Effect of therapeutic strengthening versus stretching exercises on pain, pelvic floor function, and quality of life in women with endometriosis: Pilot study

Tamara Santamaría Galicia M.D., Diana Espinoza Segovia M.D., Marco Antonio Guzmán Aguilar M.D., Victor Josue Carrasco Urrutia, Jorge Rodríguez Avalos, Aylin Saldívar Landeros M.D., Valentín Tovar Galván, Juan Gustavo Vázquez Rodríguez
2026 · doi:10.5281/zenodo.22157210 · W7204630095
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In women with endometriosis, eight weeks of pelvic floor stretching or trunk stabilization exercises combined with TENS significantly reduced dysmenorrhea and improved lumbopelvic function and quality of life.

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This pilot study evaluated the effects of two distinct therapeutic exercise protocols combined with transcutaneous electrical nerve stimulation on twelve women diagnosed with endometriosis. Participants were assigned to either a pelvic floor stretching group or a trunk stabilization strengthening group, completing an eight-week intervention program. Results indicated that while both groups experienced significant improvements in quality of life and reductions in chronic pain, the stretching regimen specifically reduced dysmenorrhea and the strengthening regimen improved lumbopelvic function. The authors concluded that both modalities are effective for managing symptoms associated with the condition. This paper is centrally about endometriosis — specifically investigating conservative physical therapy interventions for symptom management in patients with the disease.

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Abstract

Background: Endometriosis is associated with pelvic pain, functional limitations, and impaired quality of life. Physical therapy has emerged as a useful complementary alternative. Objective: To compare the results of two therapeutic exercise modalities combined with transcutaneous electrical nerve stimulation (TENS) regarding pain, pelvic floor function, and quality of life in women with endometriosis. Methods: Interventional study involving a prospective cohort of twelve patients with endometriosis. The intervention consisted of an eight-week program comprising two 55-minute sessions per week. In each session, all patients received 15 minutes of TENS followed by 40 minutes of specific therapeutic exercise: Group 1 (six patients) performed pelvic floor stretching exercises, and Group 2 (six patients) performed exercises to strengthen trunk stabilizing muscles. Three variables were evaluated at the beginning and end of the intervention: (1) intensity of chronic pelvic pain, dysmenorrhea, and dyspareunia using the Visual Analog Scale (VAS); (2) lumbopelvic function using the Active Straight Leg Raise (ASLR) test; and (3) quality of life using the short version (18 items) of the Endometriosis Health Profile (EHP) questionnaire. The Wilcoxon and Mann-Whitney U tests were applied (p < 0.05). Results: Group 1 showed a significant reduction in dysmenorrhea (p=0.027), while Group 2 showed significant improvement in lumbopelvic function (p=0.041). Both groups demonstrated a significant decrease in EHP scores (p=0.028), with no between-group differences. Conclusions: Both therapeutic exercise modalities combined with TENS showed improvement in pain, lumbopelvic function, and quality of life. Keywords: Endometriosis; Therapeutic exercise; Physiotherapy; Chronic pelvic pain; Dysmenorrhea; Pelvic floor.
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Background

Endometriosis is associated with pelvic pain, functional limitations, and impaired quality of life. Physical therapy has emerged as a useful complementary alternative.

Objective

To compare the results of two therapeutic exercise modalities combined with transcutaneous electrical nerve stimulation (TENS) regarding pain, pelvic floor function, and quality of life in women with endometriosis.

Methods

Interventional study involving a prospective cohort of twelve patients with endometriosis. The intervention consisted of an eight-week program comprising two 55-minute sessions per week. In each session, all patients received 15 minutes of TENS followed by 40 minutes of specific therapeutic exercise: Group 1 (six patients) performed pelvic floor stretching exercises, and Group 2 (six patients) performed exercises to strengthen trunk stabilizing muscles. Three variables were evaluated at the beginning and end of the intervention: (1) intensity of chronic pelvic pain, dysmenorrhea, and dyspareunia using the Visual Analog Scale (VAS); (2) lumbopelvic function using the Active Straight Leg Raise (ASLR) test; and (3) quality of life using the short version (18 items) of the Endometriosis Health Profile (EHP) questionnaire. The Wilcoxon and Mann-Whitney U tests were applied (p < 0.05).

Results

Group 1 showed a significant reduction in dysmenorrhea (p=0.027), while Group 2 showed significant improvement in lumbopelvic function (p=0.041). Both groups demonstrated a significant decrease in EHP scores (p=0.028), with no between-group differences.

Conclusions

Both therapeutic exercise modalities combined with TENS showed improvement in pain, lumbopelvic function, and quality of life.

Keywords

Endometriosis; Therapeutic exercise; Physiotherapy; Chronic pelvic pain; Dysmenorrhea; Pelvic floor. Files SANTAMARIA_PELVIC_2026.pdf Files (2.0 MB) | Name | Size | Download all | |---|---|---| | md5:879070b2f0bbd4340db78a9441edd369 | 2.0 MB | Preview Download |

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