Exercise for period pain, PMS & endo

Dysmenorrhea (period cramps): Two large network meta-analyses (29 and 49 RCTs) found relaxation exercise most effective overall, with resistance and multi-component exercise also ranking highly. Pilates was notably effective. Aerobic exercise reduced pain duration by approximately 12.5 hours per cycle.

PMS: Exercise consistently reduces PMS symptom scores, though 87% of trials have high bias risk. A network meta-analysis found running ≥3×/week best for mood symptoms, and yoga ≥3×/week for 9–12 weeks best for pain and fatigue.

Endometriosis: Exercise improves quality of life, pain, and mental health in endometriosis with no safety signals. Supports exercise as adjunctive therapy alongside medical management.

PCOS: Vigorous exercise ≥120 min/week showed the best cardiometabolic results. Both resistance training and HIIT are effective. Benefits are primarily metabolic — don’t expect exercise alone to normalize reproductive hormones.