Roughly seven million women live with excruciating pelvic pain, severe cramping, difficulty conceiving, and a strained love life due to a common reproductive disease. Endometriosis is a condition in which endometrial tissue – tissue similar to uterine lining – grows outside of the uterus, such as on the cervix, bladder, and ovaries, where it collects and thickens over the course of every menstrual cycle. Women have said it feels like ‘having a big heavy rock in my belly,’ and it causes ‘stabbing pain during my period and ovulation, all around my pelvic area, back and hips.’ Others add that it causes ‘deep, pulsating pain,’ making sufferers double over in pain. The chronic pain of endometriosis stems from the tissue growing outside of the uterus, which breaks down with each menstrual cycle. It leads to inflammation and scar tissue binding to and stiffening organs, causing a pulling sensation and sharp, shooting pains. The pain can be unbearable for some women. A build up of scar tissue can block the fallopian tubes, as well as disrupt the hormone balance necessary for ovulation, making it impossible to conceive. The impact on a woman’s quality of life can be enormous, from keeping her from working or attending school and socializing with friends, to racking up thousands in stressful debt for treatments and potential cures. Dr Bhavini Shah, a general practitioner in the UK who works for digital health platform Lloyds Pharmacy, said: ‘There is no known cure, and treatment is focused on managing pain symptoms.’ However, studies and anecdotal reports from millions of women have helped doctors zero in on certain treatments that make a noticeable difference. Below, DailyMail.com details tips from doctors for relieving endometriosis pain. Heat is one of the most powerful pain-relieving tools, according to gynecologists. Dr Shah and other physicians recommend a hot water bottle or heated wheat bag – a fabric pouch filled with natural wheat grains that can be heated in a microwave or oven – to be placed on the pelvic area to relax the muscles there and improve circulation. A heating pad is the most trusted home remedy for endometriosis pain. It loosens and soothes tight muscles in the pelvic area, reducing painful cramping and restoring blood flow to the area, which eases painful inflammation. While a heated wheat bag is an easy find on Amazon and other retailers, a rice sock is also an excellent do-it-yourself source of relief. Take a clean sock, fill it with uncooked rice, and microwave it for about two minutes. Place it gently on the pelvic area. Dr Michael Reed, a gynecologist in Beverly Hills, California, said: ‘Heating pads and warm baths are solid go-tos, but in my practice, I’ve seen a mix of medical, lifestyle, and alternative approaches make a real difference for patients. ‘Pain relief often requires a combination of methods, as what works for one person may not work for another.’ Painkillers Over-the-counter pain relievers are often prescribed and effective, such as ibuprofen, especially when taken the day before one’s period or pain is expected to begin. And Tylenol has been shown to help alleviate pain as it’s happening. In endometriosis, tissue that grows outside the uterus produces high levels of compounds called prostaglandins, which play a major role in inflammation and pain all month long, not just during a woman’s monthly period. The excessive production of these compounds leads to stronger and more painful uterine contractions, resulting in severe menstrual cramps Ibuprofen is more effective when taken before the pain becomes severe because it blocks enzymes that help produce prostaglandins before they trigger pain and inflammation. But according to Dr Reed, over-the-counter meds ‘don’t always cut it.’ He told DailyMail.com: ‘Some patients find better relief through hormonal therapies such as low-dose birth control pills, hormonal IUDs, or GnRH agonists, which suppress estrogen — the fuel for endometriosis. ‘In cases where pain has a neuropathic component, nerve pain medications can also be effective.’ Hormone therapy Dr Shah added: ‘Some hormonal treatments can stop the ovaries from being stimulated, meaning that production of estrogen stops. Therefore, women might experience side effects causing a “menopause-like” state.’ Birth control pills, patches, or rings with estrogen and progesterone can help to stabilize and suppress the natural hormonal surges in the menstrual cycle that stimulate growth of endometriosis. Progesterone-only treatments, such as pills, hormonal injections, and intrauterine devices (IUDs), can help reduce the growth of endometriosis. Additionally, medications that target gonadotropin-releasing hormone (GnRH), a brain hormone that stimulates the ovaries, are also effective in managing the condition. Both options work by altering hormone levels to slow the progression of endometriosis and alleviate symptoms. Amitriptyline Amitriptyline is another medication that may help alleviate pain. Primarily known for treating depression, the drug has pain-modifying properties by altering the body’s perception of pain. It does this through its action on raising levels of serotonin and norepinephrine, which help regulate and block pain signals from reaching the brain. It is also particularly effective at alleviating nerve pain. TENS machine Dealing with the symptoms may include trying even more advanced treatments. One such treatment uses a TENS machine (transcutaneous electrical nerve stimulation), which helps ease aches and pains, including back and shoulder pain. The machine delivers mild electrical impulses through electrodes placed on the skin, which interact with the nervous system to modulate pain perception. By overwhelming the nervous system with non-painful stimuli, the TENS machine reduces the brain’s ability to perceive pain signals from the affected area. Another method is a laparoscopic laser to blast the tissue and break it up. Depending on the patient, this surgery may have to be repeated because endometriosis is a chronic condition. New scar tissue and lesions can form on organs around one to two years after surgery. If the tissue has attached itself to other organs, like the colon or bladder, a similar surgery would be performed with a broader team of doctors to ensure that no healthy tissue is damaged. Dr Jessica Rich, a gynecologist in Florida who specializes in endometriosis, told DailyMail.com: ‘The general focus should be on treatment of the disease and leaving the normal organs in place, but some women who are no longer trying to get pregnant and have tried other strategies may opt for hysterectomy or larger procedures.’ Some aesthetic treatments often used in cosmetic gynecology also show promise for symptom relief. Dr Reed added: ‘CO2 laser therapy and radiofrequency treatments, often used for vaginal rejuvenation, can help improve blood flow, reduce inflammation, and promote tissue healing in patients with chronic pelvic pain. ‘Platelet-rich plasma (PRP) injections, which use the body’s own growth factors to encourage tissue regeneration, have also been explored for pelvic pain and discomfort.’ Physical therapy Doctors say women underestimate the power of movement and physical therapy, which is designed to strengthen or relax pelvic floor muscles, reduce pain, and manage anxiety. The inflammation, pain, and scar tissue from endo can lead to pain that spasms in the pelvic floor. According to Dr Ritch, ‘Working with a specially trained pelvic floor physical therapist can help to decrease some of this scar tissue and spasms to help reduce pain in conjunction with other endometriosis treatments.’ Doing some gentle activities when one feels like curling up into a ball on the couch, like yoga, stretching, or leisurely walks, can also increase blood flow and reduce cramping. Dr Reed added: ‘Endometriosis pain is no joke—it’s like your uterus is throwing a tantrum, and unfortunately, it doesn’t come with a mute button. ‘Ultimately, there’s no one-size-fits-all solution for endometriosis pain, but relief is possible.’