Pelvic floor physiotherapy often seems to be ignored in the U.K., particularly as a treatment for endometriosis.

Despite working for an endometriosis charity, researching, and living with the condition for several years, I only heard about physio for endo when I sat down to record my first podcast interview with the Endotwins. They swore it was one of the only methods that had helped them so far. Following that interview, it’s appeared on my radar again and again, but only in the U.S.

I chatted with a friend at last year’s EndoMarch, and she shared that pelvic floor physiotherapy had helped her. She sent me a link to the two physios she knew who were trained specifically to work with the pelvic floor, but they were miles away from my new home by the sea — and completely out of my price range.

In my experience, pelvic floor physiotherapy isn’t easily accessible in the U.K. I haven’t met a single endo patient who’s been referred by their gynecologist to a physio for endo, though I am hearing of more warriors who are seeking it out themselves.

The issue is that we don’t have a health insurance market in the U.K. like the one that exists in the U.S. I’ve found that it’s nearly impossible to get health insurance for a preexisting medical condition like endometriosis. While you can get health insurance, most companies won’t cover the costs of chronic conditions. However, I’ve heard through the grapevine that this may be changing. I hope it’s not just a rumor.

This issue has left me at the mercy of National Health Service doctors who aren’t specialists, and resulted in two ablation surgeries that didn’t fully remove my endo. Though I’ve managed my endometriosis symptoms well, I couldn’t afford other treatments, such as a nutritionist, physical therapist, or hormone expert.

I had made peace with this issue until recent challenges. My struggles with bladder health and painful sex seem to be worsening over time, despite my periods being either pain-free or manageable.

After interviewing pelvic floor physiotherapist Heba Shaheed, I became convinced that my problems aren’t merely endometriosis and painful bladder syndrome, but a tight pelvic floor, which Heba reports is a problem for many people with endometriosis. And she’s not alone in this observation.

In their book, “Beating Endo,” Drs. Iris Kerin Orbuch and Amy Stein explain how the pain of endometriosis can often lead to tense muscles, resulting in a tight pelvic floor, causing further pain and bladder dysfunction. They also detail the issue of endo adhesions tugging on muscles and further disrupting bladder functionality, and causing hypersensitivity in the nerves in and around the bladder, resulting in pressure, urgency, frequency, and more pain.

These experts suggest that pelvic floor physiotherapy can release the tightness of the pelvic floor, reduce inflammation in the muscles and the surrounding area, soothe the hypersensitive nerves, and help the muscles to realign.

I’ve made a decision. I have some money put aside, which I had intended to use for the next phase of my women’s health coaching studies. But I’ve realized that I can’t be the coach I want to be when I am experiencing my current level of daily pain and bladder symptoms. So, I’m using part of that money to begin physio and give myself some time to save up for the next stage of my course.

It was a hard decision, but after some research, I found a local expert at a more affordable rate. Judging by the pattern of my symptoms, my bladder will get worse if I don’t seek additional support.

My initial consultation is Sept. 23, and if we’re the right fit, I hope to share my experiences with you through the next few months of physio. Let’s hope that in conjunction with the right nutrition and lifestyle choices, I can reduce my bladder pain, have a happier sex life, and qualify as the vibrant, healthy women’s health coach I know I can be.

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