Menstrual Pain (Endometriosis and Dysmenorrhea)

Menstrual pain can feel like a repetitive, continuous cycle of discomfort. Severe cramping, low back/pelvic pain, pain with bowel movements, abdominal pain, heavy bleeding, and pain with sex are some of the symptoms that characterize endometrisosis or dysmenorrhea. Pelvic floor physical therapy can help to minimize the symptoms so you can live your life cycle to cycle with less pain and disruption.


– Painful, heavy periods
– Severe cramping
– Pulling sensation throughout abdomen and pelvis
– Low back or pelvic pain
– Painful bowel movements
– Painful sex (dyspareunia)


During each normal period, the lining of the uterus sheds. With endometriosis, a tissue that is very similar to the uterine lining starts to grow outside of the uterus and throughout the pelvis or even through the abdominal cavity. More specifically, it can grow throughout the ovaries, uterus, and vagina which can then cause scarring and pain, restricting mobility of the organs. In turn, pelvic floor muscles spasm causing more pain. Some patients may experience pain and/or tightness throughout the front of their hips, their pelvis, abdomen, and low back.

Dysmenorrhea can be broken down into two types. Primary dysmenorrhea refers to recurring severe pain, nausea, fatigue, or diarrhea each menstural cycle but it is not caused by any underlying condition. Secondary dsymenorrhea refers to severe pain that is caused by other conditions, such as endometriosis, pelvic inflammatory disease, or fibroids.


Your physical therapist will perform a thorough evaluation to assess your symptoms. Being the evaluation will be internal and external, you and your therapist will work together to ensure your comfort throughout the entire process. Internal evaluation will assess for muscle tightness, tenderness, and strength, if appropriate. If your therapist feels you may need further examination or testing, she will refer you to an MD.


Treatment for endometriosis or dysmenorrhea will consist of releasing the muscle muscle spasms and restrictions throughout the pelvic floor musculature through various exercises and gentle manual techniques. Your therapist will also prescribe exercises to address any external pain, such as low back or hip pain, that has resulted from these conditions. Lastly, you will review home exercises and strategies to reduce your pain and discomfort.

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