Episode 426: Endo Uncovered: Painful Periods, Endometriosis & the Symptoms Women Are Told to Ignore
Listen on Apple Podcasts | Listen on Spotify
We are officially kicking off the endometriosis series. In this first episode, Erin and Rachel Heintz, lead practitioner at The Funk’tional Nutritionist, are untangling one of the most misunderstood, underdiagnosed, and wildly dismissed conditions in women’s health.
Painful periods might be common, but that does not mean they should be normalized, trivialized, or ignored.
Erin and Rachel explain what endometriosis is, what conditions commonly overlap with it, why it is considered a chronic inflammatory whole-body condition, and how it can show up far beyond the uterus. Spoiler: we’re going inflammation hunting, and no, you do not have to just suck it up and suffer your way through being a woman!
In this episode:
The difference between normal period discomfort and the kind of pain that should not be brushed off as “just cramps”
Why recurring SIBO can be a clue that something deeper is driving the overgrowth
How toxin exposure can drive or exacerbate painful periods and endometriosis symptoms
The hopeful research Rachel shares around genetics, imaging, and the future of endometriosis diagnosis
Obscure, less common symptoms that can still be part of the endo picture
Resources mentioned:
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Rachel Heintz:
Normal periods, you might have no pain, you might have a mild or a dull ache. It can be in your lower belly, it can be in your back. You're able to complete your activities of daily living, you're not canceling plans. Whereas abnormal periods would be cramps that are not improving with medication, or cramps that require a lot of medication to control the pain, pain that's interfering with your work or your social activities. Vomiting, nausea, dizziness, or fainting from that pain or discomfort.
Welcome to The Funk’tional Nutrition Podcast, spelled with a K because we do things a little differently around here. I'm your host, Erin Holt, and I've got 15 years of clinical experience as a functional nutritionist and mindset coach, creating a new model that I call Intuitive Functional Medicine™, where we combine root cause medicine with the innate intelligence of your body. This is where science meets self-trust. Your body already knows how to heal, and this show is going to show you how. If you're looking for new ways of thinking about your health, be sure to follow and share with a friend because you never know whose life you might change.
Erin Holt:
Hello, my friends, and welcome back to the Functional Nutrition Podcast. Just a few short weeks ago, I made an announcement here. I shared with you guys that I am working on some perfectionist tendencies, and I'm doing that here on the podcast. In real time. And boy, did I get an opportunity to really practice that when I listened to today's recording and realized that my mic had been turned off the whole time. So that's never a good feeling. That's never a fun thing to discover, but I'm going to publish it anyway. I sat down with my lead practitioner, Rachel Heinz, and we recorded our very first episode in our endometriosis series. More on that in just a second. And it's such great information. We want to get it out into the hands of all of y'all.
So I'm going to hit publish anyway, but I do want to apologize for the subpar audio. We have a great editor, shout out to Steve, and I know he will work his magic with it, but I want to acknowledge that. Here's what happened. The day that we sat down to record was the same morning that we laid our older dog Murray to rest. And I'm sharing this with you guys because so many of you have listened to the podcast since day one. You've been along for so much of this journey. And Murray was with us since day one. We've had him for 14 years.
Scott and I got him right after we got married. So he predates our child even. And you don't know what you don't know. And I've never gone through this before. So I had no idea how hard it was going to be. To anybody listening, you guys get it. You know how heartbreaking it is, even when it's the right decision and the right call. It's a brutal one.
It is a brutal one. And so I came into this podcast recording thinking it was going to be a welcome distraction. And I guess I was really distracted because I recorded the whole thing without my mic plugged in. So we're just going to lean with it, rock with it, rather than try to record all of this all over again. So like I said, this is our first episode in our series on endometriosis. Last month we posted about endo on Instagram and we got a lot of traction. It's obviously something that our audience is either dealing with or at the very least has a lot of questions about. And it's something that we here at The Funk’tional Nutritionist have a pretty vested interest in.
Several of our team members have endometriosis, including Rachel, who you're going to hear from today. She's going to share her entire story on next week's show too. So I think that will be really helpful for a lot of you guys to hear. We also just work with a lot of endo clients here in our practice. So if you listen to today's show and you are looking for that kind of support and that kind of help, definitely reach out to us. Endo is admittedly a really tricky situation because it's a whole body condition. So it involves the immune system. It involves hormones, it involves the gut, it involves inflammatory pathways.
And this is all happening all at once. So yes, you can have period pain in chronic pelvic pain for sure. And I think that's where a lot of people's mind goes when we start talking about endometriosis. But you can also have fatigue, you can also have widespread pain throughout the body, you can have digestive issues, and a lot of other symptoms that we're going to get into today that seem a little obscure or things that you might not naturally connect to endometriosis. So hopefully today's episode will help you start to pull together some puzzle pieces for yourself. So here's what's real. We know that women's health has been understudied and underfunded, misunderstood at best, and completely ignored at worst. Women's needs and women's feelings have been dismissed and diminished.
Our experiences are often trivialized, and that includes pain. We know historically that pain is not taken seriously in women. But when our pain gets normalized or trivialized or even ignored instead of investigated, this leaves women suffering with no answers. And women struggling with endometriosis absolutely can get caught up in the undertow of all of this. Researchers found that it takes an average of 7 years to get diagnosed with endo. That can even be longer in some situations. And diagnosis can be really tricky. We're going to get into how to do that for yourself at the end of this episode.
But this is all why we really wanted to do this series on endometriosis, to hopefully provide you with more understanding and more answers and maybe even some next steps for yourself. It is a big topic, so it's going to take us a while to unpack this in full. So be sure to stick around for this whole thing, this whole shebang, this whole series, and definitely share today's episode with anyone that you know who struggles with either painful periods or endometriosis. The two do not always overlap, but they absolutely can. So it's really, really important to understand what is normal for what you might experience during your period and what is not normal, because we do not want to ignore, dismiss, or trivialize any pain that you're having. And so that's exactly where we're going to kick this series off. That is exactly where we're going to start with today's show. So let's get into it with Rachel.
Hello, friends, we are back and we are kicking things off with a series. This is gonna be the first episode that we do in a series on painful periods and endometriosis. So last month we posted about endo on Instagram and we got an insane amount of traction. Clearly it's something that our audience is either dealing with or is confused about, has a lot of questions about. So we wanted to really tackle this on the podcast and it's gonna take us a little bit of time to do so. So that's why it's gonna be a series. It's also something that I will say we have a pretty vested interest in here at The Funk’tional Nutritionist. Several of our team members have endo, including Rachel, who is here with me today, and we're going to share her whole story on next week's show.
Hi, Rachel.
Rachel Heintz
Hi.
Erin Holt:
Hi. We also work with a lot of clients who struggle with period issues, who struggle with endometriosis. So we figured it would be a good time to shine some light on this because endo is pretty admittedly a tricky condition because it's a whole body condition. So it involves the immune system, it involves Hormones, it involves the gut, it involves inflammatory pathways, and all of these things can be happening all at once. So you can have period pain and chronic pelvic pain for sure. That can be a hallmark of endometriosis. That can be some of the symptoms that you're experiencing, but you can also have fatigue and digestive issues and other symptoms that you might not think of when you think of endometriosis. And we're gonna get into all of those.
I also wanna speak into the fact researchers have found that it takes an average of 7 years, sometimes up to a full decade to actually receive a diagnosis for endo. And diagnosis can definitely be tricky. So we're gonna get into that at the end of today's episode so you can really understand if this is something that you are thinking about and this might be your clinical picture, how do you actually receive that diagnosis? And I'm going to start things off with this conversation. Rachel and I just recorded a couple of masterclasses for FNA, and we spoke into this because we were talking about women's hormones and women's health. But we know that historically pain is not taken very seriously in women. So pain often becomes normalized or even trivialized rather than investigated. There's not a lot of clinicians historically that will take women seriously when they come to them with pain. And so that can leave women suffering without answers.
And so part of our hope, our intention, our goal with this series is that we equip you and empower you with the education and the tools and the resources, but also the right questions to ask so that you are not dismissed in a doctor's office. So why don't we kick things off right there, Rachel, and let's start by talking about what is normal. And if we know that historically women's pain and especially period pain has been normalized, What's normal and then what's not normal for periods?
Rachel Heintz
So normal periods, you might have no pain, you might have a mild or a dull ache. It can be in your lower belly, it can be in your back. You're able to complete your activities of daily living, you're not canceling plans. And if you need medication, pain meds or supplements, they easily work and they easily stop the pain. Whereas abnormal periods would be cramps that are not improving with medication or cramps that require a lot of medication to control the pain, pain that's interfering with your work or your social activities, vomiting, nausea, dizziness, or fainting from that pain or discomfort, bleeding through a tampon or a pad every 1 to 2 hours. And I do want to mention, these symptoms absolutely can overlap with endometriosis, but they definitely don't mean that you have endo.
Erin Holt:
Okay, so I mean, I have not been somebody that has like struggled with my period. I've had a lot of, a lot of issues with my body. That has never been one of them. And so I will, on my first day of my period, or I kind of know my period's coming because I can just like feel it in my boobs a little bit. Like they feel heavy when I'm running down the stairs. Or I can feel like a dull ache, like light cramping in my low belly, like, oh, something's coming, something's happening. And that might last a day, rarely 2. But it's rarely something that I even have to take Tylenol for. It's just more of like an indication that something's happening. So that would definitely be put in like the normal category. And then like you're saying, if you're popping Advil or Tylenol or even prescription pain meds, and like that is not really doing it for you, that is really not normal pain.
So before we get into signs of endometriosis, let's start by defining what it actually is.
Rachel Heintz
So endo is a chronic inflammatory condition, and it's really caused by an abnormal immune response. There is a genetic component to this too. And endometriosis causes chronic inflammation, and it can impact your entire body. Basically, endo occurs when tissue similar to the lining of the uterus grows outside of the uterus on organs, and this can include your ovaries, your fallopian tubes, the bladder, the intestines, the diaphragm. Endometriosis has been found on pretty much every organ in the body, including the lungs and the brain. And normally when your uterine lining builds up each month, you have a period, it sheds, and it bleeds. But the problem with these endometriosis lesions is these tissues bleed every month with your period or with menstruation, But the blood has nowhere to go. It has no way to exit the body.
And then as a result, we get scar tissue building up over time, creating more lesions and adhesions. And endometriosis is considered a progressive disease. Oftentimes there is that diagnostic delay of 7 to 10 years after the onset of symptoms. And we're saying that the prevalence is 1 in 10 women. I think there's a suspicion that it might be more prevalent than 1 in 10, just because of how long it takes to receive a diagnosis. As well.
Erin Holt:
1 in 10 is— that's a lot of women. And if it's closer to a 1 in 8, 1 in 7, like a little bit of a question mark around there, like you said, I mean, this condition is affecting a lot, a lot, a lot of people. And I think it makes sense the way you described it. I think it makes sense why we would see symptoms outside just the uterus or outside just having painful periods if this tissue can grow on other organs like the diaphragm, for example, that can restrict breathing, that can make you, I would assume, like feel kind of funky and clunky up in the rib cage and stuff. So it can definitely impact more than just the uterus or like the pelvic bowl. So let's talk about some specific signs that it might be endo. How would you know?
Rachel Heintz:
So we're thinking about— so the most hallmark sign, of course, is pain. But I want to emphasize it's not always associated with pain. Pain can occur around the time of ovulation or menstruation. Like you mentioned, it doesn't have to be just In the pelvis. Pain can also occur all month long. I currently have a patient who has endometriosis. She has pelvic pain all month long. She had it until she got it excised and she's doing a lot better.
We can see pain with urination, with intercourse, with bowel movements, and it can show up in the lower back, in your legs, your hips, your chest, or your shoulders. And when it shows up in the chest or the shoulders, we're thinking about it being more related to that thoracic endo possibly affecting the lungs or the diaphragm. And the thing to think about is if your pain comes every month, it does have a cause. If there's a cyclical nature to it, there's a reason for it. So like I mentioned, pain is the most obvious symptom associated with endo, but we can also see digestive issues. So nausea and vomiting, diarrhea or constipation. Some women will experience butt lightning or butt zaps, sometimes with bowel movements, sometimes not associated with bowel movements. And then really extreme bloating where women will feel like they're— 6 months pregnant, that's unofficially called endo belly as well.
And then something else I see in practice can be recurring infections. UTIs are pretty common with endometriosis because the endo lesions can disrupt the bladder function and this can increase infection risk. But then a lot of the times, because endometriosis lesions can grow around the bladder, around those nerves, we see UTI-like symptoms where the cultures are coming back negative, but the inflammation caused by the lesions makes the woman feel like she has an infection. It's just more irritation. And then SIBO, so small intestinal bacterial overgrowth, can reoccur in women with endometriosis because there can be adhesions on the bowels that increase risk of these bacteria overgrowing, and then you clear it and then it comes back.
Erin Holt:
Yeah, and that's something we've talked about definitely on the show before, is this recurring SIBO, because we see that quite a lot in practice where somebody will have, All of the classic SIBO symptoms. We will run a breath test. We will confirm that there is SIBO, treat the SIBO, and then the SIBO comes back. And that's when we, you know, SIBO, we will say, is not always and kind of rarely a root cause, especially in that recurring SIBO. We have to figure out why it's coming back. I think you said something really interesting too that I want to highlight about if your pain is coming every month, it has a cause. Because what we know from chronic pain science, and obviously I've spoken into this so much on the podcast and in Manifest Your Health, but pain can be a decision that the brain makes, meaning that when somebody has been in pain for so long, basically there's neural pathways that tell the body like pain is the default setting. And so in those situations, we can see pain in the absence of actual injury.
This is not that, you know, this is not something that you can mindset and magic your way out of. This pain has a real origin, and that origin needs to be addressed. So I just want to speak into that for anybody that needs to hear that.
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Erin Holt:
So you mentioned SIBO. What are other conditions that can be commonly connected to endometriosis?
Rachel Heintz:
So adenomyosis gets referred to as like the evil sister of endometriosis. And that's when the tissue similar to the uterine lining will basically grow into the muscles of the uterus, so that can cause a lot of pain. ADHD can be commonly seen with endometriosis. I believe the statistic is that women with endo are 2 to 3 times more likely to have ADHD because of the neuroinflammation that we can see occur alongside it. MCAS, so mast cell activation syndrome, we will break this down in a whole episode later on in this series too, but endolesions, they're full of mast cells. And then POTS and Ehlers-Danlos syndrome. The trifecta occurs when someone has POTS, Ehlers-Danlos, and MCAS, and they're occurring together. I think endo occurs alongside that in more cases than we realize.
And then interstitial cystitis as well can be more common in women with endo just because of irritation to the bladder and even some of that histamine in the bladder as well.
Erin Holt:
And I just want to say, like, every condition you just listed are usually the ones Historically that have like kind of fallen into like a little bit of a bucket of like, we don't really know what to do with you. These are really complex, these are really confusing. And I think that these are some of the conditions that are more likely to get gaslit in kind of conventional healthcare, just because they are not as understood. I think that there is a sea change that is happening. And obviously, we are happy to see that as clinicians. But I just, I do want to speak into that. And it's interesting, because when we do talk about endometriosis on social media, the 2 big questions that we get are about adenomyosis and MCAS. Like, those are like the follow-up questions that everybody has, like, what's the connection here? So like Rachel said, we're gonna get into MCAS in a whole other episode.
Okay, what are some obscure symptoms that are related to endo that that maybe aren't super obvious?
Rachel Heintz
So nosebleeds during your period. I have a patient who definitely has this. Belly button bleeding as well, a little bit less common, but we can see that.
Erin Holt:
Like out of the belly button, like external?
Rachel Heintz:
Yeah, I learned that from my surgeon actually. He sees that a decent amount. Shoulder or chest pain, again related more to that thoracic endo. Chronic fatigue, because this is, you know, chronic fatigue can be associated to so many things, Just having chronic fatigue does not mean you have endo, but gals with endo generally are more tired.
Erin Holt:
And you just think about what's going on in the body, like, that's exhausting, you know, like every single month like that. I would be fatigued, of course, that makes sense.
Rachel Heintz:
I mentioned this already, but pain with urination or bowel movements. And then infertility. And infertility can occur with no other symptoms. 30 to 50% of women with unexplained infertility will have endometriosis. And so every woman with an unexplained infertility diagnosis should have a conversation about endo as well. That's a biggie, honestly. And then newer research is coming out that is confirming this, but an exacerbation of symptoms including pelvic pain when someone goes through IVF. We know that IVF medication can worsen endometriosis symptoms when we're pumping the body full of more hormones as well.
And my surgeon, Dr. Cameron Najat, he refers to endometriosis as the great masquerader because it can mimic and appear like so many other conditions in the body. And it can affect so many different parts of the body outside of just the pelvis.
Erin Holt:
Side note, you know how I was texting with Kristen Zames? So Dr. Kristen Zames, she is a local pelvic floor PT in my area. And we've worked with her a lot. So Rachel knows who she is. And when Rachel was going through everything in her surgery, I reached her post-op, I reached out to Kristen just to see if she had any pro tips. And And I explained that you had worked with this surgeon, but I forgot his name. And she's like, is it— I want to say Nezhat because that's how it's written. And I was like, it is.
So she knew about your surgeon all the way here in New Hampshire. He's a big deal.
Rachel Heintz:
He is one of 3 brothers. So there's the Nezhat brothers. One, I believe, is in New York, one is in Atlanta, and one is in California over by me. Nijat, my surgeon, he like pioneered and basically implemented laparoscopic surgery. And so him and his brothers are basically nationwide helping girls with endometriosis.
Erin Holt:
I mean, worldwide.
Rachel Heintz:
Just like Pitbull.
Erin Holt:
Rachel also loves Pitbull. But I started this podcast, I introed by saying that doctors can dismiss women's pain. And I think it's important to say Not all doctors, because there's some really, really, really compassionate, caring pioneers, like renegades that are like bucking the system and have been doing so for a while. So we gotta, you know, speak into that. Because isn't he like 80 years old? He's older, right?
Rachel Heintz:
He's older for sure.
Erin Holt:
Yeah.
He's been doing this shit for a while. So props to the Najat brothers who are doing God's work out there. Okay, so let's kind of switch gears because of course, we work with a lot of endometriosis patients and clients. And can you explain how you would work up and address painful periods here in practice?
Rachel Heintz:
Definitely. And I wanna start by reinforcing, we do not believe that having painful periods automatically means that someone has endometriosis. There's so much you can do to support painful periods, even with endometriosis as well. Really, I say this all the time, when we're working with our clients, we're essentially going inflammation hunting. And the more inflammation that you have in your body, more prostaglandins you will produce. Prostaglandins are these chemical messengers. They're made by the cells in your uterine lining, and the more that you have, the more pain you can experience. We work with clients to reduce inflammation.
Like I said, you know, we go inflammation hunting, and inflammation can come from so many different sources. We're thinking about possible food sensitivities, imbalanced blood sugar, toxins, an imbalanced microbiome, And/or chronic stress, just to name a few possible root causes. And ultimately, our goal again is to reduce inflammation, reduce prostaglandins, and then see a reduction in pain. I always like to start with gut health. We want to think about the estrobolome, right? There's an entire part of the microbiome that's involved in estrogen metabolism. I like to evaluate beta-glucuronidase on stool testing. So, if this enzyme is elevated, you basically are going to be reabsorbing The estrogen that you should be pooping out, and this can worsen estrogen dominance. You can have higher levels of estrogen than you're meant to have, and then again, that can cause painful periods too.
And then thinking about bile, bile is one of our digestive juices. It helps to move our hormones from our liver into our gut where we excrete it, and that's why we love looking at the gut as a whole. We run the gut panel a lot in our practice too. These are some of the markers that we would look for on a gut panel or a GI map when working someone up for endometriosis.
Erin Holt:
And then what about hormones? You think painful periods, you probably want to think about hormones too.
Rachel Heintz:
Definitely. So I love looking at hormone levels and hormone metabolism for— in gals who do have painful periods and endometriosis. So if you have low progesterone, this absolutely can worsen period pain. Excess estrogen levels can also worsen period pain. And again, hormones, they're downstream messengers. They're oftentimes responding to other things in the body. So we don't usually start by testing hormones.
But, you know, if we're not making the progress that we're hoping for, it can be really helpful to check in and see, okay, what's going on with hormone metabolism? How are we actually processing and detoxing these hormones in our liver as well? And then speaking of the liver, we love to support the liver, we love to support the gallbladder. You know, we're thinking about what are all the nutrients, the cofactors, the herbs and nutraceuticals that we need to bring in to support phase 1 and phase 2 of liver detoxification. This is a really, really nutrient-dependent process. It requires a ton of B vitamins, antioxidants. You need to make sure you're eating enough protein. So, doing those juice fasts really just restricts your body from all the nutrients that you need to properly detoxify. And then, gallbladder support too. So, your liver produces bile, bile is stored in your gallbladder, and bile is how we move toxins again from our liver and hormones from our liver into our gut where we should poop it out.
So, we want to make sure we're supporting the gallbladder as well.
Erin Holt:
And then, are you thinking about the load that the liver has to manage too? So, looking at toxicant exposure, for example?
Rachel Heintz:
I've seen this in practice definitely where more often than not, women with endometriosis have a tendency to struggle with toxins, but painful periods too. Again, we're just thinking about what's that overall burden on the liver. Even my surgeon, he's conventionally trained, he acknowledges that environmental toxin exposure can drive and exacerbate painful periods in endometriosis.
Erin Holt:
Okay, so somebody's coming to you and they have painful periods. This is kind of like the workup and the approach that you're doing. Obviously, you're going to do a workup and you're going to find stuff via lab testing and approach them individually based on what you find in the lab testing. But like, same deal for endometriosis. Like, if somebody came to you and you suspected, or they suspected endo, or they had an overt diagnosis, would you be taking a pretty similar approach here too?
Rachel Heintz:
Definitely. We treat We treat painful periods and endometriosis very similarly. If someone comes to us with a confirmed endo diagnosis, we might be diving deeper into certain aspects of their health, but we do a pretty similar workup for both conditions or both types of patients.
Erin Holt:
Okay, I just wanted to make that clear for anybody that's listening. Let's say you're listening and you just have painful periods but no endo, it's kind of like the same thing.
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Erin Holt:
Now, if somebody does suspect endo, or you're working with a client and you suspect it, how would you recommend they actually get a diagnosis? If we're talking about, you know, having to wait 7 to 10 years to get a diagnosis, how can we expedite that situation?
Rachel Heintz:
So currently, the only method to obtain an endo diagnosis is through laparoscopic surgery with histology. So they're going in there, they're biopsying the tissues, and they're looking at that microanatomy of the cells. If someone is going in for laparoscopic surgery, it's really important that it is paired with excision if endo is identified so that it can be removed. I've definitely seen women on social media share their experience where they have an exploratory laparoscopy, endo was identified, and then it wasn't removed because the doctor wasn't specialized in excision. And I'm like, oh my gosh, then you get to have an— you know you have endo, but it hasn't been removed too. So surgery is the gold standard because they have to go in, remove the tissues, biopsy it, test it in the lab. But there is a new test on the market that we just got an account set up with as well. It's called HerResolve, and this is a blood test that analyzes biomarkers that are associated with endometriosis.
The results come back pretty straightforward, detected or not detected. It's 94% accurate, 97.5% specific, and there's an 85% sensitivity. So it will detect endometriosis in 85% of the cases. It's not perfect. You know, we definitely need to be paying attention to those 15% of cases where it may not be detected. But I actually was just on a call with one of their clinical representatives, and she was saying if you get a patient's test result that comes back and it's negative, and you're like, I really do feel like they have endometriosis, they can go back and look at the actual raw laboratory data and like run it again and like parse it out specifically. And this test isn't cheap, but it's a lot cheaper than having a lab—
Erin Holt:
What would it cost a client to like—what about clients that order it,
Rachel Heintz:
The cost of the test is $500 plus shipping, and then the company itself is not partnered with a lab, but they're able to send you to various places to get your blood drawn. And I believe the cost of the blood draw is $35 or $40. So all said and done, it's probably $600-ish out of pocket. So again, not cheap, but—
Erin Holt:
Not surgery.
Rachel Heintz:
Yeah, not surgery.
Erin Holt:
Yeah. Wow.
Like a big deal. Like, this is a deal alert. I feel like that this is, you know, now on the market. You know, we can get so downtrodden when we look at the stats on women's health and how understudied women's health is and how underfunded it is. But again, I think that there really is a sea change because things like this are popping up. So this is good news for us ladies. That's really cool. Thanks for sharing.
Rachel Heintz:
And, something else I want to mention. So, a lot of time women will go to their doctors and say, I think I have endometriosis. They'll say, okay, let's have you do an MRI. Let's have you get an ultrasound done. And, a negative MRI or ultrasound is not enough to rule out endometriosis. Some really skilled doctors, they can diagnose via imaging, but this is not the norm. My surgeon, he was able to confirm endo in 3 different spots on a transvaginal ultrasound for me at my initial consultation. Again, he's been practicing for years and years and years.
He did recommend that I complete an MRI before my surgery just to help set expectations. But he specifically was like, you can only go to these 2 places so these 2 very specific doctors can analyze your test results because nobody else local to us knows how to like read an MRI for endometriosis. So kind of crazy also.
Erin Holt:
Crazy. Like, you have to like know the right people. There's no people in high places. So let's go back to that ProResolve test. If somebody were to do that, and it showed positive, like, what would be the next step from there?
Rachel Heintz:
I mean, it would depend on their goals, their symptoms, you know, where they're at kind of in their health journey too, right? And we'll talk about this more in our next episode. I knew that I had endometriosis for about 2 and a half years prior to moving forwards with surgery. And there was a lot that I was able to do to manage my symptoms that was more endometriosis-specific, right? We know there's certain nutraceuticals that can be more impactful for women with endometriosis. There's more— the Dutch test, for example. You know, I would definitely recommend we move forwards with the Dutch test if a woman has diagnosed endometriosis so we can look at those hormone metabolites. Again, it would depend on severity and what their goals are as well. Surgery could possibly be the next step, but it's not always a requirement.
Erin Holt:
Yeah, and that's kind of what I wanted I want to pick your brain on and get your thoughts on, because obviously we're a little biased being functional medicine practitioners who've built a life and like a career around this. So I want to just speak into that bias a little bit. But would you— I know what you did. For the majority of people that you see that you work with, do you think that starting with a functional medicine approach is a good place to start before immediately going to surgery or like totally case dependent?
Rachel Heintz:
I think it's case-dependent, and I think it does depend on how extensive is your endometriosis, how much has it grown. I think that depending on the severity of the endometriosis, for some women, it's possible that they might be so inflamed that they might not notice major, major changes from the nutrition. But again, everyone is so, so different. I can say in practice, every woman that I've worked with who has diagnosed endometriosis, we've seen an improvement in their symptoms.
Erin Holt:
Yeah.
Rachel Heintz:
One way or another. Again, that's because we're going inflammation hunting and we're diving deep into their symptoms too. I think that, is it a requirement to do functional medicine before you go into surgery? No, because a lot of women don't even know if they have endo until they come out of surgery. But then post-op, we think about it as a whole body inflammatory response. We do want to address that inflammation and that immune system burden that's driving the disease in the first place. So I don't think it's a problem to do it beforehand. I don't think it's a problem to do it after. I mean, I'm doing both, right?
Erin Holt:
Yeah. And I think that's like so helpful for women to hear too, because we don't know where we're catching people on their journey. And so if we're catching them before, cool. And if we're catching them after, cool. Like, there's so many options that are available to you. So I just wanted to kind of plant that seed as well.
Rachel Heintz:
Definitely. And there's also really good news and some hope for the future too, in terms of diagnosing endometriosis as well. So in April of this year, April of 2026, the largest genetic study of endometriosis ever conducted, it was completed. It analyzed 1.4 million women. It identified 80 different genetic regions that are linked to the disease. And right now also Oxford is currently trialing imaging that could detect endometriosis without surgery as well. So again, just more good news for the endo community. Women's health.
Erin Holt:
Leave us with a little like hopeful bow on the end. If anything that we're talking about sounds like you, that is definitely a place where functional medicine can shine, whether it's painful periods or suspect an endo or diagnose endo. And I will let you know that this is what we work with in our practice. We have availability in our practice. The next steps, if you're interested to work with our team, is to fill out an application on our website, and Rachel will review your application and get back to you. We're very honest and transparent about like Hey, you are a great candidate for working with us. We feel confident that we can help you, or we might not be the best fit or the best practice for you. So we will tell you that straight up.
But come back because in the next episode, Rachel's going to unpack her full story and include what she has done and what approaches she has taken to get success and to feel better. And you're going to unpack the whole thing next time around.
So come back next week.
Thanks for being here. Thank you.
Rachel Heintz:
Thank you.
Thanks for joining me for this episode of the Functional Nutrition Podcast. Please keep in mind this podcast is created for educational purposes only and should never be used as a replacement for medical diagnosis or treatment. If you got something from today's show, don't forget, subscribe, leave a review, share with a friend, and keep coming back for more. Take care of you.