Endometriosis is a condition where the tissue that lines the inside of the uterus grows outside of it, causing pain, inflammation, and sometimes infertility. It is estimated to affect up to 10% of women of reproductive age worldwide (1). Endometriosis can be a debilitating condition that can impact a person's physical, emotional, and social well-being. In this article, we'll explore the trauma behind endometriosis and how physiotherapy can help manage it.
Trauma and Endometriosis
Endometriosis can be a traumatic experience for many women. The chronic pain and discomfort can impact a person's daily life and limit their ability to participate in social activities. The condition can also affect a person's self-esteem, self-worth, and identity. Women with endometriosis often feel isolated and misunderstood, and they may experience anxiety and depression (2).
Recent research has also shown that women with endometriosis have higher levels of cortisol, a stress hormone, than women without the condition (3).
Elevated cortisol levels are associated with chronic stress and can lead to physical and mental health issues, such as cardiovascular disease, immune suppression, and anxiety.
How Can Physiotherapy Help?
Physiotherapy can play an essential role in managing the physical and emotional symptoms of endometriosis. A physiotherapist can help identify and address the physical factors that contribute to pain and discomfort, such as muscle tension, posture, and chronic pain patterns. Physiotherapists can also provide exercises to strengthen the pelvic floor muscles, which can improve bladder control and reduce pelvic pain. As a Physiotherapist with a holistic, multimodal approach I use somatic therapies such as breathwork and Yoga to work with the nervous system and manage symptoms. Yoga is a mind-body practice that combines physical postures, breath control, and meditation. Studies have shown that yoga can help manage pain and improve quality of life in women with endometriosis (1).
A randomized controlled trial found that women who practiced yoga had significant improvements in pain, anxiety, and depression compared to those who did not (2). Another study found that a 12-week yoga program improved pelvic pain, dysmenorrhea, and quality of life in women with endometriosis (3).
Breathwork is another technique that can be helpful for managing the stress and anxiety associated with endometriosis. Breathing exercises, such as slow, deep breathing, have been shown to reduce cortisol levels and improve relaxation (4). A small study found that women with endometriosis who participated in a breathwork program had significant reductions in stress and anxiety (5).
In addition to physiotherapy, a physiotherapist can also help manage the emotional trauma associated with endometriosis. They can provide counselling and support to help women manage anxiety and depression. A specialist physiotherapist can also help women develop coping strategies to manage the emotional impact of the condition.
Research has shown that physiotherapy can improve quality of life and reduce pain in women with endometriosis (4). A randomized controlled trial found that women who received physiotherapy had significant improvements in pain, fatigue, and sexual function compared to those who received standard care (5).
Endometriosis can be a traumatic experience for many women, impacting their physical, emotional, and social well-being. Physiotherapy can play an essential role in managing the physical and emotional symptoms of endometriosis. A physiotherapist can help identify and address the physical factors that contribute to pain and discomfort, as well as provide support to help women manage anxiety and depression.
If you or someone you know is living with endometriosis, consider reaching out to a physiotherapist for support or visit me online or in person at https://www.sportsandspinephysio.com/. The evidence-based treatments provided by a physiotherapist can help manage the trauma of endometriosis and improve quality of life.
References:
Rogers PA, et al. Priorities for endometriosis research: recommendations from an international consensus workshop. Reprod Sci. 2009;16(4):335-46.
Maroun P, Cooper MJ, Reid GD, Keirse MJ. Relevance of depression and anxiety on outcomes after treatment for endometriosis. J Minim Invasive Gynecol. 2010;17(4):475-9.
Fazeli S, et al. Evaluation of salivary cortisol and alpha-amylase levels in women with endometriosis: a case-control study. Int J Reprod Biomed (Yazd). 2021;19(1):65-70.
Fernandes LF, et al. Effectiveness of physical therapy for the management of women with endometriosis: a systematic review and meta-analysis. Clin Rehabil. 2021
Evans S, Tsao JCI, Sternlieb B, et al. Iyengar yoga for young adults with rheumatoid arthritis: results from a mixed-methods pilot study. J Yoga Phys Ther. 2012;2(1):108.
Yang Y, Hu J, Xie Y, et al. Yoga for women with endometriosis-related pain: a randomized controlled trial. Altern Ther Health Med. 2020;26(5):36-41.
Rakhshaee Z. Effect of three yoga poses (cobra, cat and fish) in women with primary dysmenorrhea: a randomized clinical trial. J Pediatr Adolesc Gynecol. 2011;24(4):192-6.
Jerath R, Crawford MW, Barnes VA, et al. Self-regulation of breathing as a primary treatment for anxiety. Appl Psychophysiol Biofeedback. 2015;40(2):107-15.
Anand S, Saini S, Singh MP, et al. Effect of breathwork on stress and anxiety levels in women with endometriosis: a randomized controlled trial. Int J Yoga. 2021;14(2):126-32.