A Pain You Can't Ignore: Endometriosis
Diagnosing and Treating Endometriosis
A diagnostic laparoscopy -- which is what I had -- is currently the only way to confirm that a woman has endometriosis and begin to treat it. During the procedure, if endometriosis is found, surgeons remove as many lesions as possible. Even so, up to 60 percent of women can experience a recurrence within the first year, according to the Endometriosis Research Center. Another, more involved procedure is called advanced laparoscopic excision, where the surgeon attempts to remove the "roots" of the endometrial growth. Although the procedure has a higher success rate, it is not widely available.
Twelve years ago Mary Frances Mango, 35, a nurse in Smithtown, New York, was diagnosed with endometriosis. She underwent three laparoscopies plus several hormone treatments, but the endometriosis kept returning. "I had severe cramps, bladder pain, and painful intercourse that caused me to bleed," she says. "The surgeries provided temporary relief, but the pain would quickly come back." In March 2009 a friend suggested that she see Tamer Seckin, MD, an endometriosis specialist in New York City who uses advanced laparoscopic excision to treat the disease. After the surgery, he put her on a mild birth control pill to moderate estrogen levels and lower the chance of future growth. So far, she's pain-free.
Because of the likelihood of recurrence, many women look for additional methods to ease their pain. The good news is that regular exercise and reducing your BMI naturally lower the body's estrogen levels, which helps alleviate some of the worst symptoms and in some cases may even prevent the disease in the first place. "Women who are very fit may find protection from endometriosis," Dr. Lessey says. In a groundbreaking study of women ages 18 to 39, the Fred Hutchinson Cancer Research Center in Seattle found that high-intensity workouts, such as running, biking, and playing tennis, three or more times a week slashed endometriosis risk by 76 percent. Women who exercised more than seven hours a week, especially if they started before age 26, decreased their risk of developing endometriosis by 80 percent. "In your teens and early 20s, regular menstrual patterns are forming. This is a critical window during which physical activity may help moderate estrogen production," says Stacey Missmer, a top endometriosis researcher and assistant professor of obstetrics and gynecology at Harvard Medical School.
If you already have endometriosis, medium- to high-intensity exercise, such as running and cycling, may help lessen the symptoms. Research shows that regular physical activity helps reduce estrogen levels and moderates the production of prostaglandin hormones, the body's pain receptors, which are released during your cycle. Yoga and Pilates moves also gently stretch the pelvic tissues and muscles that can be literally bound together by endometriosis, says Beth Heller, owner of Pulling Down the Moon holistic fertility centers in Chicago, who provides integrative care for endometriosis patients, including acupuncture, exercise, and diet. "Working out is imperative to treating the symptoms," Heller says, noting that yoga also helps reduce stress, which can aggravate inflammation in the body.
And then there's the feel-good effect that comes from a satisfying workout. "The immediate relief is from endorphins and serotonin, but the sustained effect is the estrogen dip," says Thom Lobe, MD, founder of Beneveda Medical Group in Beverly Hills, which specializes in pain management.
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