Between hope and disappointment: women’s experiences with pelvic floor physical therapy for endometriosis

Abstract Background Endometriosis is a chronic gynecological condition associated with substantial treatment burden. Although pelvic floor physical therapy is increasingly incorporated into endometriosis care, endometriosis is not primarily a pelvic floor disorder, making the rationale for this treatment less apparent. This study explored women’s experiences with pelvic floor physical therapy in endometriosis care. Methods A qualitative study using semi-structured interviews was conducted among adult women with endometriosis who had undergone pelvic floor physical therapy. Participants were recruited via social media. Interviews were conducted via Zoom between August and December 2023, transcribed verbatim, and analyzed using Braun and Clarke’s thematic analysis. Results Twenty women participated. Three themes were generated: (1) Pelvic floor physical therapy: hope and disappointment; (2) Seeking understanding and recognition; and (3) Caught in a cycle of seeking relief. Women described pelvic floor physical therapy as one of several treatments pursued in an ongoing search for symptom relief. Women described little or no meaningful improvement in endometriosis-related pain, yet continued treatment despite limited pain relief, reflecting the broader burden of repeated treatment-seeking. Conclusion Pelvic floor physical therapy should be guided by the presence of pelvic floor dysfunction rather than an endometriosis diagnosis alone, to avoid adding to the burden of treatments that provide little or no benefit.