Impact of Physical Activity on Symptoms and Quality of Life in Women with Endometriosis: A Narrative Review

In: Quality in Sport · 2026 · vol. 55 , pp. 70924 · doi:10.12775/qs.2026.55.70924 · W7160779254
review OA: diamond CC0

Abstract

Background. Endometriosis is an estrogen-dependent inflammatory disease that significantly impairs women’s quality of life through chronic pelvic pain, dysmenorrhea, dyspareunia, infertility, and psychological distress. Increasing attention has been directed toward non-pharmacological approaches, including physical activity. Aim. This review aimed to analyze current evidence on the effects of physical activity and different exercise modalities on symptoms and quality of life in women with endometriosis. Material and methods. A narrative review was conducted using PubMed, Scopus, and Web of Science, focusing on studies published between 2020 and 2026, including randomized controlled trials, systematic reviews, and observational studies. Results. Available evidence suggests that physical activity may reduce pain, improve quality of life, enhance mental well-being, and improve physical functioning. The most beneficial effects are associated with combined interventions including aerobic exercise, resistance training, and mind–body techniques. Conclusions. Physical activity may be an effective complementary strategy in the management of endometriosis; however, further high-quality studies are needed.
Full text 9,881 characters · extracted from oa-doi-fallback · 2 sections · click to expand

Material

and methods. A narrative review was conducted using PubMed, Scopus, and Web of Science, focusing on studies published between 2020 and 2026, including randomized controlled trials, systematic reviews, and observational studies. Results. Available evidence suggests that physical activity may reduce pain, improve quality of life, enhance mental well-being, and improve physical functioning. The most beneficial effects are associated with combined interventions including aerobic exercise, resistance training, and mind–body techniques. Conclusions. Physical activity may be an effective complementary strategy in the management of endometriosis; however, further high-quality studies are needed.

References

1. Rolla E. Endometriosis: advances and controversies in classification, pathogenesis, diagnosis, and treatment. F1000Res. 2019;8:F1000 Faculty Rev-529. https://doi.org/10.12688/f1000research.14817.1 2. Amro B, Ramírez Aristondo ME, Alsuwaidi S, Almaamari B, Hakim Z, Tahlak M, Wattiez A, Koninckx PR. New Understanding of Diagnosis, Treatment, and Prevention of Endometriosis. Int J Environ Res Public Health. 2022;19(11):6725. https://doi.org/10.3390/ijerph19116725 3. Ricci E, Viganò P, Cipriani S, Chiaffarino F, Bianchi S, Rebonato G, Parazzini F. Physical activity and endometriosis risk in women with infertility or pain: Systematic review and meta-analysis. Medicine (Baltimore). 2016;95(40):e4957. https://doi.org/10.1097/MD.0000000000004957 4. Lalla AT, Onyebuchi C, Jorgensen E, Clark N. Impact of lifestyle and dietary modifications for endometriosis development and symptom management. Curr Opin Obstet Gynecol. 2024;36(4):247-254. https://doi.org/10.1097/GCO.0000000000000969 5. Artacho-Cordón F, Salinas-Asensio MDM, Galiano-Castillo N, Ocón-Hernández O, Peinado FM, Mundo-López A, Lozano-Lozano M, Álvarez-Salvago F, Arroyo-Morales M, Fernández-Lao C, Cantarero-Villanueva I. Effect of a Multimodal Supervised Therapeutic Exercise Program on Quality of Life, Pain, and Lumbopelvic Impairments in Women With Endometriosis Unresponsive to Conventional Therapy: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2023;104(11):1785-1795. https://doi.org/10.1016/j.apmr.2023.06.020 6. Fattori V, Franklin NS, Gonzalez-Cano R, Peterse D, Ghalali A, Madrian E, Verri WA Jr, Andrews N, Woolf CJ, Rogers MS. Nonsurgical mouse model of endometriosis-associated pain that responds to clinically active drugs. Pain. 2020;161(6):1321-1331. https://doi.org/10.1097/j.pain.0000000000001832 7. Shigesi N, Kvaskoff M, Kirtley S, Feng Q, Fang H, Knight JC, Missmer SA, Rahmioglu N, Zondervan KT, Becker CM. The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis. Hum Reprod Update. 2019;25(4):486-503. https://doi.org/10.1093/humupd/dmz014 8. Nati ID, Malutan A, Ciortea R, Oancea M, Bucuri C, Roman M, Ormindean C, Milon AG, Mihu D. Exploring the Influence of IL-8, IL-10, Patient-Reported Pain, and Physical Activity on Endometriosis Severity. Diagnostics (Basel). 2024;14(16):1822. https://doi.org/10.3390/diagnostics14161822 9. Abril-Coello R, Correyero-León M, Ceballos-Laita L, Jiménez-Barrio S. Benefits of physical therapy in improving quality of life and pain associated with endometriosis: A systematic review and meta-analysis. Int J Gynaecol Obstet. 2023;162(1):233-243. https://doi.org/10.1002/ijgo.14645 10. Gabrielsen R, Tellum T, Bø K, Engh ME, Frawley H, Nedregård Tveito S, Tennfjord MK. Supervised exercise and pelvic floor muscle training eases current pelvic and genital pain but not worsens pelvic and genital pain in women with endometriosis: a randomized trial. J Physiother. 2025;71(4):246-253. https://doi.org/10.1016/j.jphys.2025.09.012 11. Gabrielsen R, Bø K, Engh ME, Tennfjord MK. Is Pelvic Floor Muscle Resting Activity Associated with Pelvic and Genital Pain, Dyspareunia, and Pelvic Floor Muscle Contraction? A Cross-Sectional Study of Women with Endometriosis. Int Urogynecol J. 2025;36(11):2277-2285. https://doi.org/10.1007/s00192-025-06190-2 12. Tennfjord MK, Gabrielsen R, Bø K, Engh ME, Molin M. Can general exercise training and pelvic floor muscle training be used as an empowering tool among women with endometriosis? BMC Womens Health. 2024;24(1):505. https://doi.org/10.1186/s12905-024-03356-w 13. Pavic T, Terrade F, Cabagno G. Acceptability of a physical activity program using a digital tool in the management of endometriosis. Disabil Rehabil Assist Technol. 2026;21(2):733-745. https://doi.org/10.1080/17483107.2025.2569791 14. Escriva-Boulley G, Philip CA, Warembourg S, Lenotre L, Flore P, Faure P, Michy T, Letouzey V, Arnold C, Piluso C, Chalmel L, Kacem R, Blum GF, Detayrac R, Trocmé C, Brigaud I, Herbach U, Branche P, Faller E, Chalabaev A. Effects of a physical activity and endometriosis-based education program delivered by videoconference on endometriosis symptoms: the CRESCENDO program protocol study. Trials. 2023;24(1):759. https://doi.org/10.1186/s13063-023-07792-1 15. Xie M, Qing X, Huang H, Zhang L, Tu Q, Guo H, Zhang J. The effectiveness and safety of physical activity and exercise on women with endometriosis: A systematic review and meta-analysis. PLoS One. 2025;20(2):e0317820. https://doi.org/10.1371/journal.pone.0317820 16. Sachs MK, Dedes I, El-Hadad S, Haufe A, Rueff D, Kohl Schwartz AS, Haeberlin F, von Orelli S, Eberhard M, Leeners B. Physical Activity in Women with Endometriosis: Less or More Compared with a Healthy Control? Int J Environ Res Public Health. 2023;20(17):6659. https://doi.org/10.3390/ijerph20176659 17. Blanco-Martínez N, Varela S, Ayán-Pérez C, Diz-Gómez JC. Perceived barriers and physical activity levels in women with endometriosis: The role of symptoms. Women Health. 2025;65(7):638-649. https://doi.org/10.1080/03630242.2025.2549986 18. Tennfjord MK, Gabrielsen R, Tellum T. Effect of physical activity and exercise on endometriosis-associated symptoms: a systematic review. BMC Womens Health. 2021;21(1):355. https://doi.org/10.1186/s12905-021-01500-4 19. Tourny C, Zouita A, El Kababi S, Feuillet L, Saeidi A, Laher I, Weiss K, Knechtle B, Zouhal H. Endometriosis and physical activity: A narrative review. Int J Gynaecol Obstet. 2023;163(3):747-756. https://doi.org/10.1002/ijgo.14898 20. Mikocka-Walus A, Druitt M, O’Shea M, Skvarc D, Watts JJ, Esterman A, Tsaltas J, Knowles S, Harris J, Dowding C, Parigi E, Evans S. Yoga, cognitive-behavioural therapy versus education to improve quality of life and reduce healthcare costs in people with endometriosis: a randomised controlled trial. BMJ Open. 2021;11(8):e046603. https://doi.org/10.1136/bmjopen-2020-046603 21. Ravins I, Joseph G, Tene L. The Effect of Practicing “Endometriosis Yoga” on Stress and Quality of Life for Women with Endometriosis: AB Design Pilot Study. Altern Ther Health Med. 2023;29(3):8-14. PMID: 35839113 22. Mansor M, Chong MC, Ping Lei C, Hamdan M, Roslim NA, Mat Isa R. Effect of mindful breathing on anxiety, depression, and quality of life among women with endometriosis. J Reprod Infant Psychol. 2026 Feb 5:1-19. https://doi.org/10.1080/02646838.2026.2622923 23. Salinas-Asensio MDM, Álvarez-Salvago F, Mundo-López A, Ocón-Hernández O, Lozano-Lozano M, López-Garzón M, Postigo-Martín P, Arroyo-Morales M, Rodríguez-Ruiz Á, Fernández-Lao C, Artacho-Cordón F. Changes in fatigue, health-related fitness, sleep quality, mental health, gastrointestinal complaints and sexual function after a multimodal supervised therapeutic exercise program in women with endometriosis unresponsive to conventional therapy: a secondary analysis of a randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2025;312:114083. https://doi.org/10.1016/j.ejogrb.2025.114083 24. Hartmann TE, Baker KA, Girard D. Is exercise duration more important than intensity in endometriosis? BMC Womens Health. 2025;25(1):625. https://doi.org/10.1186/s12905-025-04160-w 25. Pakebusch V, Schlisio B, Schönfisch B, Brucker SY, Krämer B, Andress J. Virtual reality-based pain control in endometriosis: a questionnaire-based pilot study of applications for relaxation and physical activity. Arch Gynecol Obstet. 2025;311(6):1721-1731. https://doi.org/10.1007/s00404-025-08000-y 26. Salinas-Asensio MDM, Ocón-Hernández O, Mundo-López A, Fernández-Lao C, Peinado FM, Padilla-Vinuesa C, Álvarez-Salvago F, Postigo-Martín P, Lozano-Lozano M, Lara-Ramos A, Arroyo-Morales M, Cantarero-Villanueva I, Artacho-Cordón F. ‘Physio-EndEA’ Study: A Randomized, Parallel-Group Controlled Trial to Evaluate the Effect of a Supervised and Adapted Therapeutic Exercise Program to Improve Quality of Life in Symptomatic Women Diagnosed with Endometriosis. Int J Environ Res Public Health. 2022;19(3):1738. https://doi.org/10.3390/ijerph19031738 Downloads Published How to Cite Issue Section License Copyright (c) 2026 Agata Chrobak, Kateryna Bessmylna , Alesia Kravets , Lizaveta Zhukava, Abdulrahman Alansi, Kai-Chiun Weng, Joanna Żukowska This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Stats Number of views and downloads: 233 Number of citations: 0

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosischronic_pelvic_paindysmenorrheadyspareuniainfertility

Citation neighborhood (no data yet)

We don't have any in-corpus citations linked to this paper yet. This is a recent paper (2026) — citers typically take a year or two to land, and the OpenAlex reference graph may still be filling in.

Source provenance

openalex
last seen: 2026-08-07T06:00:58.240476+00:00
License: CC0 · commercial use OK