Hyperfixed - PREMIUM UNLOCKED: Cramping My Style

Episode Date: September 10, 2026

This week, we're unlocking an episode from our premium feed: an interview with Kate Downey, Host and Creator of the CRAMPED podcast.Get tickets for the Hyperfixed live show!If you like this episode and would like to hear more like it, as well as join our discord and get discounts on merch, you can support us by going to https://www.hyperfixedpod.com/join. LINKS: CRAMPED podcast Learn about your ad choices: dovetail.prx.org/ad-choices

Fear is the virus is trending on TikTok. Vaccines are poison. Then your yoga teacher says that sex traffic children are being sacrificed by satanic liberals, but it's all okay. The Great Awakening is coming. What is happening? Every week on Conspiruality Podcast, we explore the fever dreams that suck friends, family, and wellness gurus

down the right-wing cult spiral in a search for salvation. Hey, everybody. Since our big live show is the day after this episode comes out, and that is currently soaking up a ton of our brain power, we decided to unlock an interview that aired on our premium feed in July. Our premium members had a very positive reaction to this episode, so we thought, you know, we'd give you a chance to check it out. As ever, if you would like to get more like this,

we have almost 50 bonus episodes in our archives, and you can listen to them by becoming a member at hyperfixpod.com slash join or with the subscribe button on iTunes or Spotify. Also, there are just a couple tickets left for the live show in Brooklyn, and you have about 30 hours from the moment we posted this before the show begins. Go to Tickets.hyperfixpod.com to get yours. All right, here's the episode. Enjoy. Hey, cool, cats. This is Alex Goldman.

Look, that's what it says in the script. I read what's in the script. I'm a team player, and as part of being a team player, you read what's in the script. Irony of ironies, though, that I'm calling you guys Cool Cats in what I'm calling my hot basement. That's like a normal basement, except your air conditioning isn't working. Anyway, Cool Cats, this is Alex Goldman from the Hot Basement. And if you are listening to this, then that means you're a paid member, so thank you for supporting the show. We couldn't do it without you.

This week, we have a mystery for you. But unlike our typical mysteries, it is a horrifyingly common one. The mystery of an undiagnosed illness. The question I had was like, what the hell is happening to my body? Why is it happening to so many other people who also don't have answers? And how did we get to a place where so many people are suffering and their doctors have all told them like, don't know? Like, how are we in this place? This is Kate Downey.

She's the creator and host of a podcast called Cramped, an investigative podcast about period pain. And all these questions she's asking, she has been trying to get them answered for years, not just on her podcast, but also in her personal life, because these questions are deeply personal. So I have had horrible severe period pain since I was 14. I call them death cramps. I would be completely incapacitated and I would have to lock myself in the bathroom and throw up until I passed out on the floor. So obviously this was like unsustainable. That sublime laugh is hyperfix producer Emma Cortland. And she talked to Kate back in January for an episode that we were working on about tampons. And sadly, that story didn't go anywhere. But the reason why we're sharing this interview with you today is because our conversation with Kate ended up being fascinating on its own.

And that's for two reasons. One, Kate's a lot like us. She's an investigator. And when she was experiencing these death cramps, she wasn't just going to shrug her shoulders, twiddle her thumbs, and call her. at a day, if the medical field wasn't going to take her concern seriously, she would. And so Kate started a journey to understand severe menstrual cramps. And this journey she went on was exactly why we wanted to share this interview, because it highlights a very common and sad reality about the untold stories of women's pain and how little is actually known about it.

It feels like a conspiracy. Like, as I, there's no way to talk about it without feeling like you're being a conspiracy theorist, but it's real. Kate's very real pain started back in the early 2000s when Kate was growing up in rural Maine. She had just started getting her period when all of a sudden she was hit with these intense waves of pain and nausea. I was at school. My mom came and picked me up when I couldn't stop throwing up. She took me to my first gynecology appointment and that gynecologist said, well, you know, this happens to some women.

They just have painful periods. it'll go away when you have your first baby. To a 14-year-old, which was not super helpful. Kate went home that day without a solution. But the pain persisted. Not every time she got her period, but enough to keep her guessing. Enough to dread every upcoming period, like some sort of horrible game of menstrual roulette.

Like sometimes it would be the worst thing that had ever happened to me, and sometimes it would just be like, you know, not fun, but fine. And so I never knew what to expect. I never knew if I would be able to follow through on plans I had made, on commitments I had made for work, family commitments, responsibilities. After high school, Kate went to college in Boston, and then she moved to New York to start her adult life. And all the while, her death cramps followed. One time I went to the ER, and it happened to not be in my insurance, and I ended up owing the hospital $15,000 for cramps, for going to them for cramps and them being really unhelpful and eventually giving me more. IV to like stop the cramps, but it was like, oh, this was not a good use of funds.

For years, Kate did everything she could to find a solution, something to make the pain stop, or at least to explain why it was happening. I went to so many doctors. I would go to the gynecologist. I would say, hey, this doesn't seem good. This doesn't seem normal. And they would do an ultrasound. It would come back normal.

And they would go like, well, some women just get bad periods. Have you heard of ibuprofen? or you might be stressed, have you tried meditating? No shade on meditating, but I don't think any amount of meditating is going to, like, fix this. Eventually, Kate decided to take matters into her own hands. She launched her podcast cramped and started interviewing experts searching for an answer. And that's when she learned about something called endometriosis. The inside of the uterus has a lining.

It's called the endometrium. And that lining, what it does is thicken throughout the menstrual psyche. and at the end of the menstrual cycle, for menstruation, that lining releases and bleeds out of the vagina. And that's a period. It's like an Italian way to do it. That's a period. You got to make it fun. And so endometriosis is when cells that are similar to the cells that make up the lining

of the uterus or the endometrium, for some reason, develop outside of the uterus, often in the pelvic cavity and the peritoneal cavity. So like on the outside of the uterus, on the ovaries, but it technically can be and has been found anywhere. And the reason that's a problem is that often this tissue can, the same way the endometrial tissue inside the uterus thickens and bleeds once a month, those cells, when they are outside the uterus, they can also thicken and bleed.

But it doesn't have to bleed. in order to cause a lot of problems, because that tissue is not supposed to be there, and your body's immune system reacts to it like it's not supposed to be there. Wow. So even if it is not actually bleeding, you get a ton of inflammation. All that inflammation creates a lot of scarring. And so very often what happens is the massive amount of scarring creates digestive issues, creates pain when pooping, pain when peeing, pain when having sex,

plus massive amounts of inflammation in the system makes everything else work not good, in my expert opinion. The other thing that endometriosis can do is cause a ton of severe period pain. And so when Kate learned about this, she was pretty sure she had her diagnosis. But the problem was it's actually really hard to get officially diagnosed. Kate told us that endometriosis is quite common, something like 10% of people with uteruses are estimated to have it. But on average, it takes between seven and ten years for people to get diagnosed. And there are a couple of reasons for that. One is education.

Kate says that a lot of gynecologists just aren't aware of endometriosis. But the other reason is that the only way to get officially diagnosed is to have surgery, which Kate, obviously, did not want to do if she could avoid it. And who could blame her? So Kate started experimenting with non-surgical options. I took a lot of supplements. I saw a nutritionist. I ate an anti-inflammatory low-fodmap diet. I did pelvic floor physical therapy. I totaled it up. And in one year, I spent over $15,000 on just treatment, just treatment that none of it was covered by my insurance. Because to get an official diagnosis, you have to have surgery. It felt like a medical catch-22. To get diagnosed, you need to have surgery. But to get surgery, you need to have a diagnosis. And while some of the treatments, you have a medical. You have a diagnosis. And while some of the treatments Kate was paying for out of pocket were helping, she still had a lot of pain.

And that's when Kate's medical mystery took an unexpected turn. During this time, my partner and I had also moved up our timeline of having kids because having endometriosis very often affects fertility. We were trying to get pregnant. It wasn't working. After 10 months of trying, we went and saw a fertility specialist. I got a test done where they checked to see if your fallopian tubes are open. and one of my fallopian tubes was blocked and filled with fluid. So basically I had like a water balloon attached to my uterus. Oh, my God. Every time I got my period, that fluid-filled, blocked fallopian tube was basically getting like tugged around like a water balloon on a string.

Also, the fluid is cytotoxic, which means potentially it kills fetuses. Yeah, like it's a poisonous water balloon. Yeah, exactly. A water balloon full of poison. Kate had surgery to get the poisonous water balloon removed, along with all the scar tissue that had built up. Then, doctors sent a sample of her tissue to a lab to be tested for endometrial-like cells. And what they found blew Kate's mind. And so they were like, twist. It wasn't endometriosis. That's after the break. Welcome back to the show. So, endometriosis. So, endometriosis.

Had been the red herring of Kate's medical mystery. It turns out she had a couple of endometrial-like cells, but that wasn't what caused all of the scarring. I was like, cool, what caused all that scarring? And they were like, there's no way to know. We'll probably never know. But it must have been before I got my first period. It could have been a childhood like infection. And so what is this mysterious?

What is this? Like, what could this possibly be? So you still haven't reached the end of this mystery. Oh, my God, this is so frustrating. This is the worst mystery. Yeah. So how are you doing? Actually, doing really well.

Like, so far, things are really good. Post-surgery, recovery went really well. I'm about to have period number seven since surgery. And the last three have been essentially pain-free. And it's so. crazy. It's like, is this what it's like for people? Like, there's no bone-deep exhaustion. There's no like dramatic medical emergency. For the first time in just over 20 years, Kate is not suffering month to month. But the fact that it took this long and that the answers

are still wildly unclear left her understandably very frustrated by the current research on period pain. The big thing that I am still so mad about is I didn't get answers to my questions that were, like, I didn't get answers to my issues that were really messing up my life until I was trying to get pregnant. And it really underlines what I found in a lot of my research, which is if it doesn't affect the productivity of a woman's body, meaning like the ability to get pregnant and have a kid or the ability to like go to work. And even then it's like they don't really care about that because they're like, do it anyway. Yeah.

But there really is only a motivation, it seems, to solve a problem and to investigate a problem if it is affecting a woman's ability to get pregnant and give birth. I'm so glad you brought up the productivity thing because I did want to ask, why is there so little research about this stuff? Yeah, that's the thing that blew my mind when I started doing this research. I read a lot of really amazing books, books like For Her Own Good. by Barbara Aaron Reich and Deirdre English. Caroline Creado Perez has a book. Essentially, science and medicine have been built around data about men. And it has just been assumed that whatever advice works for men, whatever conclusions they

come to based on the data about men, just scale it down a little because women, on average, way less and, like, are smaller. And then the same thing applies. And that is why women are 30 percent more likely to have. have negative reactions to medication because it's often not tested on them before being released to the public. And actually, feminists in the 70s and 80s did some really amazing work and changed the NIH standards, but it hasn't actually moved the needle as much as it should have.

The excuse that is used is that women have hormonal cycles and those shifts in hormones, they are another factor that has to be accounted for. it's a variable. And that is more complicated and that will be more expensive to deal with, to track, to figure out. However, it has also been proven that women and depending on where they are in their hormonal cycle, every organ in the body has a basically has a sex difference from men. So like our hearts work differently than like my heart works differently than a man's heart, depending on what cycle in, where I am in my cycle, what hormones are flooding through my body. I didn't know that. Yeah. Nobody fucking knows this.

Sorry, nobody knows this. Like, if you are on an SSRI or like an ADHD medication, ADD medication, which are two of the most prescribed medications to women specifically, if you are not on birth control, if you are having a hormonal cycle, if you're ovulating, that, um, you're, um, that, um, um, SSRI or ADD medication is affecting you very differently in your ludial phase, which is about half your life, is about half the month. So SSRIs and ADD medications are differently affected, depending on how much serotonin is in your body, which is also mediated by hormones. So in your ludial phase leading up to your period, which is when you feel shitty, when you more often are getting

depressed when people with PMDD are often having like huge crashes. People with ADD are having more trouble managing tasks and like focusing. Your medication is less effective. And if this was studied, if dosage was adjusted for this, we would be on different dosages depending on the medication and depending on our, where we are in our hormones. So I do take ADHD medication. And I have since I was in second grade. And Amork can tell you, that there are some weeks when I'm just like, bring it on, I'm going to destroy everything. And then there are some weeks where it's just like, what's on your to-do list? And it's like, I don't know.

It just feels like pushing that boulder up the hill. It feels like I'm pushing 10 boulders up the hell. Yeah. And that is fully legitimate. And everything around us, everything around us, every system that we live within, medical system, nine to five work schedule, consistent, like, expectations at the gym. Everything has been built around men's hormonal cycles, which are 24-hour hormonal cycles, meaning they are, you know, more awake and productive, 9, 10, 11 a.m.

There is no hormonal reason they cannot show up the same way every single day. Women are on monthly hormonal cycles. We have very different capacities, baselines, and abysmal. at different times, but we have been expected to just adhere to a very different hormonal cycle. And we beat ourselves up when we are, our bodies are like, no, rest, sit down. Like, we literally have different amounts of hormones in our bodies at different times, which doesn't have to be bad. That is not, the goal is not to become more like a man.

And what happens when you take hormonal birth, and I am not against hormonal birth control, by any means, it is really an incredible innovation, an incredible thing if you have informed consent and you decide to use that tool with full knowledge of its pros and cons and full knowledge of how it works inside your body, because what it does is it flatlines your hormones, which essentially makes you have a hormonal cycle that looks much more like a man's hormonal cycle. And I don't think that's a coincidence that any time you, you go to the doctor with period pain, they're like, go on hormonal birth control.

Now, for a lot of people with endometriosis, that can be a godsend. That can really help your symptoms. But we aren't told how it works. We aren't told, we aren't informed about also the fact that endometriosis can continue growing inside your body and the birth control can just mask the symptoms. Yeah, so this is all kind of depressing, right? because the reality that Kate's painting for us is that there isn't enough funding or research to understand women's bodies in their pain, but also the treatment that is out there might not actually be treating the problem at all.

It might just be hiding a problem as it grows. But Kate has some reassuring news. She tells Emma that there are companies looking into non-surgical methods of diagnosing endometriosis, specifically a lab called Rose Labs, and they're doing this in a very interesting way, Because they're using, can you guess, period blood. Period blood is not just blood. It is also tissue from the lining of your uterus. It is also clots.

It is also discharge. It is also often like a mucusy substance. There's also like stem cells in menstrual blood. There's all this amazing stuff in menstrual. Technically it's called menstrual effluent because it's not just blood. As it turns out, menstrual effluent only contains about 30 to 50% blood. which means that there are all these other components to study. And that's what the team at Rose Labs is doing.

So I think they're on like year 11 of studying menstrual effluent, specifically with the purpose of learning more about endometriosis and developing diagnostic tests for endometriosis that are not surgical, that are non-invasive. Basically, their whole thing was like, hey, you know how we bleed every month? how like things are coming out of the lining of our uterus into the outside world without us having to like go in there and get it and how people with endometriosis might have issues with the lining of their uterus that might show up in that effluent. Let's study it because nobody had ever done that before. Literally every other, every other bodily fluid.

You can get your poop tested. You can get your pee tested. You can get, they'll swab your spit. They'll go up your nose. Like, they'll literally test any other bodily fluid, but nothing has been developed for a diagnostic test based on menstrual effluent, which is so crazy. So they were like, I wonder if we can find a difference in the menstrual effluent of people with confirmed endometriosis and the menstrual effluent of people who do not have endometriosis. And guess what? They did.

And so they are actually now in the process of confirming those differences. and developing a diagnostic test that they can do for endometriosis that's like a pregnancy test like on your period blood. Rose Labs isn't the only company using innovative tools to study women's bodies. Kate tells Emma about a startup based in the Bay Area. Next Gen Jane is awesome. And they are doing sort of similar things to Rose Lab, but like in the private sector where they are basically they're saying

blood comes out of our vaginas without us having. to like extract it with a needle or anything like that. Can we use that blood to do things that we usually do with, with blood that we take out with a needle? So like, can we track blood sugar? Can we track A1C in diabetics so that they're not like, they don't have to prick their finger while they're on their period? Or just like, can we diagnose STIs with period blood?

Like all of these things that would just be like easier to do. So they have currently on the FDA has approved pads that can track A1C in diabetic people. And so you can get a break from pricking your finger, but they are researching a lot of other applications for this, including a non-invasive diagnostic test for endometriosis. When it comes to period pain, Kate is a bona fide expert. She knows all the research and studies and companies and tools that are improving the lives of women. who are suffering through disruptive menstrual cycles. But the thing she says is just as important as all that work is talking about it. Just that talking with other people about what you are going through,

if you are experiencing severe periods or severe period pain or any difficulty getting diagnosed or treated, talking with other people about it is incredibly helpful. Dr. Laura Payne has done all these studies that show that having, social connection actually like downgrades the pain signals in our brains. And so the fact that this stigma is keeping us isolated and silent is actually like creating more pain for us. And so getting past that stigma being able to openly talk about it is literally going to help our pain and is a key part of getting more information from the people around you who have had similar experiences. So talk about it, even if it's weird, talk about it with everybody.

Put it out there a lot more people than you think are going through very similar things to you. We'll include a link to Kate's podcast and the company she recommended in our show notes. Hyperfixed is produced and edited by Emma Cortland, Amor Yates, and Kat Shooknecht. It was engineered by Tony Williams. The music is by the mysterious Breakmaster Cylinder and me. Fun fact of the week is that cats only meow to communicate with humans, not with each other. According to the ASPCA, cats, instead of meowing, will communicate via like tail position, their scent, purring, or, you know, hissing and growling.

Meowing is just for us. So if you ever see a movie where cats are meowing at each other to have a conversation, it's a scam. Don't believe it. And ruin the illusion for your kids, too. You don't want to be teaching them junk science, I'm sure. So it's better to just rip the Band-Aid off. Okay, that's the episode for this week.

Forget to disappoint your children. See you next week. Radiotopia.