Debunking Endometriosis Myths: The Role of Integrative Pelvic Therapy
There are many myths that need debunking about endometriosis. There’s too much medical gaslighting, and even more fear mongering around endometriosis – and it has to stop. Medical gaslighting around endo and fear mongering serves no one, and further, it delays early critical care and full recovery from surgery for endometriosis. Not to mention what the negativity and misinformation does to people’s mental health. Watch my journey to an endometriosis diagnosis
I recently had an experience of my own with misinformers. Now I would usually ignore uninformed people, but I really could not, in good conscience, let this one slide…
Take this recent IG post of my own personal journey with recovery from endometriosis excision surgery, where there is no shortage of armchair experts on endo who can’t wait to contribute to din of misinformation easily found online, especially on social media.
Keep in mind that I share my story of healing and recovery OUT LOUD to give voice to all who still suffer in silence with endometriosis.
Dr. Ginger Garner
Debunking the Myth that you Can’t Run Until Your Impairments are Fully Resolved
Here’s my original YouTube short on my recovery from endometriosis at 12 weeks:
Endo warrior at 12 weeks post-op does NOT mean you fear running with a DRA (Diastasis Recti Abdominus) or POP (Pelvic Organ Prolapse).
And here’s the very first comment left on my YouTube short:
First I want to say that this response must mean I’m doing something right. I mean, it’s requisite to start debunking the myth that every single pelvic symptom you have should be GONE before taking a run. WRONG.
Second, I will give the person a little credit. You should listen to your body and your doctor, but the funny thing is, that is EXACTLY what I was doing in this short. It just so happens I am the doctor prescribing my therapy.
Third, Brittany neglected to do due diligence though, and learn that I AM a doctor AND I SPECIALIZE in endometriosis AND I am celebrating a massive milestone in my rehab and recovery after endometriosis excision with a FIRST RUN.
Here’s my response to Brittany’s uninformed post:
So – haters will hate, even when you do have a doctorate, specialize in endometriosis, and are recovering from endometriosis (and killing it as best as you can). The irony is astounding. Does this person’s self-appointed expert status to bash (an actual expert) actually think her advice is reassuring to someone?
Moving on from how much people hate when you try to celebrate a recovery (any recovery) – this post is going to address just a few of the myths, and the first stop to ending the medical gaslighting around endometriosis is to address the science and what can be done.
The role of not just pelvic physical therapy, but integrative pelvic physical therapy is a key part of comprehensive endometriosis care. First, let’s define endometriosis, because the definition is the first myth we need to bust.
What is Endometriosis?
Endometriosis is the presence of endometrial-like tissue found in other areas of the body. Notice I did not see it was endometrium, which is typically found in the lining of the uterus, and that is according to the latest evidence presented at The Endometriosis Summit 2023. Many incorrect definitions of endometriosis exist on the internet.
Though World Health Organization (WHO) has a relatively accurate definition of endometriosis, it mistakenly writes that the “endometriosis can start at a person’s first menstrual period and last until menopause.” This is categorically not true.
Endometriosis does not end with menopause. I am a testament to that. I had excision surgery in 2023, years after going through menopause. Look here, for more additional reading.
The WHO also says, “With endometriosis…(it) leads to inflammation and scar tissue forming in the pelvic region and (rarely) elsewhere in the body.” This is also grossly misinformed. While scar tissue can occur and inflammation has been identified as a driver, endometriosis lesions outside the pelvic region (many people associate the pelvic region with reproductive organs like the ovaries, uterus, and fallopian tubes) are not uncommon and can be found in the lymph nodes, the bladder and urinary tract, bowel, abdominal wall, thoracic cavity, and even the diaphragm, lungs, and pericardium.
Also note that endometriosis is also not endometritis, which Whoopi Goldberg incorrectly discussed on an episode of The View,. Endometritis is an inflammation of the endometrium, which can be treated with antibiotics. Attorney and executive producer and filmmaker Shannon Cohn, who we recently interviewed on our very own Living Well Podcast, appeared with Hillary Clinton Listen on Apple Podcast now.
Below the Belt: Addressing Medical Gaslighting in Endometriosis Care – An Interview with Below the Belt’s Shannon Cohn Medical gaslighting and gender bias in the healthcare system is a pervasive issue that affects the lives of many individuals, particularly women. This bias is rooted in societal constructs that undermine women’s credibility and agency when it comes to their own bodies and health. Watch my interview with Shannon below…
Debunking Myths around What Causes Endometriosis
Hint: It’s not “Retrograde Menstruation”
While many other major organizations also got the facts about endometriosis wrong when I was doing a mass media literature review, WHO gets it wrong one more time when they blame endometriosis on “retrograde menstruation,” a myth now debunked:
Says the Center for Endometriosis in Atlanta, GA:
‘While Sampson’s work was essential in advancing endometriosis research, some experts today worry that it doesn’t hold up to more modern and robust research. “Retrograde flow is common, occurring in most people who menstruate, so this theory wouldn’t explain why just 1 in 10 menstruators would develop endometriosis,” says Ken Sinervo, MD, the Medical Director of the Center for Endometriosis Care. The theory of retrograde menstruation is further challenged by research showing critical histological differences between the type of tissue found in the endometrium and that found in endometriosis lesions. Because endometriosis has been found in organs far from the pelvis and even in neonates and cisgender men, retrograde flow cannot explain all cases of the disease.”
Why Can’t Women Get Diagnosed with Endometriosis? by Aria Vyas for Neo.Life, Mar 31, 2022
Hint: It is (likely) genetics
The largest study to date on endometriosis included DNA from 60,600 women with endometriosis and 701,900 controls (without endometriosis). Researchers from 25 research institutions in 11 countries collaborated with researchers at the University of Oxford, provided compelling evidence of a “shared genetic basis for endometriosis and other causes of pain (seemingly unrelated to endometriosis), including migraine, back pain, and multi-site pain.”
Two other studies looked at the same, citing similar conclusions about increased familial tendency toward endometriosis. Read those here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911462/ and one from 2023 here: https://pubmed.ncbi.nlm.nih.gov/37474323/
Hint: Another myth to bust is that endometriosis is only found in women. False. Endometriosis has also been found in men.
There are so many more myths to bust, but it’s also important to discuss what can actually be done (and not just complain about what’s wrong).
Learn LOTS MORE about the gold standard treatment of endometriosis – which is excision NOT ablation – at this recent podcast I did with Dr. Sally Sarrell –
Better Endometriosis Care: From Gaslighting to Validation with Dr. Sallie Sarrel
What is the Role of (Integrative) Pelvic Physical Therapy (or OT) in Managing Endometriosis?
At Garner Pelvic Health we use Functional, Integrative, and Lifestyle Medicine, combined with specialized training in pelvic, orthopedic, and manual therapy, to help people with endometriosis. Treatment often includes yoga, using the approach I wrote about in my first textbook, Medical Therapeutic Yoga. The second approach, Lifestyle Medicine for chronic pain, can be found in my second textbook, Integrative & Lifestyle Medicine in Physical Therapy, which I co-edited with my colleague, Dr. Joe Tatta, PT, DPT. Our third major pillar at GPH is to use Functional Medicine, which searches for root cause instead of treating symptoms only.
What does integrative endometriosis treatment look like?
It starts with educating people living with endometriosis so they can debunk myths that well meaning family, friends, and even other healthcare providers, may try to push on them. It’s important to realize how much can be done to help with endometriosis management after excision surgery.
- Initial Evaluation – Your intake and first visit will begin with a complete overview of your medical history, including a lifestyle medicine assessment and physical exam.
- Functional Medicine – We consider labwork an essential part of the pelvic health experience at GPH. Any labs that may be needed in order to address gut and pelvic health, as well as musculoskeletal health, we work in concert with our physician team to make sure that inflammatory biomarkers, hormone health, and oral, gut, and/or vaginal microbiome health indicators are considered to your pelvic health treatment.
- Lifestyle Assessment – We will discuss sleep health, identify, and eliminate environmental pollutants which can increase spread or exacerbate endometriosis, review dietary habits and if necessary, identify nutritional triggers can cause an inflammatory response (which can worsen endometriosis symptoms) in the bloodstream and body, stress management (which can also increase inflammation) and response, relationship and mental health, and of course, physical activity.
- Pelvic Health Assessment – This can include both external and internal assessment not only of the pelvic girdle, but also related joints that are often included in the endometriosis sequelae, this includes tailbone pain, jaw pain, neck and facial pain, back and sacroiliac joint pain, sacral or saddle nerve pain, and/or hip pain.
- Lumbopelvic Rehab Ultrasound Imaging (RUSI) – RUSI is an advanced service, along with our integrative services, that are offered at few clinics in the United States and globally. Our therapists are trained to use RUSI to advance progress and correctly identify dysfunction in the pelvic floor, diaphragm, orofacial area, abdominal wall, and lumbosacral area. RUSI eliminates the guesswork that can happen when you do not have real time imaging, which can often result in a costly delay in your pelvic health progress.
- Other Advanced Services – Visceral mobilization, voice to pelvic floor therapy, pelvic and orofacial dry needling, and manual therapy are some of the other advanced services, in addition to RUSI, that we use at Garner Pelvic Health.
