Background and Objectives: To evaluate the effectiveness of an integral HAMMAM experience, a 4-week therapeutic program that combined hydrotherapy and Swedish massage, applied in a multisensorial immersive environment, on pain, well-being and quality of life (QoL) in women with endometriosis-related chronic pelvic pain that is unresponsive to conventional treatment. Materials and Methods: This randomized controlled trial included 44 women with endometriosis. They were randomly allocated to either the ‘HAMMAM’ group (n = 21) or to a control group (n = 23). The primary outcome, pain intensity, was evaluated using numeric rating scales (NRSs). The secondary outcomes were pain interference, pain-related catastrophic thoughts, pressure pain thresholds (PPTs), subjective well-being, functional capacity and QoL, which were evaluated using the brief pain inventory (BPI), the pain catastrophizing scale (PCS), algometry, the subjective well-being scale-20 (EBS-20), the Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) and the Endometriosis Health Profile-30 Questionnaire (EHP-30), respectively. The primary and secondary outcomes were measured at the baseline and after the intervention. The statistical (between-group analyses of covariance) and clinical effects were analyzed by the intention to treat. Results: The adherence rate was 100.0% and the mean (± standard deviation) satisfaction was 9.71 ± 0.46 out of 10. No remarkable health problems were reported during the trial. The ‘HAMMAM’ intervention improved dysmenorrhea and dyspareunia after the intervention with large and moderate effect sizes, respectively. Improvements in pain interference during sleep and PPTs in the pelvic region were also observed in women allocated to the ‘HAMMAM’ group. No effects were observed in catastrophizing thoughts, well-being nor QoL, except for the sleep subscale. Conclusions: A 4-week program of an integral ‘HAMMAM’ experience combining hydrotherapy and massage in a multisensorial immersive environment is a feasible and effective intervention to alleviate pain during menstruation and sexual intercourse as well as pain interference with sleep in women with endometriosis.

Objectives: The aim of this study is to summarize recent evidence of the effectiveness of rehabilitation interventions in managing symptoms related to endometriosis and adenomyosis. Methods: The review protocol was registered previously (CRD42022236516). A systematic search was conducted in the Medline, Web of Science, and Scopus databases for studies published up to 23 July 2025 that reported the effects of any rehabilitation intervention in women diagnosed with endometriosis or adenomyosis. Risk of bias was assessed, and meta-analyses were performed. Results: A total of 970 studies were identified, of which 19 reports from 17 trials met the inclusion criteria. Approximately one-third of the trials focused on electrophysical agents, another third on exercise programs, and the remaining studies included manual therapy-based interventions—such as pelvic floor physiotherapy (PFP), or Swedish massage—as well as other modalities. Most trials assessed changes in pain, quality of life (QoL), and mental health, showing consistent improvements following intervention. Additional outcomes evaluated included lumbopelvic impairments, sexual function, and bone mineral density. Meta-analyses of eleven studies on pain and five on QoL revealed significant effects, favoring the intervention groups. Conclusions: This review highlights promising benefits of physical rehabilitation, particularly in patients with endometriosis. A range of approaches—including therapeutic exercise, electrophysical agents, and PFP—may contribute to improvements in endometriosis-related clinical outcomes, especially pain and QoL.