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00:00In this episode we're talking endometriosis. It's a condition that affects one in ten women
00:04and yet it still takes an average of eight years to get a diagnosis.
00:09Joining me today is GP, TV doctor and endo advocate, Dr. Raj Arora.
00:14You shouldn't have to live with debilitating symptoms, with heavy periods, with not being able to get up and live
00:20your life, your best life,
00:21because you have complications of a condition that should have been picked up way before.
00:25Dr. Raj has dedicated her career to women's health and in this episode we'll get into the reality of the
00:31condition
00:31and explain why women's pain is so often ignored.
00:34Women's hormone cycles and the variability of hormones and our cycles is not something that we need to exclude from
00:41research.
00:42It's something that we very much need to include so we understand women better.
00:45The conversation is finally changing and we're starting to pull back the curtain on what it's really like to live
00:50with a chronic condition.
00:52Dr. Raj Arora, GP, women's health expert and I think it's fair to say endometriosis activist and educator.
01:00Welcome to Well Enough.
01:01Thank you Emily, thank you for having me. I'm really excited for this episode.
01:04Me too because women's health has been something that I have obviously been reporting on for a very long time
01:09now.
01:09But endometriosis, this is a subject that continues to confound people, even confuses doctors.
01:17Can we maybe start by explaining what it is for anyone that doesn't understand?
01:21Yeah, so endometriosis historically has been understood as a gynecological condition and it's essentially where cells that are similar,
01:29it's not the same, but similar to the lining of your uterus grow outside of your uterus.
01:34Okay, so these are the cells that normally, you call the endometrium, these are the cells that normally,
01:39of the tissue that normally, you know, thickens when it's time for your period and then bleeds.
01:43So now you can imagine that these similar cells outside of the uterus are behaving in a similar way.
01:49So they can typically be on your ovaries, blooping tubes, on the lining of the pelvis and that's typically where
01:56they are.
01:56But they can also grow on other organs.
01:59They can actually grow on your bladder, your bowels, even nerves for example, the limbs and they may even grow
02:04on your lungs.
02:05So actually, although historically the condition has been seen as a gynecological condition, it is quite complex.
02:11And now we are starting to see it more as a whole systemic condition, which for me is exactly where
02:16it should be placed, you know,
02:17because as these cells then react and they behave similar to this endometrium, similar to the lining of the womb,
02:24and they thicken and they bleed and they inflame, if you think about that inflammation, it then leads to sort
02:30of scarring and adhesions forming
02:33and can really leave that patient and that individual in pain, not just during menstruation, during the period, but also
02:39outside the period.
02:41And given that it can spread, you know, to areas that are not just confined to your reproductive organs,
02:47your uterus, your womb and your ovaries, it can then lead you to have not just pain,
02:52but debilitation in other areas of the body.
02:54So therefore, a whole body chronic systemic condition and it shouldn't be taken lightly or, you know,
02:59described as anything other than that because that's exactly what it is.
03:02Gosh, and this consistent pain, I mean, the thing that shocks me the most is that I read this stat
03:09all the time
03:09because it's in every single article about endometriosis and that is that it takes between 7 and 10 years to
03:14get a diagnosis.
03:15So the level of chronic pain that you're talking about, for it to take that long to actually understand what's
03:20going on with you,
03:21I mean, to me, that is absolutely wild.
03:24I agree. I think, you know, 8 years, 10 months or like 8 to 9 years is like the average
03:28diagnosis,
03:30that time to diagnosis, which to me, you know, like it baffles me.
03:34It's bizarre that it takes that long when the symptoms are so clearly, you know, extreme for most women.
03:39Why does it take that long?
03:41And I think that's the question.
03:42I think when we look at how historically women's health has been managed or, you know,
03:48how we look at women's health, we're seeing more and more of these conversations around the gender pain gap,
03:53around, you know, how we've got medical misogyny or how we're not actually listening to women when they come with
03:58this pain
03:58and we almost disregard their pain and think that it's being, you know, overinflated or it's, you know,
04:03it's psychological when actually we just need to listen to women, you know, our bodies, we understand them.
04:09And the kind of pain we're talking about or the kind of symptoms, because it's not just pain.
04:12You might have really heavy periods.
04:14You might have, you know, bowel symptoms, depending on where the endometriosis is.
04:19You might have, for example, bladder symptoms.
04:21Like I said, you might have lung symptoms.
04:22So these symptoms of pain of, you know, heavy periods or even pain outside of your menstrual cycle
04:29and your menstrual period can be debilitating because they can make sure that you are not able to get on
04:35with your daily activities.
04:36You may not be able to go to work, school, you know, and it impacts your life in a way
04:41that your quality is reduced
04:43and your potential is reduced.
04:45And that's really important for women who almost have a nine, eight to nine year diagnosis on average.
04:50Think about the young lady who's at school or a teenager.
04:53And then that's nine to ten years of her life, potentially, of her not being able to live a life
04:59of good quality
04:59or, you know, maybe even have children if she wants to have children because it can affect your fertility.
05:06Good sexual relations because it can affect, you know, it can be quite painful to have sex sometimes
05:10or even your potential in terms of your career pathway because you might be held back
05:14because every month you're having these period pains or even outside of your period pains
05:17or complications from endometriosis.
05:19Actually, there's a lot to think about and we need to think more about how we take women's health more
05:24seriously,
05:24not just as public, but also how do we equip our doctors to understand more about women's health, you know,
05:31and these conditions which historically we have not focused on enough when it comes to educating and raising awareness.
05:36So there's a very complex, I think, nuance around why it takes that long, not just for endometriosis,
05:41for a lot of women's health conditions to get the spotlight it needs and to take patients seriously.
05:47So, yeah, we're making headway in some ways, but sometimes it feels like you do come against a brick wall
05:54and it can be quite disheartening.
05:56Yeah, absolutely.
05:57I mean, as you say, it's nuanced and it's this kind of sprawling issue, isn't it?
06:01I wonder if you're comfortable, if we can talk about some of your personal experiences as well,
06:06because I remember reading that you took 11 years to get a diagnosis.
06:10I mean, that's even longer than the average.
06:12That must have been an incredibly difficult experience.
06:15Yeah, and I think there's lots of reasons, I think, when I look back at why.
06:18So from when I started my periods as a young girl, they were always really painful.
06:23And the thing I say to my patients is, if your periods are painful in the sense that they are
06:29so uncomfortable
06:30that you can't get on with your normal day-to-day life, that's not normal.
06:34I spend a lot of my time on social media and in my videos, you know, sharing that information really
06:38clearly.
06:39And it's always alarming to me how many women write back saying, I didn't know this, or I can't get
06:43out of bed.
06:43So that was me.
06:44So every period, and just before my period, I'd be in bed with extreme pain, really heavy periods.
06:51And coming from a South Asian background where, you know, there's lots of cultural barriers,
06:55we don't really talk about, you know, intimate health in certain ways, and certainly don't talk about periods.
07:00There was, you know, it was kind of dismissed quite a bit.
07:02So my parents, my mum or my grandma would just say, oh, it's normal, you know, just put up with
07:06it kind of thing.
07:07And that was just the cultural way that it was.
07:09And I think for me, as an Indian girl, an Indian young girl, I thought that was exactly what I
07:13had to do,
07:14just put up with it and just, you know, keep going.
07:16And so I spent the most part of my life thinking, what's wrong with me?
07:18Why can't I just get on with school or, you know, get on with my exams, whatever it was, that
07:22was when my period would come.
07:24Or even when I got to junior doctor, and I remember I was a junior doctor, resident doctor, as we
07:30say now, doing surgical placements.
07:33So you have to be in theatre really early, like 6am, 7am, and I remember just, if I'd started my
07:38period, feeling like I was going to pass out, you know, feeling like I was going to be sick.
07:43And I think even I'd get into theatre and scrub up with my seniors, and I would almost feel like,
07:49how am I going to get through this surgery, you know,
07:50and I'd be trying to help whilst feeling really sweaty, whilst having really extreme pain cramps.
07:54And even if I was taking pain relief, it just wouldn't touch it.
07:56So for me, the symptoms were, like, really painful periods, really heavy periods, even outside my period, always had, like,
08:03bowel symptoms as well.
08:05And I think the only time that I really came to understand that something's not right, really, was when I
08:09was trying for a baby.
08:11So I met my partner, and we then decided, okay, we're ready to try, and, you know, it was a
08:16bit of a struggle.
08:17And then I remember thinking, right, we should get things checked out, we should get tested.
08:20Everything was actually fine, and I'm actually really lucky, because I had my children fine, and there was no issues.
08:26But when I went to have some investigations done, the consultant found endometrioma, which is a typical, we call it
08:31chocolate cyst that can occur,
08:33and also found that my left ovary was stuck down a little bit.
08:36So there was all this conversation around, okay, there's some signs of endometriosis here, and that's kind of how it
08:41started.
08:41So it was actually an incidental finding for me, and that incidental finding made me seek the help I needed,
08:47which then meant that I was prepared.
08:49So when I had my first baby, I was told, like, look, when you have a period, this scarring reoccurs.
08:54You then have more chance of adhesions, and therefore this may lead to issues with fertility.
08:59So if you want a second child, think about treatment in between.
09:02So I then started, you know, I went on to the pill at the time, which helped control my periods,
09:06the flow of my periods, how painful they were,
09:09and reduced also how long my periods were, so hopefully reducing that inflammation over time.
09:16So that's how I found out.
09:17Gosh, it's really interesting that you say that your mum said, oh, it's normal,
09:21because we don't really have a benchmark for understanding what is normal, do we?
09:26Normal looks different to different people, and I want to talk later about the difference between endometriosis and a painful
09:32period,
09:33because that can be really, really difficult to understand, but also a bit more about why women's pain isn't taken
09:38seriously.
09:38You mentioned things like the gender pain gap and medical misogyny.
09:43Why is it that women are kind of expected to just get on with it and be in pain?
09:46Because as a women's health writer, I've never really understood how we can advocate better for women in these scenarios.
09:53It's really maddening to me.
09:56There's lots of different reasons why, but I think, for example, like I mentioned, the cultural barriers, the social stigma,
10:02that's one thing.
10:03So I think, for me, I remember when I talked about the endometriosis on this morning,
10:09my mum actually called me up, and she was like, oh, my God, I didn't know.
10:12Like, you know, you never really mentioned it.
10:14And I just said, look, it wasn't something that we spoke about in a South Asian family,
10:18and it was just the nuance was there that we don't talk about periods openly.
10:22Obviously, with my mum, I would.
10:23My sisters, I would.
10:23But, you know, you wouldn't really take it to the point of something's wrong.
10:27It was just understood that that's normal, and that's, we put up with it, periods can be painful, you know.
10:32But the question mark of when is it painful period, when is it endometriosis,
10:35that's something that I've learned to advocate for and to talk openly about more
10:39so that young girls out there going through their periods can understand what is normal and what is not,
10:44because that's really important to understand, firstly.
10:46Secondly, I think there's things like when we look at how we, what the research has been in the past,
10:52historically, most medical research has been done on men, you know.
10:55So that's been the physiological standards that we look at when we look at any research papers
11:00or any research that's been carried out.
11:01But what we've understood is that women, women's physiology, women's hormone cycles,
11:07and the variability of hormones and our cycles is not, is complex,
11:13but it's not something that we need to exclude from research.
11:15It's something that we very much need to include so we understand women better.
11:19And I think, historically, women have been removed from that.
11:22It's been, you know, very much based on men, what the research is,
11:24but it doesn't actually then, you know, translate into the public and into the population.
11:30So, therefore, everything we know, most things we know from research,
11:33are based on the wrong physiology.
11:35And so when the pain comes about, it's like, well, why is your pain different?
11:39But everybody experiences pain differently.
11:41Everyone's, you know, tolerance of pain is different.
11:43And depending on what conditions they've gone through,
11:45whether they're chronic, acute, underlying morbidities,
11:47anything that's going on can impact that.
11:49So I think really understanding that pain is an individual in experience, first of all,
11:53is really important.
11:54And putting more awareness to that, trying to break down those social stigmas,
11:58those cultural barriers, pushing for more research,
12:01which is based on women so that we can actually reflect
12:03and represent the right populations,
12:06not just in the sense of it, you know, genders,
12:10but also in the sense of ethnic minority backgrounds as well.
12:13So, you know, differences from where we're from
12:15and how does that impact our pain or how does that impact our experience of conditions?
12:19Really important to think about all those things,
12:20which I think have not been historically thought about.
12:22And also awareness of public health campaigns.
12:26You know, growing up, I don't think I saw any public health campaigns
12:29that talked about cervical cancer or breast cancer or, you know, women's health issues.
12:33That's all kind of come about in the last decade.
12:35It's the reason I became a women's health journalist.
12:37My own experiences with cervical cancer completely changed my outlook.
12:41And I thought, where's the information?
12:43I had to write it myself.
12:44And that was, you know, it's why we're sitting here having this conversation.
12:47Because I do think that, yes, we've seen changes,
12:51but we've still got a long way to go.
12:53Long way to go.
12:54And then we have to think about schools, obviously, and then families.
12:57So, you know, if somebody had said to my parents or my mum, for example,
13:02this is not normal, if I'd been told to them,
13:04if I'd been shared something at school about this
13:06or we'd be more informed about it, I think I would have questioned it, you know.
13:09I wasn't really ever the kind of child or adult, to be honest.
13:12It just goes with the grain.
13:13Always a bit of a rebel.
13:14So I think I would have pushed for it, you know.
13:16But I think growing up, that wasn't there.
13:20So I think being what you can't see is important.
13:22And I think being that South Asian woman that now has a media platform
13:26and is able to share health information openly
13:28and talk about things that may basically, might have cultural barriers,
13:32might then encourage other women from the same background
13:35and even from not the same background, just women.
13:37Because we come together and we all experience the same things
13:39to hopefully share that information.
13:42And there's that whole, you know, conversation around,
13:45if you tell one woman, you tell a village.
13:47And I think that's really important for me,
13:48that if we have a platform like you do,
13:50and they use it really well to share that information,
13:52to put people on a pedestal where they can talk about these things,
13:56really important.
13:57Because if you have a voice, we can have change.
13:59Absolutely.
13:59I couldn't agree more.
14:00And thank you.
14:01I think, you know, the importance of advocacy can't be,
14:04you know, can't be undermined.
14:06It's one of those things where, as you say,
14:09if you see someone talking about periods,
14:11you think, oh, it's okay to talk about periods.
14:13Because I remember being at school and it was so shameful.
14:17Yes.
14:17You know, people had tampons up their sleeves
14:19and were pretending that, you know, it wasn't happening to them.
14:21So if you were having an experience like you were,
14:24where your period was so acutely painful,
14:26you couldn't even do anything,
14:28you know, how are you going to be able to advocate for yourself?
14:30It's really challenging.
14:31So I think the work that you do with speaking to young women is phenomenal.
14:37I also want to ask you about tips
14:38because you've obviously been on this journey yourself.
14:41And I know that it's difficult to go to a doctor sometimes
14:46and say, I'm in pain.
14:48If you don't necessarily come with the right information,
14:51you know, doctors in the NHS,
14:52they have very limited time to speak to you.
14:54Do you have any tips for someone who might be in that position
14:58where they need to advocate for themselves?
15:00You know, what can women do to feel more empowered
15:02and to actually get the diagnosis that they need?
15:05So first of all, I think it's really important that you always,
15:09if you ever, this is something I say to all my patients,
15:11if you ever feel that you're not being listened to,
15:15please, please push.
15:16Ask for a second opinion.
15:18Even in the same GP surgery, go and see a different GP.
15:21So just say, I want to see somebody different
15:22or somebody with a women's health specialist.
15:24That's the first thing.
15:25Secondly, if you've got symptoms, keep a symptom diary.
15:30Because when you go to see your GP,
15:31if you have something in hand already,
15:33which says this is what's happening every single month,
15:35and this is how long my periods last,
15:36and this is how much pain I'm having,
15:37and just, you know, keep all your symptoms down flow,
15:39how many pads are you using.
15:40So you've got all that information to hand
15:42when you do go and see your GP.
15:43Sometimes there's a bit of a wait to see your NHS GP, you know.
15:45So we know this is like three-week, four-week wait,
15:48sometimes for a routine appointment.
15:49So having all that information at hand is really helpful.
15:52Do you recommend writing it down
15:53or using a tracker or something like that?
15:55You can use a tracker.
15:56So most people use their phone, their iPhone,
15:57or whatever they're using, you know, the smartphones for that.
16:00Some people will have, like, specific apps they're using for it.
16:03And you might write it down.
16:04Whatever comes, you know, any information as GPs
16:06will take it on board happily.
16:07Quite happy to have that in a very busy clinic.
16:09I also think that if you are able to use things like resources online,
16:14so there's two that I love.
16:15So one is the Endometriosis Foundation,
16:17which is a foundation close to my heart.
16:20I'm an ambassador for the foundation.
16:21And they have a menstrual helpline.
16:23So you can go on there and you can actually get help.
16:26So if you feel like you've got symptoms
16:28that you're not being listened to, that you're not sure,
16:30but you feel a little bit, you know,
16:32guarded about sharing that openly
16:34or you don't feel like you talk to your parents about it
16:36or your friends about it or at school,
16:37use that helpline to ask the questions you want to ask
16:40and you'll get some information back
16:41as to what steps you should do next.
16:43It's actually a really good tool.
16:44And then we've got Wellbeing of Women with their Symptom Checker,
16:47which I think is a fab tool.
16:48So you can go in there, put all your information,
16:50there's lots of questions you get asked,
16:51and the Symptom Checker will then actually produce for you
16:54a letter that you can take to your GP.
16:57Oh, brilliant.
16:57That's really helpful.
16:58That allows your GP to see what they're thinking.
17:02So they may say these periods are heavy
17:04or, you know, this patient has symptoms.
17:05We really recommend that you refer
17:08or you, you know, to basically listen to the patient.
17:11So it's one way of advocating for yourself
17:13in a space where you might feel the GP's not listening
17:15or they're busy
17:16or you're unable to translate or communicate effectively
17:20what's happening to you and your body.
17:22So these are tools I think are really important.
17:24And also if you're younger, if you're a teenager,
17:26just take, you know, if you don't feel comfortable
17:29going by yourself,
17:30take your parents with you
17:31or take your mum with you
17:32or sibling, whoever you feel comfortable with
17:34to help, you know, communicate the symptoms.
17:37And let's talk about the symptoms
17:39because if someone is unsure
17:40of what the symptoms of endometriosis are,
17:43what are some of the key ones
17:44that they should know about?
17:45So painful periods is a key one.
17:48Okay.
17:48So this is now pain periods can be uncomfortable.
17:52Okay.
17:52You might have some light clamping.
17:53You might be feeling like more tired.
17:56You might feel that you've got back pain.
17:59You might have all these things,
18:00but normally those symptoms are normal period.
18:03You can get on with day-to-day life.
18:05Yes.
18:05Maybe you might take a pain relief tablet.
18:07You might not, but you can get on with life.
18:09With endometriosis, the pain is normally quite severe.
18:12So not for everybody,
18:13but from some people, the pain will be quite severe.
18:15And that will mean that the cramps are really strong.
18:17You cannot really get out of bed.
18:18You know, you might feel sick with them.
18:19You might feel nauseated,
18:21like you literally want to vomit.
18:23You might feel like that with the pain.
18:24You might feel sweaty with it.
18:25You know, you might have other symptoms,
18:27for example, really heavy periods.
18:29So if you're flooding through pads,
18:31if you're having to change them,
18:33you know, numerous times,
18:34clots bigger than sort of 50 pence pieces,
18:38also to think about that as being abnormal.
18:40So you might have heavy periods,
18:41you might have painful periods.
18:42You might have other symptoms
18:43depending on where that endometriosis-like tissue is.
18:46So if you've progressed a little bit,
18:48you haven't realized.
18:49Sometimes the symptoms are silent.
18:50You might have nothing until they start to progress
18:52and affect organs and start to create scarring.
18:54So in that case,
18:55you might notice that now you've got bowel symptoms.
18:57So you've got cramping.
18:59You might have, you know, diarrhea.
19:01You might have just difference in your bowel habit.
19:04You might notice that you eat certain foods
19:05and it causes cramping.
19:06You might notice that you've got urinary symptoms,
19:08burning, stinging, lung symptoms.
19:11That's normally more rare,
19:12but you might have like coughing up blood sometimes
19:14or breathing issues as well.
19:16So nerve pain, sometimes down the limbs you might feel.
19:19So there's lots of different symptoms.
19:20There's quite a whole host of them.
19:22But normally what I say to start with
19:23is if your periods are debilitating,
19:26i.e. you cannot get on with your normal day-to-day life,
19:29that's something you need to get looked at.
19:31That's really helpful.
19:32And I do think the idea
19:34that it's just localized to period pain
19:36is something that maybe some people aren't aware of
19:39because, you know,
19:40the idea that you can have a manifestation of pain in a limb
19:44or, you know, even an issue with your lungs,
19:46you know, that's worrying,
19:48but it's also great for people to recognize and to know
19:50because if they're writing down their symptoms
19:53and they're thinking,
19:53oh, well, I've had gut trouble for weeks, months, years,
19:56it can probably be misdiagnosed as gut issues.
20:00Right.
20:00That's, you know,
20:01maybe something to do with the microbiome,
20:02but it's probably not linked to the microbiome
20:04or might be,
20:05but then, you know,
20:05there might be a red herring in there.
20:07That's it.
20:07Or like painful intercourse,
20:09of course, another one.
20:11So I think there's lots of different symptoms.
20:12And normally what happens with endometriosis is
20:14you start off with one or two,
20:16so you notice them,
20:17you might notice you have painful periods,
20:18heavy periods,
20:19painful intercourse, for example.
20:20And then as it progresses,
20:21you start to realize,
20:22oh, actually,
20:23maybe my gut issues were related to that.
20:25So as far back as I can think,
20:26I've always had gut issues,
20:28you know,
20:28and then I'm looking back and I'm thinking,
20:29oh, so I thought this was X, Y, or Z.
20:31Actually, it's more of a chronic systemic disorder.
20:35Yeah.
20:35And seeing it like that's important
20:36to understand what the steps are for management.
20:39Management.
20:40Shall we talk about that?
20:41Because treatment and management,
20:43these are two different things,
20:45but obviously for someone who feels that,
20:48you know,
20:48they've just got a diagnosis
20:49and now they want to know the next steps,
20:52what does treatment look like?
20:53And, you know,
20:54what does management look like long term?
20:56It's quite complex.
20:57So if you think about firstly diagnosis,
20:59that in itself,
21:00just go back one step,
21:01is quite,
21:02can be quite tricky
21:03because the gold standard diagnosis
21:05is to have a laparoscopy,
21:06which is a surgical procedure
21:07where we go in and visualize the pelvis
21:09and you can actually see
21:09the patches of endometriosis
21:12and then, you know,
21:13you might remove them there,
21:14but they can come back.
21:15So that's the first thing.
21:18But now, you know,
21:19imaging's really gone,
21:21it's come a long way.
21:22So now we can almost sometimes
21:24from ultrasound and MRI
21:25pick up where we can see endometriosis,
21:28where is there scarring,
21:29where is there, you know,
21:30inflammation.
21:32And obviously there are many new novel tests
21:34on the market
21:34which look at things like blood tests,
21:36you know, saliva
21:37to quickly diagnose endometriosis.
21:39I think they're making headway
21:40when we come to diagnosis,
21:41but with management,
21:42we haven't really,
21:43because we don't know
21:44enough about the condition,
21:45the causes of it,
21:46there isn't enough research in that area.
21:48We need to up that
21:49and there isn't enough research
21:50around diagnosis
21:50and what the best way of doing that is.
21:52I think this all lends itself
21:53into then what is the management.
21:55I think at the moment,
21:56there is typical things.
21:57So firstly,
21:58you might have surgery
21:59to remove the endometriosis-like tissue,
22:02sorry, endometriosis tissue.
22:03You might have medications.
22:05So for example,
22:05combined pills
22:06or pills that help to reduce
22:08the hormonal sort of,
22:12burden
22:12which might be causing
22:13or adding to the endometriosis.
22:16So the pills,
22:17they don't prevent the tissue
22:19from growing
22:20and the endometriosis itself,
22:21but they help with
22:22the heaviness of the period.
22:23Is that right?
22:24So yes,
22:24when you have a heavy period
22:26or a prolonged period
22:27or when you're having a period
22:28every month,
22:28you are putting yourself
22:30in a place where
22:31that tissue then grows
22:33and bleeds outside of the uterus,
22:36sorry, outside of the womb
22:37onto other organs
22:38and then you get the scarring.
22:39So being on hormonal treatments
22:41like the pill,
22:43like the other hormonal therapies
22:44that are offered
22:45basically help to reduce,
22:47basically help to either
22:48emit the period completely,
22:49so chemical menopause,
22:50depending on what stage
22:51of endometriosis you're at,
22:52or they help to reduce
22:54the heaviness of a period
22:55or completely stop a period.
22:57So if you're on the coil,
22:58for example,
22:59it will just stop your period
23:00altogether
23:00and these things then help
23:02reduce the likelihood
23:03of the scarring
23:04and all the other complications
23:05that come from endometriosis.
23:06There's not actually a cure
23:07for endometriosis.
23:09So that's the thing
23:09that I think a lot of patients
23:11who have struggled find
23:13because if you have extensive disease
23:15and you end up having
23:18lots of scarring around your bowel,
23:19your bladder,
23:20you can end up with
23:20lots of surgical procedures.
23:22You can end up with,
23:23you know,
23:24having to have bowel cut out,
23:25for example.
23:26I've got patients
23:27who've had to have stoma bags,
23:28you know,
23:29and to live their lives
23:31in a way that they never,
23:32ever thought
23:32or planned that it would be.
23:33So I think actually
23:35what we need
23:36is more resources,
23:39more research
23:40in this area
23:42so that we can start
23:42to think about
23:43what are the headway
23:44and what are the breakthroughs
23:45we're going to make
23:45to really prevent women
23:47from having to live lives like this.
23:48This is one of the things
23:49I find most shocking,
23:50the fact that there's no known cause
23:51and there's no cure
23:52and yet,
23:53I know so many people
23:55with endometriosis.
23:56It's something that has,
23:58you know,
23:59been kind of like a constant
24:00in my life
24:01because it's friends,
24:02it's relatives,
24:03it's people I work with,
24:04people I manage.
24:05Do you have an estimate
24:06of how many people in the UK
24:07are actually dealing with it
24:08at the moment?
24:09It's one in ten women
24:10in the UK and globally
24:12deal with endometriosis.
24:13It's common
24:13and also I think
24:14to your point of research
24:16and to your point of
24:17there's no cure
24:18and we don't know much about it.
24:20So research,
24:20you know,
24:212% to 2.5%
24:22of the entire funding
24:24in the UK
24:25for medical research
24:26goes towards
24:26women's health research.
24:27So we're not given
24:29a big chunk of it anyway
24:30and that covers
24:30all the women's health conditions.
24:31Like, right,
24:32women's health is this huge,
24:33yeah.
24:34Whereas like one in three women
24:35actually suffer from,
24:36you know,
24:37women's health conditions.
24:38So I think actually
24:39what we're looking at here
24:40is why are we not
24:41having that research?
24:42I think it's because
24:44conditions,
24:44it's a bit of a chicken and egg.
24:45So conditions
24:46are poorly understood
24:47because we don't know
24:48what's causing them,
24:48because we don't know
24:49what's actually happening
24:50in this condition.
24:50There's little interest,
24:52I guess,
24:53in then funding that,
24:54you know.
24:55And that's where
24:56awareness comes in.
24:57That's where it's important
24:57to raise information
24:58about numbers,
24:59statistics,
25:00how it's actually
25:01affecting women's lives
25:01and how it's actually
25:02affecting the NHS
25:03because NHS,
25:04once you talk about
25:04NHS burden
25:05and what that's doing,
25:07you know,
25:07in terms of
25:08how much it's costing
25:09the NHS,
25:10you might see then
25:11that there's more interest
25:12in actually funding
25:13towards research conditions
25:15that then,
25:16research towards conditions
25:17that then we can think
25:18about how we're going
25:18to prevent them
25:19with treatments
25:21or managing
25:22or whatever it might be,
25:22diagnosis.
25:23So I think
25:24the research burden
25:26and the fact
25:26that we don't have
25:27as much funding
25:27is a big issue
25:28in why we don't have a cure.
25:30Yeah.
25:31I mean,
25:31you're speaking my language now.
25:32I think that funding
25:33is so, so important
25:35and, you know,
25:36it's fundamental
25:36to how we understand
25:37everything across
25:38the spectrum
25:39of women's health.
25:40And I personally
25:41have been really frustrated
25:42in the past
25:43seeing that,
25:44you know,
25:45obviously lack of funding
25:45for research,
25:46but there's also
25:47lack of funding
25:47for resource and provision
25:49even in businesses.
25:50You know,
25:51we talked last year,
25:53you know,
25:53there was a petition
25:55for menstrual leave
25:57that didn't quite
25:57make it to parliament,
25:58but, you know,
25:59we're hopeful.
25:59There's also been
26:00menopause leave
26:02introduced in certain businesses,
26:03but we still don't see
26:04businesses catching up
26:06with supporting
26:07their employees.
26:08And that means that
26:09if you're somebody
26:10with endometriosis
26:11that's suffering
26:11with this chronic pain,
26:12you mentioned earlier
26:14when you were talking
26:14about being in theatre,
26:16you know,
26:16training as a doctor
26:17and being in this,
26:19you know,
26:19unspeakable pain
26:20or girls that are
26:22trying to do their exams.
26:23This is holding people back
26:25and it's actually
26:26going to be harming
26:27your business
26:27if you're not supporting
26:28these employees.
26:30And it is absolutely
26:31insane to me
26:32that we don't yet
26:33have the provision
26:34to take care of people
26:35who are going through
26:36this kind of thing.
26:37I find it really,
26:38really frustrating.
26:39Really frustrating
26:39and also maybe
26:40because it's women,
26:41right?
26:41So the productivity of women
26:42we need to think about
26:43actually,
26:44you know,
26:45we need to like
26:46back ourselves,
26:47don't we as women?
26:47But I think also
26:48we need the rest
26:49of the world
26:50and the public
26:50and businesses
26:51to understand
26:52what potential women have.
26:53I feel like
26:54I went to school
26:55and I had this,
26:57my teachers had
26:58an understanding of,
26:59oh, Raj is really good
27:00at X, Y, Z
27:01and she's a topper
27:01in exams.
27:02I remember them
27:02telling my parents
27:03that, you know,
27:04you really should think
27:05about putting her
27:05into a grammar school.
27:08And at the time,
27:09there was,
27:10nobody around me
27:10had been to a grammar school.
27:12I didn't really,
27:12no one really knew
27:13what I'm independent.
27:13Nobody had gone
27:14and become a doctor.
27:15So I'm the first
27:15in my family
27:16to have done that.
27:17I think that journey
27:18was so much more difficult
27:20because I guess
27:22I had moments
27:23where I was in debilitating pain
27:25and, you know,
27:26heavy periods.
27:27So if I had exams coming up
27:28and then I knew
27:29my period was going to start,
27:30I'd be in a panic
27:31because I just knew,
27:32oh my God,
27:32it's going to take out
27:33five days of my revision time
27:34or it's going to happen
27:35just before my major exam.
27:37And I actually remember
27:38taking AS level
27:39where that did happen
27:40and my grade dropped hugely.
27:42Gosh.
27:43And then I had the chance
27:44to do the summer repeat
27:45which luckily it came up.
27:46But why are we
27:47in these situations
27:47to begin with, you know?
27:49And I think the same thing
27:50with work.
27:50If you have a condition like that
27:52where you potentially
27:54are in debilitating pain,
27:57you're probably,
27:57you're not going to be productive
27:58at work or at school.
28:00So menstrual leave,
28:00I think,
28:01is an important conversation
28:03but more importantly
28:05actually preventing
28:06it happening
28:06in the first place.
28:07Yeah, absolutely.
28:08More funding,
28:09more understanding
28:10and absolutely more advocacy.
28:12100%.
28:13I remember actually
28:14when I first tried
28:15to get a diagnosis
28:16for some of my hormone issues
28:17it was quite frustrating
28:19because I went to my GP
28:20and this is when I was a teenager
28:22and I said,
28:23this is what's happening to me.
28:24And they said,
28:25are you trying to have kids?
28:27And obviously at 18
28:28I said, no.
28:29And they said,
28:29okay,
28:30we'll come back when you are.
28:31And that meant
28:32that it has taken me
28:33until my 30s
28:33to get proper diagnosis
28:34for what's going on with me.
28:37But I have found
28:38that it's because
28:39I mentioned fertility.
28:41When you get to your 30s
28:43you can say,
28:43oh actually I'm worried
28:44about my fertility
28:45and suddenly doctors
28:46take notice.
28:47And you mentioned this earlier,
28:48your own experience
28:49of saying,
28:50well I want to try
28:50for a family now
28:52meant that that was
28:53a catalyst for you.
28:55I wonder
28:56whether we can talk
28:57a little bit
28:58about how
29:00using that
29:02you know,
29:03that mention of fertility
29:04and being more conscious
29:05of your fertility
29:06can actually be helpful
29:07in these scenarios.
29:08But also why it is
29:09that we need to use that
29:11as a card that we play
29:12for doctors
29:13to actually take notice.
29:15So I think it's obviously
29:16something that
29:17when you're a medic
29:18and you're training
29:19and you're being educated
29:20or a GP
29:22you're almost learning
29:23so much about
29:24so many different things
29:25and you're never going
29:26to be a specialist
29:27in everything.
29:29And that's why
29:29I think we have GPs
29:30that specialize
29:30in one thing or another
29:31you know.
29:33And who you see
29:34in your clinic
29:35depending on if you've
29:35got a specialist
29:36in certain areas
29:37will depend on
29:38who's available that day
29:39whether you can ask
29:40for an appointment
29:40with that person
29:41whether you've got to
29:41wait two or three weeks.
29:42I think the first thing
29:43is that as doctors
29:44we always learn
29:46about red flags
29:46and safety netting
29:47you know.
29:48So you might find
29:49that a doctor's ears
29:50perk up more
29:50when you say a certain word
29:51because they think
29:52oh gosh actually yeah
29:53she's right
29:53we need to think about this
29:54you know.
29:54They're setting up
29:55thinking yeah
29:55like you know
29:56childbearing age
29:57and you need to think
29:57about children
29:58and what if she can't
29:59have children
29:59what if I've missed
30:00something
30:00and suddenly all these
30:01things are coming
30:01into your mind.
30:02So I do believe
30:03that for doctors
30:04and for GPs
30:05and you know
30:05community medics
30:06it's all about
30:07it is about getting
30:08it right for the patient
30:09but we're obviously
30:10very under resourced
30:11and we don't have time
30:12which then doesn't help
30:13and can often come across
30:15to probably the patient
30:16that my doctor doesn't care.
30:18and you know
30:19I can't speak
30:19for other doctors
30:20but for me
30:20I find that frustrating
30:22in clinic
30:22I want to be able
30:23to give each patient
30:24enough time
30:24I want to be able
30:25to go through
30:25everything with them
30:26I'm always a GP
30:27that's running an hour late
30:28if my clinic manager
30:30is watching this
30:31she'll know
30:31and I'm always the one
30:32that's like
30:33you know
30:33if there's an extra thing
30:34on the list
30:34okay let's just sort it out
30:35now you know
30:36but it means that
30:36everybody else runs late
30:37and everybody else gets
30:38a little bit less of the pie
30:40so those things
30:41are out of our control
30:43but I think when it comes
30:44to fertility
30:44it is the idea
30:45that that will spur you
30:47into getting more investigations
30:48but it shouldn't be that way
30:50because actually
30:51whether you want to have children
30:53or not
30:53that's a personal choice
30:54you know
30:55but you shouldn't have to live
30:56with debilitating symptoms
30:58with heavy periods
30:59with you know
31:00not being able to get up
31:01and live your life
31:01your best life
31:02because you have
31:04you know
31:05issues with pain
31:06or issues with
31:07now complications
31:08of a condition
31:09that should have been
31:09picked up way before
31:10the quicker you pick it up
31:12the more chance you have
31:13of it not progressing
31:14and you know
31:15us helping
31:15being able to help
31:16you manage that pain
31:17and that condition
31:17so I think you shouldn't
31:19get to the point of fertility
31:19I think the reason it does
31:20is because now
31:21there's so much more awareness
31:21around you know
31:23freezing your eggs
31:24or having that choice
31:24around fertility
31:25and I think
31:25in some ways
31:26it's almost like
31:27an easy thing
31:28for a doctor to do
31:29okay you're interested in this
31:30okay now I know
31:31which pathway to put you down
31:33whereas because
31:34there aren't clear pathways
31:35about these health conditions
31:36these women's health conditions
31:37like endometriosis
31:38it's hard for doctors
31:39who don't understand them
31:40who don't have education
31:41around them
31:42who don't have clear pathways
31:43what to do
31:44and so I think
31:45what they end up saying is
31:46oh it's a heavy period
31:47okay well you know
31:48try this
31:49or they might just give you
31:51the pill
31:51they might give you
31:52some pain relief
31:52and say come back
31:53you know
31:53and let's see what happens
31:54so I think
31:54I think it's more about
31:56educating the doctors
31:58and the healthcare professionals
31:59as well as educating the public
32:01yeah
32:02that's
32:02and I push that a lot
32:04so I say it's not just about
32:05what should the public know
32:06what should you know
32:07and what should your
32:08the young girls in schools know
32:10and you know
32:10what should
32:11it's about what the doctor
32:12should know too
32:13how do we manage these conditions
32:15what is the path that we use
32:17and that's why I quite like
32:18the symptom checker
32:19that I often refer my patients to
32:21because
32:21all right
32:22I've talked about it online
32:23so you know
32:23if you've got heavy periods
32:24use this
32:24because it almost helps the GP
32:28in a busy clinic
32:28to think
32:29oh okay
32:29yeah no
32:30I need to take this seriously
32:31okay what's happening here
32:32let me talk about this a bit more
32:33so I don't think it's lack of like care
32:35or not wanting to
32:36I think it's just that you're so inundated
32:37I did an NHS clinic the other day
32:39and I remember
32:40the morning was really busy
32:42and I just picked up
32:44a lot of serious things in that clinic
32:45and I just remember thinking
32:46oh god
32:46it seems like a really
32:48overwhelming clinic today
32:49and when you're going through all of that
32:50you know
32:51it's not to disregard something
32:52like a heavy period or whatever
32:53but obviously
32:54you might think
32:55well
32:56maybe if I just try pain relief
32:57shoot that might help
32:58but we need to not be
33:00you know
33:00minimizing pain
33:01and minimizing symptoms
33:02we need to be elevating
33:03and trying to manage them
33:05in the best way possible
33:05and I think to do that
33:06we have to be equipped
33:07as healthcare professionals
33:08and we have to feel supported
33:10because you can't just
33:11pour from an empty cup right
33:12sure
33:13makes total sense
33:14and I mean
33:14I've spoken to a lot of NHS GPs
33:16on this podcast
33:17and all of them
33:18are so deeply concerned
33:19with the welfare of their patients
33:21you know
33:21they're not people that are going
33:22yeah just get them in
33:23get them out
33:23you know
33:24that's not
33:24that's not what's happening here
33:26and you know
33:27there is a huge burden
33:28on resourcing
33:29but I love what you say
33:30about better resourcing
33:31and better education
33:32for doctors themselves
33:33because that also then means
33:35that maybe you'll be able
33:36to recommend
33:37more management techniques
33:38you know
33:39and I wonder if you have
33:40some of those as well
33:41for someone that might be
33:43you know
33:43they've had a diagnosis
33:44and now they're living
33:46with endometriosis
33:47what can they do
33:48in terms of
33:49you know
33:49their everyday management
33:50and things that they can do at home
33:52so I always say that
33:53I'm always led by
33:55you know
33:55it's a partnership
33:56so it's really important
33:57to understand
33:57what the patient also wants
33:58because you can push
34:00like medication
34:00or the pill
34:02or a coil
34:02or whatever it might be pushing
34:03but if they're not interested
34:04in that
34:04or they don't feel comfortable
34:05trying that
34:06I always take it back to basics
34:07so with endometriosis
34:08I've lived with it
34:09I live with it
34:09I know
34:10there are lots of things
34:11that can trigger it
34:11so for example stress
34:12you might find that
34:13if you've eaten
34:14the wrong kind of foods
34:14you know
34:15that can trigger it
34:15so
34:16when you're coming
34:17towards your period
34:17there are certain things
34:18that might help
34:20if you've got pain
34:21you might not want to take
34:21pain relief necessarily
34:22but you might be able to take
34:23for example heat therapy
34:24or like you know
34:25a warm water bottle
34:26or whatever it might be
34:27so
34:27lots of conservative measures
34:28as I always say
34:29get your diet
34:30you know
34:30a nutrition check
34:31so make sure you're having
34:32a good well-rounded
34:33balanced diet
34:35try to reduce things
34:37that are going to flare up
34:37your endometriosis
34:39and you'll know
34:40what those things are
34:41because they're individual to you
34:42so they might be things
34:42for your diet
34:43for me
34:43near my period
34:44if I'm having really
34:44carby food for example
34:45that can really flare me up
34:47understanding that
34:48you know
34:48your cycle is where
34:49it is having
34:51like a tracker
34:52for your cycle
34:53so knowing that
34:54when your period's coming
34:54it's going to come at this time
34:55you can manage your life
34:56around that
34:57so you know
34:57make sure that
34:58if you've got a holiday booked
34:59you might want to see your GP
35:00for example
35:01for medication
35:01that might
35:03stop your period
35:04or you know
35:05delay your period
35:07and that I think
35:07would have been a great saver
35:08for me when I was younger
35:09because I never even knew
35:10that existed
35:11so I think it's important
35:12to have that conversation
35:13if you're eligible
35:14and everything's safe
35:15and you can take that medication
35:16to talk to a GP
35:16about that for example
35:17but I think diet
35:18lifestyle exercise
35:20so for me
35:20one of the biggest changes
35:21and things that have helped me
35:22is graded exercise
35:24you know
35:24I was never like an athlete
35:26so I was just always
35:28I just run around with my kids
35:30and I'm always busy
35:31but I think what I've found
35:32is mindful exercise
35:33of Pilates for me
35:34you know
35:35breathing techniques for me
35:36these really really help
35:37and they really help
35:38to ground you
35:38they help to reduce
35:39the pain perception
35:40that you might have
35:41I mean
35:42I take less pain relief now
35:43because of that as well
35:44around my period
35:45so I think there's lots of things
35:46you can do
35:47mindfulness
35:48meditation
35:48yoga
35:49and in combination
35:50with your diet
35:51and then you can move on
35:52to the more
35:53you know
35:54invasive treatments
35:55things like
35:55having to take the pain relief
35:57having to think about
35:58you know
35:59heat therapy
36:00even
36:01I even know patients
36:02who use like
36:02TENS machines for example
36:03so you can get up
36:04for your pharmacist
36:05and you can put it on
36:06stick it on
36:07it kind of gives you
36:08a different pain experience
36:10or different sort of
36:11you know
36:11signal
36:11so you kind of deter
36:13from cramping or pain
36:14so there's lots of different
36:14things you can try
36:15but ultimately
36:15I think what we need
36:17to understand
36:17is that with endometriosis
36:18if you're having a period
36:20it's increasing the risk
36:21of that scarring
36:21and pain and adhesion
36:22so really
36:24alongside all the lifestyle
36:25changes and measures
36:26you want to think about
36:26how you're going to help
36:27reduce that
36:28so that you're not getting
36:29more chronic
36:30you know
36:31complications from it
36:32that's really good advice
36:33I mean
36:33I also think
36:35the kind of biohacking route
36:37some people
36:38are critical of it
36:39but it's certainly
36:40something that's helped me
36:41as well
36:41you know
36:42going and doing a sauna
36:44experiencing heat therapy
36:45you know
36:46breath work
36:46as you say
36:47gentle movement
36:48that has all helped me
36:49feel a lot better
36:50than I used to
36:50so I think these small hacks
36:52you know
36:52they can be quite supportive
36:53if applied in the right way
36:54obviously they don't work
36:55for everybody
36:56but I think it's good advice
36:57yeah
36:58and I think that's why
36:58I always say
36:59I say to patients
37:00I say to colleagues
37:01friends
37:01anybody who has a
37:02women's health condition
37:03or even if they're going
37:04through menopause
37:04and they're struggling
37:05I say look
37:05these are adjuncts
37:08they're there to help you
37:09they're there to ground you
37:10to make you feel more in control
37:11because actually
37:12if you're living a really busy life
37:14as a woman
37:14you know
37:14you've got children
37:15or you know
37:15you've got a busy career
37:16or whatever it is that you're doing
37:17or you're a carer
37:18because as women
37:19we do it all
37:19don't we
37:20and I think if you're somebody
37:21who's juggling all those things
37:22and they're just
37:23putting up with all this other pain
37:25that you have
37:25you know
37:26dealing with a chronic condition
37:27like endometriosis
37:28it's going to take its toll on you
37:29at some point
37:30you know
37:31you're going to feel burnt out
37:31physically mentally
37:32you're going to feel like
37:33your mood's not where it should be
37:34and you're just not going to be
37:35enjoying life
37:36so to have that best quality of life
37:37that you can have
37:38I think
37:39being mindful
37:40in what makes you grounded
37:42is important
37:42in any condition
37:43it doesn't have to be
37:44women's health condition
37:45even if you've got like
37:46chronic pain
37:46or whatever it might be
37:47and then I think moving into
37:49now what am I going to do
37:49to intervene here
37:50that's going to actually help
37:52the pathways
37:53to minimise
37:54what then might be happening
37:55in the future
37:56so I think it's two things
37:58it's not just all
38:00softly softly approach
38:01you know
38:01you do have to intervene
38:02especially if you've got symptoms
38:03that are debilitating
38:04but I think the combination of the two
38:05can be really
38:07really life changing
38:08and I really like the fact
38:10that you promote
38:10this holistic approach
38:11because I think it
38:12has been missing
38:13from women's health
38:14for quite some time
38:14and it's good to consider
38:16every possible angle
38:17for making yourself feel better
38:19one thing we haven't talked about
38:20actually is
38:21is the importance of community
38:23which is something
38:23that you've grown
38:24on your Instagram
38:25and you know
38:26with your appearances
38:27helping people kind of
38:29come together
38:29and have these conversations
38:30is really essential
38:31and I talked about how
38:32I do often find
38:34reporting on women's health
38:35quite frustrating
38:36and quite depressing
38:36but one of the things
38:38that I find incredible
38:39and really uplifting
38:40and promising
38:41is the community
38:42that's developed
38:43around women's health issues
38:44because you have
38:45apps, forums
38:46you know
38:46social media groups
38:47there's so much of it
38:48out there
38:49I wonder if you have
38:50any advice for
38:51people who feel
38:52quite isolated
38:53on how to find
38:54other people to talk to
38:56that might be able
38:57to offer support
38:58you know
38:58where can they find
38:59that kind of conversation
39:00that might be helpful
39:01to them
39:02I think women's health
39:03conditions can be
39:04so isolating
39:05and I think I've
39:06walked that path
39:07myself so I know
39:08and I think finding
39:09community can be
39:10one of the most
39:10empowering things
39:11even if you don't
39:13have the magic
39:13the silver bullet
39:14that's answering
39:15all your symptoms
39:16and managing your condition
39:17just having a community
39:18that understands
39:19that holds you
39:20that listens
39:21that shares their experiences
39:22from all different
39:23walks of life
39:24can be really
39:25really powerful
39:25so I think
39:26when looking for that
39:27there are a few things
39:28you can do
39:29like you mentioned
39:29you've got the forums
39:30you've got the social media
39:31but I think
39:32if for example
39:33it's endometriosis
39:34you have
39:35you know
39:35using a website
39:36like for the
39:36Endometriosis Foundation
39:38can be really empowering
39:39they do like webinars
39:40they do live workshops
39:43they do get togethers
39:44you actually get to meet
39:45people in person
39:46and share with them
39:47you know
39:47they get together
39:48they're experts
39:49to talk about certain things
39:51and certain topics
39:52they even go up
39:54and share
39:56you know
39:56up in parliament
39:58and they'll share
39:59with the government
39:59things and talk about
40:00policy change
40:01so I think it's really
40:02important to have that
40:03that sort of
40:03you know
40:04access to that
40:05I think using
40:05a website like that
40:06where you've got
40:07the menstrual line
40:07you've got the forums
40:08you've got the
40:09community is really important
40:10and equally for me
40:13I think social media
40:15has really
40:17changed the way
40:17I see community
40:19because we're so busy
40:20in our day to day
40:21how often do we even
40:21get to go and see
40:22a friend for coffee
40:23like you know
40:23I've got two young kids
40:24I've got a career
40:25I run a business
40:26and then I'm doing
40:27you know
40:27philanthropy work
40:28I'm doing
40:28I'm a wife
40:30I'm a sister
40:31and you're doing
40:31all these things
40:32and sometimes it's hard
40:32just to go and see a friend
40:33or make that time
40:34but having an online
40:36community
40:37I think has changed
40:38my perception of like
40:39what supports available
40:41because I find it
40:42really really
40:44therapeutic
40:44to put up a video
40:46which might say
40:47three reasons
40:48or three
40:50symptoms of painful
40:51three symptoms of your
40:52periods you should not
40:52ignore for example
40:53and the video will go
40:54viral and then you
40:55will have hundreds
40:56and thousands of
40:56comments
40:57and it's women
40:58supporting women
40:58so you know
40:59I'll often log in
41:00and I'll see a woman
41:01saying that happened
41:02to me
41:02I tried this
41:03or you know
41:04I'm so sorry to hear
41:04that let us know
41:05how your laparoscopy goes
41:07or oh my gosh
41:08let me know
41:09how that goes for you
41:09or why don't you try this
41:10they're sharing information
41:12they're supporting each other
41:14and for me
41:15just to read that
41:16and to understand
41:16that actually
41:17I've been a little bit
41:18of a catalyst
41:19and played a small role
41:19in that
41:20is really really
41:21it's quite empowering
41:23and it's quite uplifting
41:24for me
41:24having walked that journey
41:26myself
41:26where it was quite isolating
41:27at times you know
41:28and I'm in the healthcare
41:29profession
41:30I'm you know
41:32an expert
41:33as it were
41:34and I've still struggled
41:35so I think for me
41:35I'd say
41:36if you are on social media
41:37and if you are
41:38for example
41:39struggling
41:40finding those pages
41:41or those experts
41:42who focus on those areas
41:43and looking in the
41:44comment section
41:45and you'll find a community
41:46there pretty quickly
41:46I think
41:47so you know
41:48that's kind of where
41:48I'd say you look for it
41:49but I think
41:50lots of these
41:51like I said charities
41:51do these workshops
41:52do these get together
41:53so feel
41:55just feel that you can go
41:57with no expectation
41:57and no judgment
41:58and you'll probably
41:59find a community
42:00that you then
42:00stick with for life
42:01it's quite
42:02it's quite moving
42:03I think it's brilliant
42:04I mean
42:04the amount of times
42:05I've been in a room
42:06at a meetup like this
42:07where we're all supposed
42:08to be talking about
42:08women's health
42:09and people can be quite
42:10nervous to begin with
42:11they don't want to be
42:12the first person
42:12to say anything
42:13the moment people
42:14start speaking
42:15you know
42:16there's this huge shift
42:17where suddenly
42:18everyone feels like
42:18it's okay to talk
42:19about what they're
42:20going through
42:20and you do feel
42:21this incredible
42:22collective sense of support
42:23and I think
42:24you can't beat that
42:25and I'm really looking
42:26forward to more of that
42:27this year
42:28because I do think
42:28this year's going to be
42:29a big year
42:30for this kind of
42:31experiential community support
42:32and I think
42:33the shared experiences
42:34are so important
42:35because you know
42:36I've been in rooms
42:37where individuals
42:38share their experience
42:38or women are sharing
42:39their stories of childbirth
42:41or you know
42:41painful periods
42:42or what they went through
42:43in menopause
42:43or how they were dismissed
42:44and sometimes
42:45those stories can be
42:46quite depressing
42:47so you can listen to them
42:47and think
42:48oh god like this is awful
42:49but they're all equally
42:51important stories to hear
42:52because for me
42:53I'm a bit of a doer
42:53so I'll get into a room
42:55and I'll hear all these stories
42:56and I might share my experiences
42:57but I'm always thinking
42:58okay so what are we going to do
42:59from here
43:00how do we change this
43:02and so bringing together
43:03people who are happy
43:04to share experiences
43:04bringing together people
43:05who want to make change
43:06bringing together doers
43:08and the listeners
43:09and the speakers
43:10is really important
43:11in a women's health community
43:12because actually
43:13that is how
43:14we move forward
43:16100%
43:16and I wonder actually
43:19on that point
43:21say someone's in year one
43:22of pain
43:23and they haven't got a community
43:25they haven't looked
43:26on social media
43:26they haven't found you
43:27they don't know what to do
43:29what would your one piece
43:30of advice be
43:31for someone who is
43:32in that year one of pain
43:33who is experiencing it
43:34for the first time
43:35don't normalise it
43:37so don't think
43:38I'll be okay
43:38I'll check next year
43:40or I'll wait on it
43:41or I'll sit on it
43:42or you know
43:43speak to your mum
43:44your sibling
43:44and they say
43:45oh you'll be okay
43:45because you know
43:46we can't blame
43:48or put shame
43:49on cultural barriers either
43:50they're there
43:50you know
43:51and there's lots of good
43:52that comes from culture as well
43:53and I had a very happy upbringing
43:55and love my siblings
43:56very close relationship
43:57with my mum
43:57but I think
43:59they know what they know
44:00and I think you have to
44:02advocate for yourself
44:02so don't normalise it
44:03advocate for yourself
44:05go and see your GP
44:06and even if that GP appointment
44:07takes four weeks
44:09write down that symptom diary
44:10and off you go
44:11and you know
44:11always push
44:13push
44:13if you feel like
44:14in your gut
44:15you're not being listened to
44:15please just push
44:17because we do want to listen
44:18sometimes we just need
44:19to hear it twice
44:20you know
44:20so yeah
44:21you've shared so much
44:22incredible advice
44:23in this episode
44:24and I'm really hoping
44:25that it will go some way
44:27to contributing
44:28to the incredible work
44:29you're already doing
44:29and teaching people
44:30more about this
44:31you know
44:32this condition
44:32and how to manage it
44:34I do want to end
44:34by asking you
44:35for one more piece of advice
44:36if I may
44:37I ask all of my guests
44:38what their one piece of advice
44:40would be
44:40for just feeling
44:41well enough
44:42what would yours be?
44:45Gosh
44:45I had quite a rollercoaster
44:47of 2025
44:47so I think mine would be
44:49and this is going to sound
44:50so cliche
44:51but honestly
44:51I mean it with all my heart
44:53to give yourself time
44:55and I mean that
44:56in every sense of the word
44:57give yourself grace
44:58give yourself time
44:59it's okay
45:00you're not going to
45:01always have good days
45:02you know
45:02whether that's physically
45:03mentally
45:04but give yourself time
45:06come off the hamster wheel
45:07is what I'd say
45:08I think that's brilliant advice
45:10especially for people
45:11who I think
45:12maybe you know
45:13as we're starting
45:142026
45:15they're thinking
45:16okay I need to do more
45:17I need to be more
45:18I need to hit my goals
45:19I do think that there is
45:21a brilliant amount of grace
45:23in just acknowledging
45:24that things take time
45:25and that you can trust the process
45:26and there's such a pressure
45:27around this time of year
45:28and you know this year
45:29I just thought to myself
45:30every year I'm there
45:31I'm thinking about my goals
45:32and I've written not one goal down
45:34because it's just so pressurizing
45:35and actually
45:36it can make you feel quite
45:38you know
45:39again isolated
45:40or like you're not achieving enough
45:42or you're a failure
45:43when you set yourself up
45:44with all these goals
45:45then you feel like
45:46I haven't achieved them
45:47so this year I've set no goals
45:48I'm just going to see
45:49where the year takes me
45:50with a positive mindset
45:51and hopefully
45:52it's going to take us
45:52to good places
45:53I think it will
45:54thank you so much
45:54for joining me Dr. Raj
45:55it's been a pleasure
45:56thanks
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