Healing Pelvic Pain and Endometriosis: with gynecologist Dr. Peta Wright

Lorne Brown 

By listening to the Conscious Fertility Podcast, you agree to not use this podcast as medical advice to treat any medical condition in either yourself or others. Consult your own physician or healthcare provider for any medical issues that you may be having. This entire disclaimer also applies to any guest or contributors to the podcast. Welcome to Conscious Fertility, the show that listens to all of your fertility questions so that you can move from fear and suffering to peace of mind and joy. My name is Lorne Brown. I’m a doctor of traditional Chinese medicine and a clinical hypnotherapist. I’m on a mission to explore all the paths to peak fertility and joyful living. It’s time to learn how to be and receive so that you can create life on purpose.

Today on the Conscious Fertility Podcast, we have Dr. Peta Wright and we’re zooming in doing this interview. She’s in Australia. I’m over in Vancouver, Canada, and we were connected by my colleague and friend Naturopathic Dr. Lara Briden. And I want to introduce you, you all to Dr. Peta Wright. First of all, she has a fantastic book called Healing Pelvic Pain, which we’ll dive into, and she’s an MD and a gynecologist, and I’m going to read you her bio, but she’s what I call those Doctor 2.0 trained in western medicine, but kind of practice like a naturopathic doctor or a hypnotherapist really brings in the holistic perspective, which is why I wanted to have her on here. I want to hear about both sides on how to treat or what I would call an integrative approach. So Dr. Peta Wright, she’s a distinguished gynecologist and a fertility specialist. She’s deeply committed to holistic women’s health.

She completed her medical degree with honors at Monash University back in 2004, and she obtained her fellowship with the Royal Australian and New Zealand College of Obstetrics and Gynecologists. In 2013. Dr. Wright furthered her expertise with a master’s in reproductive medicine and a certificate in women’s integrative medicine In 2020. She founded Vera’s Women’s Wellness Center and you guys got to check out the website. We’ll put the link in the show notes. There are so many resources there. It’s excellent. And Vera Women’s Wellness, they aim to provide comprehensive care that addresses the physical, emotional, environmental aspect of women’s health. Her clinical interests include pediatric and adolescent gynecology, pelvic pain, endometriosis, polycystic ovarian syndrome, and menopause management. And we’re going to do our best in this short time together to kind of touch on all that. We’ll see if our dream comes true today. If not, we’ll have to bring her back.

I also want to let you know that Dr. Wright is also an advocate for addressing the impact of nutrition, stress, and lifestyle and hormonal balance. So there’s that integrative approach and her goal is to help empower women to achieve optimal wellbeing. And as I mentioned earlier in the intro, she has a book that came out back in, well, not fairly recent at the time of this recording in 2023. It’s called Healing Pelvic Pain, transforming the Trauma of Period Pain, endometriosis in Chronic Pelvic Distress, and as many people say, the book that her patients have been waiting for. Dr. Wright, thank you very much for joining me on the Conscious Fertility Podcast.

Peta Wright 

Thank you very much for having me and for persevering with my schedule, so that’s awesome. Thank you.

Lorne Brown 

Yeah, the time zone makes it a little bit of a challenge, but yes, we did persevere. We’re going to talk about pelvic pain and endometriosis and the other things that we see in the reproductive sphere. I want to get into menopause as well or the perimenopause period. And for our listeners, we talk about the Conscious Fertility Podcast. We’re going to hopefully get into the emotional trauma aspect as well in this discussion. But I’m just curious a little bit on the personal side because we’re just kind of getting to know each other. As I mentioned, Lara said you got to interview you, but how do you become Dr. 2.0 because you are trained in the Western approach, but reading your book and learning a little more about you have a very holistic approach and you’re really getting into lifestyle management and especially on the emotional side. I’m just curious, how does somebody like you get to this point? Your training would not have done that for you.

Peta Wright

No, it totally didn’t. I think basically the fact that the traditional way doesn’t really work got me to this way. And I think there were so many unanswered questions in my traditional training. And when I started, when I finished I came out as a consultant and I was doing private practice, which is a bit different to doing, working in public hospital settings where you might see somebody once and then you might not see them again. I started seeing people and you’d see the effects of what your treatment had on them so for example, someone with pelvic pain or period pain, and I was taught to do a laparoscopy to look for endometriosis and remove it and get the job done. That’s it. You’ve done what you can do as a gynecologist. But then when I did that, I started to realize that that actually wasn’t very efficient at all for many of the women that were coming to see me.

And also because when I was working in private practice, I had a lot more time to hear women’s stories. The thing that really became evident was that many women with particularly chronic pelvic pain had very similar stories in that they often had histories of developmental trauma or persistent stress in their lives. And this kind of led me that and the combination of the fact that what I was taught to do either wasn’t effective in helping someone’s pain and symptoms or in the use of say, contraceptive drugs as like a panacea for pain and for period problems often ended up with women having more problems than when they started off with. And I just thought, this isn’t really what I came into this profession to do. And so I just started asking way more questions and I wasn’t getting the answers from my peers or my mentors or the people that I worked with in private practice who were a few years older than me and were very still stuck in that conventional model.

They just weren’t giving me any answers that were adequate. I will say that I credit Lara with being part of this. I already had all these questions. Things weren’t adding up to me. It was very apparent that people’s mindset, developmental history was an incredibly important part of the symptoms and their environment. And then I was going to Vancouver actually to the World Menopause Conference in 20 17, 20 18, and I picked up La Bride’s book the Period Ripan Manual at the airport bookshop, and I read it cover to cover. By the time I got to Singapore, I’d read the whole thing and had made all these notes in the margin and was like, oh my God, yes, all of this is true. The impact of the environment on women’s symptoms, this is what I was seeing in practice. And I’d never seen a conventional doctor talk about this. So I emailed her when I got to Singapore and was like, oh my God, I love your book.

I’d love you to come and talk to our group of doctors. And by the time I got to Vancouver, she had replied to me and said, that’s fantastic. Thank you for reaching out and I’d love to. Then I made friends with my local naturopath and I went and we would go and sit with each other, me and the other naturopaths, and we would talk, we would case talk about our patients, and I would learn a lot that way. And then I did the certificate of integrative medicine, and that was where I was like, ah, this makes sense. And it just made absolute sense with the lives of the women that I was seeing. And then I started treating in that more conventional, oh, sorry, more holistic way. And lo and behold, that actually works. So that’s how I got there. And it was almost like I would tell people I just couldn’t do it the other way anymore.

It was like a veil had been lifted and I just couldn’t give what I actually feel to be substandard or incomplete, very incomplete care to the women that I saw anymore. So even simple things, women would come in with what I would normally have thought to be a simple problem in the past. It’s never a simple problem and always involves so much more in the woman’s life, the entirety of her body and her environment because of course the nervous system link and where we are in the environment our nervous system responds to and then alchemizes and changes our physiology, which then presents as symptoms. So yeah, now I can’t practice any other way, which means I have much longer appointments for my patients because 45 minutes doesn’t quite cut it. So I now have one and a half hour appointments and I do far less surgery than I was trained to do or than I used to do.

And I actually have patients who are happier and healthier with far less intervention. I do still prescribe hormonal treatments, but the pill hardly ever occasionally because I’m very much informed. These are all of the options, all of the options including pharmaceuticals, diet, lifestyle, spiritual, emotional, all of that. And for some women, they’re at the stage where those things, pharmaceuticals might suit them. So in that case I would do that, but it’s really giving women a whole menu. Whereas before, I think, and still women will go to the doctor with a period problem or a hormonal issue, and the only thing that is offered to them is the pill or a surgery, and they don’t know that there’s anything else out there that can work. So it’s just like they’re given either no help or the pill, which isn’t really a fair or complete menu.

Lorne Brown 

I want to unpack a few things. The first thing a shout out to our colleague Lara Briden who introduced you to this, and I’ll let our listeners know that Lara has an episode on the Conscious Fertility Podcast, episode 75. You want to learn more about her. You mentioned a few things that I really kind of want to unpack, and I love it that how you said, now that you know this and your appointments are longer and you’re seeing better results, your patients are happier. It’s that idea that once you know better, you have to do better. You can’t go back the old way. I’m curious though, how do your colleagues respond to this or do you even care? Because I think about it, I was just at a movie screen for the M factor, the menopause movie, and it reminds me of the endometriosis movie below the belt. I dunno if you ever saw that one of these, two conditions in women’s health, or maybe it’s just because women’s health, there’s two conditions where we’ve learned that they’re far underdiagnosed

And poorly treated, and women get dismissed when they come in with their symptoms. Right. The question I want to ask though, even in both films and just listening to the panelists quite often is they tend to dismiss the diet, the lifestyle, the supplement saying we don’t have good evidence for it. In the menopause thing, it was like you got to do MHT, menopause hormone therapy. I’m curious, what’s your clinical experience? And I know you look through the research, that was a lot of their claims. There’s these allied things, acupuncture supplements, diet mindbody. We don’t have good data for that. Do you agree with that?

Peta Wright 

I think that it’s a nuanced question in that you’ve got to think in a nuanced way about evidence-based medicine and research in that Who is it done by? Who has the money to do it? What kind of studies are they doing? And really, if you’re thinking about evidence-based medicine where they say the gold standard of a study is a randomized double-blinded clinical trial, you can only do that kind of study with the drug, right? Can’t really do that with diet. You can’t do that with exercise. It’s difficult to do with other healing modalities. So of course, if you hold that style of study up as the gold standard, the best level of evidence, then yes study, you can never have those studies for dietary interventions or for other things. So people will say there is not that level one evidence. So that’s the first problem that it’s a system that desires to have that level of evidence is just really stacked.

Again, just really for pharmaceuticals. Secondly, it costs a lot of money to do trials and it definitely costs a lot of money to do trials that would involve lifestyle changes, probably far more than drug interventions. And who is going to pay for those? That is the other thing. And secondly, there is actually really good evidence that things like acupuncture work for period pain and pain in general. There is also evidence that I think dietary is also difficult to get because of the reasons that I’ve mentioned. But also if we look at the evidence for surgery, it’s terrible. People who are saying there is really good evidence for treatment of pain for endometriosis with surgery, it’s actually really low quality evidence. Or there’s only been a couple of RCTs randomized controlled blinded studies on surgery for endometriosis. And the outcomes aren’t actually great in women who they have had a laparoscopy for endometriosis versus the other group who’ve had a laparoscopy, but their lesions weren’t excised.

So one group had these lesions excised, the other group just had holes in their tummy and no lesions excised. They found that 30%, first of all, the people who had just the holes in their tummy but no lesions, exercised had an improvement in their pain. So that’s 30% for the placebo effect, which is not nothing. It shows that there is the mind-body connection, right? I’m being validated, someone’s taking care of me, someone’s taking my problem seriously, I’m being looked after. In the surgical group, there was 70% of people who had an improvement in symptoms, but that has to include the 30% placebo effect there. So 40% of people who have their lesions exercise might have an improvement 40%, but 50% of those 40% have recurrence of symptoms within the next few years. So it’s really less than the flip of a coin whether surgery is going to be particularly effective for endometriosis.

It’s really not good. And that’s not looking at women who have what we would call pain system hypersensitivity or already centralized pain in the brain because pain is complex and it always involves the brain, particularly persistent pain. And there’s some really good recent studies out to show that women who have that, which just to put in perspective, looking at a very big public hospital pain and endometriosis clinic, 70% of the women on that wait list had scores that showed that they had pain system hypersensitivity or centrally mediated pain, 70%, right? And a study has come out showing that if you have a laparoscopy for an endometriosis and you have that level of hypersensitivity, a laparoscopy is likely to be unhelpful at best and harmful or increase your pain at worst in those women. So there is I think limited evidence that surgery is particularly good for endometriosis in all cases.

And also two other really interesting studies from the last 12 months showing that both emergency department visits for acute pain presentations were not affected by having had a laparoscopy for endometriosis. So they still had as many emergency department visits. And yeah, that doing repeat laparoscopies just has often makes things worse as well. So I think when you look at the evidence, if we’re going to play the evidence game, the evidence for things like surgery, and even if you look at things like AL contraception, if you look at the Cochran review, so that’s the collection of all of the best quality studies that are done on a particular thing. There isn’t evidence to show that oral contraceptives or hormonal drugs decrease endometriosis. They do help with pain, but also they have significant side effects, and I do completely use them to reduce inflammation in women who want them, but it isn’t the only way. And I think as long as we only look at surgery and drugs, of course that’s all we’re going to get evidence on. But the evidence isn’t great for either of those.

Lorne Brown 

Well, you said a few things that I want to talk about in your book. You mentioned the mindset already trauma, you talked about the nervous system, and I’m going to come from this angle. So I’m trained as a Chinese medicine practitioner, a doctor of Chinese medicine and a clinical hypnotherapist. So when I work with pain, I like to look at it from a bottom up and a top down way.

Peta Wright 

You’re speaking my language, I love that.

Lorne Brown 

So good. So the nervous system reset. But I got to let the audience just hear, this is why I was loving your book. So I’m not reading your book and I’m not going to tell you every chapter, but I got to tell you just some of the chapters in her book, Healing Pelvic Pain that were drawn to me. So chapter six is called Moving Beyond the Biomedical Model to let you know that she talks about the biomedical model. But then you go on and talk about the other things which we’re going to do in a moment here. I want to know what is your approach for pelvic pain, endo and part of the book, some of her practical ways to true healing? I love this. I think a lot of the ancient cultures like Ayervetic, traditional Chinese medicine and naturopathic physicians, we’re not always trying to cure but rather create healing.

And then in healing, lots of things can happen including a cure by the way, but the body heals. But one of the chapters is called reducing inflammation and supporting the immune system because again, in an integrative approach, we understand how the immune system’s impact in endometriosis, finding safety and stability in your nervous system, acknowledging trauma and stress in your life, rewiring pathways and reducing fear. I love that from my clinical hypnosis perspective. And the last one, rewinding their narrative about periods and our bodies. And then she has really cool help sections like a pain flare toolkit to bring you back into safety. So this is why you’re perfect for the Conscious Fertility Podcast. Just those chapters show you this is kind of your approach and angle. And so the question I wanted to ask you is what is your approach then of assessing somebody that comes in with pelvic pain, endometriosis, whether they’re trying to conceive or not, but also if they’re trying to conceive and what are some of the integrations that you’re looking at to support this?

And I want to add one more thing that you can tie in and share with our listeners because there is evidence that your thoughts and feelings affect your physical body. The research is called psycho neuroimmunology and they’ve extended it now they call it psycho neuroendocrine immunology. So rather than P-N-I-P-N-E-I. So can you talk about your holistic approach for pain? Because I heard that it’s not as easy as taking the birth control pill or we call it Lupron, I don’t know what your drug is called in Australia to suppress it or surgery. And you’re also talking about excision surgery, which seems to be the gold standard for endo over cauterizing burning it.

Peta Wright 

So I guess number one, I love that you talk about top down, bottom up. I think number one, when someone comes in to see me with pain, period pain or persistent pain, pelvic pain, they often have a lot of fear. And they also have this narrative because I think we’ve swung, we’ve, the pendulum has swung from, you’ve got pain, you’re a woman, suck it up, just deal with it, which is not good. Two, all pain is abnormal, and if you have pain, it must be endometriosis and you need a laparoscopy, which is incredibly flawed. And results in, I think, and I see the results of this every day in my clinic, seeing women who’ve had 10 laparoscopies who have more pain than when they started and feel completely broken and at wall with themselves. And if you know anything about healing, which means to make whole, that is the antithesis of healing, right?

So yeah, I think the first step is to do education and I think that is part of that top down processing. So top down is dealing with the brain, dealing with our thoughts, and then bottom up is dealing with the signals of safety or danger that our bodies provide to our brain. So I would always start by talking about what are the causes of pain? And that in studies like a massive study in Australia, like thousands and thousands of women, they looked at the prevalence of period pain for those one or two days is like 95%, right? Would that be less if we didn’t have the kinds of lifestyles we have? Probably so because I think that we live in a society where women have to pretend that they don’t have an inflammatory thing happening in their bodies every month and they have to just push through.

And it’s almost like we’ve created this culture where the only way women can then push through is to be on the pill, turn off their cycle, which then can create a whole host of other things. So the prevalence of some discomfort with our periods is like 95%. And that makes sense because the lining of the uterus is shedding. We are making prostaglandins, those inflammatory chemicals that are making those little mini contractions to get that blood out, to allow that lining to slough off because of an inflammatory process and that can be uncomfortable or cause some pain for some women. And so explain about that and explain how we can turn the volume up or down on pain. And that would be things like more inflammation in our diets that can then affect our gut, that can then cause our immune system to become hyperactive and can also cause toxins in the environment.

It can be stressful. So our nervous system is in constant fight or flight or freeze, which then affects our microbiome, which can then affect our gut lining and that mucus layer in the gut, which can then lead to increased intestinal permeability or leaky gut. And we know that that can upregulate a cell called toll-like receptors, which is a cell that sort of straddles the immune system and the nervous system, which can make the immune system more overactive and potentially cause more inflammation in the pelvis. In fact, when we look at all of the literature and the inflammation that’s there, the presence or absence of endometriosis and the extent of disease is actually very poorly correlated with pelvic pain with either someone having pelvic pain or the amount of pelvic pain. So if you had 10 people women presenting with pelvic pain or severe period pain, about four of them would have endometriosis if you looked in their belly with a laparoscope with camera and the other six of them would not, but identical pain and if they have persistent pain, they may have that elevation in toll-like receptor four and that neuroinflammation even if they don’t have endometriosis.

So the data tells us that the endometriosis, yeah, it doesn’t have a great correlation with pain. So that’s why I think chasing that lesion has actually probably done more harm than good. And what has happened is that because women have been completely dismissed for such a long time and because the western medical system is so biomedical and it’s like, oh actually we’ve found this thing and we can see it in your belly. And because that’s the only thing that we validate, women want that diagnosis of endometriosis to validate their experience, which makes sense. But we shouldn’t need a diagnosis of something we can see without the naked eye to validate a woman’s experience. That should be just a given when someone comes and talks about their experience. Because the thing about endometriosis is there is really good data that obviously many women have endometriosis and do not have pain, do not have symptoms.

And there’s good studies that show that when you look in the pelvises of women who say they’re going in for a tubal ligation or to have their tubes tied, there was one study with up to 44% of those women having endometriosis on laparoscopy but no symptoms. So we think that’s probably the true prevalence of superficial endometriosis. And I think the other thing is endometriosis isn’t just one thing that’s the same. There are three kinds of distinct subtypes of endometriosis and they probably have different physio or how we got to that point. About 80% of women who have superficial endometriosis or disease where there’s cells that are the cells that line the uterine lining in the pelvis, kind of like algae on the surface of a pond, just kind of superficially scattered around. And I think that that kind of endometriosis probably is representative of, I think it’s probably physiological.

I think it probably represents the wear and tear of having a period. And we know that the vast majority of women when they have a period, the blood comes out of their fallopian tubes and lands in the pelvis and then our immune system just has to clear that up. And if our immune system isn’t doing so well or it’s overactive, then we get more inflammation and potentially worse endometriosis. But we also had this idea about endometriosis in our head that it’s this incurable, always progressive disease and the evidence as well tells us that is not true for the vast majority of women. So in women, again where they’ve looked in and had seen endometriosis and then they did a really interesting study where they either did nothing, so gave them a placebo, a sugar pill, or they gave them a progestin pill like the oral contraceptive.

And then they looked in their tummies six months later and they found that both groups of women had complete regression of lesions, but the group that had the highest regression was the placebo group for some reason and it was up to 44, 40, 5% in complete regression. And in all other studies looking at the natural history of endometriosis, at least 70% of those lesions either remain the same or improve or regress. So I think that’s also really important because women have this idea that the only way to get rid of it is with surgery, but they forget that our body is dynamic, that if our immune system is working well then it can take care of that for us. The other two types of endo are deep endometriosis, which makes up about 5% of the kind of endometriosis that women have. And that’s like if you think about a weed that has roots growing down and it can kind of go into underlying structures and ovarian endometriosis, which is in the ovaries and looks like a cyst.

And that’s about 15% of women with endometriosis. So they’re not all the same either. And we know that good quality ultrasound or MRI can diagnose with over 90% certainty the ovarian and the deep endometriosis. So if you have an imaging test that shows that everything looks fine, then if you have anything, it’s likely to be superficial endometriosis. And the jury is completely out on whether or not excision of superficial endometriosis makes any difference at all. And there are a couple of really big studies actually ongoing in Europe about that or whether it makes it worse. I would usually go to explain all of this because this helps with addressing the fear that many women have. Also, the fertility infertility piece, which is yes, there can be an association between infertility and endometriosis, but for the vast majority of women who we know have endometriosis, and given what I’ve said, there’s a lot of women out there probably in the order of one and two at any given time that have endometriosis we don’t know about because they’re asymptomatic if you happen to look in their pelvises at a particular time before their immune system cleared up those cells.

And we know that the vast majority, 50 to 80% of women we know have endo have no problems with pregnancy. So it is a smaller number that may have a problem. And also there’s no evidence that doing a laparoscopy and removing endometriosis for someone who doesn’t have a history of infertility is going to improve their fertility later on because they might have completely normal agility.

Lorne Brown 

I’m going to recap a few things here. So first of all,

Peta Wright 

Go for it

Lorne Brown 

Everybody. This is DR 2.0 at first when you’re talking about the gut microbiome and how your stress or diet or the environment toxins can affect inflammation and then how that impacts the autoimmune system and the immune system, hence autoimmune like symptoms. Many people will be like, oh, this is Dr. Peta Wright. Must be a naturopathic doctor. But no, she’s an OB GYN. That’s what I love. I’ve been in practice since 2000, so I guess at the time of this recording, just over 25 years, I’ve been waiting for you. This is what I’ve been waiting for where the integration happens inside of somebody like yourself that can bring it into the clinic. So this excites me. I want to share, we have a post that we call 10 strategies for managing the endometriosis symptoms, and I’m going to list the 10 and I kind of want to know whether you’re like, no, I don’t like it or I do like it as I do it. And these are not in any order. I think they started alphabetically and then they got moved around. We use acupuncture in our practice and are recommended. So just checking in. Yay, nay.

Peta Wright 

Yes

Lorne Brown 

We use low level laser therapy. I don’t know Roberta c cha in Sydney was doing it, but are you familiar with that? Have you heard of that one yet?

Peta Wright 

What kind of laser therapy is it?

Lorne Brown 

So it’s low level, so it’d be red infrared light, but it’s low level, low power, so it can’t cut or burn. It’s not the stuff you buy on Amazon. Those are great as in they have the right wavelengths, but they may not have the right radiance or power, most of them.

Peta Wright 

I think that the big thing is, as I said, the presence or absence of endo isn’t, I think that’s been a red herring for us basically with pain. But what is very, very correlated with pain, you’ll probably like this being a hypnotherapist as well, is that the studies show again and again that what is associated incredibly strongly with pain irrespective of endometriosis state is fear. So overprotection fear and immobilization, and that is the state of the nervous system we’re looking at there. So that is people who are in a persistently dysregulated nervous system state. So anything that helps to bring somebody’s nervous system from freezing or sympathetic fight flight back into that ventral vagal safe place, I think is going to be beneficial. And so that’s where I think acupuncture is effective. I don’t know about the light, but I imagine if you’ve got a bit irrespective of the efficacy of the laser having a caring therapist.

Lorne Brown 

Well I’ll explain the laser why you may go. Oh, so there are a few studies using it for endometriosis, pelvic pain, Roberta Chows in MD in your part of the world, she did a study in the Lancet for neck pain. But when I went to see her anecdotally she was working with women with endometriosis and not so much their concern of the lesions as diagnosed with endometriosis and have the symptoms, UTIs, bowel issues, severe pelvic pain, pain with bowels, pain with sex, where that’s what really matters regardless of what the lesions look like. Are you suffering, right?

Peta Wright 

Yes.

Lorne Brown

So the light therapy regulates inflammation. Part of that’s through the process that improves mitochondrial function and increases nitric oxide and regulates inflammation. It lowers oxidative stress, it increases blood flow and depending where you put it, it originally got discovered by a pain specialist in Japan medical doctor where he was using it to treat pain and he would do some points around the vagus carotids dali ganglia to elicit the parasympathetic response.

Peta Wright 

Totally. So anything that does that, yes,

Lorne Brown 

Yes. And the cox plexus, those were his spots. And then he would go locally. So Lola laser therapy, so just I’ll share more information with you later. Naturopathic medicine, which is a whole medicine of diet, lifestyle, stress reduction, but we incorporate that supplements. Do you use any supplements?

Peta Wright 

Yeah, I do. I do suggest some, but again, I think it could be on, nothing works until you feel safe in your body. And that is my key message. So if you are tugging the supplements on a super restricted diet and you are still living in a state of fear and hyper hypervigilance about oh my God, is there gluten in that bread or whatever, that is probably going to, there are some instances where that can even be more harmful or if I miss my supplement, you know what I mean?

Lorne Brown 

Absolutely. So in Chinese medicine there’s a type of liver cheese stagnation type that has nothing to do with your western liver. And in my clinical practice you can have gut issues and one can be more of what we call spleen cheese deficiency. They got the poor microbiome, they’re chilled about most things, but they got gut health issues. Then you have somebody with gut health and they’re the liver chi in the west. The type of liver chi. In my clinical experience, giving them a restrictive diet binds up the liver chi stagnation more, it makes everything worse. They need freedom, not more restriction. So I’m in agreement with you and in Chinese medicine, the way I was trained, the number one cause of disease are your emotions out of balance.

Peta Wright 

Yeah, a thousand percent agree with that. I will say, I’ll do the supplements in one second, but I would say often the symptoms are instead of viewing it like western medicine views it like an enemy, something to kill, something to fight. And we think about how we talk about endometriosis like endo warriors, I dunno if you have that in Canada. Language and language is so important in the way that we feel and how we integrate things into our brain, which then is, as you talked about with neuroimmunology, that affects the whole programs, everything in our body. But emotions are the most important part. Viewing your symptoms as a message from you to you, it’s not your body out of whack. It is your body, not your body making a mistake. It’s not your body fighting you. Yes. And it is feedback from your nervous system that the level of stress is too overwhelming for your body to cope with and that it is changing to help you to survive. And that is great if it’s short term, but that becomes maladaptive. And if we can learn to view our symptoms as signals or important powerful messengers, then we have power that we can change things rather than, and we’re on the same team as our body. I think that is absolutely the crux, like the emotional thing. Supplements, yes. So things that I recommend, just simple ones would be magnesium,

Zinc and Omega-3, sometimes NAC, ginger root capsules. There’s a great study that looks at actual ginger root capsules and I think it’s an RCT looking at ginger root capsules versus ibuprofen and they’re equal to each other in terms of efficacy for pain and it doesn’t have the same gut effects as ongoing ibuprofen. So I often recommend ginger for periods. Curcumin also can be good.

Lorne Brown 

Everyone you said on our list, I would say from a Chinese medicine perspective, ginger, yes. But if somebody is more on the cold type, cold pain, if somebody runs really hot, it may not be because it’s such a warming herb from China, so we wouldn’t just give it to everybody and usually they’re given in combinations. We also like vitamin D with K two just because it’s regulating inflammation. But every one of those, I think he did a study in your, are you familiar, he’s part of your neck of the woods too, A friend and colleague of mine, Mike Armor.

Peta Wright 

Yes. He was the one who did the huge study on the prevalence of pelvic pain in Australian women. Yeah, absolutely.

Lorne Brown 

Yeah, I know he’s a herbalist and we’ll use that for pelvic pain. And then I maybe should have this as number one, but number six is to regulate your nervous system.

Peta Wright 

Number one, definitely if you think about it, you think about regulating your nervous system, then everything else kind of falls into place by itself. As you said before, the body heals itself because I just like to think about that whole concept of if you are in a fight flight or a freeze response, it’s like if you think about your body like a house, I did a really beautiful breathwork thing with someone the other day, and this is from this breathwork practitioner, I’m stealing it from her. It was so good. She said, think about your body like a house. And if everything’s fine, there’s no danger, you can maintain the house. So on a Monday you’ll clean the windows, you’ll vacuum the floor on a Tuesday, you’ll do the general maintenance that the house needs to keep it itself running and pristine and looking good. If there’s a fire in the kitchen, which is kind of representative of a persistent hyper arousal, sympathetic nervous system state or a freeze state, then you just have to have all your attention on this fire in the kitchen, putting it out.

And then you have no root time to or resources to spend time on the other house, cleaning, maintenance, and then that can go to ruin. And we think about our bodies, this is when we can get sick, this is when we can get inflammation goes up or when we are more likely to even have long-term cancer and all of those kinds of things. Because spending so much energy on the survival nervous system state, we don’t have time for that regular maintenance or rest and repair, which happens only in our ventral vagal or safe nervous system state. And everything is affected by the state of our nervous system, our gut health, our immune system, because it all begins in the gut. Our microbiome, how much danger we think we’re in, like our amygdala is always registering that. And especially for pain conditions. If our body is in a survival state, it’s going to think we’re in more danger and it’s going to be interpreted as a pain signal or a potential painful signal, painful stimulus, like a period as more dangerous.

So what it does is, if we are in that survival nervous system state when the normal inflammatory painful signal comes to our brain, that might just be fine. We move a bit, we have a heat pack, we have some ginger tea and it’s usually fine. But in this survival nervous system state, that signal is turned up, the volume’s turned up in the brain. And when we get into persistent pain states, it’s not only that that can be turned up, it’s bowel, it’s tummy issues, it’s bladder, it’s pain all over the body, it’s fatigue, it’s all of those things. So all of those other things that people talk about being endo symptoms, they’re not caused by endo. They’re caused by the dysregulated nervous system state, which is potentially causing the painful periods or the period pain in the first place. And then the lesions might be a flow on effect of all of that, but it’s not the cause. It’s the nervous system state. Does that make sense?

Lorne Brown 

It does make sense. And my approach after several years in the last decade at least, is to focus on the MINDBODY connection and your beliefs and your programs because your actions and behaviors are always going to be congruent with your programs and beliefs. And so as you said, if you’re in the nervous system overdrive, fight or flight, then your resources are going to simplify this. You go into fight or flight, freeze, your resources go into survival mode and they’re not available for healing, creativity or reproduction. And when you feel safe, now your resources are freed up for healing, creativity and reproduction. And so yes, it’s all about that autonomic nervous system. To me that is the top of the pyramid. And then diet lifestyle will follow when all that’s done too. You don’t need food like Prozac. You won’t do drugs, alcohol or overwork to numb yourself or dissociate. So I think the, and again comes from that, the idea of Chinese medicine, how your emotions impact your health. And when it comes to pelvic pain, they didn’t call it endometriosis, but when I was trained, one of the things that they shared was this cheese stagnation blood stasis that we see in Chinese medicine, which you guys would call pelvic pain comes from repressed emotion. So think of trauma stuff. So this is talked about two, three, 5,000 years ago that this is now showing up in the body. I can’t remember the author, but have you ever read The Body Keeps a Score

Peta Wright 

Bes VanDerKolk? Yeah, I am all with him. It’s amazing. Yeah. And the prevalence of pelvic pain in women who have had childhood trauma, particularly sexual trauma is there is a link there too,

Lorne Brown 

But it doesn’t have to be sexual trauma, does it? Any trauma can do it,

Peta Wright 

Right, any trauma. And I think, but this is the thing, when you think about this and you see patients and you take that bigger picture, that bigger history, then you realize probably the greatest trauma, when I say the greatest, I mean the most prevalent is rupture and attachment. And there is really good evidence and even more and more evidence that says, because I think we have an idea that if we don’t remember it, if it happens when we are really young, then it doesn’t have so much of an effect on us. But the research actually tells us the opposite, that the earlier that a trauma happens and a trauma and the most primary need that a baby or a little infant has is attachment because that’s our survival as a human helpless child. And if that attachment is disrupted as a baby, and that might mean spending time in NICU being born premature, it might mean mom goes back to work on week three and baby goes to daycare or any rupture in attachment, which is so prevalent because of the capitalist patriarchal society that we live in. And because there’s such little reverence for and support around family life and motherhood and allowing the research around the first thousand days in the brain development of babies and then how that affects everything else later on if there’s a ruptured attachment, which is in essence trauma because trauma is really just the imprint of a reaction to an unsafe environment.

And you can’t explain to a baby that mom has to go back to work for financial reasons, two weeks old. And so I think that is really prevalent. And so I see girls who might have siblings that were really sick and they got no attention or bullying at school or just the trauma of almost our modern lifestyles, right? There is no up switch, there is no rest, there is no return to baseline. And I could think when we think about nervous systems in our bodies from an evolutionary perspective, it gets kind of scary because we need to have these nervous system responses. We need to be able to mobilize into fight, flight, freeze to be able to help us survive. If we think about when we’re a cave of people, that is important. If a lion comes along, we need to be able to run away.

We need to be able to recognize danger. But then that passes and then we go back to lying under the tree or being with our family and just gathering in a peaceful way or whatever. There is no downtime now. And so what happens is in our nervous systems, which are so clever, a mistake is that we’re designed to be able to respond to a stressor and then we come back down to homeostasis, then rise for the stress, come back to homeostasis. But what happens in our lifestyle or if we have persistent stress is that we just start to go up and up and up and we get to this new set point. It’s called an allostatic load. So we get to this new set point. And then what happens is when we think about the nervous system, there’s a term called the window of regulation, which is the part in our nervous system that means that we can respond.

We feel like we’ve got it, we’re going through our day, we can control things, we can handle it. We feel like we’re operating within our window of regulation. We’re not flying off the handle, we’re not falling into a heat, we’re not having a panic attack. So when we’d like that window to be nice and wide so that we can tolerate lots of the things that are going to come up in our day, and sometimes we might come out of it, but we should be able to come back in if we have developed all of this allostatic load and our set point has increased because of this environment of persistent stress, that window of regulation shrinks and then where all of a sudden things that didn’t have us out of the window are out and we are hyper aroused and we are feeling that in our body and in our mind, or we’re just burnt out and it’s happening quicker and quicker because that window of regulation is decreasing.

And so the work that I do is talking to people about how that works and then helping to train with the knowledge that their bodies aren’t broken, that their bodies have reacted exactly the way they should to the environment that they’re in. And then helping them to realize that while that has happened, what that means is that we can train it to go the other way. And that’s bio, neuro and bioplastic. The fact that the body can then change, can change again. If we change our environment, we can train our nervous system to widen again. And then that often means that women aren’t having as much pain. Because the other thing I think about too, when you are talking about bottom up signals, I often think about women. I always tell them, paint me a picture of what it looks like when you have pain.

And they’re like hunched over breathing, really shallowly, immobilized in bed for hours and hours on end, afraid to move, which goes to those two things. Fear, overprotection, immobilization that we know are associated with pain. And those bottom up signals through the vagus nerve to the brain are saying danger, danger, danger. Turn the volume up on pain. And so teaching someone how to breathe, activate that vagus nerve, how to move gently, how to relax the pelvic floor because often women don’t even know about their pelvic floor because they’re so disconnected from it. But that is a huge contributor to pelvic pain, so tense and tight and can go into spasm. Then that can widen the window of regulation and improve pain absolutely massively. And with that bottom up signaling,

Lorne Brown 

I will share with you, Peta, I got to tell you two toys I have. I love doing all of this conscious work, and one of them, and I’ll send you a link to this. One of them is called neuro visor, which helps do brain engagement and it uses flashing light and bin beats. It can really shift you out of a stress response. So it’s really doing neuroplasticity on the brain. It puts a little bit of good stress on the brain, and then there’s an amusement part. You see fractals, you see colors. I take this to the IVF clinic and give it to the nurses when they have a five minute break when I’m on site there and they describe it as heaven entered my brain, I felt like somebody was tickling my brain, and most of them are feeling exhausted like they’re done for the day and then it revives them.

So just a little biohack tool. The other one is a VibrAcoustic sound table that can help put you into parasympathetic, right? Using frequencies and vibration and sound. Again, anything we can do for a parasympathetic, I keep thinking I kind of want to do like a pilot project where all these people with chronic pain have them come in two or three times a week and do the table with this and just do this for six weeks and see how this changes. Because how it keeps engaging the parasympathetic because if we can keep engaging the parasympathetic, we’re going to heal. So we talked about a few things. Number six was to regulate the nervous system. I think we both agree that that’s really important.

Peta Wright 

Thank you. Number one, I think put on number one.

Lorne Brown 

Yeah, number seven was an anti-inflammatory diet. By the way, you guys can download ours off of our website. Number eight was to support gut health. Number nine was pelvic floor physiotherapy and number 10 was considered surgery. So of all the 10, the only one that I think you weren’t familiar with was the low level laser therapy. Is there any there that you strongly disagree with from that 10? And is there anything that you do differently that you would say, no, you got to add this that I missed?

Peta Wright 

No, I think everything that you are saying, and then I think just looking at the person’s life and just really getting them to hone in what these messages are trying to tell you? If we can view these messages as benevolent powerful messages rather than an enemy to be conquered or killed or gotten rid of because as you know, a hypnotherapist as well, whenever we think something has to gotten rid of, then that actually increases fear in the body because it’s like, well, it’s bad. It must be bad. So I think looking at the pain as I think the way we view pain is extremely important because I think if we look at western medicine and its attempts to tackle pain, they’ve all been quite disastrous. You think about the opioid epidemic, all of that and surgery, and we think about the other thing with surgery, and I think this is really important for women to understand who will say, because they’re only ever given the biomedical model of laparoscopy diagnosis of endometriosis or that’s kind of it, right?

Is that in every other, particularly orthopedics where they used to do lots of surgeries for pain in joints and stuff, until there it was discovered that it wasn’t very effective, which is what we now know about endometriosis surgery, not all of the time, but for the number of cases that are having surgery without anything else. And then they’ve changed how they do that. It’s like women are being, the term being gaslit is often used for women who are ignored when it comes to their pain. But I actually think women are being gaslit into thinking that they need a laparoscopy and excision of surgery because it actually is not effective, and if we stay down that path, it’s like they are getting outdated medical care, whereas other specialties have updated with their understanding of how complex pain is and how it involves the brain. So I think that’s really important and that early diagnosis of endometriosis, which is touted, I actually think looking for that at all costs is actually detrimental, but it is early recognition and treatment of pain.

That is incredibly important. Early recognition, validation, and treatment of a woman’s pain, which may or may not include surgery, but that is the key. In fact, when we look at it there is no evidence that early diagnosis of endometriosis changes the course of a disease, improves the quality of life. What we do know is that the earlier you have a laparoscopy, the more laparoscopies you’re likely to have, which to me, I think that tells the story that it’s not very effective. They’re having to have more and more. So I think that is really, really, really, really key.

Lorne Brown 

And the approach is a holistic approach, diet, lifestyle, mind, body. You talk about supplements, there’s lots of things you can do and you’re integrative. Sometimes surgery is required and sometimes certain hormonal medications or drugs are required. When I was reading your bio, it said that you also can do IUIs or IVF with your fertility specialists as well. So do you currently still do IVF with? Okay, so your approach as we wrap up here, and I wanted to talk about PCOS. We’re not going to get there today, everybody. I got to have you back to talk about menopause and perimenopause, no pun intended, but menopause is really hot right now.

Peta Wright 

Happy to give you my take on it, which might be also a bit different to other people.

Lorne Brown 

I want to hear it

But I want to know just about this, since we’ve been talking about endometriosis, pelvic pain, and a little bit about fertility here. Do you have an approach when somebody comes in and they have fertility issues, some clinics right to IVF get you to IVF or we’ll do a couple of Clomids, letrozole, then IVF. What is your approach to somebody’s trying to conceive and they’re having difficulties? What’s your holistic approach? I’m curious how you see it and do you see a difference? I worked with, I interviewed somebody way back when out of Austria. She’s an MD who’s trained in Chinese medicine and herbal medicine, and she’s an IVF reproductive endocrinologist. And in her clinic, she doesn’t have a study, but she has anecdotal observation that those that go to IVF, those that do acupuncture, herbal leading into IVF, she sees better outcomes with the acupuncture herbal, because not everybody wants to do acupuncture, herbal, there’s extra costs and stuff, so they just do the IVF. I’m curious because you may have patients who are like, I’m not doing any of that, but give me the IVF. What’s your approach? What are you observing in your practice?

Peta Wright 

Generally I work with a naturopath. We kind of work together, so I generally recommend that they also see Alicia who’s our naturopath and she’s amazing. And just really having that focus on sperm and egg health because just doing IVF, I just think about it like cooking. You want to have the ingredients as optimal as you can. There’s no point baking a cake if the eggs are not great and the milk is off. You want to try to optimize the quality of your ingredients beforehand. And that involves a full look at diet, lifestyle, obviously obvious things like smoking and drugs and alcohol exposure to endocrine disrupting chemicals or looking at that in the environment. Stress is really important. And sleep as well for both partners. I guess it depends, I am very focused on, look, these are the options and these are the numbers that I can give you as a generic guide to pregnancy rates with the options.

I mean, IUI by itself doesn’t really add a lot unless there is an ovulatory issue that we can’t fix that we need to use Clomid or letrozole. Then you might do Letrozole IUI or F-S-H I-U-I. If someone had endometriosis or I was suspicious of it. It depends again, on what they want to do. I think about how old they are and how many kids they want to have as well. Because say if someone’s been trying to conceive for two years and they haven’t conceived, yes, there is evidence that doing a laparoscopy and removing mild, mild to moderate endo may double the pregnancy rates, but that number actually isn’t very high if they’ve come off a background of two years of infertility. And so the numbers with IVF might be better, so I just counsel them about all of those things. But I think no matter what we do, whether we do IVF, we do ovulation induction.

It’s all about trying to get to the root cause of what the problem is, and then optimizing the egg and the sperm quality. And yes, we used to have an amazing Chinese medicine practitioner in our clinic who has moved on, so we’re looking for another one. But yeah, I found that women who do regular acupuncture, definitely who look at egg and sperm health and change, making space in their lives for the child that they want to have, I think that’s really, really key. Like I used to work in a city practice where I would be starting work really early at five or six or whatever to get the women who wanted to do their IVF cycle with no disruption to their day in. And I don’t do that anymore for two reasons. One, I don’t like to get up there early. I want to be with my family.

And two, because I think it’s really, I really encourage people who are doing an IVF cycle that they can do it in a more mindful way than being on a conveyor belt, just cramming this extra thing into an already fast paced, busy lifestyle. And I think that encouraging them, at least in that second week of the stimulation and the egg retrieval, to slow down and be conscious about what is happening in their bodies and what they’re trying to bring in and using even meditation and yoga. And we have a beautiful yoga teacher called Sam who does beautiful meditations for the two week wait and for an embryo transfer and stuff can be really beneficial to get people into the right head space, which is really about, again, getting ourselves into that safe parasympathetic nervous system, which is the most important for receptivity and for telling our brain and our body that it’s safe to reproduce to have a baby. So I think that is all really foundational and some people, I mean I don’t really think people come to me who want to just do IVF and that’s it. I don’t think I have that name. So yeah, I think that’s not your vibe.

Peta Wright 

No, and I find it difficult to have a control group because yeah, I think most of the people have a similar philosophy.

Lorne Brown 

So in what I heard there, I love your baking the cake analogy. If you’re going to bake a cake, you want the ingredients to be fresh and good. And so you want the egg and the sperm to be at their peak fertility potential at the time of the IVF retrieval and inseminating those eggs with the sperm. And so that’s where you do the holistic approach of diet, lifestyle, yoga, acupuncture, naturopathic, clean up, all the things that are out of balance. So the nervous system, the blood flow, the inflammation, oxidative stress, mitochondria health, so the follicles in the sperm have a chance to mature to their peak potential. That’s what I think I heard.

Peta Wright 

And I think I do see a huge, I mean, again, you don’t know whether it’s just luck cycle to cycle, but women who have had a cycle where they’ve had a poor outcome and then they do go, yes, fine, I’ll see the naturopath and they do all the supplements and they do everything. I’m just thinking of a recent couple and then they went from having nothing, everything dying on day three to having four embryos to biopsy and ended up with three eulo beautiful embryos. So she was cursing with Napt pads for all of the supplements during those three months. But now I’m very happy.

Lorne Brown 

That’s right. It’s not forever. It is just three months. Alright, we’re going to wrap up here at time. A couple of ideas that I want to throw out to you and we could talk off camera. One is I would love to have you back, I want to talk about hormonal imbalances and in that I want to talk about things like polycystic ovarian syndrome. I want to talk about the hormonal imbalances that people experience in perimenopause and menopause. I want to talk about the birth control pill using it, how it’s used to manage some symptoms with irregular cycles and acne. I don’t think that’s your style either. You have a point of view on that. So can we try and connect again and have that as a part two? Perfect.

Peta Wright 

Yeah, absolutely. I’ve really enjoyed talking to you today.

Lorne Brown 

And the other thing I invite you from the way you talk, I hope you, if you check out some of the other, and our listeners, if you like this what Dr. Peta Wright’s sharing the Conscious Facility podcast, I think you’ll like some of those episodes because we have a lot of teachers of consciousness, quantum physicists, PhD psychologists talking your talk including Gordon Neufeld, Steven Porges that I mentioned in your colleague and friend Larry Bryden. The most important thing I want to share with the audience is healing pelvic pain with Dr. Peta Wright. I really encourage you to check out this book if you have pelvic pain, if you’ve been diagnosed with endometriosis, there’s so much information, so many resources at the back, things that you can do. So this can, I think, help you hopefully resolve the suffering that many people are experiencing. So do check out her book Healing Pelvic Pain, and then we’re going to put it in the show notes. But Peta’s website is verawellness.com.au. Remember, she’s Australian. So for our listeners that always think it’s just.com, we got to add an au at the end of it for her Australian web address. So that’s vera wellness.com.au and we’ll put that in the show notes.

Peta Wright 

Thank you. It’s wonderful to connect with like-minded practitioners, so I really appreciate you inviting me on and the opportunity to connect.

Lorne Brown 

I’m so glad you exist and that you have your passion and you’re doing what you’re doing. There are so many lucky people in Australia and because you wrote a book and you have a website, everybody around the world can learn from you as well. So thank you. Thank you

Peta Wright 

So much.

Lorne Brown 

Alright, just a quick wrap up. I just got off the camera with Peta. That was amazing. So she’s agreed to come back and we’re going to talk about menopause, other hormonal imbalances like PCOS and then her take on birth control pill and alternatives when you’re using it for acne, irregular cycles. She has a different approach than the birth control pill, so we’re going to have her back. And the menopause, it’s quite important. It’s also underdiagnosed or dismissed a lot, and so we want to make sure you get the information so you can go get empowered and get the necessary treatments and support you need so you don’t experience these unwanted symptoms. I put in the show notes as well, that blog where the top 10 things where it explains stuff, the top endometriosis treatment strategies, I’m going to put that in the show notes. And if you’re looking for, she talks about reprogramming the conscious work. You can check that at Acubalance. I offer that there. And I’m going to put in the show notes, those two toys that I like, the neuroVIZR and the Vibracoustic sound table that we offer at our clinic. Or some people want to pick up their own if they get a chance to try it. That’s in the show notes as well. Wishing you all the best of luck on your journey. 

Speaker 4 

If you’re looking for support to grow your family. Contact Acubalance Wellness Center at Acubalance. They help you reach your peak fertility potential through their integrative approach using low-level laser therapy, fertility, acupuncture, and naturopathic medicine. Download the Acubalance Fertility Diet and Dr. Brown’s video for mastering manifestation and clearing subconscious blocks. Go to Acubalance.ca. That’s acubalance.ca.

Lorne Brown

Thank you so much for tuning into another episode of Conscious Fertility, the show that helps you receive life on purpose. Please take a moment to subscribe to the show and join the community of women and men on their path to peak fertility and choosing to live consciously on purpose. I would love to continue this conversation with you, so please direct message me on Instagram at Lorne Brown official. That’s Instagram, Lorne Brown official, or you can visit my websites Lorne brown.com and Acubalance.ca. Until the next episode, stay curious and for a few moments, bring your awareness to your heart center and breathe.