You may or may not know that March was Endometriosis awareness month. In my women’s health physio world over the past month, I have been seeing non-stop reminders about the prevalence and difficulty of living with endometriosis on social media, in our groups and when participating in our monthly professional development zooms. Because of my bubble and the ladies I am seeing and interacting with in the clinic day to day, I often forget the reason that endometriosis (or endo) awareness is really required – we simply don’t know enough about the disease.

Endometriosis affects around 700 000 (1 in 9) Australian women, we think. The actual number is probably a lot higher than this, as it is quite difficult to reach a stage of definitive diagnosis, and many will be unaware they have the condition. The chances are you interact with someone who has endometriosis regularly. Endo is something that can be very difficult to live with, and the symptoms range widely. They may include pelvic pain, discomfort during intercourse, heavy periods or trouble falling pregnant. The difficulty of living with endo, besides these symptoms, is that it is very difficult to treat. The reason being – we simply don’t understand the disease, what it is, who gets it and where it comes from. 
During March, I have been reminded over and over about the role we can play as women’s health physios in helping someone with endometriosis. While for some the journey with endo is convoluted and complex, there are some basic approaches we can take for treatment. I would like to run through the top 3 things we aim to get through in a first consult with someone with suspected or confirmed endometriosis. If you know someone who has yet to see a women’s health physio or feeling unsure about where to turn, I hope this will be useful information to pass on.
A key part of managing endometriosis is understanding someone’s history. What their symptoms are like now, how they have changed over time, what their bladder and bowels were like as a child, what they do for exercise and work and things they will avoid. These clues will give us so much insight into the pelvic floor, pelvic organs and the link between them and the nervous system.
We will look further into what the pelvis is doing, its position in space, which muscles are tight and painful and what might reproduce someone’s symptoms. If we can find a relationship between the pelvic floor, deep glute, hip and lower back muscles and ‘their’ pain we can tailor a treatment plan to approach them.
And finally, we put it all together. Our aim is to explain how symptoms relate to what is going on deeper and work on some management strategies, or simply, to work out a clear plan forwards. This might include hands-on therapy, further explanation of the bladder, bowel and pelvic symptoms and looking at other lifestyle management options like exercise, diet, pain relief options, and postural positions to sit and work in.
Unfortunately for women living with endometriosis, without more knowledge around the disease and what it is there remains to be no ‘cure’. However, there are so many management options available and many people who are very passionate about working in this field. Sometimes our role is simply figuring out a plan forwards and pointing people in the right direction.