Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus often leading to significant pelvic pain, heavy painful periods, nausea, migraines and sometimes fertility challenges. It’s estimated that around 1 in 9 people assigned female at birth live with endometriosis (Rowlands et al 2021), yet it remains widely misunderstood, underdiagnosed, and can often take individuals many years to reach diagnosis.
One of the most commonly reported, and painful, symptoms of endometriosis is chronic pelvic pain (CPP). However it’s worth noting that not everyone with chronic pelvic pain has endometriosis, and not everyone with endometriosis experiences significant pain. CPP is a broader term describing persistent pain in the pelvic region that lasts six months or more and can stem from various conditions that includes endometriosis as well as, irritable bowel syndrome (IBS), interstitial cystitis, or musculoskeletal issues. While endometriosis-related pain often flares cyclically, CPP can be constant or triggered by movement, stress, or sexual activity.
Both endometriosis and chronic pelvic pain can take an emotional and relational toll which can leave individuals feeling frustrated and disheartened. As a result, many individuals experience anxiety, depression, and feelings of disconnection from their bodies. Similarly the pain can disrupt daily life, sexual function, and the ability to engage in enjoyable activities.
For those in relationships, these conditions can introduce challenges to intimacy and communication. Pain during sex is common with endometriosis and CPP and can unfortunately lead to individuals fearing intercourse, avoidance of sexual touch because of anticipatory penetration anxiety, and a sense of guilt or shame.
Approaching endometriosis and CPP through a ‘whole-person’ lens often results in better symptom management, a reduction in pain reporting and increased life satisfaction.
For some, surgery may be necessary as gynecologists can help remove endometrial lesions and reduce pain, although it’s important to be aware that recurrence is possible and repeat surgeries are often associated with increased pain reporting. Gynecologists, pain specialists and GP’s can support patients with the use of hormones including birth control pills, pain medication and progestins, which aim to regulate hormonal fluctuations and suppress endometrial growth. Physiotherapy, particularly pelvic floor therapy, helps patients address muscular tension and pain management strategies associated with endometriosis. Dieticians support patients develop tailored plans to meet nutritional needs, reduce inflammation and digestive triggers, and support gut health. Other allied health professionals support individuals managing the symptoms and impact of endometriosis/CPP.
Combining medical, physiotherapy, allied health with psychological and relational support can offer a more comprehensive path to supporting the whole body therefore improving quality of life.
Whilst pain can have an impact on connection with self and those around you, many people with endometriosis learn to navigate relationships, sexual intimacy and connection. It is important to keep in mind that there is no ‘one-size-fits-all’ approach to this however, from a broader perspective it can be useful to consider the following:
Chronic pelvic pain and endometriosis are not just physical conditions—they impact emotional well-being, identity, and relationships. At CRSW, we believe that a compassionate, whole-body approach to management can help individuals reconnect with their bodies, their pleasure, and their relationships.
Rowlands I.J., Abbott, J.A., Montgomery, G.W., Hockey, R., Rogers, P., & Mishra, G.D. (2021). Prevalence and incidence of endometriosis in Australian women: a data linkage cohort study. Journal of Obstetrics and Gynecology https://doi.org/10.1111/1471-0528.16447
