Endometriosis and adenomyosis affects 1 in 10 women, often starting in the teen years, it can often take over 10 years until the poor soul is diagnosed with it. This means that our teenagers and young women are often suffering in silence thinking that abnormally “painful periods”, crazy fatigue, brain fog and changes in bowel and bladder function are something that they just have to put up with.  Thankfully this is not the case. An expert women’s health Physio can not only administer pain relieving treatments (like manual therapy, acupuncture, LASER therapy, therapeutic exercise, TENS) but also therapeutic exercise to help reduce symptoms, scar tissue and decrease nervous system sensitivity.

Sometimes even the journey to getting a diagnosis and getting the right treatment can be as painful as the Endo itself…if that were possible!  Many young women report that they have many times told a health professional or care giver about their symptoms and are often not thoroughly assessed nor their condition taken seriously enough and sometimes it can just be downright difficult to find a good clinician with the necessary experience with Endo pain.  Therefore, so many women just don’t get the help they need early enough.  A good women’s health Physio can often detect abnormal signs and symptoms early and involve other health professionals in your care, including referral to the appropriate GP of your choice (with special interest in women’s health) as well as an expert Gynaecologist.

So what is Endometriosis and Adenomyosis?

  • Endometriosis is a condition where cells similar to endometrial tissue, that should normally be restricted to the internal lining of the uterus, are found outside the uterus. These specialised cells are sensitive to monthly hormonal changes and now residing in places where they shouldn’t can induce a chronic inflammatory reaction, swelling and pain. Over time this can result in scar tissue and further issues.  Inflammation and scar tissue can be found in/around the organs in the abdomen, the pelvic peritoneum, on the ovaries, in the recto-vaginal septum, on the bladder and bowel.
  • Endometriosis symptoms:
    • painful periods
    • painful ovulation
    • pain during or after sexual intercourse
    • heavy bleeding
    • chronic pelvic pain
    • fatigue
    • infertility
    • bowel and bladder issues during their cycle
    • impact on general physical, mental, sexual and social well-being.


  • Adenomyosis is when the endometrial tissue in the lining of the uterus grows into the muscular wall of the uterus. It enlarges the uterus, and may lead to very heavy menstrual bleeding, swelling and pain.
    • Adenomyosis symptoms:
    • Heavy periods
    • Severe cramping
    • Sharp, stabbing pelvic pain during menstruation
    • Chronic pelvic pain
    • Leg pain
    • Painful intercourse
    • Lower abdominal pressure and bloating
    • Spotting between your periods
    • Longer periods than normal
    • are as above but can also include referred pain down the leg

So how can a women’s health Physio help? 

Physiotherapy can play a valuable role in helping manage symptoms and improve quality of life for individuals with endometriosis and adenomyosis. Here’s how physiotherapy may help:

  1. Pain Management: Physiotherapists can use various techniques to help manage pain associated with endometriosis and adenomyosis. This may include manual therapy, such as massage and joint mobilization, hot/cold therapy, Acupuncture, TENS as well as LASER therapy.
  2. Pelvic Floor Rehabilitation: Endometriosis and adenomyosis can affect the pelvic floor muscles, leading to issues such as pelvic pain, urinary urgency, and bowel dysfunction. Physiotherapists can provide pelvic floor rehabilitation to help strengthen and relax these muscles to improve symptoms.
  3. Exercise Prescription: Regular exercise can help improve overall health and reduce pain associated with endometriosis and adenomyosis. Physiotherapists can prescribe tailored exercise programs to suit individual needs and abilities and show you how to do things to improve your pain and capacity.
  4. Education and Lifestyle Advice: Physiotherapists can provide education about endometriosis and adenomyosis, including advice on lifestyle modifications that may help manage symptoms. This may include dietary recommendations, stress management techniques, and ergonomic advice.
  5. Postural Correction: Endometriosis and adenomyosis can impact posture and movement patterns, leading to musculoskeletal issues. Physiotherapists can assess and address these issues through postural correction and movement retraining.
  6. Scar Tissue Management: In cases where surgery has been performed to treat endometriosis or adenomyosis, physiotherapists can help manage scar tissue through techniques such as scar massage, LASER, Acupuncture and stretching to desensitise the tissue and make it more extensible.
  7. Support and Empowerment: Physiotherapists can provide emotional support and empower individuals to take an active role in managing their condition through self-care techniques and lifestyle modifications.

Physiotherapy for endometriosis and adenomyosis is often part of a multidisciplinary approach to care, involving collaboration with our onsite gynaecologists, pain specialists, and other healthcare providers. It’s important for individuals with these conditions to work closely with their healthcare team to develop a comprehensive treatment plan. 

How can Physiotherapy help Pelvic Floor muscle Dysfunction from Endo? 

Physiotherapy can play a crucial role in addressing the pelvic floor muscle imbalances caused by endometriosis. Here’s how:

1. Assessment: A physiotherapist will conduct a thorough assessment to evaluate the strength, coordination, and tone of your pelvic floor muscles. They may use internal and external techniques to assess the pelvic floor muscles’ function and identify any imbalances.

2. Pelvic floor exercises: Based on the assessment findings we will design a customized pelvic floor exercise program. These exercises aim to strengthen weak muscles and relax overactive or tight muscles. The program may include exercises such as Kegels, pelvic floor contractions, and multi-dimensional exercises.

3. Manual therapy: Physiotherapists may use manual therapy techniques such as myofascial release and trigger point therapy, to release tension and improve the flexibility of the pelvic floor muscles. This can help alleviate pain and restore optimal muscle function.

4. Biofeedback: Biofeedback is a technique used to provide visual or auditory feedback about muscle activity. It can help you become more aware of your pelvic floor muscles and learn to control them better. Physiotherapists may use biofeedback devices to assist in the retraining of pelvic floor muscle function.

5. Education and lifestyle modifications: Physiotherapists will provide education on proper bladder and bowel habits, postural adjustments, and lifestyle modifications that can reduce stress on the pelvic floor muscles. They may also provide guidance on activities to avoid or modify to prevent further strain on the muscles.

6. Pain management and exercise: Regular exercise can help manage the symptoms of endometriosis, including pain, fatigue, and mood disturbances. We can help provide you with a tailored exercise programmes for different parts of your cycle. For example, breathing techniques, yoga and Pilates whilst you are menstruating (or in pain) and cardio and strength training in the other phases.

7. Collaboration with other healthcare professionals: Physiotherapists often work with Gynaecologists, Pain specialists, and other healthcare professionals involved in the management of endometriosis.

At Liberty Women’s Wellness we acknowledge that every individual’s condition is unique, and the Physiotherapy treatment plan will be tailored to your specific needs. It’s essential to consult with a qualified Physiotherapist experienced in treating pelvic floor muscle imbalances and endometriosis to receive the most effective care. If you have any questions or know of anyone in your family/influence that you suspect are suffering with endometriosis, let them know that help is available.

The Jean Hailes foundation provides further information on the topic. https://www.jeanhailes.org.au/health-a-z/endometriosis/symptoms-causes

As does the Endometriosis Australia website https://endometriosisaustralia.org/resources/