Exercise improves mental well-being of women living with chronic pelvic pain disorders

A new Mount Sinai study provides compelling evidence that exercise can significantly help the mental well-being of millions of women living with chronic pelvic pain disorders (CPPDs), such as endometriosis and uterine fibroids.

The researchers at the Icahn School of Medicine at Mount Sinai found that activities like brisk walking or aerobic exercise can lead to measurable improvements in mental well-being, regardless of pain levels or history of anxiety or depressive disorders. Their findings were reported in the February 26 online issue of the Journal of Pain Research.

CPPDs affect millions of women worldwide, leading to increased health care costs, reduced quality of life, and a higher risk of anxiety and depression, yet effective management strategies remain limited. This study highlights the potential of physical activity as a simple and accessible way to enhance mental well-being, say the investigators.

Chronic pelvic pain disorders are incredibly complex and burdensome for those affected, yet we still have very few effective treatment strategies. Our research suggests that physical activity could be an important tool for improving mental health in these patients, offering them a proactive way to enhance their well-being."

Ipek Ensari, PhD, lead corresponding author, Assistant Professor in the Windreich Department of Artificial Intelligence and Human Health at the Icahn School of Medicine and member of the Hasso Plattner Institute of Digital Health at Mount Sinai

The study tracked 76 women with CPPDs over 14 weeks using mobile health technology, collecting more than 4,200 days' worth of data. Participants reported their mental health, physical functioning, and pain levels weekly via an app (ehive), while Fitbit devices recorded their daily physical activity. The researchers used advanced statistical modeling to analyze how movement patterns influenced mental health outcomes over time.

One key finding was that the benefits appear to accumulate over time rather than provide immediate relief. "We were particularly intrigued to find that the positive effects of exercise seem to lag by a few days, meaning the mental health benefits may build up gradually," says Dr. Ensari. "This insight is vital for both patients and health care providers, as it underscores the importance of consistency in physical activity."

Beyond its implications for patient care, the study also highlights the growing role of artificial intelligence and mobile health technologies in chronic disease management.

"This study showcases the power of wearable technology and AI-driven analysis to uncover valuable insights about health and behavior in real time," says Girish N. Nadkarni, MD, Chair of the Windreich Department of Artificial Intelligence and Human Health at the Icahn School of Medicine, Director of the Hasso Plattner Institute for Digital Health, Irene and Dr. Arthur M. Fishberg Professor of Medicine, and Director of The Charles Bronfman Institute for Personalized Medicine. Dr. Nadkarni is also the inaugural System Chief of the Division of Data-Driven and Digital Medicine within Mount Sinai's Department of Medicine and Co-Director of the Mount Sinai Clinical Intelligence Center. "By using innovative data modeling techniques, we can better understand how lifestyle factors like physical activity interact with health conditions and pave the way for more personalized treatment approaches."

While the findings are encouraging, the researchers emphasize that physical activity should not be viewed as a replacement for medical treatment but rather as a complementary strategy. Future research will explore how different types and intensities of exercise impact mental health, pain, and fatigue, with the ultimate goal of developing personalized interventions using wearable technology and mobile apps.

The paper is titled "Trajectories of mHealth-tracked mental health and their predictors in female chronic pelvic pain disorders."

The remaining authors, all with the Icahn School of Medicine except where indicated, are Emily L. Leventhal, BA: Nivedita Nukavarapu, PhD; Noemie Elhadad, PhD (Columbia University Irving Medical Center); Suzanne R. Bakken, PhD, RN, FAAN, FACMI, FIAHSI (Columbia University School of Nursing); Michal A. Elovitz, MD; Robert P. Hirten, MD; Jovita Rodrigues, MS; Matteo Danieletto, PhD; and Kyle Landell, BA.

The study was supported by a grant award from the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health (R01HD108263). In addition, this research was supported by T32 grant 5T32GM146636.