Endometriosis Awareness Month

What is endometriosis?

Endometriosis is a condition in women which occurs when cells similar to the ones in the lining of the womb (uterus) are found elsewhere in the body. These cells can grow and change in response to hormones in the menstrual cycle; this can cause inflammation, pain and scar tissue. Endometriosis is most commonly found on the lining of the pelvis (peritoneum) and may occur in the ovaries and involve other pelvic organs, like the bowel or bladder. Less commonly, endometriosis can also be found outside the pelvis, such as in the chest.

What are symptoms and implications of endometriosis?

Endometriosis is a chronic, long-term inflammatory condition. Symptoms vary from person to person, from mild and manageable to severe and debilitating with permanent damage to organs.

Common symptoms include:

• Pelvic pain
• Painful periods that interfere with everyday life
• Heavy bleeding during periods
• Pain during or after intercourse
• Painful bowel movements
• Pain when urinating
• Difficulty falling pregnant
• Fatigue, with one or more of the above symptoms

Endometriosis significantly affects patients’ quality of life, affecting numerous aspects of their daily lives. It is also associated with an increased risk of depression, fatigue, and reduced work productivity. Endometriosis has a significant impact on public health, resulting in considerable healthcare expenditures The economic burden exceeds US$22 billion in the USA alone and £12.5bn in the UK.

Why is it so important to raise awareness about endometriosis?

Endometriosis is common, affecting 1 in 10 women of reproductive age. And yet, so many people are unaware of the condition and how it impacts a person's life.

Because symptoms are often vague and so variable, the diagnosis is often delayed. Worldwide, the average time to diagnosis is 4-12 years; in the United Kingdom, for example, the average time to receive a diagnosis is now over 9 years. This causes so much unnecessary suffering.

It is important to raise awareness of endometriosis to help women receive a diagnosis sooner, be able to identify the symptoms, and start treatment and support.

EXERCISE as part of ENDOMETRIOSIS management

Endometriosis is a chronic, long-term inflammatory condition. There is no cure. Surgery, hormonal therapy and pain control form the mainstay of management. There is increasing evidence in favour of exercise as a management strategy for endometriosis, to help manage both physical and psychological symptoms of this chronic condition.

Evidence for Benefits

• Pain Reduction: Studies indicate that regular exercise can reduce pain intensity, particularly chronic pelvic pain, and decrease the need for pain medication. A 2025 meta-analysis confirmed that exercise significantly impacts the improvement of quality of life and provides pain relief.
• Inflammation Control: Regular exercise induces an increase in systemic levels of anti-inflammatory and antioxidant cytokines. It also boosts endorphins, which act as natural painkillers.
• Hormonal Regulation: Regular physical activity can decrease oestrogen levels, which is crucial because endometriosis is an oestrogen-dependent disease. It also helps regulate ovarian function.
• Mental Health Improvements: Exercise helps combat depression, anxiety, and fatigue, which commonly co-exist in women with endometriosis.

Recommended Exercise Approach

• Types: Low-impact aerobic exercises (walking, swimming, cycling), yoga, Pilates and targeted stretching are recommended to avoid overworking the pelvic floor.
• Intensity: Moderate-intensity exercise is generally recommended. Exercise should be tailored to the individual's pain levels; overly high intensity exercise may trigger pain flares.
• Pelvic Floor Specifics: Some individuals may benefit from specialised pelvic floor physiotherapy to release tightness and improve mobility, rather than just strengthening.
• Frequency: Regular, consistent activity (e.g., at least 3 times per week) is more beneficial than sporadic, high-intensity efforts.

In summary, the evidence supports exercise as a valuable, safe complementary tool, particularly when tailored to the individual and focused on reducing inflammation and increasing flexibility. However, further standardised, more prolonged clinical studies are needed to confirm the exact type, frequency and duration of exercise that is most beneficial.

References:

1. Endometriosis UK Website www.endometriosis-uk.org; accessed 14 March 2026
2. Horne AW et al. Top ten endometriosis research priorities in the UK and Ireland. Lancet 2017; 389: 2191-2192.
3. World Health Organisation Fact Sheet on Endometriosis. www.who.int/news-room/fact-sheets/detail/endometriosis. Accessed 13 March 2026.
4. Marrodán-Wojtczak K et al. The role of physical activity in the management of endometriosis: a literature review. Int J Innov Tech Soc Science 2025; 5; 47.
5. Xie M et al. The effectiveness and safety of physical activity and exercise on women with endometriosis: A systematic review and meta-analysis. PLoS One Journal 2025; 20: e0317820.
6. Chen LH et al. A Lifelong Impact on Endometriosis: Pathophysiology and Pharmacological Treatment. Int J Mol Sci. 2023;24:7503.