"Endometriosis occurs when tissue like that which lines the inside of the uterus grows outside of the uterus, usually on the surfaces of organs in the pelvic and abdominal areas, in places that it is not supposed to grow.

The word endometriosis comes from the word "endometrium" -- endo means "inside" and metrium (pronounced mee-tree-um) means "mother. The tissue that lines the inside of the uterus (where a mother carries her baby) is called the endometrium.

Most endometriosis is found in the pelvic cavity: on or under the ovaries, behind the uterus, on the tissues that hold the uterus in place, on the bowel or bladder. In extremely rare cases, endometriosis areas can grow in the lungs or other parts of the body."

These areas of misplaced uterine-like tissue grow and shed the way the uterine lining does during a woman's monthly cycle. Unlike normal endometrial tissue these areas are bleeding into the pelvic cavity causing pain and scarring. The most common symptom is pain in the abdomen, low back and pelvic area. Menstrual cramps can be extremely painful. But there can be pain at other times of the month too such as with ovulation. Some women have painful bowel movements and/or urination and GI symptoms that resemble a bowel disorder.

The cause is unknown but there a number of theories. An early theory is called "retrograde menstrual flow" that hypothesizes that some of the tissue shed during a woman's menstrual period flows back up through the fallopian tubes and out into the pelvic cavity and implants itself and starts growing on the outside of organs in the pelvis. Apparently most menstruating women do get some retrograde menstrual flow but they do not all get endometriosis so this does not seem a likely explanation. (This theory is one of the reasons we tell women having their menses not to do inversions.)

Other theories included heredity, genetic error, endocrine disorder involving estrogen production, immune disorder, or environmental causes.

For a woman suffering with this disorder who comes to a yoga class alot will depend on the severity of her condition. If she is experiencing a high level of discomfort, I would start with very gentle poses on the floor or in a chair and emphasize relaxation and breathing techniques. Abdominal breathing and supine pelvic tilts are a safe beginning. Restorative poses could be a next step. Supported balasana is a good relaxation pose. Supported supine bound angle pose or legs up the wall with variations like butterfly could help open and relax the pelvis. Restorative supported setu bhandhasana and a gentle jathara parivartanasana with cushions or blanket supports or ardha matsyendrasana in a chair would give her a trial to see if gentle back bends or twists help relieve back discomfort. Some women find forward bends like paschimotanasana or janushirasana that give some pelvic compression are helpful for cramps but of course you have to think about any other contraindications like spinal conditions. Sitting on a cushion and resting the arms and head on the seat of a chair might be restful in these seated forward bends. If you start slowly and gently you can let her level of comfort be the guide. Yoga will help her pain by increasing her self awareness, ability to relax and by calming the mind, even if all she can do physically is savasana and breathing techniques.

Hope this helps. Wishing you all the best.

From Lisa Powers

Endometriosis: a situation of normal endometrial cells being in an abnormal location. They still act like they’re supposed to act, except they’re in the wrong place to go through their normal healthy processes. Now these cells are adhering to the peritoneal cavity, intestines, bladder, the outside walls of the reproductive organs, and anywhere else that they have decided to stick. When the hormonal message arrives to begin their monthly process they build up tissue and then slough if off, causing internal bleeding. We discourage inversions during menses because of the theoretical risk of transtubal migration of the menstrual flow. According to the web-site mentioned below, all or most women have this occur during their lifetime anyway. But due to hormonal imbalance or a deficient immune system, the cells remain in the wrong place creating trouble. So right away you can see that you’re dealing with more than “tight hips.” You’re dealing with the cellular level. You will need to go beyond stretching and strengthening. You need to impart what Yoga is to help this student.

Because Yoga practices boost the immune system and normalize hormonal function, all practices should be beneficial. As far as asanas go, Balasana is a classic pain relieving position for menstrual pain, which is a typical symptom. Asanas that focalize and move energy in the effected areas would be obvious. Paschimotanasana, Janushirasana, Salabhasana, Bhujangasana, Dhanurasana, spinal twists, etc.

>From everything I understand about endometriosis, including having it myself, one can look at the energetic healing properties of Yoga practice to search for the benefits toward minimizing symptoms and healing the condition – if the karma allows it :-). If someone does have endometriosis don’t promise cures, tell them why energizing, meditating, or doing asanas MAY help them. It will certainly help them to cope with symptoms and infertility by helping them to experience a greater sense of who they are and what life is about. This makes it a long term process and requires commitment.

One thing to beware of: There was a student in YTT once who said, “None of my female students have gotten endometriosis from doing inversions (during menses.”) Well, the only way to find out is to look around in the abdominal cavity. No one knows they have it until they begin to have symptoms.

By the way – this was an easily understandable site about endometriosis: http://www.ivf.com/endoassn.html