What is frozen pelvis? This is its relationship with endometriosis and how it can be treated

• Sex Neither pain during intercourse is normal, nor do you have to put up with it

• Woman Everything you need to know about endometriosis

Now that Women's Day has passed, let's talk about women's day-to-day.

On March 8 they congratulate us but they don't give us facilities, which is what we really need.

And it's not that they have to lower our standards, but rather stop raising them.

Undoubtedly, it is an urgent matter for what we all know, but also for what we do not know and we must shed light to

.

On this occasion I want to make visible one more attack on our body, our physical and mental health, our sexuality and all those goals and desires that depend on it, such as our professional career, motherhood or even having an orgasm, but without pain, if possible.

Because

, if they are achieved, and painful penetrations or dyspareunia, even menstruation hurts.

None of these issues should hurt, and if they did, they would have to be investigated, but pain in women has been normalized so much, "it happened to your aunt too", and so many stereotypes associated with us have been perpetuated -"weaker sex" , "complainers"-;

that we end up

from our first period, with painkillers or hormones to, supposedly, regulate a cycle that what it really does is disappear, without solving the cause of the disorder, but making us believe that it has been regulated, for example.

WHY DOES IT HURT US?

Frozen pelvis is preventable, half the time it shouldn't happen, and when it does it's usually due to medical malpractice.Shutterstock

Yes, it's all very crazy and I know it sounds like a tongue twister, but not investigating why what happens to women is

and historical.

This happens with the frozen pelvis (

) or adhesion syndrome, which is usually related to infiltrative or deep endometriosis, an

.

It is important to note that not everyone with deep endometriosis will suffer adhesion syndrome or frozen pelvis, if treated appropriately.

And precisely in this last point is the problem.

Frozen pelvis is preventable

, "half the time it shouldn't happen, and when it does happen it's usually due to medical malpractice. Because the symptoms have been ignored for 10 years," says Irene Aterido, an expert sexologist in cycles menstrual and collaborator of Intimina, a company that offers the first range dedicated to taking care of all aspects of feminine intimate health.

It is true that "there is a greater diagnostic delay

in at least 700 diseases, with the sole exception of osteoporosis", they affirm from the Dr. Antoni Esteve Foundation, where the gender perspective monograph was published in 2019 in medicine, coordinated by María Teresa Ruiz Cantero, professor of preventive medicine and public health at the University of Alicante.

GENDER BIAS

This book addresses the experience of applying the gender perspective of a group of professionals from different specialties within the care and research fields.

model is used

where the way of getting sick is that of men, since its consequences are measured in delay and errors in diagnosis, gender bias in treatment, and in the increase in avoidable morbidity and mortality in women", affirms the professor.

This gender bias in health care occurs "when, given the same health need in men and women, a greater diagnostic or therapeutic effort is made in one sex compared to the other, which may contribute to health inequalities between men and women

"

This is because "women are more frequently labeled as having mental health problems

, but if we add alcoholism and suicide to depression and anxiety, the prevalence is similar in both sexes," explains María Teresa Ruiz Cantero.

And "if

it's because it really hurts", I add;

a myth associated with his gender, "because men endure pain better and don't cry", read with irony, obviously.

But you are not to blame, it is the system that we have built, unequal and sexist, that benefits you.

"The gender perspective provides information that helps to rethink why and how gender biases can lead to an erroneous concept of certain diseases, especially in women, and influence gender biases in the care process, both in the effort diagnosis (unequal access, delay, and waiting for timely health care from the onset of symptoms, diagnostic errors) as well as in the derived effort (types of therapeutic strategies, consumption and expenditure by sex, and overprescription of therapies)", concludes

.

ENDOMETRIOSIS

Two million Spanish women suffer from endometriosis, it affects one in ten women of reproductive age.

And right there is a frequent disease, although often misunderstood, endometriosis, which

, and more than 2 million women in Spain.

Women who suffer from it have cells similar to the tissue inside the uterus (endometrium), outside it;

usually in the pelvic organs and peritoneum.

Although the causes of endometriosis are still unknown and different hypotheses are handled, one of them is the migration of endometrial cells through the blood vessels or the lymphatic system.

"Attention to

of endometriosis, since one in five women who present this pain during intercourse has this disease," says the expert in the menstrual cycle.

However, this pain is usually diagnosed as vaginismus, a

that surround the vagina, which occurs against its will, being therefore a psychological cause that pain would produce.

So that the diagnoses are not delayed, an essential issue to avoid the evolution of the disease, first "the female symptoms should be depathologised," says the expert, and in the face of coital pain "rule out that there is no endometriosis, which is a physical disease , not mentally", concludes Terido.

INTENSE PAIN

Without diagnosis there is no treatment, crucial to prevent it from getting worse, even suffering from

, whose most common symptoms are intense pain;

If the nerves to any pelvic organs are compromised by adhesions, this pain can spread down the legs in a similar way to sciatica.

Pressure

(when crossing, putting the legs together, or sitting) can also cause pain.

Other symptoms can be constipation, pain during defecation and, sometimes, urgency to micturition, caused by constriction of the bladder and/or intestines due to the formation of adhesions in the organs.

(pieces of abnormal tissue between organs) have developed

, for example between the uterus, ovaries, bladder and intestines.

This causes them to

Endometriosis in its most advanced stage due to lack of treatment is usually the most frequent cause of frozen pelvis.

However, there are other possible causes: cancer, pelvic inflammatory disease (PID) usually caused by STIs, sexually transmitted infections;

radiotherapy of the pelvic organs or surgical interventions in the pelvis.

Treatment options depend on the severity of the symptoms.

Arantxa F. Peinado, a physiosexologist specialized in women, proposes a

based on pelvic floor physiotherapy, addressing in turn the sexological sphere.

Both at a preventive level, to avoid the evolution of endometriosis and avoiding complications such as a frozen pelvis, and as a complement to allopathic medicine, after surgery, for example.

Surgical intervention (gynecological surgery) may be necessary when the symptoms have a significant impact on daily life and have not been resolved with physical therapy.

The surgery consists of eliminating the one that restricts the movement of the organs and likewise requires a subsequent physiotherapeutic rehabilitation.

"The objective is

and seek the patient's quality of life," stresses the expert.

For this, "inflammation would have to be addressed, as well as improvement of abdominal and pelvic function, both visceral and urological, gynecological, coloproctological, and sexual," Peinado details.

"The tools we use, with the maxim of always being pain-free (since women already always live with pain) range from

: diathermy mainly, painless and very pleasant," says the expert.

And finally, the sexological approach, where self-knowledge tools and sexual education would have to be offered to

the woman's body and erotica, among many other issues, since it is likely that there are sexual dysfunctions secondary to the disease and affectation in couple relationships.

A

would also be adequate , due to the long journey suffered until the diagnosis, the pain or the surgeries, if any.

And to be able to alleviate the effects and consequences that all this generates in other aspects of a woman's life.

Due to issues such as the possibility of

or the efforts to be able to develop their working life adequately, they need to be listened to, relieved and acquire tools to face her life after this hard and long journey.

But there is hope because, "with the

, women will be able to control the symptoms, improving their future health and quality of life," says Irene Aterido, an Intimina collaborator.

*Ana Sierra is a psycho-sexologist www.anasierra.es

According to the criteria of The Trust Project

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