6 Signs You Might Have Endometriosis (From a Pelvic Floor Perspective)
Endometriosis affects an estimated 1 in 10 women worldwide, yet many people live with symptoms for years before getting answers. Because painful periods are often normalized, it can be hard to know when discomfort crosses the line into something medical.
If you’ve ever wondered:
Why are my periods this painful?
How do I alleviate period cramps?
Does pelvic floor therapy treat endometriosis?
You’re asking important questions. Let’s break this down in a clear, research-supported way — and talk about how pelvic floor therapy fits into the bigger picture of care.
What Is Endometriosis?
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. These growths respond to hormonal changes during your cycle, which can trigger inflammation, scarring, and pain.
From a pelvic floor perspective, chronic inflammation often leads to:
muscle guarding
tension and spasm
nerve sensitivity
reduced mobility in pelvic tissues
Over time, these protective responses can amplify pain, even when you’re not actively menstruating.
1. Painful Periods That Go Beyond “Normal Cramps”
While many people experience uncomfortable periods, endometriosis pain is typically more intense and more widespread.
You may notice:
severe cramping
bloating
nausea
pain in the abdomen, back, or legs
heavy bleeding or spotting between periods
If you’re constantly searching for ways to alleviate period cramps and nothing seems to help, that’s worth paying attention to.
Pelvic floor therapy targets the muscular and nervous system components of pain. Research shows that reducing pelvic floor tension and improving circulation can decrease the intensity of menstrual pain over time.
2. Pain During Sex
Pain during intercourse (dyspareunia) is a common sign of endometriosis. It may feel deep in the pelvis and worsen with certain positions or deeper penetration.
This pain often has a muscular component. When pelvic floor muscles remain in a protective, tightened state, they become hypersensitive.
Pelvic floor therapy helps by:
reducing muscle guarding
improving tissue mobility
calming nerve sensitivity
retraining relaxation and coordination
This is not about “pushing through” pain — it’s about teaching the body safety again.
3. Chronic Pelvic Pain Outside Your Period
Endometriosis pain is not limited to menstruation. Many women experience persistent pelvic discomfort throughout the month.
This may feel like:
dull aching
sharp stabbing sensations
pressure or heaviness
bowel or bladder discomfort
fatigue
Chronic pain changes how the nervous system processes signals. Pelvic floor therapy uses evidence-based strategies to downregulate the nervous system and retrain muscles that have adapted to long-term pain.
4. Difficulty Getting Pregnant
Endometriosis can lead to scarring and adhesions that affect fertility. While pelvic floor therapy does not cure endometriosis, improving pelvic circulation, muscle function, and tissue mobility may support overall pelvic health during fertility care.
Many therapists collaborate with OB/GYNs and reproductive specialists to provide coordinated support.
5. Gastrointestinal Symptoms
Endometriosis can affect the bowel and surrounding tissues. Some women experience:
bloating
constipation
diarrhea
pain with bowel movements
These symptoms often worsen during menstruation. Pelvic floor therapy addresses bowel mechanics, muscle coordination, and pressure management. Research shows that targeted therapy can improve bowel-related pain and dysfunction when pelvic muscles are contributing.
6. Persistent Fatigue
Living with chronic pain is exhausting. Inflammation, poor sleep, and nervous system stress all contribute to fatigue in people with endometriosis.
Pelvic floor therapy includes breathing work, nervous system regulation, and gradual activity progression to rebuild energy and resilience.
Common Myths About Endometriosis
Myth: “Bad periods are just part of being a woman.”
Severe pain is not something you have to accept. Pain that interferes with daily life deserves evaluation.
Myth: “Generic exercises online will fix it.”
Internet advice isn’t tailored to your body. Some exercises can actually worsen pelvic floor tension.
Myth: “There’s nothing you can do unless you get surgery.”
Conservative care plays a major role in symptom management before and after medical treatment. Individualized care is almost always more effective than one-size-fits-all solutions.
What Does Pelvic Floor Therapy for Endometriosis Actually Include?
Pelvic floor therapy is not just exercises. Treatment is customized and may include a combination of hands-on and movement-based techniques depending on your symptoms.
A pelvic floor therapist may use:
Manual therapy
Hands-on manual therapy helps release tension, improve tissue mobility, and reduce pain in muscles and connective tissues affected by chronic inflammation.
Visceral mobilization
Visceral mobilization is a gentle technique that improves mobility of the organs and surrounding fascia. In endometriosis, restricted tissue around the uterus, bowel, or bladder can contribute to pain patterns.
Dry needling
Dry needling can calm overactive muscles and reduce nerve sensitivity. Research supports its role in managing chronic pain and muscle guarding when used by trained providers.
Movement and nervous system retraining
Breathing work, relaxation strategies, and graded movement help retrain how the brain and body respond to pain.
Treatment plans are individualized. Not everyone needs every technique — and therapy is always tailored to your comfort level and goals.
Does Pelvic Floor Therapy Treat Endometriosis?
Pelvic floor therapy does not remove endometrial tissue — but it treats the muscular and nervous system consequences of chronic inflammation and pain. That distinction matters.
Therapy can help:
reduce pain intensity
improve mobility and function
decrease muscle guarding
support bowel and bladder health
improve sexual comfort
restore confidence in movement
For many women, it becomes a cornerstone of long-term symptom management.
FAQ
Can pelvic floor therapy help painful periods?
Yes. Evidence supports pelvic floor therapy for reducing muscle tension and improving menstrual pain.
Is pelvic floor therapy painful?
Treatment is gentle and paced to your comfort level.
Can therapy help if I’ve already had surgery?
Yes. Post-surgical pelvic floor therapy is often recommended to prevent persistent pain patterns.
When should I seek help?
If pain interferes with work, relationships, sleep, or daily activity, it’s time to talk to a specialist.
You Don’t Have to Navigate This Alone
If any of these symptoms sound familiar, support exists. Pelvic floor therapy focuses on restoring comfort, function, and quality of life with evidence-based, personalized care.
Book a free discovery call to find out if pelvic floor therapy is right for you.
You deserve treatment that’s customized, compassionate, and grounded in science.