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Painful Periods: Why They Occur and How Intimate Physical Therapy Can Help

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What is painful menstruation?

Painful menstruation, medically known as dysmenorrhea, is one of the most common health problems among women. It is a condition in which menstruation is accompanied by intense, cramping pain in the lower abdomen, sometimes radiating to the lower back, legs, or pelvis. Many women
consider this pain “normal” because they have experienced it since their teenage years and believe it is simply a natural part of menstruation. The truth, however, is that severe pain during menstruation is a signal that the body needs something—most often relaxation, balance, and a change in lifestyle.

What is painful menstruation?

One of the main causes of painful menstruation is increased tension in the abdomen, pelvis, and pelvic floor. These structures are closely interconnected, and when any one of them is overloaded or not functioning properly, it affects the entire menstrual cycle.
Pain can also result from poor posture, increased stress, improper breathing, a sedentary lifestyle, or weakness in the deep stabilizing muscles. Menstrual pain is also influenced by hormonal changes, inflammation, or conditions such as endometriosis. Whatever the reason, it’s important to know that this pain isn’t normal and you don’t have to endure it every month.

You can learn more about endometriosis in our article: Endometriosis: Symptoms, Diagnosis, and How Intimate Physical Therapy Can Help

How Can Intimate Physical Therapy Help?

Intimate physical therapy offers a holistic approach that treats a woman’s body as an interconnected system. The goal of therapy is not merely to suppress symptoms, but primarily to improve the function of the pelvic muscles, abdominal wall, and pelvic floor, which often contribute to the development of menstrual pain. A very important part of the therapy is releasing overloaded structures. A tense pelvic floor, a tight lower abdomen, or blockages in the lower back and lumbar spine can significantly affect blood flow and organ mobility. When the tissues in this area are released, the menstrual cycle often becomes smoother and less painful.

What Is Addressed During Physical Therapy for Painful Menstruation

Physical therapy for painful menstruation is highly individualized, as every woman experiences a different type of pain and has a different underlying cause. However, the following issues are most commonly addressed:

Pelvic Floor Relaxation

Paradoxically, many women have a pelvic floor that is too tense, not weakened. Overworked muscles may react with more intense cramps during menstruation, causing dull or cramping pain. Relaxing the pelvic floor muscles (using both external and intravaginal
techniques) often provides significant relief.

Working with the Abdominal Wall and Scars

Abdominal muscles, any surgical scars (from laparoscopic surgeries in the pelvic or abdominal area, or cesarean sections), or tight fascia can restrict the free movement of the uterus, which exacerbates menstrual pain. Manual techniques help restore tissue elasticity.

Mobilization of the Pelvis, Sacral Region, and Chest

The pelvis and spine form a single functional unit. If one part is restricted, the body compensates elsewhere—often in the pelvic floor. Mobilization techniques promote mobility and blood flow in the pelvic region.

Breathing Techniques and Practice in Proper Breathing

Breathing has a significant impact on the tension in the pelvic floor and the abdominal cavity. Proper breathing techniques help alleviate painful spasms and improve tissue regeneration.

Adjusting Your Routine, Habits, and Home Exercises

Health-focused exercises, relaxation techniques, gentle stretching, and recommendations for regular physical activity can significantly reduce the incidence of painful menstruation.

When to Seek Professional Help

We recommend seeing a specialist—a gynecologist or a physical therapist—especially if the pain interferes with your daily life, if you need to take pain medication regularly, if you experience nausea, fatigue, or painful sexual intercourse, or if your periods are irregular or
unusually heavy. Pain is a signal that your body needs support.

Painful periods are not normal

Although painful menstruation is common, it is not natural. Tension in the pelvis and abdomen, a weakened or overworked pelvic floor, poor breathing, and stress are factors that can be effectively addressed. Intimate physical therapy offers functional solutions that
help reduce pain intensity, improve comfort during the menstrual cycle, and restore women’s sense of well-being in their own bodies.

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The body does not need to be fixed. It needs to be understood.

I am a woman, wife, mother and physiotherapist. Over the years of practice, I have realised that health does not come only from eliminating symptoms or solving a specific problem. Real change comes when a person begins to better understand themselves, their body, and the way they live their life.

It was this idea that led me to create the space you know today as ToBe – a place where different areas of expertise, perspectives, and approaches to health are interconnected. A place that does not see a person only through a diagnosis or individual symptoms, but as a unique whole.

My professional journey began in physiotherapy and the musculoskeletal system. Over time, clients and their stories gradually led me deeper – from working with the body through the pelvic floor to understanding the meaning of emotions, the psyche, and the functioning of the nervous system. Today, I see the body as the bearer of a person’s story, and therapy as a space where we can get to know that story, understand it, and support its natural process of change.

How I work

Years of practice have taught me to slow down. To listen more. To place less emphasis on performance, results, or quick change.

In therapy, I strive to create a safe space where clients can become more aware of their bodies, their needs, and the connections between what they are experiencing and what is happening on a physical level. I don’t focus only on symptoms; I also look for their possible causes and the context in which they arise.

Over the years, I have become increasingly aware of how closely the body, mind, and nervous system are connected. This is why I naturally integrate a psychosomatic perspective and the principles of nervous system regulation into my work – gently, clearly, and always with respect for where each client is in their own process.

I believe the body has a remarkable capacity for healing and renewal. Sometimes it doesn’t need more pressure — it needs understanding, a sense of safety, and the right conditions to begin functioning in a different way.

What I can help you with

In my practice, I specialise mainly in:

  • urogynecological physiotherapy
  • pelvic floor dysfunction
  • incontinence
  • painful conditions after childbirth
  • preparation for childbirth and postpartum recovery
  • painful menstruation
  • pain during sexual intercourse
  • functional disorders of the musculoskeletal system
  • chronic pain without an organic cause
  • unintegrated scars
  • psychosomatic connections of health problems
  • regulation of the nervous system

Methods and approaches I use

In my work, I connect physiotherapy with knowledge from psychosomatics, work with the nervous system, and a holistic therapeutic approach. I mainly use:

  • urogynecological physiotherapy
  • pelvic floor therapy
  • diagnosis and therapy of functional disorders of the musculoskeletal system
  • visceral manipulation
  • osteopathic principles
  • craniosacral therapy
  • psychosomatic approach in physiotherapy
  • principles of nervous system regulation
  • knowledge from Somatic Experiencing® training

In therapy, I combine professional knowledge with a sensitive perception of the person and their story. My goal is not only to relieve the problem, but to support the client in better understanding themselves and their body.

ToBe – the concept

ToBe grew naturally out of the original IntimFyzio centre. Over time, I increasingly felt the need to bring different areas of expertise together and create a place where a person does not have to be divided into separate parts.

Today, ToBe is a multidisciplinary space where physiotherapy, psychology, psychotherapy, women’s health, traditional Chinese medicine, work with the nervous system, and other approaches come together – united by a common idea: to see a person in their entirety and create the conditions for health, growth, and a deeper connection with oneself.

Education and professional development

I studied physiotherapy at the Faculty of Medicine of Comenius University in Bratislava, and completed my master’s degree at the University of Brighton in the United Kingdom.

I have completed a specialisation in functional and structural disorders of the musculoskeletal system at the Slovak Medical University in Bratislava. I hold a licence for independent medical practice and am a member of the Slovak Chamber of Physiotherapists.

Training that has significantly shaped my therapeutic approach

  • Somatic Experiencing® (currently in training, Lilian Troost)
  • Psychosomatic approach in physiotherapy (CKP Edu, Prague)
  • Visceral manipulation and osteopathic approach (Inge Schuermans, MSc)
  • Birth trauma in physiotherapy and self-regulation tools in client practice (Mgr. Radka Tomášková)
  • Holistic approach to scar and pelvic floor therapy (PhDr. Michaela Prokešová, PhD.)
  • Traditional care for women and mothers (Angelina Miranda Martinez)
  • Osteopathic approach in pregnancy and gynaecological dysfunctions (Inge Schuermans, Jory Paul)
  • Ludmila Mojžišová method (Mgr. Jana Jedličková)
  • Physiotherapy of pelvic floor dysfunction and urinary incontinence (Prof. Magdaléna Hágovská, Mgr. Zuzana Woleková)
  • Craniosacral therapy (Mgr. Helena Toušková, Upledger Institute)
  • Certified DNS Therapist Diploma (Prof. Pavel Kolář)
  • Diagnosis and Therapy of Functional Disorders of the Musculoskeletal System (Eva Janíková)
  • Stott Pilates (Jitka Kadish)

I believe health is not a goal to be achieved. It is a relationship we build with ourselves, our bodies, and our lives – and it is a journey I love to accompany my clients on.