Pelvic floor dysfunction (PFD) and endometriosis are closely connected, as both can cause chronic pelvic pain and affect the muscles and tissues in the pelvic region.

Pelvic floor exercises may also help relieve symptoms of endometriosis by strengthening the muscles in the pelvic floor.

Read on to learn more about the relationship between PFD and endometriosis.

Endometriosis resources

Visit our dedicated hub for more research-backed information and in-depth resources on endometriosis.

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Endometriosis is a condition in which tissue similar to the lining of the uterus, or endometrium, grows outside of the uterus. Endometriosis is likelyTrusted Source related to factors like genetics, hormonal imbalances, or immune system dysfunction.

However, pelvic floor dysfunction can develop because ofTrusted Source endometriosis due to the chronic pelvic pain and inflammation caused by the condition.

PFD may arise when the pelvic muscles become tense or imbalanced in response to the ongoing pain or scar tissue associated with endometriosis.

Pelvic floor exercises, also called Kegel exercises, involve tightening and relaxing the muscles in and around the vagina, anus, bladder, and urethra.

Although it is unclear whether pelvic floor exercises directly benefit endometriosis, some research suggests that pelvic floor exercises can be empowering for people with endometriosis and may improve their pain symptoms.

Research indicates that strengthening pelvic floor muscles can boost a person’s core strength and stability. Experts also recommend pelvic floor muscle training to help support sexual function.

Research indicates pelvic floor strength training can help with bladder control and urinary incontinence. This may help people with endometriosis by improving symptoms such as pelvic pain, pain during sex, and other urinary issues.

A small 2024 study involving 41 women with endometriosis found that engaging in group pelvic floor exercises brought an increased sense of belonging and empowerment for the participants, helping them better manage their condition.

Women’s health resources

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This section looks at some pelvic floor exercises that a person with endometriosis can do to help with pelvic pain or pelvic floor dysfunction.

These exercises focus on relaxing and strengthening the pelvic floor muscles, as well as improving overall pelvic health.

When doing these exercises, it is important to:

  • prioritize relaxation, especially when experiencing pain or tightness
  • perform exercises slowly and mindfully, paying attention to breathing and the sensations in the body
  • work with a pelvic floor physical therapist if possible, as they can tailor exercises specifically to a person’s needs and help avoid overusing already tight muscles

Learn about physical therapy and how to find a physical therapist here.

Find the right muscles

To find the pelvic floor and Kegel muscles, a person can try to squeeze their muscles as if they were trying to hold in gas. If they feel the vagina muscles tighten, they are doing the right movement.

Another way to locate the pelvic floor muscles is to stop peeing midstream. The muscles squeezed here are the muscles to focus on in the exercises.

However, while this is a useful trick to locate the right muscles, a person should not do this regularly, as it can increaseTrusted Source the risk of a bladder infection.

Kegel exercises

Kegel exercises focus on holding and tightening the muscles that control urine flow. They are very versatile, and people can do them while sitting, standing, or lying down.

To perform Kegel exercises, a person can:

  • Sit or lie in a comfortable position with their eyes closed.
  • Squeeze the muscles as if they were trying to stop a flow of urine. Tighten them as much as possible — it should feel as though the muscles are lifting because of the squeezing.
  • Hold this position for 3 to 5 seconds.
  • Release the muscles and rest for several seconds.
  • Repeat up to 10 times.

A person can also vary these exercises by doing longer or shorter, more rapid muscle squeezes.

For shorter, more rapid squeezes, a person can aim for up to 10 “squeeze and release” contractions.

For longer squeezes, a person can aim to hold the muscles tight for around 10 seconds, with 5-second breaks in between.

Try to do 10 repetitions with a full relaxation in between each. A person may have to work up to this, but it will get easier over time.

Child’s Pose

The Child’s Pose, also called the Balasana Pose, is a gentle yoga exercise that stretches and relaxes the lower back, hips, and pelvic floor.

To do this, a person can:

  1. Start on their hands and knees.
  2. Sit back onto their heels while keeping their arms extended forward on the floor.
  3. Rest their forehead on the mat, allowing their hips to sink back and focusing on breathing.
  4. Hold this pose for 1 to 2 minutes while inhaling deeply and exhaling slowly.

A person can also modify this exercise by bringing out their knees further within a comfortable range, which will widen their hips further.

Bridge Pose

The Bridge Pose can also helpTrusted Source exercise the pelvic floor.

To do this pose, a person can:

  • Lie on their back with their knees bent, with their feet flat on the floor about hip-width apart. Keep the arms by the sides with the palms facing down.
  • Contract the buttocks and pelvic floor muscles, lifting the buttocks several inches off the ground.
  • Hold this position for 3 to 8 seconds.
  • Relax the muscles and lower the buttocks to the ground.
  • Repeat this up to 10 times per set.

A good starting point is three sets of these repetitions. As pelvic floor strengthening increases, many people find that they can do more sets and repetitions.

What can be mistaken for pelvic floor dysfunction?

SeveralTrusted Source conditions can mimic the symptoms of pelvic floor dysfunction (PFD), as they often share overlapping symptoms like pelvic pain, urinary issues, and bowel problems.

Additionally, some of these conditions can occur at the same time as PFD and can cause or worsenTrusted Source PFD.

If a person experiences chronic pelvic pain, urinary issues, painful menstrual cycles, or bowel problems, it is best to contact a healthcare professional for a proper diagnosis.

What aggravates pelvic floor dysfunction?

Pelvic floor dysfunction (PFD) can be aggravated by activities that increase pressure on the pelvic area, such asTrusted Source heavy lifting, high impact exercise, or prolonged sitting.

Chronic constipation and straining, childbirth, overweight or obesity, posture issues, stress, and certain high stress physical activities can also worsen PFD by overloading the pelvic muscles.

Additionally, trauma, surgeries, or chronic pain conditions can leadTrusted Source to muscle tightness can further worsen symptoms.

Pelvic floor dysfunction (PFD) and endometriosis have overlapping symptoms, and chronic pelvic pain from endometriosis can cause the pelvic muscles to tighten over time, leading to PFD.

Scar tissue from endometriosis can also pull on pelvic muscles, further contributing to dysfunction. This relationship often results in overlapping symptoms like pelvic pain and discomfort during urination or bowel movements.

Treating both conditions together can help improve symptom relief. Pelvic floor exercises can also help relieve both PFD and endometriosis symptoms.

A person should speak with a medical professional if they suspect they may have endometriosis, PFD, or both.