Myths and Facts About Endometriosis

Endometriosis Awareness Month is a great time to learn more about this condition that affects many women. To separate fact from fiction, we asked our experts to counter some common myths about endometriosis and its symptoms.

Myth: It’s easy to diagnose endometriosis.

“The symptoms can mask other things. Two individuals could have the same symptoms but a different cause. That said, most people who we think have endometriosis don’t have to have surgery. We can assume what’s going on and treat for it. For others, surgery can help.” — Dr. Bojan Malmin, Adventist Health Women's Clinic OB/GYN

Myth: Heavy periods are normal.

“Heavy periods aren’t always abnormal or dangerous, but that doesn’t mean you just have to deal with them. There are a wide range of treatments — medication, diet, lifestyle changes — that can help with heavy or painful periods.” — Dr. Bojan Malmin, Adventist Health Women's Clinic OB/GYN

Myth: If I don’t have symptoms, I don’t have endometriosis.

“Endometriosis doesn’t always cause symptoms. Sometimes we find it during a laparoscopy for something else or during a tubal ligation.” — Dr. Bojan Malmin, Adventist Health Women's Clinic OB/GYN

Myth: If you have endometriosis, you can’t have children.

“Most women with endometriosis don’t have infertility. Endometriosis can impact fertility, but even without treatment many women with it are still fertile. Even if you struggle to conceive, we can help.” — Dr. Bojan Malmin, Adventist Health Women's Clinic OB/GYN

Myth: Surgery is the only option for improving urinary or bowel incontinence.

“Specialty rehab can help with incontinence by teaching patients how or where their incontinence is stemming from. Incontinence can be due to multiple factors and figuring out what is causing the incontinence will help us form a specific treatment plan for the patient. Things we can instruct patients about to help with their incontinence include: gentle exercises and stretching, like deep breathing and hip stretching/strengthening; strategies to form better bladder and urinary habits; strengthening their pelvic floor muscles with use of biofeedback, verbal and tactile cues; as well as gentle core strengthening to enhance pelvic floor control.” — Dr. Kara Burbach, Adventist Health Portland physical therapist

Myth: Medication is the only way to ease pain caused by endometriosis.

“Specialty rehab can help with endometriosis pain with treatment options such as gentle massage, myofascial release, gentle stretching, posture education and body mechanics education to ensure we are not placing excessive stress through their abdominal cavity. We also utilize risk reduction strategies, such as education on bladder irritants and postures, positions that place stress to the bladder or increase muscle tension/stress through the abdominals. By teaching patient proper posture in seated, standing, and when on the toilet, combined with gentle stretching and relaxation techniques, we can help reduce abdominal pain that can be caused from endometriosis.” — Dr. Kara Burbach, Adventist Health Portland physical therapist

Myth: Painful intercourse just has to be accepted by people with endometriosis.

“Specialty rehab can reduce pain with intercourse by finding what specific muscles of the pelvic floor are tight and not relaxing during intercourse. If pain with intercourse is due to a tonically tight muscle, by finding or figuring out which muscles are not able to relax we can instruct the patient on pelvic floor relaxation techniques, strategies, stretches and exercises and have them implement these prior to intercourse and into their daily routine to decrease pain. We can also instruct in various position changes/body mechanics that would take pressure off the painful, tight muscle as they are progressing with her pelvic floor program.” — Dr. Kara Burbach, Adventist Health Portland physical therapist

Myth: Painful periods are normal.

“Painful periods are not normal, contrary to what many women are told throughout their life. There can be chemical and structural causes, but almost always there is an explanation and a way to help, so please tell your doctor if your periods hurt and don't feel better with ibuprofen.” — Dr. Claire Steen, Adventist Health Women's Clinic OB/GYN

Myth: Endometriosis is just about heavy periods.

“Endometriosis is actually more of a pain syndrome, though sometimes women can have endometriosis found during surgery without any pain at all! Heavy periods are not a requirement for endometriosis. The most common symptoms of endometriosis are pelvic pain that tends to worsen with periods, painful intercourse and heavy periods. Endometriosis can also cause painful urination or urinary frequency not caused by infection, painful bowel movements, low back pain, generalized abdominal pain, nausea and vomiting, constipation or diarrhea, fatigue, problems with fertility, and ovarian cysts.” — Dr. Claire Steen, Adventist Health Women's Clinic OB/GYN

Myth: Menopause cures endometriosis.

“Endometriosis is thought to affect 2-4% of menopausal women, as opposed to approximately 10% of women in their reproductive years. While the cause and course of endometriosis is not completely understood, there seems to be a hormone-related component, which leads to improvement when estrogen levels are stabilized or lowered. This generally leads to improvement in menopausal women as estrogen levels naturally decline.” — Dr. Claire Steen, Adventist Health Women's Clinic OB/GYN

Myth: Hysterectomy is the only solution for endometriosis.

“There are several options for treatment of endometriosis that do not involve surgery. The first-line treatments are nonsteroidal anti-inflammatory medications (like ibuprofen) for pain control and combined hormonal birth control (pills, patches, vaginal rings) to help stabilize hormones. If those don't help, there are medications that temporarily "turn off" the ovaries to lower estrogen levels. Sometimes minimally invasive surgery is done to remove endometriosis from the abdomen and pelvis.

“Hysterectomy is reserved for women who have tried all other options and have not found relief. Removal of just the uterus does not cure endometriosis because most of the problem occurs outside of the uterus. Removal of the uterus and both ovaries is considered ‘definitive treatment,’ but this is generally not recommended in premenopausal women because removal of the ovaries prior to natural menopause leads to an increased risk of heart disease, stroke, neurologic problems like dementia and Parkinson's disease, depression, sexual dysfunction, osteoporosis, and death from all causes!” — Dr. Claire Steen, Adventist Health Women's Clinic OB/GYN

Myth: I just need to deal with the pain.

“The average time it takes to diagnose endometriosis is between seven and 12 years after onset of symptoms! This is because the symptoms can be vague and easily dismissed, and many women think they just have to deal with pain. You don't have to suffer. If you have pelvic pain or think you have endometriosis, see an OB/GYN doctor right away.” — Dr. Claire Steen, Adventist Health Women's Clinic OB/GYN

Getting help for endometriosis

If you or someone you love is struggling with heavy periods, pain and/or endometriosis, don’t let them suffer. Reach out to an OB/GYN and talk about options, including specialty rehab. To reach our experts, just call:

Adventist Health Women’s Health: 503-261-4423

Adventist Health Specialty Rehabilitation: 503-261-6922