June 11, 2025 • 24 mins
Recent controversial comments in the media about Endometriosis has highlighted the misconceptions about a disease that impacts 1 in 7 Aussie women. But it has wider ramifications on the way we respond to women’s health, including menopause. Specialist Obstetrician-Gynaecologist Dr Brad Robinson sets the record straight.
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Speaker 1 (00:00):
There has been a media storm recently over endometriosis after
comments from a commentator to the effect that the condition
is made up. Well, what is endometriosis, or ENDO as
it's referred to. It's something that one in seven Australian
women suffer, including me. It's a chronic disease where tissue
(00:22):
similar to the lining of the uterus grows outside of it.
It causes severe pain, messes with your mental health and
if that's not bad enough, it can lead to infertility.
It's to blame for my five year pursuit of having
a baby. The extent of my disease not laid bare
until after my c section. Just minutes after the birth
(00:44):
of my now teenage daughter, my obstetrician proclaimed as I
lay in theater that I can see why it's taken
so long, futiful pregnant, Your endometrial system is quote a mess. Now,
two things from that moment for me. The first was
obviously a great sense of achievement and elation in having
(01:05):
finally got my baby and she was.
Speaker 2 (01:07):
Healthy and well. And secondly, validation as to.
Speaker 1 (01:10):
Why it took me so long to get pregnant and
have my baby, as I'd long suspected for more than
two decades that I did actually have endometriosis because as
a young woman in my early twenties, I visited an
elderly gynecologist who when I told him about my painful periods,
he rolled his eyes into the back of his head
(01:32):
when I asked if he thought maybe.
Speaker 2 (01:33):
I should be tested for it, and so he shut
me down. He belittled me.
Speaker 1 (01:38):
He made me feel neurotic and that it was all
in my head. So I just shut down. I was
an armed with knowledge that could have prepared me for
five years of infertility and repeated miscarriages in the pursuit
of my daughter. Takes about seven years to get an
endometriosis diagnosis.
Speaker 2 (01:58):
I was let down.
Speaker 1 (02:00):
I feel the comments that ENDO has made up reinforce
that cruel, really cruel.
Speaker 2 (02:05):
Train of thought in society.
Speaker 1 (02:08):
Now you might ask, but what does that have to
do with perimenopause and menopause.
Speaker 2 (02:11):
Well, everything, because.
Speaker 1 (02:13):
It's attitudes and stigma that I'm trying to shift in
this podcast, Rage against the Menopause. But it's not just
a woman's issue. It's up to all of society to
helping changing attitudes and champing women in what they go
through all of life stages, including menopause.
Speaker 2 (02:35):
Menopause, It's coming for you no matter what. Let's build
a village of support. Why is it so damn hot
in here? Menopause is so hot right now? I think
them and menopause women.
Speaker 1 (02:48):
Just want to feel hurt rage against the menopause. I'm
going to bring in now, doctor Brad Robinson. Here's an
obstetrician and gynecologist with special interests in the management of
menopause and fertility.
Speaker 3 (03:03):
Hey Brad, Hello, Patraina.
Speaker 1 (03:05):
Is it rare that I have managed to get you
at a time that you don't have a Lady Touchwood
currently in labor.
Speaker 3 (03:12):
I don't speak too soon. The life of an obstetrician
is incredibly unpredictable, and I bet I think the obstetric
gods can hear those sort of comments.
Speaker 2 (03:23):
How many babies have you delivered to date?
Speaker 3 (03:25):
You know what? I got asked that question yesterday, and
I am embarrassed to say I've completely and utterly lost account.
It's probably north of three thousand, but I don't know.
Speaker 1 (03:35):
Yeah, wow, So how many years have you been practicing
in obstetrics?
Speaker 3 (03:39):
I started my first year working in obstetrics in at
the start of two thousand and six, so this is
my twentieth year.
Speaker 1 (03:50):
Wow.
Speaker 3 (03:51):
Yeah. They say that obstetrics chooses you, you don't choose it,
or obstetrics and gynecology. I should say the profession chooses you,
so it's not an actor decision.
Speaker 1 (04:00):
I have endometriosis and also polycystic ovarian syndrome.
Speaker 3 (04:04):
My story.
Speaker 1 (04:05):
I'm now in my fifties, so I can remember in
my early twenties I had to have a procedure done
and I did mention to the elderly gynecologist that did
the procedure. Do you think possibly I'm hearing this thing
about this thing called endometriosis? Do you think it's possible
that you know?
Speaker 2 (04:25):
I don't.
Speaker 1 (04:25):
I can't measure my pain each month compared to say
my best friends because not in her body, but to me,
it's quite crippling. Do you think it's a possibility. Is
there any way that we can investigate it? I'm not
kidding you, Brad. He sat opposite me and my boyfriend
at the time who is now my husband, and looked
(04:46):
at me with glazed over eyes and literally rolled his
eyes into the back of his head and so do
you know what that did to to me? That shut
me down, made me feel neurotic on her, and so
fast forward a really long time. So I wasn't we
weren't armed with information, right, So we started to try
(05:09):
and have a family from about the age of thirty four,
had repeated miscarriages, about five miscarriages before.
Speaker 2 (05:17):
We finally got our Audrey.
Speaker 1 (05:21):
Now, had have I known that, yes it is endo,
we probably would have changed tact and maybe tried a
bit earlier. So, yeah, she's our miracle child, but we've
only been able to have one. But goodness knows what
could have happened had have we started a bit earlier.
And you know, Brad, I had a wonderful obstetrician who
I'm sure you're aware of here in Melbourne, in Lionel Steinberg,
(05:45):
who was absolutely fabulous. And it wasn't until the very
day I had my C section with Audrey that I
also had assist in there and he said, look, when
we open you up, we'll get that fixed, and I thought.
Speaker 2 (05:57):
Yeah, gift with purchase.
Speaker 1 (06:00):
Anyway, I literally was on the table and he said, oh,
he said, I don't think I'm going to go near that.
He said, you have very bad endo. He's a Petrina
your I'm getting very personal here, but this is what
this podcast is about. We're being authentic here. Your fallopian
tube is like a tree stump. It's wrapped, it's right
wrapped around your system. It's a mess.
Speaker 2 (06:20):
I don't know how to hear you say that.
Speaker 3 (06:23):
Yep, yep, and you know.
Speaker 2 (06:24):
What it was.
Speaker 1 (06:25):
So I had this elation of this beautiful, healthy baby,
six weeks early but strong as an ox.
Speaker 2 (06:31):
We finally had got our baby.
Speaker 1 (06:33):
And also validation of oh my goodness, all those years
ago where I was made almost belittled really and made
feel like a neurotic woman of actually, yeah, you were
onto something. It's important, isn't it that women feel hurt?
Speaker 3 (06:48):
Oh, it's crucial. I'm so sorry to hear that story.
And I'm also really embarrassed to say to you, Pats
that I'm still hearing stories like that today. Now hopefully
they're not as frequent ocurrence, and hopefully they're not as
demonstrably directed as that individual executed is to you, but
(07:12):
they're still occurring, and even when they're subtle, it's still
an insult. And I mean, I had a lady yesterday
that had had a long history of significant mental dysfunction.
She was thirty five and I hadn't met her before,
but she came in, I read her referral, I spoke
to her, and it was really clear immediately that she
required treatment, and I thought it was all very straightforward.
(07:34):
But at the end of the consultation, she stopped and
turned to me and said, look, I wanted to say
thank you because I actually came in here fore armed
with all of my arguments executed in my head, ready
for when you turned me down on my requests. And
I was really I mean, I was flat and obviously
to hear the appreciation, but it was so upsetting to
(07:56):
understand and to hear directly that these women, women are
having these sorts of thoughts privticing health professionals still in
twenty twenty five.
Speaker 1 (08:05):
And I think, you know, Brad, this is what I'm
trying to overcome with this podcast series. Is the same
for perimenopause and menopause. We're hearing a lot of women
going to their GPS and they're getting given antidepressants, which
maybe some of them do need, but they're not necessarily depressed.
Speaker 2 (08:26):
They're just being misdiagnosed.
Speaker 3 (08:29):
I mean, but can you imagine if the menopause was
an event that occurred to men, No, I can't different
things would be. It would be extraordinarily different. Women wouldn't
be gasolic, they wouldn't be turned away, they wouldn't be
told it's not really you have depression. Take these. I mean,
I shouldn't laugh at it is just awful.
Speaker 1 (08:48):
It's so victorian in its attitude, like we're so far.
Speaker 3 (08:53):
I mean, women are hysterical, right, they have history from their.
Speaker 1 (08:57):
Ups for more responsibility? Do you think role models you know,
on film, wherever, in the community, what sort of responsibility
do you think role models in our community have in
the conversation about endometriosis and community perceptions.
Speaker 3 (09:18):
Look, I think people that have a platform and good
intentions have a responsibility to use that platform and those
intentions feel good. I mean, we're not Spider Man, but
we don't have a whole. With great power comes great responsibility.
But I mean people that are role models need to
speak up. And the reason for that is there's clear
(09:41):
evidence that particularly men, supporting women with endometriosis actually leads
to a reduction in what is still a prolonged delay
between onset of symptoms and diagnosis. So something is simple
as a partner supporting and advocating for his girlfriend, wife, whatever,
(10:06):
sister can actually lead to improved outcomes. So that's just
one really simple but clear demonstration of why it's important.
I am just a medical profession I'm not a role model,
but I was completely shocked that when I did my
little ill thought out, well sorry, my little Instagram post
(10:26):
that I didn't really give much thought to, at the
way in which there was just this outpouring of frustration
and anger and grief from women that I think even
I didn't understand existed. So I think that outpouring told
a story about the way in which society needs to
(10:47):
continue to shift the needle towards stepping up speaking out
for conditions such as endometriosis that affect women. And you
know what, perhaps on that post, which it's the only
time in my life I've ever as they said, the
cool kids say, went viral, but there were I think
amongst the thousands and thousands of comments from women, I
(11:09):
think there were four or five negative comments that had
a cracking me And you'd be shocked to hear that
they were all men.
Speaker 1 (11:16):
Yeah, that's what's sparing me on with this series as well,
is that. And it's proved to me and it's validation
again that word to me that women do want to
be heard. There's a thirst for it, they need it,
and I think we're moving in the right direction. As
a specialist, do you think training for GPS as a
first point of call for women who perhaps might fear
(11:38):
they have ENDO or going through perimenopause?
Speaker 2 (11:41):
Is it adequate?
Speaker 3 (11:43):
Very good question, Pats. You're really getting to the nub
of all this, and that is the front line of
our healthcare system in Australia are GPS. So if a
GP is getting something wrong, then that's going to have
a demnstromly negative effect on a patient. There is has
been a history of mental dysfunction not being taken seriously
(12:04):
by primary healthcare providers in Australia, GPS and also specialists
with that attitude of oh, come on, love, it's just
your period. Periods are meant to be painful. Now, I've
got to say I should start by saying I've got
enormous respect to the job that GPS do. They have
to know something about everything, as opposed to me, where
(12:27):
I just operate within a a more refined space of knowledge.
They've got considerable time pressures there. I know it's not
cool to say that the doctor's poorly remunerated, but gps,
relatively to their training and their commitment, are poorly remunerated.
I do think, however, pert that things are getting better.
I'm getting more exposed to the new not necessarily younger,
(12:51):
but that the gps that have been trained more recently
that certainly do have greater empathy and understanding for these issues.
I think that's probably, in some respect a reflection of
the way society hopefully is starting to move. So I
actually feel quite comfortable and encouraged by what I'm seeing
(13:12):
on the front lines. Now.
Speaker 2 (13:14):
Yeah, it's like a new generation.
Speaker 1 (13:16):
Of course, it's like that new generation is coming through
that recent Senate inquiry into menopause, for example.
Speaker 3 (13:23):
Yes, they actually visited our rooms. Really, Yeah, they came
here because we have a specialist menopause center within the
confines of our practice.
Speaker 2 (13:32):
Well, that's one that's so forward, that's awesome.
Speaker 1 (13:35):
I was shocked by one of those recommendations or what
came out of that inquiry is that, you know, medical
students really only get sixty minutes an hour of training
in their hole?
Speaker 2 (13:46):
What is it?
Speaker 1 (13:46):
Sixty course on the menopause, which is just wow, you
know what?
Speaker 3 (13:52):
I had not considered that, But I'm actually struggling to
think whether I had any teacher on that when I
went through mine. I actually can't recall having any formal
structured training on the metopause. Maybe it was mentioned, but
there certainly was nothing in any detail.
Speaker 2 (14:14):
Where are we at with treatment?
Speaker 1 (14:16):
I know each case is so so individual, Brad, but
what sort of advances are being made in treatment for endometriosis?
Speaker 3 (14:25):
Well, Pats, you know, you know as well as I
do that. Unfortunately, society is very patriarchal. Still, medicine has
been extremely patriarchal when it comes to research into women's
health conditions. When review it has been too complicated because
of hormonal fluctuations. So research historically haven't been done into
(14:46):
women's conditions. So that's the roadblock or the handbrake that
we've got. But now things are starting to change a bit.
There is now more research being done into conditions such
as endometriosis, so medicine is effectively scrammed.
Speaker 2 (15:00):
Now.
Speaker 3 (15:01):
The old approach always was surgery, and you know in
my time in practice, I've seen the way in which
gynecologists have had women with and have operated and then
have patronizingly effectively pattered them on the head. I've done
your surgery, You're cured to be Later. Now we've got
(15:23):
a far greater understanding, thankfully, of the completely multidisciplinary approach
that needs to be taken, from surgery to hormonal therapy,
to pelvic four physiotherapy, to psychology, to pain specialist pain management,
to dietary modifications to gut health, to this whole range
(15:44):
of measures that need to be considered in the context
of an individual case so you can best figure out
what can help your patient. That old approach of just
surgery is for the Yeah, but look, the government also
perhaps really needs to keep up, and there's some evidence
(16:05):
that that is happening. There's just recently the government announced
that a new hormonal medication called slender Up from the
first of May is hitting the PBS, which brings the
cost down for what can be in my experience to
a really effective treatment for endometriosis symptom control. But they're
(16:26):
still in a long way to go.
Speaker 2 (16:27):
Yeah, but it's the start.
Speaker 1 (16:28):
Can can you tell me Brad how is the perry
or menopause experience, if at all, any different for women
like me with endometriosis.
Speaker 3 (16:40):
You know what my first thought thereous parts is is
the way that it's different is for ladies that have
already been subjected to the battles that you have, or
women like you have. You'd get to the menopause then
and be confronted with new issues and you think blood.
Speaker 1 (16:57):
That's exactly what I thought. In my first series Brad,
I said that, you know, lifetime of endometriosis pcos I
had kidneying cancer ten years ago, which is totally unrelated obviously,
but I got to I got to perimenopause, and I
did stop and ask myself, do you mean to say now?
You know, I felt like I'd run this marathon and
(17:19):
it's like, now you've got to do a double you know,
another marathon that's twice as long.
Speaker 2 (17:23):
It's like you back again. Are you serious?
Speaker 3 (17:25):
Yeah?
Speaker 1 (17:27):
Yeah, why yes, But it's exactly it's so true what
you're saying.
Speaker 3 (17:31):
Yeah, yeah, Look of the One of the things that
we're getting a greater recognition of now, which is quite
interesting that certainly entered my consciousness more in recent years,
is that women that have suffered from significant endometriosis generally
then into menopause. They're treatment regiments for menopause symptoms can
(17:56):
be and should be potentially different. So I should start
this conversation perhaps by saying, I advocate for a low
threshold for treatment for menopause or symptoms. I think menopause
or hormone therapy MHT is grossly underrated. It's women have
been scared off due to the Women's Health Initiative trial
(18:17):
back in the early two thousands and the alleged links
to a whole range of medical conditions that just with
time haven't been proven to be anywhere near as significant
as they would represented to be. So it's certainly undertreated.
So I would say to any woman that has concerns
about menopause or symptoms, please go on CEEGP and start
a conversation about it, because I have no doubt your
(18:38):
life can be made better. But it does get more
complicated if you've had a history of significant dmetrilitians and
a woman's had, for instance, a hysterectomy as part of
her surgical journey, then for menopause hormone therapy, if a
woman's had a hysterectomy, she typically just is given estrogen supplementation.
(19:00):
But if you're giving just the estrogen supplementation and you've
had endometriosis and you're now menopausal, there's an understanding that
that endometri that estrogen could retrigger endometrious edmetriosis regrowth. So
now for those women that don't have a uterus, we're
putting those women more back on combination therapy to try
(19:24):
and ameliorate that.
Speaker 1 (19:25):
Yeah, gosh, it's it really, it's not a one size
fits all. It each case is so specialized, isn't it.
Speaker 3 (19:33):
Yeah, And the more we learn, the more the more
we realize we don't know.
Speaker 1 (19:35):
Yeah, if those women listening and they need help, they
need more information, what would you recommend?
Speaker 2 (19:43):
Just their local GP. Hopefully they've got a good one.
Speaker 3 (19:46):
Honestly, I would go even to a bit of looking
around to see if you can find a GP that
has an interest in those issues. So it it's endometriosis,
parentneal disease, that or menopause, look for it online and
find your GP that aligns with those conditions, and then
(20:08):
make an assessments to whether you're feeling heard and whether
you're feeling understood, and if you have concerns, I would say,
ask for a referral to a gynecologist if you're in
a position to be able to do that financially of course,
or ask for a referral to a gynecology clinic, and
just make sure that you're heard that you advocate for yourself.
(20:33):
I also hate too many stories of women that are told, look,
I'm not doing a referral for you because you don't
need it. Well, if a person wants a referral, they're
a title to it.
Speaker 1 (20:42):
I think you hit the nail right on the head
when you said the word advocate and advocate for yourself.
You shouldn't have to, but the fact is sometimes you do,
and if you're coming out not feeling satisfied, get a
second opinion.
Speaker 3 (20:58):
Absolutely, yeah, I mean, what did you say, perhaps the
delay between that gentleman role in his eye.
Speaker 1 (21:05):
Well, I was in my early twenties, I recgonized, probably
about twenty two. I had Audrey at thirty nine.
Speaker 3 (21:12):
Yeah, and that I mean that potentially impacted the course
of your life.
Speaker 2 (21:18):
Totally, absolutely did.
Speaker 1 (21:20):
And you know, really it's had a massive impact because
while she is such a blessing and is the child
that a lot of specialists said we would never get.
So I'm always thankful of what I have. More than thankful.
She's just, you know, she's our whole world. We also
(21:42):
never really set out just to have one child.
Speaker 2 (21:45):
We ideally would have liked two or three.
Speaker 1 (21:47):
But of course, you know, again, you're thankful with all
my history that we got her in the end.
Speaker 2 (21:52):
But you know, yeah, if.
Speaker 1 (21:54):
We were I think knowledge is power and hawd have
we known that, we certainly would have started trying a
bit earlier, because you know, you try all those years
not to get pregnant, and then when you want to
get pregnant, are you not exactly.
Speaker 2 (22:07):
Sure how long it's going to take her if it's
going to work.
Speaker 1 (22:10):
So yeah, that's just my experience, and I hope by
sharing what I went through that you know that younger
generation perhaps we'll learn something from it and take inspiration
and it might help their journey along the way.
Speaker 3 (22:24):
It certainly kind of her parts. It's these conversations have
had more commonly than less, people are going to be affected,
affected in the way that you will.
Speaker 1 (22:34):
Yeah, I agree, doctor Brad, you are an absolute superstar.
Speaker 3 (22:39):
Hey, can I say to your perhaps yes, I'm taking
a tangent here. I said to my wife last night,
I'm doing this amazing podcast tomorrow. She said, who's it worth?
And I said I was with the trainer that and
she looked at me and she said not not Patty
from the Christian I Iconno. Yeah, So my wife and
my three kids on the I've just cool it very
(23:01):
commonly listened to your show and my wife was apoplectic
that I was talking to you this morning.
Speaker 1 (23:08):
Oh you honestly, I've got goose bumps after you saying
that what's your wife's name?
Speaker 3 (23:14):
My wife is a bit of a BOC grade Bristain
celebrity called Rebecca Sparrow. He does a lot of work
in parenting.
Speaker 1 (23:20):
She is not C grade and she is a writer
and columbist. She is no look, that is just may
my day.
Speaker 3 (23:30):
Thank you so much, thank you lovely talking to you.
Speaker 1 (23:34):
Doctor Brad Robinson. He's a specialist obstetrician kindecologist. He joined
me from his popular practice in Brisbane. He's a respected
media commentator with regular appearances on radio as well as
print and online media and now on Rage against the Menopause.
I really loved our chat and if you or someone
(23:54):
you know suffers from indo endometriosis Australia has a brilliant
website for support. My guest in episode four is a
household name and someone I've always deeply admired. TV and
radio presenter Bridget Declo. Bridgie is a former colleague and
seriously one of the most divine women I know. She's
(24:17):
added qualified counselor to her list of achievements and she
joins me next on the couch.
Speaker 2 (24:23):
I'm Petrina Jones. Rage Against the Menopause.
There has been a media storm recently over endometriosis after
comments from a commentator to the effect that the condition
is made up. Well, what is endometriosis, or ENDO as
it's referred to. It's something that one in seven Australian
women suffer, including me. It's a chronic disease where tissue
(00:22):
similar to the lining of the uterus grows outside of it.
It causes severe pain, messes with your mental health and
if that's not bad enough, it can lead to infertility.
It's to blame for my five year pursuit of having
a baby. The extent of my disease not laid bare
until after my c section. Just minutes after the birth
(00:44):
of my now teenage daughter, my obstetrician proclaimed as I
lay in theater that I can see why it's taken
so long, futiful pregnant, Your endometrial system is quote a mess. Now,
two things from that moment for me. The first was
obviously a great sense of achievement and elation in having
(01:05):
finally got my baby and she was.
Speaker 2 (01:07):
Healthy and well. And secondly, validation as to.
Speaker 1 (01:10):
Why it took me so long to get pregnant and
have my baby, as I'd long suspected for more than
two decades that I did actually have endometriosis because as
a young woman in my early twenties, I visited an
elderly gynecologist who when I told him about my painful periods,
he rolled his eyes into the back of his head
(01:32):
when I asked if he thought maybe.
Speaker 2 (01:33):
I should be tested for it, and so he shut
me down. He belittled me.
Speaker 1 (01:38):
He made me feel neurotic and that it was all
in my head. So I just shut down. I was
an armed with knowledge that could have prepared me for
five years of infertility and repeated miscarriages in the pursuit
of my daughter. Takes about seven years to get an
endometriosis diagnosis.
Speaker 2 (01:58):
I was let down.
Speaker 1 (02:00):
I feel the comments that ENDO has made up reinforce
that cruel, really cruel.
Speaker 2 (02:05):
Train of thought in society.
Speaker 1 (02:08):
Now you might ask, but what does that have to
do with perimenopause and menopause.
Speaker 2 (02:11):
Well, everything, because.
Speaker 1 (02:13):
It's attitudes and stigma that I'm trying to shift in
this podcast, Rage against the Menopause. But it's not just
a woman's issue. It's up to all of society to
helping changing attitudes and champing women in what they go
through all of life stages, including menopause.
Speaker 2 (02:35):
Menopause, It's coming for you no matter what. Let's build
a village of support. Why is it so damn hot
in here? Menopause is so hot right now? I think
them and menopause women.
Speaker 1 (02:48):
Just want to feel hurt rage against the menopause. I'm
going to bring in now, doctor Brad Robinson. Here's an
obstetrician and gynecologist with special interests in the management of
menopause and fertility.
Speaker 3 (03:03):
Hey Brad, Hello, Patraina.
Speaker 1 (03:05):
Is it rare that I have managed to get you
at a time that you don't have a Lady Touchwood
currently in labor.
Speaker 3 (03:12):
I don't speak too soon. The life of an obstetrician
is incredibly unpredictable, and I bet I think the obstetric
gods can hear those sort of comments.
Speaker 2 (03:23):
How many babies have you delivered to date?
Speaker 3 (03:25):
You know what? I got asked that question yesterday, and
I am embarrassed to say I've completely and utterly lost account.
It's probably north of three thousand, but I don't know.
Speaker 1 (03:35):
Yeah, wow, So how many years have you been practicing
in obstetrics?
Speaker 3 (03:39):
I started my first year working in obstetrics in at
the start of two thousand and six, so this is
my twentieth year.
Speaker 1 (03:50):
Wow.
Speaker 3 (03:51):
Yeah. They say that obstetrics chooses you, you don't choose it,
or obstetrics and gynecology. I should say the profession chooses you,
so it's not an actor decision.
Speaker 1 (04:00):
I have endometriosis and also polycystic ovarian syndrome.
Speaker 3 (04:04):
My story.
Speaker 1 (04:05):
I'm now in my fifties, so I can remember in
my early twenties I had to have a procedure done
and I did mention to the elderly gynecologist that did
the procedure. Do you think possibly I'm hearing this thing
about this thing called endometriosis? Do you think it's possible
that you know?
Speaker 2 (04:25):
I don't.
Speaker 1 (04:25):
I can't measure my pain each month compared to say
my best friends because not in her body, but to me,
it's quite crippling. Do you think it's a possibility. Is
there any way that we can investigate it? I'm not
kidding you, Brad. He sat opposite me and my boyfriend
at the time who is now my husband, and looked
(04:46):
at me with glazed over eyes and literally rolled his
eyes into the back of his head and so do
you know what that did to to me? That shut
me down, made me feel neurotic on her, and so
fast forward a really long time. So I wasn't we
weren't armed with information, right, So we started to try
(05:09):
and have a family from about the age of thirty four,
had repeated miscarriages, about five miscarriages before.
Speaker 2 (05:17):
We finally got our Audrey.
Speaker 1 (05:21):
Now, had have I known that, yes it is endo,
we probably would have changed tact and maybe tried a
bit earlier. So, yeah, she's our miracle child, but we've
only been able to have one. But goodness knows what
could have happened had have we started a bit earlier.
And you know, Brad, I had a wonderful obstetrician who
I'm sure you're aware of here in Melbourne, in Lionel Steinberg,
(05:45):
who was absolutely fabulous. And it wasn't until the very
day I had my C section with Audrey that I
also had assist in there and he said, look, when
we open you up, we'll get that fixed, and I thought.
Speaker 2 (05:57):
Yeah, gift with purchase.
Speaker 1 (06:00):
Anyway, I literally was on the table and he said, oh,
he said, I don't think I'm going to go near that.
He said, you have very bad endo. He's a Petrina
your I'm getting very personal here, but this is what
this podcast is about. We're being authentic here. Your fallopian
tube is like a tree stump. It's wrapped, it's right
wrapped around your system. It's a mess.
Speaker 2 (06:20):
I don't know how to hear you say that.
Speaker 3 (06:23):
Yep, yep, and you know.
Speaker 2 (06:24):
What it was.
Speaker 1 (06:25):
So I had this elation of this beautiful, healthy baby,
six weeks early but strong as an ox.
Speaker 2 (06:31):
We finally had got our baby.
Speaker 1 (06:33):
And also validation of oh my goodness, all those years
ago where I was made almost belittled really and made
feel like a neurotic woman of actually, yeah, you were
onto something. It's important, isn't it that women feel hurt?
Speaker 3 (06:48):
Oh, it's crucial. I'm so sorry to hear that story.
And I'm also really embarrassed to say to you, Pats
that I'm still hearing stories like that today. Now hopefully
they're not as frequent ocurrence, and hopefully they're not as
demonstrably directed as that individual executed is to you, but
(07:12):
they're still occurring, and even when they're subtle, it's still
an insult. And I mean, I had a lady yesterday
that had had a long history of significant mental dysfunction.
She was thirty five and I hadn't met her before,
but she came in, I read her referral, I spoke
to her, and it was really clear immediately that she
required treatment, and I thought it was all very straightforward.
(07:34):
But at the end of the consultation, she stopped and
turned to me and said, look, I wanted to say
thank you because I actually came in here fore armed
with all of my arguments executed in my head, ready
for when you turned me down on my requests. And
I was really I mean, I was flat and obviously
to hear the appreciation, but it was so upsetting to
(07:56):
understand and to hear directly that these women, women are
having these sorts of thoughts privticing health professionals still in
twenty twenty five.
Speaker 1 (08:05):
And I think, you know, Brad, this is what I'm
trying to overcome with this podcast series. Is the same
for perimenopause and menopause. We're hearing a lot of women
going to their GPS and they're getting given antidepressants, which
maybe some of them do need, but they're not necessarily depressed.
Speaker 2 (08:26):
They're just being misdiagnosed.
Speaker 3 (08:29):
I mean, but can you imagine if the menopause was
an event that occurred to men, No, I can't different
things would be. It would be extraordinarily different. Women wouldn't
be gasolic, they wouldn't be turned away, they wouldn't be
told it's not really you have depression. Take these. I mean,
I shouldn't laugh at it is just awful.
Speaker 1 (08:48):
It's so victorian in its attitude, like we're so far.
Speaker 3 (08:53):
I mean, women are hysterical, right, they have history from their.
Speaker 1 (08:57):
Ups for more responsibility? Do you think role models you know,
on film, wherever, in the community, what sort of responsibility
do you think role models in our community have in
the conversation about endometriosis and community perceptions.
Speaker 3 (09:18):
Look, I think people that have a platform and good
intentions have a responsibility to use that platform and those
intentions feel good. I mean, we're not Spider Man, but
we don't have a whole. With great power comes great responsibility.
But I mean people that are role models need to
speak up. And the reason for that is there's clear
(09:41):
evidence that particularly men, supporting women with endometriosis actually leads
to a reduction in what is still a prolonged delay
between onset of symptoms and diagnosis. So something is simple
as a partner supporting and advocating for his girlfriend, wife, whatever,
(10:06):
sister can actually lead to improved outcomes. So that's just
one really simple but clear demonstration of why it's important.
I am just a medical profession I'm not a role model,
but I was completely shocked that when I did my
little ill thought out, well sorry, my little Instagram post
(10:26):
that I didn't really give much thought to, at the
way in which there was just this outpouring of frustration
and anger and grief from women that I think even
I didn't understand existed. So I think that outpouring told
a story about the way in which society needs to
(10:47):
continue to shift the needle towards stepping up speaking out
for conditions such as endometriosis that affect women. And you
know what, perhaps on that post, which it's the only
time in my life I've ever as they said, the
cool kids say, went viral, but there were I think
amongst the thousands and thousands of comments from women, I
(11:09):
think there were four or five negative comments that had
a cracking me And you'd be shocked to hear that
they were all men.
Speaker 1 (11:16):
Yeah, that's what's sparing me on with this series as well,
is that. And it's proved to me and it's validation
again that word to me that women do want to
be heard. There's a thirst for it, they need it,
and I think we're moving in the right direction. As
a specialist, do you think training for GPS as a
first point of call for women who perhaps might fear
(11:38):
they have ENDO or going through perimenopause?
Speaker 2 (11:41):
Is it adequate?
Speaker 3 (11:43):
Very good question, Pats. You're really getting to the nub
of all this, and that is the front line of
our healthcare system in Australia are GPS. So if a
GP is getting something wrong, then that's going to have
a demnstromly negative effect on a patient. There is has
been a history of mental dysfunction not being taken seriously
(12:04):
by primary healthcare providers in Australia, GPS and also specialists
with that attitude of oh, come on, love, it's just
your period. Periods are meant to be painful. Now, I've
got to say I should start by saying I've got
enormous respect to the job that GPS do. They have
to know something about everything, as opposed to me, where
(12:27):
I just operate within a a more refined space of knowledge.
They've got considerable time pressures there. I know it's not
cool to say that the doctor's poorly remunerated, but gps,
relatively to their training and their commitment, are poorly remunerated.
I do think, however, pert that things are getting better.
I'm getting more exposed to the new not necessarily younger,
(12:51):
but that the gps that have been trained more recently
that certainly do have greater empathy and understanding for these issues.
I think that's probably, in some respect a reflection of
the way society hopefully is starting to move. So I
actually feel quite comfortable and encouraged by what I'm seeing
(13:12):
on the front lines. Now.
Speaker 2 (13:14):
Yeah, it's like a new generation.
Speaker 1 (13:16):
Of course, it's like that new generation is coming through
that recent Senate inquiry into menopause, for example.
Speaker 3 (13:23):
Yes, they actually visited our rooms. Really, Yeah, they came
here because we have a specialist menopause center within the
confines of our practice.
Speaker 2 (13:32):
Well, that's one that's so forward, that's awesome.
Speaker 1 (13:35):
I was shocked by one of those recommendations or what
came out of that inquiry is that, you know, medical
students really only get sixty minutes an hour of training
in their hole?
Speaker 2 (13:46):
What is it?
Speaker 1 (13:46):
Sixty course on the menopause, which is just wow, you
know what?
Speaker 3 (13:52):
I had not considered that, But I'm actually struggling to
think whether I had any teacher on that when I
went through mine. I actually can't recall having any formal
structured training on the metopause. Maybe it was mentioned, but
there certainly was nothing in any detail.
Speaker 2 (14:14):
Where are we at with treatment?
Speaker 1 (14:16):
I know each case is so so individual, Brad, but
what sort of advances are being made in treatment for endometriosis?
Speaker 3 (14:25):
Well, Pats, you know, you know as well as I
do that. Unfortunately, society is very patriarchal. Still, medicine has
been extremely patriarchal when it comes to research into women's
health conditions. When review it has been too complicated because
of hormonal fluctuations. So research historically haven't been done into
(14:46):
women's conditions. So that's the roadblock or the handbrake that
we've got. But now things are starting to change a bit.
There is now more research being done into conditions such
as endometriosis, so medicine is effectively scrammed.
Speaker 2 (15:00):
Now.
Speaker 3 (15:01):
The old approach always was surgery, and you know in
my time in practice, I've seen the way in which
gynecologists have had women with and have operated and then
have patronizingly effectively pattered them on the head. I've done
your surgery, You're cured to be Later. Now we've got
(15:23):
a far greater understanding, thankfully, of the completely multidisciplinary approach
that needs to be taken, from surgery to hormonal therapy,
to pelvic four physiotherapy, to psychology, to pain specialist pain management,
to dietary modifications to gut health, to this whole range
(15:44):
of measures that need to be considered in the context
of an individual case so you can best figure out
what can help your patient. That old approach of just
surgery is for the Yeah, but look, the government also
perhaps really needs to keep up, and there's some evidence
(16:05):
that that is happening. There's just recently the government announced
that a new hormonal medication called slender Up from the
first of May is hitting the PBS, which brings the
cost down for what can be in my experience to
a really effective treatment for endometriosis symptom control. But they're
(16:26):
still in a long way to go.
Speaker 2 (16:27):
Yeah, but it's the start.
Speaker 1 (16:28):
Can can you tell me Brad how is the perry
or menopause experience, if at all, any different for women
like me with endometriosis.
Speaker 3 (16:40):
You know what my first thought thereous parts is is
the way that it's different is for ladies that have
already been subjected to the battles that you have, or
women like you have. You'd get to the menopause then
and be confronted with new issues and you think blood.
Speaker 1 (16:57):
That's exactly what I thought. In my first series Brad,
I said that, you know, lifetime of endometriosis pcos I
had kidneying cancer ten years ago, which is totally unrelated obviously,
but I got to I got to perimenopause, and I
did stop and ask myself, do you mean to say now?
You know, I felt like I'd run this marathon and
(17:19):
it's like, now you've got to do a double you know,
another marathon that's twice as long.
Speaker 2 (17:23):
It's like you back again. Are you serious?
Speaker 3 (17:25):
Yeah?
Speaker 1 (17:27):
Yeah, why yes, But it's exactly it's so true what
you're saying.
Speaker 3 (17:31):
Yeah, yeah, Look of the One of the things that
we're getting a greater recognition of now, which is quite
interesting that certainly entered my consciousness more in recent years,
is that women that have suffered from significant endometriosis generally
then into menopause. They're treatment regiments for menopause symptoms can
(17:56):
be and should be potentially different. So I should start
this conversation perhaps by saying, I advocate for a low
threshold for treatment for menopause or symptoms. I think menopause
or hormone therapy MHT is grossly underrated. It's women have
been scared off due to the Women's Health Initiative trial
(18:17):
back in the early two thousands and the alleged links
to a whole range of medical conditions that just with
time haven't been proven to be anywhere near as significant
as they would represented to be. So it's certainly undertreated.
So I would say to any woman that has concerns
about menopause or symptoms, please go on CEEGP and start
a conversation about it, because I have no doubt your
(18:38):
life can be made better. But it does get more
complicated if you've had a history of significant dmetrilitians and
a woman's had, for instance, a hysterectomy as part of
her surgical journey, then for menopause hormone therapy, if a
woman's had a hysterectomy, she typically just is given estrogen supplementation.
(19:00):
But if you're giving just the estrogen supplementation and you've
had endometriosis and you're now menopausal, there's an understanding that
that endometri that estrogen could retrigger endometrious edmetriosis regrowth. So
now for those women that don't have a uterus, we're
putting those women more back on combination therapy to try
(19:24):
and ameliorate that.
Speaker 1 (19:25):
Yeah, gosh, it's it really, it's not a one size
fits all. It each case is so specialized, isn't it.
Speaker 3 (19:33):
Yeah, And the more we learn, the more the more
we realize we don't know.
Speaker 1 (19:35):
Yeah, if those women listening and they need help, they
need more information, what would you recommend?
Speaker 2 (19:43):
Just their local GP. Hopefully they've got a good one.
Speaker 3 (19:46):
Honestly, I would go even to a bit of looking
around to see if you can find a GP that
has an interest in those issues. So it it's endometriosis,
parentneal disease, that or menopause, look for it online and
find your GP that aligns with those conditions, and then
(20:08):
make an assessments to whether you're feeling heard and whether
you're feeling understood, and if you have concerns, I would say,
ask for a referral to a gynecologist if you're in
a position to be able to do that financially of course,
or ask for a referral to a gynecology clinic, and
just make sure that you're heard that you advocate for yourself.
(20:33):
I also hate too many stories of women that are told, look,
I'm not doing a referral for you because you don't
need it. Well, if a person wants a referral, they're
a title to it.
Speaker 1 (20:42):
I think you hit the nail right on the head
when you said the word advocate and advocate for yourself.
You shouldn't have to, but the fact is sometimes you do,
and if you're coming out not feeling satisfied, get a
second opinion.
Speaker 3 (20:58):
Absolutely, yeah, I mean, what did you say, perhaps the
delay between that gentleman role in his eye.
Speaker 1 (21:05):
Well, I was in my early twenties, I recgonized, probably
about twenty two. I had Audrey at thirty nine.
Speaker 3 (21:12):
Yeah, and that I mean that potentially impacted the course
of your life.
Speaker 2 (21:18):
Totally, absolutely did.
Speaker 1 (21:20):
And you know, really it's had a massive impact because
while she is such a blessing and is the child
that a lot of specialists said we would never get.
So I'm always thankful of what I have. More than thankful.
She's just, you know, she's our whole world. We also
(21:42):
never really set out just to have one child.
Speaker 2 (21:45):
We ideally would have liked two or three.
Speaker 1 (21:47):
But of course, you know, again, you're thankful with all
my history that we got her in the end.
Speaker 2 (21:52):
But you know, yeah, if.
Speaker 1 (21:54):
We were I think knowledge is power and hawd have
we known that, we certainly would have started trying a
bit earlier, because you know, you try all those years
not to get pregnant, and then when you want to
get pregnant, are you not exactly.
Speaker 2 (22:07):
Sure how long it's going to take her if it's
going to work.
Speaker 1 (22:10):
So yeah, that's just my experience, and I hope by
sharing what I went through that you know that younger
generation perhaps we'll learn something from it and take inspiration
and it might help their journey along the way.
Speaker 3 (22:24):
It certainly kind of her parts. It's these conversations have
had more commonly than less, people are going to be affected,
affected in the way that you will.
Speaker 1 (22:34):
Yeah, I agree, doctor Brad, you are an absolute superstar.
Speaker 3 (22:39):
Hey, can I say to your perhaps yes, I'm taking
a tangent here. I said to my wife last night,
I'm doing this amazing podcast tomorrow. She said, who's it worth?
And I said I was with the trainer that and
she looked at me and she said not not Patty
from the Christian I Iconno. Yeah, So my wife and
my three kids on the I've just cool it very
(23:01):
commonly listened to your show and my wife was apoplectic
that I was talking to you this morning.
Speaker 1 (23:08):
Oh you honestly, I've got goose bumps after you saying
that what's your wife's name?
Speaker 3 (23:14):
My wife is a bit of a BOC grade Bristain
celebrity called Rebecca Sparrow. He does a lot of work
in parenting.
Speaker 1 (23:20):
She is not C grade and she is a writer
and columbist. She is no look, that is just may
my day.
Speaker 3 (23:30):
Thank you so much, thank you lovely talking to you.
Speaker 1 (23:34):
Doctor Brad Robinson. He's a specialist obstetrician kindecologist. He joined
me from his popular practice in Brisbane. He's a respected
media commentator with regular appearances on radio as well as
print and online media and now on Rage against the Menopause.
I really loved our chat and if you or someone
(23:54):
you know suffers from indo endometriosis Australia has a brilliant
website for support. My guest in episode four is a
household name and someone I've always deeply admired. TV and
radio presenter Bridget Declo. Bridgie is a former colleague and
seriously one of the most divine women I know. She's
(24:17):
added qualified counselor to her list of achievements and she
joins me next on the couch.
Speaker 2 (24:23):
I'm Petrina Jones. Rage Against the Menopause.
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