Pelvic Floor PT for Endometriosis: Managing Pain and Dysfunction

Endometriosis is a complex and often misunderstood condition. Characterized by the presence of endometrial-like tissue outside the uterus, endometriosis can lead to a wide range of symptoms—chronic pelvic pain, painful periods, pain with intercourse, gastrointestinal dysfunction, urinary urgency or frequency, and fatigue. While medical management and surgery are commonly used treatments, pelvic floor therapy for endometriosis has emerged as a powerful, non-invasive tool to help manage the pain and dysfunction that comes with this condition.

Understanding Endometriosis Pelvic Floor Therapy and Dysfunction

The pelvic floor is a group of muscles, ligaments, and connective tissue that supports the bladder, bowel, and reproductive organs. When you have endometriosis, the chronic inflammation and pain can lead to increased muscle tension and guarding in these muscles. Over time, this tension can become habitual, leading to what’s known as pelvic floor dysfunction—when the muscles are too tight, uncoordinated, or painful.

Many patients with endometriosis unknowingly develop hypertonic pelvic floor muscles, meaning the muscles are overactive and unable to relax. This can contribute to many of the common symptoms of endometriosis, such as:

• Pain with penetration

• Pelvic pain that persists even between periods

• Painful bowel movements or constipation

• Urinary frequency, urgency, or incomplete emptying

Pelvic floor physical therapy can help address these secondary dysfunctions, even if the endometriosis itself isn’t “curable.”

What Does Pelvic Floor Therapy Endometriosis Treatment Involve?

Every treatment plan should be individualized, but endometriosis pelvic floor therapy typically includes a combination of the following approaches:

1. Manual Therapy

   Your pelvic floor physical therapist may perform internal and external manual techniques to release muscle tightness in the pelvic floor, abdominal wall, and surrounding structures. This helps reduce guarding, improve circulation in the musculoskeletal system, and decrease nerve irritation.

2. Breathwork and Relaxation Techniques

   Chronic pain and discomfort sensitizes the nervous system. Pelvic floor rehabilitation often incorporates diaphragmatic breathing, down-training exercises, and other relaxation techniques to calm the body’s fight-or-flight response, allowing the muscles to relax and the brain to process pain signals more accurately.

3. Building Healthy Habits

   Lifestyle changes can play a significant role in managing endometriosis symptoms. Staying hydrated helps reduce inflammation and supports organ function, while a diet rich in whole foods can stabilize hormones and alleviate pain flare-ups. Regular movement promotes circulation, reduces stiffness, and helps regulate stress—all of which benefit your pelvic health and overall well-being.

4. Bowel and Bladder Retraining

   If you’re dealing with constipation, painful bowel movements, or urinary urgency, your therapist may help you identify and change habits, improve positioning, and retrain the pelvic floor muscles to function more efficiently.

5. Education and Empowerment

   Understanding your body is key. A skilled therapist will educate you on how pain develops, why your muscles may be reacting the way they are, and how you can regain control. You’ll learn strategies to reduce symptom flares, manage daily activity, and improve your overall quality of life.

What to Expect from Pelvic Floor Rehabilitation

It’s important to note that pelvic floor therapy for endometriosis is not a quick fix. Because endometriosis is a systemic and often progressive condition, managing symptoms takes time and a multi-faceted approach. However, many patients report significant improvements in their pain levels, ability to participate in daily activities, and overall pelvic function after working with a skilled pelvic floor physical therapist.

Some individuals may also benefit from coordination with other providers—such as a gynecologist, pain specialist, nutritionist, or mental health professional—as part of a comprehensive treatment option.

Is Endometriosis Pelvic Floor Therapy Right for You?

If you’ve been diagnosed with endometriosis—or suspect you might have it—and experience any of the following, pelvic floor therapy endometriosis care may be a helpful addition to your plan:

• Pain with intercourse

• Pelvic pain that continues between periods

• Painful bowel or bladder habits

• A history of abdominal or pelvic surgery

• Difficulty relaxing or connecting with your pelvic muscles

Living with endometriosis doesn’t mean you have to live with chronic pain. Pelvic floor therapy for endometriosis offers a safe, effective path toward healing and empowerment. If this sounds like something you’d benefit from, reach out to schedule an evaluation at The Health Lab. We’re here to help you reclaim comfort, confidence, and control.