March is Endometriosis Awareness Month, making it the perfect time to talk about this life-altering condition that affects 1 in 7 women, girls, and those assigned female at birth (AFAB)—that’s around 14% of the population.
If you live with endo (or suspect you might have it), you know the pain is real. But what you might not know as much about is how endometriosis impacts the pelvic floor—and how pelvic health physio can help.
From painful periods to discomfort with sex, bloating, and chronic pelvic pain, endometriosis can lead to tension and dysfunction in the pelvic floor muscles.
But there are ways to ease the pain and help your body feel safer and more supported. As women’s health physios, we want to shed some light on the pain cycle and how we can help.
How Endometriosis Affects the Pelvic Floor
Endometriosis is often passed off as “bad period pain,” but it’s so much more than that. It’s a complex condition that causes chronic inflammation, pain, and tension in the body. Over time, this can lead to:
- Pelvic floor tension – Your muscles tighten in response to pain, creating a cycle of discomfort.
- Pain with intercourse – Overactive pelvic floor muscles can make penetration painful.
- Pain with tampon or menstrual cup use – Another sign of increased pelvic floor tension.
- Nerve sensitisation – When pain lasts for months or years, the nervous system becomes more reactive, making even mild discomfort feel intense.
Pain Science — Understanding Your Pain to Change It
One of the biggest breakthroughs in managing persistent pelvic pain is understanding how it works. The more we understand pain, the better we can manage it.
Here’s what we know (source):
A sensitised nervous system leads to overprotective pain
When pain has been ongoing for months or years, the brain and nervous system become more sensitive. This can make non-painful things feel painful—like wearing tight clothes, exercising, or even eating certain foods. Your pain is 100% real, and these changes in the nervous system explain why it can get worse over time.
Pain doesn’t always mean damage (although sometimes it does)
Some people with severe endo have little to no pain, while others with mild endo experience debilitating pain. This is because pain is influenced by many factors, not just what’s happening in the pelvis.
How we think, feel, and experience pain can influence it
Pain can be worsened by stress, worry, and even past experiences. That doesn’t mean it’s “all in your head” (it’s not!), but it does mean that things like relaxation techniques, stress management, and gradual movement can help over time.
Pain can change—slowly, but surely
Just as the nervous system can become more sensitive, it can also become less sensitive. This takes time, but with the right pain management strategies and support, pain can improve.
How Physiotherapy Can Help you manage endometriosis pain
Managing endometriosis is a long game, but pelvic health physiotherapy can help break the pain-tension cycle and give you practical tools to manage symptoms.
1. Pelvic Floor Assessment
We start with a thorough history and assessment to understand how endo is impacting you. We look at:
- Muscle tension & pelvic floor function
- Areas of discomfort
- Your unique pain triggers
From there, we create a treatment plan tailored to your needs.
2. Pain Education & Nervous System Support
Because pain is deeply connected to the nervous system, understanding your pain can actually change your experience of it. We work with you to:
- Calm the nervous system through breathwork & mindfulness
- Reframe pain signals to reduce overprotective responses
- Use movement & body scans to ease tension
3. Pelvic Floor Down-Training & Release Work
If your pelvic floor is overactive, strengthening exercises like Kegels aren’t the right approach. Instead, we focus on:
- Soft tissue release & gentle internal techniques
- Pelvic floor stretches & mobility work
- Dilators (if pain with intercourse is a concern)
4. Pain Relief Strategies for Daily Life
We’ll help you find practical pain relief options, including:
- TENS machine trials for abdominal & pelvic pain
- Heat therapy recommendations
- Exercise modifications to support movement during flares
5. Additional Support: Massage, Nutrition & More
Endometriosis is complex, which is why a team approach works best. At The Wellness Boutique, our in-house massage therapist can offer remedial massage & lymphatic drainage to help with bloating & pain, while our in-house dietitian can offer nutrition support to manage inflammation.
We also work closely with some of the best healthcare professionals in Burleigh Heads and the Gold Coast region including GPs, gynaecologists, psychologists, and naturopaths to ensure you have a full circle of care.
Your Pain Is Real, And you deserve support
Endometriosis can feel lonely and exhausting, especially when it takes years to get a diagnosis and you’re left figuring it out on your own.
Pelvic floor physiotherapy is about so much more than just exercises—it’s about helping you feel heard, supported, and empowered in managing your pain.
If you’re struggling with endo symptoms (it doesn’t matter if you’ve been officially diagnosed or not), we’re here to help you manage your pain and discomfort so you can get answers, and get on with life.
Call us for a chat on 0434 499 478
Book your Women’s Health Assessment today
Appointments are claimable on private health.
You deserve support. You deserve answers. And most of all, you deserve to feel good in your body.
For additional endometriosis resources, visit endometriosisaustralia.org.
