A pre-post prospective study on the use of Transcutaneous Electrical Nerve Stimulation (TENS) unit in the management of endometriosis pain

OBJECTIVE: Primary aim is to identify the impact of Transcutaneous Electrical Nerve Stimulator (TENS) use on endometriosis pain based on daily self-reported Visual Analogue Scores (VAS) during pain flares. Secondary aims include quantifying TENS use on quality of life (QOL) using Endometriosis Health Profile-30 (EPH-30), and sexual function using Female Sexual Function Index (FSFI) surveys. DESIGN: Pre-post prospective trial enrolling participants will in a 3-month "baseline" period (no TENS use for endometriosis related pain flares) followed by a 3-month "treatment" period (TENS use for endometriosis related pain flares) and abovementioned surveys collected at beginning and termination of study. SETTING: Single-center academic institution with endometriosis center. PARTICIPANTS: Inclusion: Females aged 18-45 with surgical diagnosis with direct visualization and/or histopathologic confirmation of endometriosis who experience average monthly endometriosis pain flares and naïve TENS user. EXCLUSION: Pregnancy/breastfeeding, contraindication to TENS use, post-operative state <12 weeks, planned surgery or hormonal medication changes for duration of study. INTERVENTIONS: Self-directed TENS use during endometriosis associated pain flares. RESULTS: Primary VAS score decreased by 2.29 points (p = 0.44). QOL on EPH-30 survey showed a significant improvement by 16.57 points (p < 0.001). Secondary endpoint of FSFI score improved by 3.86 points (p = 0.09). Decrease in both ibuprofen and acetaminophen average daily milligram dose by 93 mg for ibuprofen (p = 0.02) and 123 mg for acetaminophen (p = 0.11). CONCLUSION: TENS use can significantly improve QOL in patients with endometriosis and decrease use of ibuprofen. While not statistically significant, it can also decrease pain, improve sexual function, and decrease acetaminophen use.