Impact of Physical Activity on Symptoms and Quality of Life in Women with Endometriosis: A Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.55.70924Keywords
endometriosis, physical activity, exercise therapy, pelvic pain, quality of lifeAbstract
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.
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: 71
Number of citations: 0