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Endometriosis

Endometrial tissue, endometriosis, endo can cause endomertiosis painendometriosis (left) and adhesions (right) can form outside the uterus

Endometriosis is a common but poorly understood disease. Its prevalence has been alternately estimated as 5 to 6 million US women, or roughly 10% of American women of childbearing age. Some women with endometriosis have severe pelvic or intercourse pain; others have "mystery pain" in the abdomen or elsewhere. Some have little or no pain at all. Endometriosis is also associated with infertility and other conditions, such as poor digestion, irritable bowel and wide-ranging pain symptoms. This disease can affect a woman’s whole existence - her ability to work, to reproduce, to have a wonderful relationship with her spouse, children, co-workers, and everyone around her.

Endometriosis refers to a condition in which endometrial tissue (which normally lines the uterus) is found in other areas of the body. It often appears on or near the reproductive organs, or within the abdominal cavity. When it appears, it causes inflammation, often accompanied by the adhesions that form when we heal from any inflammation.

This misplaced endometrial tissue responds to the menstrual cycle as if it were in the uterus. But unlike menstrual fluid that leaves the body every cycle, endometrial implants have no place to go. Like the walls of the uterus, these tissues can swell during each monthly cycle. They can even pull when we walk, move or breathe. We believe that the pull of these adhesions on pain-sensitive structures is what causes the severe, debilitating pain in women with endometriosis.

Endometriosis can cause abdominal, pelvic or low back pain or dysfunction, including infertility. Other conditions such as sexually transmitted and pelvic inflammatory diseases, vaginal, bladder or yeast infections may also cause adhesions to form, increasing the problem. Due to the adhesions which form as part of the healing process, pain tends to become chronic, unless these adhesions are removed or their bonds broken.

Unfortunately, endometriosis and adhesions have become intimately related over the years. Surgery is one of the few treatments that has had any success decreasing endometriosis pain. Part of the mechanism of that treatment is that surgery breaks the adhesions that form in the wake of endometrial inflammation.

We know of only two ways to decrease adhesions: surgery and our therapy. Surgeons save lives and improve lifestyles for their patients daily. But no matter how skilled the surgeon, they cannot stop adhesions from forming. The terrible irony is that adhesions often form from the very surgery designed to reduce adhesions.

Emerging studies question the efficacy of surgery to decrease adhesions in some women. A large study in Lancet, the British Journal of Medicine [Volume 353, Number 9163 1 May 1999] concludes that 35% of patients who had open pelvic or abdominal surgery were readmitted for at least two follow-up surgeries to treat adhesions, within ten years of their first surgery. The article states that "22% occurred in the first year after surgery, and (hospital) readmissions continued steadily over the next ten years."

Surgical adhesions have been implicated as causing infertility, intestinal obstruction, and chronic pelvic pain. Another Lancet study showed that 67% to 93% of patients develop adhesions following abdominal surgery and 55% to 100% of patients develop adhesions following gynecologic surgery.

Conscientious surgeons are concerned by the possibility of an ongoing adhesion-surgery-adhesion cycle in their patients. Unfortunately, they had little or no other option until we began conducting clinical studies. At this time, we have good evidence that we can decrease pelvic and abdominal adhesions. We are conducting more studies to quantify exactly to what extent we decrease adhesions. Scientific data on our ability to decrease adhesions is reflected in two pilot studies we recently completed. We were honored to be invited by the American Society for Reproductive Medicine (ASRM) to present these two studies to their several thousand members in September, 2006. Both of these studies have now been published in Fertility and Sterility – the medical journal of the ASRM. Study summaries are available at our medical studies page.

Clear Passage Therapies treats endometriosis, non-surgically, with a new pelvic physical therapy.Endometriosis and adhesions

Endometriosis pain study: After hearing stories of dramatically decreased pain in many of our endometriosis patients, we conducted the first study of its kind called "Treating endometriosis pain with a manual pelvic physical therapy." In it, we examined pain from endometriosis at several times during the cycle

Results showed significant improvement at all times during the menstrual cycle, with the greatest improvements at the (typically) most painful times – menstruation and sexual intercourse.

This study recently attracted the attention of the American Society of Reproductive Medicine (ASRM) who asked us to present our findings to its several thousand physician members in the Fall of 2006. The abstract was published in Fertility and Sterility (9/2006).

Endometriosis sexual function study: Due to the compelling nature of our work and our results, the ASRM requested that we present a second endometriosis study abstract to their membership. This one, also published in Fertility and Sterility (9/06) was titled “Improving sexual function in patients with endometriosis via a pelvic physical therapy.” In this oral presentation to their membership, we reported the results of our therapy in women with endometriosis on the six domains of sexual function that are measurable by science: desire, arousal, lubrication, orgasm, satisfaction and pain.

Results showed a significant improvement in all six areas, and overall, with the greatest improvements in intercourse pain. Percent pf patients who showed improvement after therapy are as follows: