Pilates and Endometriosis: What You Need to Know
One of the questions I get asked a lot in clinic is:
"Can I do Pilates if I have endometriosis?"
The simple answer? There is no rule against doing Pilates if you have endometriosis.
But, like all types of exercise, it’s not one-size-fits-all. What matters is understanding your body, your condition, and how you can optimise your Pilates practice- before, during, and after- so that it supports your health and your goals, rather than flaring symptoms.
Pilates Is a Broad Tool- You Get to Personalise It
Pilates isn’t just one thing. It can include:
Mat-based Pilates
Reformer Pilates
Classes of varying duration and intensity- from slow and restorative, to dynamic and strength-based
The key is not “Should I do Pilates?”- but rather, “How do I make Pilates work for me?”
That can mean:
✨ Choosing different types of classes depending on where you are in your menstrual or symptom cycle
✨ Giving yourself permission to say no on tough days
✨ Modifying how much you do within a class- listening to your body in the moment
✨ Supporting your pelvic floor and core muscles before and after your class (this may include working one-to-one with a pelvic health physio to optimise your muscle function)
It’s also important to notice how you feel after Pilates.
Do you feel good- more connected to your body, calmer, and looser?
Or do you experience increased pain or a flare of symptoms?
We know that gentle movement can help calm the nervous system and support the natural gliding and sliding of tissues and muscles. Other times, if the body is sensitised, you may need a different approach that day. And that’s okay.
My 3 Tips for Doing Pilates with Endometriosis
1- Research Your Class
Know what you’re signing up for- is it mat or reformer? High or low intensity? Restorative or challenging?
Make sure the studio and instructor are qualified, and that they know how to offer modifications and feedback when needed. This also extends to understanding the space.
Before your first class:
✨ Get familiar with where things are
✨ Know if it’s okay to pause or leave early if you need
✨ Check if the instructor is open to supporting your needs on the day
Feeling comfortable in the space will help you feel more confident - and safer- which matters when managing a fluctuating condition like endo.
2- Communicate with Your Care Team
Good communication can make a huge difference.
✨ If you work with a pelvic health physio, they can provide insights or a personalised program to share with your Pilates instructor.
✨ Your Pilates instructor can give real-time feedback on how you’re moving in class, and flag anything they notice that might help you and your physio work together.
This kind of team approach helps you feel supported across your care- and ensures your movement practice works with your body, not against it.
3- Prepare Your Body Before Class
Before class, I recommend:
✨ A few minutes of belly breathing
✨ Some gentle stretches
✨ Pelvic floor relaxation and encouragement of movement (not bracing)
This helps optimise how your core and pelvic floor function during Pilates. And remember- be kind to yourself. If you’re not keeping up with everyone in the room, that’s okay. You’ve turned up, you’re moving, and that is enough.
Final Thoughts
Pilates can absolutely be part of your life with endometriosis- when it’s done with self-awareness, flexibility, and compassion.
Like all forms of movement, some days it will feel wonderful. Some days it might not be right. Learning to listen to your body- and giving yourself permission to adjust- is key.
If you’d like more support figuring out what type of Pilates is best for your body, or how to build pelvic floor awareness into your practice, chat to a qualified pelvic health physiotherapist. We’re here to help.
Jo x
