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Have you heard that regular exercise helps reduce the symptoms of endometriosis? You may be wondering how physical activity could help reduce a reproductive system disorder, and what kinds of exercise you should be doing.

Have you recently been diagnosed with endometriosis? You may have heard that regular exercise can help manage the symptoms of your condition, or may, on the other hand, be worried that exercising could add to your pre-existing pain. Can exercise help with endometriosis, rendering it one of the lifestyle changes every doctor should advise you to make? 

What On Earth Has Exercise Got To Do With A Reproductive System Disorder?

Endometriosis is, simply said, a disorder in which the tissue that normally lines your uterus (the endometrium) also grows in other places — such as the ovaries, fallopian tubes, the pelvic lining, the intestines, and the bladder. Its symptoms include painful and heavy periods, painful bowel movements and urination, abdominal bloating, fatigue, and nausea. Endometriosis and infertility are also linked. [1]

When you're first diagnosed with endometriosis, your doctor will tell you about the most common conventional treatments for endometriosis:

  • NSAID painkillers to help with the pain.
  • Oral contraceptives and gonadotropin-releasing hormone (GnRH) antagonists to slow down the growth of new endometrial tissue and help prevent the formation of adhesions.
  • Surgery to remove endometrial tissue, thereby reducing pain and improving fertility.
  • A hysterectomy, sometimes in combination with the removal of the ovaries and fallopian tubes. [2]
That all makes sense, right? Endometriosis is a reproductive system disorder, and these treatments directly focus on the reproductive system or on pain relief. "What has exercise got to do with all of this?", you may wonder. 

Endometriosis, Inflammation, And Exercise

Research suggests that inflammation plays a great role in the cause of endometriosis symptoms — the lining of the inner side of your abdomen, the peritoneum, becomes inflamed in reaction to the presence of endometrial tissues. [3]. When we look at endometriosis as a disorder in which inflammation plays a key part, it makes sense that exercise would help relieve its symptoms: regular physical exercise has also been found to be beneficial for people with other types of diseases involving inflammation, like breast cancer, colon cancer, and type 2 diabetes [4, 5]. 

The reason exercise reduces inflammation is that your body releases cytokines, small proteins, that have anti-inflammatory properties when you work out. [6, 7]

This may explain the possibility suggested by a few studies that women who exercise regularly are less likely to develop endometriosis in the first place [8].

Exercise Releases Endorphins

Working out further releases endorphins, neurotransmitters that reduce our perception of pain. It's hardly surprising that doctors advise patients with conditions as varied as chronic pain, alcoholism, depression, and hypertension to exercise to help manage their symptoms [9]! 

There is even some evidence that regular physical exercise specifically reduces the symptoms of dysmenorrhea (painful periods, often along with secondary symptoms like diarrhea, nausea, and headaches), which many women with endometriosis suffer from [10]. This may mean that wonder who are wondering how to get pregnant with endometriosis directly benefit from exercise for this reason — more regular menstrual periods increase your odds of getting pregnant.

Exercise Lowers Your Estrogen Levels

Since endometriosis is estrogen-dependent [11], reducing your estrogen levels is one of the main goals of the treatment of this reproductive disorder. Guess what you can do to naturally lower your estrogen levels? That's right: exercise! [12]

Other Benefits Of Exercise For Women With Endometriosis

  • Exercise improves your blood circulation, thereby facilitating better flow of oxygen to your vital organs, making you feel better. [13]

  • Are you taking Danazol, a synthetic androgen, for your endometriosis? Research suggests that women with endometriosis who are taking Danazol have lower testosterone levels if they exercise four times a week for 40 minutes. This, in turn, leads to a lower incidence of androgen-related side effects. [14]

  • The irregular and heavy periods associated with endometriosis increase your risk of developing osteoporosis (brittle bones), but exercising regularly helps offset this risk. Weight-bearing and resistance exercise is especially important for those who would like to reduce their risk of osteoporosis. [15]

What Exercises Should I Do?

We've already seen that you're advised to exercise at least four times a week, for 40 minutes at a time. 

The available research that sought to assess whether exercising helps relieve endometriosis symptoms mostly focused on cardio exercises, such as walking, swimming, hiking, and aerobics classes, but yogic exercises such as groin stretches and hip and buttock stretches can also help relieve some of the tension that inevitably builds up in your pelvic floor as you suffer from pain. In order to keep your bones strong and healthy, you will also want to engage in strength training exercises, such as push-ups, rowing, or using a leg-curl machine at the gym. 

You may find that you're in too much pain to exercise during your menstrual periods, but you can still engage in gentle breathing exercises followed by stretching exercises to reduce pain, stay flexible, and keep your routine up during this time. 

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