Adjunctive Interventions for Endometriosis: A Review of Current Literature

In: Journal of Education, Health and Sport · 2025 · vol. 81 , pp. 66816 · doi:10.12775/jehs.2025.81.66816 · W4417039571
article OA: diamond CC0

Abstract

Background Endometriosis is a complex disease that affects many women globally. The efficacy of medication is not at its best, despite advancements in therapeutic approaches. The need for further useful, evidence-based solutions grows along with theoretical knowledge. Among these, food, exercise, and psychological support all have a potential therapeutic role when combined with pharmaceuticals. Aim The aim of this article is to assess whether it is appropriate to treat physical activity, food, and psychological therapy as therapeutic interventions in a clinical environment and to investigate their function in treating endometriosis as a supplement to medication. Review methods A comprehensive analysis of research papers available on PubMed and Google Scholar was undertaken using the search terms encompassing the following keywords: endometriosis, endometriosis pain, endometriosis management, endometriosis treatment, diet, dietary intervention, anti-inflammatory diet, supplementation, psychotherapy, psychological intervention, pain management, exercises. Conclusions Non-pharmacological interventions, including physical activity, physiotherapy, dietary modification and psychological therapies, offer valuable complementary benefits. Evidence suggests that structured exercise, pelvic-floor physiotherapy, anti-inflammatory dietary patterns and cognitive-behavioral or mindfulness-based interventions can reduce pain, enhance functional capacity and improve mental health. Cannabinoid therapy shows promise but requires more robust clinical research. Overall, integrating lifestyle, psychological and rehabilitative strategies alongside conventional treatment provides a more holistic and patient-centered approach, addressing the biological, functional and psychosocial dimensions of endometriosis.
Full text 13,597 characters · extracted from oa-doi-fallback · 3 sections · click to expand

Background

Endometriosis is a complex disease that affects many women globally. The efficacy of medication is not at its best, despite advancements in therapeutic approaches. The need for further useful, evidence-based solutions grows along with theoretical knowledge. Among these, food, exercise, and psychological support all have a potential therapeutic role when combined with pharmaceuticals. Aim The aim of this article is to assess whether it is appropriate to treat physical activity, food, and psychological therapy as therapeutic interventions in a clinical environment and to investigate their function in treating endometriosis as a supplement to medication. Review methods A comprehensive analysis of research papers available on PubMed and Google Scholar was undertaken using the search terms encompassing the following keywords: endometriosis, endometriosis pain, endometriosis management, endometriosis treatment, diet, dietary intervention, anti-inflammatory diet, supplementation, psychotherapy, psychological intervention, pain management, exercises.

Conclusions

Non-pharmacological interventions, including physical activity, physiotherapy, dietary modification and psychological therapies, offer valuable complementary benefits. Evidence suggests that structured exercise, pelvic-floor physiotherapy, anti-inflammatory dietary patterns and cognitive-behavioral or mindfulness-based interventions can reduce pain, enhance functional capacity and improve mental health. Cannabinoid therapy shows promise but requires more robust clinical research. Overall, integrating lifestyle, psychological and rehabilitative strategies alongside conventional treatment provides a more holistic and patient-centered approach, addressing the biological, functional and psychosocial dimensions of endometriosis.

References

1. Tourny, C., Zouita, A., El Kababi, S., Feuillet, L., Saeidi, A., Laher, I., Weiss, K., Knechtle, B., & Zouhal, H. (2023). Endometriosis and physical activity: A narrative review. International Journal of Gynaecology & Obstetrics. https://doi.org/10.1002/ijgo.14898 2. Sachs, M. K., Dedes, I., El-Hadad, S., Haufe, A., Rueff, D., Kohl Schwartz, A. S., Haeberlin, F., von Orelli, S., 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. https://doi.org/10.3390/ijerph20176659 3. Blanco-Martínez, N., Varela, S., Ayán-Pérez, C., & Diz-Gómez, J. C. (2025). Perceived barriers and physical activity levels in women with endometriosis. Women & Health. https://doi.org/10.1080/03630242.2025.2549986 4. Werner, F., Jasinski, V., Voltolini Velho, R., Sehouli, J., & Mechsner, S. (2025). The role of self-management in endometriosis pain. Archives of Gynecology and Obstetrics. https://doi.org/10.1007/s00404-025-08019-1 5. Xie, M., Qing, X., Huang, H., Zhang, L., Tu, Q., Guo, H., & Zhang, J. (2024). The effectiveness and safety of physical activity and exercise in women with endometriosis. PLoS ONE. https://doi.org/10.1371/journal.pone.0317820 6. Escriva-Boulley, G., Philip, C.-A., Warembourg, S., Lenotre, L., Flore, P., Faure, P., Michy, T., Letouzey, V., Arnold, C., Piluso, C., Chalmel, L., Kacem, R., Blum, G. F., Detayrac, R., Trocmé, C., Brigaud, I., Herbach, U., Branche, P., Faller, É., & Chalabaev, A. (2023). Effects of a physical activity and endometriosis-based education program delivered by videoconference on endometriosis symptoms: the CRESCENDO program (inCRease physical Exercise and Sport to Combat ENDOmetriosis) protocol study. Trials, 24, Article 759. https://doi.org/10.1186/s13063-023-07792-1 7. Tennfjord, 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, Article 355. https://doi.org/10.1186/s12905-021-01500-4 8. Shved, K., Antkowiak, K., Kędzierska, Z., Żurek, U., Dadas, K., Świercz, A., Małachowska, D., Ciecierski-Koźlarek, H., & Tołwiński, I. (2023). Physiotherapy and physical activity as adjunctive treatments in women with symptomatic endometriosis – literature review. Medycyna Ogólna i Nauki o Zdrowiu, 29(3), 145–149. https://doi.org/10.26444/monz/169984 9. Bianco, A., Gentile, A., Russo, M., Maiorana, A., Lavanco, G., Mellina, A., & Palma, A. (2021). Self-esteem, quality of life, and physical activity in women with diagnosed endometriosis: a pilot study in an Italian sample. Human Movement, 22(4), 93–97. https://doi.org/10.5114/hm.2021.103295 10. World Health Organization. (2025, 15 October). Endometriosis. https://www.who.int/news-room/fact-sheets/detail/endometriosis 11. Rahmioglu, N., & Zondervan, K. T. (2023). Endometriosis: Disease mechanisms and health disparities. In Endometriosis – Science and Clinical Practice. 12. Garvey, M. (2024). Endometriosis: Future biological perspectives for diagnosis and treatment. International Journal of Molecular Sciences, 25(22), Article 12242. https://doi.org/10.3390/ijms252212242 13. Vercellini, P., Buffo, C., Viganò, P., & Somigliana, E. (2024). Update on medical treatment of endometriosis: New drugs or new therapeutic approaches? Gynecologic and Obstetric Investigation, 89(1–2), 1–14. https://doi.org/10.1159/000542947 14. Abulughod, N., Valakas, S., & El-Assaad, F. (2024). Dietary and nutritional interventions for the management of endometriosis. Nutrients, 16(23), Article 3988. https://doi.org/10.3390/nu16233988 15. Park, W., Lim, W., Kim, M., Jang, H., Park, S. J., Song, G., & Park, S. (2024). Female reproductive disease, endometriosis: From inflammation to infertility. Molecular and Cellular Endocrinology, 582, 100164. https://doi.org/10.1016/j.mocell.2024.100164 16. Salinas-Asensio, M. del M., 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. (2025). 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. European Journal of Obstetrics & Gynecology and Reproductive Biology, 299, 114083. https://doi.org/10.1016/j.ejogrb.2025.114083 17. Whitaker, L. H. R., Page, C., Morgan, C., Horne, A. W., & Saunders, P. T. K. (2024). Endometriosis: Cannabidiol therapy for symptom relief. Trends in Pharmacological Sciences, 45(12), 890–902. https://doi.org/10.1016/j.tips.2024.10.014 18. Endometriosis and the Menstrual Pain Cycle. (2023). MyEndometriosisTeam. Retrieved from https://www.myendometriosisteam.com/resources/endometriosis-and-the-menstrual-pain-cycle 19. Gouesbet, S., Lambert, S., Amazouz, H., Breton, Z., Tran, V.-T., Missmer, S., & Kvaskoff, M. (2025). Retrospective assessment of endometriosis pain over the life course: A reliability study within the ComPaRe-Endometriosis cohort. European Journal of Pain, 29(6), e70040. https://doi.org/10.1002/ejp.70040 20. Rolla, E. (2019). Endometriosis: Advances and controversies in classification, pathogenesis, diagnosis, and treatment. F1000Research, 8, 529. https://doi.org/10.12688/f1000research.14817.1 21. Young, S. L. (2024). Non-surgical approaches to the diagnosis and evaluation of endometriosis. Fertility and Sterility, 121(4), 707–716. https://doi.org/10.1016/j.fertnstert.2023.12.020 22. Allaire, C., Bedaiwy, M. A., & Yong, P. J. (2023). Diagnosis and management of endometriosis. CMAJ, 195(10), E372–E380. https://doi.org/10.1503/cmaj.220637 23. Hansen, S., Sverrisdóttir, U. Á., & Rudnicki, M. (2022). Impact of exercise on pain perception in women with endometriosis: A systematic review. Acta Obstetricia et Gynecologica Scandinavica, 101(6), 661–670. https://doi.org/10.1111/aogs.14169 24. Desai, J., Strong, S., & Ball, E. (2024). Holistic approaches to living well with endometriosis. F1000Research, 13, Article 359. https://doi.org/10.12688/f1000research.142586.2 25. van Haaps, A. P., Wijbers, J. V., Schreurs, A. M. F., Vlek, S., Tuynman, J., De Bie, B., de Vogel, A. L., van Wely, M., & Mijatovic, V. (2024). The effect of dietary interventions on pain and quality of life in women diagnosed with endometriosis: A prospective study with control group. Human Reproduction, 39(1), 45–55. https://doi.org/10.1093/humrep/dead214 26. Mazur-Bialy, A., Tim, S., Pępek, A., Skotniczna, K., & Naprawa, G. (2024). Holistic approaches in endometriosis as an effective method of supporting traditional treatment: A systematic search and narrative review. Reproductive Sciences. https://doi.org/10.1007/s43032-024-01660-2 27. Cummings, S. C., Ennis, N., Kloss, K., & Rosasco, R. (2024). Evaluating the current evidence for the efficacy of cannabis in symptom management of endometriosis-associated pain. Integrative Medicine Research, 13(2), 100987. https://doi.org/10.1089/imr.2024.0017 28. Sinclair, J., Proudfoot, A., & Armour, M. (2023). The place of cannabinoids in the treatment of gynecological pain. Drugs, 83(3), 235–249. https://doi.org/10.1007/s40265-023-01951-z 29. Barnard, N. D., Holtz, D. N., Schmidt, N., Kolipaka, S., Hata, E., Sutton, M., Znayenko-Miller, T., Hazen, N. D., Cobb, C., & Kahleova, H. (2023). Nutrition in the prevention and treatment of endometriosis. Frontiers in Nutrition, 10, 1089891. https://doi.org/10.3389/fnut.2023.1089891 30. Meneghetti, J. K., Pedrotti, M. T., Coimbra, I. M., & da Cunha-Filho, J. S. L. (2024). Effect of dietary interventions on endometriosis: A systematic review and meta-analysis of randomized controlled trials. Reproductive Sciences. https://doi.org/10.1007/s43032-024-01701-w 31. De Araugo, S. C., Varney, J. E., McGuinness, A. J., Naude, C., Evans, S., Mikocka-Walus, A., & Staudacher, H. M. (2023). Nutrition interventions in the treatment of endometriosis: A scoping review. Journal of Human Nutrition and Dietetics, 36(6), 1363–1380. https://doi.org/10.1111/jhn.13411 32. Sienko, A., Cichosz, A., Urban, A., Smolarczyk, R., Czajkowski, K., & Sienko, J. (2023). The effect of two anti-inflammatory dietary components, omega-3 and resveratrol, on endometriosis. Ginekologia Polska, 94(10), 721–728. https://doi.org/10.5603/gpl.97573 33. Hansen, K. E., Brandsborg, B., Kesmodel, U. S., Forman, A., Kold, M., Pristed, R., Donchulyesko, O., Hartwell, D., & Vase, L. (2023). Psychological interventions improve quality of life despite persistent pain in endometriosis: Results of a 3-armed randomized controlled trial. Quality of Life Research, 32(10), 2827–2840. https://doi.org/10.1007/s11136-023-03346-9 34. Chandra, S. S., Bisby, M. A., Scott, A. J., Titov, N., & Dear, B. F. (2024). The endometriosis pain course: A randomized controlled trial of an internet-delivered psychological pain management program for endometriosis. PAIN, 165(6), 1238–1249. https://doi.org/10.1097/j.pain.0000000000003784 35. Donatti, L., Malvezzi, H., de Azevedo, B. C., Baracat, E. C., & Podgaec, S. (2022). Cognitive behavioral therapy in endometriosis: Psychological-based intervention—A systematic review. Revista Brasileira de Ginecologia e Obstetrícia, 44(5), 471–479. https://doi.org/10.1055/s-0042-1742406 36. Donatti, L., Podgaec, S., & Baracat, E. C. (2024). Efficacy of cognitive behavioral therapy in treating women with endometriosis and chronic pelvic pain: A randomized trial. Journal of Health Psychology. https://doi.org/10.1177/13591053241240198 37. Del Pino-Sedeño, T., Cabrera-Maroto, M., Abrante-Luis, A., González-Hernández, Y., & Ortíz Herrera, M. C. (2024). Effectiveness of psychological interventions in endometriosis: A systematic review with meta-analysis. Frontiers in Psychology, 15, 1457842. https://doi.org/10.3389/fpsyg.2024.1457842 38. Meissner, K., Schweizer-Arau, A., Limmer, A., Preibisch, C., Popovici, R. M., Lange, I., de Oriol, B., & Beissner, F. (2016). Psychotherapy with somatosensory stimulation for endometriosis-associated pain: A randomized controlled trial. Obstetrics & Gynecology, 128(5), 1139–1147. https://doi.org/10.1097/AOG.0000000000001691 39. Endometriosis Rates Increasing Across All Ages, Most Common in Women 35–49. (2023). Epic Research. Retrieved from https://www.epicresearch.org/articles/endometriosis-rates-increasing-across-all-ages-most-common-in-women-35-49 40. Chen, Y., & Li, T. Unveiling the mechanisms of pain in endometriosis: Comprehensive analysis of inflammatory sensitization and therapeutic potential. 41. Pelvic endometriosis: Ultrasound or MRI? (2024). Mayo Clinic. Retrieved from https://www.mayoclinic.org/medical-professionals/obstetrics-gynecology/news/pelvic-endometriosis-ultrasound-or-mri/mac-20587766 Downloads Published How to Cite Issue Section License Copyright (c) 2025 Jagoda Węgrzyn, Magdalena Waśniowska, Magdalena Wiernek This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Stats Number of views and downloads: 202 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

endometriosis

Citation neighborhood (no data yet)

We don't have any in-corpus citations linked to this paper yet. This is a recent paper (2025) — citers typically take a year or two to land, and the OpenAlex reference graph may still be filling in.

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
License: CC0 · commercial use OK