Endometriosis: Five Key Insights from a Women’s Health Physiotherapist (Based on Current Research)

Endometriosis is increasingly understood as more than a gynaecological condition. Current research highlights its impact on the nervous system, muscles, and overall function. Here are five important points that shape how we approach it in physiotherapy today.

1. Pain does not reflect disease severity

There is a weak correlation between the extent of endometriosis and the level of pain experienced.

Some individuals with minimal visible disease report severe symptoms, while others with more extensive findings have relatively mild discomfort. This is because pain is influenced by how the nervous system processes signals, not just by the presence of tissue changes.

From a physiotherapy perspective, treatment focuses on addressing the pain system as a whole, rather than only the physical lesions.

2. The nervous system plays a central role

Endometriosis is now recognised as a condition that can involve central sensitisation. This means the nervous system becomes more responsive, amplifying pain signals over time.

Factors such as stress, previous pain experiences, and ongoing inflammation can contribute to this heightened sensitivity.

Approaches such as education, breathing strategies, and gradual return to movement are supported by research to help regulate the nervous system and reduce pain.

3. Pelvic floor dysfunction is common

Many individuals with endometriosis develop an overactive pelvic floor. These muscles can become tense and less able to relax, contributing to symptoms such as:

• Pain during intercourse
• Difficulty using tampons
• Bladder urgency or frequency
• Bowel discomfort

Importantly, tight muscles are not necessarily strong. Physiotherapy often focuses on improving coordination and relaxation of the pelvic floor, rather than strengthening alone.

4. Movement remains important

Research supports the role of exercise and movement in managing persistent pelvic pain. However, the approach needs to be individualised.

Periods of pain can lead to protective movement patterns, reduced activity, and deconditioning. A structured, gradual return to movement can help improve function without aggravating symptoms.

Physiotherapy provides guidance on pacing, exercise selection, and progression to support this process safely.

5. Physiotherapy is an evidence-based part of care

Recent studies and reviews show that physiotherapy can significantly improve pain, function, and quality of life in those with endometriosis.

Effective management often includes a combination of:

• Pelvic floor rehabilitation
• Movement and exercise therapy
• Education about pain
• Support for long-term self-management

Physiotherapy is now considered an important component of multidisciplinary care, alongside medical and, where appropriate, surgical management.

Final thoughts

Endometriosis affects more than the reproductive system. It can influence how the body moves, how muscles function, and how pain is experienced.

With the right approach, it is possible to reduce symptoms, improve confidence in movement, and support a better quality of life.

Physiotherapy plays a key role in helping individuals understand their symptoms and regain a sense of control over their bodies.

Email: info@wellbeing-rehab.co.uk
Telephone: 0161 676 0341