Endometriosis is a complex and often painful condition that affects millions of women everywhere. It occurs when tissue built very similar to the lining of the uterus (endometrium) grows outside the uterus, typically on the ovaries, fallopian tubes, bladder, intestines, and other pelvic organs. This misplaced tissue still acts as it would inside the uterus—it thickens, breaks down, and bleeds during the menstrual cycle. However, because this tissue doesn’t have any way to exit the body, it leads to inflammation, scar tissue (adhesions), and chronic pain.
One of the lesser-discussed impacts of endometriosis is its effect on the vagina and pelvic floor muscles. Endometriosis can cause pain and dysfunction in these areas, complicating symptoms and affecting quality of life. In this article, discover how and why endometriosis impacts the vagina and pelvic floor muscles, as well as what you can do to manage these symptoms.
How Endometriosis Affects the Pelvic Region
The pelvic region, which includes the uterus, ovaries, bladder, and intestines, is often the most affected area in people with endometriosis. The spread of endometrial-like tissue outside the uterus creates an inflammatory environment, leading to chronic pain, stiffness, and muscle tension.
Common Effects of Endometriosis on the Pelvic Region:
- Chronic inflammation: The ongoing buildup and breakdown of endometrial-like tissue during the menstrual cycle causes persistent inflammation in the pelvic area. This inflammation can affect the surrounding muscles, nerves, and organs.
- Adhesions and scar tissue: Over time, repeated inflammation can lead to the formation of adhesions—bands of scar tissue that bind organs together or to the pelvic wall. Adhesions can restrict the movement of pelvic organs, leading to pain, discomfort, and pelvic muscle dysfunction.
- Nerve irritation: The inflammation caused by endometriosis can irritate the nerves in the pelvic area, contributing to both localized and referred pain. Nerve pain often spreads to other areas, such as the vagina, lower back, and legs.
Why Does Endometriosis Affect the Vagina?
The vagina can be indirectly affected by endometriosis because it is close to the pelvic organs and tissues where endometrial-like growths are common. Though endometrial lesions themselves rarely form directly on the vaginal walls, endometriosis can cause significant vaginal pain and discomfort.
How Endometriosis Leads to Vaginal Symptoms
Endometriosis often causes referred pain – pain that is felt in a different area from where the actual condition exists. Inflammation and adhesions in the pelvic region can cause pain that radiates to the vagina, leading to discomfort during everyday activities or intercourse (dyspareunia).
Pelvic floor muscles then may become overactive or tense in response to the pain and inflammation caused by endometriosis. Tight pelvic floor muscles can cause vaginal pain, discomfort, and even contribute to painful intercourse.
The Connection Between Endometriosis and Pelvic Floor Dysfunction
Pelvic floor dysfunction is a common but sadly often overlooked aspect of endometriosis. The pelvic floor muscles, which form a supportive hammock across the bottom of the pelvis, can become dysfunctional in response to chronic pain and inflammation. When these muscles are either too tight (hypertonic) or too weak (hypotonic), they can contribute to further pain and complications.
When faced with this pain, the body’s natural response is to tense muscles to protect the affected area. This can happen with the pelvic floor muscles in people with endometriosis. Chronic pelvic pain leads to “muscle guarding,” where the muscles remain in a state of tightness or spasm, contributing to more pain and dysfunction. Tight pelvic floor muscles can also limit blood flow to the pelvic region, exacerbating pain and reducing the body’s ability to heal or respond to inflammation.
Coping with Vaginal and Pelvic Floor Pain Caused by Endometriosis
Managing vaginal and pelvic floor pain in endometriosis requires an approach that addresses both the underlying condition and its impact on the pelvic muscles. Treatment plans often include a combination of medical interventions, physical therapy, and lifestyle modifications.
Over-the-counter or prescription pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or hormonal treatments like birth control pills, may help reduce inflammation and pain. In some cases, stronger pain management strategies, such as nerve blocks or muscle relaxants, may be needed. You might find that using a dilator for pelvic relief is a better option for you if you don’t want to rely on medication.
A physical therapist is another great option to pair with medication or using at-home dilators. They can help you strengthen or relax your pelvic floor muscles through targeted exercises, manual therapy, and biofeedback. This therapy can be highly effective in reducing pain and improving bladder and bowel function.
If you don’t want to go to a professional, try pairing it with heat therapy that you can do at home. Or you could partake in low-impact exercises like yoga, walking, or swimming, which can help improve circulation, reduce muscle tightness, and support overall pelvic health. Avoid high-impact activities that may exacerbate pain.
Conclusion
Endometriosis can have a profound impact on the vagina and pelvic floor muscles, contributing to pain, discomfort, and pelvic dysfunction. However, with proper medical care, pelvic floor physical therapy, and lifestyle modifications, it is possible to reduce pain and improve quality of life. If you’re experiencing vaginal or pelvic floor pain related to endometriosis, consult with your healthcare provider for an accurate diagnosis and personalized treatment plan to help you manage your symptoms effectively.
