Can general exercise be used as an empowering tool among women with endometriosis? Experiences and practice among women with endometriosis and women’s health physiotherapists

Abstract Background The potential benefit of exercise to alleviate symptoms of endometriosis is unclear. Still, exercise may be used to empower women and manage disease symptoms. The purpose of this study was twofold: 1) to explore how general exercise is experienced among women with endometriosis and 2) to assess whether women’s health physiotherapists are implementing exercise in their treatment. Methods Qualitative interviews were performed with 19 women with endometriosis, recruited after cessation of a randomized controlled trial (RCT), testing the effect of exercise as self-management (10 from the exercise group and nine from the control group). Responses to the question “Did participation in the study change your view of exercise as part of the treatment for endometriosis?“ were analyzed. In addition, a cross-sectional survey was performed among women's health physiotherapists working in the Nordic countries (n = 108), exploring their practice of manual treatments and supervised general exercise for endometriosis patients. Associations with manual and combined treatments of manual treatment and supervised regular general exercise were explored in relation to experience in women's health, assumed patient severity, and working in an interdisciplinary setting. Chi-square tests were used. Results From the RCT, the women from the exercise and control groups brought forward the importance of knowledge about the benefits of exercise to make informed decisions in disease management. The women in the exercise group described how exercise was perceived as less frightening and manageable when exposed to various intensities and types of exercises in a safe and supportive environment. The supervised exercise brought an extra dimension of belonging through group participation. From the survey, 75% of the physiotherapists stated to offer manual treatments only, whereas 24% combined manual treatments with regular supervised general exercise training individually or in groups. No differences between groups related to the variables of interest were found. Conclusions To experience exercise as safe and non-threatening, creating a sense of belonging through regular supervision and guidance is essential. Still, few women's health physiotherapists offer exercise for self-management of pain as part of their daily practice in treating women with endometriosis. Trial registration NCT05091268