Exercise and endometriosis: do’s and don’ts of physical activity
While exercise can’t address the underlying cause of endometriosis, it may help with symptom management and improve mental health. This is important because studies suggest people with the condition are at greater risk of depression and other related mental health conditions.
Given that symptoms like pain and bloating can make it hard to feel like exercising, and that sometimes exercise might even make the pain worse, this article will talk about ways to safely and effectively exercise if you have endometriosis.
But first, a little more about the condition…
Understanding endometriosis
Current research tells us that endometriosis affects approximately one in nine Australian women, making it a common chronic condition.1 Endometriosis, commonly referred to as ‘endo’, is a gynaecological disorder where tissue that is similar to the lining of the uterus, grows outside of the uterus, primarily around pelvic organs such as the bowel, bladder, and ovaries. But, unlike normal uterine cells, this tissue cannot be expelled by the body.
With each menstrual cycle, this tissue creates inflammation and scarring, causing a variety of symptoms like chronic pelvic pain, painful menstruation, bloating, cramping, gut issues and more. These symptoms can vary widely from person to person too.
The benefits of exercise for endo
While there are no specific exercise guidelines for endo, we can draw on existing research into chronic pain and exercise, which suggests physical activity can help manage symptoms – both physical and mental.
In the physical realm, exercise is known to improve sleep and decrease inflammatory markers, both important for people with endo. It can also help to address muscle tightness and pain associated with what pelvic physiotherapists call ‘chronic pain posture’. It’s where the body takes on a guarded position bracing itself to protect against pain. This bracing can affect various muscle groups, including the pelvic floor, abdominal wall, hip flexors, adductors, and posture. So, focussing on lengthening and strengthening these muscle groups may be helpful.2
Strength training may help undo some of these patterns, while Pilates and yoga can be effective in releasing tension. Additionally, stretches for the muscles in the lower back and pelvic region, such as seated gluteal stretches, seated hip flexor stretches, and wall side bend stretches may be beneficial.2
Get Active Victoria offers free workouts, including Pilates, yoga, strength training, and stretching sessions, to help you establish an exercise routine at home. It’s important to remember that each body is unique, so finding what feels good for you is key. If you experience any pain or discomfort with a particular exercise or style, try exploring alternative options.
Beyond the physical, the benefits of exercise on mental health are well documented. But, considering that research suggests that people with endo are more likely to experience depression and anxiety, exercise becomes an even more vital part of a strategy to help manage the condition.3
Pacing and a plan
Experts in endo treatment and support recommend exercise but stress that the key is having a well-paced plan. That plan should include realistic goals that give your body time to adapt gradually to increased activity, with scheduled rest days. 4 , 5
Taking an all-or-nothing approach to exercise may lead to a vicious cycle with limited results. Overdoing it tends to cause a flare up of symptoms, which is then corrected by stopping physical activity altogether and the cycle repeats.5
The Julia Argyrou Endometriosis Centre at Epworth has a helpful video for anyone with endo looking to plan a paced exercise routine. Watch the video here.
Incidental exercise
Get Active Victoria champions the mantra of ‘Move more, every day’, which should also be embraced by anyone with endo. Don’t be disheartened by missing a planned exercise activity, but remind yourself that all activity is good.
The activity you do each day, like walking, still counts within your paced plan.
Exercises to avoid
If you’ve been diagnosed with endometriosis, there are certain exercises that may be best to avoid, such as high-intensity abdominal exercises that put strain on the abdominal wall and lower back (like crunches) and high-impact exercises (like jumping or burpees).2
More information
If you find exercise is causing you pain or an increase in symptoms, seek advice from your GP, physiotherapist or an accredited exercise physiologist about an exercise plan that will work for you.
You can find out more about endometriosis at Health Direct.
Information, including tips to manage the symptoms of endometriosis, is also available at:
References
- HealthDirect 2023, Endometriosis, accessed 8 August 2024, https://www.healthdirect.gov.au/endometriosis
- Cogger, B 2024, Exercise for Endometriosis, Exercise Right, accessed 8 August 2024, https://exerciseright.com.au/exercise-for-endometriosis/
- Dereje G. Gete, Jenny Doust, Sally Mortlock, Grant Montgomery, Gita D. Mishra, Associations between endometriosis and common symptoms: findings from the Australian Longitudinal Study on Women’s Health, American Journal of Obstetrics and Gynecology, Volume 229, Issue 5, 2023, Pages 536.e1-536.e20, ISSN 0002-9378, https://doi.org/10.1016/j.ajog.2023.07.033. (https://www.sciencedirect.com/science/article/pii/S0002937823005057)
- Jean Hailes for Women’s Health 2023, Living with endometriosis, accessed 8 August 2024, https://www.jeanhailes.org.au/health-a-z/endometriosis/living-with-endometriosis#physical-health
- Julia Argyrou Endometriosis Centre, Endometriosis and Exercise, Epworth, accessed 8 August 2024, https://www.epworth.org.au/our-services/endometriosis-centre/about-us/support-group/endometriosis-exercise
Last updated: March 5, 2025 at: 3:08 pm
