If you're on the journey of managing endometriosis, you may have heard that your pelvic floor muscles are overactive or even in spasm. For many "Endo Warriors," this is just another layer of complexity added to an already challenging condition. Let’s break down what it means to have overactive pelvic floor muscles and how it connects to your endometriosis.
What are the Pelvic Floor Muscles?
The pelvic floor muscles are a set of muscles that play a crucial role in your body's core strength, bladder and bowel control, and sexual function. They are divided into deep and superficial layers. The deep muscles form a sling-like structure from your pubic bone to your tailbone, while the more superficial layers sit near the opening of your bladder, vagina, and rectum. These muscles, when working well, help prevent issues like prolapse, incontinence, and support sexual health.
Most people are familiar with weak pelvic floor muscles, but with conditions like endometriosis, the opposite problem is more common: the muscles become too tight or overactive, which can lead to a host of uncomfortable symptoms.
Why Do Pelvic Floor Muscles Tighten in Endometriosis?
Pain is a key symptom of endometriosis, and your body's natural response to pain is to tighten muscles. If you experience pain regularly—especially during your menstrual cycle—your pelvic floor muscles can become chronically tight without you even realizing it.
Over time, instead of the pelvic muscles maintaining their flexible, sling-like shape, they can stiffen into a tense band, losing the ability to properly contract and relax. This can cause a variety of issues that can affect your quality of life.
Additionally, the organs and structures in your pelvis are packed closely together and often share nerve pathways. This means that if your endometriosis causes inflammation in one area, like your bladder, it can lead to overactivity in the nearby pelvic muscles. The reverse can also happen where irritated muscles can affect the organs, worsening symptoms like bladder pain or bowel discomfort.
Common Symptoms of an Overactive Pelvic Floor
If your pelvic floor muscles are overactive, you may experience some or all of the following symptoms:
- Slow or uncomfortable urination
- Constipation or difficulty emptying your bowels
- Painful or uncomfortable sex (dyspareunia)
- Difficulty using tampons
- Abdominal, back, or groin pain
What Can You Do If You Suspect Overactive Pelvic Floor Muscles?
If you're dealing with any of these symptoms, seeking help from a pelvic floor physiotherapist who specialises in pelvic pain is a crucial first step. They can help you regain control of your pelvic floor muscles, teaching them to contract and relax properly again. This not only relieves some of your symptoms but also supports your overall pelvic health.
Physiotherapy for overactive pelvic floor muscles often includes:
- Breathing exercises and stretches to relax the pelvic floor
- Manual therapy and gentle movements to help desensitise your nervous system
- Postural adjustments to improve bladder and bowel emptying
- Biofeedback tools, such as EMG or real-time ultrasound, to help you visualise and relax your pelvic muscles
- Dilator therapy to gradually reduce muscle tightness and improve comfort
Final Thoughts: You’re Not Alone
Dealing with endometriosis and its many layers—like overactive pelvic floor muscles—can feel overwhelming. But remember, you are not alone in this battle. Many Endo Warriors are walking a similar path, and with the right support, treatment, and self-care, it’s possible to manage these symptoms and reclaim your quality of life.
Take it one step at a time, listen to your body, and know that help is available. A pelvic floor specialist can provide a personalised plan to help you navigate this part of your endometriosis journey with confidence.
