Medically reviewed by Dr. Fatema M Dawoodbhoy 

There are several ways to manage severe period cramps in endometriosis. For primary dysmenorrhea, non-medical treatments like heat therapy or exercise can be helpful. However, for secondary dysmenorrhea with endometriosis, medication may be necessary. 

Heat therapy

Heat therapy is recommended by Kathleen, a member of our endometriosis panel, as a useful strategy for managing period pain, especially if you experience clots in your menstrual blood. 

“Applying heat to areas of pain is an effective pain relief method as it increases the blood flow to the affected muscles and hence the oxygen supply, ultimately allowing your cramping muscles to relax.”

Dr. Fatema M Dawoodbhoy

TENS pad

Another recommendation from our endometriosis panel is using a TENS (Transcutaneous Electrical Nerve Stimulation) pad for severe period cramps. TENS is a non-invasive, drug free strategy that sends gentle, painless electric pulses to the site of pain. These devices come with adhesive pads that you place wherever you feel pain. They work by blocking the pain signals being sent to your brain andstimulating your body to produce its own natural pain killers. 

NSAIDs and hormonal therapy

NSAIDs (non-steroidal anti-inflammatory drugs) and hormonal therapy are commonly used for the treatment of dysmenorrhea. NSAIDs like ibuprofen or naproxen help reduce the levels of prostaglandins and other inflammatory chemicals. Hormonal therapy, such as birth control (contraceptives), work by balancing oestrogen and progesterone levels, which can reduce the growth and inflammation in lesionsassociated with dysmenorrhea. Some continuous birth control methods like the Mirena Coil or the Nexplanon implant prevent periods, eliminating period pain.  


The gold standard for endometriosis management is laparoscopic surgery through excision or ablation to remove the presence of lesions. However, this is not typically a first-line treatment since it is an invasive surgery, and your gynaecologist may recommend holding off on this unless they suspect you have severe and deep endometriosis and are unresponsive to treatment.  

“While laparoscopic surgery it not always recommended in patients, it has been shown to improve the quality of life for people with endometriosis. However, there is usually a 2-5 year recurrence rate of the endometrial lesions in people (depending on severity of the endometriosis and how effective the operation was) which might mean further surgery down the line.”

Dr. Dawoodbhoy

Botulinum toxin injections (Botox)

An emerging strategy to tackle endometriosis symptoms are botulinum (Botox) injections in the uterus or pelvic floor muscle. Although primarily used to reduce chronic pelvic pain (cramps that happen outside of your period), a significant population of sufferers felt that it helped with severe dysmenorrhea. 

they happen. Track your pain symptoms in the Joii App, where it identifies patterns based on your own logs, so you get detailed predictions when they may occur and what you can do to manage your pain.

Written by: Medically Reviewed


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