My Top Tips For Managing Endo & Pelvic Pain

An image of beautiful endo bodies from my Endometriosis Empowerment Photo Shoot in Auckland. © Ainsley DS Photography

Pain, Pain Go Away. 

Endo, adenomyosis, pelvic pain and bad periods can be absolutely debilitating. Some days I have been hunched over on the floor in tears as ripples of extreme cramps coursed through my body. There were days where the pain was so bad I would accidently drop something on the floor and I would burst into tears knowing that I would not be able to pick it up again. I’ve missed countless days of work and social events cuddled up in the foetal position. It’s been a decade or so of managing pain like this, but over the years, I have learned a few tips and tricks along the way to help manage these days. None are magical solutions that make your symptoms disappear, but every single one adds to the toolkit of things you can do when the pain is next level. 

1. Pharmaceutical Medications for Extreme Period Pain.

If you have bad period pains you probably know that paracetamol and ibuprofen generally do not cut it. That’s when it’s time to start looking at some stronger options. Pain relievers like tramadol, oxytocin worked well for me at my worst times, these do however have some pretty gnarly side effects (like constipation which can make pain worse) and can become addictive so should be used with caution. Then there are also other daily meds to help with nerve pain such as amitriptyline and gabapentin. Personally, gabapentin did not work at all for me (insane brainfog) but I have been on amitriptyline for a few years now and find that its biggest benefit is that it helps me sleep. If you have been nervous about taking something stronger than Panadol and ibuprofen, perhaps have a chat with your GP or specialist to see what might work for you.

Sometimes you just have to give in and take the meds…

2. Non-Pharma Meds for Chronic Pain. 

Despite the stigma surrounding it, I can honestly say that CBD and THC oil have been my biggest life savers on this endo journey. CBD helps a lot with sleep, anxiety and calm. THC doesn’t necessarily take the pain away, but it definitely helps me manage the mental toll of the pain a lot better. I also find THC oil works well at helping my muscles relax which are often very tense when I am in a high level of pain. There is a warm wave of looseness that comes over you when the THC hits and it’s such a relief for the body. Some GP’s aren’t yet comfortable with giving prescriptions for canna products so if it’s your first time trying cannabis based medication you might want to chat to a specialist cannabis clinic which will give you a proper consultation.

Nature has incredible healing powers that should not be stigmatised. © Ainsley DS Photography

3. The Magic of Heat!

Heat pads, hot water bottles, hot baths, scorching showers, deep heat rub…. Heat is the most immediate and effective pain reliever for me. I highly recommend these electric heat pads available at Chemist Warehouse for around $40, they provide the warmth close to a hot water bottle without the risk of burns and they hold the heat a lot longer. I bought my trusty one before my surgery in May of 2023 and it has been used every single day since then and it is still going strong. 

A hot bath is one of the best things for a sore and tired body. © Ainsley DS Photography

4. Calm Muscle Pain And Cramping With Gentle Yoga. 

Gentle, slow stretching aimed at reducing pelvic pain is a great way to help tense muscles release and bring a sense of calm back to the body. Poses like Child’s Pose can be especially soothing, as it mimics the foetal position while providing gentle pressure where your tummy needs it most. Other positions such as Cat-Cow can also ease pelvic tension, improve circulation, and support relaxation. Practicing even a few minutes of yoga during a flare can make cramps feel more manageable, while regular practice may also help reduce the intensity of future pain episodes. Yoga with Adriene on YouTube has some fabulous free sequences designed specifically for period pain and gentle movement, making it easy to follow along from the comfort of your home.

Child’s pose is an excellent position for immediate pain relief. © Ainsley DS Photography

5. Breathing Techniques For Bad Menstrual Cramps.

You know those breathing techniques they teach women in labour to help manage pain? Well, you need to learn them too. Because in reality, your cramps are a form of contractions, so it makes sense that the same pain relief techniques apply. Deep breaths can help to stretch and expand the muscles in the pelvic area which can help to reduce some of the intense tightness that cramps cause. You can see some on YouTube here.

Deep belly breaths much like those used for contractions in childbirth can be helpful for bad cramps. © Ainsley DS Photography

6. Get Your Hands On A TENS Unit For All Types of Pain.

TENS machines (Transcutaneous Electrical Nerve Stimulation) work for pelvic and period pain by delivering small electrical impulses through pads on the skin, which stimulate nerves and block pain signals from reaching the brain. The pulses also trigger the body's release of natural painkillers, endorphins, and may improve blood flow to the uterus, further reducing pain. It can feel a little weird and tingly in the beginning and may take a bit of getting used to, but once you do… sweet relief! TAP Health is a great NZ company that sells pretty and practical tens machines. 

TAP Tens machines are great at providing relief from period and muscle pain.

7. Give Tampons and Menstrual Cups a Miss and See If It Helps Your Pain.

I eventually figured out that tampons and cups actually made my inflammation and tenderness a lot worse so I switched to period undies. They are way more absorbent than a pad or tampon and obviously much more friendly for the environment. Period undies can take a bit of getting used to (rinsing them then throwing them in the washing) but once you get into the swing of using them you will never go back! AWWA is my favourite go to brand also owned by amazing NZ wahine!

AWWA period undies are my favourite go-to.

Not only are period underwear more comfortable but they look pretty too! This set is from AWWA.

8. Try Hot/Cold Therapy For Inflammation and Muscle Pain.

Heat and cold therapy can be a simple but powerful way to manage endometriosis and period pain. Heat relaxes tight pelvic muscles, boosts blood flow, and eases cramps, while cold reduces inflammation and numbs sharp pain. Alternating between the two—like a hot shower followed by a cold plunge, or using heat packs with ice—can improve circulation and calm flare-ups. Even gentle movement in warm water or time in a sauna can bring added relief, making hot/cold therapy a versatile tool in your pain management toolkit.

Take a plunge and see if it helps your endo © Ainsley DS Photography

9. Don’t Be Afraid! Give Acupuncture a Go.

Many people with endometriosis find acupuncture helpful for easing pain, stress, and tension. The science is a bit wishy-washy on exactly how it works, but it’s thought to release endorphins, calm the nervous system, and improve blood flow. While the idea of needles can be daunting, they’re very fine and usually cause little more than a slight pinch. It may not be for everyone, but plenty of people swear by it—so it could be worth giving it a try. In my opinion, there is a good reason why such an old pain relief technique is still popular today.

Acupuncture can help with a wide range of health issues © Ainsley DS Photography

10. Pelvic Physiotherapy to Release Pelvic Pain.

I personally could not get behind this with my level of gyno trauma, however, I know so many people who absolutely SWEAR by pelvic phsysio as being the best thing that they have done for their pain. Pelvic physios work by using internal and external massage to release tense muscles and pain points. They are also incredibly knowledgeable on all types of pelvic pain/ issues and are a great resource for learning more about healing.

Pelvic physiotherapy works wonders for many people. Image from the endo empowerment photoshoot in Auckland. © Ainsley DS Photography

11. Psychotherapy and Counselling To Give Your Pain A Place To Go.

Unfortunately therapy may not help your physical symptoms, however it may be able to help you cope with the trauma and stress that comes with this level of pain that few people understand. Having severe period pain or chronic pain is a huge contributing factor to mental health struggles, so it makes sense that we might need a bit of extra help in this area. This is not to say that the pain is in your head, it’s simply trying to give you some coping strategies so that the pain doesn't send you into a place of despair. If you’re unsure where to start looking, you can ask for a referral to the pain clinic or psychologist from your GP or find a list of mental health resources here.

Having a support system can help you manage the pain better. © Ainsley DS Photography

12. Raspberry Leaf Tea For Menstrual Cramps.

Raspberry leaf tea has some magical properties which relax the uterus allowing for an easier flow. Women often take it at the end of their pregnancy to help labour run smoothly and it’s also packed with loads of vitamins and minerals. It also tastes yummy! Some supermarkets do stock it, otherwise it's available for purchase from NZ owned a couple of NZ owned tea companies including Tea Total.

Raspberry leaf tea is another magical medicine provided by nature.

13. Go Back to The Roots of Aotearoa With The Healing Powers of Kawakawa.

Kawakawa is an indigenous Aotearoa leaf that has been used for medicinal purposes for hundreds of years. It is good at reducing inflammation, supporting digestive health, aiding in the treatment of skin conditions, and providing a calming effect- thanks to its rich mix of antioxidants and bioactive compounds. It’s easy to brew into a tea or you can make it into a blast with coconut oil. Kawakawa grows just about anywhere in Aotearoa (especially on the west coast of Auckland!) but if you don’t have any handy you can buy Kawakawa tea from here.

The healing powers of Kawakawa work well in fighting inflammation.

14. Try Altering Your Diet to Include Lots of Anti-Inflammatory Foods.

New research shows that an anti-inflammatory diet can be incredibly helpful in managing endometriosis symptoms. Anti-inflammatory foods like leafy greens, berries, fatty fish, and nuts can help calm the body’s inflammatory response, while limiting processed foods, refined sugars, and red meat may reduce flare-ups. Incorporating fiber-rich foods supports healthy digestion and estrogen regulation, which is key in endometriosis management. I highly recommend getting your hands on a copy of HEAL ENDO by katie evans which is a fantastic resource for learning about endo and how it can be improved through diet. 

Increasing fresh fruits and veggies in your diet makes a big difference © Ainsley DS Photography

15. Take a Break From It All.

Blocking out the world, with an eye cover, audiobook/ meditation music/ white noise and a comfortable space. Sometimes all you can do is escape and try to breathe your way through the pain. 

Sometimes all you can do is escape from it all and take some time to yourself © Ainsley DS Photography

16. Use The Power of Education to Empower Yourself.

Education is the biggest tool you have in your fight against endo and adeno. Both diseases are sorely underfunded and under researched and if I’m honest the majority of doctors know jack shit about them. It is therefore up to us to put the effort and time into learning everything we can about these diseases so that we can figure out what works best for us to manage it. And don’t let any doctor tell you that getting pregnant or having a hysterectomy will cure you! Make sure you are following Endo Warriors Aotearoa for all their educational and advocacy work and keep an eye out for a blog post on all my favourite educational books coming soon.

There’s nothing like education to empower yourself and your community. Join me on photo shoot designed for people with endometriosis. © Ainsley DS Photography

Living with endometriosis, adenomyosis, and chronic pelvic pain is exhausting and can feel incredibly isolating- but you are not alone. While there’s no magic fix, building your own pain management toolkit can make an enormous difference in how you navigate flare-ups and regain a sense of control. From medications and natural therapies to lifestyle changes and mental health support, every small step counts toward improving your quality of life. Remember, what works for one person may not work for another, so listen to your body, keep learning, and advocate fiercely for your health. Most importantly, give yourself grace, managing this level of pain is a full-time job, and you are doing your best every single day. When you are ready come and book an Endo Empowerment shoot with me and let’s celebrate how far you have come! XX

Got any extra pain relief techniques? Please share them below!

Note- some of the products mentioned have been previously gifted to me by the company. However I would not recommend them if I did not absolutely believe in them and I don’t make a commission by recommending them to others, these are just my preferred brands!