Physical activity and endometriosis risk in women with infertility or pain: Systematic review and meta-analysis

Elena Ricci, Paola Viganò, Sonia Cipriani, Francesca Chiaffarino, Stefano Bianchi, Giorgia Rebonato, Fabio Parazzini

Research output: Contribution to journalArticlepeer-review


Background: The potential association between endometriosis and physical activity (PA) has been suggested in several epidemiological studies. We aimed to establish whether PA influences endometriosis risk. Methods: MEDLINE and EMBASE were searched using "physical activity" OR "exercise" combined with "endometriosis, " in Medical Subject Headings and free text. We selected original articles in English, published up to April 2016, evaluating the association between endometriosis and recent or past PA (case-control or cohort studies). References of retrieved papers were reviewed. We computed summary odds ratios (ORs) of endometriosis for recent and past PA. Results: Six case-control and 3 cohort studies included 3355 cases for recent PA and 4600 cases for past PA. The summary OR for endometriosis according to PA level, calculated by the random-effect model, was 0.85 [95% confidence interval (CI) 0.67-1.07] for any recent versus no PA. As compared to no recent PA, ORs for low and moderate/high PA were 1.00 (95% CI: 0.68-1.28) and 0.75 (95% CI: 0.53-1.07), respectively. Conclusions: Though it suggests that PA may reduce the risk of endometriosis, this meta-analysis does not conclusively support the hypothesis. Whether our findings are really explained by the benefit of exercise at molecular and endocrine level, or related to confounding mechanisms, such as study design, choice of controls, and PA potentially improving pain, needs to be further investigated.

Original languageEnglish
Article numbere4957
JournalMedicine (United States)
Issue number40
Publication statusPublished - 2016


  • Endometriosis
  • Gender medicine
  • Meta-analysis
  • Physical activity
  • Risk factors
  • Systematic review

ASJC Scopus subject areas

  • Medicine(all)


Dive into the research topics of 'Physical activity and endometriosis risk in women with infertility or pain: Systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this