Ava's Story*
Step 1
Ava discovered what mattered
Ava (she/her) is a 16 year old student whose mum, Emma had always worried that she might inherit her endometriosis. Emma’s worst fears were confirmed when Ava had pain from her first period at age 11. Ava regularly missed a week of school every month, and the once happy-go-lucky child became increasingly sedentary and socially isolated. After discussing this with their GP, Ava was referred to a gynaecologist who prescribed the pill to suppress her periods. This helped for a while, however Ava began experiencing pelvic pain again, especially when playing sport, trying to use a tampon, or when stressed with schoolwork and friendship challenges. Ava didn't understand why this was happening and thought she needed surgery to find out. Working together, we discovered Ava was holding tension in her abdominal and pelvic floor muscles and that there was a link between her stress and pain experience. This led to Ava withdrawing from the school netball team due to fear of making her pain worse.
Ava's Pelvic Health Goals:
- Understand why I am having period pain again even though I am on the pill. Do I have endo like mum? Or is there something else going on?
- Work out what might be making my pain worse and is it okay to play netball or not.
- I’d like to be able to use a tampon so that I can go to the beach over summer.
- To be able to go to parties with my friends and not cancel at the last minute due to pain.
- To not miss so many days of school because I get behind and then get stressed that I won’t do well in my exams.
Step 2
Ava restored what mattered
Ava and Emma were surprised to learn that period and pelvic pain isn’t always caused by endometriosis. Emma had never received any of this information and wished her care had been different. Ava decided to return to swimming which she’d enjoyed when younger, discovering it was very useful in reducing her stress and her pain. Ava’s treatment was planned alongside discussions with her gynaecologist and her parents regarding the most appropriate timing for Ava to have her first laparoscopy.
Step 3
Ava enjoyed what mattered
Over 12 months, Ava reduced muscle tension and increased her activity level, through an understanding of her nervous system and mind-body connection. She returned to netball, attended most of the 16th birthday parties and was keeping up with schoolwork. Ava and Emma were more comfortable with the plan of not having a laparoscopy until Ava was a bit older. Ava felt confident to self-manage with her new knowledge and skills and planned to return only if she experienced a pain flare that she was unable to manage or prior to her first laparoscopy.