Endometriosis Meets Pelvic Floor Therapy

March is Endometriosis Awareness Month — a time to shine light on a condition that affects millions of women and people with uteruses, yet is still widely misunderstood.

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. This can lead to pelvic pain, painful periods, bladder and bowel symptoms, pain with intercourse, fatigue, and inflammation throughout the body.

But something that isn’t talked about enough?

The pelvic floor is often deeply involved.

I have a lot of women who have asked me, "how can pelvic floor therapy help my endo?" Years of pain, inflammation, and guarding can cause the pelvic floor muscles to become tight, overactive, and sensitive. Stack on abdominal lesions and tension, gripping patterns, nervous system upregulation... This is where pelvic floor therapy can be incredibly helpful.

Endo meets Pelvic Floor Therapy

In honor of Endometriosis Awareness Month, I want to share a few pelvic-health-informed strategies that many people with endometriosis find supportive alongside medical care.

1. Full Inversion (When Appropriate)​
Gentle inversion can help support lymphatic flow and pelvic circulation. Positions such as legs up the wall or a supported inversion on a wedge can help the pelvis decompress and encourage fluid movement.

This can be especially helpful for:
• pelvic congestion
• heavy pelvic pressure
• end-of-day pelvic fatigue

Always listen to your body and avoid inversions during active pain flares if they aggravate symptoms.

2. Abdominal Rolling / Visceral Mobility Work​
Endometriosis can contribute to adhesions and restrictions in the abdomen and pelvis. Gentle abdominal rolling (with a soft therapy ball or by hand) may help:

• improve tissue mobility
• decrease abdominal wall guarding
• support bowel motility
• improve connection to the deep core

Think of this as restoring movement to tissues that may have been protecting for a long time.

3. Castor Oil Packs​
Castor oil packs have long been used in integrative medicine to support circulation and lymphatic flow.

Many people with endometriosis report benefits such as:
• decreased pelvic congestion
• improved digestion
• reduced pelvic discomfort

They are typically used over the lower abdomen for about 30–45 minutes several times per week (avoiding use during menstruation).

Here are my favorite castor oil products: I like the Earthley castor oil since it has a hot and cold option with infused herbs, but I also like Plant Therapy as well. I’ve included the flannel and wrap that I personally use as I have found them to be fantastic!

Earthley castor oil https://earthley.com/products/castor-oil-pack/?affiliateId=aleta-wagner

Plant Therapy castor oil https://amzn.to/4rIi5n5

Castor oil flannel (2 pack) https://amzn.to/4cC8yt5

Hot pack wrap https://amzn.to/4cjs2CC

4. Downtraining the Pelvic Floor​
With chronic pelvic pain, the pelvic floor muscles are often overactive rather than weak.

Pelvic floor therapy may focus on:
• relaxation training
• breath coordination
• nervous system regulation
• gentle internal or external manual therapy
• learning how to fully release the pelvic floor

For many people with endometriosis, learning how to let the pelvic floor soften can significantly improve symptoms like bladder urgency, pain with penetration, and pelvic aching.

5. Nervous System Support​
Living with chronic pain can keep the nervous system in a protective state. Practices that support nervous system regulation can help decrease overall pelvic pain sensitivity.

Helpful tools may include:
• diaphragmatic breathing
• gentle mobility work
• walking in nature
• heat therapy
• restorative yoga

The Endo Dilemma

You Are Not Meant to Navigate This Alone

Endometriosis is complex and often requires a team approach — including knowledgeable surgeons, supportive medical providers, and pelvic floor therapy.

Pelvic therapy can help address the muscle, nervous system, and connective tissue components of endometriosis pain, helping you move, exercise, and live your life with less restriction.

If you or someone you love is struggling with endometriosis symptoms, pelvic floor therapy may be an important piece of the puzzle.

You deserve care that looks at the whole picture. I see clients in person and virtually, and would love to support you on this journey! Reach out for a free Discovery Call to determine if I would be a good fit for your needs!