{"paper_id":"1adde82e-9018-400f-a60a-3ed194f2c9b5","body_text":"Adapted physical exercise programme and symptoms management in endometriosis: a case series\nDOI:\nhttps://doi.org/10.51224/SRXIV.454Keywords:\nadapted physical activity, pelvic pain, wellbeing, Fatigue, acute measure, case-seriesAbstract\nPhysical exercise is increasingly used to manage endometriosis symptoms, but acute changes pre- and post-session have never been studied. This case series study involved six women with endometriosis who completed a 3-month adapted physical exercise programme delivered via videoconference (1–2 hours/week). Participants completed pre- and post-intervention questionnaires assessing psychosocial outcomes, along with sessional ratings of pain, fatigue, and wellbeing using a 0–10 visual analogue scale. Results varied according to session type and perceived intensity of physical exercise. These findings suggest potential pain decrease with adapted physical exercise and highlight the importance of considering individual experiences to tailor future interventions.\nMetrics\nReferences\nAllaire, C., Bedaiwy, M. A., & Yong, P. J. (2023). Diagnosis and management of endometriosis. CMAJ : Canadian Medical Association Journal, 195(10), E363‑E371. https://doi.org/10.1503/cmaj.220637\nAppleyard, C. B., Cruz, M. L., Velazquez-Cruz, J., Rivera-Mendez, R. M., Jimenez-Garcia, J. G., Rivera, L. A., Mendez-Casillas, M. D. M., Flores, I., Al-Nakkash, L., & Chompre, G. (2021). Voluntary Wheel Running Reduces Vesicle Development in an Endometriosis Animal Model Through Modulation of Immune Parameters. Frontiers in reproductive health, 3(Query date: 2023-10-11 13:56:48). https://doi.org/10.3389/frph.2021.826541\nArmour, M., Sinclair, J., Chalmers, K. J., & Smith, C. A. (2019). Self-management strategies amongst Australian women with endometriosis : A national online survey. BMC complementary and alternative medicine, 19(1), 17. https://doi.org/10.1186/s12906-019-2431-x\nAwad, E., Ahmed, H. A. H., Yousef, A., & Abbas, R. (2017). Efficacy of exercise on pelvic pain and posture associated with endometriosis : Within subject design. Journal of physical therapy science, 29(12), 2112‑2115. https://doi.org/10.1589/jpts.29.2112\nBlanco-Martínez, N., Varela, S., Ayán-Pérez, C., & Diz-Gómez, J. C. (2025). Perceived barriers and physical activity levels in women with endometriosis : The role of symptoms. Women & Health, 65(7), 638‑649. https://doi.org/10.1080/03630242.2025.2549986\nBoiché, J., Gourlan, M., Trouilloud, D., & Sarrazin, P. (2019). Development and validation of the ‘Echelle de Motivation envers l’Activité Physique en contexte de Santé’ : A motivation scale towards health-oriented physical activity in French. Journal of Health Psychology, 24(3), 386‑396. https://doi.org/10.1177/1359105316676626\nBooth, J. E., Benham, J. L., Schinbein, L. E., McGinley, S. K., Rabi, D. M., & Sigal, R. J. (2020). Long-Term Physical Activity Levels After the End of a Structured Exercise Intervention in Adults With Type 2 Diabetes and Prediabetes : A Systematic Review. Canadian Journal of Diabetes, 44(8), 680-687.e2. https://doi.org/10.1016/j.jcjd.2020.03.012\nBorg, G. (1998). Borg’s Perceived Exertion And Pain Scales. In Human Kinetics.\nCarpenter, S. E., Tjaden, B., Rock, J. A., & Kimball, A. (1995). The effect of regular exercise on women receiving danazol for treatment of endometriosis. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 49(3), 299‑304. https://doi.org/10.1016/0020-7292(95)02359-k\nChauvet, P., Auclair, C., Mourgues, C., Canis, M., Gerbaud, L., & Bourdel, N. (2017). Psychometric properties of the French version of the Endometriosis Health Profile-30, a health-related quality of life instrument. Journal of Gynecology Obstetrics and Human Reproduction, 46(3), 235‑242. https://doi.org/10.1016/j.jogoh.2017.02.004\nCosta, R. J. S., Snipe, R. M. J., Kitic, C. M., & Gibson, P. R. (2017). Systematic review : Exercise-induced gastrointestinal syndrome-implications for health and intestinal disease. Alimentary Pharmacology & Therapeutics, 46(3), 246‑265. https://doi.org/10.1111/apt.14157\nCraig, C. L., Marshall, A. L., Sjöström, M., Bauman, A. E., Booth, M. L., Ainsworth, B. E., Pratt, M., Ekelund, U., Yngve, A., Sallis, J. F., & Oja, P. (2003). International Physical Activity Questionnaire : 12-Country Reliability and Validity. Medicine & Science in Sports & Exercise, 35(8), 1381‑1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB\nElo, S., & Kyngäs, H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62(1), 107‑115. https://doi.org/10.1111/j.1365-2648.2007.04569.x\nEnsari, I., Lipsky-Gorman, S., Horan, E. N., Bakken, S., & Elhadad, N. (2022). Associations between physical exercise patterns and pain symptoms in individuals with endometriosis : A cross-sectional mHealth-based investigation. BMJ open, 12(7). https://doi.org/10.1136/bmjopen-2021-059280\nEuropean Commission, Directorate-General for Education, & Youth, Sport and Culture. (2022). Sport and physical activity – Full report. Publications Office of the European Union. https://data.europa.eu/doi/10.2766/356346\nFerreira-Valente, M. A., Pais-Ribeiro, J. L., & Jensen, M. P. (2011). Validity of four pain intensity rating scales. Pain, 152(10), 2399‑2404. https://doi.org/10.1016/j.pain.2011.07.005\nFriggi Sebe Petrelluzzi, K., Garcia, M. C., Petta, C. A., Ribeiro, D. A., Monteiro, N. R. de O., Céspedes, I. C., & Spadari, R. C. (2012). Physical therapy and psychological intervention normalize cortisol levels and improve vitality in women with endometriosis. Journal of psychosomatic obstetrics and gynaecology, 33(4), 191‑198. https://doi.org/10.3109/0167482X.2012.729625\nGambadauro, P., Carli, V., & Hadlaczky, G. (2019). Depressive symptoms among women with endometriosis : A systematic review and meta-analysis. American Journal of Obstetrics & Gynecology, 220(3), 230‑241. https://doi.org/10.1016/j.ajog.2018.11.123\nGonçalves, A. V., Barros, N. F., & Bahamondes, L. (2017). The Practice of Hatha Yoga for the Treatment of Pain Associated with Endometriosis. Journal of alternative and complementary medicine (New York, N.Y.), 23(1), 45‑52. https://doi.org/10.1089/acm.2015.0343\nGuérin, F., Marsh, H. W., & Famose, J.-P. (2003). Construct validation of the Self-Description Questionnaire II with a French sample. European Journal of Psychological Assessment, 19(2), 142‑150. https://doi.org/10.1027/1015-5759.19.2.142\nHashash, J. G., & Binion, D. G. (2017). Exercise and Inflammatory Bowel Disease : Insights into Etiopathogenesis and Modification of Clinical Course. Gastroenterology Clinics of North America, Complementary and Alternative Medicine in Inflammatory Bowel Disease, 46(4), 895‑905. https://doi.org/10.1016/j.gtc.2017.08.010\nINSERM. (2019). Activité physique : Prévention et traitement des maladies chroniques (EDP Sciences). https://www.inserm.fr/expertise-collective/activite-physique-prevention-et-traitement-maladies-chroniques/\nJones, K., Kimble, R., Baker, K., & Tew, G. A. (2022). Effects of structured exercise programmes on physiological and psychological outcomes in adults with inflammatory bowel disease (IBD) : A systematic review and meta-analysis. PLOS ONE, 17(12). https://doi.org/10.1371/journal.pone.0278480\nLeach, H. J., Crisafio, M. E., Howell, M. J., Nicklawsky, A., & Marker, R. J. (2023). A Group-Based, Videoconference-Delivered Physical Activity Program for Cancer Survivors. Translational Journal of the American College of Sports Medicine, 8(2), e000221. https://doi.org/10.1249/tjx.0000000000000221\nLutfi, M., Dalleck, L. C., Drummond, C., Drummond, M., Paparella, L., Keith, C. E., Kirton, M., Falconer, L., Gebremichael, L., Phelan, C., Barry, C., Roscio, K., Lange, B., & Ramos, J. S. (2023). A Single Session of a Digital Health Tool-Delivered Exercise Intervention May Provide Immediate Relief from Pelvic Pain in Women with Endometriosis : A Pilot Randomized Controlled Study. International journal of environmental research and public health, 20(3), 1665. https://doi.org/10.3390/ijerph20031665\nMardon, A. K., Leake, H. B., Hayles, C., Henry, M. L., Neumann, P. B., Moseley, G. L., & Chalmers, K. J. (2023). The Efficacy of Self-Management Strategies for Females with Endometriosis : A Systematic Review. Reproductive sciences (Thousand Oaks, Calif.), 30(2), 390‑407. https://doi.org/10.1007/s43032-022-00952-9\nMastrangelo, M., & Turnbull, D. (2022). The impact of surgically diagnosed symptomatic endometriosis on women’s social lives, work and education : An inductive classical content analysis. The Australian & New Zealand Journal of Obstetrics & Gynaecology, 62(2), 274‑279. https://doi.org/10.1111/ajo.13447\nMazéas, A., Rausch, F., Pereira, B., Penando, S., Roland, M., Chalabaev, A., & Duclos, M. (2025). Three-Year Follow-Up of a Hybrid Adapted Physical Activity Program Including Telehealth in Comparison to In-Person Care for Chronic Conditions. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 62, 00469580251390287. https://doi.org/10.1177/00469580251390287\nMc Gettigan, N., Allen, K., Saeidi, R., O’ Toole, A., & Boland, K. (2023). A systematic review of the effect of structured exercise on inflammation and body composition in inflammatory bowel disease. International Journal of Colorectal Disease, 38(1), 143. https://doi.org/10.1007/s00384-023-04437-2\nMcKnight, K., Omotosho, O., Jassim, S., & Cotter, A. (2024). Exercise and endometriosis-is there a promising future? A narrative review. Irish Journal of Medical Science, 193(5), 2375‑2387. https://doi.org/10.1007/s11845-024-03733-2\nMińko, A., Turoń-Skrzypińska, A., Rył, A., Bargiel, P., Hilicka, Z., Michalczyk, K., Łukowska, P., Rotter, I., & Cymbaluk-Płoska, A. (2021). Endometriosis-A Multifaceted Problem of a Modern Woman. International journal of environmental research and public health, 18(15). https://doi.org/10.3390/ijerph18158177\nMontenegro, M. L., Bonocher, C. M., Meola, J., Portella, R. L., Ribeiro-Silva, A., Brunaldi, M. O., Ferriani, R. A., & Rosa-E-Silva, J. C. (2019). Effect of Physical Exercise on Endometriosis Experimentally Induced in Rats. Reproductive sciences (Thousand Oaks, Calif.), 26(6), 785‑793. https://doi.org/10.1177/1933719118799205\nNorton, K., Norton, L., & Sadgrove, D. (2010). Position statement on physical activity and exercise intensity terminology. Journal of Science and Medicine in Sport, 13(5), 496‑502. https://doi.org/10.1016/j.jsams.2009.09.008\nO’Hara, R., Rowe, H., & Fisher, J. (2019). Self-management in condition-specific health : A systematic review of the evidence among women diagnosed with endometriosis. BMC Women’s Health, 19(1), 80. https://doi.org/10.1186/s12905-019-0774-6\nPalstam, A., Larsson, A., Löfgren, M., Ernberg, M., Bjersing, J., Bileviciute-Ljungar, I., Gerdle, B., Kosek, E., & Mannerkorpi, K. (2016). Decrease of fear avoidance beliefs following person-centered progressive resistance exercise contributes to reduced pain disability in women with fibromyalgia : Secondary exploratory analyses from a randomized controlled trial. Arthritis Research & Therapy, 18(1), 116. https://doi.org/10.1186/s13075-016-1007-0\nPereira, T. A. B., Santos, I. B., Mota, R. F., Fukusawa, L., Azevedo-Santos, I. F., & DeSantana, J. M. (2023). Beliefs and expectations of patients with fibromyalgia about telerehabilitation during Covid-19 pandemic : A qualitative study. Musculoskeletal Science and Practice, 67, 102852. https://doi.org/10.1016/j.msksp.2023.102852\nPeterson, B., Mikocka-Walus, A., & Evans, S. (2023). ’It just stops me from living’ : A qualitative study of losses experienced by women with self-reported endometriosis. Journal of advanced nursing, 79(10), 3888‑3898. https://doi.org/10.1111/jan.15745\nPoli-Neto, O. B., Oliveira, A. M. Z., Salata, M. C., Rosa-E-Silva, J. C., Machado, D. R. L., Candido-Dos-Reis, F. J., & Nogueira, A. A. (2020). Strength Exercise Has Different Effects on Pressure Pain Thresholds in Women with Endometriosis-Related Symptoms and Healthy Controls : A Quasi-experimental Study. Pain medicine (Malden, Mass.), 21(10), 2280‑2287. https://doi.org/10.1093/pm/pnz310\nPonterotto, J. G. (2005). Qualitative research in counseling psychology : A primer on research paradigms and philosophy of science. Journal of Counseling Psychology, 52(2), 126‑136. https://doi.org/10.1037/0022-0167.52.2.126\nRamin-Wright, A., Schwartz, A. S. K., Geraedts, K., Rauchfuss, M., Wölfler, M. M., Haeberlin, F., von Orelli, S., Eberhard, M., Imthurn, B., Imesch, P., Fink, D., & Leeners, B. (2018). Fatigue – a symptom in endometriosis. Human Reproduction, 33(8), 1459‑1465. https://doi.org/10.1093/humrep/dey115\nRavins, I., Joseph, G., & Tene, L. (2023). The Effect of Practicing « Endometriosis Yoga » on Stress and Quality of Life for Women with Endometriosis : AB Design Pilot Study. Alternative therapies in health and medicine, 29(3), 8‑14.\nSaad, M., Ansari, I., Ibrahim, Z. S., Batool, R. M., Ahsan, S. I., Arshad, M. S., Collins, P., & Ahmed, R. (2025). Increased risk of cardiovascular disease in women with endometriosis : A systematic review and meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology, 312, 114081. https://doi.org/10.1016/j.ejogrb.2025.114081\nSachs, M. K., Dedes, I., El-Hadad, S., Haufe, A., Rueff, D., Schwartz, A. S. K., Haeberlin, F., Orelli, S. von, Eberhard, M., & Leeners, B. (2023). Physical Activity in Women with Endometriosis : Less or More Compared with a Healthy Control? International journal of environmental research and public health, 20(17), 6659. https://doi.org/10.3390/ijerph20176659\nSalehpoor, Z., Jahromi, B. N., Tanideh, N., Nemati, J., Akbarzade-Jahromi, M., & Jahromi, M. K. (2023). High intensity interval training is superior to moderate intensity continuous training in enhancing the anti-inflammatory and apoptotic effect of pentoxifylline in the rat model of endometriosis. Journal of reproductive immunology, 156(Query date: 2023-10-11 13:56:10), 103832. https://doi.org/10.1016/j.jri.2023.103832\nShafrir, A. L., Farland, L. V., Shah, D. K., Harris, H. R., Kvaskoff, M., Zondervan, K., & Missmer, S. A. (2018). Risk for and consequences of endometriosis : A critical epidemiologic review. Best Practice & Research Clinical Obstetrics & Gynaecology, Endometriosis: Clinical Understanding, Diagnosis and Treatment, 51, 1‑15. https://doi.org/10.1016/j.bpobgyn.2018.06.001\nSilva, T., Oliveira, M., Oliveira, E., Macena, R., Silva, G. T. de O., Câmara, S. M. A., & Micussi, M. (2024). Are women with endometriosis more likely to experience reduced physical performance compared to women without the condition? PeerJ, 12, e16835. https://doi.org/10.7717/peerj.16835\nSoliman, A. M., Coyne, K. S., Zaiser, E., Castelli-Haley, J., & Fuldeore, M. J. (2017). The burden of endometriosis symptoms on health-related quality of life in women in the United States : A cross-sectional study. Journal of Psychosomatic Obstetrics & Gynecology, 38(4), 238‑248. https://doi.org/10.1080/0167482X.2017.1289512\nSperandei, S., Vieira, M. C., & Reis, A. C. (2016). Adherence to physical activity in an unsupervised setting : Explanatory variables for high attrition rates among fitness center members. Journal of Science and Medicine in Sport, 19(11), 916‑920. https://doi.org/10.1016/j.jsams.2015.12.522\nTennfjord, M. K., Gabrielsen, R., & Tellum, T. (2021). Effect of physical activity and exercise on endometriosis-associated symptoms : A systematic review. BMC women’s health, 21(1), 355. https://doi.org/10.1186/s12905-021-01500-4\nTourny, C., Zouita, A., Kababi, S. E., Feuillet, L., Saeidi, A., Laher, I., Weiss, K., Knechtle, B., & Zouhal, H. (2023). Endometriosis and physical activity : A narrative review. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, (Query date: 2023-10-11 13:56:48). https://doi.org/10.1002/ijgo.14898\nTross, L. F. S., Magalhães Dias, H., & Callegari Zanetti, M. (2024). Maintaining exercise in fitness centre settings : Insights from the physical activity maintenance theory. International Journal of Qualitative Studies on Health and Well-being, 19(1), 2409832. https://doi.org/10.1080/17482631.2024.2409832\nTurk, D. C., & Okifuji, A. (2002). Psychological factors in chronic pain : Evolution and revolution. Journal of Consulting and Clinical Psychology, 70(3), 678‑690. https://doi.org/10.1037/0022-006X.70.3.678\nWestphal, T., Rinnerthaler, G., Gampenrieder, S. P., Niebauer, J., Thaler, J., Pfob, M., Fuchs, D., Riedmann, M., Mayr, B., Reich, B., Melchardt, T., Mlineritsch, B., Pleyer, L., & Greil, R. (2018). Supervised versus autonomous exercise training in breast cancer patients : A multicenter randomized clinical trial. Cancer Medicine, 7(12), 5962‑5972. https://doi.org/10.1002/cam4.1851\nXie, 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, 20(2), e0317820. https://doi.org/10.1371/journal.pone.0317820\nZhao, L., Wu, H., Zhou, X., Wang, Q., Zhu, W., & Chen, J. (2012). Effects of progressive muscular relaxation training on anxiety, depression and quality of life of endometriosis patients under gonadotrophin-releasing hormone agonist therapy. European journal of obstetrics, gynecology, and reproductive biology, 162(2), 211‑215. https://doi.org/10.1016/j.ejogrb.2012.02.029\nDownloads\nAdditional Files\nPosted\nVersions\n- 2026-04-22 (3)\n- 2025-05-20 (2)\n- 2024-09-19 (1)\nLicense\nCopyright (c) 2024 Marie-Anne Jean, Lionel Lenôtre, Charles-André Philip, Emilie Faller, Ulysse Herbach, Sophie Warembourg, Patricia Branche, Tracy Milane, Géraldine Escriva-Boulley (Author)\nThis work is licensed under a Creative Commons Attribution 4.0 International License.","source_license":"CC0","license_restricted":false}