Pelvic floor muscle contraction-plus-relaxation versus relaxation-only with mindfulness for women with endometriosis-associated pelvic pain: A randomised controlled feasibility study

Shaza Kadah, S Soh, Mélanie Morin, Udari N. Colombage, Jim Tsaltas, Nyasha Gwata, Bethany White, Helena Frawley
In: Journal of Endometriosis and Pelvic Pain Disorders · 2026 · doi:10.1177/22840265251406141 · W7124428577
article OA: closed CC0 ⤵ 1 in-corpus citation
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

A randomized controlled feasibility study found that pelvic floor muscle contraction-plus-relaxation with mindfulness was more feasible, acceptable, and effective for endometriosis-associated pelvic pain than relaxation-only with mindfulness.

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Abstract

Introduction: Pelvic floor muscle (PFM) exercises are commonly prescribed to women with endometriosis-associated pelvic pain (EAPP) but the feasibility and effects of different PFM protocols remain unknown. Objectives: To evaluate the feasibility and acceptability of conducting a randomised controlled trial (RCT) comparing PFM contraction-plus-relaxation (PFMC + R) and PFM relaxation-only (PFMR) protocols combined with mindfulness in women with EAPP, and to explore changes in pelvic pain and PFM morphometry. Methods: An 8-week hybrid intervention of PFMC + R or PFMR with mindfulness was evaluated in a feasibility RCT. Primary outcomes were feasibility and acceptability; secondary outcomes were EAPP symptoms and PFM morphometry. Results: Of 95 participants assessed for eligibility, 45 were randomised to PFMC + R ( n = 23) or PFMR ( n = 22). The PFMC + R group had higher retention (86% vs 63%) and acceptability rates (82% vs 63%), and greater improvements in pelvic pain (mean difference (MD) = −2.80, 95% confidence interval (CI) −4.22, −1.45), dyspareunia (MD = −2.43, 95% CI: −3.90, −1.03), anorectal angle (MD = 3.61, 95% CI: 2.52, 9.48) and levator hiatus (MD = 0.34, 95% CI: 0.14, 0.63) at rest than the PFMR group. Conclusion: The PFMC + R protocol was more feasible and acceptable than the PFMR protocol and demonstrated greater improvements in EAPP symptoms and PFM morphometry. Larger studies are needed to verify these findings. Trail Registration: The Australian New Zealand Clinical Trials Registry, registration number: ACTRN12622001393741, trial registry URL).

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Outcome instruments

NRS-pain rASRM Enzian

Condition tags

endometriosisdyspareunia

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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