Treating the pain of endometriosis

Many women suffer through years of painful menstrual periods before they are able to get an answer about what’s causing them: a common and often undiagnosed condition called endometriosis.

What is endometriosis?

Endometriosis is a condition that occurs when tissue much like the tissue that lines a woman’s uterus — called the endometrium — starts to grow in other places inside the body. Most commonly, these growths are within the pelvis, such as on the ovaries, the fallopian tubes, the outer surface of the uterus, or the bladder.

During the menstrual cycle each month, the tissue lining the uterus grows thicker, then breaks down as blood that exits through the vagina. The wayward tissue growths of endometriosis respond to the same hormones as the uterine lining. But instead of draining through the vagina as a menstrual period, blood from tissue growth elsewhere in the body has nowhere to go. It pools around nearby organs and tissues, irritating and inflaming them, and sometimes causing scarring. In addition to pain, endometriosis can cause other symptoms, such as bowel- and bladder-related problems, heavy periods, sexual discomfort, and infertility.

Diagnosing endometriosis may take time

In some cases, diagnosis of endometriosis is delayed because teenagers and adult women assume that their symptoms are a normal part of menstruation. Those who do seek help are sometimes dismissed as overreacting to normal menstrual symptoms. In other cases, the condition may be mistaken for other disorders, such as pelvic inflammatory disease or irritable bowel syndrome.

A study by the World Endometriosis Research Foundation found that among women ages 18 to 45, there was an average delay of seven years between the first symptoms and the time of diagnosis. Most cases are diagnosed when women are in their 30s or 40s. The problem of getting an accurate diagnosis and treatment is worse for some minority groups, including people of color and indigenous people, according to the Endometriosis Foundation of America.

Getting relief from endometriosis

While there is no known cure for endometriosis, the good news is that medications, surgery, and lifestyle changes can help you find relief and manage the condition.

Your doctor might recommend one or more treatments to help relieve pain and other symptoms. These include:

  • Nonsteroidal anti-inflammatory (NSAID) medications. These may be either prescription or over-the-counter formulations, including ibuprofen (Advil, Motrin) and naproxen (Aleve), which are used to relieve pain.
  • Hormone therapies. Because endometriosis is driven by hormones, adjusting the hormone levels in your body can sometimes help to reduce pain. Hormone medications are prescribed in different forms, from pills, vaginal rings, and intrauterine devices to injections and nasal sprays. The goal is to modify or halt the monthly egg-releasing cycle that generates much of the pain and other symptoms linked with endometriosis.
  • Acupuncture. This is an alternative medicine treatment, which uses small needles applied at specific sites on the body to relieve chronic pain.
  • Pelvic floor physical therapy. This practice addresses problems with the pelvic floor, a bowl-shaped group of muscles inside the pelvis that supports the bladder, bowel, rectum, and uterus. Pelvic pain sometimes occurs when muscles of the pelvic floor are too tight, causing muscle irritation and muscular pain, known as myofascial pain. To treat myofascial pain, a specially trained physical therapist uses her hands to perform external and internal manipulations of the pelvic floor muscles. Relaxing contracted and shortened muscles can help alleviate pain in the pelvic floor, just as it would in other muscles in the body.
  • Cognitive behavioral therapy. Another option to help manage pain is cognitive behavioral therapy (CBT). Although few studies have looked at the effects of CBT on endometriosis symptoms, it has been used to successfully manage other conditions that cause chronic pain. CBT is based on the idea that healthier thought patterns can help reduce pain and disability, and help people cope with pain more effectively.
  • Stress management. Experiencing chronic pain can cause stress, which may heighten sensitivity to pain, creating a vicious cycle. Because stress can make pain worse, stress management is an important component of endometriosis management.
  • Lifestyle improvements. Maintaining a regular exercise program, a healthy sleep schedule, and a healthful, balanced diet can help you better cope with and manage stress related to your endometriosis.
  • Surgery. Your doctor may recommend surgery to remove or destroy abnormal tissue growth, to help improve your quality of life or your chances of getting pregnant. Some studies have shown that removing growths of abnormal tissue and scar tissue caused by mild to moderate endometriosis can increase the likelihood of getting pregnant.

Ultimately, it may take time to find the right combination of treatments to ease pain and manage this condition. But working closely with your doctor makes it more likely that you will be able to do so.

The post Treating the pain of endometriosis appeared first on Harvard Health Blog.

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Ballet dancer turned filmmaker Sophia Bender gives a voice to women with endometriosis

Sophia Bender knew from a young age she wanted to be ballerina.

“I started dancing at the age of three at the Barbara Todd Ballet School and I just loved it right from the beginning,” she said.

At 16, Ms Bender moved to Sydney to study at prestigious performing arts school McDonald College.

She was later accepted into the Western Australian Academy of Performing Arts (WAAPA).

But in her third year of an Advanced Diploma of Dance, things started to unravel.

Sophia’s dreams of a ballet career were dashed by endometriosis.(Supplied: Sophia Bender)

“Towards the end of my third year at WAAPA, when I was getting a lot of injuries and slowing down a bit, I started to get a lot of really bizarre symptoms,” she said.

“I was really bloated, I was really tired all of the time and I was just getting all of these really strange pains.”

Ms Bender was diagnosed with endometriosis, a debilitating condition in which tissue that is similar to the lining of the womb grows outside of it, in other parts of the body.

Her mother, Deborah Bender, said the disease was not even on her radar.

Deborah Bender looks at her daughter Sophia Bender
Sophia Bender’s mum Deborah says she felt helpless after her daughter’s endometriosis diagnosis.(ABC News: Tony King)


“It was actually a very big shock when the diagnosis came through, and heartbreaking to see the suffering that went on and actually feeling very helpless a lot of the time,” she said.

With her dream of becoming a ballerina on hold, the head of dance at WAAPA suggested Ms Bender transition into film making.

“I remember laughing and thinking it was really absurd because I was so tunnel-visioned with ballet my entire life,” she said.

But she followed the advice and found a way to combine both passions.

After completing a Bachelor of Fine Arts at the Victorian College of the Arts, she landed a job as the film content coordinator for the Australian Ballet.

In her spare time, the 27-year-old decided to make a film to raise awareness about the disease that changed her life.

“Really struggling with my own endometriosis at the time after my surgery and coming to terms with it, I thought ‘I’ve got to make a film about this because I’ve got to raise awareness and I really want to get the word out there’.”

Forced to take a pregnancy test when still a virgin

The faces of 12 women involved in the Endo Girl film
Endo Girl tells the very personal stories of women who suffer from endometriosis.(Supplied: Instagram)

Ms Bender’s 20-minute film, Endo Girl, tells the stories of 13 women from all different backgrounds struggling with endometriosis.

As well as writing and directing the film, Ms Bender shares her own deeply personal experiences.

The women range in age from 13 to 50 and their stories are brought to life through dance.

“The women’s stories are just so empowering and I felt like to do them justice, I wanted to really bring them to light in a way that was really captivating and really memorable,” Ms Bender said.

“With my passion for dance and dance film I decided there had to be dance in it.”

Actor and composer Tomas Parrish said the film was unique.

“The dance is used as a vehicle to assist in storytelling in the same way that the music is … so I have never seen anything like it,” he said.

Premiere on hold due to COVID-19

Former ballet dancer Sophie Bender holds a camera
Ms Bender is using her skills as a film content coordinator to raise awareness of endometriosis.(ABC News)

The film, which Ms Bender describes as a “docu-dance drama”, was due to be released in March but with film festivals cancelled due to COVID-19, everything is on hold.

“Most of the film festivals all around the world have really been affected by COVID19 and so it’s been really hard,” she said.

Seventy-five people were involved in the making of Endo Girl, which cost about $50,000 and was almost entirely self funded.

Ms Bender is keen to release the film and start raising awareness.

“I’m ready to show it to the world and I’m hoping that I’m able find some kind of platform where I can show the film to a wider audience,” she said.

“The story is just so important and I really want to get it out there.”

Cameraman films dancers in a forest for a short film
Tomas Parrish believes the film will have a huge impact.(Supplied: Pippa Samaya)

Tomas Parrish said the delay was incredibly frustrating.

“It’s just put a halt on the entire film, some film festivals are now going online which is a great hope but there are no guarantees.”

Mr Parrish believes it will have a huge impact.

It is estimated one in 10 women are affected by endometriosis.

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