One complication of endometriosis is its impact on the bladder, which can result in a condition known as interstitial cystitis. Interstitial cystitis (IC) is a chronic bladder condition characterized by bladder pain, urgency, and frequency. The exact cause of IC is unknown, but it is thought to result from a combination of bladder inflammation, nerve dysfunction, and pelvic floor muscle dysfunction (Nickel, 2012). IC is often misdiagnosed as a urinary tract infection or other bladder condition, which can delay proper treatment.
Endometriosis can cause bladder dysfunction through several mechanisms. The most common is direct infiltration of endometrial tissue into the bladder wall, which can result in inflammation, scarring, and adhesions. These changes can cause bladder irritability and pain, frequent urination, and painful urination (Howard et al., 2019) and even symptoms consistent with those of a UTI. Endometriosis also impacts the pelvic floor muscles which can directly contribute to the bladder symptomsmentioned above (Brawn et al., 2011). One study even found that women with endometriosis were nearly three times more likely to develop IC than women without endometriosis (Chung et al., 2017).
This bladder irritation rarely exists alone and many individuals with endometriosis, who also report bladder issues might also complain of chronic pelvic pain, bowel issues and even pain with intercourse. From a psychosocial perspective, those persons with endometriosis experiencing bladder issues and/ or IC also have to deal with quality of life concerns such as poor sleep hygiene, difficulty working (increased time off from school and/ or work), and difficulty engaging in social activities. Add to that those who may be experiencing sexual and even bowel dysfunction and now we have an individual who has difficulty maintaining a healthy sexual relationship, in addition to persistent fatigue, depression, and anxiety.
So given all this information, what can we do, or rather how does pelvic floor physical therapy help?
Pelvic floor physical therapy is a specialized form of physical therapy that focuses EVERYTHING “between the belly button and the knees”- all the muscles, connective tissues, nerves, joint structures and organs. Pelvic floor physical therapists even take into consideration areas of the body outside of the pelvis that might be having an impact indirectly on pelvic floor structure and function, such as the feet, TMJ issues and so on. Therapists use a number of techniques to directly and indirectly impact the pelvic floor muscles, neurological structures, including central nervous system desensitization, movement practices and more. They work on improving awareness of the pelvic floor to promote relaxation and when necessary improve endurance and strengthening all with the purpose of correcting dysfunction of the bladder (and all pelvic organs), improving pelvic pain, improving sexual satisfaction and improving overall quality of life (Eschenbach et al., 2018).
If you or someone you know is dealing with endometriosis, or any bowel, bladder or sexual health concerns, please see a pelvic floor physical therapist. Pelvic floor physical therapists can also assist in directing you to the necessary specialists for any other concerns that may arise. You owe it to yourself to be able to live your best life! Find a pelvic floor PT near you or reach out to us at JMM Health Solutions. We offer in-person (home or office) and virtual sessions for our patients’ convenience. Call us at 770-790-1460 to schedule or visit our website at www.jmmhealthsolutions.comBe well,
Dr. J
JMM Health Solutions Blog 