I’ve been asked so many times about Livia in the past month that I figured it’s time for me to just post on it.
The makers of the device claim it is an “off switch for period pain” and that it is a “new device.”
It’s neither.
What Livia appears to be is a TENS unit, which is a transcutaneous electrical nerve stimulation device. This is not new technology and it isn’t new for period pain. I have been prescribing them for well over 10 years. I probably prescribe 1-2 a week, sometimes more.
TENS is in fact so well entrenched for period pain that there is even a Cochrane review that supports its use (with high frequency settings). The review was first written in 2002, so yeah, like I said not exactly new.
There is nothing listed in the site for Livia nor anything the CEO has said that suggests the device is anything but a TENS. In fact, he even uses the term “gate theory,” which is of course one possible mechanism of action of a TENS.
What’s the gate theory? Think of the connections in your brain as gates, with both vibration and pain each having one. The first gate that closes, or feels the input, stops the other gate from closing. Basically, the fastest signal wins out and shuts the other gate to the pain. Vibration travels faster than pain, so it gets to the gates first. That’s a very simplified explanation of course, but it’s why you rub something when you hurt it – the vibration from the rubbing reduces the pain. TENS units may also work by stimulating endorphins. We don’t really know. So it is rather a bold and definitive statement to say that Livia (i.e. a TENS) unit in an off switch. It’s more like kind of sort of maybe and other things.
As TENS technology for period pain has been around for a long time it seems rather disingenuous to call it “new.” And then there is the $85 cost – you can get a decent one on Amazon for $30.
So absolutely talk with your doctor and/or a physical therapist about a TENS for painful periods. They can really be helpful, but until Livia can prove head to head it is better than a TENS or release some kind of data to there is a biologically meaningful difference between their device and a TENS, it is just an expensive, albeit pretty, TENS unit.
Dr. Jen Gunter 
Thank you so much. I’ve had a tens unit for about 8 years and never thought to use it for menstrual cramps until this week. Now that I’m using it again I’m wondering why Tens are not recommended more frequently for all sorts of pains. Instead we’ve approved super oxycodone and oxycodone for kids. I’ve never had an obgyn mention tens even though I’ve been on Vicodin for periods for decades. We need to get the word out for sure.
I felt like a sucker for buying one of these for the exact reasons you stated in the blog post… Almost like it was a “pink tax” type thing. BUT, to be fair, the Livia is really small and designed to be worn under your clothes, clipped your waistband. Other TENS units I see online are much bigger and clunkier and you wouldn’t really be able to wear them around all day. So I guess that somewhat justifies the extra cost.
Note: I don’t work for Livia, and I’m not a fan of the way they operate. The first unit they sent me was defective, and I had to pay $60 in shipping to return it to Israel and get a new one. Crappy business practices for sure. But it does work for menstrual pain and it is convenient. As long as I can figure out a cheap way to avoid buying their cutesy flower-shaped (and expensive) replacement gel pads, I will continue to use it!
My tens ( 8 years old now) is slightly larger than a credit card. It’s a pink tax for sure. Still, I’m 51 and just realized the tens could be used this way so I guess if Lucia gets the word out that tens is helpful that’s still a good thing. I usually take Vicodin so getting the word out is a needed service.
Thank you! Saw an advert and thought that was just a horrendously expensive TENS unit. You can buy them over the counter in a pharmacy for a tenth to a fifth of the price.
I am a user of Livia for almost two years. It worked in the beginning but after a year device started to work a bit weird and stopped to send signals equally. It was very painful to me, as signal hurt me, suddenly. Finally it stopped work and was sending signals randomly. I decided to contact with LIVIA customer service, I have to say that I went through very long and heavy discussion about the problem, (aprox 6 weeks) and finally, they decided to offer me to exchange the device. BUT not so easy! I had to pay £15 parcel cost and when finally I received a message from the courier that my parcel is in GB. I faced another surprise, I was told that I should pay £23 VAT ??? I was seriously upset now, so almost £40 for exchanging under guarantee? When I asked Livia team about explanation, they answered that I should read Terms and Conditions. I have never met such a low level of guarantee service in whole my life. After that, I got distraught and informed them that I am not going to have anything common with LIVIA anymore and will tell all my friends about their service level. After that, they offered me to refund me when the Livia back to their office. And still after that, they will refund me in 30 DAYS !!! – amazing. So I cancelled my courier delivery and waiting what will happen next. Just bought another TENS device much cheaper and worked in the same way. I would never advise anyone to rely on LIVIA, I had to fight for my obvious rights. The device is small and comfortable in use, but low quality strings damage very short so I need to buy another ones after a year. Poor poor quality irrelevant to the price.
Thanks for the feedback!
A similar thing happened to me, the unit they sent me was defective as you described… I had to pay out of my own pocket to mail it back to Israel and I want to say it was something like 60 bucks!! They did eventually send me a replacement… But totally crappy customer service for sure.
Dr. Jen – I found this post via a random google search and I am TRYING to find any info on whether using this machine (or any TENS device) on your abdomen would pose any risks to the eggs in one’s ovaries. Specifically (and please bear with me), would the TENS unit “cook” your eggs, being that it uses electric currents for treatment? I’m wondering how it ultimately affects a woman’s fertility since she uses it so close to her reproductive organs? Thank you!
Is it safe for the reproductive system? Since where the Livia patches are to be placed are rather close to the ovaries
Have you been able to find any info on this? I just asked the same question you did and have been trying to find info online with no luck?
if you want, find me on facebook – Rada Valeckaite, and i will send you their user manual, that I got from asking the company in private messeges if there are any side effects of Livia.
Or you can write them, they usually reply in a few days
Dear doc, thank you very much for these details!
My 45€ TENS unit’s user’s manual says that I should not use it for more than 20 minutes a session, only twice a day! This is definitely not enough for my terrible period pains that sometimes wake me up at night and last for hours at a time.
Livia states I can use it whenever whatever – do you know why? and whether my TENS unit instructions are only following the policy ‘better safe than sorry’ exaggerating the precautions?
Many many thanks
The good thing about Livia is I didn’t know about TENS units before, now I do. I forgot how I figured it out it was a TENS unit- guess it was some article comparing Livia to these things. I’ve found a few tiny TENS units online, but I have to say the portability and discreetness of the Livia is appealing. I’ll do some more digging and see if I can find something that isn’t outlandishly expensive. The price has certainly gone up since this article was written, and I do agree, it is false advertising to call it ‘new’ but a lot of so-called new products these days are just existing products with fancy designs catered to Millennials.
Sadly, lots of doctors will not even mention that TENS is an option for period pains. I had no idea before I saw the Livia (which I immediately recognised as a TENS unit from having used one for other purposes at work. A friend of mine also got one for pain relief during the early stages of giving birth). Googling TENS units will give me a ton of different uses for them, most sites does not mention period pain. I’ve been on hormonal birth controll since I was 15 to handle my period pains (they say it’s most likely not endometriosis), that’s almost 20 years now.
If medical professionals were better at informing patients of our options, perhaps less people would buy Livia because they thought it was their only option and the people buying it could do so for the design and small size instead. I appreciate that you wrote this piece, but please also try to get your colleagues to understand that TENS is an option AND to prescribe it to their patients. Thank you.
I have severe cramps to where i cant take a sip of water. Livia lets me run errands, eat out and work. I have to teach full time. I can’t walk around with a silly mechanism duck-tapped to my mid-section. More people should invest in making women’s lives easier. It’s the only one on the market advertised for cramps only. IF more people join in, it would be cheaper, smaller, more powerful… and better to beat competition.
Thank you very much Dr. JEN. I just saw a video on YouTube about this thing and immediately posted that people were paying too much because all it is, is a glorified Tens unit. And, stated that you can buy one at Walmart for $32.00 dollars. I read their claims and they said their machine was set to period pain frequency which is nothing but b.s. p.r. so people will buy the Livia unit instead of just purchasing a cheap Tens machine. I soncerly hope people research before they buy these things.
I also thought “TENS”, the moment I saw the video first time. And yes; there are many cheaper TENS-options. But although this message perhaps somewhat drowns in the relatively short video, I recognize the product for a various of reasons:
-Design; which is very cool, casual yet discrete. A device by which many women would not feel pathologized as with a regular TENS-device.
-Its easily rechargeable battery through USB devices that are already available in most households; e.g. PC’s, smartphone-chargers.
-Its large and seemingly relatively firm electrodes for the replaceable gel-pads, which seems easily applicable and easy to clean. The rugged edge making effective and hygienic cleaning more difficult than necessary though.
-Its ready-to-use-concept with a very easy interface. You do not have to study length of bursts, frequencies and Hertz, tu use the device. On the other hand; and for the very same reason, this device is of course less useful with other pain-conditions in contrary to a regular TENS-device.
I understand why my daughter likes this device and why she would prefer Livia over my own “clinic-like TENS-device” with many buttons, flashing LED’s and several settings irrelevant for her specific problem.
It may not be new, but it is more convenient than the larger TENS units and for the layperson is easier than setting up your own parameters. It does work. It’s small and has a rechargeable battery. I used something similar with a coin battery, and it worked well for me and several patients. I don’t think the current $97 ($85 & $12 shipping) on Indiegogo is terribly expensive. 🙂
There are pretty compact atEnS units. It may be easier for some, but it is blatant false advertising to say it is new.
It was very cool seeing you in the video, but I wish they would have mentioned what you said, that the technology has been around for years!
Totally agree!