A contribuição da fisioterapia pélvica para o tratamento da endometriose: avaliação dos encaminhamentos médicos

Abstract

Introduction: Endometriosis is a chronic inflammatory gynecological disease that affects 10 to 15% of women of reproductive age, causing pelvic pain, dyspareunia, and infertility. Although treatment is primarily based on medication and surgery, pelvic physiotherapy has proven effective in reducing symptoms and improving quality of life. However, there is a low rate of medical referrals, often linked to a lack of information and multidisciplinary integration. Objective: To evaluate medical referrals of patients with endometriosis to pelvic physiotherapy, identifying the circumstances under which these referrals occur, their perceived effectiveness, and physicians’ perspectives on integrating this approach into treatment. Method: A cross-sectional observational study conducted with 29 gynecologists and obstetricians from different regions of Brazil. Data were collected between May and July 2025 through an electronic questionnaire containing multiple-choice and open-ended questions. Analysis was performed using descriptive statistics. Results: All participants reported being familiar with pelvic physiotherapy, and 82.8% refer patients with endometriosis, mainly for pain relief (96.2%), improved quality of life (92.3%), and pelvic floor function (76.9%). Most (93.1%) consider the practice effective, but among those who do not refer, 80% cited lack of specific knowledge and 20% reported difficulties with the referral process. The most frequently reported benefits by physicians were relief of pelvic pain and dyspareunia (72.4%) and improvement in pelvic floor function (44.8%). Conclusion: Pelvic physiotherapy is recognized as an effective and complementary resource in the management of endometriosis, but barriers related to knowledge and access persist. Broader studies and dissemination strategies are needed to strengthen its integration into multidisciplinary treatment