Women's Health

Endometriosis

Endometriosis: Symptoms and Treatments for Pelvic Pain

Endometriosis is a condition in which endometrium tissue which is normally found lining the inside of the uterus is found outside of the uterus. Often times the endometriosis tissue becomes trapped around the organs of the pelvis including the ovaries, fallopian tubes, and sometimes the bladder and rectum. Occasionally endometriosis spreads to the organs outside the pelvis.

During a regular menstrual cycle the endometrium inside the uterus thickens, breaks down, then bleeds resulting in a period.

Endometriosis tissue responds similarly, however because it is outside of the uterus the tissue breakdown and bleeding becomes trapped in the pelvis and abdomen.

Because of this, it can cause pain in the pelvis, digestive issues such as diarrhea and constipation, and sometimes infertility. Often painful sex and pelvic floor dysfunction effects women with endometriosis. Pelvic physical therapy can be a beneficial treatment to address the pelvic pain, pain with sex, and pelvic floor dysfunction associated with endometriosis.

Additionally, some at home remedies can help to alleviate pelvic and abdominal pain with endometriosis. These include:

Gentle Movements, Stretching, Exercise:

Motion is lotion as they say, and gentle yoga, Pilates, and cardio exercise can help reduce inflammation and decrease pain. Endorphins are released with exercise and these “happy” chemicals can also help as a coping strategy for endometriosis symptoms.

A few yoga poses that help to relax the pelvis and pelvic floor are:

Child’s Pose Modified with a Pillow:

Child’s pose allows for pelvic floor muscle, back, and hip relaxation. It is a good resting pose when cramping and pelvic pain are bothersome.

IR - Child’s Pose Modified with a Pillow - Intimate Rose

Place a pillow in the fold of the knees, the press your tail bone back to the pillow with arms reaching past the ears.

IR - Child’s Pose 2 Modified with a Pillow - Intimate Rose

You can also place the pillow in the front fold of the hips and gently stretch the arms past the ears.

Deep Squat:

Deep squat can be done with the head up or down with the chin tucked in. This pose is also good for releasing the pelvic floor muscles.

IR - Deep Squat - Intimate Rose

 

Use Dilators (Vaginal Trainers) to prevent painful sex:

Use of vaginal dilators (vaginal trainers) is helpful to restore vaginal width, depth, and elasticity to allow for sexual activity, tampon use, medical exam, or other needs. This remedy for endometriosis includes the use of vaginal dilators while learning to relax the pelvic floor muscles.

To decrease pain with vaginal penetration it is important to be consistent and establish a routine practice. 

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Learning to breath properly is an important part of healing pelvic and vaginal pain from endometriosis. Many women with pelvic pain breath shallowly, and into their chest. Breathing through the rib cage and belly improves overall circulation, reduces the strain on the pelvic floor muscles, and reduces tension in the neck, head, and shoulders. It is often best to couple this training with vaginal dilator training.  

Perform this breathing method prior to using the vaginal trainers daily. To begin, find a comfortable position lying down. It is helpful to put pillows or a bolster under the knees to reduce tension in the low back.

Place one hand on the chest bone, and the other on the stomach. The goal during this breathing exercise is to keep the chest still, and to allow the stomach to rise and fall with the breath.

IR - stomach to rise Intimate Rose

Breathe in slowly and deeply through the nose, allowing your stomach to gently rise, keeping the chest still. Exhale gently through the mouth as if you were blowing on hot food, allowing the stomach to gently fall.

Pay close attention to your stomach rising and falling as you breathe in through the nose, and out through the mouth. Continue to take nice, slow breaths as you allow all thoughts and disruptions to fade away. Visualize the tension in your body being released as your body relaxes.

Watchthis quick video For more information on using this breathing technique with vaginal dilator training to reduce pelvic pain.  

Use a massage wand for pelvic pain:

The Wand is a tool that assists you to release painful trigger points and tender points in the pelvic floor muscles. Trigger points are defined as areas of muscle that are painful to touch. They are characterized by the presence of taut bands or “knots” in the muscle and the generation of a referral pattern of pain.

Tender points are areas of tenderness occurring in muscle, muscle-tendon junction, bursa, or fat pads. They are commonly present in conditions of chronic pelvic pain such as endometriosis.

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The unique ergonomic design of the Intimate Rose Pelvic Wand allows you to reach the deep muscles of the pelvic floor for relief. Tender point release should be coupled with relaxation techniques and focused attention on training the muscle. Your health care provider may have a unique training plan for you outside of the recommendations made here.

The wand can be used to gently sweep through the vaginal opening with either end until you encounter a tender point. When you find a tender point, gently compress the end of the wand into the tender point with the firmness you would use to check a tomato for ripeness (don’t press so hard you squish your tomato!)

Hold gentle pressure on the tender point and slowly move your bent knee left and right until you find a position that stops the pain in the pelvic floor muscle. When you find this position, remain there for 1-2 minutes to allow the tender point to fully release. Continue to breathe deeply. Repeat this technique as often as is necessary for relief of pelvic pain.

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By Dr. Amanda Olson, DPT, PRPC