Exercises for Endometriosis
By Dr (TCM) Attilio D'Alberto | Traditional Chinese Medicine Practitioner, Wokingham
Endometriosis affects 1 in 10 women of reproductive age and is one of the most debilitating conditions I treat in my clinic. Pain — during periods, during sex, and often chronically throughout the cycle — is the dominant symptom, and it significantly limits many women's ability to exercise. Yet movement is one of the most important non-pharmacological interventions for endometriosis. Choosing the right type of exercise, at the right intensity and timing, can reduce pain, support the effectiveness of treatment, and improve quality of life considerably.
How Exercise Helps Endometriosis
Regular exercise reduces systemic inflammation — the key driver of endometriosis pain and progression. It lowers oestrogen levels (by reducing body fat and improving hepatic oestrogen metabolism), modulates prostaglandin production (reducing cramping), and raises endorphin levels that counteract pain. Research has confirmed that physically active women with endometriosis have lower pain scores and better quality of life than sedentary patients.
Best Types of Exercise for Endometriosis
Low-impact aerobic exercise — walking, swimming, and cycling are the most consistently beneficial. They improve circulation, reduce inflammation, and raise endorphins without the high-impact jarring that worsens adhesion-related pain. A 30-minute brisk walk five days per week is a sustainable and evidence-backed starting point.
Yoga — particularly yin yoga and restorative yoga — is one of the most consistently reported beneficial practices for endometriosis. It reduces cortisol and inflammatory markers, improves pelvic floor flexibility, and provides gentle movement that supports circulation without exacerbating pain. Certain poses that open the hips and lower abdomen also address the liver qi stagnation and pelvic blood stasis that TCM identifies as the root of endometriosis.
Pilates — core strengthening with controlled breathing supports pelvic stability and reduces the structural tension that worsens endometriosis pain.
Swimming — the buoyancy reduces impact on the pelvic structures while providing excellent cardiovascular benefit.
What to Avoid
High-intensity exercise during menstruation is best avoided in women with significant period pain — it can increase prostaglandin production and worsen cramping. Exercises that create excessive downward pressure (heavy weightlifting, high-impact running) may aggravate pain in women with deep infiltrating endometriosis or significant adhesions. Listen to your body — pain during exercise is a signal to reduce intensity or change activity.
The TCM Perspective on Movement
In traditional Chinese medicine, endometriosis is understood as blood stasis in the lower burner — and movement is one of the primary ways of moving qi and blood to prevent accumulation. Regular, moderate exercise supports the liver's role in ensuring smooth flow, reduces liver qi stagnation, and promotes pelvic circulation. The gentle, rhythmic movements of yoga, Tai Chi, and walking are particularly valued in TCM for their ability to move qi without depleting it. Acupuncture and Chinese herbal medicine work synergistically with these movement practices to address the root pattern.
Timing Exercise Across the Cycle
The follicular phase (days 1–14) is generally when energy is highest and exercise tolerance is best. The luteal phase (days 15–28) and particularly menstruation itself call for more gentle activity. Adapting exercise intensity to the cycle phase — more vigorous activity in the follicular phase, gentler activity approaching menstruation — respects the body's natural energy rhythms and reduces the likelihood of exercise worsening symptoms.
To discuss endometriosis treatment, contact me or book a consultation in Wokingham.
