Exercise Programming for Women with Endometriosis: A Narrative Review of Training Modalities and Dose Parameters

Abstract

Background: 

Endometriosis causes pelvic pain and fatigue, impairing physical fitness and sports participation. While physical activity helps manage symptoms, precise exercise programming guidance remains limited. 

Aim:  

This narrative review evaluates sports science and clinical evidence relevant to individualized exercise programming for women with endometriosis. 

Material and methods:  

PubMed was the principal database, supplemented by Google Scholar and Scopus. The search covered publications from 2016–2026, including systematic reviews, meta-analyses, interventional studies, and guidelines. Evidence was classified as direct, component (multimodal), or extrapolated. 

Results:  

A favourable signal arises from progressive multimodal physical activity programmes, though evidence certainty is low and active components cannot be isolated. Yoga and assessment-guided pelvic floor training have direct, population-specific support. No validated endometriosis-specific FITT (Frequency, Intensity, Time, Type) training protocol is established. Modality selection should reflect dominant symptoms, pelvic floor findings, and responses to physical loading. 

Conclusions:  

Targeted physical activity is a valuable management component, but a universal training prescription is currently unjustified. A symptom-responsive framework is offered to guide exercise professionals; comparative dose-finding sports science trials are required before firm recommendations can be made.