Endometriosis & Physiotherapy: An Evidence-Based Guide for Women’s Health

Endometriosis affects nearly 1 in 10 women worldwide, yet diagnosis can take years. Many women are told their pain is “just a bad period,” leading to years of unnecessary suffering.At MindHerWellness, we believe in changing that story — by combining medical care, physiotherapy, and education so women can regain control of their bodies. Here’s what research says about physiotherapy’s role in managing endometriosis pain and improving quality of life.

What Is Endometriosis?

Endometriosis is a chronic inflammatory condition where tissue similar to the uterine lining grows outside the uterus — often on the ovaries, fallopian tubes, bowel, bladder, or pelvic lining. This tissue reacts to hormonal cycles, causing inflammation, scarring, and adhesions.

Common symptoms include:

·        - Severe period pain (dysmenorrhea)

·        - Pain during or after intimacy

·        - Pain with urination or bowel movements

·        - Chronic pelvic or lower back pain

·        - Fatigue and bloating

·        - Difficulty conceiving (for some women)

The Pain Puzzle

Endometriosis pain is complex and not just caused by lesions. Research shows that pelvic floor muscle overactivity, myofascial trigger points, nerve sensitization, and posture/movement changes all contribute to persistent pain. This is where physiotherapy plays a critical role — addressing muscular, postural, and nervous system contributors.

Evidence-Based Physiotherapy Guidelines

Recent systematic reviews and meta-analyses support physiotherapy as part of first-line conservative care.

Pelvic Floor Physiotherapy: Gentle internal and external release, trigger point therapy, and down-training to reduce pelvic floor hypertonicity. Evidence shows significant reduction in pain with intimacy and daily activities.

Pain Education & Nervous System Calming: Teaching pain neuroscience, breathing techniques, and mindfulness to reduce central sensitization.

Manual Therapy & Scar Mobilization: Myofascial release for abdominal wall, hips, lower back, and scar mobilization post-surgery to restore mobility.

Exercise Therapy: Core and hip strengthening, stretching, yoga or Pilates to improve posture and function. Evidence shows pain reduction over 8–12 weeks.

Physical Modalities: Use of TENS, low-level laser therapy, or heat as adjunctive pain management tools.

Benefits of Physiotherapy

✅ Reduced pelvic and abdominal pain

✅ Less pain with intimacy and daily tasks

✅ Improved bladder and bowel comfort

✅ Better posture and core stability

✅ Increased energy, mobility, and participation in daily life

Best Practice: A Multidisciplinary Approach

Physiotherapy works best alongside:- Medical management (hormonal treatments, surgery)- Nutrition (anti-inflammatory dietary strategies)- Mental health support (CBT, mindfulness, stress management).

When to See a Pelvic Health Physiotherapist

You should book an assessment if you have pain that persists despite medication, pain with intimacy, urination, or bowel movements, pelvic floor tightness, or posture changes due to pain.

MindHerWellness Takeaway 💜

Endometriosis is not just a gynecological condition — it’s a whole-body challenge that deserves a whole-person approach. Physiotherapy offers safe, evidence-based strategies to calm pain, improve mobility, and empower you to take control of your health.

🔗 Take the first step: Book a consultation with a pelvic health physiotherapist or explore our women’s wellness resources.

References

1. Can G, et al. (2025). Physiotherapy for endometriosis-associated pelvic pain: a systematic review and meta-analysis. PubMed PMID: 40705433

2. Abril-Coello I, et al. (2023). Benefits of physical therapy in improving quality of life and pain associated with endometriosis. PubMed PMID: 36571475

3. Tennfjord MK, et al. (2021). Effect of physical activity and exercise on endometriosis-associated symptoms. BMC Women’s Health, 21: 156.

4. Wójcik M, et al. (2022). Physiotherapy Management in Endometriosis. PMC PMCID: PMC9740037