Pelvic Floor Dysfunction

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Remember, the information on my website, podcast, Instagram, and any other ways I communicate and/or produce content is educational information only and not medical advice. Always check with your qualified medical professional before making any changes to your treatment plan for endometriosis or any other health problems. See my full disclaimer here.

The muscles, ligaments, nerves, and fascia can all drive pain

Because of this, many people with endometriosis find pelvic floor therapy (PFT) to be helpful.

Many people often do PFT as a next step after having excision. However, it can be helpful prior to excision too, or just in general! PFT may help with painful sex, bladder and bowel symptoms, pelvic pain, and more.

Your therapist should have experience with endometriosis

Just like we need to see an actual specialist in endometriosis and not just any gynecologist for our endometriosis treatment, we need to see a pelvic floor therapist who is familiar with treating patients with endometriosis. Pelvic floor therapy is not one size fits all, and some pelvic floor therapists may not have the knowledge to treat the pelvic floor of someone with endometriosis. Many people with endometriosis have a hypertonic pelvic floor, meaning that its very tense and doesn’t relax. This would need to be treated differently than a hypotonic pelvic floor, which is a weakened pelvic floor (often common after pregnancy and childbirth).

Tips to help you prepare for your first PFT appointment

I take credit for none of these – they’re a summary of what contributed when I asked for tips in my Instagram stories. Thank you to everyone who responded!

Your comfort

-Ask ahead of time what will happen in the session.

-Premedicate if you’re in a lot of pain prior.

-Use medicated suppositories after if needed.

-You’re in control of your visit. You can say no to anything you’re not comfortable with. A good PT will not rush you into anything. PT can still be very effective without every exercise.

-Always trust your gut!

-Try to be open and as honest as possible.

-Find a PT with empathy that you like talking to. You’ll be very vulnerable and it helps to feel confident and relaxed with them.

Their knowledge

-Research your PT. Make sure they are trained properly in your presenting issues, especially endometriosis. Too many focus only on pre/post partum.

-Pelvic floor therapy is not one size fits all, and some PF therapists don’t have the knowledge to treat the pelvic floor of someone with endometriosis.

-Ask ahead if you require a queer-friendly or trauma-informed therapist.

-If they give you exercises to do at home, ask if you can video them demonstrating.

Be prepared

-Make a list of your symptoms and questions ahead of time in case you get nervous and forget.

-Bring a list of your medications.

-Bring a pen and paper or use Notes app to write info down.

-Wear loose clothing.

Keep in mind

-The first time can cause some extra discomfort.

-They might do internal work, meaning they put gloves on and put their fingers inside. However, they should ask your permission before they do this!

-They’ve likely seen it all.

-They’re in this work because they care.

-The first time is always awkward but try to relax and stay open.

-Some patients find that PFT makes them feel sore, fatigued, or nauseous for several hours afterwards, so you may want to schedule your PFT on days when you can relax afterwards, at least until you see how it affects you.