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Endometriosis Explained: Dr. Elif Polat on Advocacy and Empowerment | MaternalRx · Pharmacy Podcast Network

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Speaker 1: You are listening to the global network of podcasters dedicated
0:09
Speaker 1: to the pharmacy profession. Welcome to the Pharmacy Podcast Network.
0:30
Speaker 1: Welcome to Maternal RX on the Pharmacy Podcast Network, where
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Speaker 1: we empower pharmacists to drive change across the pharmacy journey
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Speaker 1: from preconception to postpartum. With maternal health and crisis, pharmacists
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Speaker 1: have the power to bridge critical gaps and care. Today,
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Speaker 1: we're shining a light on endometriosis, a condition that too
0:48
Speaker 1: often goes undiagnosed, in exploring how pharmacists can make a
0:52
Speaker 1: lasting impact for those affected. Quick disclaimer before we get started.
0:57
Speaker 1: This podcast is for education only. Please consult your health
1:01
Speaker 1: care providers for medical advice. Everything I share on this
1:04
Speaker 1: podcast is strictly from my own experience and education and
1:08
Speaker 1: not a reflection of any company where I work. I'm
1:11
Speaker 1: doctor Danielle Plummer, pharmacist, and your host for today's interview.
1:15
Speaker 1: I am so excited for our guest today, Doctor Elif Pullott,
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Speaker 1: a passionate physician and researcher whose work focuses on improving
1:24
Speaker 1: outcomes and reproductive health by bridging together medicine, advocacy and education.
1:30
Speaker 1: She's a medical doctor who holds several very unique certifications
1:34
Speaker 1: including health Equity, Research and Practice, Local and Global Lessons
1:38
Speaker 1: and Bioethics, the Law Medicine and Ethics of Reproductive Technologies
1:43
Speaker 1: and Genetics. She's also a member of both American College
1:46
Speaker 1: of Cardiology and American College of Obstetricians and Guynecologists. She
1:51
Speaker 1: serves as the Turkey representative for the Worldwide Endomarch, a
1:55
Speaker 1: global movement dedicated for raising awareness and advocating for people
1:59
Speaker 1: affective by endometriosis. Through events, campaigns, and educational programs, She's
2:05
Speaker 1: helping to bring much needed attention and support to this
2:08
Speaker 1: important cause. Her mission is to make a real impact
2:12
Speaker 1: of a physician scientist, advancing medicine while improving the well
2:16
Speaker 1: being of patients around the world. Today, we'll be talking
2:20
Speaker 1: about endometriosis, global awareness and advocacy, infertility and how healthcare professionals,
2:26
Speaker 1: including pharmacists, can get more involved in spreading awareness. So,
2:31
Speaker 1: doctor Paula, thank you so so much for joining us today.
2:34
Speaker 1: I reached out to you because I saw some of
2:36
Speaker 1: the work that you were doing on LinkedIn and though
2:40
Speaker 1: I never learned this, probably most pharmacists haven't. And what
2:44
Speaker 1: can we do and I am just so grateful for
2:46
Speaker 1: you to bring your expertise, which is so unique and
2:50
Speaker 1: different from anyone else that I've interviewed and other clinicians
2:54
Speaker 1: that I've met, and I would like you just to
2:56
Speaker 1: add any details that I might have missed in the
2:58
Speaker 1: introduction and tell us how you got involved in improving
3:01
Speaker 1: outcomes for and demetriosis.
3:03
Speaker 2: Hello, it's so nice media, and thank you. Thank you
3:06
Speaker 2: very much for invitation today. I'm really excited to be
3:09
Speaker 2: here because most of the experts that you actually interviewed
3:13
Speaker 2: with I've been following them for such a long time,
3:16
Speaker 2: so it is so important and it's such an honor
3:19
Speaker 2: for me to be here today, and thank you for
3:23
Speaker 2: your kind introduction as well. I've been working in the
3:27
Speaker 2: woman's health area and woman's health advocacy for four years
3:30
Speaker 2: and actually more than four years now, and I've got
3:33
Speaker 2: involved with Worldwide in the March four years ago. Doctor Kermanjat,
3:37
Speaker 2: the founder of the Worldwide in the March and the
3:40
Speaker 2: father of the modern proscopy, is like one of my idols,
3:45
Speaker 2: and today that I've been working with him, I'm so
3:49
Speaker 2: happy to be working with him for four years and
3:52
Speaker 2: he is like kind of a mentor for me, like
3:54
Speaker 2: I haven't endless you know, respect to him and his work.
3:58
Speaker 2: So it's it's totally an honor for me to represent
4:02
Speaker 2: Turkey in the globelar on our own behalf of worldwide
4:05
Speaker 2: in the march, because you know, women's health affects men's
4:09
Speaker 2: health at the same time. So it's so important to
4:12
Speaker 2: let everyone know about in the matriosis and let them
4:16
Speaker 2: get information, starting from the teenagers to the adult ages,
4:21
Speaker 2: so we can talk about in themetriosis and the symptoms
4:26
Speaker 2: of the end of metriosis. I just want to mention
4:29
Speaker 2: what is endometriosis at first and what are the main
4:33
Speaker 2: symptoms of it. So in the metriosis as a medical
4:37
Speaker 2: condition where the end the matrial tissue grows in other
4:41
Speaker 2: places outside of the bomb, we can say that and
4:45
Speaker 2: such as the reproductive organs like ovaries and pelopian tubes.
4:49
Speaker 2: But in the metriosis is actually a multi systemic disease
4:53
Speaker 2: that can affect anywhere of your body. So with the
4:57
Speaker 2: less we can say less commonly and matrial tissue can
5:01
Speaker 2: go further from your bomb and has been found in
5:05
Speaker 2: the digestive system or like urinary tracts, even lungs, even diaphragm,
5:10
Speaker 2: even breast, eyes, or anywhere else in your body. And
5:14
Speaker 2: at the same time, I want to emphasize that like
5:17
Speaker 2: the wone blinding, the endometrial tissue reacts of course to
5:21
Speaker 2: the hormones in your body, so that can cause blood
5:25
Speaker 2: and that can bleed. But at the same time the
5:29
Speaker 2: blood is if the blood is unable to leave your body,
5:33
Speaker 2: that can cause inflammation, pain or like the scar tissue
5:36
Speaker 2: in your body, and that's going to cause pain and
5:39
Speaker 2: inflammation again, So it's like a cycle.
5:42
Speaker 1: We had no idea that it goes outside and can
5:46
Speaker 1: affect any organ in the body. And this explains why, Yeah,
5:51
Speaker 1: this explains the systemic pain that women with the demetrius have.
5:57
Speaker 1: You brought up a good point. It's not just affecting them,
6:00
Speaker 1: it's affecting the families as well. I looked in some
6:04
Speaker 1: statistics and endometriosis affects an estimated ten percent of women
6:09
Speaker 1: of reproductive age worldwide. You're looking at one hundred and
6:13
Speaker 1: ninety million women in the United States. It is estimated
6:17
Speaker 1: to effect between five to ten percent of women. And
6:21
Speaker 1: I want to quote doctor Marlena Fejo, who I work.
6:24
Speaker 1: Fortunately have been able to work with and is really
6:28
Speaker 1: just fundamental and improving care for women with divise that
6:31
Speaker 1: I suffered from hyperemesis. Graviderum, who just two days ago,
6:35
Speaker 1: posted on her LinkedIn profile a statement she said, we
6:39
Speaker 1: put a man on the moon half a century ago,
6:42
Speaker 1: but it still takes ten years to get an endometriosis diagnosis.
6:47
Speaker 1: Why doctor bullat? What is going on here?
6:52
Speaker 2: We can say that I can actually mention the importance
6:56
Speaker 2: of the symptoms of endometriosis here because there are some
7:00
Speaker 2: very common symptoms that patients have been could be could
7:03
Speaker 2: have been experiencing for such a long time, and sometimes
7:07
Speaker 2: even being gas lighted or like getting manipulated. Because of this,
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Speaker 2: The first and one of the most important symptoms of
7:14
Speaker 2: endometriosis is pain. Pelvic pain, painful periods that could affect
7:20
Speaker 2: could have been affecting your everyday life, pain during or
7:23
Speaker 2: end or after sex, or like pain when you're pink,
7:27
Speaker 2: or like pooing during your period, or like tiredness or fatigue.
7:31
Speaker 2: These are not like specific symptoms to one of the diseases,
7:38
Speaker 2: especially to endometriosis. Most of the disease could have caused
7:43
Speaker 2: pain or like tiredness or fatigue. So I don't actually
7:47
Speaker 2: mean that definitely not meaning that if you have these symptoms,
7:51
Speaker 2: you have endometriosis, but endometriosis could could have been one
7:55
Speaker 2: of the reasons behind these symptoms. So most of the people,
8:01
Speaker 2: most of the patients that's been experiencing that kind of
8:05
Speaker 2: pain or like we can say, by the way, the
8:08
Speaker 2: butt pain, leg pain, shoulder pain. Pain mostly depends on
8:13
Speaker 2: the place where the lematorial tissue has thriven. So if
8:17
Speaker 2: you have shoulder pain, you could have had any materials
8:22
Speaker 2: in your diaphragm and you could have been experiencing even
8:24
Speaker 2: shoulder pain. So there are some cases like in the
8:29
Speaker 2: matrial tissue in the eye and keeps bleeding in every
8:33
Speaker 2: period of these patients. So pain is one of the
8:38
Speaker 2: unspecific conditions and symptoms behind most of the you know
8:43
Speaker 2: illnesses we can say, but and it's not totally specific
8:47
Speaker 2: tend materials. That's why most of the women could have
8:51
Speaker 2: been could have getting manipulated even in their you know,
8:58
Speaker 2: uh cycles or like periods. And I just want to
9:02
Speaker 2: say to all of these women, if you're experiencing that
9:05
Speaker 2: kind of pain like monthly in your period or like
9:08
Speaker 2: you have the other symptoms we can say heavy mestial bleeding, spotting,
9:15
Speaker 2: like feeling sick, even depression, back pain, leg pain, or
9:21
Speaker 2: like bot pain. If you're experiencing these kind of symptoms
9:24
Speaker 2: symptoms and you are being told that this is in
9:28
Speaker 2: your head, uh, this is not obviously in your head.
9:31
Speaker 2: The pain is real. So you should see your doctor
9:36
Speaker 2: and you should get your medical advice from your expert
9:40
Speaker 2: to talk about in the metriosis. I just want to
9:44
Speaker 2: mention again, and the matriosis is not the only diagnosed
9:49
Speaker 2: behind all of these symptoms. Most of the other you know,
9:53
Speaker 2: organic causes can cause these kind of symptoms, but and
9:57
Speaker 2: the matriosis should have been considered one of the possible
10:01
Speaker 2: diagnosis behind all of these symptoms.
10:03
Speaker 1: Again, and that explains why it takes so long to
10:07
Speaker 1: get the correct diagnosis. So we see this with many
10:10
Speaker 1: of women's health issues, non specific symptoms, overlapping symptoms, and
10:17
Speaker 1: it's a disease. It sounds like to me, a disease
10:19
Speaker 1: of rule out. Is that a correct way to say it? Yeah,
10:25
Speaker 1: So you'd have to go, well, it could be this
10:27
Speaker 1: or it could be that, and go down an algorithm
10:29
Speaker 1: until nothing else has created a solution. You're still experiencing pain,
10:36
Speaker 1: what you do now what type of diagnostic or prognostic
10:40
Speaker 1: tests might be available when a woman goes to the doctor.
10:44
Speaker 2: So in most of the times, like women are having
10:50
Speaker 2: like MRIs City skins ultrasounds to understand what causes this pain,
10:58
Speaker 2: especially if they're experiencing like a al or abdominal pain,
11:02
Speaker 2: because you know, one of the first things that's coming
11:05
Speaker 2: to mind to there's something wrong with your you know,
11:08
Speaker 2: reproductive system if you're experiencing pelvic pain or like abdominal pain.
11:13
Speaker 2: So there go, they're going to their doctors and they
11:17
Speaker 2: are getting m RIZ City scans and ultrasounds. But we
11:19
Speaker 2: have so many patients that still m RIS City scans
11:23
Speaker 2: and ultrasounds are clean, but still having the matriosis. So
11:27
Speaker 2: at this point, the historioscopy could be useful and histroscopy
11:33
Speaker 2: is being performed to these patients to diagnose if there's
11:36
Speaker 2: an amatriosis, because you know, this is one of the easiest,
11:40
Speaker 2: not easiest way in a medical, uh term, but easiest
11:45
Speaker 2: way to see what's going on inside the organs. So
11:50
Speaker 2: historoscopy is kind of a laproscopic system that you can
11:54
Speaker 2: just see inside the pelvis and you can see the
11:59
Speaker 2: organs in their productive system and basically in the uterust
12:04
Speaker 2: and if there's an emtrial tissue outside of the uterus,
12:07
Speaker 2: you can just see it and diagnose and matriosis then
12:11
Speaker 2: take it out.
12:13
Speaker 1: And what type of specialists would would a woman want
12:15
Speaker 1: to see to get this procedure done?
12:18
Speaker 2: O'b I specialists and they're endometrios specialists like doctor Nejat
12:25
Speaker 2: are taking care of that kind of uh sortical procedures.
12:30
Speaker 1: You probably see women traveling far from far away to
12:33
Speaker 1: get the procedure done, I would guess from around the world,
12:37
Speaker 1: and they're coming because they're not getting that diagnosis correctly
12:42
Speaker 1: where they are, or maybe they're being told you need
12:44
Speaker 1: this procedure, but nobody near them offers that. You know,
12:48
Speaker 1: in the United States, we have these what we call
12:50
Speaker 1: maternal deserts. We don't have obg y ns in so
12:53
Speaker 1: many counties, and it's really not good for the women
12:57
Speaker 1: right who live around and need to travel far. But
13:00
Speaker 1: I'm just grateful for people like you and the team
13:03
Speaker 1: that you work with to offer this procedure to get
13:05
Speaker 1: women this diagnosis after so much time has passed and
13:10
Speaker 1: being like you said, gaslighted right of course you're you know,
13:14
Speaker 1: of course you're you're tired. I bet they have anemia too.
13:17
Speaker 1: They have, like we said, these overlapping symptoms. You know
13:21
Speaker 1: that how do you how do you make that correct diagnosis?
13:24
Speaker 1: You have to go to where the experts are and
13:26
Speaker 1: get the right treatment to find out or right diagnostic
13:30
Speaker 1: tool and testine to find out.
13:32
Speaker 2: Not just about to Actually I'll be giants like uh
13:35
Speaker 2: in the all of the medical fields and medical experts
13:38
Speaker 2: should be considered in the matriosis as one of the diagnosis,
13:42
Speaker 2: like possible diagnosis because sometimes in like most countries in
13:48
Speaker 2: the world, uh, physicians are so uh getting specialized with
13:56
Speaker 2: their area and sometimes it just be you know, being
13:59
Speaker 2: forgotten about the end of matrios is. It could be
14:01
Speaker 2: one of the health conditions that should be considered as
14:06
Speaker 2: as you know, the cause one of of this symptoms.
14:10
Speaker 2: So it should be considered by all of the medical
14:15
Speaker 2: experts in the field.
14:18
Speaker 1: And I say that always through every interview, through all
14:21
Speaker 1: my different work experiences, multidisciplinary care leads to the best.
14:25
Speaker 2: Outcomes, definitely.
14:28
Speaker 1: So in this case, we want to make sure our
14:30
Speaker 1: pain management doctors understand our psychologists or other mental health
14:35
Speaker 1: providers are aware of it fertility experts, right, So how
14:40
Speaker 1: it endometrio says, affect somebody who's trying to become pregnant
14:44
Speaker 1: and would like to grow family.
14:46
Speaker 2: Yeah, this is an important point because most of the
14:49
Speaker 2: times there is like an unexplained infertility and or like
14:56
Speaker 2: we can say in the matrials, is associated infertility at
14:59
Speaker 2: some point because endometriosis, you know, we said is can
15:06
Speaker 2: be difficult to diagnose as many of these symptoms are
15:09
Speaker 2: similar to other conditions and it doesn't always show up
15:12
Speaker 2: on you know, the scams, and for so many women
15:16
Speaker 2: it is it takes years to find it and figure
15:19
Speaker 2: out they have endometriosis. And from the perspective of infertility,
15:27
Speaker 2: we can say that in the metriosis does not necessarily
15:30
Speaker 2: cause infertility. Like you, there is a possibility that you
15:35
Speaker 2: have you have had like totally healthy pregnancies, totally healthy babies,
15:40
Speaker 2: and you you know, you didn't experience any kind of
15:45
Speaker 2: pregnancy complications and you delivered like totally healthy babies. But
15:50
Speaker 2: you could have still have had endometriosis without any symptoms.
15:54
Speaker 2: So we don't say that and the matriosis causes infertility
15:58
Speaker 2: one hundred percent, this is not true. But there is
16:02
Speaker 2: an association with fertility problems with you know, the end
16:05
Speaker 2: of matriosis. Even with severe indometriosis, natural conception is still possible.
16:13
Speaker 2: But we can say that for women who do not
16:16
Speaker 2: have endometriosis, the monthly pregnancy rate is like between fifteen
16:21
Speaker 2: or like twenty percent, but for women who have in
16:25
Speaker 2: the matriosis, the chance of getting pregnant in a single
16:28
Speaker 2: month of trying is between two and ten percent. So
16:34
Speaker 2: we can say that if there's an unexplained infertility and
16:38
Speaker 2: the matriosis could be one of the causes behind it,
16:43
Speaker 2: but we definitely need to mention that you still have
16:47
Speaker 2: and can still have endometriosis and you can still experience
16:50
Speaker 2: one hundred percent healthy pregnancy. So that's why for me,
16:57
Speaker 2: this is one of the hardest parts of this medical
17:02
Speaker 2: condition because we don't definitely know what causes endometriosis and
17:07
Speaker 2: there is no exact cure for it. So in terms
17:12
Speaker 2: of the pregnancy and infertility, there are some you know,
17:15
Speaker 2: uh procedures could be getting could be performed for it,
17:21
Speaker 2: like IVF or like i UI. We can say for
17:27
Speaker 2: the infertility site, but we can definitely stay that since
17:33
Speaker 2: we don't have the exact part of physiology behind endometriosis,
17:36
Speaker 2: and we don't have exact cure for it, it gets
17:41
Speaker 2: makes harder to control all of these heights and tread
17:45
Speaker 2: all of these types of the matrios.
17:47
Speaker 1: This is where advocacy really plays the most important role. Right,
17:53
Speaker 1: you said something very powerful. We don't know the exact
17:56
Speaker 1: cause we don't have an exact treatment. What do we
18:00
Speaker 1: do right? And there are methods? This is where we
18:03
Speaker 1: want to get pharmacists involved. If you have patients coming
18:06
Speaker 1: into your retail pharmacy or they're in the hospital for
18:10
Speaker 1: other procedures, and you're talking to them and they're saying,
18:13
Speaker 1: I've been wanting to grow family, I'm having a hard
18:15
Speaker 1: time getting pregnant. Nobody seems to know why tests are
18:19
Speaker 1: coming out normal, or I'm in a lot of pain
18:22
Speaker 1: again imagings coming out normal. What do I do right?
18:25
Speaker 1: Bring this to light, Talk to your doctors and say,
18:28
Speaker 1: is it possible I have endometriosis? Can we start the
18:32
Speaker 1: testing to see if this is something? And then if
18:36
Speaker 1: I do want to have children? What are my odds?
18:39
Speaker 1: Let's improve those odds. Like you said, let's give hope
18:42
Speaker 1: to everyone out there trying because it's not impossible. It
18:45
Speaker 1: is possible for you then to become pregnant. It might
18:48
Speaker 1: just be a longer journey. So last year I interviewed
18:51
Speaker 1: doctor Katie Wood, who specializes in people that are having
18:55
Speaker 1: difficult getting pregnant, to shorten that journey. Traditional guidelines say
19:01
Speaker 1: wait a year before you start other testing because even
19:05
Speaker 1: for healthy women and their spouses or significant others, it
19:10
Speaker 1: can still take a long time to become pregnant. It
19:12
Speaker 1: can still take many months. So how do you know
19:14
Speaker 1: if it's just natural occurrences or there's something underlying that
19:18
Speaker 1: needs to be addressed. And I am so grateful for
19:21
Speaker 1: you bringing this to light that give everyone hope it
19:24
Speaker 1: is possible. But as ask the questions, because not always
19:28
Speaker 1: are the clinicians bringing this to the conversation.
19:33
Speaker 2: So, yeah, it still could take time to get pregnant,
19:37
Speaker 2: like after years of trying. But if you're a patient
19:42
Speaker 2: that's been experiencing that kind of symptoms for years, especially
19:46
Speaker 2: starting from the young age, and you have having a
19:52
Speaker 2: hard time to get pregnant at the same time, that
19:56
Speaker 2: at this point you could see your doctor and tell
19:59
Speaker 2: everything about it, your medical history, like you've been experiencing
20:02
Speaker 2: that kind of pain and you didn't tell before about
20:05
Speaker 2: your doctor about this and now you're having hard times
20:09
Speaker 2: to get pregnant. That should be like kind of you know,
20:16
Speaker 2: symptom for your doctor as well to think about indometriosis.
20:19
Speaker 2: So your doctor can you know, suggest you to have
20:25
Speaker 2: a historoscopy if you're like the other scans are clear
20:28
Speaker 2: and your tests are normal, but you're still having that
20:32
Speaker 2: kind of heart experiences now, that could be a time
20:37
Speaker 2: to do a hextroscopy and see what's going inside. But
20:41
Speaker 2: we could say that extroscopy is not always being considered.
20:45
Speaker 2: So if you need to see your doctor, because you know,
20:49
Speaker 2: everything should be you know, patient oriented and patients specialized.
20:55
Speaker 2: So I don't want to say that extroscopy is the
20:58
Speaker 2: only way to do it. So everything should be considered
21:06
Speaker 2: to your medical history, your family history. At this point,
21:10
Speaker 2: I want to actually mention that, yes, we don't know
21:14
Speaker 2: about the endometriosis background and like pataphysiology now, but there
21:19
Speaker 2: are so many research that's been mentioning the other factors
21:26
Speaker 2: like you know, behavioral traits, dietary preferences or like smoking,
21:31
Speaker 2: alcohol intake or like caffeine intake, genetics, family history, you know,
21:37
Speaker 2: so there are so many the other kinds of approach
21:40
Speaker 2: to tell talk about indometriosis for those of.
21:45
Speaker 1: Us not familiar with histeroroscopies. So I'm looking this up.
21:49
Speaker 1: Inspection of the uterine cavity by endoscopy with access through
21:53
Speaker 1: the service? Is this something? Is it painful? Is it
21:57
Speaker 1: not painful? Do they get payments for it? My goal
22:00
Speaker 1: is just to keep women calm so they know what
22:03
Speaker 1: to expect for something. It seems somewhat invasive, but maybe
22:09
Speaker 1: it's considered a non invasive.
22:11
Speaker 2: Yeah, it's an invasive approach. And histoscopy is basically a
22:15
Speaker 2: kind of a laproscopy approach to the uterus. And like
22:19
Speaker 2: the other public organs, you are taking like anastasia to
22:25
Speaker 2: get it, get it because it's then you know the
22:27
Speaker 2: surgical procedure. So yeah, you should be talking about this
22:33
Speaker 2: with your doctor because it should be you know, all
22:36
Speaker 2: the medical approaches should be patients specific. So if you
22:41
Speaker 2: are being seen that you are you're in the need
22:46
Speaker 2: of hysteroscopy, then you should go for it. I don't
22:49
Speaker 2: recome on like to you like go to your doctor
22:52
Speaker 2: and get extroscopy. Not this is not true. This is
22:54
Speaker 2: definitely not true.
22:56
Speaker 1: After we've rolled out these other potential diseases that could
23:00
Speaker 1: be causing these symptoms, and this would be your next
23:02
Speaker 1: step in the process, potentially perfect. And what can pharmacists
23:09
Speaker 1: do when they see these patients saying I have this pain.
23:13
Speaker 1: Maybe you know we mentioned how psychiatrists or psychologists or
23:17
Speaker 1: mental health providers might be involved because these patients are
23:20
Speaker 1: potentially depressed. You mentioned pain management, right, so they might
23:24
Speaker 1: be coming to the pharmacy for pain medications, for antidepressive medications,
23:31
Speaker 1: for hormone replacements. And I know our conversations today is
23:34
Speaker 1: not about medication management, but about advocacy, and this is where,
23:39
Speaker 1: like I mentioned, pharmacists then can say, hey, have you
23:42
Speaker 1: discussed the potential of having endometriosis with your provider? Do
23:47
Speaker 1: you have other suggestions on what pharmacists can do.
23:50
Speaker 2: So I just want to say one more thing about
23:53
Speaker 2: the before like talking about pharmacist, because it's the important
23:56
Speaker 2: point of all of the conversation. But I just want
23:59
Speaker 2: to say say that, like in terms of the infertility
24:02
Speaker 2: and getting pregnant, I can say that some studies suggest
24:09
Speaker 2: that woman with endomatriosis have a higher risk of an
24:12
Speaker 2: ectopic pregnancy because if the the matrial tissue placed in
24:17
Speaker 2: your uh fallopian tubes for example, there is actually like
24:24
Speaker 2: higher rate for you to experience an ectopic pregnancy, which
24:29
Speaker 2: is a health like health riading condition. So I just
24:34
Speaker 2: want to I just wanted to mention that because it's
24:36
Speaker 2: it's a very important point of the end of metriosis.
24:42
Speaker 2: And there is another misconception about in thematriosis. UH. Most
24:47
Speaker 2: of the people think that pregnancy can cure endometriosis, but
24:51
Speaker 2: pregnancy actually doesn't cure indometriosis. But for many women the
24:56
Speaker 2: pain improves during pregnancy because their periods. Stuff. Endometriosis is
25:03
Speaker 2: actually is a hormone dependent condition and mainly driven by astrogen.
25:09
Speaker 2: So and demetriosis is actually influenced by progesterone resistance and inflammation.
25:15
Speaker 2: So we don't say that endometriosis only depends on the hormones.
25:21
Speaker 2: But endometriosis is an inflamment inflammatory disease and a hormone
25:27
Speaker 2: dependent disease at the same time. So in terms of
25:30
Speaker 2: the hormones there are we can say that hormones involved
25:36
Speaker 2: in endometriosis. There is a couple of hormons. Like we
25:40
Speaker 2: can talk about estrogen, we can talk about progesterone. We
25:43
Speaker 2: can also talk about prostaglandis and inflammatory mediators and at
25:49
Speaker 2: the point, at this point, there are some effects of
25:52
Speaker 2: these hormones of course to your body. So at this
25:56
Speaker 2: point pharmacists gets really like gets really important place to
26:04
Speaker 2: treatment of in the matriosis, and not just because of
26:09
Speaker 2: the medical treatment options, but the you know, the emotional
26:15
Speaker 2: support because in the materials this affects patients lives and
26:20
Speaker 2: like well being so much, not just by the way
26:25
Speaker 2: their psychiatric condition, but all their families or they'll be
26:30
Speaker 2: beloved ones, and this is so important to make them
26:34
Speaker 2: feel that they're being taken care of. So I want
26:39
Speaker 2: to thank you at this point for doing this. It's
26:43
Speaker 2: really matters for so many women and so many actually
26:46
Speaker 2: people in this world that you are actually voluntarily doing this.
26:51
Speaker 2: This is so important.
26:53
Speaker 1: As my pleasure. I know you're as passionate about improving
26:56
Speaker 1: women's out as I am and so many other people
26:59
Speaker 1: I get to work with, and I'm just grateful to
27:01
Speaker 1: have these connections and colleagues to share their expertise. Tell me,
27:05
Speaker 1: I know you do something very exciting, which was probably
27:08
Speaker 1: the first reason I reached out to you. What is
27:10
Speaker 1: end of March. How can we get involved in when?
27:13
Speaker 1: Where tell us all about it?
27:15
Speaker 2: So in the Worldwide in the March is a global
27:18
Speaker 2: and themateriosis foundation and based in Palo Alto, California. And
27:25
Speaker 2: the founder of the Worldwide in the March is doctor
27:27
Speaker 2: carmin Nejat who has the actually the mother who has
27:32
Speaker 2: the father of the modern laproscopy at the same time
27:35
Speaker 2: and one of the for me, the best inmates expert
27:41
Speaker 2: in the world. So he has found this foundation to
27:47
Speaker 2: help women all around the world and support them and
27:51
Speaker 2: make them support each other by the in the Matus
27:56
Speaker 2: advocacy and let them you know, for me endometriosis, especially
28:02
Speaker 2: representing Turkey in the Global Ara on behalf of world
28:05
Speaker 2: my Worldwide on the March. It's so important for me
28:07
Speaker 2: because in this time that I've been involved in four
28:11
Speaker 2: years actually four and a half years, I had a
28:15
Speaker 2: chance to starting from the medical school, I had a
28:18
Speaker 2: chance to hear so many stories, so many women's stories,
28:23
Speaker 2: so many you know, teenagers stories and that had you know,
28:28
Speaker 2: that had no chance to stand up for themselves and
28:31
Speaker 2: talk about their stories. So I have as I have
28:33
Speaker 2: a voice to speak up for the other women. Even
28:36
Speaker 2: I don't have endometriosis. I have never experienced that kind
28:39
Speaker 2: of pain in my life, but this is so important
28:42
Speaker 2: for me to be their voice and like tell to
28:47
Speaker 2: you know, all the world about these women's stories. This
28:50
Speaker 2: is so important because as I said before, women's health
28:54
Speaker 2: affects men's health in every aspect. So not just women,
29:00
Speaker 2: but for men, they should know about in the metriosis
29:04
Speaker 2: and they should be supportive. They should be helpful for
29:07
Speaker 2: their partners because you know today you don't have even
29:12
Speaker 2: to have a uterus to have in the metriosis. You yeah,
29:17
Speaker 2: you may have experienced underwent hysterectomy and after you uh
29:24
Speaker 2: figured out you have in the matriosis. So this is
29:28
Speaker 2: so important to know about this disease and support their
29:34
Speaker 2: partner that this pain is real and I'm with you,
29:38
Speaker 2: like saying that I'm with you and I support you.
29:40
Speaker 2: It's so important starting from the teenage to coming to
29:45
Speaker 2: the you know, adult life. So for standing up for
29:50
Speaker 2: the ind metriosis and talking about in the matriosis is
29:53
Speaker 2: not just women's health. It's not just about women's health.
29:56
Speaker 2: It's about actually like the adolescent health, like the young girls,
30:02
Speaker 2: young boys, because letting them know about this theseias in
30:05
Speaker 2: the schools, in the you know, daily life is important
30:09
Speaker 2: because there are so many countries in the world today
30:15
Speaker 2: women's rights are not being considered as humans rights. So
30:20
Speaker 2: this is so important to let them know they are
30:24
Speaker 2: being you know, taken care of by the physicians and
30:27
Speaker 2: like by women and men actually and they are, yeah,
30:33
Speaker 2: they are, just they need to know this, you know.
30:37
Speaker 2: So this is this is so important, Like if I
30:40
Speaker 2: I had the train I had trained for humanity is
30:46
Speaker 2: health and I'm so so voluntarily doing this, like this
30:50
Speaker 2: is so important for me to help people because I
30:53
Speaker 2: know that even these seconds that we're talking now, it's
30:57
Speaker 2: somewhere in the world people are just dealing with pain
31:00
Speaker 2: or like dealing with these some kind of health conditions,
31:03
Speaker 2: and I want to help them. So you don't have
31:05
Speaker 2: to know everything about endometrials is to get start to
31:10
Speaker 2: advocate for women's health or like in the matrios help
31:14
Speaker 2: but you need to be like you need to volunteer
31:18
Speaker 2: to learn and tell the other people how important this
31:21
Speaker 2: disease is. So I'm really so thankful to you to
31:27
Speaker 2: get in touch with me and asking me for talking
31:30
Speaker 2: about in thematerisics because it is so important for me
31:33
Speaker 2: to let them know that someone is still taking care
31:37
Speaker 2: of them.
31:40
Speaker 1: We have listeners, not visual watchers, so no one else
31:44
Speaker 1: can see you. But you just light up, you glow
31:47
Speaker 1: just talking about this and to not having had gone
31:51
Speaker 1: through this, which I'm grateful, right and to be this
31:55
Speaker 1: advocate in this expert in this space. I know you're
31:58
Speaker 1: doing work that we're not even tapping into today that's
32:02
Speaker 1: really going to have profound outcomes for these patients. Thank
32:05
Speaker 1: you as well. I just get childs kind of thinking
32:09
Speaker 1: about it, because there's so many women's health diseases that,
32:12
Speaker 1: as you mentioned earlier in the interview, they get gaslighted. Right,
32:16
Speaker 1: of course you're in pain, of course you're tired. Well
32:19
Speaker 1: not of course you're in pain, but is that pain
32:20
Speaker 1: in your head?
32:21
Speaker 2: Right?
32:21
Speaker 1: And this has gone on for decades, for centuries for
32:24
Speaker 1: that matter, right from the beginning of time. And I
32:27
Speaker 1: love how you're getting the men involved as well the
32:31
Speaker 1: other family members for these patients to understand this is
32:34
Speaker 1: a real disease. We see on scans. We don't have
32:39
Speaker 1: the exact diagnostic tools, there's no specific treatment. We want
32:44
Speaker 1: to lessen the burden of this to have the best
32:46
Speaker 1: patient outcomes and that's where this advocacy comes into play.
32:50
Speaker 1: So I know the next end of March is literally
32:54
Speaker 1: in March. Is that correct?
32:57
Speaker 2: March is a intemadioss wet. So there are so many
33:01
Speaker 2: you know, stuff actually going on all around the world,
33:04
Speaker 2: and we have annual meetings for as a worldwide in
33:08
Speaker 2: the March. We organize annual meetings in every March to
33:11
Speaker 2: talk about animatriosis with world re owned experts and global
33:17
Speaker 2: volunteers from all around the world, from all the countries.
33:21
Speaker 2: So it's a huge event actually that's being held in
33:24
Speaker 2: every March.
33:25
Speaker 1: And where would patients go? Is there a website? How
33:28
Speaker 1: would they find more patients and clinicians to find out
33:31
Speaker 1: about this upcoming event?
33:33
Speaker 2: Oh, you can just goggle Worldwide in the March, and
33:35
Speaker 2: it's just going to let you know about all the
33:38
Speaker 2: worldwide in the March events that will be done next month.
33:44
Speaker 2: So you can just Goggle Worldwide in the March and
33:46
Speaker 2: you can go to the website.
33:49
Speaker 1: Perfect and I hope everybody does this. I learned so
33:52
Speaker 1: much from you beginning with endometriosis can affect any organ
33:56
Speaker 1: in the body. The eyes if I ever see any
34:00
Speaker 1: with like bloodshot looking eyes and they're saying they're in
34:02
Speaker 1: vain and their entire and yeah, I was.
34:06
Speaker 2: A medical student when I just first read about that case.
34:10
Speaker 2: It was totally shocking, like knowing that patients and the
34:15
Speaker 2: materials is in their eyes. Yeah, in every cycle, her
34:19
Speaker 2: eyes were bleeding at the same time with her uterus,
34:23
Speaker 2: So it's.
34:25
Speaker 1: Just incredible to be aware they're non specific, overlapping symptoms.
34:30
Speaker 1: This is the disease of rule out, which is why
34:32
Speaker 1: it takes up to decade or more to get the
34:36
Speaker 1: correct diagnosis. And hopefully moving forward that we will have
34:39
Speaker 1: better tools in place, better treatments, and for those who
34:43
Speaker 1: want to grow family, they want to become pregnant, stay positive,
34:47
Speaker 1: let's get that inflammation down. It seems like a lot
34:51
Speaker 1: of the causes of this are just all over the board,
34:55
Speaker 1: and some may be controllable, but many are not. Like
34:57
Speaker 1: you mentioned, genetics seems to be the root cause of
35:01
Speaker 1: so many diseases. And we're looking what can we do
35:05
Speaker 1: with our diet with exercise to decrease inflammation, but it's
35:08
Speaker 1: pretty much unknown whether that approach will decrease endomet truth's
35:15
Speaker 1: rate and improve outcome. So I'm looking over to my
35:18
Speaker 1: functional and integrative pharmacists and medical colleagues to start exploring
35:23
Speaker 1: that as well. And for all the colleagues I have
35:26
Speaker 1: out there and everyone listening, please go ahead google endometriusis
35:31
Speaker 1: end of March, and do what you can to create
35:34
Speaker 1: awareness and improve outcomes for these patients. Doctor Pullett, thank
35:38
Speaker 1: you so much.
35:39
Speaker 2: Anything any last.
35:40
Speaker 1: Words of wisdom or advice you'd like to add.
35:43
Speaker 2: I just want to thank you so much for getting
35:46
Speaker 2: me involved in your podcast series. This was my first
35:50
Speaker 2: time talking in a podcast as a guest speaker, so
35:53
Speaker 2: I'm so excited to be here and I'm still so
35:57
Speaker 2: thank you. Thank you so much for getting me involved
35:59
Speaker 2: in your podcast. This one was really so exciting for me,
36:03
Speaker 2: and thank you for just your volunteerily talk like you know,
36:10
Speaker 2: wanting to talk about in the materials is so important,
36:12
Speaker 2: and thank you very much for this.
36:15
Speaker 1: Absolutly my pleasure as well. The first interview for your
36:19
Speaker 1: podcast the first of many to come. Your face, your
36:23
Speaker 1: voice just just shines, It just glows and gives hope
36:26
Speaker 1: to so many women and their families to help understand this,
36:30
Speaker 1: and and thank you as well. I look forward to
36:33
Speaker 1: many more interviews and better outcomes in the future.
36:37
Speaker 2: Very mine. I appreciate your support. This is so important.
36:40
Speaker 1: Thank you so much for listening to my interview with
36:42
Speaker 1: doctor Alif Paula about endometriosis, but the pharmacist still listening.
36:48
Speaker 1: I thought it would be important to share some final thoughts.
36:51
Speaker 1: For one, what is it understand this disease? Clearly, it's
36:55
Speaker 1: a chronic estrogen dependent inflammatory condition in which and do
36:59
Speaker 1: me treo like tissue grows outside of the uterus. This
37:03
Speaker 1: causes pelvic pain, dysmineria, dysprunia, and infertility, but symptoms may
37:08
Speaker 1: also be non specific, presenting us bowel or bladder pain,
37:13
Speaker 1: and chronic fatigue. Because of this, diagnosis is often delayed
37:17
Speaker 1: seven to ten years, and pharmacists are in the perfect
37:21
Speaker 1: place to help shorten that gap by recognizing red flags.
37:25
Speaker 1: If you do speak to patients with endometriosis, council effectively
37:30
Speaker 1: emphasize treatment adherence and realistic expectations. Pain improvement may take
37:35
Speaker 1: two to three cycles. For example, discuss side effect management
37:40
Speaker 1: like bone health, mood, libido, and bleeding changes. Encourage consistent
37:45
Speaker 1: pain tracking to assess response, and educate on non pharmacological
37:50
Speaker 1: support like diet, exercise, stress reduction, and physical therapy. For
37:56
Speaker 1: the pelvis. Support multidisciplinary care as mentioned in the interview.
38:02
Speaker 1: Collaborate with your gynecologists, your pain specialists, your psychologists, and
38:06
Speaker 1: your fertility experts. Pharmacists can coordinate careen and sure medication
38:10
Speaker 1: reconciliation when switching between hormonal agents and or surgery. Advocate
38:17
Speaker 1: and destigmatize. This is the most important thing we can do.
38:22
Speaker 1: Through my life, I have met so many women with
38:25
Speaker 1: pelvic pain or severe pain during their menstrual cycles and
38:29
Speaker 1: they have just been dismissed, not believed, spoken behind their back.
38:34
Speaker 1: And this is unacceptable and needs to stop. So please
38:38
Speaker 1: do your role. Many patients experience dismissal symptoms and pharmacists
38:43
Speaker 1: are in the perfect place to validate their experiences and
38:46
Speaker 1: encourage follow up. Raise awareness that severe peerid pain is
38:50
Speaker 1: not normal. And thank you so so much for everyone
38:53
Speaker 1: listening for what you do to improve women's health and
38:57
Speaker 1: the pregnancy journey.
39:02
Speaker 2: To hockey, to to