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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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What Our Patients Have to Say

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Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by Jackie W.

I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

-- Jackie W., 1/19/17 via Yelp!

Testimonial by R.D., age 38

"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.

Read more: Testimonial by R.D., age 38

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

Testimonial by Mary L.

I started seeing Heather to treat my Interstitial Cystitis in November 2016. At this time, I was extremely miserable, in constant pain, and felt as though no one was listening or understood what was going on with my body. I have just finished my last appointment and I can honestly say that my life has completely changed for the better because of Heather and her team of PTs! I live almost completely pain free, and when I do have flare ups, I am able to treat them at home on my own. I am so grateful that this office was recommended to me a honestly cannot recommend them enough!

Read more: Testimonial by Mary L.

Testimonial by R.S.

I wanted to thank you so much for helping me get through something I thought I may never be able to. We have achieved pain-free intercourse and this has really solidified our marriage. We are so grateful to you for all the work you do! Thank you!!

-- R.S.

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