March is Endometriosis Awareness Month.  This link provides you with videos, articles, ebooks, photos, and blog posts from our Clear Passage Physical Therapy blog category on endometriosis. http://www.clearpassage.com/blog/archives/category/conditions/endometriosis-conditions

For ideas on how to help spread the word during Endometriosis Awareness Month, visit The Endometriosis Association, Official Site. http://www.endometriosisassn.org/marchawareness.html

Larry Wurn, Director of Clinical Research, Clear Passage Therapies, talks about adhesions and endometriosis pain in this short video clip with multiple illustrations. Wurn discusses reducing endometriosis pain with a natural physical therapy treatment (Wurn Technique).

Endometriosis and adhesions can form outside the uterus and cause pain

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Click here to download the free ebook, chapter 17  “Endometriosis Pain” from “Miracle Moms.” Includes theory, research, and heart-warming stories from women struggling with endometriosis pain.
(http://www.clearpassage.com/resources/ebook.php)

“Miracle Moms, Better Sex, Less Pain” by Larry and Belinda Wurn with Richard King, MD will be available September 15, 2009 (Med-Art Press). Foreword by New York Times best-selling author Christiane Northrup, MD  and endorsed by physicians from Harvard, Columbia, Northwestern, and other fine professionals.

Mary Lou Ballweg, Ph.D., President, Endometriosis Association, says, “Adhesions are a major problem for women with endometriosis, causing pain which can continue for decades, sexual and bowel function problems, difficulty with exercise and other movement. Previously, only surgery was available, which in itself could lead to more adhesions. This book will bring new hope to many women now suffering.”

By Jackie

As a part of endometriosis awareness month, today’s post is devoted to one of the main symptoms of endometriosis: painful menstruation. Doctors theorize that endometriosis can cause painful menstruation because the endometrial cells outside of the uterus respond to the same hormones that control the menstrual cycle. Thus, estrogen causes the cells to thicken, but they cannot exit the body through the vagina. As a result, they can cause pain and inflammation. Some doctors believe that over time, this can lead to scar tissue that causes organs to stick together. In some women, this “sticking together” causes infertility, chronic pain, bowel symptoms, and other painful symptoms.

In October of 2008, researchers published a study in the Gynecological and Obstetric Investigation, in which they investigated factors associated with the risk of developing painful menstruation in women with ovarian endometriomas. Ovarian endometriomas occur when endometrial cells form small cysts on the outside of the ovary. As they respond to hormone stimulation each month, they produce more cysts and can enlarge. Endometriomas (also known as chocolate cysts) can rupture and spill into the uterus, sometimes causing adhesions (scar tissue) and pelvic pain.

In the above study, researchers evaluated and interviewed 710 women with surgically confirmed ovarian endometriomas. 376 of these women also had a major complaint of painful menstruation. The researchers found that the following items as risk for dysmennorhea (painful menstruation):

• Age: A younger age at time of surgery increased a woman’s risk of developing menstrual pain
• Previous Medication Use
• Presence of Adhesions
• Presence of Adenomyosis, which had the strongest correlation

At Clear Passage Therapies, we specialize in treating adhesions. Our therapists have often noted a strong correlation between adhesions and endometriosis pain and dysfunction. We have found that by gently breaking apart the adhesions with manual techniques (see What is the Wurn Technique?) pain subsides and function returns. To learn more about our treatment, please visit our endometriosis pain page.

By Jackie

March is endometriosis awareness month, and one of the main issues that women are promoting is early detection and diagnosis of endometriosis. Because endometriosis can only be diagnosed through laparoscopic surgery, many women live with significant pain and dysfunction for years without being diagnosed or treated.

Laparoscopic surgery

The good news is that the same procedure to diagnose endometriosis can also be used to treat it. During laparoscopic surgery, the physician inserts a tube in or near the belly button, then pumps carbon dioxide into the pelvic cavity. As the gas expands, it creates a space between all of the pelvic organs. The surgeon then inserts a tiny camera to observe and film any mechanical anomalies, such as endometriosis. If she finds endometriosis, she may burn it with a laser. If she finds adhesions (which are commonly found with endometriosis), she will also burn the adhesions.

A significant amount of women find pain relief after the procedure. However, some women continue to experience pain. In our clinical experience, we have found that many women who still experience pain after laparoscopic surgery have a significant amount of adhesions. (For more information about adhesions and endometriosis, please see our post An Option for Women who are Still Infertile after Laparoscopic Surgery for Endometriosis.)

Some doctors also note that pain recurs because endometriosis has re-grown. In a study published by the Journal of Minimally Invasive Gynecology (2005), researches retrospectively evaluated 115 women who underwent laparoscopic surgery for deep endometriosis. Deep endometriosis can be defined as “rectovaginal lesions as well as infiltrative forms that involve vital structures such as bowel, ureters, and bladder” (Journal of minimally Invasive Gynecology). The researchers evaluated these women to find predictors of deep endometriosis recurrence after surgery.

Of the 115 women, 28 experienced pain recurrence and 15 patients presented with recurrent clinical findings of deep endometriosis. From this group, the researchers were able to determine that the following predicted recurrence:

• Age: Younger patients had a greater risk of recurrence
• Obliteration of the pouch of Douglas: The pouch of Douglas is the space between the rectum and back wall of the uterus. When this cavity is closed during surgery, patients experience a higher risk of recurrence.
• Surgical Completeness: The study found that surgical incompleteness was the only predictor of a necessary second operation for deep endometriosis

If you are considering undergoing laparoscopic surgery for endometriosis, you may ask your doctor about the procedure and how she will minimize the risk of recurrence. If you have already undergone laparoscopic surgery, you may obtain a copy of the surgical report or speak with your doctor to determine if you had any significant risks for recurrence.

To learn more about pain or dysfunction after laparoscopic surgery, see endometriosis pain.

By Jackie

March is endometriosis awareness month and thousands of women are working hard to bring endometriosis to national attention. The endometriosis blog community is abuzz, trying to create unique and effective awareness campaigns.

Why does endometriosis need national attention? There are multiple reasons:. Despite the debilitating pain and dysfunction caused by endometriosis, there is still no simple diagnostic test for the disease (surgery is currently the only way to definitively diagnosis endometriosis). There is also still no cure for endometriosis. While treatment forms exist, these treatments cannot guarantee 100% removal of the disease or a patient’s return to a pain-free, normal life.

At Clear Passage Therapies (CPT), we offer treatment for the pain and dysfunction caused by endometriosis, but we do not treat or remove the endometriosis. Instead, our therapists address adhesions that may attach to endometrial implants. CPT theorizes that when endometrial implants attach to underlying surfaces, they may cause irritation and inflammation. This inflammation may lead to adhesion formation between the endometrial implants and nearby tissue. CPT postulates that when the endometrial implants swell each month in response to a woman’s natural hormone cycle, they pull on the adhesive attachments, causing pain. Our therapists work to slowly deform and detach these adhesions and many women find they no longer experience pain or dysfunction after our treatment. However, it is important to note that the endometrial implants remain. (To learn more about our treatment, please see our endometriosis page.)

No one knows exactly what causes endometriosis and more research is needed. However, research takes money and before medical companies, researchers, and other interested organizations are ready to invest, they want to understand why more research is needed. Endometriosis awareness month is an effort to bring attention to endometriosis so that others learn and understand the numerous issues and areas that merit and desperately need more research.

In an effort to aid endometriosis awareness, CPT is creating a special endometriosis newsletter for the month of March. In the newsletter we will provide free online copies of the endometriosis chapters from our upcoming book (see Miracle Moms, Better Sex, Less Pain), share the stories of two women with endometriosis, present articles related to endometriosis, and much more. If you would like to receive a copy, please sign-up for our newsletter here. Is there something you would like to see in the newsletter? Please leave a comment below to let us know. To learn more about endometriosis, please see www.endometriosis.org and Jeanne’s Endo Blog.

Many women with endometriosis are able to become pregnant through conventional treatment methods such as laparoscopic surgery, IUI, and IVF. Other women who do not have success with conventional treatment methods or who are uncomfortable with these options turn to alternative therapies and become pregnant.

But what if you have tried both and have still not experienced success? It may be time to try using conventional and alternative methods in conjunction with each other. Although conventional medicine and alternative therapies often present themselves as mutually exclusive, the combination of the two types of medicine can bring great success.

Endometriosis (the purple cells) and their adhesive attachments (white bands) can lead to infertility

At Clear Passage Therapies (CPT), we strive to prepare the entire body for a pregnancy by addressing mechanical components that may block fallopian tubes, restrict the uterus, and impair hormonal infertility. Our treatment has helped numerous women become pregnant naturally, in addition to preparing over 75 women for successful IVF transfers.

Our treatment for endometriosis works by focusing on the adhesions that form at and around endometrial implants. Adhesions can impair fertility by constricting, blanketing, and pulling on the sensitive female reproductive structures. Adhesions can also pull on the ligaments of the uterus, causing uterine spasm. If a woman undergoes an IVF procedure, the embryo may not successfully implant because of adhesions or the resulting uterine spasm. Similarly, a woman who undergoes laparoscopic surgery for endometriosis may still be unable to conceive afterward because of adhesions present within the reproductive tracts or its ligaments. Because the female reproductive structures can be so delicate, it can be very difficult for a surgeon to remove adhesions from them without compromising the function of those organs.

CPT physical therapists use manual physical therapy techniques to gently break apart the adhesions in and around the reproductive system. The techniques have been shown to help women become pregnant or later have a successful IVF transfer.

One such woman was Samantha, a woman who came to our clinic after several unsuccessful IUIs and two unsuccessful IVF transfers. When Samantha came to CPT, she didn’t know the cause of her infertility. Her therapist examined her and felt that she had the characteristic scarring, tightness, and restriction of a woman with endometriosis. The therapist worked to restore proper mobility and reduce adhesions in her pelvis.

After treatment, Samantha spoke with her doctor and decided to undergo diagnostic surgery for endometriosis. As it turned out, her physical therapist was correct: Samantha was diagnosed with endometriosis. After the procedure, Samantha underwent a fresh IVF transfer and became pregnant right away with twins. Two years after her twins birth, Samantha and her husband tried another round of IVF. They were disappointed when it didn’t work, but were then caught by surprise when Samantha learned she was pregnant naturally.

Samantha reported that she couldn’t attribute the success of her IVF transfer or pregnancy to just one treatment form. For her, it was the combination of conventional medicine and alternative therapies that helped. She told us, “It’s hard to say which treatment ‘worked’ for me. I think a large part of my success was learning to relax. My treatment at Clear Passage enabled me to become more familiar with my body and calm down. I know their treatment helped to restore balance in my body and mind, preparing me for my transfers and natural birth.”

Samantha’s full story, told in her own words, will be featured in our upcoming book Miracle Moms, Better Sex, Less Pain. Miracle Moms contains over 17 chapters and discusses how manual physical therapy can be used exclusively or in combination with other conventional treatment options. Please visit our website to learn more about our treatment for endometriosis, female infertility, and IVF transfers.

By Jackie

Madison never thought she wouldn’t be able to conceive. “I was shocked when I could not become pregnant,” she reported.

After a year of trying naturally, Madison and her husband sought the help of their doctor. Madison had an HSG to see if her fallopian tubes were functional. The results showed everything was fine. Madison then consulted with another doctor, who suspected she might have endometriosis. She underwent laparoscopic surgery and sure enough, the physician found severe endometriosis encasing the majority of her reproductive system.

Endometriosis on the outside of the uterus

Unfortunately, Madison and her husband were still unable to become pregnant after the surgery. They tried Clomid, but had no success after six months.

Madison decided it was time to consult with another specialist. He suggested they try intrauterine inseminations (IUI) with hormonal shots. But three IUIs later, they still hadn’t conceived. Their specialist suspected that Madison’s endometriosis had re-grown, so Madison agreed to a second surgery.

Once again, Madison and her husband couldn’t become pregnant after surgery. On the advice of their specialist, they decided it was time to move on to IVF. There were no complications with the retrieval of eggs or the transfer of the embryos, but there was still no pregnancy. Three months later, Madison and her husband tried IVF again. They were devastated by another unsuccessful transfer.

Despite the hardships they had experienced, Madison and her husband were determined to not give-up. They scheduled a third IVF transfer.

Before their transfer, Madison learned of Clear Passage Therapies (CPT). After reading over the treatment, they felt it could make their 3rd transfer successful. Madison attended an intensive week of therapy one month before her transfer. She told us, “After treatment, my body felt looser and healthier. When I returned home, my husband and I were elated to find there was no longer any pain with sex. My husband joked that he would send me back for more treatment in a heartbeat. Another amazing outcome was that I no longer experienced pain from my endometriosis.”

The next month, Madison completed her 3rd IVF transfer and was finally pregnant! She carried the baby to full-term and delivered a healthy baby girl.

Five months after her birth they got a surprise – Madison was naturally pregnant! She told us, “After struggling with infertility for so long, my husband and I never considered using any form of birth control. It was then I knew CPT had healed and restored proper function to my body.”

Madison’s full story, told in her own words, will be featured in our upcoming book Miracle Moms, Better Sex, Less Pain. To learn more about our treatment for endometriosis or female infertility, please visit our website.

By Jackie

In our upcoming book, Miracle Moms, Better Sex, Less Pain, we share over 75 stories of patients who came to Clear Passage Therapies (CPT) for help with chronic pain, female infertility, and female sexual dysfunction. An entire chapter in the book is devoted to endometriosis-related infertility. Over eight patient stories are included in this incredible chapter that explains how endometriosis and adhesions can cause infertility and what you can do about it.

One former patient featured in this chapter is Michaeleena, who struggled with infertility for four years. Michaeleena and her husband tried to become pregnant on their own for two years, but then decided to seek the help of a doctor. All the tests appeared normal for Michaeleena, so they started IUI treatments with Clomid®. After the fourth failed IUI cycle, she underwent diagnostic laparoscopic surgery and learned she had endometriosis. Her doctor told her that her left ovary and fallopian tube were covered by endometrial implants and her tube was completely blocked. To make matters worse, her right tube was barely open.

Michaeleena and her husband tried to get pregnant for a few months following surgery and then decided to try another IUI. When it didn’t work, Michaeleena felt distraught. Her doctors pushed her to have an IVF transfer because her FSH levels were high and she was “old” – age 38.

About this time, Michaeleena learned of CPT from a friend. After speaking with many massage therapists and physical therapists, she decided to attend an intensive week program. After treatment, Michaeleena was doubtful it would work, but told us, “I took Clomid just in case it did work.” To her surprise, she became pregnant the month after treatment. Her healthy son was born nine months later.

To learn more about our treatment, endometriosis and female infertility page. CPT also has years of experience treating endometriosis pain and discomfort. In our upcoming book, we also devote an entire chapter to endometriosis pain, its causes, and how physical therapy can help. To read current patient feedback about our therapy for endometriosis pain, please see our endometriosis patients speak page.

By Jackie

Endometriosis is a crippling disease for millions of women. Common symptoms include painful periods, chronic pelvic pain, pain with intercourse, and painful bowel movements. However, many young women do not seek the help of a doctor because they believe their pain is normal – something that all women experience.

Unfortunately, when women finally decided to speak with their doctors, they often do not receive the correct diagnosis. A recent study published by Fertility and Sterility (Jan 2009) reviewed the experiences of 4,343 women with endometriosis. The study found that 63% of the women had been told by a doctor that “nothing was wrong with them.” This is an absolutely horrifying statistic. Over half of the women who sought help for debilitating pain caused by endometriosis were told they were fine!

What’s behind this statistic?

• First, endometriosis is a difficult disease to diagnose. A doctor can only make a definitive diagnosis of endometriosis through direct visualization during laparoscopic surgery. When doctors do not perform this surgery, they cannot see the endometriosis or the cause of their patient’s pain. Unfortunately, this leads some doctors to conclude that the patient’s pain is “all in her head.”
• Second, symptoms of endometriosis are commonly associated with other disorders, making it hard for doctors to piece together the actual cause. For example, a doctor may believe a patient has dysmennorhea (painful menstruation) and not realize that this is one of the symptoms of endometriosis.
• Third, doctors who do not specialize in female reproductive health may not readily recognize endometriosis symptoms. The above study found that women who spoke with a gynecologist about their pain were more likely to be correctly diagnosed than those who went to a general practitioner.

If you suspect you might have endometriosis, speak with a gynecologist about your symptoms. Do not be afraid to mention that you feel your symptoms could be related to endometriosis. If your doctor still feels there is “nothing wrong with you,” do not give-up! Seek a second opinion. All of the women in the study above eventually learned that they did in fact have endometriosis – but they had to speak with more than one doctor to get the correct diagnosis.