IWK to open first multidisciplinary endometriosis and chronic pelvic pain clinic in the Atlantic Provinces

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IWK Health is set to open the first dedicated multidisciplinary endometriosis and chronic pelvic pain (CPP) clinic in the Atlantic Provinces. The clinic will include a gynecologist, anesthesiologist, nurse practitioner, and physiotherapist, and hopes to add a counsellor as well as several other health professionals with specialized training in endometriosis and CPP to meet the needs of this underserved patient population.

Endometriosis is a medical condition in which cells similar to the lining of the uterus grow outside the uterus, most commonly on the ovaries, fallopian tubes, and surrounding tissues. The most common symptoms of endometriosis are pelvic pain and infertility, and the condition is the most common gynecological cause of CPP (pelvic pain that lasts greater than three to six months and is not entirely related to menstruation, sexual activity, or bowel movements).

From left to right: Bethany Lezama, physiotherapist, Dr. Elizabeth Randle, gynaecologist, Dr. Allana Munro, anesthesiologist, Leah Pink, Nurse Practitioner. Photo by Ryan Wilson, IWK.

“By developing a multidisciplinary clinic, we hope to provide high-quality, streamlined care for patients who suffer from chronic pelvic pain as a result of endometriosis,” says Dr. Elizabeth Randle. “The development of this clinic is in keeping with national recommendations for providing high-quality endometriosis care. The preliminary research we have completed has demonstrated a need for this kind of care in the HRM, and likely all of Nova Scotia, and will facilitate access to resources for patients who are currently receiving fragmented care from multiple providers and locations across the province.”

Endometriosis and CPP is associated with significant health care costs due to physician and emergency department visits, medications, surgeries, and hospital admissions. It has been estimated that CPP is responsible for $1.8 billion in total annual costs in Canada, not to mention the personal costs to those suffering.

Left to right: Dr. Baharak Amir, Chief of Gynaecology and Tracy Dryden, Manager, Women’s Ambulatory, Perioperative and Breast Health Services

“Approximately 15 per cent of women of reproductive age in Canada suffer from CPP and this can have a tremendous impact on quality of life,” says Leah Pink, Nurse Practitioner in the Women’s Ambulatory program at IWK Health. “Here in the Atlantic region barriers to care can include lengthy wait times and geographical distance. COVID-19 has only exacerbated these issues. Drawing on the expertise of multiple healthcare professionals and by using innovative strategies to provide care we will better meet the needs of this underserviced patient population.”

The chronic and continuous nature of CPP deteriorates quality of life, and women often seek medical treatment or surgical procedures. While endometriosis may be present in women who have CPP, the reason a chronic pain syndrome develops is often multifactorial. CPP can include physiologic and musculoskeletal changes, depression, sleep disturbance, and sexual dysfunction, which can complicate treatment. Without intervention, a phenomenon called central sensitization can occur, which can result in increased sensitivity to pain and the development of overlapping chronic pain syndromes.

March is endometriosis awareness month.