Endometriosis Awareness Month

March is Endometriosis Awareness Month – so here is what you need to know about the painful condition that affects more than 700,000 Australian women.  

Endometriosis is a chronic condition that affects at least one in nine women of reproductive age in Australia. However, it is believed that this figure is even higher because ‘endo’, as it is commonly known, is difficult to diagnose with the average period for diagnosis ranging from 7-12 years.  

It can affect women and girls, transgender, non-binary and gender-diverse people assigned female at birth, regardless of age, background or lifestyle. Unfortunately, it cannot be cured but there are a range of treatment options available.  

What exactly is it and what causes it?  

Endometriosis occurs when cells similar to those found in the lining of the uterus grow in other parts of the pelvis, such as the bladder, bowel or ovaries. Symptoms can include pelvic pain, uncomfortable sex (dyspareunia), and heavy periods (dysmenorrhoea).  

The cause is unknown but the following factors may increase your risk: 

  • Close family relative with the condition (up to 10 times more likely to get endo) 
  • Having your first pregnancy at an older age  
  • Heavy periods and periods lasting longer than 5 days 
  • First period occurring before age 11 
  • Low body weight 
  • Alcohol use 
  • Commonly found in twins, especially identical twins  

How is it diagnosed?  

Unfortunately, most women learn they have endometriosis when they struggle with infertility, or it is discovered during a procedure for another medical issue.  

Some women do not have any symptoms, though pain in the lead up to a period occurs in most women. Although period pain is common, severe period pain that does not respond to over-the-counter pain medications can be a high indicator of endo.  

As the symptoms of endometriosis can be different for each woman and change over time, there is no current effective screening test for endo and the only means for diagnosis is a laparoscopy – a minor procedure done under anaesthetic.  

How is it treated?  

Some common treatment options for endometriosis include the oral contraceptive pill to help with the control of hormones, progestins (the synthetic form of progesterone which can be taken as tablets, injections, implant or intrauterine device), or laparoscopy surgeries to remove the endometrial patches and adhesions.  

Like many other chronic conditions, exercise can assist with the pain and symptoms associated with endo. Whilst everyone living with endo has a different experience and symptoms, there are some general guidelines for using exercise as medicine.  

What exercise should I be doing if I have endometriosis?  

It is important to be physically active as often as possible in whatever form of exercise you love to do! That could be walking, swimming, cycling, gym classes, strength training, Pilates, yoga, team sports – as long as you enjoy it and it doesn’t exacerbate your symptoms.  

Endometriosis is an inflammatory condition which means that exercise is a great treatment option as it increases anti-inflammatory markers. Physical activity also increases blood flow to the abdomen, which improves clearance of the by-products of inflammation.  

It is also important to restore length and strength of the anterior muscles in your body. Due to the pain associated with endo, many of the muscles through your front line (ie. abdominal muscles, chest, anterior hip) can become very tight and posterior muscles can become weak. Your body responds to pain by causing muscles to contract to ‘protect’ and restricts your movement – but this can actually have the opposite effect and make you feel worse.  

While you are bloated, curled into a foetal position with a sore pelvis and cradling a hot water bottle, the idea of movement is probably the last thing on your mind but mobility and stretching exercises can help reduce the tension in these muscles, increase your blood flow and decrease your pain. 

Most importantly, listen to your body! If you need to avoid high intensity exercise or your usual gym class at a certain time during your cycle, listen to what your body needs and swap it out for a gentle walk or Yoga flow. If you need some help learning about your body and how to best support it with an individualised program, speak to our team of exercise physiologists who can assist in creating a program specific for you and your needs. 

By Millicent Nixon