Physical rehabilitation and sexual function in endometriosis: a systematic review and meta-analysis.

BACKGROUND: Endometriosis is a chronic gynecological disease associated with pelvic pain and dyspareunia that negatively affects sexual function. Physical rehabilitation programs have emerged as a non-pharmacological therapeutic alternative; however, evidence regarding their effectiveness remains limited. OBJECTIVES: To analyze the effectiveness of physical rehabilitation programs on sexual function in women with endometriosis, assessed using the Female Sexual Function Index (FSFI). METHODS: A systematic review with meta-analysis was conducted following PRISMA guidelines. Searches were performed in PubMed, Web of Science, Scopus, and the Cochrane Library, including randomized controlled trials involving women with endometriosis undergoing physical rehabilitation interventions. Methodological quality was assessed using the CASPe checklist and the Jadad Scale. Standardized mean differences (SMD) with 95% confidence intervals (95% CI) were analyzed using a random-effects model. RESULTS: Results showed a trend toward improved sexual function in the intervention group; however, no statistically significant differences were observed (SMD = 0.12; 95% CI: -0.39 to 0.63). Given the small number of studies and clinical variability between interventions, these findings should be interpreted cautiously. CONCLUSIONS: Physical rehabilitation programs may have a potential beneficial effect on sexual function in women with endometriosis; however, the available evidence remains limited and inconclusive, and the pooled estimate should be interpreted as exploratory. Further adequately powered randomized controlled trials with standardized rehabilitation protocols are needed.