{"paper_id":"a0886fe5-c750-46c5-b2d7-1ca9bb8c92dd","body_text":"Abstract\nBackground\nChronic pelvic pain is one of the most disabling manifestations of endometriosis and is frequently associated with impaired quality of life, bladder dysfunction, and sexual dysfunction. Pelvic floor muscle (PFM) dysfunction may contribute to a potential contributor to symptom persistence; however, objective evidence regarding its role in women with endometriosis is limited.\nObjective\nTo examine and compare pelvic floor muscle (PFM) function, assessed using vaginal manometry, together with patient-reported measures of pelvic pain, pelvic floor symptoms in women with and without endometriosis. Secondary aims were to explore preliminary between-group differences and examine the associations between PFM function and symptom severity.\nMethods\nIn this pilot cross-sectional case–control study, 31 women aged 18–45 years were recruited. One participant was excluded from the control group, resulting in a final sample of ; 30 participants, including 15 women with medically confirmed endometriosis and 15 controls.\nParticipants completed the Pelvic Pain Impact Questionnaire (PPIQ), Numeric Rating Scale (NRS) for pain, and Australian Pelvic Floor Questionnaire (APFQ). Pelvic floor muscle function was assessed using intravaginal manometry, including measures of resting pressure, maximal voluntary contraction (MVC), and the number of rapid contractions performed within 30 seconds. Group differences were examined using univariate analyses and analyses of covariance controlling for age, body mass index, and vaginal delivery history. Spearman correlations were calculated to investigate associations between PFM function and patient-reported outcomes.\nResults\nWomen with endometriosis reported significantly higher average and maximal pain intensity, greater pelvic pain-related disability, and more severe bladder and sexual symptoms than controls (all p < 0.05). They also demonstrated significantly higher vaginal resting pressure and lower MVC values. After adjustment for covariates, significant group differences remained for pain outcomes, pelvic pain impact, bladder and sexual function, total APFQ score, and resting PFM tone (p < 0.05). MVC was moderately associated with bladder symptoms (ρ = −0.384, p = 0.036), sexual function (ρ = −0.470, p = 0.009), and overall pelvic floor symptom burden (ρ = −0.435, p = 0.016). No significant associations were observed between PFM parameters and pelvic pain-related disability.\nConclusions\nWomen with endometriosis showed higher symptom burden and differences in selected pelvic floor muscle parameters compared with controls without a diagnosed gynaecological disorder. These exploratory findings warrant confirmation in prospective studies with larger sample sizes.\nTrial registration\nClinicalTrials.gov Identifier: NCT07713108 (01.07.2026)\nAbbreviations\n- PFM:\n-\nPelvic Floor Muscle\n- PPIQ:\n-\nPelvic Pain Impact Questionnaire\n- NRS:\n-\nNumeric Rating Scale\n- AFPQ:\n-\nAustralian Pelvic Floor Questionnaire\n- MVC:\n-\nMaximal Voluntary Contraction\nAcknowledgements\nThe authors would like to thank all women who participated in this study for their valuable contribution.\nFunding\nThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nEthics approval and consent to participate\nThe study was approved by the Scientific and Research Ethics Committee of the Medical Research Council (TUKEB), Hungary (approval number: NNGYK/83478-5/2025). Particpants gave informed consent before starting the examination. All procedures were performed in accordance with the ethical standards of the responsible committee and the Declaration of Helsinki and its later amendments.\nConsent for publication\nNot applicable.\nCompeting interests\nThe authors declare no competing interests.\nAdditional information\nPublisher’s note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nOpen Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.\nAbout this article\nCite this article\nKovács-Szabó, Z., Ács, P., Makai, A. et al. Pelvic floor muscle function, pain, and symptom burden in women with endometriosis: a pilot case–control study. BMC Women's Health (2026). https://doi.org/10.1186/s12905-026-04861-w\nReceived:\nAccepted:\nPublished:\nDOI: https://doi.org/10.1186/s12905-026-04861-w","source_license":"CC0","license_restricted":false}