Associations of Endometriosis Development and Progression with Smoking, Physical Activity, and Nutrition: A Literature Review

Abstract

Aim of the study. To evaluate scientific literature data on the associations of smoking, physical activity, and diet with the development and progression of endometriosis, as well as the potential for disease prevention and management, considering modifiable behavioural factors. Methods. A systematic literature review was conducted in accordance with PRISMA guidelines. Scientific publications were retrieved from major international databases using targeted keywords related to smoking, physical activity, and diet. Inclusion criteria encompassed original studies published within the last 15 years. Of more than 3500 identified records, 30 studies meeting predefined eligibility criteria were included in the final analysis. Results. The selected studies included data from 949,803 women. The types of studies were as follows: 11 cross-sectional, 8 cohort, 6 case-control, 4 interventional, and 1 retrospective case series. Dietary factors were examined in 17 studies, physical activity in 8, and smoking in 5. Findings suggest a possible association between healthier lifestyle patterns and reduced risk or severity of endometriosis; however, further high-quality research is required. Conclusions. Modifiable lifestyle factors may play a supportive role in the prevention and  comprehensive management of endometriosis.