Exercise improves mental health for women with chronic pelvic pain disorders

Key takeaways:

• Moderate to vigorous physical activity improved global mental health scores for women with chronic pelvic pain disorders.
• This association was independent of pain measures and psychiatric diagnosis history.

Women with chronic pelvic pain disorders who engaged in moderate to vigorous physical activity had improved mental health scores vs. those who did not, according to study results published in the Journal of Pain Research.

“Moderate to vigorous intensity physical activity could be a beneficial way for patients who have a chronic pelvic pain disorder to manage their overall mental health,” Ipek Ensari, PhD, assistant professor in the department of artificial intelligence and human health at the Icahn School of Medicine at Mount Sinai, told Healio. “This seems to be a consistent effect, because even after we adjusted for things like physical pain, physical function and pre-existing psychiatric diagnoses, we still saw this positive significant association between physical activity, behavior and their mental health and well-being at each week as we looked at the results.”

Ensari and colleagues analyzed data from 76 women (mean age, 35 years; 42% white; 17% Hispanic) with diagnosed chronic pelvic pain disorders Using a mobile app, all participants completed the PROMIS Global Mental Health Questionnaire to estimate self-reported mental health, the PROMIS physical function survey and the McGill Pain Questionnaire to assess weekly pain. Researchers obtained data on moderate to vigorous physical activity via wrist-worn Fitbit devices. Participants received $15 for every 2 weeks of data collection and $20 for the final week.

Overall, 51 women had endometriosis, one had adenomyosis, two had uterine fibroids, one had interstitial cystitis, three had inflammatory bowel syndrome and one had inflammatory pelvic dysfunction.

Before the intervention, the mean global mental health and physical functioning scores were 42.166 and 45.19, which were 7.83 and 0.48 standard deviations below the population mean, respectively. At baseline, 28% of women had at least one diagnosis of a psychiatric condition, such as anxiety or depression, with 39% of women reporting scores corresponding to “fair” mental health and 39% reporting scores corresponding to “good” mental health. More than 40% of women performed fewer than the recommended 150 minutes of weekly moderate to vigorous physical activity.

Researchers observed that predicted global mental health scores rose with increasing daily moderate to vigorous physical activity (P < .001). Moderate to vigorous physical activity predicted mental health scores independently of pain measures and prior psychiatric diagnoses.

Physical functioning was positively associated with global mental health scores (P < .001). However, pain was negatively associated with global mental health scores (P < .05).

In addition, being employed and married were both positively associated with global mental health scores, whereas age was negatively associated.

“Our hope is that this gives more confidence to the physicians and health care professionals who work with this patient population for recommending physical activity as a component of their overall treatment and symptom management protocols, and that they would encourage this not just as an interventional but ideally as a preventive method,” Ensari told Healio. “Before symptoms flare up or there is an increase in symptoms, women should regularly exercise and maintain a certain intensity. We should also encourage women to continue this behavior, so that in the long term, they have better mental health.”

According to Ensari, these findings provide evidence for the efficacy of physical activity on mental health for women with chronic pelvic pain.

“Even if you had a pre-existing anxiety or depressive disorder, you still benefited from this effect,” Ensari told Healio. “If somebody has a comorbid diagnosis for one of these conditions, and if they are worried that their symptoms might be too severe to benefit, that is not the case. They can also benefit from being physically active.”

For more information:

Ipek Ensari, PhD, can be reached at ipek.ensari@mssm.edu; X (Twitter): @AIHealthMtSinai and @HPI_MS.