This randomized, sham-controlled, double-blinded clinical trial aims to investigate the effects of pulsed electromagnetic field therapy (PEMF) on pain intensity, quality of life, and pelvic floor morphometric changes assessed by four-dimensional trans perineal ultrasound (4D TPUS) in women diagnosed with endometriosis. Participants will be randomly allocated into either a PEMF therapy group or a sham PEMF control group. Both groups will continue receiving stable standard medical care throughout the study period. Assessments will be conducted at baseline, after completion of the 8-week intervention period, and at 3-month follow-up.

Endometriosis is a chronic inflammatory gynecological disorder characterized by ectopic endometrial tissue growth and commonly associated with chronic pelvic pain, dysmenorrhea, dyspareunia, and impaired quality of life. Myofascial dysfunction and pelvic floor muscle hypertonia are increasingly recognized as contributing factors to persistent pain and pelvic floor dysfunction in women with endometriosis. Pulsed electromagnetic field therapy (PEMF) is a non-invasive physical modality with reported analgesic, anti-inflammatory, and tissue-healing effects in musculoskeletal and chronic pain disorders. However, evidence regarding its use in women with endometriosis remains limited. Therefore, this study aims to evaluate the effectiveness of PEMF therapy on pain severity, disease-specific quality of life, and pelvic floor morphometric changes assessed using four-dimensional trans perineal ultrasound (4D TPUS). The study will also investigate whether improvements in ultrasound-derived levator hiatal dimensions and pelvic floor relaxation are associated with clinically meaningful reductions in chronic pelvic pain.

Inclusion Criteria:

1. Women aged 18 to 45 years
2. Clinically, radiologically, or laparoscopically diagnosed endometriosis
3. Chronic pelvic pain persisting for at least 6 months
4. Stable pharmacological or hormonal treatment for at least 3 months before enrollment
5. Ability to understand study procedures and provide written informed consent

Exclusion Criteria:

1. Pregnancy or planned pregnancy during the study period
2. History of gynecological or pelvic malignancy
3. Active pelvic inflammatory disease or acute pelvic infection
4. Implanted electronic medical devices such as pacemakers or neurostimulators
5. Previous pelvic surgery within the past 6 months
6. Participation in another clinical trial during the previous 3 months
7. Neurological, rheumatological, or severe musculoskeletal disorders affecting assessment procedures
8. Contraindications to electromagnetic therapy

Participants and outcome assessors will be blinded to group allocation. The sham device will appear identical to the active device in shape, sound, and operating indicators without delivering therapeutic electromagnetic output. Treating therapists will not participate in outcome assessment or data analysis.