Who Does It Affect?  Endometriosis is a painful reproductive and immunological disease afflicting over seven million women and teens in the United States alone (twice the number of Alzheimer's patients and seven times those with Parkinson's Disease). The disease is a leading cause of female infertility, chronic pelvic pain, and gynecologic surgery. It accounts for more than 120,000 of the 500,000 hysterectomies performed annually. There are several methods of treatment, which may alleviate some of the pain and symptoms associated with endometriosis.

What is Endometriosis? Endometriosis is a disease in which endometrium tissue (the tissue that lines the inside of the uterus which builds up and is shed each month during menstruation) is found outside the uterus. Even though not in the uterus, the tissue still responds to hormonal commands each month, and breaks down and bleeds. However, unlike the lining of the uterus, the tissue has no way of leaving the body. The result is internal bleeding, degeneration of blood and tissue shed from the growths, inflammation of the surrounding areas, and formation of scar tissue. In addition, depending on the location of the growths, there may be interference with bowel, bladder, intestines, and/or other areas of the pelvic cavity.

Diagnosis and Treatment: Currently, the gold standard for a positive diagnosis of endometriosis is by surgery, either a laparoscopy or the more invasive laparotomy. The disease itself cannot be positively diagnosed with a sonogram, CT scan, MRI or other diagnostic procedure. The use of high-power color sonograms are currently being investigated, but their detection rates seem limited at this time in confirming the recurrence of the disease in previously diagnosed patients.

The most effective thing an endometriosis patient can do is to find a specialist who treats the disease, such as an experienced gynecologist with a history of treating endometriosis patients or a reproductive endocrinologist, especially if infertility is a concern. The patient should form a partnership with her professional,  so informed decisions can be made regarding your treatment. Endometriosis is a serious disease, which requires serious treatment.

Symptoms: The range of symptoms is from none to severe. Endometriosis symptoms are often most severe just before and during the menstrual cycle and get better as the menstrual period is ending. However, for some women, pain is ongoing and does not improve. Ongoing pain is especially common in teens with endometriosis. Symptoms may include:

Pain, which can be: Pelvic pain; severe menstrual cramps; low backache 1 or 2 days before the start of the menstrual period (or earlier)--becoming less during the period; pain during sexual intercourse; rectal pain, and pain with bowel movements.

Infertility: which may be the only sign that you have endometriosis. Between 20% and 40% of women who are infertile have endometriosis.

Abnormal bleeding. This can include: Blood in the urine or stool; some vaginal bleeding before the start of the menstrual period (premenstrual spotting);
vaginal bleeding after intercourse.

How Can Physical Therapy Help: The endometrium tissue implants are thought to swell during each cycle, causing endometriosis pain. The related adhesions may pull on internal structures when walking, moving, or breathing. The pull of these adhesions on pain-sensitive structures may be one cause of severe endometriosis pain. By addressing the adhesions that appear to cause endometriosis pain, manual physical therapy treatment has shown success in decreasing pain from endometriosis while increasing reproductive and digestive function in many women. The focus of physical therapy is to decrease endometriosis pain and the adhesions that form at the endometrial tissues, as well as to promote good posture and movement strategies for successful management of the pain