Lexi Answers Your Top Questions About Pelvic Floor Therapy and Endo
If you’ve ever been told “everything looks normal” while living with bladder frequency and urgency, painful sex, bowel dysfunction, or pelvic tension—you’re not alone. For many patients with endometriosis or chronic pelvic pain, those symptoms go unexplained for years.
The truth is pelvic floor dysfunction is incredibly common in the endo community—but rarely talked about in standard care. That’s why at ESSE, we integrate pelvic floor therapy into our whole-body approach. It’s not just about managing pain—it’s about restoring safety, movement, and trust in your body.
We’re proud to partner with Lexi Butman, a licensed pelvic floor physical therapist who brings clinical precision and deep empathy to every patient she meets. In our Whole-Body Care for Endometriosis webinar, Lexi joined Dr. Karli Provost Goldstein to answer your most important questions—and offer a gentle path forward for healing pelvic pain from the inside out.
About Lexi Butman
Lexi’s care is rooted in connection—between the nervous system, pelvic floor, breath, and whole-body function. She helps patients unwind long-held patterns of pain, tension, and fear through slow, supportive, personalized care.
- Licensed physical therapist with advanced training in pelvic health
- Specializes in complex pelvic pain, endometriosis, IC, and post-surgical recovery
- Uses a trauma-informed, nervous system-based approach
- Offers manual therapy, movement, breathwork, and functional retraining
- Creates a safe, shame-free space where patients feel heard, seen, and empowered
Whether you're seeking one-on-one pelvic floor therapy or looking for gentle tools to support healing at home, Lexi Butman offers trauma-informed, endo-aware solutions that meet you where you are.
Why Pelvic Floor Therapy Matters in Endometriosis Care
The pelvic floor is a complex group of muscles, fascia, and nerves that support the bladder, bowel, uterus, and sexual function. When there’s chronic inflammation—as there often is with endo—these muscles can become tight, guarded, or hypersensitive.
Pelvic floor dysfunction can lead to:
- Painful sex or insertion
- Bladder frequency, urgency, or retention
- Constipation or pain with bowel movements
- Lower back, hip, or abdominal pain
- Difficulty relaxing or connecting with the body
Pelvic floor therapy helps release tension, improve coordination, reduce pain, and restore functional movement. But just as importantly—it helps rebuild trust in the body.
What Our Patients Are Wondering—Lexi Answers Your Questions
Pelvic floor therapy can feel mysterious, even intimidating—especially when you’re already navigating chronic pain or preparing for surgery.
That’s why during our Whole-Body Care for Endometriosis webinar; we asked Lexi to speak directly to the questions so many of our patients are holding. What does therapy really involve? Is it painful? What if I’ve had trauma?
Here, Lexi shares her honest, compassionate answers—so you can feel informed, grounded, and supported in deciding if pelvic floor therapy is right for you.
What exactly is pelvic floor therapy?
Lexi’s Answer: Pelvic floor therapy is about treating the muscles, fascia, and nerves in and around the pelvis. But it’s more than that—it’s about understanding how your body is holding tension, how pain has changed the way you move or breathe, and how we can gently restore function. I use a combination of manual therapy, breathwork, movement, and nervous system regulation to help the body come back into balance.
Does it always involve internal work?
Lexi’s Answer: Not at all. Internal work can be helpful for some patients, but it’s never where we have to start—and it’s never required. I work with each patient’s comfort level. Often, we begin with external work: things like posture, breath, and movement. My priority is that you feel safe, informed, and fully in control of what happens in the room.
Is pelvic therapy painful? I’m afraid it’ll make things worse.
Lexi’s Answer: That’s one of the most common fears, and I completely understand it. My approach is gentle, consent-based, and always guided by your body’s response. Pain is never the goal. In fact, we work to create the opposite—ease, softness, and a sense of safety. Many of my patients say they feel calmer after sessions, not triggered.
What actually happens in a session with you?
Lexi’s Answer: Every session is personalized, but we might work on breathing patterns, gentle mobility, core connection, or release techniques. We might focus on posture, nervous system regulation, or home practices you can take with you. It’s not about doing more—it’s about doing what your body needs right now.
How often do I need to come in?
Lexi’s Answer: That really depends on where you are in your journey. Some patients benefit from weekly or biweekly sessions, especially early on or post-surgery. Others come monthly for ongoing support. I collaborate closely with Dr. Goldstein and the ESSE team to time therapy in a way that complements your surgical, hormonal, or recovery plan.
Can pelvic floor therapy help after surgery—like excision or bowel resection?
Lexi’s Answer: Absolutely. After surgery, muscles can be guarded, inflamed, or weakened. I help you gently reintroduce movement, address scar tissue or fascial restriction, and rebuild strength without pushing. Whether it’s early recovery or several months out, pelvic therapy plays a vital role in healing.
Can this help with painful sex?
Lexi’s Answer: Yes—and I hear that concern so often. Endo-related pain with sex is real, and it’s not just physical—it’s emotional, too. I work with patients to release tension, build trust in their body again, and slowly reintroduce comfort. It’s never rushed, and always on your terms.
What if I’ve had trauma or feel nervous about pelvic therapy?
Lexi’s Answer: That’s such an important question. Trauma-informed care is at the heart of what I do. You are always in control. You get to say what feels okay, what doesn’t, and what we do together. There’s no pressure, no agenda—just support. For many patients, therapy becomes a place where they start to feel safe in their body again. That’s the real work.
Learn how pelvic floor therapy, nutrition, expert surgery, and whole-body support come together to create lasting, integrated care—not just temporary relief.
Why Lexi Is a Trusted Partner in Whole-Body Care at ESSE
Pelvic floor therapy isn’t just about easing tension—it’s about rebuilding a relationship with your body that feels safe, supported, and sustainable.
Lexi brings not only technical skill, but also deep presence and care. She sees the layers—physical, emotional, and nervous system-driven—that show up in chronic pelvic pain. Her approach is rooted in consent, clarity, and compassion.
She works hand-in-hand with Dr. Karli Provost Goldstein and the full ESSE team to ensure that pelvic therapy complements your entire treatment plan—from surgery to hormones to recovery. Whether you’re navigating sexual pain, post-op healing, bladder or bowel dysfunction, or general pelvic tension—Lexi offers a place to begin again.
Her work reminds us that healing isn’t just about getting rid of pain. It’s about restoring ease, movement, confidence, and trust. And you don’t have to do it alone.
Catch the top 5 takeaways on pelvic floor therapy and whole-body wellness for endometriosis.
