This list is the main reason why I wanted to build a website. Your doctors are not the one-all-be-all. Hormonal treatments and surgery are NOT your only options for managing the symptoms of endometriosis. While it is true that there is no cure for endometriosis, your best option is to find treatments that help you manage your pain. Here is a list of those options you have. Personally, I have done them all.

1. Pelvic Floor Physical Therapy. Many physical therapy offices have at least one therapist who specializes in the pelvic floor. Ideally, you will want someone who does internal work (in a perfect world, someone who has experience with endometriosis). Internal work is when they use hands-on assessments and treatments through the vaginal and rectal canal. Don’t worry! They do not use any tools, and it shouldn’t be painful. You do not have to do internal work if you do not want to! PT’s with this training often will have a better understanding of the pelvic floor. Prepare to work! You will be given plenty of stretches and exercises to work on daily.

2. A TENS unit. A tens unit is a treatment that passes a weak electrical current to your nerves which can relieve pain. This small machine can be used as much as you wish to use it, without any side effects. Don’t use it on your face or chest area, and don’t use it with creams like IcyHot! Any TENS unit will work. Don’t spend your money on a subscription service or a fancier machine. They all work the same! Your PT can help you learn where to put the pads to best help your specific pain.

3. Trigger point injections. These injections are performed by many doctors. You will point to the area/areas that hurt, and they will inject a mixture of medications to help reduce or eliminate pain. Often these are multiple short injections (like a shot) around the areas that hurt. If it helps, you can usually repeat these every few months. Insurance usually tends to cover this procedure.

4. Medications. Besides hormonal options, often nerve medications can be used to help alleviate pain. Vaginal suppositories are also a good option. Usually, these will have a muscle relaxer in them, and often a nerve medication. By using them vaginally, the medication will be directly delivered to your pelvic floor with less side effects than orally taken. Oral muscle relaxers can also be helpful in managing pain but can cause drowsiness. While opiates are a last resort for many doctors, they can be extremely useful for helping you maintain a quality of life when nothing else works.

5. Vitamins. If you have long and painful periods, it is important to have your iron levels checked as they can easily be low from all the blood loss. Vitamin D, turmeric, and fish oil are all good supplements to reduce inflammation, which can, in turn, reduce pain. Magnesium is also helpful. Seeing a naturopathic doctor is a worthy investment, as they can give you options with the fewest side effects.

6. Castor oil (topical). Castor oil can be used for menstrual cramps by relaxing muscles. Castor oil can also help break up adhesions from endometriosis and scar tissue from surgeries. A naturopath or acupuncturist can guide you on the best practice for using this oil. Generally, it is ideal to get an oil that is unrefined or cold-pressed.

7. Diet. Many with endometriosis swear that diet can improve pain. While I never found that to be true, eating a healthy diet does help me feel physically better overall. A good diet can be especially useful for managing any GI symptoms like painful bowel movements or nausea. I follow the Mediterranean diet as it is heart-healthy and doesn’t eliminate any foods. This diet is easy to follow and maintain, while still providing anti-inflammatory benefits.

8. Body work. Any massage therapist who specializes in pelvic pain and myofascial release can help reduce pain. While the actual massage itself is painful, it helps release the muscle tension from chronic pain with endometriosis. This is something that your PT is likely to perform on you as well.

9. Heat and ice. Heating pads are the most widely used and treasured method for pain management. There is also something called a “moist heating pad.” These heating pads can penetrate deep tissue faster than the well-known “dry” heating pads. Ice packs are also something that can be helpful for “sharp” or “stabby” descriptions of pains. Alternating between heat and ice, in 30-second intervals, creates something called “a pumping action” to reduce swelling, improve circulation, and relieve pain. I use an ice bath to manage pain, which essentially just numbs my body. The colder the water, the longer I stay numb. This can be accomplished by adding ice to a cold-water bath or by using frozen plastic bottles with water. Athletes use this method of muscle recovery and pain relief. If this helps, there are kits you can buy that include a tub (usually blow-up), and a machine that keeps the tub cold. I have one that I use on a regular basis.

10. Somatic yoga. This is a specific type of yoga that focuses on mindfulness and intentional movement that promotes body awareness, eases pain, can release stored emotions, and reduces stress. Traditional yoga tends to focus on strengthening muscles and perfecting various forms. Somatic yoga can be very useful for pain. Find videos on YouTube, or your local yoga studio may hold classes.

11. Acupuncture. This can come in the form of Chinese or Japanese acupuncture. While many insurers will not cover acupuncture, it is a worthy investment for pain relief. Some acupuncturists will also be able to use a practice called “cupping” (promotes blood flow and healing), use Chinese Herbs, and have a degree in naturopathy. Explain your specific pain and situation in detail, and they will be able to determine what can help you most.

12. Education. Learn about chronic pain and how it works in your brain. This will allow you to communicate more effectively with healthcare providers, which can improve your care. Understanding how pain works can reduce some fear and anxiety around it. Understanding pain can change the way you respond to it.

13. Creams, roll on, etc. While creams like IcyHot, Arnica, Tiger Balm, or CBD cream won’t necessarily reach the deepest pain within, they can be useful for radiating pain. Use it on pain that radiates down the leg during menstrual cycles or on your back during an endo belly flare! You can also use a TENS unit, but don’t use both!

14. Meditation. Any relaxation technique you learn can help you with pain. When we breathe while in pain, we tend to breathe in a way that only worsens pelvic pain. By belly breathing, your pelvic floor will relax. Practicing any type of meditation, belly breathing, or box breathing can become second nature to you. When you’re in a flare, your body will have a better chance of automatically switching to one of these relaxation techniques that can help you get through the flare. YouTube has plenty of excellent videos. There are also apps with exercises to practice, and even reminders for you to practice these daily!

15. THC/CBD. While highly taboo, pot helps with pain. Countless women with endometriosis swear by a combination of THC and CBD in edible form. Some also smoke, but most tend to prefer edibles. It’s worth a shot, if this is an option for you.

16. Hot baths. Most people tend to take a hot bath to relax. Using this for endometriosis pain is not any different. Add Epsom salts, light a candle, and set a mood for optimum relaxation. Baths can help menstrual pain, sleep, and more.

17. Orgasm. If this doesn’t cause pain for you, have an orgasm! Orgasms release endorphins and oxytocin, which can reduce pain and relax your body. These natural body chemicals temporarily block the perception of pain.

18. Therapy. Endometriosis is a very difficult disease to live with. The diagnostic journey alone will drive you crazy and easily cause depression and anxiety. It is easy to feel like a burden to your family and friends when endometriosis impacts so much of your life. A therapist can give you tools to manage your emotions, and a place to talk and vent about the journey. You don’t have to worry about hurting anyone's feelings with a therapist. They can be very useful!