Endometriosis and exercise

RosemaryM 17

By Rosemary Marchese

Physiotherapist and mum of 3 fit kids

Can exercise help alleviate symptoms?

No one really knows why some women have to suffer through endometriosis but it is more common than you might think. I personally know at least a handful of women who endure this every day. Symptoms can vary in type and severity but can include painful or heavy periods, pain during sexual intercourse, severe PMS and an increased risk of infertility. If you’re a little unfamiliar, here’s a basic crash-course. Cells that you would typically find in the lining of your uterus end up in other places where they should not be. So, you can find these cell implants in various places and this can cause severe and often completely debilitating pain.

Who is at risk?

Evidence in this area is still requiring further research but there may be a genetic link. There is also some evidence to suggest that it can begin as early as a girl’s very first period. This is really tricky because these ‘severe’ cramps often get brushed off as typical of menstruation, with many girls suffering in silence without a proper diagnosis until later into adulthood.

It’s quite a challenge for doctors because there is currently no real way of definitely ‘picking this up’ for early diagnosis in the early stages of endometriosis.

Endometriosis pain is not ‘normal’ pain

The ‘suck-it-up’ approach to pain doesn’t cut it here. Some women suffer so badly that they resort to narcotic pain relief and often surgery is used to try to remove the extra bits that have grown in the wrong places. Unfortunately this is not the end of the story with surgery causing its own set of lesions and other possible complications. Often when a woman gets to ‘surgery’ stage they really have found no other option. Some women end up opting for the ‘last-resort’ of a hysterectomy because the signs and symptoms are too severe to maintain any quality of life.

Can exercise help?

For the women that have been diagnosed, there starts the path of trying to find ‘treatment’ options. Just Google ‘endometriosis’ and it won’t take you long to find a long list of websites that will provide you with medications and surgery for pain and inflammation management. I struggled to find much in the way of mainstream ‘help’ that indicated exercise was the top option. So, I went searching for the science to back up what is being said out there. Here’s what I found.

While we know that the protective effects of exercise are starting to be used more widely in the treatment of other inflammatory diseases such as type 2 diabetes and colon and breast cancer there is little research, relatively, available that investigates exercise. This doesn’t mean exercise is not good for these women, but at the moment the literature is lacking in this area, and the research that does exist is not conclusive.

A systematic review of the literature (2014) investigated several studies that reported on the effects of exercise on endometriosis was unfortunately inconclusive. The investigators concluded that the positive effects that exercise could potentially have for these women needs further study. From what I can see the focus in science has been on treating these women with medications and surgery and exercise has not been top priority.

But don’t get disheartened just yet.

That doesn’t mean that exercise wouldn’t be beneficial. It’s just that the research still needs more work. That happens in lots of areas of science and medicine.

What we do know is that exercise leads to increases in systemic levels of various cytokines (proteins) with anti-inflammatory properties. Since endometriosis is very much an inflammatory condition then one has to wonder the logic of telling women not to exercise. Exercise may even have a protective effect from developing endometriosis in the first place with some evidence available suggesting that girls who are active during childhood are much less likely to develop the condition.

What if there is too much pain to exercise?

Endometriosis is a serious, and often very lonely condition. It’s not often talked about and this can lead to many women suffering in silence. You must have a thorough conversation with your doctor to plan your management and treatment of this condition. It’s quite possible that exercise would be beneficial for many reasons, one being weight control because many of the medication side effects include weight gain.

Light to moderate intensity exercise may often be a good starting point for many of these women. If you are suffering from the condition but have days with less pain then it is quite possible that exercise may help you to manage the symptoms. It’s also going to make your body stronger and healthier. The bottom line is that you need to discuss this with your doctor. Find a doctor that is up-to-date and keeping informed about current research and the benefits of exercise and alternatives to medications. Medications have their own side effects. Often you then need more medications to cope with those side effects! A ‘medication only’ treatment plan is not a winning plan if you ask me.

For the ‘I really can’t move days’ there may be no choice other than to relax. Your body may just need a rest and the reality is you may not be able to move. Those are the days for which you really need a healthy plan of attack, and one that is supported by the right health professionals around you. Light exercise or gentle movements, perhaps even water based exercise may be soothing.

On the days, or during the weeks, when you are feeling better then you may be able to follow the general recommendations of trying to achieve 30 minutes of moderate intensity exercise, such as a brisk walk, on most, if not all days of the week. Adults are also recommended to commit to resistance training 2-3 times per week. This doesn’t have to mean you become the next Olympic lifter, although go for it if that’s your thing, but even body weight training exercises can be used for resistance training. The Fit Busy Mum website is packed with ideas with 5 minute to 30 minute workouts, including videos for those ‘I can’t be stuffed’ days www.thefitbusymum.com.au

Health tips for the everyday situation

If endometriosis is part of your life then it’s a massive reason to consider your health in everything you do, possibly more son than the average person. Remember your body is already battling something quite severe, so taking the time to nourish your body, mind and soul is going to be even more important for you.

  1. Quality sleep is non-negotiable. While many of us live in a sleep-deprived state this is even less ideal for the endometriosis sufferer. Pain, and constant and severe pain at that, is exhausting. Continue like this for a long time and your body’s health will suffer in other ways. Lack of sleep can also be linked to depression and poor mood.
  1. Think twice about what you put into your mouth. It’s so important that the food you choose to eat is nourishing. Keeping a food diary to monitor your signs and symptoms and discuss this with your doctor if you start to see any link in symptoms with food. Food won’t be the cause of your condition but food can be a massive factor determining how you feel from one day to the next.
  1. Consider all management strategies and the impact of each on your health. Have an open dialogue with your doctor and make sure you discuss exercise as an option. Some women rely on massage for releasing tension built up from constantly experiencing pain.

The take-home message here really is that you need to find the strategies that work for you, but don’t exclude exercise as a possible treatment option.


Rose is a Fit Busy Mum of 3 fit kids. She aims to empower mums who are time poor. She acknowledges that mums are ‘busy’ but tries to inspire them to regain their fitness through simple everyday habits that she promotes through her book ‘The Fit Busy Mum: Seven habits for success’. Visit www.thefitbusymum.com.au

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