The effectiveness and safety of physical activity and exercise on women with endometriosis: A systematic review and meta-analysis.

Endometriosis causes chronic pelvic pain that can persist despite medical and surgical treatment, so researchers have been exploring whether physical activity or structured exercise might help ease symptoms alongside standard care. This systematic review pulled together randomized controlled trials testing exercise interventions in women with endometriosis, looking at outcomes like quality of life, pain, mental health, pelvic floor function, and bone density. Across six trials involving 251 women, the overall pattern pointed toward benefit, particularly for quality of life and pain relief. However, the studies used such different outcome measures and reporting methods that the authors could only formally combine results from two of them in a meta-analysis, which did show improvements in pain-related quality of life, feelings of control, and emotional well-being.

Because the evidence base is small, the studies varied in quality, and treatment periods were short, the findings should be seen as encouraging rather than conclusive, with the authors calling for larger, longer, higher-quality trials.

If you live with endometriosis, you know that pelvic pain can be exhausting and hard to manage even with medical or surgical treatment. This review looked at whether physical activity or exercise programs might help, pulling together findings from six small clinical trials involving a total of 251 women. The overall picture suggested that exercise could improve quality of life, reduce pain intensity, support mental health, and help with pelvic floor issues and bone density.

When researchers were able to statistically combine results from two of the studies, women who exercised reported meaningful improvements in pain-related quality of life, sense of control, and emotional well-being. That said, this is still early evidence. The studies differed a lot in how they measured outcomes and were often short in duration, so it's hard to know how lasting these benefits might be or how they'd play out in a larger group of women.

The researchers themselves say more high-quality, longer-term studies are needed before firmer conclusions can be drawn.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review and meta-analysis identified six randomized controlled trials (n=251) evaluating physical activity or exercise interventions in women with endometriosis, assessing quality of life, pain intensity, mental health, pelvic floor dysfunction, and bone density. Substantial heterogeneity in outcome measures and incomplete reporting across studies limited the authors to a formal meta-analysis of only two trials. Within that pooled analysis, statistically significant improvements favored exercise for pain-related quality of life (P<0.0001), control and powerlessness (P<0.00001), and emotional well-being (P=0.006), using weighted mean differences with 95% confidence intervals.

The broader systematic review narratively described beneficial trends across the remaining outcomes, but these were not amenable to pooling, so their strength of evidence is considerably weaker than the meta-analyzed findings. Given the small number of included trials, variability in intervention protocols and outcome instruments, and short intervention durations, the certainty of these findings is low. No adverse events were characterized in the abstract, so no safety conclusions can be drawn.

The authors explicitly call for larger, methodologically rigorous, longer-duration randomized controlled trials with standardized outcome measures before these results can inform practice.