ENDOGYM: A Holistic Approach With Pelvic Floor Physiotherapy and Yoga for Endometriosis Pain Relief

NCT07245537 | Completed DMC

• 1 other identifier: 511/2024/OSS/AOUMO
• Study Type: observational
• Target: 82
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to evaluate the combined effects of Yoga practice and pelvic floor physiotherapy (PFP) on chronic pelvic pain (CPP) and dyspareunia in endometriosis patients. This is a retrospective study carried out from April 2024 to November 2024 conducted by University Hospital Modena (Italy). A total of 82 women with confirmed diagnosis of endometriosis were initially enrolled in the ENDOGYM program. Among them, 50 patients (61%) were therefore included in the final analysis. ENDOGYM consists of 12 weekly sessions over a period of 3 months. It includes two PFP sessions, lasting 1 hour each (one at the start and one at the end of the program), and 12 Yoga sessions, once a week, each lasting 60 minutes. EHP-30 questionnaire was used before and after the program to evaluate women's QoL; NRS scale was used before, half-way and after the program to evaluate CPP and dyspareunia.

Conditions

Endometriosis

Keywords

endometriosis; yoga; pain; quality of life; complementary therapies

Outcome Measures

Primary Outcomes (1)

• Evaluate the combined effects of Yoga practice and pelvic floor physiotherapy (PFP) on chronic pelvic pain (CPP) in endometriosis patients

  Before the start of the project, a disease-specific questionnaire to measure the QoL of women with endometriosis, the Endometriosis Health Profile-30 (EHP-30) questionnaire, was used to collect data about pain, control and powerlessness, emotional well-being, social support, self-image, work life, sexual intercourse, relationship with children, the medical profession, treatment, and infertility. Response categories are evaluated using a five-point Likert scale (0-4), and each EHP-30 scale is converted into a scoring system ranging from 0 to 100, where 0 indicates the best possible health status and 100 represents the worst possible health status. The Italian version of EHP-30 was used. Finally, at the end of the project, the women completed the EHP-30 questionnaire again. Comparisons of EHP-30 total and domain scores before and after the ENDOGYM program were performed using paired t-tests (two-tailed).

  From enrollment to the end of the lessons at 3 months

Secondary Outcomes (1)

• Evaluate the combined effects of Yoga practice and pelvic floor physiotherapy (PFP) on dyspareunia in endometriosis patients

  From the enrollment till the end of the lessons at 3 months

Study Arms (1)

Patients with endometriosis and chronic pelvic pain and/or dyspareunia under medical treatment

ENDOGYM consists of 12 weekly sessions over a period of 3 months. It includes two PFP sessions, lasting 1 hour each (one at the start and one at the end of the program), and 12 Yoga sessions, once a week, each lasting 60 minutes. EHP-30 questionnaire was used before and after the program to evaluate women's QoL; NRS scale was used before, half-way and after the program to evaluate CPP and dyspareunia

Other: Yoga; Other: Pelvic Floor Physiotherapy

Interventions

Yoga OTHER

The Yoga sessions were designed to address specific physiological needs related to endometriosis, such as CPP, myofascial pain, chronic fatigue, and hormonal imbalance. The asanas were selected to stimulate the nervous system, promote blood circulation, and relax the pelvic muscles. The poses were adapted to avoid any direct pressure on the pelvic organs, fostering a sense of lightness and awareness. Deep breathing techniques were taught to reduce stress and improve tissue oxygenation, with a positive impact on pain management and immune function. The breathing exercises were often hypopressive to reduce the load on the pelvic area. The use of mindfulness was encouraged to increase awareness of bodily sensations, reduce anxiety, and improve emotional balance. The practice was not just "a physical activity" but an opportunity for the participant to deeply connect with her body, promoting an overall improvement in the QoL.

Patients with endometriosis and chronic pelvic pain and/or dyspareunia under medical treatment

Pelvic Floor Physiotherapy OTHER

During the two one-hour sessions of PFP, various tools were used, such as balls of different textures and a cylindrical cushion provide tactile biofeedback and help identify the boundaries of the perineum. Patients were free to adjust the intensity of the feedback by choosing or removing the appropriate aid. By perceiving the different muscular layers of the perineum and altering the posture of the pelvis and lower limbs, patients learned about perineal movements, muscle activation, and myofascial tensions. The goal was to internalize the therapeutic exercises demonstrated and apply them in various daily life situations to maintain improvements in the perineal-pelvic structures.

Patients with endometriosis and chronic pelvic pain and/or dyspareunia under medical treatment

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Patients with an ultrasound and/or post-operative histological diagnosis of endometriosis followed at the Endometriosis and Pelvic Pain Center of the Mother-Infant Department, Institute of Obstetrics and Gynecology, University of Modena and Reggio Emilia (Italy).

You may qualify if:

• women with an ultrasound and/or post-operative histological diagnosis of endometriosis
• aged between 18-50 years
• currently undergoing medical treatment (for at least 3 months before the start of the study), and/or who have previously undergone surgical treatment
• with myofascial pain ≥ 7 (NRS scale) and deep dyspareunia ≥ 7 (NRS scale).

You may not qualify if:

• being pregnant
• undergoing surgery in the past 6 months
• concurrent diagnosis of fibromyalgia
• documented pelvic and/or spine trauma within 5 years of recruitment
• patients with interstitial cystitis and \> 2 urinary tract infections per year, unless possibly related to endometriosis (non-bacterial)
• patients with recurrent vaginal infections, mucocutaneous inflammations of the vulva and vagina.

Sponsors & Collaborators

• Azienda Ospedaliero-Universitaria di Modena: lead

Study Sites (1)

AOU Policlinico di Modena

Modena, Emilia-Romagna, 41125, Italy

Location

Related Publications (25)

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MeSH Terms

Conditions

Endometriosis; Pain

Interventions

Yoga

Condition Hierarchy (Ancestors)

Genital Diseases, Female; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Genital Diseases; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Mind-Body Therapies; Complementary Therapies; Therapeutics; Spiritual Therapies; Exercise Movement Techniques; Physical Therapy Modalities

Study Officials

• Carlo Alboni, MD

  AOU Policlinico di Modena

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 3 Months
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD

Study Record Dates

• First Submitted: September 29, 2025
• First Posted: November 24, 2025
• Study Start: April 1, 2024
• Primary Completion: November 30, 2024
• Study Completion: August 31, 2025
• Last Updated: November 24, 2025

Record last verified: 2025-11

Locations

IT (1)