Are there preventative steps to avoid endometriosis?

While there is currently no known prevention of endometriosis, early diagnosis and treatment is key to managing the disease and preventing it from advancing.

What are the risks if endometriosis is left untreated?

If left untreated, endometriosis can lead to several complications, such as debilitating and chronic pelvic pain, infertility, ovarian cysts, and adhesions (scar tissue from the disease). With advanced disease, endometriosis can infiltrate surrounding structures or organs, such as the bowel, ureters (the tubes that carry urine from the kidneys to the bladder), and/or bladder. Left untreated, women with advanced disease may develop a bowel obstruction or even lose their kidney. Women can also have distant endometriosis invade their diaphragm and lungs, causing the lung to collapse. Moreover, endometriosis is associated with an increased risk of certain types of ovarian cancers.

Are there other related conditions to endometriosis?

Adenomyosis, which is endometrial glands and stroma which invade the muscle of the uterus, often occurs with endometriosis. Women with endometriosis and adenomyosis may have a higher risk of having infertility, autoimmune diseases and developing certain types of ovarian cancers.

Can endometriosis cause hip pain?

Endometriosis can affect the whole body and can have a widespread area of pain and inflammation. The underlying inflammatory endometriosis lesions themselves can be found both inside and outside the pelvis. When endometriosis lesions are within the pelvis, there is underlying inflammation affecting the pelvic floor muscles, which are a sling of muscles from the pubic bone to the tailbone supporting the pelvic organs. The structures in the hip – including the muscles, nerves, fascia, ligaments – can all become restricted and irritated due to the tight and weak pelvic floor muscles. This can contribute to hip and groin pain. Also, there can be referred pain to the groin and hip. The nerves going to the hips and groin can be irritated as well and cause pain.

Can I have endometriosis without a menstrual cycle?

Put simply: Yes. Endometriosis may occur with or without the presence of a menstrual cycle. Remember: endometriosis is not a gynecologic disease. It is an inflammatory disease – you can have it without menstruation, and it can cause pain without a period.

Does birth control help with endometriosis?

Birth Control can help with Hormonal suppression of Endometriosis as endometriosis is a hormonally mediated disease process.

When should I seek treatment for my endometriosis symptoms?

We recommend scheduling an appointment with one of our pelvic pain/endometriosis specialists if you have been experiencing symptoms that are not normal for you. We also often tell patients that as a rule of thumb, if your pain is causing you to miss school, work, or social events, then the pain is too much, and you should seek help.

What can i expect at my appointment with an endometriosis specialist?

You’ll meet with one of our pelvic pain specialists, who focus solely on pelvic pain. We’ll start with reviewing your full health history, including a discussion of your symptoms. This will help us understand what you’ve been experiencing, so we can work to identify the source of your pain. Next, we’ll conduct a full pelvic exam. Externally, we will look at your hips, abdomen, and posterior sacrum. Internally, we will evaluate the nerves and the muscles within the pelvic area. This full exam is necessary, as it will help our pelvic pain specialists understand the connection between your symptoms and your nerve and muscle pain and dysfunction. There is no speculum, so the exam is gentle and more comfortable than that of, for example, gynecological exams you may have experienced in the past. We will discuss our findings with you and come up with a comprehensive treatment plan TOGETHER. We want you to know that your pain is validated and that we are here to work with you on getting you back to the life you deserve.

Causes, Symptoms, and Treatment Options

Endometriosis

Endometriosis is quite common, affecting one in nine women, yet it takes on average 7-12 years for women to receive a diagnosis. It is often misdiagnosed, leaving patients feeling silenced and silent. On average, patients with endometriosis make 7 visits to their primary doctor before being referred to a specialist, and 75% of these patients experience a misdiagnosis.

At PRM, we believe that endometriosis patients deserve options and validation when it comes to their treatment, and a team of specialists to assist them in the lifetime management of the disease.

Request an Appointment

What is Endometriosis?

Understanding Endometriosis Pain

Endometriosis is a systemic inflammatory disease process in which tissue similar to the uterine lining grows outside of the uterus. Endometriosis can start at a person’s first menstrual period and last beyond menopause. It can occur with or without menstruation. While the cause of endometriosis is definitively unknown, the impact on patients’ health can be severe. The pH balance of the tissues can be disrupted and the muscles and nerves can be put into disarray. Neurotransmitters begin stimulating an inflammatory cascade that can cause chronic pain.

Endometriosis falls into the category of an inflammatory disease process. Endometrial plaques release a form of “inflammatory soup” into the pelvis which contributes to inflammation around the pelvic nerves.

Endometrial lesions are typically located in the pelvis, but they can occur at other locations, including the bowel and diaphragm. Endometriosis is fairly common and can cause chronic pelvic pain and infertility. Symptoms range from minor to severely debilitating.

Symptoms of Endometriosis

The primary symptom of endometriosis is persistent lower abdominal-pelvic pain. Other symptoms which usually increase in intensity during the menstrual cycle include pain during or after sexual intercourse, bladder pain, urinary urgency or frequency or burning, constipation and abdominal bloating, diarrhea, and/or painful bowel movements, nausea and/or vomiting, leg and/or back pain, shortness of breath, and unexplained infertility.

The severity of the disease does not necessarily correlate with severity of symptoms. For example, many women may have severe symptoms with mild disease and other women may have no symptoms, but have severe disease. We always tell patients: pain is never normal.

The most common symptoms of endometriosis we see at PRM are GI complaints such as abdominal bloating, abdominal pain, constipation, and pain/discomfort with bowel movements. However, there are many other symptoms of endometriosis:

Coccydynia Pain

Endometriosis Post-Op Pain

GI Symptoms

Lower Abdominal & Groin Pain

Pain After Hysterectomy

Pain During Intercourse

Pain with Sitting

Pain with Periods

Postpartum Pelvic Pain

Postpartum Sexual Dysfunction

Rectal Pain

SI Joint Pain

Urinating Urgency and Frequency

Vaginal Pain

Bladder Pain

Chronic Constipation

VIEW ALL SYMPTOMS

Your Pain From Endo is Real

What Causes Endometriosis?

There are several theories of the etiology of endometriosis. While the exact cause is unknown, some explanations are:

“Induction Theory” or Transformation of Peritoneal…

“Induction Theory” or Transformation of Peritoneal Cells: This is where factors, such as hormones or the immune system transform the peritoneal cells (which are cells that line the inside of your abdomen and pelvis) into endometrial-like cells.

Embryonic cell transformation: This theory suggests…

Embryonic cell transformation: This theory suggests that embryonic cells, which are present during development in the womb, are transformed by hormones such as estrogen intro endometrial-like cells during puberty.

Surgical scar implantation: After uterine surgery,…

Surgical scar implantation: After uterine surgery, such as a cesarean section or hysterectomy, the endometrial cells may be exposed to the pelvic cavity and implant either to the pelvic sidewalls or to the surgical incision.

Endometrial cell transport: Endometrial cells may…

Endometrial cell transport: Endometrial cells may be transported to other organs or parts of the body (such as the lung) through blood vessels or tissue fluid (lymphatic) systems.

Immune system disorder: Endometrial tissue or…

Immune system disorder: Endometrial tissue or cells are supposed to be inside the uterus, not outside of the body. A problem with the immune system may compromise the body’s ability to recognize and destroy this abnormal tissue.

Take The Endometriosis Symptom Quiz

Understanding the Endo Diagnosis

Diagnosing Endometriosis

Endometriosis is definitively diagnosed by histologic evaluation of the diseased tissue. This requires a surgery, most often laparoscopy, and many patients opt for excision surgery. At Pelvic Rehabilitation Medicine, we consider ourselves on the front-lines of endometriosis, with 70% of our patient population being female and most of which coming to us with symptoms of endometriosis. We believe that endo patients deserve 1) A Comprehensive Treatment Approach to Endo 2) A care team that works closely with excision surgeons with the ultimate goal of decreasing the total number of surgeries patients have to undergo in their lifetime.

Starting your period at an early age
Heavy menstrual cycles
Having one or two female relatives with endometriosis
Reproductive tract abnormalities
Nulliparity (never having given birth)

Starting the Treatment Journey

Treatment Options for Endometriosis

Endometriosis is a chronic disease and requires a combination of both treatment and management of the disease. Often, endometriosis patients are told that the only way to treat endometriosis is by surgical excision with histopathological confirmation – this is an excellent first step. However, it is important to treat the nervous system and pelvic floor muscle dysfunction in endometriosis for full resolution of symptoms. Even when endometriosis has been removed, the nerve pain and pelvic floor dysfunction was present in the body for so long that it often requires direct treatment to reset them to less irritated, more calm pathways. Through the PRM Protocol™, we will work to reduce these symptoms.

Step One – First, our providers will ask questions about your medical history and listen to your symptoms to get a full picture of what is going on with you.
Step Two – Next, an external exam of your hips, abdomen, and posterior sacrum.
Step Three – Next, your pelvic nerves are evaluated externally with a soft cotton tip.
Step Four – Next, with your consent, gel is placed on a gloved finger and an internal exam is performed to allow us to evaluate the nerves and muscles within the pelvis. There is no speculum required as we are evaluating the pelvic floor muscles and nerves not the organs.
Step Five – Sometimes patients will need Imaging to help us understand if there is an associated cause of the pelvic nerve and muscle pain and dysfunction found on exam.
Step Six – Oftentimes, treatment can be started the same day as there is no down time. Our patients have been suffering with pelvic pain symptoms for 6+ months. We like to get them on the road to feeling better as soon as we can as the longer the symptoms are present the harder it is for us to resolve them.

Request an Appointment

PRM Protocol™

Nutrition Health Coaching

Endometriosis Surgery

PRM’s Endometriosis Center of Excellence

Treatment Options for Endometriosis

Unfortunately, endometriosis is a chronic disease and requires a combination of both treatment and management of the disease. The only way to treat endometriosis is by surgical excision with histopathological confirmation. Once the disease has been excised, management of the disease usually entails medication therapies, such as anti-inflammatories, hormonal suppression, and lifestyle modifications.

VIEW ALL TREATMENT OPTIONS

Causes, Symptoms, and Treatment Options

Endometriosis

What is Endometriosis?

Understanding Endometriosis Pain

Symptoms of Endometriosis

Coccydynia Pain

Endometriosis Post-Op Pain

GI Symptoms

Lower Abdominal & Groin Pain

Pain After Hysterectomy

Pain During Intercourse

Pain with Sitting

Pain with Periods

Postpartum Pelvic Pain

Postpartum Sexual Dysfunction

Rectal Pain

SI Joint Pain

Urinating Urgency and Frequency

Vaginal Pain

Bladder Pain

Chronic Constipation

Your Pain From Endo is Real

What Causes Endometriosis?

Understanding the Endo Diagnosis

Diagnosing Endometriosis

Starting the Treatment Journey

Treatment Options for Endometriosis

PRM Protocol™

Nutrition Health Coaching

Endometriosis Surgery

PRM’s Endometriosis Center of Excellence

Treatment Options for Endometriosis

In the News & From Our Providers

Featured in Woman’s World: Dr. Shrikhande on Why Pelvic Floor Health Matters (Alternate: Dr. Shrikhande Featured in Woman’s World for Pelvic Floor Health)

Dr. Shrikhande Answers the Question, What is Chronic Pelvic Pain Syndrome (CPPS)?: Featured in Rosy

Dr. Allyson Shrikhande And Dr. Melanie Carminati of Inspira Physical Therapy Discuss Pelvic Pain And Physical Therapy

Pelvic Rehabilitation Medicine Founders Honored for Revolutionizing Pelvic Pain Treatment and Creating National Impact

Pelvic Rehabilitation Medicine Releases State of Endometriosis Survey Data

A Comprehensive Approach To Vulvodynia & Vulvar Pain with Dr. Allyson Shrikhande

Find Endometriosis Pain Relief