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What is Endometriosis?

Endometriosis is a disorder in which the tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. This endometrium most commonly implants on your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely it can occur beyond the area where pelvic organs are located, like your diaphragm or skeletal muscle.

The endometrium acts as uterine tissue and is sensitive to your body's estrogen levels — it thickens, breaks down and bleeds with each menstrual cycle. This is why those folks with endometriosis have a significant increase in symptoms around their period, and also why hormonal birth control that limits periods can be helpful in pain management. The pain from endometriosis is present because this tissue has no way to exit your body, and eventually develops scar tissue and adhesions.

What are the symptoms?

The most common symptom of endometriosis is pelvic and abdominal pain, but you may also experience any of the following:

  • Painful Periods (sometimes very severe pain)

  • Pain with penetrative sex, pelvic exams, or tampon placement

  • Pain when emptying the bladder or bowels

  • Excessive bleeding during periods and bleeding in between periods

  • Infertility

  • And more…fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods

What are the risk factors?

Several factors place you at greater risk of developing endometriosis, such as:

  • Never having given birth

  • Starting your period at an early age

  • Going through menopause at an older age

  • Short menstrual cycles — for instance, less than 27 days

  • Heavy menstrual periods that last longer than seven days

  • Having higher levels of estrogen in your body or a greater lifetime exposure to estrogen

  • Low body mass index

  • A family history of endometriosis

Endometriosis usually develops several years after the onset of menstruation. Signs and symptoms of endometriosis may temporarily improve with pregnancy and may go away completely with menopause, unless you're taking estrogen

What treatments are available?

Treatment for endometriosis usually involves medication or surgery. The approach you and your doctor choose will depend on how severe your signs and symptoms are and whether you hope to become pregnant.

Options for treatment include:

  • Pain management: often in the form of oral medications

  • Hormone therapy: most common type is oral contraceptives

  • Surgeries - excision of the affected tissue, ablations, or hysterectomy


As Pelvic Floor Physical Therapists we cannot “CURE” your endometriosis, but we play a large part in helping you manage the symptoms and get back to a pain free life.

In endometriosis, the original “driver” of your pain is the uterine lining that becomes implanted in places other than the uterus. These tissues have their own highway to the brain, and are sending pain signals each time they grow, shed, and bleed. This causes your brain to “sound the alarm” and put the pelvis into a “fight or flight” response.

When the brain does this, it does not selectively send an alarm to the uterus alone. It sends the alarm to the entire pelvis: the bowel, bladder, vagina, and pelvic floor muscles. When our pelvic floor muscles receive this alarm, their response is to tighten up, get guarded, and stay that way until they’ve been told there is no more alarm.

THIS is where your pelvic health PT/OT comes into play! It’s often very difficult for you as the patient to realize which of your muscles are in this “fight or flight” response. We help you locate the muscle(s), and teach you how to release that tension. People with endometriosis will often also have tension in the muscles of the abdomen, hips, and low back.

Pelvic health practitioners are experts in all things bowel, bladder, and sexual dysfunction. We are specialists in working with pelvic and abdominal pain, scar tissue, muscular tightness, and more!

Once you’ve received a diagnosis of endometriosis, it’s time to find your pelvic rehab provider. Go to to find a practitioner near you!

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