The Role of Pelvic Floor Therapy in Endometriosis Care for Those Trying to Conceive

Endometriosis is more than just a diagnosis—it’s a journey that impacts so many aspects of your life. For those trying to conceive, it can feel especially overwhelming. As an occupational therapist who specializes in pelvic health, I want to talk about how pelvic floor therapy can be a crucial part of your fertility journey. Endometriosis can bring pelvic pain, painful intercourse, and infertility, and addressing these issues is so important when trying to conceive. Pelvic floor therapy doesn’t just target physical symptoms—it takes a holistic approach to support your overall health, helping you navigate this challenging journey with a little more ease.

Understanding Pelvic Floor Dysfunction in Endometriosis

Endometriosis often brings inflammation, adhesions, and chronic pain, all of which can directly affect your pelvic floor. The pelvic floor is made up of muscles, ligaments, and tissues that support the pelvic organs, and when these muscles are affected by endometriosis, dysfunction can occur, impacting both fertility and overall well-being. Here’s how it can play out:

1. Pelvic Floor Muscle Tension

Pelvic floor muscles naturally have some tension to help with bodily functions like preventing unintentional urination or bowel movements. However, chronic tension in these muscles, often caused by ongoing pain, can become problematic. When the pelvic floor muscles tighten and become overactive, it not only adds to the pain but can also make conception more difficult.

2. Visceral Adhesions

Endometriosis can lead to adhesions that restrict the normal movement of organs like the uterus and ovaries. When these organs can't move freely, it impacts their function, and this can make conceiving more challenging.

3. Central Sensitization

Long-term pain can alter the way your nervous system responds to stimuli. What may normally feel neutral or non-painful can start to feel painful because the nervous system begins to overreact, which can make navigating everyday activities and TTC even more difficult.

How Pelvic Floor Therapy Helps

Pelvic floor therapy offers a non-invasive, holistic approach to addressing these issues, helping to alleviate pain, improve function, and support your fertility goals. Here’s how it works:

1. Addressing Muscle Dysfunction

  • As a pelvic floor therapist, I assess and treat muscle tension or weakness in the pelvic floor. This can include techniques like myofascial release, biofeedback, targeted exercises, and nervous system down-training.
  • By releasing muscle tension and improving blood flow, we can help support the functioning of your uterus and ovaries, which is essential for fertility.

2. Managing Pain

  • Pain is a major symptom of endometriosis, and it can be debilitating for some. Through manual therapy, nervous system regulation, and gentle stretching, we work to address pain associated with endometriosis.
  • One of the key tools we use in pelvic floor therapy is down-training techniques, such as diaphragmatic breathing and somatic practices. These techniques help calm an overactive nervous system and reduce the heightened pain response that often comes with central sensitization.

3. Enhancing Organ Mobility

  • While there is limited research specifically on the use of visceral mobilization for endometriosis, it can potentially offer several benefits for individuals with this condition. Visceral mobilization techniques can help address adhesions and improve the mobility of pelvic organs. These techniques can help reduce the tension between the uterus, ovaries, and surrounding structures, enhance circulation a lymphatic flow, and alleviate pain and discomfort.

4. Supporting Sexual Function

  • Painful intercourse (dyspareunia) is a common and often distressing symptom of endometriosis. It can significantly affect intimacy and efforts to conceive. Pelvic floor therapy helps by addressing all sexual health-related concerns such as muscle tension, positions, arousal, and desire, allowing you to feel more comfortable and connected during intimacy.

5. Holistic Care

  • As a pelvic floor therapist, I work closely with your broader care team—including gynecologists, reproductive endocrinologists, naturopaths, and nutritionists—to provide truly comprehensive care.
  • I also offer education on lifestyle modifications, such as reducing inflammatory foods, managing stress, and incorporating physical activity. These changes can all support your fertility goals and overall well-being.

A Holistic, Supportive Approach

If you’re dealing with endometriosis and trying to conceive, pelvic floor therapy is a valuable, non-invasive tool to add to your care routine. It’s about addressing the whole person—not just your symptoms—by reducing pain, improving muscle function, and supporting your emotional well-being. Pelvic floor therapists like me are here to provide individualized care that works in tandem with your other treatments, helping to make your fertility journey feel a little more manageable. You don’t have to walk this path alone—there’s support available to help you on your way.

Jacklyn Iannitti

Jacklyn Iannitti is the owner of Integrative Pelvic Wellness and a dedicated occupational therapist specializing in pelvic health and primary care prevention. With expertise in trauma-informed care and as a Certified Sexuality OT, Jacklyn empowers individuals through life's major transitions—pregnancy, postpartum, and (peri)menopause. Her mission is to create a safe space where clients feel heard, supported, and equipped to thrive in every aspect of their lives.

https://www.integrativepelvicwellness.com/
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