Gloria Cheung Pidor

A note from Clinical Education Coordinator, Registered Physiotherapist & Clinical Pilates Instructor, Gloria Cheung Pidor on Endometriosis.

What is Endometriosis?

Endometriosis is a chronic, estrogen-dependent, and inflammatory disease of unknown etiology and without a cure; it is defined by the presence of endometrial-like tissue outside the uterus. It affects 6–10% of reproductive-aged women, leading to a range of chronic pain symptoms. The range of symptoms can be confusing for the patient and care provider, often leading to an unfortunate 6–12 year delay in diagnosis. Endometriosis-related pain affects the ability to function physically and mentally, leading to social withdrawal, psychological symptoms such as depression, and reductions in quality of life.

How Common is Endometriosis?

Endometriosis affects an estimated 176 million women worldwide

Where does it occur?

  • Typical: Endometriosis typically develops on the pelvic structures including the ovaries, fallopian tubes, bladder, and bowels.

  • Common: Top of the vagina (anterior cul-de-sac) and in the peritoneal cavity between the rectum and the posterior wall of the uterus (posterior cul-de-sac).

  • Rare: Endometriosis can spread to the diaphragm, lung, kidney, appendix

Symptoms of Endometriosis?

  • Dysmenorrhea (painful periods)

  • Chronic pain in the lower back

  • Spotting or bleeding between menstrual cycle

  • Menorrhagia (heavy bleeding during the menstrual cycle)

  • GI abnormalities:

∙ Bloating, Gassiness, Cramps, Diarrhea or constipation

∙ Constipation or nausea during the menstrual cycle

  • Dyspareunia

  • Neuropathy

  • Infertility

Not all women with endometriosis experience symptoms. And the severity of their symptoms is not related to the severity of the disease.

How is it diagnosed?

While a physical exam and other imaging tests can give insight into whether or not a patient may have endometriosis, the only way to definitively diagnose endometriosis is through laparoscopic excision surgery. This must be accompanied by a biopsy sample that is sent to pathology to confirm a diagnosis of the disease. Radiological diagnosis of endometrioma, whether Transvaginal sonography or MRI, is dependent on the experience of the imager and institution. If suspecting Endometriosis, refer back to GP for a referral to BC Women’s Pelvic Pain & Endometriosis Clinic.

Pelvic Floor Physiotherapy’s Role

Endometriosis cannot simply be managed by surgery alone. It is a multi-system condition that requires an integrative approach. Everyone is different and endometriosis manifests in many ways in the body – thus working together with the client to create an individualized treatment plan is best.


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