• Katie Moise PT, DPT

Treating Endometriosis: A Multidisciplinary Approach

March is endometriosis awareness month. Did you know 1 in 10 women are diagnosed with endometriosis? Unfortunately, research estimates it can be anywhere from 7 to 12 years before a proper diagnosis of endometriosis without countless doctors appointments and treatments that may not be providing any relief. Endometriosis is a silent disease and one that cannot be confirmed without surgery. It does not show up on an x-ray, ultrasound or MRI, making it even more challenging to diagnose. This can also result in anxiety and depression as one is searching for answers to symptoms that may not be explained by medical providers. Ultimately, the defining symptom of endometriosis is pain: a painful bladder, painful periods or pain with intercourse. Pelvic floor physical therapy is an integral part of treating endo, as there is no “cure.” Click here to read more about our treatment approach to endometriosis.


So what is endometriosis?


The endometrium makes up the lining of the uterus. When cells similar to the lining of the uterus are found outside of the uterus, an inflammatory response can be triggered that may result in a multitude of symptoms. Endometriosis often times involves your ovaries, fallopian tubes and the tissue lining your pelvis. Essentially, the endometrial-like tissue acts as endometrial tissue would. It thickens, breaks down and bleeds with each menstrual cycle. Since this tissue has no way to exit your body, it becomes trapped with nowhere to go. These cells can be triggered to multiply during one's monthly cycle leading to worsening of symptoms over time. Ultimately, the defining symptom of endometriosis is pain: a painful bladder, painful periods or pain with intercourse.


Treatment for endometriosis:


Since there is no “cure” for endometriosis, it is important to take a holistic, multidisciplinary approach to the treatment of endometriosis. Pelvic floor physical therapy is an integral part of this treatment plan. When there are cells growing outside of the uterus, they start to infiltrate the pelvic cavity. This pelvic bowl is where your bladder, uterus and rectum are supported by your pelvic floor muscles. These muscles form a sling running from your pubic bone all the way to your tailbone. As one experiences pain in this area of their body, the body’s natural response is to guard and protect against this pain. This results in tension or tightening of the pelvic floor muscles as well as other muscles like the abdominals surrounding the pelvis.


Pelvic Floor Physical Therapy for Endometriosis

Pelvic floor physical therapy aims to use a variety of hands on techniques to reduce tension in these muscles and to teach you different exercises and stretches that you can do on your own at home. Here are a few of our favorite movements:


  • Breathing - we like to bring our hands to our ribcage and focus on letting the ribs expand as if an umbrella is opening up underneath the ribcage as we inhale through our nose and then exhale through the mouth. Spending 5 minutes a day on breathing can help calm down the nervous system

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  • Pelvic floor drops- breathing and releasing tension in your pelvic floor. As you inhale, envision letting your pelvic floor lengthen and drop down as if it is opening like a blooming flower.


  • Hip stretches- Here are a few of our favorites.






  • Abdominal wall stretches- our go-to favorite is cat/cow. This gentle movement adds in some spinal mobility while stretching out the front of your abdomen




  • Pelvic floor physical therapists will also work with you to optimize your bladder and bowel function.


Multidisciplinary Approach to Treating Endometriosis


Since treating endometriosis takes a village, here are some other important disciplines that are integral in our approach to managing endometriosis symptoms.


  • Nutrition: working with a nutritionist and focusing on eliminating inflammatory foods is so important in reducing the inflammation in your body from endometriosis.


  • Naturopathic Doctor/Functional Medicine Provider: getting to the root cause of your symptoms and understanding the potential imbalance in hormones that may be contributing to symptoms


  • Mental health therapist: stress management and calming down the nervous system is so important. Mental health therapists can help equip you with the tools to manage your pain and reduce stress


  • Surgeon or Endometriosis Specialist: Excision surgery is the gold standard for treatment of endometriosis. Hysterectomies are not a cure for endo, neither is taking birth control. These things can help manage symptoms but the endometrial tissue needs to be removed from the body through excision surgery. We are lucky in Atlanta to have the Center for Endometriosis Care right in our backyard. If you are not local to Atlanta, look for someone who specializes in treating endometriosis and has experience in excision surgery.


At ATL Pelvic Health, we are here to support you and help you navigate a diagnosis of endometriosis. You can check THIS out to find out more about what to expect at your first visit. Ready to get started? Schedule your discovery visit HERE.

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