Episode 16: The truth about periods, pain, and hormone health with Tanya Borowski
This week’s episode is a special collaboration between Women of the Well and The Best of Women’s Health Podcast.
It was recorded live at Vera Wellness during an event celebrating renowned naturopath Lara Briden’s latest book, The Metabolism Reset.
British podcast host and functional nutritionist Tanya Borowski sat down with Dr Peta Wright and Dr Thea Bowler for an honest, eye-opening discussion about why conventional approaches to periods, pelvic pain and hormonal health might not be enough.
🎧 Listen now to find out:
🌿 Why pain doesn’t always mean surgery – reframing the approach to endometriosis and pelvic pain.
🌿 How the nervous system and immune system influence hormonal health (and what you can do to support them).
🌿 Holistic alternatives for managing periods, pelvic pain, and hormonal imbalances.
This episode is packed with insights, practical tools, and a fresh perspective on women’s health that you won’t want to miss.
Resources and Recommendations:
📖 The Body Keeps the Score by Bessel van der Kolk – Insights on trauma and the nervous system.
📖 Period Repair Manual and Hormone Repair Manual by Lara Briden
We would love to hear from you.
If you have any questions about you’d like us to answer on a future episode of the podcast, please email them to hello@verawellness.com.au or contact us on Instagram @verawellness.com.au.
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To stay in the loop with every new episode of Women of the Well and gain first access to special resources and events – join our Podcast VIP Club here.
Episode transcript:
Ep 16 – The truth about pain, periods, and hormone health with Tanya Borowski
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[00:00:00] Dr Peta Wright: Hello and welcome to this special episode of Women of the Well. This was our very first live recording of our podcast, which
[00:00:08] lucky enough to do with Tanya Borowski, who is a women's health practitioner from the UK, and the amazing Lara Briden, a naturopath and author of several incredible books.
[00:00:20] about women's cycles, about menopause, and her new book is about, metabolism. And we were so excited to host, these two wonderful women at Vera for this event. We really hope you enjoy listening.
[00:00:36] Tanya Borowski: Okay, so I am absolutely honoured to be here today at Vera Wellness, uh, and I am sat here in the, for the Best of Women's Health podcast in a truly magical and sort of unique setting here in the hinterland of Queensland, just out, so about 45 minutes outside of Brisbane. And I'm here at the, at Vera Wellness, which is an integrative [00:02:00] practice, uh, which has been founded by the wonderful gynecologist, Dr.
[00:02:06] Peter Wright. And the focus here at Vera Wellness is on women's health. So it's no surprise that that's sort of drawn me to be here. And they specialize in treating infertility, pelvic pain and endometriosis, which is going to be a big topic of what we're going to be discussing today. Uh, ovulatory dysfunction, amenorrhea, adolescent gynecology, which is so important, perimenopause, menopause, hormonal disorders.
[00:02:39] So really across the entire life stage of, of a woman. And I'm here today to interview and have really open discussion with, uh, two integrative gynecologists, Dr. Peter Wright and Dr. Thea Bowler. So, um, thank you so much for having me here. It's really is just such an, such an honor. And we're here to really open up the conversation on the topic of pelvic pain and endometriosis, but really more about the landscape.
[00:03:16] And the narrative that accompanies that, because I, we sort of were talking out in the corridor about, we have very much fallen through, through sort of through my lens, we've very much fallen into this, into this sort of dialogue of chasing a diagnosis. And I think in the area of women's health, it's fantastic that the conversation around women's health, the pendulum has swung.
[00:03:41] We're talking about menopause more. We're talking about perimenopause, but we're so quick to want to then chase a diagnosis. Um, and very much what comes through in all of your, in your podcast, in your dialogue [00:04:00] is about actually what comes first is education. And so when we talk about pain and menstrual cycles and period pain, could we first of all sort of start off by framing how that is, do you see that there is a place to actually maybe better educate young women?
[00:04:23] and, and young men and from about what is expected within the menstrual cycle. Could we start with that?
[00:04:34] Dr Peta Wright: I think that traditionally, like at least the time that I've been working in this space, I think it's gone from, as you said, the pendulum has swung from, we don't talk about any women's issues. And if you have pain or any symptoms with your menstrual cycle, it's just like suck it up.
[00:04:52] There's no room to talk about it. To now it's like, and women, of course, that's not, that's not good. Women want to be heard. Women want to be validated. They deserve that. Um, but we have to think about the wider context that we're existing in. And we live in an environment where women's biology, women's hormones differ to that of men and our whole world, at least in Western, the Western is set up for in a very linear fashion.
[00:05:24] For men who don't have hormones that are going up, going down, um, that affect then every part of our biology, our nervous system, our immune system, how we feel day to day is not the same. And I guess the way that we have treated. Period pain is, um, more about, like, if you, if you're unable to cope in this very narrow linear construct, um, then there's got to be something wrong with your body and it's pathological.
[00:05:54] And then we have to give you this diagnosis and then you hit the gamut of [00:06:00] tests and surgeries and hormones. And, um, there hasn't been a val an education about what's going on, validation of a person's experience. and another way that has been offered. So it's like, um, if your period pain is not, so I think there, that education about what's happening, like why are periods, can periods sometimes be painful, um, because of the inflammation, prostaglandins that happen, but it is a, rather than viewing it as, Um, some, a design flaw, thinking about it as a message from our body, information from you to you about how you need to look after yourself.
[00:06:42] And that has never been part of the education. It's been, you know, if your period pain isn't managed and you can't get along and do exactly the same things you were doing on day 14 of your cycle, if it's not managed with. non steroidal drugs like norepinephrine and whatever, um, then, you know, the next step is hormones to turn everything off, um, and then, you know, if that doesn't work, then the next thing is surgery, because there could be endometriosis, which, you know, has a very tenuous link.
[00:07:13] It's, it's presence and its extent is a very tenuous link to severity of pelvic pain. What we know in all of the studies is the thing that actually has a very strong link to pelvic pain and period pain is the state of our nervous system and nervous system dysregulation. And it's like we are then, um, but that isn't really the case.
[00:07:36] What's taught to young women and we're in the context of all of our nervous systems are so Dysregulated because we're not getting enough sleep. Our circadian rhythm is disrupted Where you know our diets aren't great. We're not getting those cues of safety that Lara was talking about We're not moving our bodies in ways that are nourishing young women have like So much pressure and ridiculous, [00:08:00] um, beauty standards.
[00:08:02] So the young women I see are often not eating regularly. They are, you know, starving themselves, doing too much exercise, um, on social media, on screens a lot. So disconnected from their bodies. And. There is not any education about how our menstrual cycle is part of, again from Lara's talk, an ecosystem, which is larger than just our hormones and our periods, that encompasses our whole body and the environment in which we exist.
[00:08:33] And that is the education that I would like to see. being rolled out to, to young women. Yes. And I
[00:08:42] Dr Thea Bowler: think when you, um, talk about that, like if you think about that state of the environment that we're all living in and all of our nervous systems are probably in some sort of degree of dysregulation. And then when you think about, I guess, even zooming out more, the way that women's bodies are perceived, You know, culturally, you know, it's the air that we breathe growing up that like periods are going to be bad, periods are gross.
[00:09:11] You know, to be a woman is somehow less than, and then we're all feeling stressed and frightened. It's no wonder that when our periods come along, of course, they can tend to feel really dangerous, really painful. because our nervous systems are primed to look for danger.
[00:09:33] Dr Peta Wright: And there's no safety built in. And then when we do go to the doctor and we say, I've got painful periods and the doctor says, Oh my God, that like, so the person that's going is, is, is distressed by their pain for all of the reasons we've talked about.
[00:09:48] And they're met often, very often by a practitioner. Who is distressed by the pain like they can't can't hold that so it's always good Well, we have to turn it off. We've got to operate us, you [00:10:00] know, and that is Reinforcing that the body is dangerous that the natural processes of the body are dangerous and to a 13 year old girl and I see so many women who have, who might be, you know, 10 years after the time they first presented to their GP who put on the pill, who didn't really have any understanding of why at that time, but they were like, well, the doctor said it was the best thing to do.
[00:10:26] They seem to be worried. I felt like, and then that just reinforces that whole cycle of danger in that person doing nothing to address the nervous system and often making it worse. And the chasing of the diagnosis thing is, That, you know, and then the data does reflect this as well. If you have this early, if you have an early diagnosis of say endometriosis in your late, late teens, early on, um, you're more likely to have further laparoscopies, um, which is a process that, yes, it's sometimes part of the treatment for endometriosis, but the degree of which we have been doing it in the last 15 years, where pelvic pain rates have simply been getting more is, um, doesn't make any sense.
[00:11:14] Dr Thea Bowler: I think that's something really important to address is that it's so wonderful and amazing that, you know, the awareness of endometriosis and pelvic pain and all of these things are growing You know, women's pain, of course, needs to be taken seriously, but concurrent to that, pain, women's pain is increasing.
[00:11:35] It's not getting better.
[00:11:36] Tanya Borowski: Which segues beautifully into the question around exactly is this that the awareness around women's health, but the, the, the chasing the diagnosis of endometriosis. Is cat in my experience is instilling fear because it's correlating with pain and actually so could we sort of, [00:12:00] could we, first of all, just recap what endo actually is, and then the, the, your amazing works that you both do, and that you both talk about so articulately around, there are different types of lesions and those don't necessarily the presence of those lesions don't correlate with.
[00:12:20] pain, which is sort of, which is what is, and that they have to go, which is actually what the, sort of, the, the dialogue actually is. It's what, okay, you've got a diagnosis of endo, we've got to get rid of it. We've got to switch it off, or we've got to switch off the hormones. Or we've got to cut it out. So, can we unravel that?
[00:12:40] Dr Thea Bowler: Absolutely. I think that, um, a sole focus on endometriosis as the cause of pain is really detrimental. Primarily for the things we've spoken about, that it increases fear, it exposes women to lots of perhaps unnecessary interventions. But it also fails to miss all of the other reasons why pain can occur and that's things like the nervous system, obviously, pelvic muscle tension, gut dysposis, lots of other things.
[00:13:15] And so I guess what endometriosis is, is the presence of endometrial like cells outside of the uterus. So the endometrium is the lining of the uterus that proliferates and sheds each month with a bleed. Um, and endometriosis is that cell type elsewhere in the pelvis and very, very, very rarely elsewhere in the body.
[00:13:36] Um, and I think that, you know, historically from when we first started doing laparoscopies, um, you know, these lesions were noticed and immediately thought to be abnormal. But when we think about what happens in the process of a period, we know that all women bleed both out through the cervix and vagina, but also [00:14:00] have a degree of what's called retrograde menstruation, which is blood actually coming back out the fallopian tubes and sitting in the pelvis.
[00:14:06] And if you do a laparoscopy they're having their bleed, you will see blood sitting in the pelvis. Um, and within that blood is contained endometrial cells and Um, I think that for, for a proportion of women, those endometrial cells can implant on the peritoneal surfaces of the pelvis. And for those people with an intact immune system over time get broken down.
[00:14:31] And I guess the reason that, that, um, that is a possibility is that there have been studies that look at, um, women who've had sequential laparoscopies over time. And what those laparoscopies have seen is that in. Probably about 70 percent of women, 75 percent of women, endometriosis lesions that were seen at the first laparoscopy were found to either go away or to have stayed the same at the second laparoscopy for the vast majority.
[00:15:00] But the fact that these lesions can Change can regress, can disappear completely. Um, I think is a sign that endometriosis isn't always upward. And that it's dynamic.
[00:15:13] Tanya Borowski: That's right. Yeah, this is a really key component.
[00:15:16] Dr Peta Wright: Absolutely. So that the messaging of, And if you do a little quick Google search, um, for any young woman who hears about endometriosis, you know, this is a chronic, um, progressive, progressive, incurable disease.
[00:15:32] Now, like we were talking before about this amazing lady called Alan Langer, who's like known as the mother of mindfulness in the States. And she's done all these amazing studies in Harvard, Harvard. Um, At, uh, the mind body connection, essentially. And, you know, what a diagnosis, you know, how, how a diagnosis like that can have an effect on our nervous system and hence, if we then understand the way [00:16:00] our nervous system intertwines with all the other systems in our body, if we enter that sort of stressed state because we think, oh my god, this is my fate, this is, which flies in the face of actually all the evidence that we have.
[00:16:12] Um, yeah, those words, words, uh, Words are powerful and you know, like how often have we had a patient who has had some pain and gone to their doctor and they've had a scan or something and the language that is used with the scan will be, Oh, I've got a, I've got a cyst and it ruptured, which another way of saying I've got a cyst and it ruptured is ovulation.
[00:16:38] Like that is, like literally that, so when we can do a scan and say this cyst is a follicle which contains all of the nutrients to nurture your egg that lives inside there. It's supposed to do precisely what it's supposed to do. And perhaps you had more pain and ovulation. Because you might have had a little bleed, you might have had a huge amount of stress in your life at the moment, it might have been an upregulation of your pain because of your nervous system at that time.
[00:17:06] But, you know, and then the relief on their faces when they're like, Oh, because like to think that you have like literally a grenade that can go off in your belly every once in a while. Like women, they end up in this place where they think that their body is out to get them. And that is, you know, I think, you know, it's a terrible thing and yeah, Alan works, Alan Langer's work shows that a doctor has power, it's almost like a magical spell, giving a diagnosis to somebody because it can change their nervous system, the way they act, their, their, um, prognosis and the way their disease or their physiology works.
[00:17:46] Yeah, absolutely.
[00:17:47] Tanya Borowski: The way and the work that you are doing here is the, the woman is the same, the woman is the same woman, but the way that you deliver the words that you [00:18:00] choose and the, I use the term, the storytelling around what is actually happening on a biological level is profound because that then completely changes her interpretation And those are then the signals that her nervous system is then resonating and reverberating around her body of how she is going to deal with that.
[00:18:22] Absolutely. And
[00:18:23] Dr Thea Bowler: when we think of the autonomic nervous system's ability to, um, and our, um, uh, and our brain and our peripheral nerves as well, ability to either amplify or suppress pain signaling within the body, the autonomic Anything that puts us into a dysregulated state of our nervous system that makes us feel safe automatically increases.
[00:18:46] pain signaling. And so it's no wonder that the more fear we have about our body, the more pain we sense, the more distressing symptoms we have.
[00:18:57] Dr Peta Wright: And you see, for example, like as an example of this, you can have one woman who might have, and the data is as well with women with persistent pelvic pain, that six out of 10 of those women will not have endometriosis, right?
[00:19:11] So again, there's, uh, endometriosis. things going on, which I think is the nervous system and the amplification of pain and then the pelvic muscles and all of that, um, that are probably still going on for the four in ten women who do have endometriosis because if it was all about just the endometriosis lesions, the surgeries would be helpful and they're Very, very often not.
[00:19:30] So we think about too, and I think this, the paradigm of it just being about endo is unhelpful for the six out of ten women who don't have endo because they still have exactly the same pain and but they don't have this support group and the, all of the resources and things that come with that
[00:19:48] Dr Thea Bowler: diagnosis.
[00:19:49] And I think on the flip side of that is that, you know, we do surgeries incredibly often and see patients incredibly often who have endo. severe endo. You know, like, often [00:20:00] far worse than other people and have never had a day of pain in their entire life. So I
[00:20:05] Dr Peta Wright: think, yeah, if you think about, I was thinking about two patients, one patient who has not had endo, has had a laparoscopy, nothing, and still has, you know, debilitating pain versus, I was talking about a lady that I, who was a patient.
[00:20:19] who we saw at a fire dance that we went to, who's probably got arguably the worst like, you know, bilateral seven centimeter endometriomas, so endometriosis in her ovaries, who's never wanted surgery and manages her periods with Chinese medicine and clearly fire dances under the moon. And that's her chosen path.
[00:20:40] But I think when we think about it as well, like, The, um, all of the, any paper you read about endometriosis or, or discussions about it will be, it's all these days of lost productivity. It's all these costs this much. I think the lost productivity again is through a lens of like capitalism, mass linear, masculine kind of world, which, which is killing the world and it's hugely detrimental to all of our human health.
[00:21:09] So I think that all of the globe has a lot to learn from that cyclical wave. Living, um, and, what was the beginning of it, what was I saying?
[00:21:23] Dr Thea Bowler: Yes, the productivity. Oh yeah,
[00:21:24] Dr Peta Wright: and the cost of endometriosis. The cost of the endometriosis is often our treatment. which, you know, often don't work or actually harmful.
[00:21:36] And like the number of women we see who have either more pain or didn't have pain before, but were treated because they had a lesion, but they didn't have any symptoms. And then they had pain after their laparoscopy. And I
[00:21:49] Dr Thea Bowler: think it's like, if you just think about it logically, like, you know, The fact that we're doing so many laparoscopies for people, like the patients that come here, you know, they will frequently have had [00:22:00] five or more surgeries for endo, and doesn't that just make you think, the first one obviously didn't work.
[00:22:05] Tanya Borowski: Well,
[00:22:05] Dr Thea Bowler: I
[00:22:05] Tanya Borowski: mean, it may be sound like a very basic question, but actually, yeah, it's like, can we just stop and say, Repeatedly, we have women coming into our own, all of our clinics, or we have friends and they, yeah, uh, four, five, six, ten, it's like, oh, hang on a minute, something isn't quite stacking up here. So, back to the nervous system, which is sort of, which is, is really, is our, is a major, sensor communicator to that beautiful ecosystem.
[00:22:38] And it is exquisitely linked to all of our other systems. One I'd like to sort of, uh, talk to you a bit more about is the immune system is because both the sort of signaling and they're picking up cues. And the immune system ultimately is the system that is responsible for pain with its communication.
[00:23:02] So these danger signals, which for those practitioners amongst us we can call PAMP stamps, so pathogen associated molecular patterns, or from, there's quite a link between We've talked, Lara spoke about it, about the gut and sort of LPS bacteria, but anything that is upregulating the immune system to be in this sort of up, this overly stimulated, vigilant, aberrant response.
[00:23:34] is then going to be sort of offsetting and dysregulating the nervous system too. Could we talk about your experience around that too?
[00:23:41] Dr Peta Wright: Well, all of, yeah, data on persistent pain and then so if we think about what happens with our nervous system and how it can affect our gut and our immune system, because it all is about the gut as well, um, is that if our, if we are sensing danger, And we're having high cortisol, high adrenaline, [00:24:00] um, that has an impact on our digestion.
[00:24:02] So if we, like, thinking about this from a biological perspective or an evolutionary perspective, our brains don't really understand the modern environment that we're in. So any time we get a signal of danger, um, so our amygdala, an area in our brain that is like responsible for sensing fear, uh, or danger, will, um, increase cortisol and adrenaline, and it's like we are, like, from our, when we were cave women, that would be if our life was in danger, if there was a bear chasing us, if there was food scarcity, if we were ejected from the tribe.
[00:24:39] Now, obviously, when we're stressed nowadays, our life is very often not in danger, but it, our brain does not understand that, the difference, so it will have the same response. So it makes, um, When I'm talking about it, it makes sense if we think about, like, the body isn't getting it wrong. It's just that the environment isn't conducive, right?
[00:24:59] So we're getting those same signals like if we were being chased by the bear and our life was in danger. So it's not going, our body isn't going to prioritize digestion because we could be dead tomorrow if we spend that energy. So our digestion is affected. We might have lower, like less motility, less energy.
[00:25:16] Um, food moving, uh, we might feel nauseous, we often have butterflies, we might, you know, be sick, we might have abdominal pain, and it affects our gut microbiome. So, I think Laura was talking about the microbiome in the gut, which is, with discovering more and more and more how incredibly important that is for the health of the rest of our body for not only digestion, but for metabolism, the hormones for production of neurotransmitters for our metabolic health, um, for so many things.
[00:25:49] And our microbiome is then affected by that dysregulated nervous system state. We then, um, tend to get more leaky gut. So that is the, I. the [00:26:00] name for when, um, if we think about the intestine, we've got the inside food, the bacteria, toxins, everything from the environment. Then we have a mucus layer. Then we have one single layer of cells that is basically separating what we're eating, what we're taking in from what's on the other side of that single layer of cells, which is the About 80 percent of our immune system, so all of our immune cells.
[00:26:25] And normally those little cells, that single layer, are tightly held together. And if those tight junctions are damaged because of, you know, uh, our diet, toxins, whatever, and also persistent stress, we can get little gaps in that single layer of cells. And then bacteria, so you mentioned LPS, so, um, lipopolysaccharide.
[00:26:47] Thank you. Um, which is part of a bacterial cell wall can enter through the gap into interact with our immune cells, particularly cells like toll like receptor. And they can be upregulated and cause the immune system to become sort of dysregulated. And that might be why, uh, and there have been those kinds of LPS cells found in the peritoneal fluid of pelvic fluid of women with endometriosis.
[00:27:12] But, um, interestingly, the upregulation of toll like receptor. For which then can increase inflammation everywhere in the body and in the brain and cause more neuroinflammation to and amplify pain, pain signaling that way has been found to be upregulated in women with pelvic pain, whether or not they have endometriosis.
[00:27:33] So the same thing from an immunological perspective is happening. Yes, I
[00:27:38] Tanya Borowski: love
[00:27:38] Dr Peta Wright: a toll light receptor
[00:27:40] Tanya Borowski: conversation. I love toll, especially number four. I do, sadly. And that also, I've read in your book, um, that, that, there is also a really, so, Theo, you spoke about this sort of the, if you like, the older hypothesis [00:28:00] of retrograde menstruation being the key hypothesis for endo.
[00:28:06] But what we are now, we now appreciate far more, sort of in this world, is that actually it's part of that dysregulation of the immune system then means it's not, it loses its capacity or becomes suboptimal at being able to, yeah, to be able to help clear out that the normal physiological event of, because most, most of it, most women, most menstruating women, it's part of physiology, right?
[00:28:34] We have this retrograde, but if we have a balanced and stable immune system, then we can process that in the right way.
[00:28:43] Dr Thea Bowler: Yeah, that's right. And I think, you know, in the presence of, um, LPS and that toll like receptor upregulation, then the pelvic environment tends to be more inflammatory. And therefore, um, those endometrial cells may be more likely to persist as an endometriosis lesion.
[00:29:01] But I think it's also key, as we just said, to realize that the toll like receptors Themselves can increase neuroinflammation in the absence of endo so they can cause pain on their own without an endometriosis lesion at all. Um, and I think the thing is, you know, we can get really into the nitty gritty of like, what causes the endometriosis lesion?
[00:29:25] What's, you know, what, what is the. cascade of inflammatory events. What are the hormonal things? But I think when you think about the fact that you can have endometriosis and no pain, it still doesn't answer the whole question.
[00:29:39] Tanya Borowski: No, but the key, but the, I think the message that you guys are delivering, which needs to be shouted from the rooftops is that you can identify lesions or not, but that doesn't, and we're actually treating the whole person realistically.
[00:29:56] Dr Thea Bowler: It's
[00:29:57] Tanya Borowski: totally separate and that's the [00:30:00] message that I don't feel is is why is broadly recognized And that's what we really want to get across
[00:30:05] Dr Peta Wright: Especially because if you think about the person with pain, right who has maybe they've had a laparoscopic No had an ultrasound which is fine And we now know that good quality ultrasound is very good at detecting, you know Yes, like deep nodules and definitely ovarian endometriosis, right?
[00:30:26] It may miss superficial, but we've already talked about the fact that superficial endometriosis may be part and parcel of menstruating. It's there one day you look and it's gone the next day because our immune system's done its job, right? So the significance of finding a spot of superficial endo is Kind of irrelevant, but if someone had pain and it may be due to more nervous system dysregulation That we've spoken about but they happen to have a laparoscopy that on that day They have a spot of endometriosis that may be likely to be physiological then they get the label of the chronic, debilitating, incurable disease, right?
[00:31:02] And then, um, the person who has a laparoscopy in the same context who doesn't have endometriosis is just told, oh well, I don't know, we don't have anything else for you, maybe just continue to do menstrual suppression. Like, it fails, this paradigm fails everybody in this.
[00:31:19] Tanya Borowski: No,
[00:31:22] Dr Peta Wright: it makes no
[00:31:24] Tanya Borowski: sense. Thea, you talked, you touched on, which I'd love to circle back to, around, uh, how the nervous system, how that communicates sort of when there is, you when there are danger signals that there can be this, there is a, there is a memory and that can actually, that that can be past trauma, physical or mental and emotional trauma that then has a long term effect on the muscles within the pelvic [00:32:00] area.
[00:32:00] Could we, I think that's a really fascinating and really sacred actually part to, because that isn't discussed in the, in the main body of the literature at all. And it's a really, really important component of what you guys do here. Could you, could you explain, could we talk about Yeah.
[00:32:20] Dr Thea Bowler: So I think, um, you know, what we've experienced in our life parries forward as an imprint, as we all know.
[00:32:31] And there was an incredible study That was done 30 years ago now, that ACES study. Um, yeah, which was the Adverse Childhood Experience study. Um, which was actually done by a gastroenterologist, who was looking at his obese patients. And he would find that they would put them into like a diet and lifestyle modification program.
[00:32:53] They would lose weight. But by and large, they would gain weight again, and he really wanted to understand why this was happening in that subset of people. Um, and in talking to his patients, he realized that actually the people who weren't gaining weight again had a huge degree of childhood trauma, um, in their, in their past.
[00:33:16] And so he did this big study called the ACES study where they looked at eight different, um, You know, um, kind of descriptors of childhood trauma, including things like sexual abuse, um, physical abuse, domestic violence, lots of other things, parents who had drug or alcohol problems, and then looked at their health later in life and independent of, you know, other risk taking behaviors like drug use and smoking and alcohol in later life.
[00:33:48] He found that early life trauma was significantly associated with not only You know, mood, diagnoses and chronic pain, but also, you know, [00:34:00] almost every aspect of chronic disease that you could think of. So yeah, high blood pressure, diabetes, high cholesterol, cancers, like all sorts of different things. And, and yes, psychiatric disorders.
[00:34:12] Issues and pain as well. And so it was sort of postulated that there were actually physiological changes that went on within the body that, um, occurred as a result of trauma activation of that, those protective mechanisms that actually impacted on. inflammation and chronic disease later in life. Um, and so this has been studied more and more and there's an incredible book, um, The Body Keeps the Score by Bessel van der Kolk, um, where he kind of summarizes a lot of the studies that have been done looking at people who've experienced, um, childhood adversity and, you know, really distinct changes in markers of immune function later in life.
[00:34:58] Um, and so I think, you know, that's an incredibly important consideration and to think about it through the lens of the nervous system as well, which is that, you know, our nervous systems, our brain and our, and our nerves and nervous systems are coming online really probably up until late teens, early twenties and learning how to interact with the world, learning what we need to do to keep ourselves safe, to keep ourselves loved.
[00:35:26] And when we experienced traumas in early life, and that might not be big Trauma, sexual abuse, and things. It might be a parent who was a bit neglectful, who didn't love us in the way we needed to be loved, or a sibling who was really unwell and kind of took a lot of their family's attention away, whatever it is.
[00:35:44] But you know, where we had to make modifications to our behavior to keep ourselves safe, and safe is loved as a child, um, then we learn, okay, we need to activate our survival brain. We need to activate, you know, our [00:36:00] sympathetic Um, nervous system and sometimes, you know, activate the freeze part of our nervous system as well.
[00:36:05] We've experienced severe traumas and we almost, our nervous system almost gets wired that way. That's right. Yeah. And so then we're experiencing life through a nervous system that is in threat detection mode, danger detection mode. And if you think about it, like our brain not knowing the difference between, you know, life is stressful or all of the experience difficulties as a child, and I'm about to get eaten by a bear when we're, um, when we're being chased by a bear, we don't need hormonal function.
[00:36:43] We don't need, you know, um, backgrounds, immune function. We don't need a digestion. We dial up inflammation ready for an injury. and dial up cortisol and adrenaline and we dial up our senses because we need to, you know, feel where the animal is, look for places to hide. And in dialing up our senses, we do that to the world around us.
[00:37:01] So we can feel hypervigilant, anxious, or depressed if we've entered more of a dissociated state. But we also dial up our senses to our inner world and pain signaling within the body is a natural increases in pain signaling in the body or any sort of natural byproduct of that sympathetic activation.
[00:37:22] And so then we can operate in the world, constantly looking for danger, our body and our, um, and our nervous system constantly looking for danger within and dialing up all of the sensations that go on. Thank you. Um, in the body. And so that coupled with those alterations in immune function that we see from, from early life adversity, Um, can, for some people, um, leave them in a state where they have chronic pain.
[00:37:53] Dr Peta Wright: And then part of that is that Tension of muscle muscles. So because when you're in [00:38:00] that sympathetic state where we're going to protection mode So our brain is trying to protect us all the time. This happens a lot if we have pain If we might we might start off not having pain, but we've had the stressful You know chronically stressful life or events that will especially true for sexual assault Which makes sense that our pelvic muscles turn on and they go into a And in fact, then any pain that's happening around our pelvis, um, uh, we get that increased tension.
[00:38:30] And we are all, all familiar with when we're stressed out, we might have neck and shoulder pain. And the same thing happens in our pelvic floor, which is a whole, you know, sling of muscles that, uh, Holds up our vagina and our bowel and, um, and attaches to all these bony points in our pelvis. But we're so often disconnected from that part of us that we're unconscious.
[00:38:52] We're not sure, we're not aware of that tension like we are with neck and shoulder pain and headaches. And so, so often women with pain will have an up regulated pelvic floor. I don't like to use the word dysfunctional because it's not dysfunctional for the body. The body is doing what it is designed to do in the environment where it senses danger and it's trying to protect.
[00:39:14] So then what happens is women, like that may be part of the initial driver of pain as well, that increased tension in the pelvic floor. And then. When women have, because it's women having periods, we have this special monthly potential painful stimulus each month, right? So we're having those inflammatory prostaglandins being released when we have our period.
[00:39:38] I think that it's more painful because of the state of the world that we live in. Um, and then our pelvic muscles tense up and then that creates more pain and The other thing that's so interesting and is really important to understand about the nervous system is that, so when we think about our autonomic nervous system and our vagus nerves, which are coming down here to our heart, our lungs, our gut, [00:40:00] our cervix, um, they're, they're actually sending most of the signals, about 80 percent of the signals that travel along the vagus nerve come from the body to the brain.
[00:40:10] So if we are in a state of Um, contraption like immobilization where like this we're not breathing, we're breathing really shallowly into our chest, our pelvic floor is tight, we don't even know that we're doing it because we've gone into protection mode and we're spending the day in bed because we're immobilizing.
[00:40:31] Um, we are sending signals of, um, danger to our brain up the vagus nerve because that protection is saying I'm not safe. We're not taking big breaths. We're not activating the vagus nerve in that way. All of the signaling, we call it bottom up signaling to the brain is you're in danger. And so you can see how if we're in an environment where We don't have space to rest, to look after ourselves during a period we're told that no pain is normal, we're told that it might be endometriosis and that could be terrible.
[00:41:04] Then we're like this and then that's reinforcing that pain and that whole cycle is Not a signal of safety. It is so not. So it's about, um, stepping that back. And helping to, that is the education that I think is really important. You've just
[00:41:21] Tanya Borowski: completely, yeah. So we've kind of, we've got, we've come pretty much full circle, which is beautiful in itself.
[00:41:29] Um, back to sort of that education piece. And I mean, obviously this is a podcast, so everybody is listening to this, but Peter just sort of did, sort of was in the, pretty much the fetal position, which is described where she was sort of showing. pain and that is the image that is put on all of our screens that that's what our young women are shown anything to do with our menstrual health that is you know that was you know I have a [00:42:00] 20 yeah daughter myself and that is without that's what they're all doing that's uh it's that image of curling up it's sort of um that message is needs to change in terms because It's the segue between sending the wrong signals, again.
[00:42:19] Yeah,
[00:42:20] Dr Thea Bowler: and you can see then that if we're only addressing endometriosis, we're failing to think about, you know, the pelvic floor, the bottom up signaling that we're in control of, you know. Um, and really failing to treat such a huge component of women's pain.
[00:42:38] Tanya Borowski: Yeah, and it's interesting when I work with gut health, I talk to practitioners about actually there is this, so it's, I sort of said, take a top down approach.
[00:42:48] It's like, don't just think it's the microbiome. Think about what the signals are coming in from the brain. Is the, as the upper, are you producing enough stomach acid? Is it going? producing and our enzymes don't just focus on just the gut microbiome. It's a, like you've just said, it's a complete dynamic system.
[00:43:05] Dr Peta Wright: And the top down is the education, helping people to understand what's going on. Um, and all of the options available to them, which is more than just, you know, hormones or surgery, and then an understanding pain as a danger signal in the nervous system. And the bottom up is the actually helping them to experience safety in their nervous system, which has everything to do with,
[00:43:28] Dr Thea Bowler: you know,
[00:43:29] Dr Peta Wright: movement, breath, being co regulated by practitioners, by family and friends that are safe.
[00:43:37] people by being in nature, by having regular nourishing foods, um, listening to music, doing yoga, doing things that make people feel happy and joyful. Um, and like, yes, and literally, you know, if I have somebody who tells me this is like, like you can change that happening. quite [00:44:00] quickly, you know, and then you'll see someone come back three months later and they're like, I changed all these things, bottom up, top down, changed all of that.
[00:44:07] And it's a lot better, you know, but that's not the, women don't know. I think at the moment, the problem is it's like a diagnosis and then you get help and then you get validated or you don't have that. You don't, you don't get help. You don't get validated. You don't get support to feel safe in this world.
[00:44:28] And so of course, Of course, people who are suffering want that, but that also isn't helping, and they realize that how, you know, along the journey that it's actually more dysregulating. Um, but all we need to do is create a middle path of, we need to provide that safety, and that comes from educating our practitioners as well.
[00:44:49] Dr Thea Bowler: And the thing is, it's so empowering because so much of it is, It's great.
[00:44:55] Tanya Borowski: Mm hmm. It is. But it comes, but actually, that middle path, and it comes back to, a lot of us here, a number of us here have come off the back of a, um, a conference that was, that was centered around understanding pathology, so blood markers, specific blood markers.
[00:45:14] But the key, key component, the key message that was embedded in that is, case history is actually looking in the eyes of your client of all of these wonderful patients that are sat here and actually taking the time to unravel the story because embedded within that story is actually the source of the trigger of the, of the upregulation of the immune system and then sort of the, the snowball effects of what then upsets the nervous system, right?
[00:45:45] So Can I ask you to, in terms, we will come to some interventions to close, but in terms of what your, your, your map, your roadmap looks like. When you studied [00:46:00] gynecology, this, you, were you, did you always have, I mean you, I suppose you inferred that you picked up Lara's book and it was, I, it was, It was a whole other world that opened up to you.
[00:46:12] So when you study to become a gynecologist, do you, are you, did you have an inkling to look at the body through this lens? Or was it sort of something that called you that there is more?
[00:46:24] Dr Peta Wright: The reason I picked up her book was because I just started private practice and I was realizing incredibly rapidly that what I had been taught wasn't true.
[00:46:34] And I was realizing that what I'd been taught and how I'd been taught to manage people didn't work. And what I learnt, you know, when I like just sat and I listened and I saw women, you know, had more continuity of care because it's private practice. I just started to notice Gosh, like, you know, the, the holistic, what people have been through has a huge effect on what they're presenting with, um, and their symptom, their symptoms and, um, and I just like, it just didn't make sense to me anymore.
[00:47:08] It, this kind of very blunt thing of, oh, well. Uh, rather than looking for the root cause, it was very, what we learned was not root cause based, unless it was, you know, a polyp or something to cut out. Um, the answer was always, Oh, you've got, you've got menstrual cycle dysfunction. So the pill, that is, that is literally it or an operation.
[00:47:29] And, um, it just became rapidly apparent that that was, and not good enough. And then, yeah, and then, um, I went down and what, you know, I'm so grateful for Lara's book because it rang true. It really rang true. And, um, and then I started like I did some more stuff in integrative medicine. And then I was like, ah, yes, this is it.
[00:47:52] Tanya Borowski: Well, for stepping outside of the and moving the paradigm because you, you, you are what you're doing here. [00:48:00] It's, um, It's truly inspirational and it's wonderful to be a part of that community. And I think that there is much, there is so much. interest and dialogue, uh, around women's health. And I think that it is our role to help make sure that it steers in this sort of more keeping the lens broad rather than sort of it being narrow and shallow.
[00:48:25] But let's keep the lens as broad as possible so we can see All of the different connections and the microcosm of it. So, um, I think there'll be lots of questions. So we will thank you so much for coming onto my small little podcast and, uh, for inviting me to be here. And hopefully it's brought up some, it's been illuminating and it's brought up some questions that we will answer.
[00:48:50] Dr Peta Wright: so much for
[00:48:52] Tanya Borowski: having us
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DISCLAIMER:
This podcast is for information and educational purposes only and is not intended as a substitute for medical advice, diagnosis, or treatment.
