Can exercise help manage the symptoms of endometriosis?
Endometriosis can be complicated and the symptoms of it will vary from woman to woman. However, there is research investigating if exercise can help manage endometriosis in any way.
This blog post summarises the research carried out by Bonocher et al in 2014 in the journal Reproductive Biology and Endocrinology.
The authors carried out a systematic review looking at endometriosis and physical exercises.
The authors start the paper by reminding us of the fact that exercise itself seems to have anti inflammatory effects, and as endometriosis is an inflammatory condition, it stands to reason that exercise may help manage endometriosis. So, the aim of their research was to assess the relationship between physical exercise and the prevalence and/or improvement of the symptoms associated with endometriosis.
The authors reviewed numerous pieces of research asking this question. Some of the research they reviewed, for example, Cramer et al 1986, found that women who exercised regularly before the beginning of the study had a significantly lower risk for endometriosis compared to women who did not exercise. On this basis, physical exercise had a protective effect limited to women who started exercising before 26 years of age, at least two hours per week. However it should be noted that this research was only carried out on white women and so another, more inclusive study would be needed to make these findings more widely applicable to women of colour.
Signorello et al. in 1997 related the risk of endometriosis to other less studied factors such as anthropometric variables (height, weight and BMI), physical exercise, smoking, and alcohol consumption. The authors observed an inverse association between vigorous physical exercises and endometriosis, although without statistical significance. The authors also pointed that is possible that the protective effect of exercise in patients with endometriosis result from the fact that women who suffer from endometriosis do not feel well enough to practice exercise. To try decrease the bias, they separate the groups by cases and control that practiced exercise. Women who exercised 4 hours per week or more reduced by 65% the risk of endometriosis compared to women who exercised less than 4 hours a week.
Further research carried out by Dhillon and Holt, in 2003 was also reviewed. Dhillon and Holt investigated the link between endometriosis and physical activity. A significant 76% reduction of the risk to develop an endometrioma was observed in patients who exercised frequently (3 times a week or more, 30 minutes or more per episode and 10 months or more per year/2 years) and at high intensity (running, bicycle riding and playing tennis). A reduction of the risk was not observed in patients who practiced exercise of low intensity (golf, bowling and light walking).
Whilst these studies to point to the idea that exercise can be helpful when dealing with endometriosis, the authors also note that there are no controlled and randomized studies identifying whether physical exercise prevents the occurrence or progression of the endometriosis and how and to what extent physical exercise could be beneficial for women with endometriosis. The few existing studies are of an observational type, with little or no statistical significance, but that indicate an inverse relationship between the practice of physical exercise and the risk of endometriosis. These studies also draw attention to the possibility that conclusions about non-protective effect of exercise in women with endometriosis can be due the discomfort experienced, what prevent the practice of physical exercise.
This means that better quality, more systematic research is needed to draw a firmer conclusion on how exercise and endometriosis may work together.
To read the article in full, please follow this link.
For more information about endometriosis you can watch this TEDx video:
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