What is the Evidence on Lifestyle Interventions for the Symptom Management of Pelvic Pain in Women With Endometriosis or Adenomyosis? A Scoping Review

Endometriosis and adenomyosis are chronic, debilitating, inflammatory conditions affecting women of reproductive age. Current management primarily focuses on pharmacologic therapies and surgical interventions; however, many individuals adopt self-directed lifestyle modifications despite limited evidence-based guidance to support these approaches. This scoping review aimed to collate and evaluate the available evidence for lifestyle interventions in the management of pelvic pain among women with endometriosis and/or adenomyosis, with consideration of key lifestyle medicine domains including nutrition, physical activity, mind-body practices, social connection, sleep, substance cessation, and self-management. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Electronic databases (MEDLINE [OVID], CINAHL, and Scopus) were systematically searched to identify relevant interventional studies. Following abstract and full-text screening, 21 studies met inclusion criteria. Included studies demonstrated substantial heterogeneity in methodology, sample size, intervention type, and duration of follow-up. Only one study specifically included participants with adenomyosis. Findings suggested potential benefits of dietary modification, physical activity, mindfulness-based interventions, yoga, digital health programs, and transcutaneous electrical nerve stimulation (TENS) for pelvic pain management. However, small sample sizes and methodological variability limit the strength of conclusions. Overall, the current evidence base remains limited and underscores the need for rigorously designed interventional studies. Future research should incorporate broader outcome domains, including quality of life, fertility, and mental health, and should more comprehensively address lifestyle domains such as sleep and substance use. Greater inclusion of individuals with adenomyosis is also essential to inform evidence-based lifestyle recommendations in this population.