Perceived barriers and physical activity levels in women with endometriosis: The role of symptoms

Endometriosis affects approximately 10 percent of women of reproductive age. Although physical activity has shown beneficial effects for managing endometriosis-related symptoms, women with this condition often engage in lower levels of activity. This study aimed to assess physical activity levels and identify perceived barriers to exercise among women diagnosed with endometriosis. A cross-sectional study was conducted using online questionnaires distributed through endometriosis associations in Spain. Participants (<i>n</i> = 154, mean age: 39 ± 7 years) completed the Barriers to Being Active Quiz (BBAQ) and the International Physical Activity Questionnaire - Short Form (IPAQ-SF). Sociodemographic and clinical data were also collected to explore potential associations between symptoms and activity patterns. The most prevalent barriers were lack of energy (68.2 percent) and lack of willpower (50.0 percent). Lack of energy was significantly associated with pain, dysmenorrhea, fatigue, and depression, and emerged as the primary limiting factor. Despite reporting moderate-to-high levels of physical activity, as defined by IPAQ criteria - moderate (≥600 MET-min/week) or high (≥1,500 MET-min/week with vigorous activity ≥ 3 days/week, or ≥ 3,000 MET-min/week with activity on ≥ 7 days/week) - symptoms such as pain (79.2 percent) and fatigue (79.9 percent) remained prevalent. Psychological and physical symptoms, especially fatigue and depression, significantly influence exercise participation among women with endometriosis. These findings underscore the need for tailored strategies to address perceived barriers and promote sustained physical activity in this population. Integrating psychological support and individualized exercise guidance, and pain management interventions, may enhance adherence and long-term outcomes.