Exercise and health conditions in young women

Endometriosis

Simply put, endometriosis is a chronic gynaecological condition where cells similar to those found within the uterus are found outside the uterus. It affects not only the pelvic region but also the nervous system, leading to central pain sensitisation [2], or in other words where your brain and spinal cord can become overly sensitive to pain signals.

Endometriosis affects approximately 5-10% of women of reproductive age worldwide (approximately 176 million women) within clinical symptoms such as pelvic pain (50-80%), infertility (50%), period pain and mental illness (87%) [3]. There is good news though, in recent years there has been significantly more research and awareness around endometriosis, so we are starting to get a much better idea not only about what the condition is, but also how to treat and manage it.

Research has shown that exercise could be a good tool in managing symptoms associated with endometriosis, in particular quality of life and pain relief [4]. However, a personalised approach must be undertaken that also ensures that the overly sensitised central nervous system does not become further sensitised from more high-intensity forms of exercise (heavy weight lifting, sprinting etc.), with some studies reporting adverse effects of exercise on pain and function in women with endometriosis [5]. This is why it is important to see a professional expert in exercise management for endometriosis, who will personally support you in finding what exercise modality best suits your goals, your body, and your lifestyle.

This could be why types of exercise like Pilates, which have a heavy focus on mindful movement and tuning into one’s mind and body, have such good outcomes for women with endometriosis. From our clinical experience it can be so important to find calm and a positive movement experience, and then building in exercise challenges when you and your body are ready.

Polycystic Ovary Syndrome (PCOS)

PCOS is an endocrine* condition that affects 9.2% of women in reproductive age [6]. Symptoms include fluctuations in your menstrual cycle, infertility, acne, excessive hair production on face and body, hair thinning, weight gain (particularly around the belly). If you have PCOS you are also more likely to have Type 2 Diabetes, hypertension (high blood pressure), high cholesterol, heart disease, and some cancers [7], as well as mental health implications [8]. In summary, it is a complex and chronic condition that can affect multiple parts of your body and have a significant impact on your quality of life.

Exercise has been shown to be effective for multiple symptoms or risk factors associated with PCOS. Positive benefits have been shown in weight management, insulin resistance, blood lipid profile, blood pressure regulation, mental health and physical fitness [9]. In particular, there is more and more evidence supporting moderate- to high-intensity strength training over aerobic training (running, cycling etc.) in managing symptoms of PCOS [9].

So, where to now?

In summary, we know that exercise is important for all women, but we are also starting to understand the benefits of healthy exercise practices for women with health conditions as well. In this blog, we have provided a short overview of two common health conditions that affect many young women: Endometriosis and PCOS, and how exercise could play a role in effective symptom management of both conditions. We have also highlighted how important it is to find an expert in exercise delivery for managing these conditions who takes a biopsychosocial view of health that takes into consideration your goals, your body, your lifestyle and your environment.

* The endocrine system is a messenger system in which a network of glands work together to release hormones that regulate many responses across the body. This is all controlled from the hypothalamus in your brain. For a deeper dive into how exercise can influence hormones, read Katina’s previous blog ‘The neurophysiology behind exercise’.

Author: Katina McCulloch
Co-founder and director at Waves  

Disclaimer: this site cannot and doesn’t contain medical/ health advice. The medical/ health information is provided for general informational and educational purposes only and is not a substitute for professional advice. Accordingly, before taking any actions based upon such information, we encourage you to consult with the appropriate professionals. 

References

$[1]$ EuroHealthNet. (2023). Young women’s health priorities in Europe. https://eurohealth.ie/wp-content/uploads/2023/10/Young-Womens-Health-Priorities-in-Europe.pdf

$[2]$ Taylor, H. S., Kotlyar, A. M., & Flores, V. A. (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

$[3]$ Li, L., He, M., Zhu, X., Wei, Y., & Lu, Y. (2024). Global burden of endometriosis: Trends in prevalence from 1990 to 2019. Lancet Regional Health – Western Pacific, 42, Article 100878. https://doi.org/10.1016/j.lanwpc.2024.100878

$[4]$ Xie, M., Qing, X., Huang, H., Zhang, L., Tu, Q., Guo, H., et al. (2025). The effectiveness and safety of physical activity and exercise on women with endometriosis: A systematic review and meta-analysis. PLOS ONE, 20(2), e0317820. https://doi.org/10.1371/journal.pone.0317820

$[5]$ Dağ, Z. Ö., Güngör, S., Karahan, N., & Şimşek, T. (2022). The effects of exercise on pain perception in women with endometriosis: A systematic review. Acta Obstetricia et Gynecologica Scandinavica, 101(7), 686–696. https://doi.org/10.1111/aogs.14169

$[6]$ Salari, N., Nankali, A., & colleagues. (2024). Global prevalence of polycystic ovary syndrome in women: A comprehensive systematic review and meta-analysis. Archives of Gynecology and Obstetrics.

$[7]$ World Health Organization. (n.d.). Polycystic ovary syndrome [Fact sheet]. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome

$[8]$ Tabatabaeian, M., Roozitalab, M., Najafabadi, M. M., et al. (2024). Psychosocial aspects of polycystic ovary syndrome: A narrative review. Frontiers in Psychology, 15, Article 10823298. https://doi.org/10.3389/fpsyg.2024.10823298

$[9]$ Benham, J. L., Yamamoto, J. M., Friedenreich, C. M., Rabi, D. M., & Sigal, R. J. (2020). Exercise training and reproductive function in women with polycystic ovary syndrome: A systematic review and meta-analysis. Frontiers in Physiology, 11, Article 606. https://doi.org/10.3389/fphys.2020.00606