Exercise and Endometriosis: What the Research TELLS US
By Zsofia Jamieson and Marta Han, co-founders of The Fertility Class and certified Aviva Method instructors with 25 years of combined teaching experience.
Last updated October 2026.
In short: Endometriosis affects roughly one in ten women of reproductive age. A 2025 systematic review of six randomized trials found that regular exercise, including yoga, stretching and gentle aerobic activity, improved quality of life for women with endometriosis, particularly in pain, sense of control and emotional well-being. The evidence is still early, and movement works best as a companion to medical care, never a replacement for it.
Endometriosis is a chronic condition in which tissue similar to the lining of the uterus grows outside it, most often on the ovaries, the fallopian tubes and the lining of the pelvis. It can cause severe period pain, pain during sex, fatigue and, for many women, difficulty conceiving. The World Health Organization estimates that it affects around 190 million women and girls worldwide.
Treatment belongs with a medical team and may include pain relief, hormonal therapy or surgery. Alongside that care, researchers have begun to ask a practical question: can the way a woman moves change how she lives with the condition?
What the research shows
The most comprehensive answer so far comes from a systematic review published in PLoS ONE in 2025. Its authors analyzed six randomized controlled trials involving 251 women, testing aerobic exercise, yoga, stretching, lumbopelvic stabilization and progressive muscle relaxation.
When the comparable trials were pooled, women who exercised scored better on the Endometriosis Health Profile, a standard quality-of-life measure, in three areas: pain, control and powerlessness, and emotional well-being. Individual trials, including one on yoga, reported lower pain scores, although results on pain were not consistent from study to study.
The authors are clear that the evidence is preliminary. The trials were small, the programs varied widely, and only two could be combined statistically. What emerges is a consistent direction rather than a final verdict: regular, moderate movement tends to help women with endometriosis feel better and more in control of their symptoms.
Why gentle movement may help
Circulation in the pelvis
Slow, rhythmic movement increases blood flow to the pelvic organs. Better circulation may ease some of the congestion and heaviness that build up around chronic pelvic pain. We explore this in more depth in The Importance of Pelvic Blood Flow for Fertility.
Muscle tension
Persistent pain teaches the body to brace. Over months, the pelvic floor and the muscles of the hips and lower back can hold tension that adds a second layer of pain. Gentle mobility work gives those muscles a chance to release.
The stress response
Chronic pain keeps the nervous system on alert. Slow, breath-led movement is one of the most accessible ways to settle it, which may help explain the gains in emotional well-being seen in the research.
What kind of movement fits
With endometriosis, more effort is not better. High-impact training, heavy abdominal work and positions that compress the pelvis can aggravate pain, especially in the days around a period. The programs studied in the research share a different character: gentle, rhythmic and controlled.
- Start below your limit. A short practice you can repeat every day is worth more than an ambitious one you cannot sustain.
- Work with your cycle. Many women have more capacity in the weeks after their period and need far less in the days before and during it.
- Let pain guide the session. Discomfort that eases as you move is usually fine to continue. Sharp or worsening pain is a signal to stop.
- Ask before returning after surgery. If you have had a laparoscopy, your surgeon can tell you when movement is safe again.
How The Fertility Class approaches endometriosis
The Aviva Method, the foundation of our program, is built on short, rhythmic sequences centered on the pelvis. For members with endometriosis, our program includes dedicated sequences. The Ease-In Sequence is the starting point: soft, slow movement that supports pelvic circulation without strain. The Follow-On Sequence goes a step further once the first feels comfortable.
Both sit alongside the cycle-based classes in the main program, so members can adjust from week to week, and from good days to difficult ones. Our classes are designed to be practiced from home, anywhere in the world, at the pace your body allows.
Common questions
Is exercise safe with endometriosis?
For most women, yes. The trials in the 2025 review did not report adverse events, and gentle, low-impact movement is the usual starting point. Check with your doctor first, particularly after surgery or if your pain is severe.
What exercise should I avoid with endometriosis?
On painful days, avoid high-impact exercise, heavy abdominal work and positions that put pressure on the pelvis. Many women tolerate more on good days, so it helps to adjust as you go rather than follow a fixed plan.
Can exercise reduce endometriosis pain?
Some trials have found lower pain scores with regular yoga or stretching, and pooled results show improvement in the pain domain of quality-of-life measures. Results are not yet consistent, so exercise is best seen as one support alongside medical treatment.
Can I exercise while trying to conceive with endometriosis?
Yes. Gentle, circulation-focused movement fits well alongside fertility treatment. Our guide to Exercise During IVF and IUI explains how to adjust movement through each phase.
Sources
- World Health Organization, Endometriosis fact sheet, 2023
- Xie M, et al. The effectiveness and safety of physical activity and exercise on women with endometriosis: a systematic review and meta-analysis, PLoS ONE, 2025
More research on the movement behind our program is collected on our Studies page.
