LIFESTYLE INTERVENTIONS IN THE MANAGEMENT OF ENDOMETRIOSIS-ASSOCIATED PAIN: A NARRATIVE REVIEW

In: International Journal of Innovative Technologies in Social Science · 2026 · vol. 3(1(49)) · doi:10.31435/ijitss.1(49).2026.5438 · W7154467213
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This narrative review evaluates physical activity, diet, physiotherapy, and psychological approaches, finding they may influence inflammation, hormones, and pain processing to complement endometriosis management.

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This narrative review evaluated evidence on non-pharmacological lifestyle interventions for endometriosis-associated pain, drawing on interventional and observational studies and systematic reviews from databases including PubMed, Scopus, and Web of Science. Across the included physical activity, dietary, physiotherapy, and psychological approaches, the authors report that lifestyle interventions may affect multiple mechanisms (including inflammation, hormonal regulation, neuromuscular function, and central pain processing), with physical activity linked to pain reduction and improved psychological well-being, dietary strategies showing potential anti-inflammatory symptom effects, and multimodal approaches showing the most consistent benefits. The review emphasizes that findings are heterogeneous and constrained by methodological variability across studies. This paper is centrally about endometriosis — it synthesizes evidence on lifestyle and non-pharmacological interventions for endometriosis-associated pain.

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Abstract

Endometriosis is a chronic inflammatory condition associated with significant pain, reduced quality of life, and functional impairment. Although pharmacological and surgical treatments remain the standard of care, increasing attention has been directed toward lifestyle and non-pharmacological interventions as supportive management strategies. The aim of this narrative review was to evaluate the role of physical activity, dietary interventions, physiotherapy, and psychological approaches in the management of endometriosis-associated pain. A literature search was conducted using major electronic databases, including PubMed, Scopus, and Web of Science, focusing on studies examining non-pharmacological interventions in women with endometriosis. Both interventional and observational studies, as well as systematic reviews, were included. The available evidence suggests that lifestyle interventions may influence multiple mechanisms involved in endometriosis, including inflammation, hormonal regulation, neuromuscular function, and central pain processing. Physical activity appears to reduce pain and improve psychological well-being, although participation remains limited due to symptom burden. Dietary strategies, particularly anti-inflammatory patterns, may contribute to symptom improvement, while physiotherapy and psychological interventions address functional and emotional aspects of chronic pain. Multimodal approaches appear to provide the most consistent benefits. Despite promising findings, the evidence remains heterogeneous and limited by methodological variability. Lifestyle interventions should be considered as complementary strategies within a multidisciplinary treatment framework. Further high-quality studies are needed to establish standardized clinical recommendations.
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LIFESTYLE INTERVENTIONS IN THE MANAGEMENT OF ENDOMETRIOSIS-ASSOCIATED PAIN: A NARRATIVE REVIEW DOI: https://doi.org/10.31435/ijitss.1(49).2026.5438Keywords: Endometriosis, Chronic Pelvic Pain, Lifestyle Interventions, Physical Activity, Physiotherapy, Dietary Interventions, Psychological Interventions, Quality of LifeAbstract Endometriosis is a chronic inflammatory condition associated with significant pain, reduced quality of life, and functional impairment. Although pharmacological and surgical treatments remain the standard of care, increasing attention has been directed toward lifestyle and non-pharmacological interventions as supportive management strategies. The aim of this narrative review was to evaluate the role of physical activity, dietary interventions, physiotherapy, and psychological approaches in the management of endometriosis-associated pain. A literature search was conducted using major electronic databases, including PubMed, Scopus, and Web of Science, focusing on studies examining non-pharmacological interventions in women with endometriosis. Both interventional and observational studies, as well as systematic reviews, were included. The available evidence suggests that lifestyle interventions may influence multiple mechanisms involved in endometriosis, including inflammation, hormonal regulation, neuromuscular function, and central pain processing. Physical activity appears to reduce pain and improve psychological well-being, although participation remains limited due to symptom burden. Dietary strategies, particularly anti-inflammatory patterns, may contribute to symptom improvement, while physiotherapy and psychological interventions address functional and emotional aspects of chronic pain. Multimodal approaches appear to provide the most consistent benefits. Despite promising findings, the evidence remains heterogeneous and limited by methodological variability. Lifestyle interventions should be considered as complementary strategies within a multidisciplinary treatment framework. Further high-quality studies are needed to establish standardized clinical recommendations. References Zondervan, K. T., et al. (2018). Endometriosis. Nature Reviews Disease Primers, 4(1), 9. https://doi.org/10.1038/s41572-018-0008-5 Taylor, H. S., et al. (2021). Endometriosis is a chronic systemic disease: Clinical challenges and novel innovations. The Lancet, 397(10276), 839–852. https://doi.org/10.1016/S0140-6736(21)00389-5 Facchin, F., et al. (2015). Impact of endometriosis on quality of life and mental health: Pelvic pain makes the difference. Journal of Psychosomatic Obstetrics & Gynecology, 36(4), 135–141. https://doi.org/10.3109/0167482X.2015.1074173 Cuffaro, F., et al. (2024). 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Impact of exercise on pain perception in women with endometriosis: A systematic review. Acta Obstetricia et Gynecologica Scandinavica, 100(9), 1595–1601. https://doi.org/10.1111/aogs.14169 Hartmann, T. E., Baker, K. A., & Girard, D. (2025). Is exercise duration more important than intensity in endometriosis? BMC Women’s Health, 25(1), 625. https://doi.org/10.1186/s12905-025-04160-w Escriva-Boulley, G., et al. (2023). Effects of a physical activity and endometriosis-based education program delivered by videoconference on endometriosis symptoms: The CRESCENDO program (inCRease physical Exercise and Sport to Combat ENDOmetriosis) protocol study. Trials, 24(1), 759. https://doi.org/10.1186/s13063-023-07792-1 Salinas-Asensio, M., Álvarez-Salvago, F., Mundo-López, A., et al. (2025). Changes in fatigue, health-related fitness, sleep quality, mental health, gastrointestinal complaints and sexual function after a multimodal supervised therapeutic exercise program in women with endometriosis unresponsive to conventional therapy: A secondary analysis of a randomized controlled trial. European Journal of Obstetrics & Gynecology and Reproductive Biology, 312. https://doi.org/10.1016/j.ejogrb.2025.114083 Desai, J., et al. (2024). Holistic approaches to living well with endometriosis. F1000Research, 13, 359. https://doi.org/10.12688/f1000research.142586.2 Mazur-Bialy, A., et al. (2024). Holistic approaches in endometriosis - as an effective method of supporting traditional treatment: A systematic search and narrative review. Reproductive Sciences, 31(11), 3257–3274. https://doi.org/10.1007/s43032-024-01660-2 Shved, K., Antkowiak, K., Kędzierska, Z., Żurek, U., Dadas, K., Świercz, A., Małachowska, D., Ciecierski-Koźlarek, H., & Tołwiński, I. (2023). 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Effect of dietary interventions on endometriosis: A systematic review and meta-analysis of randomized controlled trials. Reproductive Sciences, 31(12), 3613–3623. https://doi.org/10.1007/s43032-024-01701-w De Araugo, S. C., et al. (2025). Nutrition interventions in the treatment of endometriosis: A scoping review. Journal of Human Nutrition and Dietetics, 38(1). https://doi.org/10.1111/jhn.13411 van Haaps, A. P., et al. (2023). The effect of dietary interventions on pain and quality of life in women diagnosed with endometriosis: A prospective study with control group. Human Reproduction, 38(12), 2433–2446. https://doi.org/10.1093/humrep/dead214 Abulughod, N., et al. (2024). Dietary and nutritional interventions for the management of endometriosis. Nutrients, 16(23), 3988. https://doi.org/10.3390/nu16233988 Neri, L. C. L., et al. (2025). Diet and endometriosis: An umbrella review. Foods, 14(12), 2087. https://doi.org/10.3390/foods14122087 Donatti, L., et al. (2022). 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PAIN, 167(1), 80–93. https://doi.org/10.1097/j.pain.0000000000003784 Meissner, K., et al. (2016). Psychotherapy with somatosensory stimulation for endometriosis-associated pain: A randomized controlled trial. Obstetrics & Gynecology, 128(5), 1134–1142. https://doi.org/10.1097/AOG.0000000000001691 Del Pino-Sedeño, T., et al. (2024). Effectiveness of psychological interventions in endometriosis: A systematic review with meta-analysis. Frontiers in Psychology, 15, 1457842. https://doi.org/10.3389/fpsyg.2024.1457842 Downloads Published Issue Section License Copyright (c) 2026 Karolina Orda, Karolina Niewola, Kamil Arciszewski, Natalia Hariasz, Philip Kłakowicz, Jakub Szumiło, Klaudia Kasperska, Mariana Markiv, Michał Słowik, Paweł Stenzel This work is licensed under a Creative Commons Attribution 4.0 International License. All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). 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