Thinking about trying physiotherapy for endometriosis pain? Here’s what to expect

10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

Endometriosis is a condition that affects women and girls. It occurs when tissue similar to the lining of the uterus ends up in other areas of the body. These areas include the ovaries, bladder, bowel and digestive tract.

Endometriosis will affect nearly one million Australian women and girls in their lifetime. Many high-profile Australians are affected by endometriosis including Bindi Irwin, Sophie Monk and former Yellow Wiggle, Emma Watkins.

Symptoms of endometriosis include intense pelvic, abdominal or low back pain (that is often worse during menstruation), bladder and bowel problems, pain during sex and infertility.

But women and girls wait an average of seven years to receive a diagnosis. Many are living with the burden of endometriosis and not receiving treatments that could improve their quality of life. This includes physiotherapy.

Netpixi/Shutterstock

How is endometriosis treated?

No treatments cure endometriosis. Symptoms can be reduced by taking medications such as non-steriodal anti-inflammatories (ibuprofen, aspirin or naproxen) and hormonal medicines.

Surgery is sometimes used to diagnose endometriosis, remove endometrial lesions, reduce pain and improve fertility. But these lesions can grow back.

Whether they take medication or have surgery, many women and girls continue to experience pain and other symptoms.

Pelvic health physiotherapy is often recommended as a non-drug management technique to manage endometriosis pain, in consultation with a gynaecologist or general practitioner.

The goal of physiotherapy treatment depends on the symptoms but is usually to reduce and manage pain, improve ability to do activities, and ultimately improve quality of life.

What could you expect from your first appointment?

Physiotherapy management can differ based on the severity and location of symptoms. Prior to physical tests and treatments, your physiotherapist will comprehensively explain what is going to happen and seek your permission.

They will ask questions to better understand your case and specific needs. These will include your age, weight, height as well as the presence, location and intensity of symptoms.

You will also be asked about the history of your period pain, your first period, the length of your menstrual cycle, urinary and bowel symptoms, sexual function and details of any previous treatments and tests.

They may also assess your posture and movement to see how your muscles have changed because of the related symptoms.

Physio assesses patient
During the consultation, your physio will assess you for painful areas and muscle tightness. Netpixi/Shutterstock

They will press on your lower back and pelvic muscles to spot painful areas (trigger points) and muscle tightness.

If you consent to a vaginal examination, the physiotherapist will use one to two gloved fingers to assess the area inside and around your vagina. They will also test your ability to coordinate, contract and relax your pelvic muscles.

What type of treatments could you receive?

Depending on your symptoms, your physiotherapist may use the following treatments:

General education

Your physiotherapist will give your details about the disease, pelvic floor anatomy, the types of treatment and how these can improve pain and other symptoms. They might teach you about the changes to the brain and nerves as a result of being in long-term pain.

They will provide guidance to improve your ability to perform daily activities, including getting quality sleep.

If you experience pain during sex or difficulty using tampons, they may teach you how to use vaginal dilators to improve flexibility of those muscles.

Pelvic muscle exercises

Pelvic muscles often contract too hard as a result of pain. Pelvic floor exercises will help you contract and relax muscles appropriately and provide an awareness of how hard muscles are contracting.

This can be combined with machines that monitor muscle activity or vaginal pressure to provide detailed information on how the muscles are working.

Yoga, stretching and low-impact exercises

Yoga, stretching and low impact aerobic exercise can improve fitness, flexibility, pain and blood circulation. These have general pain-relieving properties and can be a great way to contract and relax bigger muscles affected by long-term endometriosis.

These exercises can help you regain function and control with a gradual progression to perform daily activities with reduced pain.

Physio talks to woman resting her feet on a fit ball
Low-impact exercise can reduce pain. ABO Photography/Shutterstock

Hydrotherapy (physiotherapy in warm water)

Performing exercises in water improves blood circulation and muscle relaxation due to the pressure and warmth of the water. Hydrotherapy allows you to perform aerobic exercise with low impact, which will reduce pain while exercising.

However, while hydrotherapy shows positive results clinically, scientific studies to show its effectiveness studies are ongoing.

Manual therapy

Women frequently have small areas of muscle that are tight and painful (trigger points) inside and outside the vagina. Pain can be temporarily reduced by pressing, massaging or putting heat on the muscles.

Physiotherapists can teach patients how to do these techniques by themselves at home.

What does the evidence say?

Overall, patients report positive experiences pelvic health physiotherapists treatments. In a study of 42 women, 80% of those who received manual therapy had “much improved pain”.

In studies investigating yoga, one study showed pain was reduced in 28 patients by an average of 30 points on a 100-point pain scale. Another study showed yoga was beneficial for pain in all 15 patients.

But while some studies show this treatment is effective, a review concluded more studies were needed and the use of physiotherapy was “underestimated and underpublicised”.

What else do you need to know?

If you have or suspect you have endometriosis, consult your gynaecologist or GP. They may be able to suggest a pelvic health physiotherapist to help you manage your symptoms and improve quality of life.

As endometriosis is a chronic condition you may be entitled to five subsidised or free sessions per calendar year in clinics that accept Medicare.

If you go to a private pelvic health physiotherapist, you won’t need a referral from a gynaecologist or GP. Physiotherapy rebates can be available to those with private health insurance.

The Australian Physiotherapy Association has a Find a Physio section where you can search for women’s and pelvic physiotherapists. Endometriosis Australia also provides assistance and advice to women with Endometriosis.

Thanks to UTS Masters students Phoebe Walker and Kasey Collins, who are researching physiotherapy treatments for endometriosis, for their contribution to this article.

Peter Stubbs, Senior Lecturer in Physiotherapy, University of Technology Sydney and Caroline Wanderley Souto Ferreira, Visiting Professor of Physiotherapy, University of Technology Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Don’t Forget…

Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

Recommended

  • In Crisis, She Went to an Illinois Facility. Two Years Later, She Still Isn’t Able to Leave.
  • Healthiest-Three-Nut Butter
    Ditch additives with our three-nut blend recipe – perfect for those with or without nut allergies. Enjoy a healthier, homemade alternative to store-bought spreads!

Learn to Age Gracefully

Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Oat Milk vs Almond Milk – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing oat milk to almond milk, we picked the almond milk.

    Why?

    This one’s quite straightforward, and no, it’s not just our bias for almonds

    Rather, almonds contain a lot more vitamins and minerals, all of which usually make it into the milk.

    Oat milk is still a fine choice though, and has a very high soluble fiber content, which is great for your heart.

    Just make sure you get versions without added sugar or other unpleasantries! You can always make your own at home, too.

    You can read a bit more about the pros and cons of various plant milks here:

    Which Plant Milk?

    Enjoy!

    Share This Post

  • What Your Doctor Wants You to Know to Crush Medical Debt – by Dr. Virgie Ellington

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    First things first: this one’s really only of relevance to people living in the US. That’s most of our readership, but if it’s not you, then apologies, this one won’t be of interest.

    For the US Americans, though, Dr. Ellington starts strong with “you got a bill—now get the right bill”, and then gives a step-by-step process for finding the mistakes in your medical bills, fixing them, dealing with insurers who do not want to live up to their part of the bargain, and how to minimize what you need to pay, when you actually arrive at your final bill.

    The biggest strength of this book is the wealth of insider knowledge (the author has worked as a primary care physician as well as as a health insurance executive), and while this information won’t stay current forever, its relatively recent publication date (2022) means that little has changed since then, and once you’re up to speed with how things are now, it’ll be easy to roll with whatever changes may come in the future.

    Bottom line: if you’re living in the US and would like to not be ripped off as badly as possible when it comes to healthcare costs, this book is a very small, very powerful, investment.

    Click here to check out What Your Doctor Wants You to Know To Crush Medical Debt, and be armed with knowledge!

    Share This Post

  • How To Triple Your Breast Cancer Survival Chances

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Keeping Abreast Of Your Cancer Risk

    It’s the kind of thing that most people think won’t happen to them. And hopefully, it won’t!

    But…

    • Anyone (who has not had a double mastectomy*, anyway) can get breast cancer.
    • Breast cancer, if diagnosed early (before it spreads), has a 98% survival rate.
    • That survival rate drops to 31% if diagnosed after it has spread through the body.

    (The US CDC’s breast cancer “stat bite” page has more stats and interactive graphs, so click here to see those charts and get the more detailed low-down on mortality/survival rates with various different situations)

    We think that the difference between 98% and 31% survival rates is more than enough reason to give ourselves a monthly self-check at the very least! You’ve probably seen how-to diagrams before, but here are instructions for your convenience:

    (This graphic was created by the Jordan Breast Cancer Program—check them out, as they have lots of resources)

    If you don’t have the opportunity to take matters into your own hands right now, rather than just promise yourself “I’ll do that later”, take this free 4-minute Breast Health Assessment from Aurora Healthcare. Again, we think the difference early diagnosis can make to your survival chances make these tests well worth it:

    Click Here To Take The Free 4-Minute Breast Health Assessment!

    Lest we forget, men can also get breast cancer (the CDC has a page for men too), especially if over 50. But how do you check for breast cancer, when you don’t have breasts in the commonly-understood sense of the word?

    So take a moment to do this (yes, really actually do it!), and set a reminder in your calendar to repeat it monthly—there really is no reason not to!

    Take care of yourself; you’re important.

    Share This Post

Related Posts

  • In Crisis, She Went to an Illinois Facility. Two Years Later, She Still Isn’t Able to Leave.
  • Healthy Hormones And How To Hack Them

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Healthy Hormones And How To Hack Them!

    Hormones are vital for far more than they tend to get credit for. Even the hormones that people think of first—testosterone and estrogen—do a lot more than just build/maintain sexual characteristics and sexual function. Without them, we’d lack energy, we’d be depressed, and we’d soon miss the general smooth-running of our bodies that we take for granted.

    And that’s without getting to the many less-talked-about hormones that play a secondary sexual role or are in the same general system…

    How are your prolactin levels, for example?

    Unless you’re ill, taking certain medications, recently gave birth, or picked a really interesting time to read this newsletter, they’re probably normal, by the way.

    But, prolactin can explain “la petite mort”, the downturn in energy and the somewhat depressed mood that many men experience after orgasm.

    Otherwise, if you have too much prolactin in general, you will be sleepy and depressed.

    Prolactin’s primary role? In women, it stimulates milk production when needed. In men, it plays a role in regulating mood and metabolism.

    Read: What Causes High Prolactin Levels in Men?

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • 100 Hikes of a Lifetime – by Kate Siber

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This is published by National Geographic, so you can imagine the quality of the photos throughout.

    Inside, and after a general introduction and guide to gear and packing appropriately, it’s divided into continents, with a diverse array of “trips of a lifetime” for anyone who enjoys hiking.

    It’s not a narrative book, rather, it is a guide, a little in the style of “Lonely Planet”, with many “know before you go” tips, information about the best time to go, difficult level, alternative routes if you want to get most of the enjoyment while having an easier time of it (or, conversely, if you want to see some extra sights along the way), and what to expect at all points.

    Where the book really excels is in balancing inspiration with information. There are some books that make you imagine being in a place, but you’ll never actually go there. There are other books that are technical manuals but not very encouraging. This one does both; it provides the motivation and the “yes, you really can, here’s how” information that, between them, can actually get you packing and on your way.

    Bottom line: if you yearn for breathtaking views and time in the great outdoors, but aren’t sure where to start, this will give you an incredible menu to choose from, and give you the tools to go about doing it.

    Click here to check out 100 Hikes Of A Lifetime, and live it!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Figs vs Passion Fruit – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing figs to passion fruit, we picked the passion fruit.

    Why?

    Both are top-tier fruits! But the passion fruit is just that bit more passionate about delivering healthy nutrients:

    In terms of macros, passion fruit has slightly more carbs, notably more protein, and a lot more fiber, giving it the win in this category.

    In the category of vitamins, figs have more of vitamins B1, B5, B6, E, and K, while passion fruit has more of vitamins A, B2, B3, B9, C, and choline, making for a marginal win by the numbers for passion fruit here.

    When it comes to minerals, figs have more calcium, manganese, and zinc, while passion fruit has more copper, iron, magnesium, phosphorus, potassium, and selenium. A clearer win for passion fruit this time.

    Adding up the sections makes for an easy overall win for passion fruit, but again, figs are really a top-tier fruit too; passion fruit just beats them! By all means enjoy either or both; diversity is good!

    Want to learn more?

    You might like:

    Top 8 Fruits That Prevent & Kill Cancer ← figs have antitumor effects specifically, while removing carcinogens too, and additionally sensitizing cancer cells to light therapy

    Enjoy!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: