Why do so many people with endometriosis also have food sensitivities, bloating, bladder symptoms, migraines, fatigue, POTS or hypermobility? Is it coincidence, or are we missing part of the picture?

Recorded live at the 2026 Australian POTS Foundation Conference, we sat down with internationally recognised cardiologist Dr Alexis Cutchens to talk about mast cell activation syndrome (MCAS), a topic many of us were never taught about, but one that keeps showing up in complex patients.

We explore what mast cells actually do, why MCAS can look like much more than "just allergies", and why clinicians working in pelvic pain often find themselves learning about POTS, connective tissue disorders and immune dysfunction.

Along the way, we discuss everything from heavy periods, bladder symptoms, medication sensitivities, hormones and pregnancy through to perimenopause, antihistamines, and the very real experience of patients who seem to collect diagnosis after diagnosis without anyone joining the dots.

This is a conversation about curiosity and complexity. We don't have all the answers, but if you've ever wondered whether these conditions might be more connected than we realise, come along for this incredible ride!

Have you ever wondered how a pathologist actually decides whether tissue is endometriosis?

Endometriosis is often described as “endometrial-like tissue” growing outside the uterus. But what does that really mean? What does endometriosis actually look like under the microscope? Where does it come from? And what can pathology tell us about this complex disease?

Joining us is anatomical pathologist Dr Rebecca Morrow, who spends her days examining endometriosis, cancer and other complex gynaecological conditions under the microscope.

Together, we tackle some of the biggest questions in endometriosis:

• What are pathologists actually looking for when diagnosing endometriosis?

• What does endometriosis look like under the microscope?

• Where does it come from?

• Why do pathology reports sometimes seem confusing?

• Can endometriosis be missed?

• How is endometriosis different from cancer, despite some surprising similarities?

• What should patients know about their biopsy results?

A fascinating conversation that takes us inside the pathology lab and offers a microscopic view of one of medicine’s most misunderstood conditions

Why do so many people with pelvic pain feel like they have constant UTIs… even when the tests keep coming back negative?

In this episode, we sit down with urogynecologist and pelvic floor expert A/Prof Tanaka Dune to unpack the incredibly complex world of bladder pain, urgency, frequency, pelvic floor dysfunction and the nervous system.

We talk about:
• why bladder pain is so often misunderstood
• the overlap between pelvic floor tension, endometriosis, bowel symptoms and bladder symptoms
• what urogynecologists actually do
• why some people may have “UTI symptoms” without a standard urine test showing infection
• the emerging science around the bladder microbiome
• interstitial cystitis/bladder pain syndrome
• how stress, trauma, posture, gait, back pain and the pelvic floor all connect
• common bladder irritants including caffeine, alcohol and carbonated drinks
• why pelvic floor exams can be such a lightbulb moment for patients
• and the surprisingly powerful role of mirrors in helping women reconnect with and understand their anatomy

Tanaka brings a deeply compassionate and systems-based approach to pelvic pain care, and this conversation completely shifts the way you think about the bladder.

This episode is for anyone living with bladder symptoms, recurrent “UTIs”, pelvic pain, painful sex, urgency/frequency, or clinicians wanting a better framework for understanding these presentations.

You can find A/Prof Tanaka Dune online as “Dr Pelvic Floor”.

Endo Untangled is hosted by Dr. Alecia Macrow and Cherie Noble.
New episodes released fortnightly.

If you’ve been told your ultrasound was normal but your pain isn’t, this episode is for you.

Join us on Endo Untangled as Dr Alecia Macrow and Cherie Noble sit down with Alison Deslandes – clinical academic sonographer, endometriosis researcher and founder of Astute Ultrasound Education – to explore how advanced imaging is reshaping the diagnostic landscape for people living with endometriosis and pelvic pain.

In this episode you’ll hear:

• ​Why a “normal” scan doesn’t always mean everything’s fine – and what to ask if the standard ultrasound isn’t giving you answers
• ​How specialised transvaginal ultrasound protocols and the “sliding sign” technique help detect deep-disease and posterior pouch involvement that many imaging pathways miss.
• ​Who the hell is Douglas and why is he in my pelvis? and other anatomy including where to find the uterosacal ligaments and where exactly is the peritoneum in the pelvis.
• ​The real-world impact of Australia’s new Medicare rebate for endometriosis imaging, and why access still hinges on finding ultrasound services with the right training and expertise.
• ​The emerging role of artificial intelligence in sonographer training – and what that could mean for future scans, reporting and surgical planning. Alison Deslandes

Whether you’re a healthcare practitioner committed to improving care, a patient seeking better diagnostic clarity, or a partner navigating the care journey together – this episode offers practical insight, nuance and hope. Tune in, open your mind and equip yourself with the language and questions to get the ultrasound conversations you deserve.

Why do we have periods at all, when most mammals don’t?

In this episode we catch up with Dr. Deena Emera, evolutionary biologist and author of A Brief History of the Female Body, and look at menstruation through an evolutionary lens that shifts the usual framing.

We unpack what’s actually happening between the brain, ovaries and uterus, and why menstruation may be less about a monthly inconvenience and more about an active, coordinated process. One of the more interesting ideas is the uterus behaving less like a passive lining and more like a kind of checkpoint, responding to what’s happening upstream.

We also get into how far modern cycles have drifted from what the body likely evolved for. More cycles across a lifetime, higher hormone peaks, and a different symptom burden. That context matters when you’re thinking about pain, PMS, and conditions like endometriosis.

If you work in this space, or you’re trying to make sense of your own cycle, have a listen to this great hour of evolutionary insight.

Find Dr Emera's great book here:

https://www.amazon.com.au/Brief-History-Female-Body-Evolutionary/dp/1728275156

More on Prof Beverly Strassman:
https://sites.lsa.umich.edu/bis/

Pelvic pain isn’t driven by one thing. It’s multiple systems hitting each other and keeping pain in motion.

In this episode, we zoom out and examine some of the main drivers of persistent pain and how they interact, in particular, our key swinging balls: menstrual cycling, bowels, pelvic floor and the nervous system.

If you’ve tried everything and you’re still stuck, this is the episode to listen to.

So much of pelvic pain care focuses on finding and fixing a single cause.

But what happens when the system itself becomes part of the problem?

In this episode, we’re joined by psychologist Laura Grace to explore:how the nervous system learns painwhy dismissal, delay, and fragmentation matterthe impact of trauma and “micro-traumas” in healthcarehow neurodivergence changes the way pain shows upand what it actually means to feel safe in your body again

This is about making sense of pain, not dismissing it.

About Laura Grace

Laura Grace is a Brisbane-based registered psychologist with a focus on pelvic pain, chronic illness, and women’s health. She has training in both health and clinical psychology and works with patients navigating complex, long-standing conditions.

Her approach is trauma-informed and centred on the nervous system, helping patients understand pain, build safety in the body, and make sense of their experiences.

She supports people with persistent pelvic pain, medical trauma, neurodivergence, and the broader impacts of chronic illness.

Laura Grace Psychology: https://www.lauragracepsychology.com.au

Pelvic Pain Foundation of Australia: https://www.pelvicpain.org.au

NOI Group (pain science resources): https://www.noigroup.com

Is the pill just a band-aid for pelvic pain and endometriosis? It’s a question many patients ask, and one that comes up again and again in clinics and online.

In this episode of Endo Untangled, Dr Alecia Macrow and Cherie Noble are joined by women’s health GP Dr Jessica Floreani to unpack how hormonal treatments actually work.

From the basics of the menstrual cycle through to combined pills, progestogen-only options, ovulation suppression and withdrawal bleeds, this conversation explores why these treatments are used and what they are trying to achieve.

They also tackle some common misconceptions around “synthetic hormones”, why one pill can feel completely different from another, and why finding the right option is often a process of trial and adjustment. A practical, thoughtful episode for anyone navigating pelvic pain, endometriosis or heavy periods.

In this episode we discuss

• How estrogen and progesterone drive the menstrual cycle
• Why endometrial tissue responds to hormones
• How hormonal treatments help manage pelvic pain and bleeding
• Why different pills contain different progestogens
• Combined pills vs progestogen-only options
• Why one pill may suit someone while another does not

Our guest

Dr Jessica Floreani is a specialist women’s health GP and director of Aware Women’s Health in Adelaide. She has extensive experience in contraception, endometriosis care and women’s health education, and has previously worked with SHINE SA as a LARC coordinator and medical educator.

More about Dr Jess: https://www.awarewomenshealth.com.au/jessica-floreani

If you've got pelvic pain, you probably know it's not just about the endometriosis lesions. But did you know how much your muscles are contributing to your symptoms?
Pelvic health physio Caz Berry is back to explain the anatomy that matters. She's brought her pelvis model and she's not afraid to use it.
In this episode, we're covering the three things Caz wishes every patient knew before walking into her clinic: understanding your core (spoiler: it's not about abs), why breathing actually matters for pelvic pain, and yes—how to poo properly.

Caz explains why that "just breathe" advice isn't a brush-off, why pushing on the toilet is working against you, and why that deep stabbing pain might not be your ovary at all—it could be a cranky hip muscle called the obturator internus.
We also get into the nitty gritty: tight activewear as a pain trigger, why sitting with your knees together isn't helping, and how trauma and stress literally change what's happening in your pelvis.
Practical, honest, and genuinely useful information for anyone dealing with pelvic pain, endometriosis, or bowel and bladder issues.

Pelvic pain doesn’t exist in isolation — and neither does the nervous system that processes it. In this episode, world-renowned pelvic health physio and storyteller Michelle Lyons explains why what happens in the vagus nerve shows up everywhere.

We explore persistent pelvic pain through a nervous-system lens, unpacking how the vagus nerve connects pain with the gut, bladder, pelvic floor, immune system and stress response. Michelle breaks down why pain can persist even when scans are normal or tissue has been treated, and how an upregulated nervous system can keep the body stuck in protection mode.

This episode offers a compassionate, science-based reframing of pelvic pain — moving beyond “just the pelvis” toward understanding the whole person. If you’ve ever felt like your symptoms don’t make sense, or that your body is reacting bigger than expected, this conversation may finally connect the dots.

Michelle's website: https://celebratemuliebrity.com/Michelle's podcast: https://podcasts.apple.com/au/podcast/celebrate-muliebrity-with-michelle-lyons/id1689238440

Book we discussed:Why Zebras Don't Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping . https://www.amazon.com.au/Why-Zebras-Dont-Ulcers-Stress-Related-ebook/dp/B0037NX018