Endometriosis Associated Pain: What Can we Do? Episode 131 with Michelle Lyons

Hello & welcome to today's episode where I'm going to explore our role as pelvic rehab clinicians when it comes to the management of EAP

I think an important question to consider is:

'What does a woman with endometriosis associated pain actually need from us, beyond medical/surgical treatment?'

(particularly when those approaches have not been effective in reducing her pain or increasing her quality of life)

I believe we absolutely need to understand the pathophysiology of endometriosis - but it is vital that we don't stop there!

The amount of pain someone experiences does not always correspond neatly to the stage, amount, size of location of her endometriosis lesions - two women can walk into your clinic and have very different pain experiences.

EAP can be complex - we need to understand nociceptive inputs from inflammation/ tissue pathology, neuropathic and visceral components, pelvic floor dysfunction, chronic overlapping pain conditions, as well as changes in central pain processing and nociplastic mechanisms.

Our job is to figure out - which mechanisms appear to be contributing in this woman right now - AND - how can we help her build capacity?

Asking her 'what would you like to be able to do that your pain is currently stopping you from doing?'

we are not necessarily trying to achieve zero pain but rather trying to increase capacity, confidence, participation, self-efficacy and quality of life

And that means a different rehab conversation, where we are asking better questions to get better outcomes

Questions about her pelvic floor, bowel, bladder, movement (and how to prescribe and dose it), sleep, stress, sexual health, breath, her pain management toolbox and how to talk about nervous system sensitivity....

I think a really key question for us to consider might be 'how can I help her increase her capacity to live well alongside a condition that will fluctuate?' - and what does that look like in clinical practice?

If you'd like to learn more, the Endometriosis module, as well as modules on IC/Bladder Pain Syndrome, Vulvodynia, Dyspareunia and more, have all gone through their 2026 update and are available now in my online course, Female Pelvic Pain Rehab course! (already enrolled? you have access!) All of the course info can be found at CelebrateMuliebrity.com

Until next time, Onwards & Upwards! Mx #celebratemuliebrity