The  Role of Physical Activity in Reducing Endometriosis Pain

Emilia Bąk; Daria Michałka; Natalie Papachristoforou; Zuzanna Gałuszka; Monika Makar; Tomasz Bartuś; Żaneta Góra; Justyna Głowacka; Aleksandra Kocjan; Radosław Chmiel

doi:10.12775/QS.2025.37.56929

Authors

Emilia Bąk https://orcid.org/0000-0002-6407-4063
Daria Michałka NZOZ „Centrum Zdrowia i Profilaktyki Dąbie” sp. z o. o., Widok 31 street, 31-567 Kraków https://orcid.org/0009-0009-6812-6543
Natalie Papachristoforou SP ZOZ MSWiA Hospital in Kraków, Kronikarza Galla 25 street, 30-053 Kraków https://orcid.org/0009-0006-8417-3794
Zuzanna Gałuszka SPZOZ Hospital in Myślenice, Szpitalna 2 street, 32-400 Myślenice https://orcid.org/0009-0009-1729-2146
Monika Makar Niepołomickie Centrum Profilaktyczno- Lecznicze, Stefana Batorego 41C street, 32-005 Niepołomice https://orcid.org/0009-0009-8023-6964
Tomasz Bartuś Andrzej Frycz Modrzewski University in Kraków, Gustawa Herlinga-Grudzińskiego 1 street, 30-705 Kraków https://orcid.org/0009-0000-3980-3191
Żaneta Góra Stefan Żeromski Specialist Hospital in Kraków, Osiedle Na Skarpie 66 street, 31-913 Kraków https://orcid.org/0009-0006-3859-9786
Justyna Głowacka Gabriel Narutowicz Municipal Hospital in Kraków, Prądnicka 35 street, 31-202 Kraków https://orcid.org/0009-0009-8289-8822
Aleksandra Kocjan Ludwik Rydygier Specialist Hospital, Osiedle Złotej Jesieni 1 street, 31-820 Kraków https://orcid.org/0009-0001-5740-6867
Radosław Chmiel SP ZOZ MSWiA Hospital in Kraków, Kronikarza Galla 25 street, 30-053 Kraków https://orcid.org/0009-0002-2726-6207

DOI:

https://doi.org/10.12775/QS.2025.37.56929

Keywords

endometriosis, endometriosis and lifestyle, endometriosis and physical activity

Abstract

Endometriosis is a chronic condition characterized by the presence of endometrial tissue outside the uterine cavity. This leads to pain, inflammatory states, and disruptions in the functioning of pelvic organs, including infertility. Physical activity influences the symptoms of endometriosis associated with the presence of ectopic endometrial tissue in the body.

This study analyzes available scientific evidence regarding the role of physical activity in alleviating pain caused by endometriosis. Research findings indicate that regular physical exercise of varying intensity can provide benefits by reducing inflammation, improving pelvic blood flow, and reducing muscle tension. The impact of physical activity on the hormonal system, including the modulation of endorphin levels and the endocannabinoid system, may contribute to pain relief. The effectiveness of exercise in endometriosis therapy depends on the type of exertion, its intensity and frequency, as well as individual factors such as the severity of the disease and the patient's health status. Studies point to yoga, Pilates, and aerobic exercises as the most beneficial forms of activity. Regardless of the type of activity studied, the most crucial factor is the frequency and duration of the exercise. The study also emphasizes the need for further research to develop personalized recommendations for physical activity for patients with endometriosis.

In conclusion, physical activity can provide valuable support in the treatment of endometriosis, contributing to an improvement in the quality of life of patients through pain reduction and overall well-being.

References

Barcena de Arellano, M. L., & Mechsner, S. (2014). The peritoneum – an

important factor for pathogenesis and pain generation in endometriosis.

Journal of Molecular Medicine, 92(6), 595–602.

1007/s00109-014-1140-2

May, K. E., Villar, J., Kirtley, S., Kennedy, S. H., Becker, C. M., & Brothers, J.

(2011). Endometrial alterations in endometriosis: a systematic review of

putative biomarkers. Human Reproduction Update, 17(5), 637–653. DOI:

1093/humupd/dmr015

Liang, Y., Han, J., Jia, J., & Cao, D. (2018). Perineural invasion in

endometriotic lesions contributes to endometriosis-associated pain. Journal of

Pain Research, 11, 1999–2009. DOI: 10.2147/JPR.S179487

Yilmaz, B. D., & Bulun, S. E. (2019). Endometriosis and nuclear receptors.

Human Reproduction Update, 25(4), 473–485. DOI: 10.1093/humupd/dmz013

Ghersa, F., Carnevale, C., & Medina, F. (2019). Reduced inflammatory state

promotes reinnervation of endometriotic-like lesions in TNFRp55 deficient

mice. Molecular Human Reproduction, 25(8), 385–396. DOI:

1093/molehr/gaz027

McAllister, S. L., Dmitrieva, N., & Berkley, K. J. (2012). Sprouted innervation

into uterine transplants contributes to the development of hyperalgesia in a rat

model of endometriosis. PLoS ONE, 7(2), e31758. DOI:

1371/journal.pone.0031758

Scheerer, C., Schlake, C., Seliger, G., & Kaufmann, M. (2017). Reduced

sympathetic innervation in endometriosis is associated with semaphorin 3C

and 3F expression. Molecular Neurobiology, 54(7), 5131–5141. DOI:

1007/s12035-016-0045-8

Borghese, B., Barbaux, S., & Chapron, C. (2016). Genetic and epigenetic

factors in endometriosis. Best Practice & Research Clinical Obstetrics &

Gynaecology, 30, 79-88. doi:10.1016/j.bpobgyn.2015.08.009

Taylor, H. S., Lebovic, D. I., & Viganò, P. (2019). "Endometriosis and

Angiogenesis." Fertility and Sterility, 112(3), 415-424.

DOI:10.1016/j.fertnstert.2019.03.021

Vercellini, P., Viganò, P., Somigliana, E., & Fedele, L. (2014). "Endometriosis:

pathogenesis and treatment." Nature Reviews Endocrinology, 10(5), 261-275.

doi:10.1038/nrendo.2014.25

Stratton, P., & Berkley, K. J. (2011). "Chronic pelvic pain and endometriosis:

translational evidence of the relationship and implications." Human

Reproduction Update, 17(3), 327-346. doi:10.1093/humupd/dmq053

Fauconnier, A., & Chapron, C. (2005). "Endometriosis and pelvic pain:

epidemiological evidence of the relationship and implications." Human

Reproduction Update, 11(6), 595-606. doi:10.1093/humupd/dmi023

Giudice, L. C., & Kao, L. C. (2004). "Endometriosis." The Lancet, 364(9447)

-1799. doi:10.1016/S0140-6736(04)17403-5

Berkley, K. J., Rapkin, A. J., & Papka, R. E. (2005). "The pains of

endometriosis." Science, 308(5727), 1587-1589.

DOI:10.1126/Science.1109989

Titulaer, I., & Giudice, L. C. (2019). "Inflammation and Endometriosis: A

Complex Interplay." Journal of Reproductive Immunology, 135, 1-10.

DOI:10.1016/j.jri.2019.01.001

Borghese, B., Barbaux, S., & Chapron, C. (2016). "Genetic and epigenetic

factors in endometriosis." Best Practice & Research Clinical Obstetrics &

Gynaecology, 30, 79-88. doi:10.1016/j.bpobgyn.2015.08.009

Bulun, S. E. (2009). "Endometriosis." The New England Journal of Medicine,

(3), 268-279. doi:10.1056/NEJMra0806216

Khan, K. N., Kitajima, M., & Fujishita, A. (2016). "The role of the peritoneal

microenvironment in the pathogenesis of endometriosis." Reproductive

Medicine and Biology, 15(2), 109-120. doi:10.1007/s12522-015-0247-9