What is pelvic floor physical therapy like, and will it hurt?

Pelvic floor physical therapy usually starts with a detailed conversation about your symptoms, followed by a gentle external—and sometimes internal—assessment to understand muscle tension, tenderness, and coordination. Treatment may include hands-on techniques to release tight or irritated muscles and connective tissue, along with guided retraining to help the pelvic floor relax and lengthen when it’s been stuck in a protective “guarding” pattern.

It should not feel like a painful exam, and in our experience the best progress happens when sessions are paced to avoid triggering a flare. Some people do feel temporary soreness or a brief increase in symptoms after a session, especially early on, but that typically settles as the tissues calm and your nervous system becomes less reactive. If therapy feels sharp, escalating, or lingers as a significant flare, that’s a sign the approach needs to be adjusted—our team can help you coordinate care and decide whether pelvic floor therapy fits into your overall endometriosis or adenomyosis treatment plan.