Banjanin, Dasha (2026) Resistance training and endometriosis: a scoping review, and online questionnaire to understand exercise practices, perceptions and impacts among Australian women living with endometriosis. Research Master thesis, Victoria University.

Abstract

Endometriosis is a chronic, progressive inflammatory condition affecting one in seven Australian women, with an average individual cost burden of AUD $30,000 per patient annually. Despite recognised benefits of resistance training (RT) for inflammatory conditions, its impact on endometriosis remains unclear, with no specific guidelines for RT prescription in this population. This thesis aimed to: 1) map the extent and nature of evidence on RT prescriptions, outcomes, and knowledge gaps for women with endometriosis; 2) investigate RT practices (frequency/intensity/time/type), perceptions of RT as a symptom management strategy, and barriers to regular RT participation among Australian women with endometriosis; and 3) examine how these perceptions and barriers vary across the lifespan. To address aim one, a scoping review of RT studies and endometriosis was completed. To address aims two and three, a quantitative cross-sectional questionnaire investigated RT practices among Australian’s living with endometriosis. The scoping review of eight studies indicated that while bodyweight and low-load RT appear feasible and generally well tolerated within multimodal programmes, the evidence base remains sparse, methodologically heterogenous, and inconsistent in reporting key training variable and symptom-management approaches, precluding clear guidance on who benefits, at what dose or intensity, and for how long. An online questionnaire was distributed nationally via support organisations, social media, and healthcare networks to women aged over 18 years with a confirmed clinical diagnosis of endometriosis. The questionnaire and subsequent analyses used descriptive statistics to assess demographics, general exercise and RT behaviours, barriers and perceptions of RT, evaluated withinquestionnaire test-retest reliability of symptom severity scores using intraclass correlation coefficients (ICC) and Bland-Altman plots, and explored relationships between RT practices and symptom outcomes using Spearman’s rho and Kendall’s tau-b correlations. 60 participants completed questionnaires, with 44 respondents’ data analysed. A prevailing sociodemographic consensus is that women with endometriosis are “white, lean, middle-class, career-driven”, however, the present study found that while respondents were predominantly of white ethnic backgrounds, they diverged from this profile with an overweight BMI, lower annual incomes, and part-time work patterns. Symptom severity measures demonstrated moderate-to good test-retest reliability, with strongest agreement for fatigue, dyschezia, and dysuria, and weakest reliability for dysmenorrhoea, bloating, and headache/migraine. Among 29 respondents participating in RT, most completed two to three weekly sessions of 30-60 minutes, primarily using bodyweight and recreational lifting, training at commercial gyms or home with free weights and machines. Correlations between RT frequency, duration, and intensity and symptom severity were mostly weak or negligible, with a small number that reached moderate-strong effect thresholds having wide 95% confidence intervals. Among non-participants, barriers included lack of time, fatigue, symptom concerns, and limited guidance, with many identifying condition-specific programs, clear information, and professional support as facilitators. Preliminary lifespan patterns suggested differing priorities across age groups, underscoring the need for tailored rather than one-size-fits-all RT approaches. Findings indicate that Australian women with endometriosis engage in RT in diverse, adaptive, and individualised ways, often without adequate guidance, highlighting the need for co-designed, endometriosis-specific RT guidelines to support safe, effective participation and symptom management across the lifespan.

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