did make a bit of a difference at first because I could finally predict my periods and even skip if it was becoming too painful. It wasn’t until I finished school and started uni that I noticed that what I was going through wasn’t exactly normal and I went back to my GP who referred me on to a gynaecologist. I was diagnosed when I was 18. It was a bit of a push at first with the specialist to get me to even get checked for endometriosis because at the time I had no family history and I was deemed “too young” to have the disease but luckily I had a persistent GP who ensured the problem was seen to.
How has Endometriosis impacted your life thus far, Does it impact you daily?
Right up until I was first diagnosed and had my first surgery, it was intense, getting to the point where I wouldn’t be able to move because of the pain I was in and my iron levels were always low due to heavy bleeding. Prior to my second surgery, I was experiencing this again for about a year which would make me feel nauseous and I would get migraines close to my period. I think one of the largest impacts of the disease that isn’t really talked about is the psychological effects it has on the person. The time taken to even be considered for diagnosis is 7-10 years on average. I was very lucky in a sense to be diagnosed quite young, but even then, it was about 5/6 years until it was acknowledged that something was wrong. I would often find myself dismissing any signs or symptoms as being just “bad period pain” and even found myself thinking that after diagnosis. When I was diagnosed the surgeon was able to remove the lesions he found and burn off those he couldn’t cut out. After the surgery, I was told that they wouldn’t know if it would return but if it does, it would return in 5 years and was sent on my way. It’s really a place of limbo because of a lot of the uncertainty. My second surgery was 3 years after, and they found that it had grown back and spread, I was also diagnosed with Adenomyosis, which was very unnerving. I think it is something always in the back of my mind, but I try not to let it get the better of me.
Have your studies in Anatomy and Physiology changed how you view the disease?
My studies in human biology have definitely helped in understanding what is known about the disease. Not much is known about the disease mechanisms so we don’t study it in isolation but it was discussed in my reproductive biology units. I have found that because of my experience with endo, I have found a real interest in reproductive health, specifically women’s reproductive health. I am hoping to start post-grad studies in this area next year.
Have you always been as open about your experience with endometriosis, who/where have you found support?
At first, I was very reluctant to talk about my diagnosis or experience with endometriosis because it was associated with periods and people may not be comfortable with the topic. I think my feminist streak over-rode this when I found how common it was and how under-discussed and diagnosed it was. This mentality of dismissing female health issues due to people’s discomfort with the topic is the reason this disease is so misunderstood. I now speak very openly about my experiences with those who want to know or maybe experiencing something similar. I hope that this kind of open dialogue becomes more and more common on both a public and private level as it may help more people to seek diagnosis early and assist the wider public to understand what endometriosis is. In terms of support, I have found forming a good relationship with my regular GP and psychologist has helped with managing symptoms and gaining understanding. There are also closed Facebook groups available to those with the disease where participants are able to openly ask questions regarding pain management and general life with endo.
How has endometriosis and it’s symptoms affected exercise, sport?
When I played netball through high school, I did find the pain tended to hinder me in games at times and in training but I haven’t since noticed a major difference in exercise. I feel it has more so encouraged me to stay active to alleviate some pain and symptoms where possible. I find doing light exercise like walking during my period to help with cramping and the back pain that comes with it. I have also started swimming more regularly which helps in a similar way.
Has your physiotherapist been able to give you any management strategies, pain relief for your endometriosis?
After my first laparoscopy, physiotherapy really helped with the recovery and to rebuild my core and pelvic floor strength gradually. Through physiotherapy, I was introduced to the use of a tens machine for pain relief which I have found to be super effective, especially when at work or at university where I am seated for longer periods of time and not always able to stand and stretch frequently. I have since also found physiotherapy and remedial massage to be useful in the management of back pain that I often experience with my periods, equipping me with suitable and effective stretches to maintain progress.
If you have been diagnosed with Endometriosis and are in need of a Physiotherapist, the staff at Mount Lawley Physiotherapy, Podiatry and Massage can help. To make an appointment call us on (08) 9271 8805 or book online via our website.
