Prevalence of Pelvic Floor Tension Myalgia and Pelvic Floor Myalgia in Females Presenting with Symptoms Suggestive of Endometriosis

Study Objective: To estimate prevalence of pelvic floor tension myalgia and pelvic floor myalgia among individuals with endometriosis. The secondary outcome is to determine specific symptoms suggestive of pelvic floor tension myalgia or pelvic floor myalgia. Design: Retrospective cross-sectional (2020–2024). Setting: Patients recruited from the National Endometriosis Clinical and Scientific Trial (NESCT) registry assessed at a single private gynecological practice known for endometriosis and pelvic pain care. Participants: Inclusion criteria included participants >18 years old with symptoms suggestive of or confirmed endometriosis who also underwent a pelvic floor examination during their initial medical consultation. Interventions: Pelvic floor muscular examination. Measurements and Main Results: A total of 587 patients were assessed, with 219 patients included in the analysis. Of those, 164 participants (28%) did not have documented pelvic floor examination at their initial visit. The median age of participants was 32 years (18–60); the majority were nulliparous (59.3%) and had a surgical diagnosis of endometriosis (70.8%). The combined prevalence of pelvic floor tension myalgia and pelvic floor myalgia was 73% (41.8%–84.6%). Multivariable analysis of conditions associated with pelvic floor tension myalgia or pelvic floor myalgia were depression (OR, 2.16, p = .046), cyclical headache (OR, 4.75, p = .05), non-cyclical dyspareunia (OR, 4.60, p = .001), and strain during bowel movement (OR, 2.24, p = .030). Conclusion: Pelvic floor tension myalgia and pelvic floor myalgia are highly prevalent among reproductive aged women with suspected or confirmed endometriosis. These findings support appropriate routine pelvic floor muscular assessment, enabling targeted non-surgical interventions alongside conventional management of endometriosis.