Can Pelvic Floor Therapy Help With Endometriosis?

‍Endometriosis is a chronic condition that can cause pelvic pain, painful periods, bowel and bladder symptoms, and pain with intimacy. This article explains how endometriosis can affect the pelvic floor and how pelvic floor therapy may help manage symptoms associated with pelvic floor dysfunction.

Pelvic floor therapy does not cure endometriosis, but it may help reduce muscle tension and improve bladder, bowel, intimacy, and pain-related symptoms. Pelvic floor physical therapy can provide individualized treatment based on each patient's symptoms and response to care.

What Is Endometriosis?

Endometriosis is a condition where tissue like the one found inside the uterus grows outside of the uterus. It can affect many organs in the pelvis including but not limited to the uterus, rectum, and bladder but can also affect the thoracic cavity and diaphragm. For many patients, symptoms get worse around their menstrual period, but it is important to understand that endometriosis is not a reproductive disease.

Furthermore, it is very important to note that while endometriosis is common, 1 in 9 women suffer from this disease, delayed diagnosis is rampant. It takes an average of 7-10 years for most patients to receive a proper diagnosis. Also, symptoms of endometriosis can vary. The most common symptoms including worsening menstrual cramps that cause patients to miss school or work, pain with intimacy, pain with bowel movements, pain with urination and infertility. A typical presentation is a female patient who has to miss progressively more school and work and is experiencing debilitating pain by the time she is in her early 20s.

Common symptoms of endometriosis include:

-          Severe menstrual cramps

-          Pain with menstruation

-          Pain with intercourse

-          Pain with urination

-          Infertility

-          Low back pain with periods

-          Heavy bleeding during period

-          Abdominal pain

-          Abdominal bloating

-          Pain with bowel movements

-          Rectal pain

-          Constipation

-          Vaginal pain

-          Vulvar pain

-          Blood in stool during period

-          Pain or soreness after intercourse

-          Bladder pain

-          Urinary frequency or urgency

How Endometriosis Affects the Pelvic Floor

Chronic abdominal pain conditions, such as endometriosis, can lead to pelvic floor tension or dysfunction over time. The pelvic floor is close in proximity to the abdominal organs, so if there is pain or inflammation in the organs above, the pelvic floor muscles will respond over time with tension.

Pelvic floor tension can cause urinary, bowel and intimacy symptoms. Patients with endometriosis can experience urinary urgency, urinary frequency, incontinence, pain with intercourse, constipation, rectal spasm and tailbone pain in addition to pelvic pain. A skilled pelvic floor therapist can determine if the pelvic floor muscles are contributing to these symptoms.

What Is Pelvic Floor Therapy?

Pelvic floor therapy is the treatment of bladder, bowel, intimacy and other pelvic floor symptoms. Pelvic floor therapists are trained to directly assess the pelvic floor muscles vaginally and rectally (only with enthusiastic consent from patients). While an internal examination is not required and is always discussed, it can be very helpful for assessment and treatment.

It is also important to note that pelvic floor therapists do not only do internal assessment and treatment. In fact, this is only one part of what we do. Pelvic floor therapists have extensive orthopedic training and assess externally as well.

How Pelvic Floor Therapy May Help

Pelvic floor therapy can help with endometriosis symptoms by treating pelvic floor tension. While it is important to note that pelvic floor therapy is not a cure for endometriosis, it is very helpful in treating symptoms caused by pelvic floor dysfunction. Since pelvic floor tension can contribute to pain and urinary/bowel symptoms, helping these muscles relax and regain efficient coordination can be very helpful.

Treatments that help to relax the pelvic floor include direct internal treatment through manual therapy, breathing and relaxation techniques, tools such as dilators or pelvic wands and vagus nerve stimulation. Patients may also respond well to strengthening hip and core muscles, abdominal massage, visceral therapy and the use of a TENS machine for pain management.

 Treatment is decided on a case-by-case basis. For example, many endometriosis patients may have very sensitive nervous systems or concurrent conditions that need to be considered when determining a plan of care. Some patients, for example, respond very well to manual therapy. Others may have more adverse effects to hands on treatment.

Common Symptoms That Can Improve

Pelvic floor therapy can help many symptoms related to endometriosis. Symptoms such as urinary urgency, urinary frequency, incontinence, pain with bowel movements and pain with intimacy can all be improved through pelvic floor therapy.

Patients may also find relief with menstrual pain, abdominal pain, digestion and more. It is important to understand that every endometriosis patient is different and will respond differently to therapy. Some symptoms may not fully improve as they may be caused by the lesions themselves.

Other Treatments That May Be Recommended

The gold standard treatment for endometriosis is excision surgery. It is very important to find a surgeon that is skilled in excision. Unfortunately, there are surgeons that are performing ablation surgeries on patients with endometriosis. While these procedures may provide temporary relief, they do not fully remove the endometriosis and many patients have symptoms that return within a short period of time.

While excision surgery is the gold standard, we are starting to understand that endometriosis is a chronic life-long condition and unfortunately many patients will require more than one excision surgery to manage their symptoms.

Patients also find that other treatments such as acupuncture, nutrition changes and pain management through pelvic injections or medications may be helpful.

Where to Find Pelvic Floor Physical Therapy For Endometriosis In Queens, NYC

If you are experiencing pelvic floor symptoms due to endometriosis, help is available! Pelvic floor physical therapy can be very helpful for improving and managing endometriosis symptoms. If you are in the Forest Hills, Queens, NYC area and you are looking for help today, reach out to us! Give us a call or fill out our contact form today!

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