Endometriosis: Why You Should Know About It and How A Physical Therapist Can Help

March 1, 2025

Endometriosis affects 1 out of 10 women. Typically it starts out as painful periods, but can progress to chronic pelvic pain, abdominal pain, painful intercourse, and/or bowel and bladder issues. It can even lead to infertility.

It is common for someone to have signs and symptoms of endometriosis for years (and sometimes decades) before being formally diagnosed with it. This prolonged process leads to unnecessary suffering, feelings of embarrassment and isolation, and reduced quality of life. That is why awareness is key.

If you are diagnosed with endometriosis, remember that you are not alone. There are many resources and things you can do.

Before I get into how pelvic floor physical therapy can help, let’s further explore this condition.

What is endometriosis?

Endometriosis is a systemic inflammatory disease characterized by the presence of abnormal endometrial tissue outside the uterus. These lesions resemble the inner lining of the uterus and they can cause pain, adhesions, fibroids, scar tissue, and organ dysfunction.

The symptoms of endometriosis can range from mild to severe and may include pelvic pain, particularly during menstruation. While menstrual cramping is common, individuals with endometriosis often experience significantly more intense pain, described as sharp, stabbing, or debilitating. The pain may also worsen over time.

How to diagnose endometriosis?

The gold standard for diagnosis is exploratory surgery, however not every person needs to be taken to the operating room to suspect endometriosis. A clinical diagnosis based on understanding a patient's symptoms, medical history and key questions can at least start the conversation about endometriosis or “float the idea” that a person may have endometriosis to watch for changes that may occur with disease progression.

Some questions to consider:

  • Do you have painful periods?
  • Do you miss work or school because it is so painful?
  • Nausea or vomiting because periods are so painful?
  • Pain or frequency with urination?
  • Is sexual intercourse painful?
  • Do you have bloating, constipation or painful bowel movements?

Individuals with endometriosis often need to advocate for themselves in obtaining diagnoses and managing their condition. It is crucial to speak up to your primary care physician and gynecologist if you are having any signs or symptoms of endometriosis.

In general, the most effective treatment for endometriosis involves consulting a gynecologist who specializes in endometriosis care. Such specialists can perform laparoscopic excision procedures to remove endometrial tissue.

How can a pelvic floor physical therapist help?

Chronic pain associated with endometriosis can cause trauma to the muscles, ligaments, nerves, and fascia of the pelvis and abdominal wall. This trauma can result in pain in the pelvis and impair the essential functions of the pelvic floor, including urination, defecation, sexual intercourse, lymphatic drainage, and support during movement.

Pelvic floor physical therapy addresses these issues by strengthening and relaxing the pelvic floor muscles, improving mobility, and reducing pain. It directly addresses the pelvic floor and abdomen to alleviate symptoms.

Furthermore, research suggests that pelvic floor physical therapy (administered after surgery) yields the most favorable outcomes, as pelvic floor dysfunction can persist even after tissue removal.

If you underwent surgery or think you might have endometriosis, please reach out to me at Activcore Bernardsville for a consultation.

Also check out these valuable resources:

iCareBetter

Endometriosis Research Center

The Endometriosis Summit

Endo What?

Below The Belt

Endometriosis Foundation of America

Disclaimer:  The views expressed in this post are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

Dr. Shawna Poltricitsky

Physical Therapist
Shawna Poltricitsky is a Doctor of Physical Therapy (DPT) and Board Certified Orthopedic Clinical Specialist (OCS) who specializes in pelvic health, women's health, and general orthopedics and manual therapy. She works at Activcore in Bernardsville, New Jersey.
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