Diagnosis & Treatment
Endometriosis & menstrual pain patients are, sadly, suffering right now.
People with endo spend decades attempting to get diagnosed,and many just recently found a doctor that believes their pain. Finally! A doctor who listens, validates the pain, and has clear treatment options.
Enter Coronavirus (AKA COVID-19), which caused many “elective”surgery cancellations, including excision surgeries. Physical therapy sessions are being delayed. Patients no longer have access to the clinicians they spent decades trying to find. The stress of the situation is causing pain flares. Endo definitely doesn't stop due to a pandemic.
To help everyone with endometriosis and other menstrual pain and pelvic pain conditions currently stuck at home, we’ve curated a list of resources you can use to manage your pain at home. We don’t get any commissions from any products we recommend below, we just want to deliver science-based content so you can stop endlessly Googling.
Although you might not be able to see your pelvic floor physical therapist right now, Visana Health’s physical therapist, Dr. Jenn Joslyn of Motion Minnesota, performed a live stream pelvic floor relaxation routine and Q&A. We’ve posted the video on YouTube so you can replay it on-demand.
For those that don’t know, many women with pelvic pain condition shave tight pelvic floor muscles, also known as “pelvic floor dysfunction.” [1,2]This can cause pain, and just like you can stretch your back to reduce back pain, you can stretch your pelvic muscles to reduce pelvic pain.
Stress can cause pain flares, and we’re in a very stressful time.  While you’re stuck at home, you can learn to meditate or practice general relaxation techniques. Apps you can use include Calm and Headspace (both paid) or the free VA Meditation App.
With the video below, you can learn square breathing, a technique that can help manage pain flares.
Transcutaneous electrical nerve stimulation, or “TENS” for short, are machines that pass low voltage electrical current that passes through electrodes placed on your skin. TENS machines have been studied in many pain conditions, including osteoporosis, fibromyalgia, neck pain, and, yes,menstrual pain.
Unfortunately, rigorous clinical studies show that this isn’t the “instant pain relief” often purported by many of the TENS manufacturers. Instead, studies show that, specifically, high frequency TENS is effective in reducing menstrual pain, but only by a small amount. 
It won’t be an instant cure, but it might help you manage.
Do you have a heating pad or a hot water bottle? If not, you need to get one! Clinical studies have repeatedly shown that they can help reduce menstrual pain. [6,7] Scientists believe heat works to reduce cramping by relaxing the muscles of your uterus and improving blood flow.
There are many options you can try: heating pads, wraps, and hot water bottles. Use whatever works for you, but be careful not to burn yourself.
You’ve probably seen claims that CBD can cure almost anything: people claim it can even cure cancer. Unfortunately, CBD hasn’t been well-studied to determine whether it can help relieve menstrual pain and endometriosis.  However,in a survey, many women with menstrual pain reported they have tried CBD and say it’s effective in reducing pain.  Remember: a lack of evidence doesn’t mean it’s ineffective, it just means we don’t know yet.
At Visana Health, we only give science-based recommendations, so we can’t fully endorse CBD at this time. However, if you’ve been thinking of trying it, now might be a good time while you’re stuck at home.
It’s important to know that CBD products are not heavily regulated by the FDA because it’s marketed as a supplement. Make sure you buy from a quality source.
The endometriosis, menstrual pain, pelvic pain, & chronic pain communities are stronger together. Have other ideas you’d like to share with Endo Warriors, Adeno Warriors, IC Warriors, and others? Shoot us an email at firstname.lastname@example.org and we’ll add them to the list.
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 Assessment of pelvic floor muscles in women with deep endometriosis, Santos dos Bispos et. al, General Gynecology 2016: https://link.springer.com/article/10.1007/s00404-016-4025-x
 Treatment of pelvic pain associated with endometriosis,The Practice Committee of the American Society for Reproductive Medicine, Fertility and Sterility 2008: https://www.sciencedirect.com/science/article/abs/pii/S0015028208034742
 Mechanisms of pain in endometriosis, Morotti et. al,European Journal of Obstetrics & Gynecology and Reproductive Biology 2017: https://www.sciencedirect.com/science/article/abs/pii/S0301211516308247
 Gibson, William, et al. “Transcutaneous Electrical Nerve Stimulation (TENS) for Neuropathic Pain in Adults.” Cochrane Database of Systematic Reviews, 14 Sept. 2017.
 Elboim-Gabyzon, Michal, and Leonid Kalichman.“Transcutaneous Electrical Nerve Stimulation (TENS) for Primary Dysmenorrhea: An Overview.” International Journal of Women’s Health, vol. Volume 12, Jan.2020, pp. 1–10.
 Akin, M. “Continuous Low-Level Topical Heat in the Treatment of Dysmenorrhea.” Obstetrics & Gynecology, vol. 97, no. 3, Mar.2001, pp. 343–349.
 Chaudhari, et. Al. “A Randomized Controlled Trial of Exercise and Hot Water Bottle in the Management of Dysmenorrhea in School Girlsof Chandigarh, India, Indian Journal of Physiology and Pharmacology, 2013.
 Xiong, Wei, et al. “Cannabinoids Suppress Inflammatory and Neuropathic Pain by Targeting Α3 Glycine Receptors.” The Journal of Experimental Medicine, vol. 209, no. 6, 14 May 2012, pp. 1121–1134,www.ncbi.nlm.nih.gov/pmc/articles/PMC3371734/
 Armour, Mike, et al. “Self-Management Strategies amongst Australian Women with Endometriosis: A National Online Survey.” BMC Complementary and Alternative Medicine, vol. 19, no. 1, 15 Jan. 2019.