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In this podcast interview, Leah Hechtman joins Emma Sutherland and the FXmedicine team. They discuss endometriosis, focusing on neuro patterning, trauma responses, and the deeper emotional dimensions.

** Potential trigger – this discussion contains references to sexual trauma, abuse and emotional challenges. Please be mindful if this is appropriate for you at this time.

Key Points

  • Endometrial pain is linked to dysregulated neural pathways, inflammation, and hormonal factors.
  • The anticipation of pain itself can trigger painful episodes for people with highly altered pain neurocircuitry.
  • Thermoregulation is common in women a typical symptom being cold hands and feet. This can indicate blood stagnation that can be inflammatory.
  • Trauma can intensify endometriosis pain. Proper referral is crucial for managing emotional triggers in pain management. 
  • Building trust and providing a safe environment for women with endometriosis is essential. Pay attention to their cues and desires for exploration, without forcing conversations. Knowing when to refer is important. 
  • Antidepressants for endometriosis can be reframed as reducing the brain’s perception of pain caused by amplified neural circuitry.
  • Eye movement desensitisation and reprocessing (EMDR) therapy may be considered to refer out to for women who have experience trauma.

Episode Outline

[01:04] Welcoming back Leah Hechtman
[02:23] Pain as an enduring symptom in endometriosis
[07:18] Inflammation influences pain processing
[13:18] Retraining the brain’s neurocircuitry
[16:57] Vascularisation and coagulation challenges with endometriosis
[19:39] Biomarkers to assess and track inflammation
[22:23] Trauma, the mind-body connection and endometriosis
[28:40] Addressing trauma in clinic
[30:30] The use of antidepressants in women with endometriosis
[33:24] Upskilling to support patients with trauma
[35:58] Cautions and tips around case-taking when trauma is present
[40:20] Sexual health as part of recovery
[42:53] Looking to the future of women’s health
[46:24] Thanking Leah and closing remarks

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