Endometriosis is a chronic condition that affects many women, often leading to debilitating pain, fatigue, and other symptoms. While it’s primarily known as a condition where tissue similar to the lining of the uterus grows outside of it, the ripple effects can extend throughout the body. This can impact not only the reproductive organs but also the muscles, nerves, and surrounding tissues, leading to widespread physical discomfort. Physiotherapy offers an effective, non-invasive approach to managing the physical effects of endometriosis, helping women regain control over their bodies and improve their quality of life. However, it’s not just the body that endometriosis affects—chronic pain conditions like this also take a significant toll on mental health. Integrating psychological support can be crucial in helping women manage both the physical and emotional impacts of the condition. 

The Psychological Impact of Endometriosis

Living with chronic pain requires immense psychological resilience, especially when that pain is misunderstood or stigmatised. Women with endometriosis often find themselves having to explain or justify their symptoms, which can be isolating and embarrassing. This is particularly challenging when the pain interferes with everyday activities, making it difficult to maintain work, relationships, or even personal identity. The stigma surrounding reproductive health and menstruation further compounds this, leading many women to minimise or dismiss their own suffering.

Endometriosis also creates a vicious cycle between pain and emotional well-being. The persistent, excruciating pain can lead some to experience feelings of hopelessness, anxiety, and depression. In turn, depression and anxiety can amplify the experience of pain, making it more difficult to cope and causing many to withdraw from activities they once enjoyed. The potential psychological burden of living with this condition should not be overlooked, as it affects self-esteem, body image, and overall mental health.

“Chronic pain, such as that experienced with endometriosis, can create a cycle of pain and psychological distress. Evidence shows that depression and anxiety can exacerbate pain perception, making management more challenging. Therefore, it’s crucial to address both the emotional and physical aspects simultaneously to break this cycle. Improving pain tolerance, building confidence and a sense of self, emotional regulation and helping women build resilience in the face of chronic pain can generate global benefits for people beyond their pain experience. We support people not just to manage pain, but to thrive and feel good about themselves again.” — Dr. Annemarie O’Connor, Clinical Psychologist and Chief Innovation Officer at HelloSelf.

Managing Pelvic Pain and Tension

One of the hallmark symptoms of endometriosis is pelvic pain, which can range from mild discomfort to severe, chronic pain. Pelvic health physiotherapists trained in women’s health physiotherapy are skilled in evaluating and addressing pelvic floor dysfunction, which is common in women with endometriosis. Ongoing  pelvic pain often causes the pelvic muscles to become tight and overactive, contributing to further pain and discomfort. Manual therapy, myofascial release, and specific pelvic floor relaxation exercises can help alleviate muscle tension, reduce pain, and improve overall function in the pelvic region. From a psychological perspective, this reduction in physical pain can provide emotional relief, reducing anxiety and helping women feel more in control of their bodies.

Improving Mobility and Flexibility

The inflammation and adhesions caused by endometriosis can lead to stiffness and restricted movement in the pelvic area, hips, and lower back. Physiotherapy helps to improve mobility through targeted stretching, joint mobilisations, and soft tissue techniques. A personalised exercise program can help restore flexibility and movement patterns, making daily activities more comfortable and manageable. By improving mobility, physiotherapist helps women with endometriosis regain their physical independence and improve their overall sense of well-being.

However, maintaining activity when you’re in pain requires careful pacing. Many women feel overwhelmed and fatigued, making it difficult to stay consistent with treatment. Physiotherapists and psychologists can work together to create manageable, long-term plans, where the focus is on “chunking” tasks—breaking them into smaller, achievable steps—and encouraging patients to engage when they have energy, rather than pushing themselves when they feel exhausted. This approach reduces the likelihood of feelings of frustration and hopelessness.

Addressing Lower Back and Abdominal Pain

Many women with endometriosis also experience lower back and abdominal pain due to the close proximity of the endometrial lesions to the lumbar spine and abdominal muscles. Back Pain Physiotherapy treatments such as manual therapy and gentle core strengthening exercises can be used to manage lower back pain symptoms. Strengthening the core and surrounding muscles helps reduce the strain on the lower back and abdomen, alleviating pain and providing much-needed support to these areas. Having strategies to cope with the pain helps improve emotional resilience, breaking the cycle of pain-mental distress-pain.

Enhancing Posture and Body Alignment

Endometriosis can affect posture, leading to imbalances and compensatory movement patterns that contribute to discomfort and pain in other areas of the body, such as the hips, shoulders, and neck. Physiotherapists can assess and correct these postural imbalances, ensuring that the body is aligned and functioning optimally. Postural re-education and ergonomic advice also help women with endometriosis perform their daily activities with less strain on their bodies, which can help in reducing the recurrence of pain.

Feeling comfortable in one’s own body, however, is not just about posture—it is also about identity. Many women with endometriosis struggle with changes in body image and the frustration of feeling “different” because they can’t engage in activities or even wear the clothes they want to due to bloating or pain. Addressing these emotional aspects can be as important as addressing physical imbalances.

Supporting Exercise and Physical Activity

Exercise is a key component in managing the long-term effects of endometriosis, but for many women, physical activity can feel daunting due to the pain and fatigue caused by the condition. Physiotherapists can design individualised exercise programs that focus on low-impact, pain-free movement. These programs often include gentle stretching, yoga-based movements, and strengthening exercises that are tailored to the individual’s level of comfort and ability. Over time, building strength and endurance helps to improve energy levels and reduce the frequency and intensity of pain episodes.

Compliance with exercise recommendations can be difficult when fatigue, pain, or mental health challenges are at play. This is where a collaborative approach between physiotherapists and mental health professionals can be transformative. Together, they can address barriers to staying active, using psychological strategies to boost motivation, manage fatigue, and improve engagement with physiotherapy, ultimately leading to benefits in mood, anxiety and discomfort.

A Holistic Personalised Approach

Endometriosis is a condition that affects both the body and mind, and effective management requires a holistic approach. Physiotherapy can address the physical aspects of the condition, helping women regain mobility, reduce pain, and improve function. At the same time, mental health support can provide essential coping strategies to navigate the emotional and psychological toll of living with chronic pain. By working together, physiotherapists and psychologists can offer a comprehensive personalised care plan that promotes healing, both physically and emotionally, and empowers women to live fuller, healthier lives.

If you’re struggling with the physical and emotional impact of endometriosis, it’s important to remember that you’re not alone. Thanks to a new partnership between HelloSelf and Excellence Physiotherapy, we can support your holistic recovery, addressing both the mind and the body. Together, we aim to help you regain control and live a fuller, healthier life.

For more information or to Contact HelloSelf
Visit www.helloself.com or Call them Directly on 020 3936 8384

For more information or to Contact Excellence Physiotherapy:
Visit www.excellencephysiotherapy.com or Call them directly on 0207 125 0262