Non-drug therapies refer to pain-relieving therapies that do not depend on medicines.

The major symptom experienced by endometriosis patients is pain — abdominal pain, pelvic pain, period pain, pain while passing urine, pain while emptying the bowels, or pain while having sex.

Therapies such as painkillers can be used to reduce pain associated with endometriosis. These medications may be combined with non-drug therapies to more effectively manage the pain. Non-drug therapies can also be used when the medicines do not provide adequate pain relief or cause severe side effects.

Non-drug therapies include heat therapy, physiotherapy, TENS, and other therapies.

Heat therapy

Hot water bottles, wraparound heat packs, heated wheat bags, or a hot bath can help reduce endometriosis’ patients pain. Heat may work by relaxing muscles, relieving cramps, releasing tension in an area that is rigid with pain, and calming aggravated nerve endings.


Physiotherapy, especially focusing on the pelvic region, can be useful in reducing pain associated with endometriosis. It may include pelvic muscle massages and exercises and relaxation techniques to help strengthen pelvic floor muscles, reduce pain, and manage stress and anxiety.

Transcutaneous electrical nerve stimulation (TENS)

Transcutaneous electrical nerve stimulation (TENS) is a procedure that is used to relieve pain and relax muscles by applying mild electric current to the skin. It uses a small machine with electrodes that send electrical pulses into the body when attached to certain areas on the skin. The electrical pulses do not hurt, but feel ticklish.

The exact mechanism by which electrical pulses reduce pain is not known, but it is thought that they may work by blocking the pain signals as they travel through the nerves to the brain. They may also help the body produce endorphins or hormones that interact with receptors in the brain to reduce the perception of pain.

A clinical trial (NCT02769052) at the University of Campinas in Brazil is evaluating the effectiveness of TENS for the treatment of pain in women with deep endometriosis.

Patients should consult with their doctors before using TENS machines, as they are not suitable for people with heart problems or those who are pregnant.

Other therapies

Pain associated with endometriosis may also be alleviated using therapies such as yoga, acupuncture, repetitive transcranial magnetic stimulation (rTMS), and Pilates.


Yoga — a practice that includes meditation and stretches — has been found to be effective in reducing pain and calming the body. A randomized clinical study (NCT03784976) in Illinois is recruiting patients with endometriosis to study the effectiveness of yoga therapy for treating pain associated with the disease.


Acupuncture is a Chinese remedy used to treat various conditions by inserting needles in certain areas of the body. A multi-center controlled clinical trial (NCT03125304) is recruiting around 106 women with endometriosis in China to evaluate the efficacy of acupuncture for the treatment of pelvic pain associated with endometriosis.

Repetitive transcranial magnetic stimulation (rTMS)

Repetitive transcranial magnetic stimulation (rTMS) is a painless procedure that uses repeated magnetic pulses to stimulate nerve cells in the brain. A clinical trial (NCT03204682) is recruiting about 24 patients with endometriosis in France to evaluate the efficacy of rTMS for the treatment of pain.


Pilates — a set of exercises that help strengthen the body — may also help the abdominal and back muscles regain strength, reducing pain.


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