Endometriosis Awareness Month

March is Endometriosis Awareness Month, an opportunity not only for women but for all of us—as a society and within the healthcare system—to better understand a condition that affects 10% of women.

Endometriosis occurs when tissue similar to the lining of the womb grows in other places like the lining of the pelvis, the ovaries (where cysts can develop), fallopian tubes, and in the area between the vagina, the bladder or the bowel. It can occur elsewhere in the body such as the chest, but this is uncommon. These cells can grow and then breakdown and bleed in response to hormones in the menstrual cycle. There is no way for this blood to leave the body and this can cause inflammation, pain and scar tissue.

Endometriosis can affect women at any age, from puberty to menopause, though its impact may persist throughout life. It is not just "bad period pain"—it is a long-term condition, and each person’s experience with endometriosis is different. Some may have mild symptoms that do not interfere with daily life, while others may suffer from severe symptoms, including fertility issues. Importantly, the severity of symptoms does not always correlate with the type, amount, or location of endometriosis.

Why endometriosis occurs is still not well understood and no theories have been proven. It’s important to note that it’s not infectious or contagious.

Women with endometriosis experience a wide range of symptoms, with the most commonly recognised including:

? Heavy periods (needing to change pads/tampons every hour or so)

? Painful periods that interfere with daily activities

? Pelvic, abdominal or back pain, sometimes radiating down the thighs

? Pain during or after sex

? Pain with urination or having a bowel motion

Fatigue, bloating and nausea can also be experienced as well as anxiety and depression.

A 2024 report published by Endometriosis UK found that, on average, it takes 8 years and 10 months from a woman’s first doctor's visit to receive a diagnosis. Diagnosing endometriosis can be challenging, as it does not always how up on scans, there are no specific blood tests, and symptoms often overlap with other conditions, such as pelvic inflammatory disease, adenomyosis (endometrial tissue affecting the womb’s muscle layer), fibroids (non-cancerous growths), and irritable bowel syndrome.

Currently, there is no cure for endometriosis, so treatment focuses on controlling symptoms. Management is individualised based on factors like age, severity, and symptoms. Treatment options include pain management, hormone therapy, surgery, and supportive therapies such as physiotherapy, dietetics, and emotional support.

Physiotherapy management may include addressing the pelvic floor muscles, exercises for the back and pelvis, "hands on” therapy to the back and pelvic muscles, bladder retraining, bowel management and lifestyle advice and education.

I would encourage anyone concerned about their symptoms to speak with their GP and seek support.

Megan Davenport, MISCP is a CORU registered Senior Physiotherapist in Pelvic Health at Blackrock Clinic.

*References available on request