Endometriosis: How can we be of help?

What is endometriosis?

It’s an inflammatory condition in which tissue similar to endometrium (which lines the uterus each month in preparation for pregnancy and is shed in menstruation if no pregnancy occurs) migrates outside the uterus and grows into the pelvic bowl or even higher within the abdominal cavity and sometimes beyond, creating lesions, adhesions, and scar tissue. This exterior tissue responds to the monthly hormonal cycle: it thickens, breaks down, and bleeds with the period, which can cause or co-occur with a variety of symptoms: painful periods or pain all month, pain during sex, pain with bowel movements or urination, excessive bleeding, fertility challenges, fatigue, diarrhea, constipation, back pain, an off-center or tipped uterus, interstitial cystitis, IBS, and bloating. 

What causes it?

The cause is unknown. It’s complicated, and there are many possible factors. One is the traditional idea in yoga that a woman should avoid inverted postures (headstand, shoulder stand, etc.) during her period, the reason being that we don’t want to contradict the downward flow during that time; we don’t want endometrial tissue to backflow into the fallopian tubes. For this reason, traditional healers also warn against having penetrative sex while menstruating. Another factor is our environment: we are all exposed to estrogen-mimicking chemicals in modern life, and these and other kinds of pollution very likely contribute. An inflammatory diet of processed foods can make it worse. Genetics may be a factor, and as usual, the question is, what turns the potential in the genes on or off? That may depend on a person’s immune system. Sometimes the condition is only discovered for some other medical reason, but there haven’t been any symptoms. In such cases, the extra-uterine endometrial tissue does not bleed with the monthly cycle or cause pain, and this may be due to a strong immune system at work. What makes the immune system function well in some people and go offline for others? It has to do with the autonomic (unconscious) nervous system; for more on that, see the section on coaching, below.

How is it treated medically?

Medical interventions include hormonal medications or surgery. Hormonal medications may or may not help with symptoms, and they disrupt the system in a way that’s not curative but is in itself another cause of imbalance. Surgery can be helpful, especially if the surgeon is skilled at excision and is able to leave the uterus and ovaries intact. Whether or not you’re considering surgery, we recommend seeing us first to start healing your system now. If you do decide on surgery, you’ll want to see us once you’ve recovered, to prevent recurrence going forward.

How do we approach the condition at KNÓSIS?

Because it’s so complex, we think it’s wise to take a multi-pronged approach. We offer three services that treat endometriosis from different vantage points, all of which complement and optimize each other: Pelvic Floor Physical Therapy, Abdominal Therapy, and Mind/Body Wellness Coaching.

Pelvic Floor Physical Therapy with Rebecca Gordon

Pelvic Floor Physical Therapy is an essential part of managing endometriosis, addressing pain and functional issues related to the pelvis and surrounding structures. Rebecca Gordon DPT uses a combination of manual techniques, therapeutic exercise, breathwork, and patient education to ease muscle tension, improve lumbopelvic alignment, and optimize movement mechanics, helping to promote optimal pelvic floor function. In addition to pelvic pain, pelvic floor PT can also address urinary and bowel symptoms often associated with endometriosis, such as urgency, frequency, constipation, and rectal pain. For those recovering from surgery to remove endometrial lesions, pelvic floor therapy supports scar tissue mobilization, reduces adhesions, and aids in a safe return to exercise. Through personalized treatment, which integrates hands-on care, strengthening routines, and breathing techniques, pelvic floor therapy provides lasting relief and helps patients regain control, confidence, and improved pelvic health.

Abdominal Therapy with Megan Renee Backus, LMT

Also known as Arvigo Maya Abdominal Massage or womb/uterine massage. Megan, a licensed massage therapist at Knosis, has done advanced training in this healing system of bodywork and adjacent care founded by her teacher Dr. Rosita Arvigo. This work is equally helpful for digestive or reproductive conditions for anyone, and is based on Rosita’s training in bodywork and herbs combined with the wealth of knowledge she gained from working many years alongside a traditional Maya healer in Belize, Don Elijio Panti. The Maya people have practiced abdominal manipulation for health since time immemorial and continue to do so today. The basic premise is that abdominal and pelvic congestion is the leading cause of much of what ails us, and gentle, skilled manual work relieves this stagnation and promotes optimal circulation in five systems of flow: venous and arterial blood, nerve impulses, energy, and lymph, leading to a more efficient fluid exchange and better health overall. The work is relaxing and soothing, and can be done with a very light touch, according to the patient’s comfort.

How does Abdominal Therapy help with endometriosis?

We want to calm an overactive nervous system, relieve inflammation, increase healthy circulation throughout the abdominal cavity top to bottom, release adhesions, center the uterus in the pelvis, add warmth, and dispel cold. Seeing Megan for Abdominal Therapy on a regular basis will help with all of the above (once a week or twice a month to start; after improvement begins, once a month until symptoms are completely resolved), and in addition, performing specific self-care at home has been shown to reduce pain and symptoms considerably. In one of the office visits, Megan will teach the patient a simple, quick routine of abdominal self-massage and she recommends they do this often to continue the decongesting process. Megan will also teach patients how to do castor oil packs and vaginal steaming at home, which are highly recommended as a valuable adjunct to the massage. An Abdominal Therapy colleague of Megan’s who is a naturopath says that daily steaming is the only thing that makes her life with endometriosis bearable, and without it she was in continual pain.

Mind/Body Wellness Coaching with Megan Renee Backus

Megan completed Dr. Gabor Maté’s yearlong program in therapeutic coaching, Compassionate Inquiry, and is a trained practitioner of Internal Family Systems as well as a Certified Trauma Care Practitioner. She is deeply immersed and experienced in working with the connection between mind and body when it comes to physical dysfunction. Here’s why that matters: when we have unresolved trauma, usually from childhood, our autonomic nervous system might (unconsciously) believe we are still in danger and so it remains in continual sympathetic activation. The sympathetic nervous system is designed for immediate action only: it prepares us for “fight, flight, or freeze,” and suppresses the parasympathetic “rest and digest,” which includes the immune system. We are meant to be in the latter almost all of the time. Those stuck in sympathetic may feel on edge a lot, ready to fight, run, or shut down, and may have trouble with digestion and sleep as well as with other systems, such as reproductive. A recent study shows a high number of endometriosis sufferers have a history of sexual abuse in childhood or adolescence. In talk sessions with Megan, we gently get in touch with the parts of us stuck in a fearful past and get to know them, befriend them, and eventually help them to come into the present day where they see the old danger is past, and that it’s safe to allow the immune system to function properly again.

Endometriosis is not a quick fix, but help is possible

At KNÓSIS we believe in treating disease by supporting health, and our program for endometriosis is gentle, nurturing, harmless, and effective. We want to partner with you to grow a future without pain or dysfunction, the future that is your birthright. With consistent care over time, we can expect substantial and ongoing improvement in symptoms, fertility, and overall wellbeing. The sooner you start, the sooner you will understand that you can have a handle on this debilitating condition. It’s not a life sentence.