Summary
Endometriosis is often approached as though it were only a pelvic, hormonal, or cyclical condition. But this view is too narrow. Research increasingly describes endometriosis as a complex, chronic, inflammatory, systemic, and neuro-immune condition.
This changes how we think about yoga.
A pelvic-only approach, or a few poses used only during pain, may offer some relief. But it is rarely enough to meet the wider reality many women live with: pain, fatigue, digestive symptoms, sleep disruption, nervous system sensitivity, reduced resilience, and fluctuating capacity.
For yoga teachers, this means moving beyond generic sequences and learning to support the whole person.
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For many years, yoga support for endometriosis has often been framed in a rather narrow way.
A few poses for painful periods.
A practice only during flares.
An approach centred mainly on the lower abdomen and pelvis.
And of course, that may help.
It may bring some relief.
It may offer comfort in the moment.
But is it enough?
As I prepared for an Endometriosis Summit and returned to some of the more recent research, I felt encouraged to see something I had sensed from the very beginning becoming more clearly articulated.
Endometriosis cannot be understood only as a local pelvic issue.
And yoga support cannot be built only around the pelvis either.
That changes how we practise.
And it changes what we can offer our students.
Endometriosis is not only pelvic
Endometriosis is still often spoken about as though it were mainly a pelvic, hormonal, cyclical condition.
Something local.
Something that appears around menstruation.
Something confined to the lower belly.
This older way of framing endometriosis is still common. But it does not fully reflect the lived reality of many women, nor the broader scientific understanding now emerging.
What research increasingly confirms is a broader, more complex picture. Endometriosis is being understood more and more as chronic, inflammatory, systemic, multifactorial, and neuro-immune in nature (Chang L, Shan J, Li D, Wang X. (2025) · Ariana F. Rahman (2026)).
What endometriosis is increasingly understood to involve
Endometriosis is increasingly described as a chronic, systemic, inflammatory, multifactorial, and neuro-immune condition.
What does this mean?
Systemic means that its effects are not necessarily confined to one location. Even if lesions are located in or around the pelvis, the consequences may be felt across multiple systems.
Inflammatory means that inflammatory activity is part of the picture, and may influence symptoms, sensitivity, and the internal environment of the body.
Neuro-immune refers to the close relationship between the nervous system and the immune system. These systems communicate constantly. In endometriosis, this interaction may help explain why pain, reactivity, sensitisation, fatigue, sleep disturbance, and broader symptoms can become part of the picture.
Multifactorial means there is no single cause and no single uniform presentation. Endometriosis does not look or feel the same from one person to another.
This broader understanding matters, because it helps explain why many women experience much more than pelvic pain alone.
Why a pelvic-only yoga approach does not suffice
If endometriosis is broader than the pelvis, then a yoga approach focused only on the pelvis will often be too narrow to go at the source and to support all the systems involved in endometriosis in a sustainable way.
Many women are also navigating:
- fatigue
- digestive discomfort or bloating
- poor sleep
- nervous system dysregulation
- reduced stress tolerance
- pain sensitivity
- difficulty concentrating
- emotional strain
- fluctuating physical capacity
- …
A few “pelvic relief” poses may still have value. But they do not necessarily address the whole terrain.
This is one of the reasons I do not believe that yoga support for endometriosis should begin and end with the question:
What should I do during pain?
That question matters. But it is not the only question.
A more useful one may be:
How can yoga support the whole person living with a complex, fluctuating condition?
The body does not live in separate compartments
This is something yoga and Ayurveda had already taught me early on, and something research now supports more clearly: the systems of the body do not function in isolation.
The nervous system influences digestion.
Pain affects breath.
Sleep affects resilience.
Inflammation influences energy and sensitivity.
Stress and fatigue can amplify symptoms.
Emotional and mental states are not separate from the body’s experience.
This does not mean everything is caused by stress, nor that yoga can solve everything.
It means that interconnection matters.
And if interconnection matters, our teaching must reflect that.
What this means in practice
For yoga teachers, this changes the approach.
It means we do not reduce support to:
- a fixed sequence
- a set of pelvic stretches
- a few poses during menstruation
- a one-size-fits-all “endo yoga class”
That is not what many students are living.
And it is often not what their bodies are asking for.
A broader understanding invites a broader response.
It asks us to look not only at pain, but at how the whole person is functioning:
their energy, their sensitivity, their breath, their relationship to effort, their capacity to recover, their sleep, their emotional load, their sense of internal safety, their confidence in movement.
This changes the questions we ask.
Not:
What is the endometriosis sequence?
But:
What is this person experiencing today?
What is their system asking for right now?
What kind of yoga support is appropriate in this moment, within our role?
That shift alone changes the quality of teaching.
Why I teach principles rather than protocols
This is one of the reasons I teach principles over protocols.
Endometriosis does not present in one uniform way.
So a single standard sequence is rarely enough.
This is why I believe the real work is not to memorise “the endometriosis sequence,” but to learn how to observe, interpret, adapt, and respond more skilfully.
That, for me, is a more mature and more useful form of yoga teaching.
What yoga can offer
When approached in a holistic and thoughtful way, it may support self-regulation, pain management, stress regulation, quality of life, and moments of restoration and reconnection.
In the French HAS and CNGOF recommendations, yoga is included among the complementary approaches that may be offered alongside medical care for endometriosis.
In practice, yoga may help support pain management through breath regulation, adapted movement, and appropriately chosen postures. These practices may help reduce muscular tension and guarding, calm nervous system reactivity, support circulation, and create a greater sense of ease in the body, which can make pain feel more manageable. Yoga can also support rest, recovery, and a greater capacity to navigate flares and day-to-day symptoms.
This is not about cure, but about meaningful support within a broader and more holistic approach. It can help women develop tools not only for acute moments, but for living more steadily with the condition over time.
This has always been one of my deepest intentions: not only to relieve, but to support a more lasting rebalancing where possible, through a broader and more respectful approach to body and mind.
The heart of the EndoYoga approach
For me, this is at the heart of EndoYoga.
An approach that does not reduce endometriosis to pelvic pain.
An approach that does not reduce yoga to a sequence.
An approach that tries to meet the whole person.
An approach grounded in physiology, and in the frameworks of yoga and Ayurveda that allow us both to:
– offer practical tools to help manage pain more effectively in the moment and in daily life;
– and go further, by supporting the regulation and balance of all the systems involved in endometriosis, through a broader, more holistic, and more sustainable approach.
This is also what I care deeply about transmitting to yoga teachers: a way of working that is clear, grounded, responsible, and truly relevant to the realities their students may be living.
That shift changes the quality of teaching.
And it changes the quality of support.
About the author
Aurélie Maire is a yoga therapist, women’s health educator, teacher trainer, and author specialising in endometriosis, menopause. With a background in biochemistry and nutrition, she integrates modern physiology with the broader frameworks of yoga therapy and Ayurveda. She is the founder of EndoYoga®, a specialist approach and training dedicated to supporting women with endometriosis and adenomyosis through thoughtful, evidence-informed yoga
Useful links
If you are a yoga teacher and would like to deepen your understanding of this work, you may also explore:
+ EndoYoga® Teacher Training: Yoga Therapy for Endometriosis
https://aureliemaire.com/en/50h-yoga-teacher-training-yoga-for-endometriosis/
+ Teaching Yoga for Endometriosis: How to Stay Within Your Role
+ Free guide: 5 Practical Ways to Support a Student with Endometriosis in Your Yoga Class
Références:
- Simancas-Racines D, et al. Endometriosis as a Systemic and Complex Disease (2026).
- Rahman AF. Endometriosis as a Neuroimmune Disorder: Integrating Inflammation, Innervation, and Sensitization(2026, abstract).
- Chang L, et al. Neuroendocrine–Immune Axis in Endometriosis: A Review (2025).
- Aydin H, et al. Pain pathways and stem cells in endometriosis pathogenesis (2025).
- Wang X, et al. Macrophages in endometriosis: key roles and emerging therapeutic strategies (2025).
- Yang FC, et al. Depression and anxiety in patients with endometriosis (2025)
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