Heyl Family Practice

What is endometriosis?

Endometriosis is a medical condition where tissue similar to the lining of the uterus, called endometrium, grows outside the uterus. Normally, the endometrium thickens, breaks down, and is expelled during menstruation. However, in endometriosis, the displaced tissue has no way to exit the body. This can lead to the formation of painful adhesions, cysts, and scar tissue.

What are the symptoms of endometriosis?

Endometriosis symptoms can vary from person to person, and some women may experience mild symptoms while others may have more severe manifestations. Common symptoms of endometriosis include:

  • Pelvic Pain: The most prevalent symptom is often pelvic pain, which can range from mild to severe. The pain may be chronic or occur cyclically, especially during menstruation.
  • Painful Menstruation (Dysmenorrhea): Women with endometriosis frequently experience intense menstrual cramps that may interfere with daily activities.
  • Painful Intercourse (Dyspareunia): Sexual intercourse may be accompanied by pain, particularly deep pelvic pain.
  • Painful Bowel Movements or Urination: Some individuals with endometriosis may experience pain during bowel movements or urination, especially during menstruation.
  • Excessive Bleeding: Heavy menstrual bleeding or irregular bleeding may occur.
  • Infertility: Endometriosis can be associated with fertility issues. The presence of endometrial tissue outside the uterus may affect the function of reproductive organs, leading to difficulties in conceiving.
  • Fatigue: Chronic pain and other symptoms associated with endometriosis can contribute to fatigue.

What symptoms of endometriosis can pelvic physical therapy help?

Pelvic Physical Therapy can help

  • Pelvic Pain: Pain from endometriosis can occur anywhere around the pelvis or abdomen. Pelvic physical therapy can help reduce the pain through massage, exercise, and pain neuroscience (teaching you how pain works and how you respond to it) and get you back to the activities you love. 
  • Painful Menstruation (Dysmenorrhea): Painful cramps can be debilitating and are caused by changes in hormones and muscle function. Pelvic physical therapy can help reduce pain through visceral mobilizations, massage, and exercise. 
  • Painful Intercourse (Dyspareunia): Pelvic physical therapy can help by teaching you how to relax the pelvic floor, strengthening the hips, and calming the nervous system. Over the course of treatment this can reduce or eliminate pain with sex. 
  • Painful Bowel Movements or Urination: Pelvic physical therapy can help to teach you to relax painful muscles to allow you to have bowel movements and urinate easily and without pain. 

How can pelvic physical therapy help with endometriosis symptoms?

Pelvic physical therapy plays a pivotal role in managing symptoms of endometriosis by reducing pain and improving quality of life. Pelvic Physical Therapists can help by:

Using massage and visceral mobilizations for endometriosis

Massage can help to calm overactive, painful muscles, which can reduce the pain from endometriosis. Visceral mobilizations can help to reduce restrictions in the abdomen, allow for better organ function, and reduce pain from endometriosis. (1)

Using movement and exercises to reduce pain from endometriosis

Re-training movement patterns, re-coordinating the muscles in the core, and strengthening underactive muscles can help the core system to work better and reduce pain from endometriosis. Exercise in general has been shown to have an effect on pain, so specific, directed exercise from a pelvic physical therapist can greatly reduce pain from endometriosis.(1)

When to make an appointment at Resilient Women’s Health:

If you have any symptoms that you think may be endometriosis, make an appointment with one of the doctors at Resilient Women’s Health. Our pelvic physical therapists can help you determine the root cause of your symptoms, get you started on the path to feeling better, and help you find additional resources for support for endometriosis.


Wójcik M, Szczepaniak R, Placek K. Physiotherapy Management in Endometriosis. Int J Environ Res Public Health. 2022 Dec 2;19(23):16148. doi: 10.3390/ijerph192316148. PMID: 36498220; PMCID: PMC9740037.