Endometriosis and beta-endorphin research

If you are putting together an endometriosis pain management strategy, you might like to discuss the following information with your GP, pain specialist or physiotherapist.

The American College of Obstetricians and Gynecologists reports that in a 1992 study of 75 patients undergoing laparoscopy for chronic pelvic pain and / or infertility:

  • Beta-endorphin levels were 24% lower in the endometriosis group
  • Low beta-endorphin production during the luteal phase may have implications in the development and/or maintenance of endometriosis

Pain relief evidence

Anecdotal evidence

There is a substantial body of anecdotal evidence in support of transcutaneous electrical nerve stimulation (TENS) therapy for treating the pain associated with endometriosis.

Clinical evidence

Due to a lack of research, there is no specific clinical evidence relating to endometriosis related symptoms and TENS pain relief. However there is broad evidence that low frequency TENS therapy does increase levels of beta-endorphin.

Weighing the benefits

TENS effectiveness possibly depends on individual variables: e.g. location of pain, originating cause, secondary causes of pain, changes in the pain sensing system and emotional factors.

While TENS will not help every woman with endometriosis, it may help a large proportion. You should definitely consider it as part of your pain management strategy. Therefore, we suggest you give TENS therapy a try for yourself:

  • Speak to a pelvic floor physiotherapist
  • Borrow a unit - but don't borrow the pads
  • Hire a unit

AND to ensure you give the therapy a proper trial, look for instructions that are relevant to your experience of endo pain.

Here are the pain relief results for 42 of our customers suffering with pelvic pain.

  • 50% excellent results
  • 22% very good
  • 21% good
  • 2% satisfied


  • Only 5% not satisfied

Your Pain Experience

The experience of endometriosis pain varies from person to person. Pain is often described in terms of where the pain is located or the time when it is at its worst.

If your pain is experienced in the pelvis, groin or referred down the leg, it may be caused by chronically tight muscles of the pelvic floor. Used correctly, TENS is a very effective therapy for relaxing tense muscles.

Location of pain

  • Pelvis
  • Abdomen (cramps)
  • Hips
  • Groin
  • Low back
  • Legs
  • Sacrum / rectum

When pain is worst

  • Menstruation
  • Ovulation
  • Urination
  • Bowel movement
  • Exercise
  • During or after intercourse
  • Constant

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Signal Intensity

In order of strength, the 3 main intensity levels are:

  • Sensory threshold – when you can just feel the tingling, pins and needles sensation
  • Motor threshold – when you can feel your muscles contract
  • Pain threshold – when the stimulation becomes painful to you

NEVER use TENS therapy at or above pain threshold.

Operating Modes

  • If you already know that you have high levels of prostaglandins then EASE mode is the mode of first choice for you
  • If you know that your beta-endorphin levels are low, then use the RELAX mode on a regular basis to increase them
  • If you know you suffer from chronic inflammation then RELIEVE or RELAX modes are probably your best options
  • If you know that you have chronically tight muscles, do not apply the therapy to your pelvic floor muscles at or above motor threshold

Electrode options

Use standard electrodes for:

  • Abdomen
  • Lower back
  • Leg
  • Hip
  • Groin
  • General musculoskeletal pain

Use external pelvic floor electrodes for:

  • Pelvis
  • Groin
  • Sacrum / rectum


EllaEase endo treatment guide

Pain Location ModeElectrodes IntensityTime
Abdominal cramps EASEStandard Muscles should contractMaximum 1 hour each day
Abdominal cramps EASE or RELIEVEStandard Muscles should NOT contractAs long as necessary
Pelvic pain – cramps EASEPelvic floor Muscles should NOT contractMaximum 1 hour each day
Pain pain – tight muscle EASE or RELIEVEPelvic Floor Muscles should NOT contractAs long as necessary
Low back, leg, hip, groin pain RELIEVEStandard Muscles should NOT contractAs long as necessary
Sacrum, rectum EASEPelvic floor Muscles should contractMaximum 1 hour each daily
Sacrum, rectum RELIEVEPelvic Floor Muscles should NOT contractAs long as necessary
Early intervention RELAXStandard or Pelvic floor Muscles should NOT contractSeveral hours
Assisting sleep RELAXStandard Muscles shoudl NOT contractOvernight