Let’s talk about endometriosis and exercise. And I’m not going to give you some toxic positivity rubbish about “pushing through the pain” or “mind over matter,” because honestly? When you’ve got endometriosis, sometimes everything just hurts, and pretending it doesn’t won’t help anyone.

But here’s the thing: whilst exercise isn’t a cure for endometriosis (spoiler: there isn’t one), staying active can genuinely help manage some symptoms. The trick is figuring out how to move your body in a way that helps rather than makes things worse.

So let’s have a proper, honest chat about exercising with endometriosis – the good, the bad, and the days when getting off the sofa deserves a bloody medal.

One thing before I get into it: I write about health topics from personal experience and a lot of reading, but I’m a blogger — not a doctor or a gynaecologist. Endometriosis is a complex medical condition and what works for one person’s pain and activity levels won’t be right for everyone. If you’re managing endo and haven’t yet spoken to a GP or specialist about what exercise might be appropriate for you, that’s worth doing. I’m writing from the perspective of someone who’s lived with chronic pelvic pain and figured out a lot by trial and error — not from a clinical one. Right, on with it.

May 2026

What Is Endometriosis? (The Quick Version)

Endometriosis is when tissue similar to the lining of your womb grows outside of it – on your ovaries, fallopian tubes, bowel, bladder, or other places it absolutely shouldn’t be. Every month, this tissue acts like the lining of your womb – it thickens, breaks down, and bleeds. But unlike your actual period, this blood has nowhere to go, which causes inflammation, scarring, and pain.

Symptoms can include:

• Extremely painful periods (we’re talking beyond normal cramps)
• Pelvic pain throughout the month
• Pain during or after sex
• Painful bowel movements or urination
• Heavy periods
• Fatigue
• Difficulty getting pregnant

About 1 in 10 women of reproductive age in the UK have endometriosis, though it often takes years to get diagnosed. If you’re reading this and thinking “hang on, that sounds like me,” please go and speak to your GP.

Why Exercise Might Help (And Why It’s Complicated)

Right, so here’s what we know from research: regular exercise can help reduce endometriosis pain for some women. Not all women, and not all the time, but enough that it’s worth talking about.

Exercise can help by:

Reducing inflammation: Endometriosis causes chronic inflammation, and regular moderate exercise has anti-inflammatory effects. Over time, this might help reduce pain levels.

Releasing endorphins: These are your body’s natural painkillers. They won’t make severe endo pain disappear, but they can take the edge off and improve your mood.

Improving circulation: Better blood flow might help reduce pelvic congestion, which can contribute to pain.

Managing stress: Living with chronic pain is exhausting and stressful. Exercise can help regulate your stress response and improve mental health.

Reducing oestrogen levels: Endometriosis is oestrogen-dependent, meaning the tissue grows in response to oestrogen. Regular exercise can slightly lower oestrogen levels, which might help slow disease progression.

But – and this is important – exercise can also make pain worse if you overdo it, especially during flare-ups. So it’s not as simple as “just exercise and you’ll feel better.”

The Best Types of Exercise for Endometriosis

I’ll be honest — when I first read that yoga and swimming were the most recommended types of exercise for endo, my eyes glazed over a bit. It felt like the sort of thing people say when they don’t really have an answer. But there’s actually a reason for it. It’s not that high-intensity exercise is categorically off the table — it’s that anything that significantly increases intra-abdominal pressure or raises cortisol sharply can aggravate pelvic pain in a way that lower-impact movement often doesn’t. Walking counts. Gentle cycling counts. You’re not being told to give up and do gentle stretches forever — you’re being told that on difficult days, these things are less likely to make it worse.

Low-Impact Cardio

Walking, swimming, cycling, or using an elliptical are all brilliant options. They get your heart rate up and blood moving without putting excessive stress on your pelvic area.

Walking is massively underrated. A 20-30 minute walk can help reduce pain and improve mood without exhausting you. Plus, you can adjust the intensity based on how you’re feeling that day.

Swimming is particularly good because the water supports your body weight, reducing pressure on your pelvis. Plus, if you’re dealing with bloating (hello, endo belly), being in water can feel really comforting.

What to do:

• Aim for 20-30 minutes of gentle cardio most days of the week
• Listen to your body and adjust intensity as needed
• On bad pain days, even a 10-minute walk counts

Strength Training (With Modifications)

Building muscle strength is important, especially for your core and pelvic floor. However, you need to be careful with certain exercises that put pressure on your abdomen.

Exercises to generally avoid or modify:

• Heavy squats or deadlifts during flare-ups
• Intense abdominal crunches
• Anything that causes sharp pelvic pain

Focus on:

• Upper body strength work
• Light to moderate lower body exercises
• Core work that doesn’t aggravate pain (planks might be better than crunches)
• Using resistance bands or lighter weights more frequently

What to do:

• 2-3 strength sessions per week when you’re feeling okay
• Start light and gradually increase resistance
• If something hurts in a bad way (not just muscle burn), stop

Yoga and Pilates

These can be absolute game-changers for endometriosis. Gentle stretching can help release tension in your pelvic area, improve flexibility, and activate your parasympathetic nervous system (the “rest and digest” mode).

Certain yoga poses are particularly helpful:

• Child’s pose (opens up your lower back and pelvis)
• Cat-cow stretches (gentle spinal movement)
• Legs up the wall (reduces pelvic congestion)
• Gentle hip openers

Restorative yoga, where you hold gentle poses with props and focus on breathing, can be especially beneficial for managing pain and stress.

What to do:

• Include yoga or gentle stretching 2-4 times per week
• Focus on poses that feel good and avoid anything that increases pain
• Consider trying yin yoga or restorative yoga specifically

Pelvic Floor Work

Many women with endometriosis have pelvic floor dysfunction – either muscles that are too tight (hypertonic) or too weak. A physiotherapist who specialises in pelvic health can assess this and give you specific exercises.

If your pelvic floor is too tight (which is common with endo), you might need to focus on relaxation and stretching rather than Kegels. This is why seeing a specialist is important – doing the wrong exercises can make things worse.

What to Avoid (Or Be Careful With)

High-Impact Exercise During Flare-Ups

Right, this is the bit I actually needed someone to explain to me when I was first trying to figure out how to keep moving on bad days. Because there’s a difference between “rest when you need to” — which everyone says, very helpfully — and actually having a framework for what a bad day looks like versus a stay-on-the-sofa day versus a day when you push through and regret it deeply.

I got that wrong a lot before I figured out what my body was telling me. I’d drag myself to a workout on a four-out-of-ten pain day and end up worse for two days after. I’d also write off perfectly manageable days because I was scared to try. Neither was useful.

Running, jumping, or intense HIIT workouts can jar your pelvis and worsen pain when you’re having a flare-up. That doesn’t mean you can never do these things, but timing matters.

If you love running, you might find you can do it during good weeks but need to switch to walking during bad weeks. That’s completely fine – it’s not “giving up,” it’s being sensible.

Exercises That Increase Intra-Abdominal Pressure

Things like heavy lifting, intense core work, or bearing down can increase pressure in your abdomen and pelvis. For some women with endometriosis, this can trigger pain or make existing pain worse.

This doesn’t mean you can never do these exercises, but you need to be mindful. If something consistently causes pain afterwards, it’s probably not right for you at the moment.

Over-Exercising

I know it’s tempting to “fight through” bad days or to try to maintain your pre-endo fitness routine, but over-exercising when you have endometriosis can:

• Increase inflammation
• Worsen fatigue
• Suppress your immune system
• Make pain worse in the long run

Rest is not weakness. Rest is essential.

Creating a Flexible Exercise Routine

The key word here is flexible. You need a routine that can adapt to how you’re feeling because endometriosis is unpredictable.

Good Week Routine:

• 3-4 days of moderate exercise (mix of cardio and strength)
• 2-3 days of yoga or gentle stretching
• 1-2 rest days

Flare-Up Week Routine:

• Gentle walking when you can
• Restorative yoga or stretching
• Lots of rest
• No guilt whatsoever

Sample Week (Good Phase):

Monday: 30-minute walk or swim
Tuesday: Gentle strength training (30 minutes)
Wednesday: Yoga or Pilates (30 minutes)
Thursday: Rest day
Friday: 30-minute walk or cycle
Saturday: Upper body strength work (20-30 minutes)
Sunday: Gentle yoga or complete rest

But remember – this is just a template. Some weeks you’ll do more, some weeks you’ll do less. Both are okay.

Listening to Your Body (Without the Guilt)

This is the hardest part, honestly. There’s so much pressure to “stay consistent” and “push yourself,” but with endometriosis, you have to learn the difference between:

Discomfort: The normal feeling of exercise, slightly breathless, muscles working. You can push through this.

Pain: Sharp, stabbing, or severe pain that feels wrong. This is your body telling you to stop.

If you wake up on a day you’d planned to exercise and you’re in pain, it’s okay to rest. It’s not laziness, it’s not failure – it’s managing a chronic condition.

Some women find keeping a symptom diary helpful. Track your pain levels, energy, and what exercises you did. Over time, you might notice patterns that help you plan your activity better.

Other Things That Help

Exercise works best as part of a bigger pain management strategy:

Heat therapy: Hot water bottles, heat pads, warm baths – brilliant for cramping and pain.

Anti-inflammatory diet: Reducing processed foods and increasing omega-3s might help reduce inflammation.

Stress management: Chronic pain is stressful, and stress makes pain worse. It’s a horrible cycle. Breathing exercises, meditation, or just doing things you enjoy can help.

Proper treatment: Exercise is not a replacement for medical treatment. If you haven’t been diagnosed yet, push for a referral to a gynaecologist. If your current treatment isn’t working, go back and ask for other options.

When to See a Professional

Consider seeing a pelvic health physiotherapist if:

• Exercise consistently makes your pain worse
• You’re not sure what’s safe to do
• You have bladder or bowel symptoms
• You have pain during sex
• You’re not making progress with general exercise

These specialists understand endometriosis and can give you personalised advice and exercises.

The Honest Truth

Exercise can help manage endometriosis symptoms, but it’s not a cure, and it won’t work miracles. Some days you’ll feel well enough to work out, and you’ll feel good afterwards. Other days, just having a shower will feel like an achievement.

That’s endometriosis. It’s unpredictable, it’s frustrating, and it’s not your fault.

The goal isn’t to exercise through the pain or maintain some perfect fitness routine. The goal is to move your body in ways that feel good and potentially help manage symptoms, whilst being kind to yourself on the days when your body needs rest.

You’re not weak for having bad days. You’re not lazy for needing to modify workouts. You’re dealing with a chronic condition that literally causes tissue to grow where it shouldn’t be. That’s a lot.

If exercise helps you feel better, brilliant. If some days it doesn’t, that’s okay too. Listen to your body, be flexible with your routine, and remember that rest days are just as important as active days.

And please, if you’re struggling with symptoms or think you might have endometriosis, see your GP and push for proper investigation. You deserve to be taken seriously, and you deserve proper treatment.

I’m off to have a lie down with a hot water bottle.

Endometriosis is genuinely difficult, and managing fitness on top of it takes a particular kind of stubbornness. If you’re figuring it out slowly and imperfectly, that’s exactly right. There’s no version of this that looks like someone without endo’s workout routine, and that’s fine.

If you’ve found something that helps — whether that’s a specific type of movement, a particular approach to rest days, or just something that made it feel more manageable — I’d really like to hear it in the comments. x

Ready to Learn More?

Explore the complete guides:

• Women’s Health and Hormones

Understanding Your Cycle:

• How to Exercise During Your Menstrual Cycle: A Week-by-Week Guide
• Can Exercise Really Help With PMS? Here’s What the Science Says
• Which Painkillers Work Best for Periods?

Managing Hormonal Conditions:

• PCOS and Exercise: What Actually Works (And What Doesn’t)

Life Stage Changes:

• Perimenopause and Exercise: Why Your Usual Routine Might Not Be Working Anymore
• Menopause and Fitness: The Importance of Exercise for Women’s Health

Supporting Your Hormones:

• The Best Foods for Hormonal Balance (That Don’t Involve Eating Like a Rabbit)
• Birth Control and Your Workouts: What You Need to Know