Six to seven times less likely to be physically active: Low self-determination and basic psychological needs support in women with endometriosis—A cluster analysis

Abstract

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