Endometriosis & Pelvic Health

Living with endometriosis can mean living with pain that affects far more than your menstrual cycle. Pelvic pain, painful intercourse, bowel or bladder symptoms, muscle tension, and difficulty staying active can all impact your daily life.

At Core Pelvic Health & Wellness, I provide individualized pelvic health physical therapy to address the musculoskeletal and pelvic floor factors that may contribute to your symptoms and help you improve comfort, movement, and quality of life.

What is endometriosis?

Endometriosis is a chronic condition in which tissue similar to the lining of the uterus grows outside the uterus. It can cause inflammation, pain, and other symptoms that vary significantly from person to person.

Endometriosis is a medical condition that requires appropriate medical management. Physical therapy does not remove or cure endometriosis, but it can address musculoskeletal and pelvic floor dysfunction that may develop alongside the condition.

How can endometriosis affect the pelvic floor?

Pain can change the way your muscles work.

When pain persists over time, the pelvic floor and surrounding muscles may become tense or overactive as the body attempts to protect the area. This can contribute to additional pain, muscle guarding, changes in movement, and difficulty relaxing the pelvic floor.

Over time, this can create a cycle in which pain leads to muscle tension, muscle tension contributes to additional pain, and everyday activities become increasingly difficult.

Pain → Protective Muscle Tension → Reduced Movement → Increased Sensitivity → More Pain

Physical therapy focuses on addressing the musculoskeletal contributors to this cycle while working alongside your medical care.

What symptoms can pelvic health PT help with?

Endometriosis may be associated with:

  • Pelvic pain

  • Painful periods

  • Pain with intercourse

  • Pain with penetration

  • Pain with bowel movements

  • Constipation

  • Bowel urgency

  • Urinary urgency or frequency

  • Bladder discomfort

  • Low-back pain

  • Hip pain

  • Abdominal or pelvic muscle tension

  • Pain with prolonged sitting

  • Difficulty exercising

  • Pelvic floor muscle overactivity

  • Scar-related restrictions following surgery

Not everyone with endometriosis experiences the same symptoms. Your evaluation will focus on your individual concerns and goals.

Endometriosis and painful sex

Pain with sex is not something you have to simply accept.

Endometriosis can be associated with pain during or after sexual activity. Pelvic floor muscles may become tense or protective in response to pain, which can contribute to discomfort with penetration or other sexual activity.

Physical therapy may address pelvic floor muscle tension, breathing, hip and pelvic mobility, scar tissue, and other musculoskeletal contributors to pain.

Treatment is always individualized and progresses at a pace that feels appropriate for you.

Endometriosis, bowel & bladder symptoms

Endometriosis can affect more than your reproductive system.

Some people with endometriosis experience bowel or bladder symptoms, particularly around their menstrual cycle. Pelvic floor muscle tension and changes in how the pelvic and abdominal muscles coordinate can contribute to these symptoms.

Depending on your presentation, physical therapy may address pelvic floor coordination, relaxation, breathing, bowel mechanics, bladder habits, and musculoskeletal factors.

Endometriosis & surgery

Preparing for and recovering from endometriosis surgery

If you are having laparoscopic or other pelvic surgery for endometriosis, physical therapy may be helpful before or after surgery.

Preoperative education may include breathing, mobility, movement strategies, and preparation for recovery.

Following surgery, treatment may address scar mobility, abdominal and pelvic muscle function, breathing, mobility, strength, and gradual return to daily activities and exercise

Your postoperative plan will be coordinated with your surgeon's recommendations and your individual stage of healing.

My whole-body approach

Endometriosis doesn't exist in isolation.

Pelvic pain can affect the way you move, breathe, exercise, sit, sleep, and use your abdominal and pelvic muscles. Over time, these adaptations can influence the hips, low back, abdomen, and surrounding tissues.

My orthopedic and pelvic health background allows me to evaluate these connections and address the broader movement system—not just the location where you feel pain.

How can pelvic floor physical therapy help?

Your individualized treatment may include:

  • Pelvic floor relaxation

  • Breathing techniques

  • Manual therapy

  • Soft tissue techniques

  • Abdominal and pelvic mobility

  • Scar tissue mobilization

  • Hip and spine mobility

  • Core rehabilitation

  • Strengthening

  • Movement retraining

  • Exercise modification

  • Nervous system regulation strategies

  • Bowel and bladder strategies

  • Education and self-management techniques

Treatment does not have to mean “strengthening your pelvic floor.” For some people with endometriosis, learning to relax and coordinate the pelvic floor is an important part of treatment.

What happens during your evaluation?

We start by listening.

I will ask about your pain, menstrual cycle, bowel and bladder symptoms, sexual health concerns, previous surgeries, medical history, activity level, and goals.

We look at the whole body.

Depending on your symptoms, I may assess:

  • Breathing

  • Posture

  • Abdomen

  • Pelvic floor

  • Hips

  • Spine

  • Pelvic mobility

  • Strength

  • Movement patterns

  • Scar mobility

We create a plan together.

I'll explain what I find and develop an individualized treatment plan that complements your medical care and is based on your goals.

Internal examination

Do I need an internal pelvic floor examination?

Not necessarily. An internal examination is not automatically required. Depending on your symptoms and goals, an external assessment may provide valuable information.

If an internal examination is recommended, I will explain why it may be helpful and discuss it with you beforehand. You are always in control of your care.