Endometriosis is associated with the abnormal growth of a tissue similar to the lining of the uterus developing elsewhere. These abnormal growths, or lesions, react to reproductive hormones in the same way as the lining of the uterus, thickening and breaking down as part of the menstrual cycle. Because there is no exit route for them to leave the body, however, they cause inflammation, the scarring of internal organs, and severe pain.

Several medications exist that can ease the symptoms of endometriosis. But some women find that physical therapy, alongside other treatments, also helps to reduce pain caused by the condition. Research into pelvic floor physiotherapy, in particular, is ongoing and may help improve the quality of life for patients.

What is physical therapy?

Physical therapy involves a skilled professional manually examining a patient’s body, looking for specific areas that are the source of pain and working to ease it. This could involve both an external and internal examination.

Through manual therapy, the physical therapist can work to relax trigger points, where muscles have contracted, or tightened, and are causing pain. They can also help the patient learn new techniques and assign exercises tailored to individual needs that work to strengthen the body and address pain.

Pelvic floor physical therapy

The pelvic floor muscles are a group of muscles that support the pelvic organs, which include the bladder, bowel, and uterus. Other roles of the pelvic floor muscles include stabilizing joints and the spine.

Endometriosis can contribute to the pelvic floor muscles working less effectively, failing to fully coordinate how these muscles contract and relax. This is called pelvic floor dysfunction. The muscles can struggle to relax and can start to spasm, worsening the symptoms of endometriosis-associated pain and affecting bowel control and intercourse.

Strengthening and increasing the flexibility of the pelvic floor muscles can provide some pain relief for women with endometriosis. It may also help in better controlling the bowels and make sexual intimacy less painful and more enjoyable.

Physical therapy in clinical trials for endometriosis

A randomized clinical trial (NCT03572075) is now investigating the impact of pelvic floor physiotherapy in about 80 women with endometriosis at the University of Bologna in Italy. Patients are being assigned to either standard care with six individual physiotherapy appointments or standard care alone, with changes in endometriosis-related symptoms measured after four months. The study is expected to finish in April 2019.

The results of a retrospective analysis of physical therapy on life quality among women who had surgery to treat endometriosis were presented at the 2017 AAGL Global Congress of Minimally Invasive Gynecology. The analysis was carried out by Sarrel Physical Therapy on 45 women attending U.S.-based clinics for pelvic physical therapy, and used the female National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) to assess changes in pain. An abstract of its results, published in the Journal of Minimally Invasive Gynecology, suggested that pelvic physical therapy could benefit quality of life and ease pain during sex in these patients post-surgery.


Endometriosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.