When you live with endometriosis or persistent pelvic pain, it’s easy to feel like your body is working against you- especially when people don’t often discuss the pelvic area. And then you get referred to Pelvic Physiotherapy, and have no idea what to expect!

Many clients arrive at their first Pelvic Physiotherapy session feeling anxious. Some are scared it’s going to hurt and others are worried that something about their vulva, labia, or vagina isn’t “normal.” I’ve lost count of how many people have nervously asked: “Is it okay down there?” or whispered, “Sorry, I haven’t waxed…”

So let’s discuss this and clear things up- with kindness, facts, and zero shame.

If you live with endometriosis or persistent pelvic pain, you probably already know that pain doesn’t follow a neat, predictable schedule. Some days are manageable. Others are overwhelming. And many days fall somewhere in between.

It’s one of the most common- yet least talked about- challenges of living with endometriosis: bowel symptoms.

Many people with endometriosis experience bloating, constipation, diarrhoea, pain with bowel movements, or a sensation of incomplete emptying. These symptoms can occur even without endometriosis directly affecting the bowel, because of the condition’s links with inflammation, nerve sensitisation, and pelvic floor dysfunction.

One of the most common questions I hear from patients is:
"Can I do Pilates if I have endometriosis?"

And the answer is: there is absolutely no rule against it.

Research confirms what many patients have known for years: endometriosis is associated with significantly higher rates of insomnia, poor sleep quality, and daytime fatigue compared to those without the condition.

The words we use in endometriosis care can either build trust or cause harm. In this blog, clinician Jo shares how subtle shifts in language can help avoid medical gaslighting, validate lived experience, and foster safer, more compassionate care for people with endometriosis.