Is exercise duration more important than intensity in endometriosis?

BACKGROUND

Exercise may be a useful adjunct treatment strategy to manage symptom severity and improve quality of life of women with endometriosis. This cross-sectional observational study aimed to investigate the associations between exercise habits, systemic biomarkers, quality of life and mental health in women with endometriosis.

METHODS

Exercise habits, health related quality of life (via the endometriosis health profile (EHP-30)), adiposity and salivary measures of c-reactive protein (CRP), cortisol, and estradiol were collected from 21 women with endometriosis and compared to a control group (n = 13; women without endometriosis). Self-reported exercise habits and health-related quality of life were collected via an online survey. Saliva was self-collected via passive drool on day 12 of the menstrual cycle (within 45-60 min of waking) and analysed for biomarkers. Body composition was assessed via dual-energy x-ray absorptiometry.

RESULTS

An inverse relationship between minutes completed per individual exercise session and levels of CRP, estradiol, android and gynoid fat mass, and pain associated with endometriosis were observed in women with endometriosis (p < 0·05). There were no significant relationships between total volume, metabolic equivalent of task (MET) minutes or vigorous MET minutes in women with endometriosis (p > 0·05). Levels of CRP were positively correlated with gynoid fat mass, whereas higher levels of pain were positively associated with android fat mass(p < 0·05). Furthermore android fat mass was positively correlated with poor self-image and lower levels of control and increased powerlessness (p < 0·05).

CONCLUSIONS

The inverse relationship between the duration of individual exercise sessions and CRP, estradiol, pain and fat distribution is a novel finding, suggesting that longer durations of acute bouts of exercise, regardless of intensity and total volume, are associated with improvements in biological and psychological variables in women with endometriosis.