As though the periodic agony is not enough for women to endure, endometriosis sufferers can also find themselves the victims of issues ranging from other physical conditions to mental troubles.
That is because the extremely painful disorder is capable of making sexual intercourse an ordeal, force women to use the bathroom more than normal, and create the type of social exclusion and job underperformance that makes sufferers believe something is wrong with them mentally.
As explained by Consultant Obstetrician and Gynaecologist and British Fertility Society Certified Lecturer Specialist Dr Damian Best during a lecture last month, endometriosis is a monthly torture that comes on before, or during the period, but is much more painful and devastating to the extent that it renders some women incapable of doing any useful work at that time.
Medical science is unsure of the cause of endometriosis, but what is known is that outside of surgery it never goes away because any successful medication must be taken until menopause. That surgical procedure and the medicinal treatment carry risks for those of childbearing age who wish to have or continue having children.
Following that National Drug Service and the Barbados Association of Endometriosis-sponsored presentation, two specialists who help make living with the disease easier for women shared a few of the issues and treatment.
Jasmine Evelyn, a Chartered Physiotherapist and registered Yoga Teacher, said that endometriosis can cause other discomforts such as bloated belly, a compulsion to urinate frequently, and below-the-belt pains in the pelvic area reaching all the way down to the foot. These are caused by the muscles in abdomen and pelvic floor.
“My role is to help patients; first of all [to] educate them on what these muscles are, and what they do, and then to help them relax the muscles,” she explained.
“I do this through manual therapy where I’m helping to massage the muscles, teaching patients how to do it themselves.”
She said, “a lot of times women have endo belly where they get very bloated and sometimes this [is] because those muscles [in the abdomen] get very tight and there is nowhere for the tummy to expand [so] it expands outwards and makes you look very bloated”.
The other has to do with muscles at the base of the pelvis, or pelvic floor muscles. Evelyn described the pelvis as a bucket without a bottom, “it holds things in the body but at the bottom of the bucket our pelvic floor muscles act to help keep everything inside. So, at the bottom of the pelvis are muscles”.
“If you’re a woman who has endometriosis, you’re having severe pain every month [and] those muscles are going to become tight, hyper-tonic. The tonicity, the length of the muscles is going to be short. It’s going to become really tight.”
She said that condition is similar to a tightening of track muscles in the neck that creates trigger points, “sometimes if you press a muscle in your neck it causes pain down in the arm, same thing can happen in the pelvic floor muscles where they develop trigger points. Some women with endometriosis will have pain going down their legs”.
Though similar, this condition is not to be confused with sciatica.
“These muscles work for us every day duly. They help to keep us continent. It has a close relationship to the pelvic floor so women with endometriosis feel this urgency to go to the bathroom with this bladder pain, and a lot of times it is coming from these very tight pelvic floor muscles.”
The severe pre-menstrual and menstrual pain along with other agony and discomforts can affect the head.
“Definitely conditions like endometriosis can affect mental health,” said Vania Patrick-Drakes, a Registered Psychologist and Fitness Nutrition Specialist.
She explained that mental health touches a wide spectrum of experiences, but social pressure causes it to be suppressed.
“The term mental health is associated with a lot stigma, a lot of shame. It’s okay if I come and say I broke my leg yesterday, but if I come and say I have mental health issues people look at me a little bit differently,” she said.
But this holder of a Master of Science in Counselling Psychology explained that mental health deals with three main facets: emotional well-being, how you feel day to day; psychological well-being, how well are your thoughts and if you’re thinking clearly on a day-to-day basis; and the social well-being, the relationships that you have with other people. Are you able to get along with others, do you want to have healthy relationships with others?
“The status of your mental health can affect a lot of things, your choices and behaviour, and of course mental health can be affected by chronic conditions like endometriosis.”
Among the examples of the connection between the physical condition and mental health she cited painful intercourse.
“If I have endometriosis and the [sexual] intercourse is painful every single time that we attempt it how, how is that now going to affect my relationship with my husband?”
She also cited the matter of sufferers being constantly fatigued affecting work where there are obligations. She painted a workplace scenario where the employer becomes sceptical, colleagues gossip, are sour and complain that an endometriosis sufferer does not like work. These experiences, Patrick-Drakes explained, can lead to plummeting self-worth. Friends eventually stop inviting such persons out because the endometriosis sufferer is constantly in pain and turns down many invitations. In one of all of these situations, “your psychological health is affected,” she said. (GA)