{"paper_id":"0bda272c-ba24-4ea0-a878-90722b5d363a","body_text":"The Interplay Between Endometriosis, Athletic Performance, and Physical Activity: A Narrative Review on Symptom Management and Training Adaptations in Active Women\nDOI:\nhttps://doi.org/10.12775/QS.2026.75.75648Keywords\nendometriosis, athletic performance, physical activity, menstrual cycle, chronic pelvic pain, training loadAbstract\nBackground: Endometriosis is a chronic, systemic inflammatory condition affecting 10% of women, characterized by chronic pelvic pain, \"endo-fatigue\" and myofascial hypertonia. In athletes, these symptoms compromise exercise tolerance and neuromuscular function, yet performance-limiting impacts remain under-researched. A critical gap exists regarding training adaptations in active women, as studies traditionally focus on sedentary cohorts.\nAim: This review evaluates the bi-directional relationship between endometriosis and athletic performance, synthesizing evidence-based strategies for tailored exercise and training load periodization.\nMaterial and methods: PubMed and Scopus were searched using integrated clinical and exercise science terminology. Eligibility focused on peer-reviewed studies of active populations and physical activity interventions, using thematic narrative synthesis to integrate pathophysiology with performance metrics.\nResults: Endometriosis induces objective neuromuscular deconditioning, specifically reduced isometric strength and compromised lumbopelvic control. Structured physical activity and pelvic floor rehabilitation act as anti-inflammatory modulators, reducing pain perception and fatigue while improving cardiorespiratory tolerance. Cycle-adjusted periodization, intensifying loads during peak estrogen phases and utilizing symptom-triggered modifications, maintains training adaptations without provoking flare-ups.\nConclusions: Endometriosis is a systemic performance constraint requiring interdisciplinary sports medicine care and proactive screening. Success requires flexible, symptom-aligned periodization and normalizing menstrual health in competitive sports. Individualized interventions are essential for the well-being and performance longevity of active women.\nReferences\n1. Álvarez-Salvago, F., Lara-Ramos, A., Cantarero-Villanueva, I., Mazheika, M., Mundo-López, A., Galiano-Castillo, N., Fernández-Lao, C., Arroyo-Morales, M., Ocón-Hernández, O., & Artacho-Cordón, F. (2020). Chronic Fatigue, Physical Impairments and Quality of Life in Women with Endometriosis: A Case-Control Study. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph17103641 2. Awad, E., Ahmed, H. 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Offered Support and Knowledge about the Menstrual Cycle in the Athletic Community: A Cross-Sectional Study of 1086 Female Athletes. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph191911932\n30. Xie, M., Qing, X., Huang, H., Zhang, L., Tu, Q., Guo, H., & Zhang, J. (2025). The effectiveness and safety of physical activity and exercise on women with endometriosis: A systematic review and meta-analysis. PLOS ONE. https://doi.org/10.1371/journal.pone.0317820\nDownloads\nPublished\nHow to Cite\nIssue\nSection\nLicense\nCopyright (c) 2026 Aleksandra Szymańska, Piotr Szymański, Anna Hajduk, Jagoda Stańska, Aleksandra Baranowska, Aleksandra Dobrzańska, Kacper Kmieciak, Klaudia Borycka, Filip Kostanek, Maria Berek\nThis work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.\nStats\nNumber of views and downloads: 26\nNumber of citations: 0","source_license":"CC0","license_restricted":false}