Resources

Pelvic Health Physiotherapy: A Guide for People With Endometriosis

The purpose of this resource is to describe pelvic health physiotherapy and how it can be used to help manage symptoms people with endometriosis have, both from their endometriosis or from other conditions they may also have.

Pelvic health physiotherapy is an effective, evidence‑based treatment for some symptoms of endometriosis, like pain with sexual activity. It’s also helpful for treating other conditions and diseases that many people with endometriosis have, either independently or as a result of endometriosis.

A registered physiotherapist trained in treating pelvic health conditions can help address issues that can impact muscles, joints, and other tissues in and around the pelvis and abdomen. All of the treatment options are explained prior to beginning treatment. You can decide not to proceed with any treatments you aren’t comfortable with and you can agree to (consent to) treatments you would like to proceed with.

Pelvic health physiotherapists are trauma-informed healthcare practitioners. They are trained to be aware of the impact of trauma, create a safe and supportive environment, and adapt their practices to avoid re‑traumatizing patients.

Pelvic health physiotherapists use a biopsychosocial approach to treatment. This approach considers not only the medical aspects of a person’s health but also their mental and emotional state, and the social and environmental factors that may impact their health. This approach is recognized to be critical for treating chronic pain.

Pelvic health physiotherapy can treat some of the symptoms of endometriosis, as well as some other conditions that people with endometriosis may also have. These include:

  • Chronic urological pain syndromes, which include both painful bladder syndrome and interstitial cystitis. There are conditions that cause pelvic and/or bladder pain and discomfort, and frequent urination because of pain.
  • Pelvic floor dysfunction is a condition where the pelvic floor muscles, which are located inside your pelvis, do not work efficiently. In some people, the pelvic floor muscles can be weak, but in most people with pelvic pain and endometriosis, the pelvic floor muscles have too much tension. This can result in many different issues, like pelvic pain, painful sex, and bowel and bladder problems. A pelvic health physiotherapist will be able to properly assess these muscles to guide treatment to help reduce your symptoms.

Pelvic floor muscles

You can find a trained pelvic health physiotherapist online at www.pelvichealthsolutions.ca. It is important to receive pelvic health physiotherapy from a physiotherapist who has been trained to use internal techniques to treat pelvic dysfunction.

Pelvic floor physiotherapy has played a crucial role in managing my pelvic floor issues, particularly while living with endometriosis. My physiotherapist has significantly impacted the quality of my life by ensuring that I always feel comfortable and safe while teaching me various techniques to alleviate pains associated with my pelvis, including my bladder, bowels, as well as muscular and fascial pain in my pelvis. This treatment has been a life-changing experience for me, and I feel empowered and supported throughout the entire process. I highly recommend pelvic floor physiotherapy to anyone who is struggling with similar issues.

Download Pelvic health physiotherapy: A guide for people with endometriosis

If you found this page helpful, feel free to download this resource as a PDF so you can reference it later. All of our patient resources are available as downloads.

References

  • Allaire, C., Williams, C., Bodmer-Roy, S., Zhu, S., Arion, K., Ambacher, K., Wu, J., Yosef, A., Wong, F., Noga, H., Britnell, S., Yager, H., Bedaiwy, M. A., Albert, A. Y., Lisonkova, S., & Yong, P. J. (2018). Chronic pelvic pain in an interdisciplinary setting: 1-year prospective cohort. Am J Obstet Gynecol, 218(1), 114.e111-114.e112.
    See reference
  • Ball, E., & Khan, K. S. (2020). Recent advances in understanding and managing chronic pelvic pain in women with special consideration to endometriosis. F1000Res, 9.
    See reference
  • da Silva, J. P., de Almeida, B. M., Ferreira, R. S., de Paiva Oliveira Lima, C. R., Barbosa, L., & Ferreira, C. W. S. (2023). Sensory and muscular functions of the pelvic floor in women with endometriosis - cross-sectional study. Arch Gynecol Obstet, 308(1), 163-170.
    See reference
  • Faghani, N. (2018). Physiotherapy provides significant benefits for patients with chronic urologic pain. Can Urol Assoc J, 12(6 Suppl 3), S171-s174.
    See reference
  • FitzGerald, M. P., Payne, C. K., Lukacz, E. S., Yang, C. C., Peters, K. M., Chai, T. C., Nickel, J. C., Hanno, P. M., Kreder, K. J., Burks, D. A., Mayer, R., Kotarinos, R., Fortman, C., Allen, T. M., Fraser, L., Mason-Cover, M., Furey, C., Odabachian, L., Sanfield, A., . . . Nyberg, L. M. (2012). Randomized multicenter clinical trial of myofascial physical therapy in women with interstitial cystitis/painful bladder syndrome and pelvic floor tenderness. J Urol, 187(6), 2113-2118.
    See reference

Financial contribution:

The views expressed herein do not necessarily represent the views of Health Canada.

 

Clinical expert review by:

and Pelvic Physiotherapy Expert Clinicians