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Endometriosis evolves from teenage years into adulthood, often progressing from manageable period pain to symptoms outside the menstrual cycle that no longer respond to hormonal treatments. Dr. Megan Wasson, Chair of Medical and Surgical Gynecology at Mayo Clinic Arizona, breaks down this journey and provides clarity on when to consider moving beyond conservative management.

• Endometriosis commonly progresses in both disease burden and symptom severity over time
• Common misdiagnoses include IBS, anxiety, "lack of sexual experience," primary dysmenorrhea, and orthopedic issues
• Decision for surgery should be individualized based on quality of life considerations
• Surgery may be appropriate when diagnostic uncertainty causes anxiety
• Surgical treatment can be beneficial when symptoms aren't controlled by hormonal treatments
• Removing endometriosis can optimize fertility for both natural conception and assisted reproductive technologies
• Complementary approaches like pelvic floor physical therapy and acupuncture can support conventional treatments

Send your questions to [email protected] or visit endobattery.com/contact, and we'll bring you expert answers in our next Quick Connect episode.

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Dr. Abhishek Mangeshikar explores how endometriosis severity varies globally, highlighting the interplay between genetics, environmental factors, and healthcare access. While genetic components exist in endometriosis development, expression is influenced by epigenetics including diet, stress, and environmental conditions that determine disease progression patterns.

• Endometriosis has a genetic component, but gene expression depends on epigenetic factors
• Environmental factors, diet, hormones, and physiological stress influence disease expression
• Healthcare access significantly impacts observed disease severity across regions
• Lower-income countries typically see more advanced disease due to delayed diagnosis
• Early intervention in higher-income countries often prevents progression of certain disease types
• More diverse, multicultural studies are needed to understand global endometriosis patterns

Send your endometriosis questions by using the link in the description, emailing [email protected], or visiting the endobattery.com contact page.

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Two leading endometriosis specialists discuss why performing excision surgery before fertility treatments often leads to better outcomes for patients struggling with both endometriosis and infertility.

• Dr. Sadikah Behbehani recommends excision surgery before IVF when endometriosis is suspected
• Removing endometriosis first may enable natural conception without needing IVF
• When IVF is still needed after surgery, success rates are significantly higher
• For patients with both PCOS and endometriosis, ovarian drilling can be performed during the same surgery
• Ovarian drilling creates small holes in the ovary to reduce androgen production and help with ovulation
• While not done as a standalone procedure anymore, ovarian drilling has minimal side effects when performed during endometriosis surgery

Have questions about endometriosis or fertility? Send them in using the link in the episode description, email [email protected], or visit the endobattery.com contact page.

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Your nervous system plays a crucial role in endometriosis pain, with practical tools available to help manage symptoms through the emerging field of neuropelviology. Professor Marc Possover, a world-renowned pioneer in treating chronic pelvic pain, explains how targeting pelvic nerves can bring relief to patients who've been told to simply live with their pain.

• Three ways to activate the vagus nerve for pain relief
• Transauricular vagus nerve stimulation through the ear for 10 minutes morning and evening
• How positive morning thoughts can significantly impact your pain levels throughout the day
• Using subliminal audio messages to reduce pain through autosuggestion
• Physical activities like swimming and hiking decrease sympathetic nervous system activity
• Exercise creates a natural massage of the solar plexus, reducing pain perception
• Smoking increases sympathetic nervous system activity, potentially worsening pain

Send your questions by using the link in the description, emailing [email protected], or visiting the EndoBattery.com contact page.

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Finding the right endometriosis surgeon can feel like searching for a needle in a haystack—especially when you’re already dealing with chronic pelvic pain and the emotional toll of the disease. The wrong choice can cost you years of suffering, but the right surgeon can change your life. In this episode, Dr. Melissa McHale, a gynecologic surgeon specializing in minimally invasive endometriosis excision surgery, shares a proven step-by-step framework to help you confidently choose the right surgeon and reclaim your quality of life.

You’ll discover:

• Why traditional ways patients pick surgeons often fail—and how to avoid being misled by those who simply tell you what you want to hear
• How to research a surgeon’s qualifications, training, mentors, and real-world excision surgery experience
• Where to check public medical board records, license status, and malpractice history for surgeons and their practice partners
• How financial structures in a gynecology practice can influence care quality and surgical flexibility
• What a thorough preoperative workup should include, from advanced imaging to detailed preparation
• How to critically read patient reviews and spot patterns across multiple platforms
• Why transparency matters—surgical documentation, photos, and post-op explanations are key to trust
• How to evaluate a surgeon’s communication style and whether they give detailed, thoughtful answers
• The importance of a multidisciplinary care team in successful endometriosis treatment
• How to combine instinct and objective evidence when making your final decision

Whether you’re just beginning your search for an excision specialist or are feeling stuck after disappointing care, this episode will give you the tools and confidence to find the right endometriosis surgeon for your needs.

DOWNLOAD FREE SURGEON VETTING WORKSHEET HERE

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This summer brought unexpected clarity. In this heartfelt solo episode, I share why I stepped back from endometriosis advocacy a bit to focus on what matters most—my family, my health, and realigning with purpose.

I open up about the emotional toll of advocacy, the guilt of burnout, and the beauty of rediscovering what I’m truly called to. If you’ve ever questioned your path, struggled to find balance, or felt lost in your chronic illness journey—this one’s for you.

You’ll hear:

• Why I paused the podcast and social media
• How faith, family, and rest helped me reset
• What it means to find purpose through your pain
• What’s next for Endo Battery

If this resonates, please share, rate, or review—it helps more than you know.

#Endometriosis #ChronicIllness #PodcastForWomen #InvisibleIllness #Burnout #Advocacy #FaithAndHealing #EndometriosisSupport #PurposeDrivenLife #EndometriosisPodcast

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Dr. Allyson Bontempo discusses the significant research gaps in understanding endometriosis diagnostic delays across different racial, ethnic, and gender groups. With the average diagnostic delay at over eight years based on predominantly white research samples, the delay for minority patients likely remains unknown and potentially much longer.

• Most endometriosis research samples consist of about 85% non-Hispanic white participants
• Existing research shows Black patients typically experience longer diagnostic delays for various conditions
• Dr. Bontempo is collaborating with Baylor College of Medicine to study diagnostic journeys of racial, ethnic, and gender minorities
• Current increased awareness may reduce delays for some patients while including previously excluded minorities in research
• Research partnership between EndoBlack and a university is currently gathering data on Black patients' experiences

Send your questions by using the link in the description of this episode, emailing [email protected], or visiting the endobattery.com contact page.

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Dr. Yaniv Larish, a board-certified urologist, joins us to explore the complicated relationship between endometriosis and bladder symptoms. We uncover how urinary issues like urgency, frequency, and nocturia can be important indicators of endometriosis involvement in the urinary tract.

• Common bladder symptoms include urgency, frequency, nocturia, and feelings of incomplete emptying
• Patients often deny urinary or fecal incontinence but admit to wearing pads daily or difficulty cleaning after bowel movements
• No definitive test exists for endometriosis other than surgery, making proper questioning essential
• Many patients have been dismissed by doctors, making it harder to get accurate symptom reporting
• Surgical interventions may involve trade-offs between pain relief and preserving bladder function
• Post-surgical issues can occur if nerves governing bladder function are affected during treatment
• Cases requiring second or third opinions often involve complex reconstruction after previous surgeries

Do you have more questions? Send them in by using the link in the top of the description of this podcast episode or by emailing [email protected] or visiting the endobattery.com contact page.

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Dr. Megan Wasson from Mayo Clinic explains how pediatric gynecological exams can be performed without causing trauma to young patients. She shares expertise on using external examinations and imaging techniques as alternatives to traditional speculum exams for diagnosing pelvic pain in adolescents.

• Speculum exams generally aren't appropriate for pediatric and adolescent patients, especially those who aren't yet sexually active
• External inspection of the vulva and introitus can identify conditions like imperforate hymen without invasive procedures
• Abdominal ultrasounds can effectively check uterine and ovary structure without internal examination
• Healthcare providers should avoid CT scans for young patients due to radiation exposure concerns
• MRIs should be used selectively as the lengthy, noisy procedure may cause trauma for children
• Physicians must balance diagnostic benefits against potential physical and emotional harm

Send your questions to [email protected] or visit endobattery.com/contact to get expert answers on future episodes.

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Dr. Zachary Spiritsos shares expert insights on the connections between digestive issues and conditions like POTS, MCAS, and EDS. He explains how these overlapping conditions present with distinct symptom patterns that can help patients better understand their complex health challenges.

• Neurogastroenterologists are "electricians, not plumbers" - focusing on nervous system connections to digestive issues
• POTS typically presents with racing heart upon standing, brain fog, blood pooling, and various GI symptoms
• MCAS features "twitchy" mast cells that react to everything from temperature changes to emotions
• Primary MCAS symptoms include skin manifestations (itching, rashes), ENT issues, and GI symptoms like unexplained heartburn
• EDS often shows up through joint hypermobility, subluxations, and can be assessed using the Beighton score
• These conditions frequently overlap, requiring thorough questioning to properly identify and treat

Send in your questions by using the link in the top of the description of this podcast episode, emailing [email protected], or visiting the endobattery.com contact page.

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