TONTS. - Endometriosis with naturopath Freya Lawler

Episode Date: November 11, 2022

Album Launch Tickets available here https://www.eventbrite.com.au/e/claire-tonti-album-launch-tickets-460602724147Freya Lawler joins me again today to deep dive into Endometriosis, a condition that effects so many women and is still chronically under diagnosed and often misunderstood. Freya Lawler is a bachelor qualified nutritionist, naturopath and natural fertility educator specialising in reproductive health, fertility and hormones. She is passionate about helping people achieve whole body wellness through a root-cause approach to women's health. In this episode we talk specifically about the paths to diagnosis for Endo, the common symptoms, what to look out for in our teenage girls who may be getting their period for the first time, methods of treatment and life style and dietary approaches that can really make a difference in you or someone you know suffers from this condition. Freya also has some wonderful resources you can access from her website and an Endometriosis starter kit that will help equip you with lots of strategies, good quality, well researched support and knowledge.For more from Freya Lawler you can head to www.freyalawler.com.au or Instagram @freyalawlernaturoFor more from Claire Tonti you can head to www.clairetonti.com or instagram @clairetontiShow credits:Editing – RAW Collings, Claire TontiMusic – Avocado Junkie Hosted on Acast. See acast.com/privacy for more information.

I would like to acknowledge the traditional owners of the land on which I create, speak, and write today, the Wurundjeri people of the Kulin Nation, and pay my respect to their elders past, present, and emerging, acknowledging that the sovereignty of this land has never been ceded. Hello, this is Taunt, the podcast of in-depth interviews about emotions and the way they shape our lives. I'm your host, Claire Tonti, and I'm really glad you're here. Each week, I speak to writers, activists, experts, thinkers, and deeply feeling humans about their stories. And this week, I have a big episode for you. It's a really big deep dive into endometriosis, something that is really underdiagnosed and affects so many women. I have with me again, the incredible Freya Lawler

naturopath. And if you haven't already, I would really encourage you to go back into the feed and listen to the episode I did with her on hormones and stress. I think it was so valuable and I had lots of people share it with their friends because what she had to say was just so important about caring for ourselves and our bodies. And we didn't get a chance to touch an endometriosis in that episode. And so I really wanted to do a big, deep dive into it. If you are someone that suffers from endometriosis or know someone that does, there are so many helpful tips within this episode. And so many women go completely underdiagnosed with this

condition that can be so debilitating and incredibly painful. And also if you are a mother or a parent of daughters, this is so great too. Freya gives us some things to look out for in our teenage girls when they start getting their period and what happens there. So I really encourage you to check it out. Here she is, the incredible Freya Lawler. Well, hello, Freya. It's so nice to have you back again on Taunt. So good to be here. We had so much fun last time and I think we could have talked for another 16 hours.

So it's quite good having another little allocation of time to go through my favourite topic. Well, this is what I thought. And I know at the end, I listened back to it and realized I talked so fast because I had so much to cover and ask you about. And so many questions are moving in my life. So we didn't touch endometriosis and I'm really glad we can spend a whole episode on it because I think it's such a, an underdiagnosed condition, I would think. Do you want to start by telling us what it actually is? What's endometriosis? Absolutely. And I'll preface this by saying we are still learning so much, Claire. No doubt the description that I'm going to give everybody about what endometriosis is will

probably be somewhat different in five years, 10 years, 20 years, as we learn a bit more. Unfortunately, the funding going into endometriosis is fairly minimal, although it is increasing, which is great. So at the moment, our current understanding of what it is, is it's a chronic inflammatory disease with ginormous immune involvement and hormonal drivers, specifically estrogen. So what endometriosis is, in essence, is it's cells that are very similar to the cells we find in our uterus in the endometrium that are found elsewhere in the body. So not in the uterus. So these cells are getting produced outside of the uterus and they can be found in the peritoneal cavity. They can be found in the lungs. They have been found in the brain. Endometriosis is quite commonly referred to as a women's reproductive condition. However, that's not actually the case. Endometriosis

has been found in prepubescent males. I know, yeah. It's been found in postmenopausal women who did not have it before menopause. It's been found in prepubescent females and in all sorts of different locations. I mean, most commonly it is found in females around the reproductive organs, but it is not isolated to those. There are lots of different types as well. And this is really important because certainly from a clinician's perspective, when I'm treating somebody with endometriosis, the type of endometriosis, the location and the stage really help me to refine my treatment plan because depending on the location, if it's connected to

the bowel or if it's connected to the bladder, obviously we're going to need more digestive support or we're going to need more bladder support. If it's all over the ovaries, we're going to need a lot more fertility support if that is a goal and hormonal support. So lots of different iterations. It's a really complicated condition. It's sophisticated and we're still learning so much. And I guess maybe that's why I love learning about it so much because it's so fascinating. There's not one presentation that I've seen that's the same in one person and the same in the other.

So am I right in saying that it's like a growth of cells? Yes. It sounds like a tumour but it's not a growth of cells. Yes. It sounds like a tumour, but it's not a tumour. It's just cells that would usually be found inside the uterus or on the utero, like the wall. Yeah. Externally, somewhere in your body. Exactly.

And I guess when we think of tumour, we think of like a lump or a mass of cells, don't we? You think tumour and you think lump, right? Yeah, that's kind of what I'm imagining. Yeah. However, yes, that can happen, absolutely. However, in the stages one and two, which are those more earlier stages of disease progression, what we can get is these, if you imagine cling wrap sort of layered over an organ or just some cling wrap sort of floating through the peritoneal cavity, it can be as thin as cling wrap or tissue paper and just sort of spread around. So it doesn't

necessarily have to be in a mass like a lump or tumour as you might imagine it. However, it's interesting you talk about the tumour idea because they do believe that endometriosis sort of spreads like cancer. Wow. So that means that when you talk about stages, is that just how much of this tissue is present as it goes through? Yeah, essentially it's the volume of tissue, but also the location. So if there's ovarian involvement, often the stage will accelerate the more progressed form of endometriosis if there are cysts typically known as chocolate cysts that's generally a later stage as well and this also gets into how you diagnose it as well because the stage of endometriosis if you have stages one or two you really do need to have a laparoscopy to diagnose

those stages because it's really hard to see. We might speak about it today, actually, about ultrasound technology and how that can be so amazing at diagnosing. But you have to imagine if you've got this really layer of tissue paper, it's so hard for an ultrasound to be able to see that tissue. However, if there's lumps, nodules, cysts and things like that, it's so hard for an ultrasound to be able to see that tissue. However, if there's lumps, nodules, cysts and things like that, it's really easy to see in a scan. Right. So let's start with the symptoms. So we know, we're getting a sense of what it is, but what are the common symptoms that people come with? I'd like to start off by saying about 30% of people with endometriosis have no idea they have it. It's

typically when these people, if they are wanting to conceive, they might find out about it during that journey. If they're having, you know, it's taking longer than they would expect to fall pregnant, then you would have further investigations. And endometriosis is quite commonly investigated. And that's because 30% of people experiencing subfertility do have endometriosis. So, you know, fertility specialists are pretty onto it. So first and foremost, you can have no symptoms, but most commonly, really obviously the things that jump out to me in clinic are of course, period pain. And that is to any degree I'm always my you know picking picking my interest if somebody says they have period pain even more so if they have pain during

intercourse bloating or alternating bowels that is not being resolved with typical treatment I do so much gut work you know we might do a microbiome assessment, treat what comes back and then expect for the majority of those symptoms to subside. However, if they do persist, I'm always going, is there some endometrial tissue or adhesions connected to that bowel that then change the shape and the form of the bowel, which is then impacting the symptoms. That's actually so common. So gastrointestinal symptoms are a big one. Bladder symptoms are big too. Quite common to have endometrial tissue or adhesions around the bladder.

So that could just be really frequent urination or another symptom is incomplete urination as well. Fatigue. I know that's so general, but I don't think there's one person with endo that doesn't have fatigue. They would probably be the most obvious. Does it affect mood as well? Does it cause PMS to be more serious? I mean, typically, from a hormonal perspective, it's not necessarily as though there's a marked hormonal imbalance in every case absolutely in some but I think it's actually what can happen is the chronic pain can have a significant impact on mood huge impact yeah because this is such a this is so heavy I'm

aware as well all of this content because people who are suffering from this condition and people who have never even been diagnosed, I know I have good friends of mine that took seven, eight years for them, for someone to pick it up. And they went to doctor after doctor who told them things like, oh, it must be your bowels. It must be your gut. You must just need to have kids and it'll reset your painful periods, take more ibuprofen. You know, just the list goes on, the gamut of things that women get told about this. So it's such a huge passion of mine as well for women to get more information. And it is such a heavy thing to talk about. You mentioned period pain. And I think this is so interesting because you've said this before, that period pain is not necessarily normal and I think it's often normalized, right, for women. Like, sure, you're supposed to get some pain during period. Can you talk into, when we're

talking about endometriosis, what that pain is? And again, it can be completely different from person to person and we're going to get into some some of the nitty-gritty aspects of systemic health that can then exacerbate and impact the endometriosis experience but I think it's really no one-size-fits-all approach when it comes to pain and it also depends on somebody's trauma history their exposure to stress their upbringing their socioeconomic status. So many things like that will influence your experience of pain. So it's a really big, the really big piece. And it's certainly not something that I will typically address on my own as a practitioner. That's where we want to get psychological support in as best we can,

whether it's a counsellor or a psych, you know, whoever's available to help us. But it's really any pain that impacts your ability to go about your normal day-to-day life, really as simple as that. If you're having pain that requires painkillers to function, you're having to take days off work. If it's impacting, yeah, your home life, your work life, that's significant enough for there to be an investigation. Because just remember, 30% of people don't have symptoms. So some of the people I work with have very minimal, minimal pain, but they use sort of something kicking around that they have to take a painkiller

or two or an apogiesic for. And that's still enough for me to want to investigate things but that can span to you know some of my patients that can only work from home so they'll be in administrative roles so they can work from home uh take naps throughout the day and this could be you know for two weeks a week in the lead up to their period the pain kicks in and then during and that's you know an eight out of ten type pain so it really varies it can be minimal to extremely severe yeah I've had friends who've reported that they've fainted with the pain yes yeah yeah that's really common yeah and I hear about that a lot actually Claire in young females in high school Whenever I go back into their medical history and speak about when they first got their period,

the way that endometriosis presents itself can change over the course of your lifetime based on how you've lived your life. But I mean, I guess most people, if they're living the way that teenagers do with a typical teenager diet and things like that, and they first get their period, the symptoms are often a lot worse

around that time, fainting, vomiting at school, so full on. I have a beautiful friend who I asked who has endometriosis and I asked her if she had any questions specifically and I was going to wait till the end but I think this ties in so beautifully. She messaged me and said, my question would be around how would you know if your teenage daughter has it? What point would you see a GP? Some of the symptoms seem to be more if you are a sexually active woman. So would you seek help if she has a heavy period or high

pain? My GP suspects I had endo from when I was a teenager and I remember being 15 and fainting from period pain, my second period ever at my casual job at an electronics store and being taken home. And mum just gave me painkillers and said to take them on my first few days of my period. And I just really want something better for my daughter. So what are the symptoms there to look out for? Yeah. I mean, all absolutely would be pointing me in the direction of saying, absolutely go and see your GP. Yeah, I mean, all absolutely would be pointing me in the direction of saying, absolutely, go and see your GP. Yeah, for sure. Particularly with, I mean, the family history absolutely skyrockets things for me. No questions. The genetic piece is a really big one. Certainly

not all the case or in all cases, but the majority. And often, I guess, depending on the generation of people that I'm working with, their parents didn't have, there weren't great enough investigations to even diagnose it. So they often say, oh, mum did have bad periods, but no idea if she had endo. I have a bit of trouble conceiving. The young women one's interesting just in terms of the investigation. So I'll kind of, we'll probably cover this further through, but I'll cover it now. So you can actually diagnose endometriosis if it's the stages three or four via ultrasound technology, if there's lots of caveats here.

It all comes down to the skill of the sonographer and the quality of the equipment. Yeah. So I'll certainly, if I'm referring people for these ultrasounds, I'm extremely specific on where they go and who they have it done with. But remembering that will only pick up stages three or four, but it is a fantastic option for a minimal invasive assessment of endo. Sure, nothing may come up, but for the cost, which might be $280 to $320 versus going straight in for a laparoscopy just to find out which can cost upwards of $5,000, $10,000. It can be a really excellent option just to go in and have a look. The only thing there is if you have a daughter that is not sexually active, the pelvic ultrasound

may not be the most suitable option for obvious reasons. It goes in through the vagina. So if you're not sexually active, there would be other procedures that would need to happen in order for them to do that. You can get an abdominal ultrasound, which is by no means as visually specific. However, if there's something really obvious happening around the ovaries or a cyst or something like that, they can absolutely see it so that's quite a good investigation to have if your child isn't sexually active and there are a few other things you can do in terms of clues with blood tests and

things like that but you i'd really say gp and then gynecologist would be the best first steps some people unfortunately have experienced a lot of medical trauma and just have been denied so many times that they don't want to go down that route. You can simply go to the GP and request the deep endometriosis ultrasound and just go and get the ultrasound. And the sonographer actually interprets it for you on the spot. They're highly specialized. And that's going to give you an idea of what's going on and sort of the next steps. And then you could take that to a gynaecologist or a specialist laparoscopic surgeon and have things investigated. But I am very, very passionate about getting in early in terms of diagnosis, because at the moment,

it's one in nine people have got endometriosis. However, it takes up to 10 years to get a diagnosis. So I'm assuming or we assume that that level of people with endometriosis is far higher given the amount of time it takes to get diagnosed. So maybe it's more like one in five or something like that. So in young people, I think if you've got it in, you go and get all of the investigations done. Yeah. Why do you think that is, that it's so underdiagnosed and misdiagnosed?

Well, there's a lot of reasons. There's a lot of reasons. First and foremost, the number one thing that I see in clinic is if a person has had a good experience with a GP, the GP has recognised their pain as abnormal and has sent them for a pelvic ultrasound. The pelvic ultrasound is only as good as the sonographer completing the ultrasound and the technology and sophistication of the equipment they are using. So for example, most people in a general situation of using a general GP who doesn't have experience in this, they'll send you to a general ultrasound radiology clinic where the sonographer has probably scanned somebody's knee before they did your pelvic ultrasound. So their skills are general and it plays an absolute huge role in their ability to

pick up what they're seeing. Based on that skill of the sonographer, you need to have extra experience in detecting endometriosis because in some cases it could be a shadow over an ovary or something really minimal and really refined like that. And if you're not specialised in that area, it's going to be very, very difficult to be able to pick that up. And then the actual sophistication of the technology that they're using. So the majority of Australians would be being referred to a general ultrasound clinic with the general ultrasound technology. Therefore, if you have got endometriosis in locations that aren't very obvious, you know,

they're good at picking up a cyst and really obvious things like that. They're not specific enough for picking up endo in other locations or earlier stages. So I think that first and foremost is a bit of an issue. Can you see? Can you see that? Yeah, completely. Yeah. I mean, how do we fix that, right?

Oh, that's huge. Because even if you just go, you think you've done the right thing. You've gone to the GP. Yeah. I mean, how do we fix that, right? Oh, that's huge because then if you just go, you think you've done the right thing, you've gone to the GP. Exactly. And then even you've braved or even sought a GP who will then acknowledge your pain and refer you but then in the referral process they say nothing's there. So then you think there's no issue. There's nothing.

And I could see how that would then cause trauma for people too because it takes a lot to even do all of that process for women. Huge. It's totally huge. And I think trauma as well because they then go away and feel as though they've done the necessary investigations but they continue to live with pain and because they've had the investigations then they're continually dismissed until they find the right person to care for them. But I guess even before that is most of the time you're

prescribed the oral contraceptive pill for pain management or naprogesic, even before you're recommended to go and actually have things assessed further. So I guess the concern we see there is, is that the time, yes, the pill actually, particularly in younger women, whilst it's not my number one favourite medication, for people of teenage age, it can actually be good for symptom management and quality of life for somebody of that age. It can be helpful in some cases as a consideration. However, when you're taking it with most of your

reproductive life until you want to conceive, all sorts of things can pop up. We know that the pill does not cure or eradicate endo because it's not purely hormonal and the pill is just working on suppressing hormones. It's not working on the inflammatory process or the immune process whatsoever. Helpful for symptoms though. Right. But then you might still have endometriosis there that's been underdiagnosed. And would you still have symptoms anyway, even if you're on the pill, but they're milder? You certainly could.

So some people experience things like breakthrough bleeding on the pill. They still experience some level of pain? Often that fatigue is still there because what's happening is that inflammatory and immune process is still happening. Yeah, and that's typically what makes you feel fatigued, foggy and rubbish. I have to say, Freya, this all makes me so angry. Oh, I am being very level-headed right now.

You are, but it makes me so angry because I know there's an element to this of women's pain not being believed and conditions that affect women in the majority just not having enough funding or research or being taken seriously. And I see that so often in so many of my friends have spent their whole lives with really awful painful periods or taking the pill, which can be really wonderful, I agree, but also has side effects. Totally.

And hides the symptoms of your period to be able to give an indication of your overall health. And so then we have these like generations of women dealing with things that actually they don't have to have been dealing with in this excruciating. And it's excruciating. It's not just like, oh, a bad period. Oh, take some Panadol.

It's, like we said, fainting, vomiting sometimes. It's incredibly excruciating. Do you think that that is a piece as well, this idea that women's pain is just not as acknowledged sometimes? Oh, absolutely, 100%. There's no doubt about it. Pain is considered normal, particularly period pain. Yeah, like it's a right or a sort of lot in life or something.

Absolutely. And, I mean, I guess I don't want to speak down against male GPs, but I do hear a lot of stories, particularly about male GPs and their dismissing of female reproductive pain. Yeah, it happened to me even just with the symptoms I was having with perimenopause. I was really just told, oh, you're too young to have any issues with your female cycle and that was kind of it.

And he's a lovely guy who has seen my kids and been great with them. So that's why I went to him because I thought, well, he'll be able to refer me on to someone or get some extra blood tests done. And it was like he didn't even have the language. So I wonder if it's partly training, medical training too, that's lacking. There's no doubt about it. And it's so, I also, you know, as much as they drive me mad, I also really feel for the GPs. I do, genuinely, because our healthcare model relies

on a general practitioner for everything. We expect them, or most people expect them, to have the answer for everything when that's not actually in their skill set. They're there to diagnose acute and chronic illness and pick up red flags. It's the complicated, fiddly stuff in between that number one they don't have the time in a consultation to actually be able to sit down and

properly review and pick these things up or the skills let alone the reference range on the pathology um to be able to see something that jumps out obviously for them in a consultation with time restriction. It's really just not working in their favour. They're looking for things that are really obvious, a direct referral, an obvious red flag, not the funny stuff in between. It's tricky for them. Yeah, and my mum's a GP and she has said before how much their GPs

are struggling at the moment because of the cost of consultations, the length of consultations, the amount of pressure on them and people come in with a huge list of symptoms with 10 minutes for them to be able to consult and they don't make that much money necessarily from that consultation either. So it's really complicated. So my mum said the best thing you can do is actually book a long consultation with your GP, right? Which you are allowed to do and can do. And people seem reticent because they're like, well, I can pay a little bit less and have a short one and still tick all the boxes. But then with you, I'd sit for an hour and have a consultation and it's wonderful.

So from my mum, she said that that's, you know, a big part of it and having compassion for GPs. But also there's lots of other things going on there too. It's really big. It feels. There's lots going on. It does. It feels really big.

But things are looking good. Things are looking good. We're getting, you know, I think the current government have just released lots of money for some more research and things like that. So things are looking better. And I think social media has played a huge role in people with endometriosis speaking out. Huge role, which for once, I guess, social media is working in our favor, which is great.

So I think things are looking up, you know, in terms media is working in our favour, which is great. So I think things are looking up, you know, in terms of endometriosis awareness, which is really hopeful. That's really great. So we've looked at diagnosis. Is there anything else you wanted to say about diagnosis before we move on to how to address some of the symptoms and how you would treat someone with endometriosis? I mean, it sort of depends. Some people come to me that have absolutely no idea that endometriosis could even be a factor in their life. And there are sort of a specific set of things that I will do, look at their general bloods, inflammatory markers.

There's an amazing marker called CA-125, which is incredible, very specific marker. It's called cancer antigen 125. And that is typically used to detect ovarian cancer, which sounds a bit scary. That's not what we're looking for. Very specific for endometrial inflammation. It's an inflammatory marker specific to that area, which is super cool. Obviously very minimally invasive, so you can just tack it on when you go and get your general bloods. And in those very initial stages of reviewing somebody for endometriosis that's

always something I'll put in and it's just to give me clues of you know how far do we go with this is going for a pelvic ultrasound getting into the system seeing a gynecologist booking a laparoscopy is this really all necessary or is this actually just are there other reasons for the pain so there's a few little things like that that I'll cross out before we progress onwards. But I think, yeah, GP, pelvic ultrasound, gynaecologist, and also, sorry, to anybody listening who's considering going down that path, please look up. If you're going down the surgery route, they must be a laparoscopic excision specialist. So I'll just touch on that really briefly for people because

a lot of people don't know. So there's two different types of surgeries for endometriosis, ablation where they burn the tissue, excision where they cut it out. The excision is cutting it out at the root. The burning is essentially sort of just burning it off. It's not fully removing it. And I really don't want people who have had ablation to feel like they haven't had the best standard of care. I'm sure they were offered the best that was available to them at that time. But if you do have the choice and the means, because often there is an increasing cost with the excision specialists, these specialists actually do an extra two years of training on top of their gynecological training so they're highly specialized this is

extremely important the research shows far greater outcomes of reduced tissue growth and better quality of life better preservation of fertility and my number one goal in clinic and lots of other functional doctors is to reduce as much as possible the amount of surgery we can. You know, multiple surgeries equals more scar tissue and more adhesion, which can often equal more pain and more chances of nerve damage. So even some patients, very sadly, who go for their laparoscopic surgery come out with higher levels of pain. So I must say, you know, surgery needs to be really deeply considered and not something that you should just jump into. You want to find the best surgeon properly, do a

lot of research and, you know, think about your reproductive health goals and things like that. There's a lot to think about. And preparation. I know we're going to speak about post-surgery support perhaps later in the podcast, but there's quite a lot of pre-prep I do as well to enhance the outcomes and the healing from that surgery. Because often surgery is one of the main solutions really isn't it but it's not a permanent one am I right in saying that too? You're so right because the surgery can improve the excision surgery, certainly improve fertility rate if you're struggling to conceive, and it can play a role in preserving fertility potential no matter what your age.

However, in some cases, particularly if it's an earlier stage of endo, the surgery may not actually be necessary and you may manage your symptoms naturally, reduce inflammation through diet, lifestyle and supplements. But there is unfortunately no guarantee that post-surgery your tissue won't grow back and that your pain will be reduced. So what do you recommend in terms of those factors, like lifestyle, diet? I know this is a big thing because obviously it's individual to people's own body and their own life and the symptoms they've got. But overall, what do you recommend? For endo in general?

For endo in general. Diet and lifestyle? Yeah. Yeah, yeah. So certainly from nutrition perspective, in consultations can get very, very specific. However, and this is because everybody is so uniquely different. However, as a general rule of thumb, anti-inflammatory nutrition is absolutely key.

And, you know, the Mediterranean diet has got the most research for anti-inflammatory nutrition. You can do a quick Google or, you know, if you have Mediterranean background, imagine what your grandpa and your grandpa, your grandma would be eating. So mostly plants, minimally refined foods, lots of whole foods. Anti-inflammatory eating can also involve things like, you know, if you typically have margarine at home, switching that for butter or for ghee. If you typically use processed seed oils like canola oil and things like that in the home, switching to extra virgin olive oil is an incredible swap for amazing anti-inflammatory effects. On endo, I will

often talk with people about gluten and dairy, not in every case, because this starts to get a little bit more complicated, you know, in the fabric of people's lives because they are often, you know, quite commonly consumed foods, two of the most common. So I tread gently there depending on people's ability to make nutrition changes, but also the severity of their symptoms. But one really cool swap is swapping A1 dairy protein to A2 dairy protein. So A1 dairy protein is sort of, I think, 80% to 90% of the Australian dairy industry. And that is, I can't remember the breed of cow that it is. It could be Friesian.

But the A2 dairy protein is from a different type of cow that's got some cute little humps on it. And it is in research. They haven't researched it directly against endometriosis, but they've researched it against inflammation in general. And it can be, in some people, hugely helpful to reduce inflammation is what they've seen in the research. But to also keep your bowels moving, which is a really big one in people with endometriosis, particularly before their period. A lot of people come to me with constipation for a week in the lead up to their period. A lot of people come to me with constipation for a week in the lead up to their period. And if you're constipated, often your pain levels then increase

and the experience of the pain during your period is far worse. So a little swap from A1 to A2 proteins can be great. So you can do that by just buying that A2 milk. Everybody would have seen it at Coles or Woolies. Yeah, you see it, right? But so many of us don't actually know what it is. It's just from a different breed of dairy cow. Yeah.

It contains that protein. Yeah. But what you can also do is sheep and goat are also A2 proteins. So if you love cheese, you can just, you know, switch your parmesan to pecorino, your mozzarella to buffalo mozzarella. That's a great swap. Enjoy, you know, delicious mozzarella. That's a great swap. Enjoy, you know, delicious Meredith's goat's feta. So you can still really drink milk and eat cheese.

You know, you can, I love this Meredith's sheep's yogurt I'm eating at the moment. So you can still consume those dairy-like products. It's not the hardest switch to make, but some people feel so incredibly better just from that switch. Wow. Is that the same with gluten? Yeah. So gluten is an interesting one. There's a lot of preliminary things I would do firstly to assess if gluten is a concern, and that is testing your gluten antibodies in the blood to see if there's an obvious immune response mounted against it. And in some cases, I will check your genetic potential for celiac disease. And that is because endometriosis isn't an autoimmune disease, but it almost qualifies as an autoimmune disease. So there can be a number of comorbid conditions in endometriosis, and a lot of those are autoimmune diseases.

And we know in the autoimmune diseases that gluten and autoimmunity aren't really friends. The main thing to consider is the protein component of gluten called gliadin can, the simple term is induced leaky gut, better known as intestinal hyperpermeability. So it can push those cells apart in our small intestine, meaning molecules, substances, toxins, and harmful things can enter into the bloodstream, cause an inflammatory reaction that should not be there. And we know that gliadin in gluten does do that. So really the aim of the game is reducing inflammation from as many sources as we possibly can. But sometimes that will be slow and steady depending on what people are able to commit to. And that can still be incredibly helpful.

Can you explain just very briefly what autoimmune disease actually is? Because I hear that around a lot and I think in my head, is it that we're just, our immune system doesn't work as well? I know that there are specific diseases, but could you give us just a snapshot of what that is? Yeah, absolutely. It's essentially where your own immune system produces antibodies, which are immune cells, that attack your own body cells. It's like a loss of tolerance. A body should know what its own cells are, right? It shouldn't be attacking them. But often due to genetic reasons, not always genetic, there's this loss of tolerance and confusion where the body starts to attack its own cells so in celiac disease this is probably quite a good example we've got these beautiful we call them microvilli which are these finger-like projections in our small intestine that are responsible for absorbing the nutrients from our food if everybody could see me right now

i'm moving my fingers i love it it's like fingers. That's what the microvilli are like. And in celiac disease, if you consume gluten, the body's own cells start to attack those microvilli in the small intestine. And what happens is they flatten. So now I've got a clenched fist, if everybody can picture that. So what it means is, you know, you're not able to absorb your nutrients, there's major malabsorption, all because the body induced an immune attack on itself that was triggered by gluten. Right. I was going to ask you about meat as well, because I know a friend of mine was recommended to not eat meat or avoid it as much as possible. Yeah, in endometriosis. Yeah, look, absolutely. And I think mostly plants in an endometriosis? Yeah, in endometriosis. Yeah. Look, absolutely. And I think mostly plants in an endometriosis type ideal diet is amazing because they offer so much, right, anti-inflammatory support and phytochemicals.

However, I personally am not fully for 100% plant-based in everybody. I think it depends on the person, particularly if you're consuming conventional red meat that isn't grass fed, that's grain fed. We absolutely know it can be pro-inflammatory. No questions there. Yeah. Right. Okay. So if you have endometriosis and you want to continue eating your meat wherever possible, if you can look for grass-fed as a first step is really great in reducing that pro-inflammatory status of the meat. Second would be free range. Third would be organic if you can. Just being conscious of that sourcing and what the animal has actually been fed because that will impact the quality of the meat and then its impact on inflammation. So we hear the term inflammation in the body a lot. What do you mean Freya? What do you mean? I know right so whenever we talk about inflammation, inflammation

is actually a cascade of events triggered by the immune system. Whenever you hear inflammation I want you to think immune activation. So inflammation is obviously highly beneficial and it is an absolute lifesaver. So you imagine if you're, what's a good example, you cut your finger off, okay? There is an inflammatory response that's going to take place to stop the bleeding. There's going to be clotting factors, immune cells to protect there from being infections in the blood and sepsis and things like that. However, in a state of chronic inflammation, that immune response can be detrimental to health in that it induces more harm than help, I guess, in a myriad of different ways. Inflammation, inflammatory responses were only

ever designed to be short term and quick, very much like our stress response. Right. And so am I right in saying that a lot of factors to do with inflammation are our diets now? And I'm curious, is that additional chemicals? Is that the way our food is grown? Is it stress related? Why do so many people present with higher levels of inflammation? My goodness. So this would be stress. It would be poor sleep. It would be alcohol.

It would be nutrition. It would be toxins. So many of the elements of our modern day lives contribute to inflammation. But from a specific endometriosis perspective what they're finding is a big driver of endo and they've we've actually got research in pregnant women who had a higher exposure to toxins particularly the endocrine disrupting chemicals there was a higher incidence of endometriosis in their female children. Right. So also toxins and BPA chemicals and phthalates have been coined the plague to fertility in the 21st century. Absolutely. There's a whole hidden piece there of toxins and

sprays and chemicals that can absolutely influence your inflammatory status, but more specifically, actually, that growth and pathogenesis of the endometrial tissue. The stress is ginormous. Like I just said, that cortisol acute fight or flight response is supposed to be short, swift and fast. It's not supposed to be chronic. When it's chronic, it becomes inflammatory and it impacts our immune system, chronic

stress. I guess I just want to touch on sleep and how very important deep sleep is particularly. So I don't know if anybody wears a wearable device or anything like that, but there's often lots of wearables that can determine how much deep sleep you have. And we're sort of aiming for up about two hours a night. Most people I see are achieving about 30. And that is the time actually where our immune system fully resets so if you think you've got a chronic inflammatory and immune

sort of driven condition you want your immune system to be functioning as best as it possibly can so just going right back to basics how are you sleeping are you getting enough deep sleep you don't necessarily need one of those fancy devices but you know are you sleeping? Are you getting enough deep sleep? You don't necessarily need one of those fancy devices, but are you getting eight hours sleep? Do you feel refreshed? How many times are you waking throughout the night? That's a big one, actually. It'd be a lot more difficult to achieve that deep sleep if you're waking at multiple times. You really need that prolonged sleep to be able to enter that state. But even things as minor, I guess, as that can play a huge, huge role. Because otherwise our immune system can't reset. You've got all of these things going on throughout the day. It needs to rest. It needs to rejuvenate. More white blood cells, more immune cells need to

be produced and ready to go for the next day. Poor sleep, particularly chronic, will have a huge impact on your immune system. You said a huge phrase before, and I feel like we could do a whole podcast on fertility. It was huge. You said, what was the phrase? A plague on our fertility in the 20th century or the 21st? We're in the 21st century. Maybe we can pin that idea for another podcast.

But in brief, do you mean that because of the toxins particularly in plastics around us yeah yeah right and that's causing an increase plastics but also yeah it's causing an increase in endometriosis particularly the endocrine disrupting chemicals so i guess the name's a little bit of a giveaway there endocrine system, you know, is our hormone system, I guess. So what can happen is more specifically from terminology perspective, we have xenoestrogens in the endocrine disrupting chemicals. We know that endometriosis is an estrogen driven condition. So when we're having exposure to these xenoestrogens through these chemicals and plastics and things

like that, the xenoestrogen tricks the body into thinking it is an estrogen. And for many reasons that can impact the severity, the presentation of the endo, the triggering of it, the development and things like that. So even if you're not pregnant yet and you don't have endometriosis, what a great thing you could do by start cleaning up your toxic load for when you do conceive. If that's a goal of yours and you do have a female, you can play a big role in reducing their potential to endo just by being considerate about your exposure to toxins. And so what do you mean by that? Removing plastics from the home? God, that's a big thing. Yeah, I mean, I know it's huge. So the first thing I say, first and foremost,

is do you drink out of a plastic water bottle? Change it immediately. You know, that's a biggie. Secondly, and perhaps even more important, is please don't heat your food in plastic. Please, because unfortunately, and it kind of kills me to say it, but the leaching of the chemicals used to make the plastic do will absolutely do leach into the food, which is really scary.

Even freezing, because it's changing the chemical, it changes the chemical makeup of the plastic. The plastic is supposed to stay stable at that, you know, basic temperature. And when we go above or beyond that, it changes the structure of the plastic and therefore its ability to leach the chemicals. So even freezing in plastic will have a similar effect. The heating is worse, but the freezing is still impactful.

That's probably like the biggest thing that people could make in terms of beneficial change for plastics. Switch your water bottle and please don't heat. And then if you can take it one step further, try not to freeze I mean the great thing is there's so many good options out there now it's but I guess I mean yeah I don't want to freak people out too much but you know if you're a nerd like me even looking at

your jug your kettle you know I've thought of somebody brought this up with me a few years ago like the lid of the kettle is plastic often um and you're raising the temperature all the time and if you drink 60 million cups of tea like i do that that's changing the stability of the plastic and then yeah this is a leaching of the chemicals into the water so it's really hard to avoid it right but there are really um straightforward practical things you can do like you can change your water bottle I've got old you know milk jars and stuff like that from glass I'm sure you've got a glass bottle lying around totally or a stainless bottle you know yeah completely and it did it does strike me that

I don't use plastic but my kids do I've just got into the habit because I grew up with kids having plastic so I just and I actually don't know why because I don't throw their bowls on the floor but I just have this idea in my head that the kids have to drink out of plastic cups and plastic eat out of plastic totally it's common it's the common knowledge everybody yeah just kind of a done thing isn't it easy light won't break yeah exactly so that's something I'm gonna and you can absolutely change right that notion oh god there's so much Freya we're dealing with so much aren't we we're dealing with a lot we're dealing with a lot our environment there's even research that was conducted on people's immune response from so they had somebody go and stand on the corner of a road a really busy road

without a mask on they checked their immune cells before they went out to the corner of the road and then they checked their immune cells after and the immune cells the behavior in the immune cells was so completely astonishingly different after standing there and crossing that road just from the fumes of the cars. I mean, and just what's in the air that we breathe. So maintaining, and this is something I talk about, you know, with my sort of endometriosis patients who I'm working with more long-term when we have the time to really get into these essential factors of health is supporting your detoxification pathways, whether, you know, know sure not everybody has enough money to

have one of those great infrared saunas as much as we all want one at home they are really good but so is the sauna at your gym the regular sauna but even better costs nothing is getting yourself from an exercise perspective up to a point of sweat that's slightly profuse, is enough to rid yourself of many stored chemicals and toxins because those toxins are actually stored in our fatty tissue. So I don't know if anybody's ever experienced this when they've tried to lose or they've lost weight quite rapidly. It can make people actually feel really rubbish because you are liberating a lot of stored chemicals, often from exposure

from your whole life, in that fat that has then become liberated in the bloodstream. People might lose weight and then they have psoriasis or eczema or hives, these skin conditions or fatigue, just feeling generally rubbish. So the more we can support our detox pathways on a day-to-day level, the better, basically, because they do get stored. They get stored and they'll get stored there forever, unless you are sweating and looking after your detoxification system. It strikes me that a lot of this stuff is things that our grandparents and even our parents did when they were growing up. And it's in such a short time that our culture and society has changed so much.

And so we've developed other habits and other ways of parenting and other ways of being in the world. And so as you have taught me, just from everything we've talked about, endometriosis aside, general health, it's so much about looking at all of it, isn't it? Our lifestyle choices, our sleep, our stress levels, the way our lives run, and really seriously thinking about whether we can make any changes. 100%. And that's why actually, Claire, I developed the endometriosis course, essentials course, which hasn't launched yet. It was supposed to launch, but it became so much bigger than I thought.

I called it endometriosis essentials and I was like, holy heck, this is more than the essentials. So that's not coming out until Feb. But the whole reason I wanted to do this and call it endometriosis essentials is because there is so much that you can do in your lifestyle and diet and stress and sleep that is going to positively impact your experience of this condition. There is no question about it. It's really powerful stuff that, you know, in consults with me, we often don't actually have the time. I mean, some people who can afford and see me long term, yeah, but there's just so much. That's why I've developed the course so people can have content to go back to refer to for as long as they possibly need, you know,

one whole modules on detoxification and toxins. Yeah. Yeah. So there's lots of things you can do, amazing things that don't cost really much at all. And I think that's a really important piece of this. I know your Instagram has lots of wonderful stories and things on there too about endometriosis specifically, but there's lots of hope and lots of solutions, I think. Oh, absolutely. And even more than there were. So let's look quickly at herbs for endometriosis and belly pain. Let's talk about that. Yes. Oh, my favorite is called berberine. It is a mainstay in most people I see with endometriosis. Probably not the herb that I would encourage listeners just to go out and buy and treat with themselves. Just because there's a few things to be considerate of,

it's completely contraindicated in pregnancy, can impact your blood sugar significantly. So if you already have low blood sugar, you know, it could induce dizziness and things like that. So best for this one to be done under the care of a practitioner. But berberine is so unbelievably amazing and one of its primary roles, it has many, but there is a hypothesis that the generation of that endometrial tissue growth can be promoted by something called an LPS toxin. This is getting a bit nerdy, but basically it's a toxin produced by bacteria in the gut that travels through potentially leaky gut intestinal hyperpermeability into the peritoneal cavity and the peritoneal fluid then it travels through that fluid induces inflammation and that growth of the endometriotic lesion so that was a mouthful right what the berberine does

what the berberine does is it gets rid of those nasty they're called gram negative bacteria that produce that toxin first and foremost so it is working on an inflammatory level by reducing that toxin. But what that bacteria can also do and be associated with is something called SIBO, which is small intestine bacterial overgrowth. We could do a whole podcast on that. But just in essence, the symptoms are chronic bloating, often alternating bowels, nutrient deficiency, burping and things like that. So the berberine will work to knock out the nasty toxin producer. It'll help to reduce your bloating, but it also works to zip up those leaky cells, that leaky gut or intestinal hyperpermeability.

It also works very well on blood sugar. So something I've spoken about on my socials is, I haven't done research on this, but clinically I see it a lot, is endometriosis and insulin resistance and blood sugar, high blood sugar. And the berberine is amazing at lowering that blood sugar too. So it just hits all of these different points, which is the beauty of herbal medicine, Claire. It's just so amazing. I always have people coming to me. I'll put them on specific herb and they'll come back and they will report all of these other symptom improvements. That's the beauty of herbs. They have so many different indications and often very little side effects. And that's what makes them so exciting, I guess,

for me, is they can really be working on other systems of the body as well. They're such a great investment for your health. So berberine number one. Next one's super simple and everyone can get this one, peppermint, or particularly for endobelly. So there's even research on peppermint specific to endometriosis and also IBS and reducing bloating. It works as a calminative, reducing gas, reducing flatulence. You can get peppermint oil, but also strong peppermint tea. So when we're talking about really having a therapeutic influence from herbal medicines at home, if you just throw, you know, your tea bag in the cup and you take the tea bag out, which I think is madness, I'm a strong tea drinker, you leave the tea bag in, maybe add two or three of those tea bags, you leave the teabag in, maybe add two or three of those teabags. You want the flavour to

be at a point where it's, you know, slightly on the edge of, oh, is this delicious or a little bit too strong? You really want that slightly too strong flavour there so that you know you've gotten all the goodness and actives out of the peppermint before you drink it. This is when we really enter that therapeutic territory with herbal medicines at home. Because the reality is if you're just throwing your teabag in for a few seconds, squeezing it and throwing it out, it's probably not really going to do what you want and you're going to think that Freya's telling fibs,

peppermint has not helped. You need to have quite a lot of it to have an impact. But peppermint is awesome, particularly as well post-laproscopy. Essentially in the laproscopy, they pump you with a lot of it to have an impact, but peppermint is awesome, particularly as well post-laproscopy. Essentially in the laproscopy they pump you with a lot of gas to pop out the abdomen, I guess, so that they can get in to those organs and see properly. The most common complaint I see from people post-laproscopy is quite chronic constipation and bloating.

So that peppermint tea, strong, strong, strong, strong peppermint tea is a lifesaver for people experiencing those symptoms post laparoscopy as well. And then there's ginger. Ginger is my other favourite. So much research on ginger as an anti-inflammatory. There's so much research on ginger, not on endo, but on period pain, which the medical term is dysmenorrhea so some people you know particularly if they're needing something more budget friendly could go and buy the blackmore's travel sickness ginger tablet really simple i think they're about eight dollars or something like that and you could take two or three of those during your pain or just before your pain window and it can be incredibly

helpful for your period pain which is super cool or up, get your fresh ginger and smash it up in a mortar and pestle, boil it, make a really concentrated drink and sip on that during your period. It can be beautiful. It also works on motility, so helping the intestinal contents of food move through the gut more swiftly to reduce bloating and just keep everything moving. They're my favorite. Amazing. I saw a really interesting post you did about pain medication

for endometriosis. Yeah. And there's a pain window you mentioned. Could you talk to us about that? Absolutely. So the most common medications you'll be prescribed from a GP or just know that you'll get yourself for your period pain will be a non-steroidal anti-inflammatory drug. And the way that these drugs work is they work to reduce the presence of inflammatory prostaglandins, which are the immune cells that are responsible for inducing pain. So they work very well. However, to get more out of your pain medication, if that's what you're taking for your pain, you must take it 24 hours before the pain window begins.

So it really is working to lower those inflammatory prostaglandins and keep them at bay before they have risen. So a lot of people will take these types of drugs and they are not helpful. And that's when they're getting more creative with their pain meds and adding in much stronger alternative options and really layering their pharmaceuticals up which in some cases is necessary but not always so if you're somebody that experiences you know marked monthly pain try taking your non-steroidal anti-inflammatories which are typically your norepinephrine and ibuprofen in Australia, 24 hours before the pain window. Also, please make sure you have it with food because it can dramatically

irritate your stomach lining and lead to things like gastritis, microbial imbalances and poor gut health. And that's the last thing you want when you've already got into the triosis. That's such helpful advice, just changing the timing of when you take it. I also did a really great live with an amazing, beautiful acupuncturist called Naomi Jankowski as well. And she is a specialist in pelvic pain. And definitely acupuncture is something I encourage you to seek out for pain management

because the impacts of acupuncture are cumulative. So the more you do, the better long-term results you'll get. So you don't just have to have acupuncture every month. And then when you don't go, you won't experience symptom improvement. You will. It's sort of longer lasting, which is amazing. But we spoke a lot about the timing actually of your interventions for pain. They're so commonly not spoken about. Even things like the timing of your pelvic physio or the timing of your acupuncture, doing it right before a pain window is so much better than in a pain window because we have more influence of impacting those pain signals actually right before they develop than once they are already active. So something important to think about,

I guess not all acupuncturists, you know, I think Naomi's pretty amazing, but just speak to, if you're getting acupuncture or pelvic physios or any osteo or treatments like that, try to think about doing it before your pain window, because I'm sure you'll get actually more bang for your buck with that timing. Yeah. Absolutely. At the end of this painful period, if you have incredibly painful periods and heavy periods, either from endometriosis or maybe other factors, how would you care for someone? How could they care for themselves to kind of recover from something like that? So in the laparoscopy, that is sort of still considered that gold standard for diagnosing endometriosis. And that's because it can detect the stages one and two, not just the three and four of

the tissue growth. However, as we do know, it is very costly, often very costly. You really need to see a very skilled surgeon for that. And the outcomes post-laparoscopy are not always less pain relief. I just want to preface that. So there's a lot of prep that we can do pre and post-laparoscopy to help to improve your outcomes. But more specifically from a pain perspective, a lot of people do sadly experience more pain post laparoscopy. And we don't know exactly why, but one reason that, you know, I feel pretty comfortable sharing is through any surgery that you have, there's going to be scar tissue that's developed.

Any surgery, any cutting of tissue, there's scar tissue that generates to heal that tissue, right? So in endometriosis, the same thing happens. Scar scar tissue and adhesions which are just part of an inflammatory kind of healing process I guess so what how that can impact somebody's pain post-laparoscopy I explain the pain of adhesions is like if you get a rubber band and you pull it tight and say you connect that between your bowel and your ovary and you move your bowel and you've got this tightly pulled rubber band there already and the bowel moves slightly and it pulls it a little bit more. It's like this sharp sort of stretching feeling

and it's really quite painful. And that is one symptom quite commonly associated with adhesion type pain. The adhesion like sticks itself to things it's kind of like a wet spider web and it becomes quite tight so if you move or if you do high intensity exercise or something like that some people get a huge pain flare because it's stretching those adhesions the reason i'm banging on about this is you can there are things that you can do and strategies you can do to reduce inflammation and reduce that adhesion formation and just I mean I use some quite

sophisticated enzymes and things like that to reduce adhesions but even outside of that if you can adopt a really beautiful nourishing anti-inflammatory diet even for that fortnight post-liposcopy it is going to help you because it's the inflammatory process that induces the adhesion formation. And it's the adhesion formation that can be one of those reasons as to why your pain can be sometimes a little bit worse after the laparoscopy or different. It can be nerve-related things as well, but all of those things we spoke about regarding reducing inflammation can be incredible. From a nutrition perspective, vitamin C is totally essential for tissue healing. So just say you had stage four endometriosis and it was all through that peritoneal cavity,

you've had so much tissue cut off. That tissue has to heal and remodel and you know re-establish normal functioning it's really you know it's a big operation to have so vitamin c as simple as it is is vital for tissue remodeling so you can just get some simple vitamin c ascorbic acid from the chemist but also boost your vitamin c rich foods so kiwi fruit citrus and broccoli are my favourite. Antioxidants are amazing for inflammation. People will love this. Dark chocolate plus 80% is fantastic. Full of polyphenols, blueberries, green tea is ideal. If you're a coffee drinker, you know, you might consider switching to green tea.

What else? Water, post-laparoscopy is extremely important. A lot of people don't really feel like drinking water but that's for a detoxification mechanism it's actually to get rid of all of the anesthetic and nasties and things that they have prescribed for the procedure so hydration is a very simple one but you want to keep those organs of elimination working really well so making sure you're going to the bathroom enough and drinking enough water super important the other thing post-soproscopy that's the big one I touched on this before but a lot of people report really chronic constipation if you imagine constipation after you've just had really significant surgery yeah in the abdominal area

that not go so well with pain at all. I mean, obviously, just that difficulty passing and that pressure is going to induce pain. So it can be more painful than the actual host operative pain itself, just the constipation. So maybe getting some strain-specific probiotics that really help with motility. I'll share this with you. It's mouthful, but it's lactobacillus plantarum 299V. You can get it from Chemist Warehouse. It's excellent at keeping your bowels moving. You can take that, you know, directly after surgery.

But cool things like having chia puddings for breakfast are incredible to keep the bowels moving. Dried fig before bed is an amazing soluble fibre. And just generally eating warming and easy to digest food. So traditional Chinese medicine are all about foods that support circulation in endometriosis. They believe, and I do too, that it is a very stagnant condition. So anything we can do to keep that blood flow traveling to the reproductive area or wherever that tissue healing needs to be the better because we need to get nutrients to that site to heal it so if you

have poor circulation like i do and lots of people things like acupuncture are amazing for you you've got poor circulation and you have endo it very likely means that there can be some restriction of delivery of blood and nutrients and oxygen to the areas that really need it. But even application of heat is fantastic for circulation. Gosh, I could talk about the whole circulatory system in relation to endo for ages, but I think they're sort of my main things post-laproscopy that I would recommend. Yeah. Strikes me that they would be good recommendations

for post-caesarean too. Yes. Oh, absolutely. It would actually be the same. Yeah. Yeah, I was thinking about that. Exactly the same. Yeah.

Yeah. Just because it is, it's endocrinal surgery. So, yeah, for sure. And I don't think we ever, I ever, because I had a caesarean, there was nothing about that really. Isn't it amazing, the post-healing journey? And actually one thing I forgot there, Claire, most of my patients are sort of aware of how passionate I am about protein, but protein is totally essential for tissue healing.

So, you know, if you're living off vegetable soups with no legumes or protein post-laparoscopy, that's great, but you've got no protein coming in whatsoever. And our cells are made of protein. So in order to facilitate the healing journey, you want to boost your protein. Even a couple of scoops of collagen in your cup of tea, if you can't manage eating meat or anything like that, can still be hugely helpful for that tissue remodeling. Right. This has just been so beneficial and granular, which I think has just been incredible because that's what I love about your approach. It's so detailed and it really then can actually have an impact and really make a massive difference. I hope so. I really hope so.

Yeah. I wanted to just ask you, this is a funny question and probably a bit more personal. Is there a reason why you're so passionate about endometriosis? I think, you know, I actually suspect that I probably have it, but I manage, you know, I experienced debilitating periods for most of my life, as did my mother. She has fibroids. My sister did too. They've never had it investigated, but we have a genetically quite high estrogen state in our family, all very painful periods, very estrogen-driven conditions like fibroids and things like that in the heavy period. So I've been through it myself.

I mean, I'm not at the point where I can confidently say that it's there, but I have to say most people in clinic, I'm surprised if they don't have it. Genuinely, I'm surprised if somebody doesn't have it. It is so common. I have to say most of my patients that see me, even if it's not related to period pain, whether it's fertility or whether it's PMS or PMS migraines or something to do with the hormonal picture. And we do the investigation. I'm seeing it multiple times a day, multiple, multiple, multiple times a day. So I think it's a personal experience, a family experience. You know, certainly for me, it was always I've seen multiple doctors and it was always be go on the pill or take a pain medication. It didn't ever really have that proper care.

And I guess from a family perspective as well, it wasn't sort of something that was really encouraged to go and get investigated because it was kind of normal for the family. We all sort of felt like that. But I guess at the same time, my symptoms are very manageable, just to have a little suspicion there. But I guess also the same time, my symptoms are very manageable. Just have a little suspicion there. But I guess also as to why I'm so passionate, it's not just about my own journey

by any means, is there are so many people out there who are not getting answers or the healthcare that they really need to manage this condition. Because as everybody would have noticed throughout our conversation, it is so complex. It's so multifactorial, but there are so many things that we can do to improve our experience of it that are just not being, this education isn't being shared and it's not available if you don't know where to find it. So where would you send someone next? We've said the GP. Where would you send someone other than there if they suspect? Yeah, the GP is the best bet because the GP can where would you send someone other than there if they suspect? Yeah, the GP is the best bet because the GP can give you the referral to the gynecologist and

things like that. However, if you prefer more of a holistic approach, I mean, you know, I'm not here to promote naturopaths or anything, but I guess we do come at it with more of a holistic lens and a lot of people that I see in clinic have already been to a GP and haven't had a good experience so I don't necessarily just want to say everybody go to the GP but I think at the very least if you can afford to see a naturopath who's specialised in this area that would be amazing they can guide you throughout the whole journey however at the very least if you could go to the GP, but just go do your research in terms of finding somebody who potentially has experience in reproductive health.

There's lots of really good Facebook groups. I suggest people join that are free and they have amazing resources. There's like Endo Sisters Melbourne. Just Google, you know, Facebook groups endometriosis and this is people with endo sharing their direct story, sharing the surgeons they've seen, the GPs they've seen. It's such an incredible resource and can provide a lot of relief that people have a lot of questions with a new diagnosis that can't afford to go and see a naturopath or are not able for whatever reason.

So those Facebook groups are actually awesome. I would suggest doing that, but I would say go to the GP in a really informed, so write down when you experience the pain, have a think about if there's any family members with pain that you can share with them, tell them what you have tried before and go in with confidence about what you're hoping to achieve. You're looking to get a referral from a specialised gynaecologist who has experience in excision and endometriosis and you're looking for a specialist women's ultrasound referral i think yeah just that that piece of going in with the confidence of knowing what you want is important too yeah and i definitely recommend people checking out what you're releasing in February too.

The Essentials. Endometriosis Essentials. You know what else there is? I completely forgot. Goodness, I'm not very good at promoting myself, but there's a free. I didn't think you need to. I think your skill speaks for itself, to be honest. Oh, you're so kind.

But I do have a free resource and this is actually great for anybody who has period pain or endo belly, or, you know, they're not getting the results they want for their endometriosis with their typical conventional treatment. There is a free resource you can get off my website and it tells you my top three blood tests to go and request from the GP, some dietary changes. Some of them were spoken about today, some herbal medicines and some more emotional strategies to start managing your pain. And that's totally free. And that can be a good place to start if you have endo or you suspect you do.

And you just want to, you know, you need somewhere to start in terms of getting on top of your experience of the condition. Thank you so much, Freya. Oh, this has been absolutely so valuable. And I'm hopeful that it gets to the people that need to hear it as well. I really hope so. Yeah, I think so.

And thank you for, again, for all the work that you're doing. It's wonderful and you're such an incredible resource and a great communicator. So thank you so much for coming on Tons again. Thanks for spreading the word and for your amazing platform, Claire. Thank you. You are welcome. You've been listening to a podcast with me, Claire Tonte, and this week with the wonderful Freya Lawler.

For more from Freya, you can visit her Instagram account or head to her website, and all that information is in the show notes. As always, thank you to Royal Collings for editing this week's episode and to Maisie for running our social media. If you have any questions, you can contact the show at tauntspod at gmail.com. And I have another podcast that comes out every Thursday with my husband, man, James Clement, where we recommend you things to watch, read and listen to called Suggestible. That comes out every Thursday. So that's a fun deep dive and a bit of an argument sometimes

about the things that we're watching and reading. So if you want something for Netflix to watch when you sit down after the kids go to bed, that one is for you. And I also have a live show coming up if you are in Melbourne on the 12th of February, 3pm at the Wesleyan. I'm launching an album of music called Contrescence. It's about love and desire and identity and what happens when we become mothers. And it's 11 songs and I'm so

proud of it. I can't wait to share it. It'll all be available for digital release after that date. I'll be releasing a couple of singles over the next few months. So keep an eye out there on my Instagram at Claire's20 for all the details and I'll let you know here as well. But that's it there. So if you haven't, grab a ticket. They're almost sold out now. So I would really encourage you if you'd like to be there on the 12th

to grab one at the link below. All right, that's it from me. Take care. Talk to you soon. Bye.