Treating Endometriosis with Pelvic Floor Physiotherapy

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What is Endometriosis?

Endometriosis is a complex condition in which tissue similar to the lining of the uterus grows outside the uterus resulting in pain. Living with Endometriosis can be life altering – physically, emotionally and mentally. Symptoms that are associated with endometriosis varies between people but often include (but are not limited to):

  • Painful periods

  • Chronic pelvic pain

  • Painful intercourse

  • Fatigue

  • Pain during voiding (bladder and bowel)

  • Depression and/or anxiety

  • Abdominal bloating or “endo belly”

  • Nausea

Currently, there is no cure for endometriosis – however, treating endometriosis with pelvic floor physiotherapy can be hugely beneficial to those living with this condition.

Improve pelvic floor function with physiotherapy

Endometriosis can alter the mobility of internal organs, fascia (connective tissue) and muscles due to the adhesions, lesions and scar tissue that endometriosis causes. This change in function can result in dysfunction of the pelvic floor muscles and surrounding tissues. Pelvic floor physiotherapy can treat this dysfunction by helping to normalize how the pelvic floor contracts and relaxes.

Physiotherapy can help reduce painful penetration

Endometriosis can often lead to spasms and tightness in the pelvic floor which can make inserting tampons (or a menstrual cup), or having intercourse very uncomfortable. Additionally, persistence of pelvic pain can lead to a hypersensitive central nervous system which can lead the brain to sound the danger alarm when anything in the pelvic environment changes. A pelvic floor physiotherapist can help you reframe how your brain experiences pain, and help downregulate the muscles of the pelvic floor which can improve pain with penetration.

Treat "Endo Belly"

Many people with endometriosis will complain of excessive bloating for little to no reason. Due to the inflammatory nature of endometriosis, many people will benefit from treatment of the pelvic floor as It assists in venous and lymphatic exchange in the body which can reduce the extent to which the belly balloons outwards. Additionally, if the muscles in the abdomen, including the hip flexors are in spasm or have tightened, you will have outpouching which appears like bloating.

Manage symptoms of endometriosis with pelvic floor physiotherapy

As people continue to live with endometriosis for years, the cumulative effects of the condition on the fascial layers (a connective tissue that is like a plastic wrap that surrounds everything in the body) can result in alterations of how the body and brain sense the position (or proprioception) of internal organs. This often leads to abdominal and pelvic pain complaints in addition to the abdominal bloating. Some pelvic floor therapists use a technique called “visceral mobilization” that can help with bloating and distension by treating these fascial abdominal tissues.

If you or someone you know is living with endometriosis pain, without a pelvic floor physiotherapist in their corner, we encourage you to reach out today and allow us to show you how we can help you live a happier, healthier and more pain-free life. 


  1. Faubion S, Shuster L, Bharuchac A. Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction. Mayo Clin Proc. 2012;87(2):187-193.

  2. Aredo J, Heyrana K, Karp B, Shah J, Stratton P. Relating Chronic Pelvic Pain and Endometriosis to Signs of Sensitization and Myofascial Pain and Dysfunction. Semin Reprod Med. 2017;35(1):88-97.

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