multimodal rehabilitation programme on epigenetic biomarkers, quality of life, sexual function and muscle strength in women with dyspareunia and endometriosis.

Conditions: Multidisciplinary Communication

Summary: this study aims to evaluate the impact of a multimodal rehabilitation programme on epigenetic biomarkers in blood, quality of life, sexual function and pelvic floor muscle strength and endurance in women with dyspareunia and endometriosis.

introduction: endometriosis is a benign gynaecological disease that affects approximately 10% of women of childbearing age, causing chronic pelvic pain and profound dyspareunia, which significantly impairs quality of life. this study aims to evaluate the impact of a multimodal rehabilitation programme on epigenetic biomarkers, quality of life, sexual function and muscle strength in women with dyspareunia and endometriosis. study design: pilot of randomised controlled clinical trial according to consort and tidier guidelines. the study will run from january 2025 to january 2026. inclusion criteria: women between 18 and 55 years old, diagnosed with endometriosis with dyspareunia and chronic pelvic pain, with the ability to communicate in spanish, and approval of their gynaecologist. exclusion criteria: neurological, oncological, autoimmune or serious psychiatric diseases that prevent exercise or manual therapy. sample size: 20 women diagnosed with dyspareunia and endometriosis, randomly divided into two groups: 10 in the intervention group and 10 in the control group. intervention: the intervention group will receive a multimodal rehabilitation programme including therapeutic exercise, health education and manual therapy. the control group will not receive this intervention. primary results: measurements will be taken at four key points in time: baseline (t0), 2 months (t1), 6 months (t2) and 12 months (t3). to assess the effect of the intervention on mir-21 levels in saliva, quality of life (sf-36 questionnaire), sexual function (fsfi), pain, and pelvic floor muscle strength (measured with oxford and perfect scales). second results: measurement of systemic inflammation by crp and il-6, hormone levels (oestrogen and progesterone), stress and psychological well-being (hads), muscle strength (epi-no), adherence to treatment and satisfaction with the intervention. ethics and privacy: the study will have the approval of the ethics committee of the university of pablo de olavide, following the declaration of helsinki and spanish regulations (law 14/2007 on biomedical research). participants will sign an informed consent form, and the data will be managed in accordance with the spanish data protection act (law 3/2018).

Eligibility criteria:
inclusion criteria: * women diagnosed with endometriosis * women with dyspareunia and chronic pelvic pain * ability to communicate fluently verbally and in writing in the language of the research team, in this case spanish. * approval to participate in the study by your regular gynaecologist who is part of your diagnosis and treatment. exclusion criteria: * a neurological, oncological or autoimmune disease that prevents the participant from performing exercise. * any type of pathology that prevents the participant from performing exercise. * a diagnosis of severe psychiatric or neurological disorders that do not allow the participant to follow orders.

Keywords: endometriosis dyspareunia multimodal rehabilitation epigenetic biomarkers quality of life sexual function muscle strength