Should I see a pelvic floor physical therapist if I have endometriosis?

If you're experiencing pelvic pain, painful periods, pain with sex, bladder symptoms, constipation, hip pain, low back pain, or abdominal pain related to endometriosis, pelvic floor physical therapy may be beneficial. Many people seek treatment before surgery, after excision surgery, or alongside medical management to improve symptoms and function.

Can pelvic floor physical therapy help after endometriosis excision surgery?

Absolutely. Surgery addresses endometriosis lesions, but it does not automatically resolve muscle tension, scar tissue restrictions, movement changes, or nervous system sensitivity that may have developed over time. Pelvic floor physical therapy can help restore mobility, reduce pain, improve scar mobility, rebuild strength, and support your return to exercise and daily activities.

Can pelvic floor physical therapy help before surgery?

Yes. Beginning physical therapy before surgery can help reduce pelvic floor muscle guarding, improve mobility, optimize breathing mechanics, and prepare your body for recovery. Many patients find that entering surgery with better movement and less muscle tension makes rehabilitation easier afterward.

Is an internal pelvic floor exam required?

No. Internal pelvic floor examinations are never required. Your physical therapist will explain every part of the evaluation, answer your questions, and only perform an internal assessment if you feel comfortable and provide consent. If you prefer not to have an internal exam, we can still begin treatment using many effective external techniques.

Does physical therapy help painful sex caused by endometriosis?

Yes. Painful intercourse is often related to overactive pelvic floor muscles, connective tissue restrictions, nervous system sensitivity, or muscle guarding that develops in response to chronic pain. Pelvic floor physical therapy addresses these contributors to improve comfort, muscle coordination, and confidence with intimacy.

How many physical therapy visits will I need?

Every treatment plan is different. The number of visits depends on your symptoms, medical history, goals, activity level, and whether you're recovering from surgery. During your evaluation, your physical therapist will discuss recommendations based on your individual needs and create a plan that works for your lifestyle.

Will I receive exercises to do at home?

Yes. Home exercises are an important part of treatment. Your program may include stretching, mobility exercises, strengthening, breathing techniques, nervous system regulation strategies, and activity modifications designed specifically for your symptoms and goals.

Can I continue exercising if I have endometriosis?

In many cases, yes. Rather than avoiding exercise altogether, we help you identify activities that feel good, modify movements that increase symptoms, and gradually rebuild strength and confidence. Our goal is to help you safely return to the activities you enjoy without unnecessary pain.

Do I need a diagnosis of endometriosis before starting physical therapy?

No. Many people begin pelvic floor physical therapy because they have symptoms that are consistent with endometriosis but have not yet received a formal diagnosis. If you're experiencing chronic pelvic pain, painful periods, painful intercourse, bladder symptoms, or bowel symptoms, physical therapy may still be appropriate while you continue working with your healthcare provider.

What happens during my first appointment?

Your first visit includes a one-hour evaluation with a doctor of physical therapy. We'll discuss your symptoms, medical history, goals, daily activities, and concerns before performing a comprehensive movement assessment. If appropriate and with your consent, we may also perform an internal pelvic floor examination. Together, we'll develop a treatment plan tailored to your needs and answer any questions you have.

Can pelvic floor physical therapy cure endometriosis?

No. Physical therapy cannot cure endometriosis or remove endometrial lesions. However, it can effectively treat the muscle, joint, connective tissue, movement, and nervous system changes that often contribute to pain, helping many people experience incredibly meaningful improvements in symptoms and quality of life.

Pelvic Floor PT for Endometriosis

Q: Can physical therapy help bladder and bowel symptoms caused by endometriosis?

Yes. Endometriosis commonly affects bladder and bowel function. Pelvic floor physical therapy can help improve constipation, painful bowel movements, urinary urgency, urinary frequency, bladder pain, and pelvic floor muscle dysfunction that contributes to these symptoms.

Pelvic Floor & Whole-Body Care for Endometriosis

Endometriosis can cause chronic pelvic pain, painful periods, pain with sex, painful bowel movements, bladder symptoms, and abdominal tension that persist even after surgery or medication.

At Sage Physical Therapy in Denver, our pelvic floor physical therapists specialize in treating the muscle, nerve, and movement impairments that often accompany endometriosis, helping patients reduce pain and return to the activities they love.

What Is Endometriosis?

Endometriosis is a chronic inflammatory condition in which tissue similar to the lining of the uterus grows outside the uterus. These growths can cause inflammation, irritation, and scar tissue (adhesions), leading to pain that often extends beyond your menstrual cycle. While endometriosis commonly affects the ovaries and pelvic organs, it can also contribute to pain throughout the hips, abdomen, low back, and pelvic floor.

Many people with endometriosis develop overactive pelvic floor muscles as the body's natural response to ongoing pain. Just as you might tighten your shoulders when you're stressed, the muscles of the pelvic floor can become tight and protective when they have been guarding against pain for months or years. Over time, this muscle tension can contribute to symptoms such as painful intercourse, painful bowel movements, bladder urgency or frequency, difficulty relaxing the pelvic floor, and persistent pelvic pain - even if the endometriosis itself has been treated with medication or surgery.

Pain from endometriosis is also influenced by the nervous system. After months or years of ongoing pain, the nervous system can become more sensitive, meaning that everyday movements or activities may begin to feel painful even when there is no new tissue growth. This does not mean the pain is "all in your head." Rather, it reflects how the brain, nerves, muscles, and connective tissues adapt to chronic pain.

Because of these changes, treating endometriosis often requires more than addressing the endometrial lesions alone. Pelvic floor physical therapy focuses on the musculoskeletal and nervous system components of pain, helping reduce muscle tension, improve mobility, calm an overprotective nervous system, and restore comfortable movement so you can return to the activities that matter most.

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Common Symptoms of Endometriosis

Endometriosis affects everyone differently. While many people think of painful periods as the hallmark symptom, endometriosis can cause a wide range of pelvic, abdominal, bowel, bladder, and musculoskeletal symptoms. If you've been told your symptoms are "normal" or you've struggled to find answers, pelvic floor physical therapy may be an important part of your treatment plan.

Pelvic Pain

Chronic pelvic pain
Pain during or between menstrual periods
Deep pelvic aching or cramping
Pain that worsens with prolonged sitting or standing
Pain with exercise or physical activity

Pain with Sex

Pain during penetration
Deep pain with intercourse
Pain that lingers after sex
Difficulty relaxing the pelvic floor muscles

Bladder Symptoms

Urinary urgency or frequency
Pain or burning with urination (without an infection)
Bladder pain or pressure
Difficulty fully emptying the bladder

Bowel Symptoms

Painful bowel movements
Constipation
Pain with straining
Bloating or abdominal discomfort that worsens around your menstrual cycle

Hip, Back & Abdominal Pain

Low back pain
Hip or buttock pain
Groin pain
Abdominal wall tightness or pain
Pain that radiates into the thighs or tailbone

Pelvic Floor Muscle Dysfunction

Ongoing pain from endometriosis often causes the pelvic floor muscles to become tight, overactive, and protective. These muscle changes can continue to cause symptoms even after excision surgery or medication has reduced the endometriosis itself. Pelvic floor physical therapy addresses these muscular and movement-related contributors to pain, helping improve mobility, reduce muscle guarding, and restore more comfortable daily function.

If you're experiencing any of these symptoms, you don't have to wait until they become severe to seek care. Early treatment can help reduce pain, improve function, and support your overall quality of life.

How Can Pelvic Floor Physical Therapy Help Endometriosis?

While pelvic floor physical therapy cannot remove endometriosis lesions, it can address many of the musculoskeletal and nervous system changes that contribute to ongoing pain. Many people with endometriosis continue to experience symptoms even after medication or excision surgery because the muscles, connective tissues, and nervous system have adapted to living with chronic pain.

At Sage Physical Therapy, we take a whole-body approach to treating endometriosis. Rather than focusing only on the pelvic floor, we evaluate how your muscles, joints, breathing patterns, movement habits, and nervous system may be contributing to your symptoms.

Pelvic floor physical therapy may help improve:

Chronic pelvic pain
Painful intercourse (dyspareunia)
Pain with tampon use or pelvic exams
Low back, hip, groin, and abdominal pain
Bladder urgency, frequency, and pelvic pressure
Painful bowel movements and constipation
Pelvic floor muscle tension and muscle guarding
Pain with exercise, lifting, or returning to sports
Core weakness and movement limitations following surgery

How Physical Therapy Works

Endometriosis often causes the pelvic floor muscles to remain in a constant state of tension. Over time, these muscles can develop trigger points, become less flexible, and contribute to pain with everyday activities. At the same time, chronic pain can make the nervous system more sensitive, meaning that normal movement or touch may begin to feel painful.

Pelvic floor physical therapy helps by addressing these underlying contributors to pain. Treatment may improve muscle coordination, decrease protective muscle guarding, restore mobility throughout the pelvis and hips, improve breathing mechanics, and help calm an overactive nervous system. As pain decreases, many people are able to return to exercise, intimacy, work, travel, and other activities they have been avoiding.

Because every person experiences endometriosis differently, your treatment plan is individualized based on your symptoms, goals, and medical history. Whether you've recently been diagnosed, are preparing for excision surgery, recovering after surgery, or have been living with endometriosis for years, pelvic floor physical therapy can play an important role in your overall care.

How We Treat Endometriosis at Sage Physical Therapy

No two people experience endometriosis the same way, which is why every treatment plan at Sage Physical Therapy is individualized to your symptoms, goals, and stage of recovery. Whether you've recently been diagnosed, are preparing for excision surgery, recovering after surgery, or have been living with endometriosis for years, our pelvic floor physical therapists create a plan tailored specifically to you.

Comprehensive Evaluation

Your first visit includes a thorough assessment of your symptoms, medical history, movement patterns, posture, breathing mechanics, core function, hips, spine, and pelvic floor. When appropriate and with your consent, we may perform an internal pelvic floor examination to better understand how your muscles are contributing to your symptoms. Internal exams are never required, and your comfort and preferences guide every step of your care.

Pelvic Floor Physical Therapy

Many people with endometriosis develop pelvic floor muscle tension, trigger points, and muscle guarding as a response to chronic pain. Treatment focuses on improving your ability to relax and coordinate these muscles, decreasing pain, and restoring normal function.

Manual Therapy

Hands-on treatment may be used to improve mobility of the pelvic floor, abdomen, hips, low back, and surrounding connective tissues. Gentle manual therapy can help reduce muscle tension, improve flexibility, decrease pain, and restore comfortable movement.

Dry Needling

When appropriate, dry needling may be used to reduce muscle tension and treat persistent trigger points that contribute to pelvic pain, hip pain, abdominal pain, or low back pain. This technique is often combined with movement and exercise for longer-lasting results.

Exercise & Strength Training

Exercise is an important part of managing endometriosis, but the right program depends on your symptoms and where you are in your recovery. We develop individualized strengthening and mobility programs that help you build confidence, reduce pain, improve core and hip strength, and safely return to the activities you enjoy.

Nervous System & Pain Education

Living with chronic pain can cause the nervous system to become more sensitive over time. We help you understand how pain works and teach practical strategies - including breathing techniques, pacing, movement, and relaxation exercises - to help calm an overprotective nervous system and improve your quality of life.

Bowel & Bladder Health

Endometriosis frequently affects bowel and bladder function. We provide strategies to improve constipation, painful bowel movements, urinary urgency, urinary frequency, bladder pain, and healthy bathroom habits that support long-term pelvic health.

Scar Mobility & Post-Surgical Rehabilitation

If you've had laparoscopic or excision surgery for endometriosis, physical therapy can help improve scar mobility, restore abdominal and pelvic movement, reduce muscle guarding, and safely rebuild strength as you recover.

Collaboration With Your Healthcare Team

Endometriosis often requires a team approach. We regularly collaborate with gynecologists, endometriosis specialists, primary care providers, mental health professionals, dietitians, and other healthcare providers to ensure your care is coordinated and supports your overall treatment plan.

Our goal is not simply to reduce pain - we want to help you return to exercise, work, travel, intimacy, and the activities that matter most. Through evidence-based pelvic floor physical therapy, we help people with endometriosis move with greater confidence, improve their quality of life, and regain trust in their bodies.

Unlike many clinics that focus only on the pelvic floor, we evaluate how your hips, spine, abdominal wall, breathing mechanics, strength, and movement patterns interact with your pelvic floor. This whole-body approach helps us identify contributors to pain that might otherwise be overlooked and supports lasting improvements in function.

Why Choose Sage Physical Therapy for Endometriosis Treatment in Denver?

Choosing the right physical therapist for endometriosis is about more than finding someone who treats the pelvic floor. Endometriosis is a complex condition that often affects the muscles, joints, nerves, connective tissues, and movement patterns throughout the body. At Sage Physical Therapy, our approach is designed to address all of these factors - not just your symptoms.

Specialized Pelvic Floor Physical Therapists

Our doctors of physical therapy have advanced training in pelvic floor dysfunction and regularly treat people with endometriosis, chronic pelvic pain, painful intercourse, bladder symptoms, bowel dysfunction, and complex pelvic pain conditions. Pelvic health is not just one of the services we offer - it is a primary focus of our practice.

A Whole-Body Approach to Endometriosis

Endometriosis doesn't only affect the uterus or pelvic organs. Chronic pain often changes how your entire body moves. We assess your pelvic floor alongside your hips, low back, abdomen, breathing mechanics, posture, strength, and movement patterns to identify everything that may be contributing to your symptoms.

This whole-body perspective allows us to treat the underlying musculoskeletal factors that can keep pain going, even after medication or excision surgery.

One-Hour, One-on-One Appointments

Every appointment at Sage Physical Therapy is a full hour with your doctor of physical therapy. You'll work with the same provider throughout your care, allowing us to build a thorough understanding of your symptoms, monitor your progress, and adjust your treatment plan as your needs change.

Evidence-Based, Individualized Care

No two people experience endometriosis the same way. Your treatment plan is built around your unique symptoms, goals, activity level, and medical history. We combine the latest evidence with clinical expertise to create a plan that helps you make meaningful, lasting progress.

Advanced Treatment Techniques

Depending on your needs, treatment may include pelvic floor physical therapy, orthopedic rehabilitation, manual therapy, dry needling, mobility training, strength and exercise programming, scar mobility treatment, nervous system regulation strategies, and education to help you better understand and manage persistent pain.

Care Before and After Endometriosis Surgery

Whether you're preparing for laparoscopic surgery, recovering after excision surgery, or managing endometriosis without surgery, physical therapy can play an important role in your recovery. We help reduce muscle guarding, improve mobility, restore strength, address scar tissue restrictions, and support a safe return to everyday activities.

Helping You Return to the Life You Want to Live

Our goal is not simply to decrease pain during your appointments. We want to help you feel confident returning to exercise, hiking, running, work, travel, intimacy, caring for your family, and the activities that make your life meaningful. Treatment is always centered around the goals that matter most to you.

Conveniently Located in Denver

Sage Physical Therapy proudly provides pelvic floor physical therapy for people with endometriosis throughout the Denver metro area. We care for patients from Denver, Cherry Creek, Wash Park, Platt Park, Highlands, Capitol Hill, Englewood, Littleton, Lakewood, Aurora, Centennial, and surrounding Colorado communities who are looking for specialized, one-on-one pelvic floor care.

Who We Help

People seek care at Sage Physical Therapy for endometriosis if they are:

Newly diagnosed with endometriosis
Preparing for excision surgery
Recovering after laparoscopic or excision surgery
Living with persistent pelvic pain despite surgery
Experiencing painful sex
Struggling with bladder or bowel symptoms
Trying to return to exercise without flaring symptoms
Looking for a pelvic floor physical therapist in Denver who specializes in endometriosis

People choose Sage Physical Therapy because they are looking for:

A pelvic floor physical therapist in Denver with experience treating endometriosis
One-hour, one-on-one appointments
Care before or after endometriosis excision surgery
Treatment for painful sex, bladder symptoms, bowel symptoms, and chronic pelvic pain
A whole-body approach that combines orthopedic and pelvic floor expertise
Evidence-based care designed to help them return to exercise, work, and everyday life

Frequently asked questions

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Yes. While pelvic floor physical therapy cannot cure endometriosis or remove endometrial lesions, it can address many of the musculoskeletal changes that contribute to pain. Endometriosis often causes the pelvic floor muscles to become tight and overactive, leading to pelvic pain, painful intercourse, bladder symptoms, bowel symptoms, and difficulty returning to normal activities. Physical therapy helps improve muscle function, mobility, strength, and movement while reducing pain and improving quality of life.
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Your first visit includes a one-hour evaluation with a doctor of physical therapy. We'll discuss your symptoms, medical history, goals, daily activities, and concerns before performing a comprehensive movement assessment. If appropriate and with your consent, we may also perform an internal pelvic floor examination. Together, we'll develop a treatment plan tailored to your needs and answer any questions you have.
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Sage Physical Therapy is a pelvic floor physical therapy practice in Denver that specializes in treating complex pelvic pain conditions, including endometriosis. Our clinicians combine orthopedic and pelvic health expertise to address the muscles, joints, connective tissues, movement patterns, and nervous system factors that contribute to pain. Every appointment is one hour, one-on-one, with the same doctor of physical therapy, allowing us to provide individualized, evidence-based care that helps patients return to the activities they love.
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Take the Next Step Toward Feeling Better

Living with endometriosis can feel overwhelming, but you don't have to manage it alone. Whether you've recently been diagnosed, are preparing for surgery, recovering after excision surgery, or have been living with pelvic pain for years, pelvic floor physical therapy can help address the muscle, movement, and nervous system changes that often contribute to persistent symptoms. At Sage Physical Therapy in Denver, our doctors of physical therapy specialize in helping people with endometriosis reduce pain, improve bladder and bowel function, return to exercise, and feel more confident in their bodies. If you're looking for a pelvic floor physical therapist in Denver with experience treating endometriosis, we're here to help you take the next step toward getting back to the life you love.

Reviewed by Dr. Katherine Koch, PT, DPT

Owner, Sage Physical Therapy | Pelvic Floor Physical Therapist | Featured Speaker for the Colorado Chapters of ACOG and AASECT | Interviewed by Backpacker Magazine

Published July 2026