What is Endometriosis

The endometrium is the inner lining of the uterus, which changes throughout the menstrual cycle and is the tissue that sheds during a period. Endometriosis occurs when this endometrial‑like tissue grows outside the uterus in places it does not belong, but still behaves as if it were inside the uterus.

Even in these abnormal locations, the tissue continues to respond to hormonal changes. It can thicken, release inflammatory chemicals, and break down or bleed cyclically, similar to the endometrium inside the uterus. Because of this, symptoms can vary widely depending on how much tissue is present, how active it is hormonally, and where in the body it is located.

Most commonly, endometrial implants are found within the pelvis, including on the:

• Ovaries

• Fallopian tubes

• Vagina

• Cervix

• Pelvic soft tissues

Less commonly, endometrial tissue can appear in more unusual locations, such as:

• Surgical scars

• Lungs or their lining (pleura)

• Diaphragm

• Kidneys

• Spleen

• Gallbladder

• Nasal passages

• Around the spinal cord

• Stomach

• Breast

Symptoms of Endometriosis

Endometriosis can be challenging to diagnose because many of its symptoms overlap with other conditions, and some people have no noticeable symptoms at all. When symptoms are present, they often depend on where the endometrial implants are located. Common complaints include pelvic pain (often linked to the menstrual cycle) and heavy periods. Other possible symptoms include:

• Painful periods (dysmenorrhea)

• Heavy or irregular menstrual bleeding

• Ongoing pelvic pain

• Lower abdominal or low back pain

• Difficulty conceiving (infertility)

• Pain or discomfort with intercourse (dyspareunia)

• Pain with bowel movements (dyschezia), sometimes with alternating diarrhea and constipation

• Bloating, nausea, or vomiting

• Groin pain

• Pain or burning with urination, and/or increased urinary frequency

• Pain during exercise

• Blood in sputum (in rare cases involving lung tissue)

• Seizures that fluctuate with the menstrual cycle (in very rare cases where implants affect the nervous system)

How Pelvic Health Physiotherapy Can Help

Pelvic Health Physiotherapy at Ottawa Pelvic Health can play a supportive role in managing pain and pelvic symptoms associated with endometriosis.

1. Improving pain and pelvic symptoms related to bladder and bowel function

Endometriosis can alter the mobility of internal organs, fascia, and muscles within the pelvis. These changes may contribute to pelvic floor muscle dysfunction. Pelvic Health Physiotherapy can help restore more optimal patterns of pelvic floor contraction and relaxation, which in turn can reduce pain, urgency, and other pelvic symptoms.

2. Reducing pain with penetration (intercourse, menstrual products)

Endometriosis often leads to increased pelvic floor muscle tension or spasms, making tampon or menstrual cup insertion, pelvic exams, or intercourse painful. Over time, persistent pain can also sensitize the nervous system, causing it to “sound the alarm” even with mild stimulation. A Pelvic Health Physiotherapist can:

• Help down‑train and relax the pelvic floor muscles

• Use manual therapy and graded exercises to retrain the body and brain

• Support you in breaking the cycle of pain and fear with penetration

3. Supporting relief of bloating and abdominal discomfort

Bloating and abdominal distension are common with endometriosis. Over time, changes in the connective tissue and fascial layers can alter how the brain senses the position and movement of internal organs. Working with a Pelvic Health Physiotherapist who has training in visceral mobilization can help address restrictions in fascia and connective tissue around the abdominal organs. These techniques may reduce pressure, improve mobility, and help ease bloating and discomfort.

If you’re wondering whether Pelvic Health Physiotherapy could help with endometriosis‑related pain or pelvic symptoms, Ottawa Pelvic Health is here to support you. You can book a complimentary 15‑minute phone consultation with one of our specialized Pelvic Health Physiotherapists to discuss your concerns and explore whether this approach is right for you.