Six to seven times less likely to be physically active: Low self-determination and basic psychological needs support...

To explore how clusters of motivational regulations, self-determination, and basic psychological needs (BPNs) relate to physical exercise participation in women with endometriosis.

This cross-sectional online study included women aged ≥ 18 years with endometriosis. The Behavioral Regulation in Exercise Questionnaire-3 (BREQ-3) was used to assess motivational regulations and the Basic Psychological Needs in Exercise Scale (BPNES) to evaluate BPNs-autonomy (sense of choice), competence (confidence in ability), and relatedness (sense of connection and belonging)-followed by a two-step cluster analysis to identify motivational profiles. Associations with physical activity were tested using logistic regression (adjusted for pain score, education level, skin color, and marital status).

A total of 508 women (mean age = 34 ± 7 years) participated in the study. Women in the more controlled behavior cluster (OR = 6.14; 95% CI = 3.72-10.1) and in the BPN more thwarted cluster (OR = 7.61; 95% CI = 4.25-12.8) were significantly less likely to engage in physical activity compared to those in the more autonomous behavior - driven by personal interest - and in the more BPN satisfied cluster.

Women with endometriosis with diminished self-determination and low BPNs support profile were six to seven times less likely to participate in physical activity, highlighting the need for tailored interventions to enhance motivation and exercise adherence.