Endometriosis and osteopathy
Known since antiquity but defined in 1860 by Doctor Karl Von Rokitansky, this gynecological pathology is still too little known. This article aims to lift the veil on this disease from which a multitude of women suffer.
What is endometriosis?
Endometriosis is a gynecological condition that affects approximately 1 in 10 women. This disease is linked to the abnormal proliferation of endometrial tissue, similar to the uterine mucosa because it is itself made up of endometrium. This anarchic proliferation of tissue can be found in the body of the uterus, the ovaries, the fallopian tubes, but also outside, on other organs. Clinically, this results in pain, particularly during menstruation, which can be very severe. Endometriosis is one of the main causes of infertility.
Men and endometriosis?
Men are only very rarely affected by endometriosis. The cases found in the studies show that the cause is linked to the theory of embryonic remains: during embryonic development, the female structures regress when the embryo becomes male, but in certain cases there are embryonic remains that can cause endometriosis in men.
Endometriosis: different types :
We are not talking about one but several endometrioses:
- Pelvic Endometriosis
- Ovarian Endometriosis
- Deep endometriosis with infiltration of the bladder, rectum and/or ureters
- Extrapelvic endometriosis (parietal, thoracic, diaphragmatic)
The physiopathology of endometriosis
The endometrium is one of the layers of the uterus. Throughout the cycle, this layer will thicken to detach and evacuate on the 28th day (approximately) of the cycle, i.e. at the time of the period. In reality, menstruation corresponds to the evacuation of pieces of endometrium.
In endometriosis, instead of evacuating during menstruation, parts of the endometrium migrate to the fallopian tubes or ovaries or into the abdomen. Some people refer to this as retrograde menstruation.
The problem is that during the next menstrual cycle, these pieces of endometrium will react exactly like the uterine endometrium. That is to say, they will thicken but because of their location, they will not be able to be evacuated, and so on, this is the vicious circle of endometriosis...
The causes of endometriosis
The causes of endometriosis are not completely identified. In this section, we will only provide you with some leads:
Retrograde menstruation
It would seem, as described above, that during menstruation, the endometrium does not completely evacuate and migrates to other areas (tubes, ovaries or abdominal cavity). However, studies show that only 10% of women with this type of endometriosis will develop endometriosis.
Trauma
Studies link the development of endometriosis to childhood abuse:
- Childhood abuse increases the risk of developing endometriosis by 20%.
- If it is sexual violence, the risk is increased by 50%.
- The higher and more intense the violence, the greater the risk...
Other
- The use of tampons? No study shows this at this time.
- Vaccine? No study currently shows this.
Environmental factors
Endocrine disruptors disrupt the hormonal and immune system which may be one of the causes.
Embryonic origin
This is the theory of embryonic remains. Researchers have discovered endometrial remains in human fetuses.
Power supply
- Eating green vegetables and fruit reduces the risk of developing endometriosis and many other diseases.
- Eating red meat increases the risk.
Tobacco
Tobacco, against all odds, has a beneficial effect on endometriosis since it inhibits the production of hormones. However:
- Smoking increases the risk of developing other diseases.
- Childhood exposure to passive smoking increases the risk of developing endometriosis.
The symptoms of endometriosis
The symptoms do not indicate the severity of the condition. Some women have excruciating pain and are at an early stage and others have almost no pain and are at a very advanced stage.
The pain
- Chronic pelvic pain, sometimes very severe
- Dysmenorrhea: pain related to menstruation. The endometrium is a tissue under the influence of female sexual hormones. The menstrual cycle will lead to an anarchic proliferation of the endometrial tissue, lesions and bleeding at the origin of pain.
- Pain outside of menstruation
- Dyspareunia: pain during sexual intercourse. These pains can be a function of the positions.
- Dysuria: pain when passing urine
- Dyschesia: pain when passing stool
Infertility
There are many things yet to be discovered that endometriosis and infertility. Here are the leads that are emerging from the studies:
- The anarchic proliferation of endometrial tissue forms a mechanical barrier to fertilization. This tissue can, for example, block the fallopian tubes.
- Abnormal genes can cause uterus hostile to embryo implantation, according to studies.
No symptoms
Endometriosis is often asymptomatic, which means that you can suffer from endometriosis and have no symptoms. You can therefore be affected without knowing it. Endometriosis is then discovered by chance during a medical examination, for example during infertility tests.
Bleeding
As explained above, the endometrium proliferates under the influence of hormones. Thus, each piece of ectopic endometrium can proliferate and thus cause bleeding, sometimes outside of the period.
Chronic fatigue
If only because being in pain all the time is very tiring.
Intestinal disorders
Complementary examinations for endometriosis
The diagnosis is made through questioning and clinical gynecological examination as well as through complementary examinations. Among the different possible examinations, we find :
- Endo-vaginal ultrasound
- Pelvic or even abdominal-pelvic MRI
- Endoscopy:
- Laparoscopy
- Hysteroscopy
- Cystoscopy
- Endo-rectal ultrasound
- Colonoscopy
- Fertiloscopy
Endometriosis and its associated pathologies
- Certain cancers: in patients with endometriosis, the risk of thyroid or ovarian cancer is slightly increased. But only by 1% for ovarian cancer. There is no increased risk for breast or uterine cancer.
- Rheumatoid arthritis
- Lupus
- Cardiovascular pathologies
- Celiac Disease
- Basedow's disease
- IBD
- Hemorrhagic recto colitis
- Asthma
Treatments for endometriosis
- Hormonal treatment
- Surgical treatment: in some cases, it is necessary to remove the endometrial tissue by surgery (usually laparoscopy). This can be useful in cases of procreation or pain. Unfortunately, the proliferation will continue...
- Alkaline diet: basic foods are to be preferred. Processed foods and gluten should be avoided.
- Osteopathy
- Other: yoga, meditation, acupuncture, sophrology, relaxation, etc.
Osteopathy and endometriosis
Unfortunately, your osteopath cannot treat endometriosis itself with his hands. However, it can bring relief and improve the patient's autonomy.
Thanks to a set of painless techniques, your osteopath will do his best to optimize the body's functioning despite the lesions.
The structure governs the function, and the function governs the structure
In cases of desire for pregnancy, the role of your osteopath will be to remove all mechanical dysfunctions to optimize the function of the body and particularly the small pelvis.
What is the status of endometriosis research?
Currently, studies are being conducted on the use of high frequency ultrasound and the use of Elagolix. This substance is a GnRH antagonist and recent studies have shown a decrease in pelvic pain and endometrial thickness after 6 months of treatment.
Marie Messager
Osteopath D.O.
Specialized in gynecology and pediatrics
2 rue Alexis de Tocqueville
78000 Versailles
