Received June 16, 2025
Accepted February 20, 2026

Background: Endometriosis is a gynecological disorder marked by the formation of endometrial tissue (gland and stroma) outside the uterine cavity. Macrophages, erythrocytes, and apoptotic endometrial tissue transplant into the peritoneal cavity, free radicals, and oxidative stress play a vital role in endometriosis. This study focused on unraveling the combinatorial effect of treadmill exercise with hesperidin (HESP, a citrus flavonoid) on histoarchitecture and biochemical [reactive oxygen species (ROS), nitric oxide (NO), total thiol (T-SH), glutathione (GSH), TBARS levels, catalase, glutathione peroxidase (GPx), superoxide dismutase (SOD), glutathione–s-transferase (GST), and monoamine oxidase activities] molecules in endometrial tissue of female rabbits. Methods: The rabbits underwent surgery by resecting one uterine horn, isolating the endometrium, and fixing the tissue segment to the pelvic peritoneum, and they were grouped into 5 (n = 6). Group 1: normal control (NC) Group 2: untreated endometriotic rabbits (ENDO); Group 3: HESP-treated endometriotic rabbits (ENDO + HESP); Group 4: exercised endometriotic rabbits (ENDO + EXER); Group 5: exercised endometriotic rabbits administered with HESP (ENDO + HESP + EXER). Result: The result revealed that antioxidant enzyme activities and non-antioxidant molecules were reduced in untreated endometriotic rabbits compared to NC. However, there was a significant increase in antioxidant status in exercised endometriotic rabbits treated with hesperidin. Conclusion: This finding revealed that combining physical exercise with the consumption of hesperidin-rich fruits can be explored to alleviate oxidative stress, a major risk factor in endometriosis.