Project Summary-Abstract The goal of the funded study is to develop a multi-modal intervention based on the EE paradigm tested in the team's animal model and test its efficacy in women with endometriosis. The start of the intervention was set to begin January 11, 2020, and by December 2019 all logistics of the interventions were in place. However, due to natural disasters affecting Puerto Rico (a series of earthquakes in January-February 2020, and the COVID-19 pandemic), the scientific team had to make the difficult decision to postpone the start of the intervention. The team factored in that the high levels of stress in the PR population would affect the study as it would be difficult to disentangle the effect of ongoing natural disasters to the stress of living with endometriosis. Currently, vaccination for COVID-19 in Puerto Rico continue to advance rapidly, positivity rates are lower than 5%, and the government has lifted most restrictions on gatherings and curfews. The scientific team made the decision to start the intervention in August 2021. In preparation for this, the team requested an NIH no -cost extension to allow for the continuation of this study for an additional year, which was approved. However, the remaining funds do not include the salary of a key position in the study team, the Research Coordinator, Ms. Paola Ramos. We are hereby requesting additional funds to support the Research Coordinator's salary for an additional year to make up for the time lost due to COVID-19 related restrictions. In addition, we are requesting additional funds to cover costs related to measures to prevent COVID-19 during the interventions. The Research Coordinator position is crucial for the success of the project as this position is in charge of overall organization of the logistics involved in the activities, data collection and analysis, and follow-ups on study subjects, venues, and coaches delivering the interventions. In addition, the Research Coordinator contributes extensively to data entry, quality control, and analysis as well as the generation of progress reports, presentations, and publications.