Endometriosis is thought to affect one in nine Australian women by the age of 44, and is a disorder where tissue similar to the lining of the uterus is found growing outside of the uterus, commonly found within the pelvic region impacting areas such as the bowels, bladder, ovaries, intestines, and sometimes even kidneys or diaphragm. Endometriosis can present with symptoms such as chronic pelvic pain, heavy bleeding in periods, fatigue, digestive issues, infertility, and a tense or weak pelvic floor.
This tissue can continue to act like endometrial tissue – bleeding and breaking down each cycle, causing scar tissue and adhesions. Endometriosis can have a negative impact on multiple aspects of a woman’s life, including physical, financial, relationships, as well as mental health. Currently there is no cure for endometriosis but rather management strategies including surgery, pain medication, physiotherapy, and exercise.
Why Exercise?
- Pain management
- Decreases inflammation
- Relax muscles that may be overactive around the pelvic region
- Manages insulin, blood glucose levels, and stress hormones
- Protective against other diseases & complications
- Assist in the operative recovery post laparoscopy, excision, or hysterectomy
- Improve quality of life!
How do I establish a regular physical activity routine?
- A mode that you can enjoy and adjust to flares e.g: walking, jogging, swimming, dancing, modified Pilates, resistance training
- Address endo specific considerations: managing intra-abdominal pressure, down training of pelvic floor, tightness of muscles around the pelvis
- Moderate intensity
- Large muscle group involvement
- Tailored to your specific needs!
It is important to take an individualised and tailored approach to exercise, as just over one third of participants in research studies reported adverse events during self-managed and unguided exercise, including increased fatigue, pelvic pain, and more frequent ‘flare ups’ (Armour et al., 2019).
Exposure to exercise needs to be gradual to build tolerance and prevent flares, in order to assist you to return to usual levels of daily activities or reach optimal exercise guidelines. Some studies have found that women had a 76% reduced risk of developing endometrioma (endometrial like tissue in and around the ovaries), as well as reporting reduced intensity of pelvic pain, when exercising three times a week at a high intensity regularly for at least ten months (Bonocher et al., 2014).
An exercise physiologist can work with you to begin with light intensity and low impact exercises, keeping mind to control abdominal pressure to manage pain & begin building exercise tolerance, then work with you to progress intensity to develop a routine of regular moderate-high intensity activity. They can also equip you with the tools and strategies on how to adapt in the event of a painful flare.
Summary:
The evidence in using exercise in the management of endometriosis is ever growing and developing, and is starting to show that exercise is a great adjunct therapy to manage pain and disease progression, in addition to preventing other health complications. An exercise physiologist can assist you in developing a tailored and graded exercise routine to minimise risk of flare ups.
The myPhysioSA fitness and rehabilitation team of accredited exercise physiologists (AEPs) can help you with your goals. This can be one-to-one through a range of referral pathways including Medicare and through your private health insurance.
Accredited exercise physiologists (AEPs) are skilled in determining exercise prescription specific to your needs.
If you would like further information on endometriosis & exercise, please do not hesitate to contact us at myPhysioSA on 1300 189 289.
References:
- Armour, M., Sinclair, J., Chalmers, K.J. and Smith, C.A. (2019). Self-management strategies amongst Australian women with endometriosis: a national online survey. BMC Complementary and Alternative Medicine, 19(1). doi:10.1186/s12906-019-2431-x.
- Awad, E., Ahmed, H.A.H., Yousef, A. and Abbas, R. (2017). Efficacy of exercise on pelvic pain and posture associated with endometriosis: within subject design. Journal of Physical Therapy Science, [online] 29(12), pp.2112–2115. doi:10.1589/jpts.29.2112.
- Bonocher, C.M., Montenegro, M.L., Rosa e Silva, J.C., Ferriani, R.A. and Meola, J. (2014). Endometriosis and physical exercises: a systematic review. Reproductive Biology and Endocrinology, 12(1), p.4. doi:10.1186/1477-7827-12-4.
- Rowlands, I., Abbott, J., Montgomery, G., Hockey, R., Rogers, P. and Mishra, G. (2020). Prevalence and incidence of endometriosis in Australian women: a data linkage cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. doi:10.1111/1471-0528.16447.
