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mental load of endometriosis
iStock/Delmaine Donson
There is a lot of information on our site, in books, and across the internet about the physical aspects of endometrios, including causes, symptoms, and treatments, but the mental load of endometriosis often goes overlooked. Health Central writer Gabrielle Kassel takes on the subject and how best to deal with it in this latest article. Here is a brief synopsis of the article along with a link to the full article below.

Heather Jeffcoat, DPT

Looking to Lighten the Mental Load of Endometriosis?

Learning to tend to your emotional wellbeing can go a long way in helping you cope with endo.

Enodmetriosis (or just "endo") is defined as the growth of endometrial tissue - which normally grows only inside the uterus and is shed during each menstrual cycle - outside of the uterus. Endometriosis can bring with it chronic pain during menstruation, painful premenstrual cramps, pain with sex and penetration, bladder pain, pain with bowel movements, and it has also been associated with infertility.

With all of the various types of physical pain that come with endo, it's no wonder that the mental load of endometriosis can take its toll over time. This article takes a critical look at the causes of the pain and the associated anguish, and looks to highlight some solutions that mainstream medcine doesn't always have to offer.

The article begins:

WHEN YOU READ about the pain associated with endometriosis, it’s often a catalogue of the physical kind that ensues when endometrial cells grow outside the uterus and wreak havoc. But, as most anyone with endo can tell you, the mental and emotional spillover is real, too. “Endometriosis impacts everything from someone’s sex life to their social life,” says Shannon Chavez Qureshi, Psy.D., a psychologist and sex therapist in Beverly Hills, CA. “The frustration with getting relief can make someone feel isolated, stuck, shamed, stressed, and depressed.” Our experts show you the TLC that can help you maintain a healthy headspace.

There are a number of factors that we asses when someone comes to us for endo treatment, including their daily physical routine and habits. There are often ways to improve wellbeing just by changing up their daily routine. Some specific exercises can really help. Even just being more active in general can sometimes help break down endo related scar tissue and adhesions in the pelvic area.

From our article entitled "Physical Therapy for Endometriosis and Chronic Pelvic Pain":

Inflammation, scar tissue, and adhesions

Typically, organs and tissues in the abdomen and pelvis are slippery and have movement. Internal scar tissue can form into wide bands called adhesions, which attach to organs, muscles, and fascia, causing things to stick together and create problems such as abdominal and pelvic pain, vomiting, bloating, inability to pass gas, constipation, and painful sex.

With monthly cycles of growth and shedding, endometrial tissues can cause inflammation and the formation of adhesions. Layered on top of the monthly tissue changes, clients with endo often undergo many invasive diagnostic and treatment surgeries, including laparoscopic procedures and hysterecomies, which add even more scar tissue to the area.

And while therapy is a great place to start, it also really helps to have a support group. Don't be shy about having confidants whom you feel comfortable sharing your situation with, and don't think you are alone with your diagnosis. Communicating with others who share in your pain just might even lead to newfound ways to deal with the mental load of endometriosis.

Create an Inner Circle of Confidants

Like many chronic pain conditions, endo is invisible to the outside observer. “People with endometriosis often look fine, while dealing with a war zone inside their body,” explains Chavez. As much as you may feel tempted to keep this private issue totally to yourself, she recommends talking about your diagnosis and symptoms with your partner(s) and the people closest to you. “That way, they can be a part of your healing journey by coming to doctor appointments, helping out after surgery, or being there to support you during a bad flare-up and painful day,” she says.

We cannot stress enough how important it is to connect with health care providers who are familiar with endo. A general practioner for example might be great for dealing with common maladies, but have no specific knowledge of endo and its associated symptoms and treatments. Here at Femina PT we have a wealth of experience treating endo and a long list of testimonials to the effectiveness of our protocols.

Make Sure Your Doctor Is on The Same Page

Unfortunately, it's not uncommon for healthcare providers who do not specialize in endometriosis to minimize their patients’ symptoms, says Heather Jeffcoat, a doctor of physical therapy and author of Sex Without Pain. Indeed, one survey by the Alliance of Endometriosis found that 42% of people living with endometriosis are disbelieved, dismissed, or ignored completely by their doctors. “It takes a tremendous toll having to advocate for your health with providers,” Chavez adds. If this sounds like you, utilize The The American End of Endo Project Provider Directory or iCare Better Expert Search to find an endometriosis specialist near you.

The more you know about what's causing your pain, the better you can cope with the mental load of endometriosis. My book "Sex Without Pain" is widely recognized as an invaluable resource, and should be at the top of your list of recommended resources.

Do Some Reading on Endometriosis

Endometriosis affects roughly 10% of women, but just about every woman who comes into my office really feels like they're the only person in the world suffering,” says Iris Orbuch, M.D., an obstetrician-gynecologist in New York City who specializes in endometriosis and a co-author of Beating Endo. Reading more about endometriosis can remind you that you aren't alone, says Jeffcoat, who actually suggests starting with Dr. Orbuch’s book for coping strategies. But if memoir is more your speed, read Vagina Problems by Lara Parker, Ask Me About My Uterus by Abby Norman, or What Doesn’t Kill You by Tessa Miller.

To counteract the depression that can set in due to chronic pain, it's also important to learn techniques that can quiet the mind and put your body in a more relaxed state. We have a large number of articles that cover all aspects of endo here.

Try Meditation

One review in Annals of Behavioral Medicine found that mindfulness significantly reduced symptoms of depression and improved quality of life in those with chronic pain. “Regularly using a meditation app such as Calm or engaging in a routine practice of deep, diaphragmatic breathing can both be helpful,” says Jeffcoat. Meditation may be especially key for people who are newly diagnosed and tend to be more sensitized to the pain, according to Dr. Orbuch. “We can downregulate patients' response to pain through breathwork and meditation,” she says. Her recommendation: Commit to meditating every day at the same time for six weeks.

Click here if you would like to read the full article at Health Central, and if you find yourself struggling with the mental load of endometriosis, contact us here for an appointment at one of our Los Angeles area offices.

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I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

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I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

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While pregnant with my twins, Heather took care with keeping me on my feet and pain free. She saved my back, my sanity and the holidays! I would recommend her to every “mom” looking to stay on her feet during pregnancy and post-partum.

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"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

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