Inclusion Criteria
- Female, 22-45 years old
- Assigned female at birth
- Fluent in English
- Capacity to consent
- Confirmed diagnosis of endometriosis by a qualified physician, via:
- Laparoscopic surgery with biopsy-proven endometriosis, OR
- Clear evidence of ovarian endometrioma or deep infiltrating endometriosis on ultrasound/MRI
- Pain levels:
For menstruating participants, all of the following need to be met:
- Regular menstrual cycles (21-35 days)
- Mean DYS NRS ≥4 during menstrual bleeding days (over the last 28 days, self-assessed)
- AND Mean NMPP NRS ≥4 during non-menstrual days (over the last 28 days, self-assessed)
For non-menstruating patients, all required:
- Irregular/absent cycles OR post-hysterectomy OR surgically menopausal
- Mean pelvic pain NRS ≥4 (over the last 28 days, self-assessed)
- Pain present on ≥50% of days
- Access to a smartphone with an internet data plan, phone must be iOS 13.4+, or Android 12+.
- No hormonal contraception or at least 6 months of consistent adherence to any hormonal contraception (e.g., IUD, pill, injection).
- Capacity to follow instructions and operate the study device.
Exclusion Criteria
- Pregnancy/breastfeeding or planning to become pregnant in next 6 months
- History of epileptic neurological conditions in the immediate family
- Severe/untreated neurological disease (e.g., epilepsy or seizure disorders, stroke or transient ischemic attack \[TIA\], subarachnoid hemorrhage, traumatic brain injury \[TBI\] with persistent neurological deficits, brain tumors \[malignant or benign\], multiple sclerosis, Parkinson's disease, Alzheimer's disease or other dementias, Huntington's disease, cerebral aneurysms or arteriovenous malformations \[AVMs\], active central nervous system infections \[e.g., meningitis, encephalitis\], hydrocephalus, other neurodegenerative diseases not otherwise specified, or any other neurological condition that, in the opinion of the principal investigator, may increase risk or interfere with study participation or outcomes)
- Metal implants/electronic devices in brain, head, or neck area
- Participating in any other clinical trial
- History of stroke, brain surgery, tumors, head trauma
- Active skin lesions, open wounds, cuts, or infections on the scalp
- Active scalp conditions (dermatitis, eczema, psoriasis)
- Significant scarring/burns/other skin damage on scalp
- Schizophrenia or bipolar disorder
- History of suicidal behavior or clinically significant self-injurious behavior (e.g., one or more suicide attempts, non-suicidal self-injury \[NSSI\], or other behaviors indicative of intent to harm oneself), as determined by participant self-report.
- Treatment plan must be stabilized (≥6 weeks analgesic/ ≥6 months hormonal contraception, and crucially no new medication changes before randomization)
- Planning to commence any new treatment during intervention period
- Lack of capacity to consent
- Participation in a neurotechnology or drug trial in the last 6 months.
- Recent surgical intervention for endometriosis within 6 months of enrollment or planned surgical intervention for endometriosis during the study period.