We Cannot Treat Endometriosis. We Can Treat What It Does To You.

What Endometriosis Actually Is

Cells that should be lining the uterus find their way outside of it, and then proceed to wreak all kinds of havoc in the abdomen.

The best known symptom is painful periods. But it causes far more than that, and a lot of people spend years not connecting the rest of it to endo at all.

Most People Get Here The Long Way

Endometriosis can currently only be confirmed by surgery, with tissue samples sent for testing. Because there is no non-surgical test, a lot of people spend years having their symptoms dismissed or put down to something else.

So by the time we see someone, they have usually been dealing with severe pain for a long time. Some come to us before excision surgery and some after. A fair number arrive after a second or a third surgery, having never been referred to pelvic floor PT at any point, and having found us themselves.

That last group is the one worth naming, because pelvic floor therapy is recommended in the research as part of care alongside excision surgery. It should be in the plan from the start rather than something you find on your own after a third operation. That said, one wonderful thing about physical therapy is that you do not necessarily need to be referred by a physician, you can take the power back and seek care on your own.

The other thing we see often is people who are surprised there is anything we can do at all. When your pain has been dismissed for years, you stop expecting help, and being told there is something treatable here often lands as a shock. That part is heartbreaking and uplifting at the same time.

Why Does The Pelvic Floor Get Involved?

Because of how the body reacts to endometriosis. The nervous system doesn’t quite know what’s going on, but it knows something isn’t right. This leads our body to enter lockdown mode as a form of protection (think curling into the fetal position and pretending everything is going to be okay).

So the pelvic floor muscles get tight and tense, and that creates more pain. The knots in the muscle hurt directly, and they irritate the pelvic structures nearby indirectly. Things snowball from there. Pain begets more pain.

This is the part we can do something about. The endometriosis is not ours to fix. The guarding response, the tension it produces, and the pain that tension adds on top, are.

It is also why treating the disease does not always settle everything down. Once you have been in pain for a long stretch, the body holds the effects of that, and the pelvic floor tension carries on driving its own set of symptoms. Take one piece of the puzzle away and the others can still be there. That is the reason this works best alongside your medical care rather than instead of it.

Who Else Should Be On Your Team

Most people we see for this are already under gynecologic care, because endometriosis affects people who are menstruating and they are commonly going for routine screening or contraception care anyway. So, it is rarely a case of sending you to a gynecologist you do not already have.

Where we do refer on, if needed, is to minimally invasive gynecologic surgery (or “MIGS”). Those are gynecologists who specialize in the more invasive end of endo management, but it is not only surgery: it covers medication management and less aggressive procedures too. If what you need is beyond routine gynecologic care, that is usually the right door rather than a general practice.

It also runs the other way. Some people arrive here without a diagnosis at all, having had years of symptoms brushed aside, and we are the first to say that their experience may not be “just painful periods.” This leads to a conversation of: Has anyone talked to you about the possibility of endometriosis? Does anyone in your family have it? Then we point you at someone we trust to listen to you and answer your concerns properly.