Osteopathy for endometriosis
Endometriosis is one of the most common chronic gynaecological conditions. It occurs when tissue similar to the lining of the uterus (the endometrium) grows outside the uterus, for example on the ovaries, the peritoneum, the bowel, the bladder, or the supporting structures of the pelvis. This tissue can trigger inflammatory processes, cause pain, and contribute to the formation of adhesions (scar tissue).
Endometriosis affects far more than the menstrual cycle. Many patients report that the condition impacts almost every aspect of their lives, including work, leisure activities, relationships, sexuality, family planning, and emotional well-being.
Chronic pain can lead to increased sensitisation of the nervous system. As a result, pain may occur even outside of menstruation or be perceived more intensely. Many women also experience fatigue, sleep disturbances, and reduced physical resilience. Over time, chronic pain may lead to protective movement patterns and unconscious tension in the pelvic floor and abdominal muscles, which can further contribute to discomfort.
Possible symptoms include:
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Severe menstrual pain (dysmenorrhoea)
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Chronic lower abdominal or pelvic pain
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Pain during sexual intercourse (dyspareunia)
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Pain during urination or bowel movements, particularly—but not exclusively—during menstruation
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Digestive symptoms such as bloating, constipation, diarrhoea, nausea, or a feeling of fullness
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Lower back pain, sacral pain, hip pain, or pain radiating into the groin or thighs
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Significant fatigue
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Pain during physical activity or prolonged sitting
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Difficulty conceiving (subfertility or infertility)
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Increased tension in the pelvic floor muscles
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Symptoms that persist continuously or occur independently of the menstrual cycle
The wide variety of symptoms reflects the complexity of the condition. Endometriosis can affect multiple organs, and the combination of chronic inflammation and changes in pain processing may influence the body well beyond the pelvis.
How can osteopathy help?
Chronic pain often leads to changes that extend far beyond the original site of inflammation. Fascial tissues may lose their ability to glide freely, muscles can become tense, joint mobility may be reduced, and the pelvic floor often develops a persistently increased resting tone.
Depending on the individual assessment, osteopathic treatment may include the following approaches:
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Fascial and scar tissue treatment: Scars following laparoscopic or open abdominal surgery, as well as fascial restrictions within the abdomen and pelvis, may limit tissue mobility. Gentle manual techniques can be used to improve tissue mobility and address local areas of tension.
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Mobilisation of the pelvis and lumbar spine: Pain often results in protective movement patterns and altered posture. Improving the mobility of the pelvis, hips and lumbar spine may help distribute mechanical loads more evenly and support more efficient movement.
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Pelvic floor treatment: Many patients develop an overactive or chronically tense pelvic floor. This may contribute to pain while sitting, during sexual intercourse, or during urination. Manual techniques can help improve body awareness, promote relaxation of the pelvic floor muscles, and restore more balanced muscle function.
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Visceral techniques: Gentle manual techniques directed at the abdominal and pelvic organs aim to support the natural mobility of the tissues and reduce tension within the surrounding connective tissue.
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Supporting nervous system regulation: Persistent pain is often associated with increased activity of the autonomic nervous system. Many patients also experience tension in the jaw and neck. Gentle, calming manual techniques may help improve body awareness, reduce pain sensitivity, and promote relaxation.
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Internal techniques (vaginal or rectal): When clinically indicated and performed with the patient's informed consent, internal techniques may be used to assess and treat restrictions within the pelvic floor and surrounding connective tissues. They may be beneficial in patients with pelvic adhesions, significant pelvic floor hypertonicity, bladder pain, or persistent pelvic pain. Learn more about internal pelvic floor treatment here.