The Women's Journal

Living With Endometriosis

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Dr. Bianca-Alexis Ferrante PT, DPT

Have you been experiencing low back pain, abdominal pain, pelvic pain, or intestinal pain? Do you suffer from excruciating, debilitating menstrual cramps? How about nausea and/or vomiting, constipation and/or diarrhea, bloating, or fatigue? These are common, but dreadful, symptoms that are related to countless diagnoses; and may even cause you to miss school, work, or fun social outings. Did you know these could be symptoms of Endometriosis? In addition to the above symptoms, endometriosis can include short menstrual cycles, heavy menstrual periods, spotting between periods, pain with urination or bowel movements, painful intercourse, chronic fatigue, digestive problems, and infertility.

Endometriosis “Endo” is a condition where the endometrium, which is the tissue that lines the inside of the uterus, grows outside of the uterus. This tissue often stays within the pelvic region, attaching to the ovaries, fallopian tubes, and the tissue lining of the pelvis; however, it can travel outside the pelvic organs to other parts of the body including the bowel, bladder, abdomen, lungs, and brain. The endometrium naturally sheds with each menstrual cycle. The displaced endometrium bleeds as well, however the body is unable to shed it, causing pain and inflammation in that trapped location. The severity of the condition and the amount of pain one experiences are not synonymous. One can have multiple adhesions throughout the body with little to no pain, and vice versa.

A common myth is that this condition only affects women in their 30’s and 40’s. In reality, any woman in her reproductive years can be affected. A diagnosis often takes several years, and the only way to accurately diagnose the condition is through laparoscopic surgery. The cause of endometriosis is unknown, however there are many theories, including a genetic component, the condition being present at fetal development and activated at puberty by increasing estrogen levels, and retrograde (back flow) menstruation. Regardless of the cause, there is no cure for endometriosis. The symptoms though can be treated through pain medication (NSAIDS), hormones (birth control, IUD, or gonadotropin-releasing hormone (GnRH) agonist), surgery (to remove the adhesions, or a hysterectomy), or pelvic floor physical therapy. These treatments are not permanent solutions, but do help to greatly reduce the effects of endometriosis (by relieving the associated pain and inflammation).

I will now expand on Pelvic Floor Physical Therapy. The pelvic floor is comprised of a group of muscles, tendons, and ligaments that all act as a sling to the organs in the pelvic region. These muscles have an important part in urination, bowel movements, and sexual intercourse. If the endometrial tissue gets lodged in any of the musculature, organs, or tendons and ligaments in the pelvic region, it will most likely cause extreme pain and decreased mobility. Adhesions in the musculature could prevent normal contracting and relaxing, within full range leading to weakness and/or tightness, causing pain, incontinence, constipation, and/or diarrhea. 

Pelvic Floor physical therapy can help with stretching and strengthening affected muscles, decreasing fascial restrictions, and increasing blood flow to affected areas to promote healing. Exercise, as simple as walking, 3-4 days a week could help reduce pain and inflammation. Pain can cause the pelvic floor to become hypertonic, leading to painful trigger points and muscle spasms. Treatment would include relaxing of the muscles to stop the spasms. Another symptom that can occur is the bloated “endo belly,” resulting from excessive pressure, inflammation, and adhesions. Cupping and manual therapy, such as myofascial release and soft tissue mobilization, aid greatly in ceasing muscle spasms and relieving the bloated belly. In addition, deep belly breathing and relaxation are also ways to help ease the pain and promote mobility in the abdomen and pelvic floor. 

Pelvic Floor physical therapy is essential to holding the symptoms of Endo at bay and living an energetic, active life.


Dr. Bianca-Alexis Ferrante is the owner & founder of Revive Health & Wellness. A graduate of the University of Hartford, she treats women with pelvic floor dysfunction. 

After graduation, Dr. Ferrante worked in various physical therapy settings (skilled nursing facility, outpatient, acute care hospital, and home health care). While treating rehab patients, Dr. Ferrante saw the correlation between aligning the body and successful treatment of incontinence and pelvic discomfort. The Herman and Wallace Pelvic Floor courses provided her with the knowledge to properly treat these patients. Seeing how women were limiting themselves and not living life to their potential, instilled the desire within her to create an environment that would empower women to heal. 

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