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  • Nicole Cozean, PT, DPT, WCS

Reducing Endometriosis Stress with Physical Therapy and Psychology


An endometriosis diagnosis can be stressful, and rightly so. The condition is invisible and poorly understood, and it may feel like there is nothing that can be done. The accompanying feelings of helplessness can increase stress. Pain research demonstrates that stress increases pain, and gaining a sense of control over a medical condition can reduce both.

Stress and Endometriosis

Researchers set out to see if a combination of pelvic floor physical therapy and psychological intervention could reduce stress levels for endometriosis patients. They measured stress (using cortisol) of volunteers who spent 2.5 hours each week with a psychologist and pelvic floor PT.

They collected data for ten weeks, and the results were striking. Both perceived stress and levels of cortisol in the blood were significantly lower - in many cases, back to a 'normal' level. Patients reported improvements in vitality, social functioning, and mental health.

“Physical and psychological intervention...[for] women suffering of endometriosis was effective in reducing perceived stress, normalizing cortisol levels, increasing vitality, and improving physical functioning."

Finding ways to take control of your condition - whether through physical therapy, psychological intervention, yoga, meditation, or even just a hot bath - can have significant benefits on quality of life with endometriosis!

Additional Resources

Dr. Nicole Cozean is the founder of PelvicSanity physical therapy, Orange County's premier pelvic floor physical therapy clinic. One of only 270 PTs to be board-certified in the pelvic floor, and the first PT to serve on the ICA Board of Directors, Nicole is the author of the acclaimed and best-selling book The Interstitial Cystitis Solution (2016). She is an adjunct professor at her alma mater, Chapman University. The PelvicSanity blog focuses on presenting practical, positive information to help patients beyond the walls of Nicole's clinic.


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