Endometriosis can cause cyclical and non-cyclical pelvic pain, painful intercourse, bowel and bladder symptoms, and low back or hip pain. Pain may persist even after surgery due to myofascial and nerve factors. MPM focuses on identifying each driver and coordinating with gynecology so you get a unified plan.
What is endometriosis?
Endometriosis occurs when tissue similar to the uterine lining is found outside the uterus. It can inflame, scar, and irritate nearby structures and nerves, leading to pain that may become chronic.
What are the causes?
- Inflammatory lesions and adhesions
- Pelvic floor muscle spasm and trigger points
- Nerve irritation, including pudendal or obturator branches
- Central sensitization after years of pain
- Coexisting conditions such as IBS or bladder pain syndrome
What are the signs and symptoms?
- Pelvic pain that may worsen around menses
- Pain with intercourse, bowel movements, or urination
- Low back, hip, or groin pain
- Bloating, constipation, or urinary urgency
- Pain flares with activity or prolonged sitting
What are the risk factors?
- Family history of endometriosis
- Early onset of painful periods
- Prior pelvic surgery
- Coexisting migraine or centralized pain conditions
How is it diagnosed?
Diagnosis is based on detailed history, pelvic exam, and contribution from imaging when helpful. Laparoscopy remains the surgical standard when the diagnosis is uncertain or when excision is planned. At Manhattan Pain Medicine, we map pain sources, assess muscles and nerves, and coordinate with your gynecologist to avoid redundant testing.
What are possible treatment options?
- Pelvic floor physical therapy and home programs
- Myofascial and trigger point treatments, including targeted injections when appropriate
- Image-guided pelvic nerve blocks for selected patterns of pain
- Visceral and scar management strategies when adhesions are suspected
- Pain modulation strategies and flare plans
- Nutrition and bowel care strategies in coordination with your medical team
- Close collaboration with gynecology for hormonal management or surgical planning
Are there preventative steps?
- Early management of painful periods and flares
- Regular movement and core strength
- Bowel and bladder routines that reduce strain
- Stress and sleep strategies that lower pain reactivity
What are the risks if it is left untreated?
- Progressive pain and activity limits
- Pelvic floor dysfunction and sexual pain
- Central sensitization that complicates recovery
- Impact on mood, relationships, and work
Are there other related conditions?
Pelvic Floor Dysfunction, Pelvic Pain, Bladder Pain Syndrome, IBS, Hip and Low Back Pain, Pudendal Neuralgia.
Key takeaways
- Endometriosis pain often involves muscles and nerves, not only lesions.
- A coordinated plan with gynecology improves outcomes.
- Many patients achieve better function with combined rehab, targeted procedures, and self-care skills.
Recommended next steps
- Request Appointment
- Share prior surgical notes or imaging if available.
- Complete our intake and pain map.
- We will clarify contributors and align your pain plan with your gynecology care.
