Welcome to the After Show! In this episode, we continue our conversation with our expert, Dr. Christine Metz, over endometriosis and how to start connecting the dots for getting your own diagnosis.
Welcome to the After Show!
Dr. Metz joins us for an amazing conversation that helps shine a light on endometriosis and periods. Learn how to start connecting the dots on your condition to kickstart your journey of getting the proper diagnosis you deserve. Lastly, help end the stigma surrounding periods to secure a better future for all uterinekind.
Send your Hear Me! Hear Me! questions to hello@hellouterus.com to be featured in an upcoming segment.
Join us back here every Tuesday for all things uterus, in service to you, uterinekind.
Carol:
Welcome to Hello Uterus, The After Show, where we continue our conversation with our experts. And this week, we continue a conversation about endometriosis and the study of menstrual blood with Dr. Christine Metz. In the podcast, we spoke with Dr. Metz about her research, menstrual blood, and what she's learned, which is incredibly fascinating and what her goals are, which is to be able to diagnose get a definitive diagnosis of endometriosis without having to undergo laparoscopic surgery, as well as to understand. I'm not sure if it's mechanism, but I'm going to say it anyway understand the mechanism of endometriosis and be able to treat it without having to resort to a hysterectomy. One in ten people are dealing with endometriosis, and I know that you know more than ten people with a Uterus. So there are individuals out there who need help. They need someone to help them connect the dots on this debilitating, monstrous condition. And that's why we're here. We're going to get you the information from experts like Dr. Metz, and then you're going to take it out into the world to the people that you know, and you are going to help change the way uterine healthcare is experienced by everyone. So thank you for that. And now we're going to dive right back into our conversation with Dr. Christine Metz.
Dr. Metz, there's a theme in women's stories who live with endometriosis, and that theme is that the medical community has failed them. Based on your research, has the medical community failed them? And if so, in what ways?
Dr.Metz: I think it's a combination of the medical and the research field has failed them. Since we have a very limited understanding of endometriosis, developments in new treatments for endometriosis are seriously lacking. I think in the last 15 years, there has been one drug introduced to market to treat endometriosis. And as I said earlier, most of these treatments are hormone based, but we don't believe the entire disease is only due to aberrant hormones. It's not clear whether that's an effect or a cause of the disease. And I think that we're lacking in better ways of treating this disease. Since these treatments don't halt the disease in any way, they simply stop paying. The one new drug that's new to the market is called or Lisa. It's the pill form of Lupron, which was originally as an injected medication that puts these young women into menopause and completely shuts down their hormones, basically their typical Uterine and ovarian functions. While some people have some relief and pain with this kind of traumatic treatment, there has been some serious problems with these drugs. And there is a class action lawsuit regarding Lupron as a medication for endometriosis. And I think the major problem is that women complain that they have cognitive deficits from taking Lupron. I think that could be very significant considering the treatment didn't alter the course of the disease. Right. And then created additional issues.
Carol: So cognitive deficits, what would an example of what that could be.
Dr.Metz: For a young person when you can't remember what you ate for breakfast?
Carol: Oh, my gosh.
Dr.Metz: When you have difficulty remembering how to get from one location A to another location B,
Carol: and this could be a 15-year-old girl. These could be young people.
Dr.Metz: Yes, very young people. I mean, not that it matters, but yeah, they also have very serious problems with their bones because estrogen is so important to keep our bones healthy that many of them end up with very severe osteoporosis and brittle bones.
Carol: Wow. So what kind of a connection then could I make to somebody having a hysterectomy in their 30s because of endometriosis? What kind of support are they going to need ongoing because of the effects of having the uterus removed at that age?
Dr.Metz: If you're uteruses and we've heard much younger cases, very sadly to hear around this country. I don't think that medical care is equal in all places across this country, unfortunately, and have heard about hysterectomies and young 20-year-olds. Very discouraging to hear those things. But those females will definitely need serious hormonal support to replace what's missing. If the hysterectomy is performed without removing the ovaries, the lesions that they have will continue to grow unless they undergo some kind of an excision surgery. A hysterectomy doesn't remove the lesions that have been misplaced and are growing in the abdominal cavity and elsewhere in the body. So they have to really understand what status their lesions are at before they start undergoing any of the hormone workups and replacement. Therapies you had talked about having to undergo laparoscopic surgery as a method of diagnosing endometriosis. So that then says that like an abdominal ultrasound isn't picking up these lesions. So an abdominal ultrasound or an MRI could pick up the lesions, but they have to be quite large and it doesn't tell you the content of the lesions. So they may be cysts of some kind that aren't endometriosis necessarily. So it's kind of tricky to diagnose endometriosis without the lesion. And unfortunately, earlier this year, the four societies that kind of define endometriosis, including these minimally invasive surgery organizations that are professional societies that actually define diseases for us, they have defined endometriosis based on the lesion itself. So it requires a pathological review of that lesion. Just like a cancer, you could find a tumor using MRI or ultrasound, but it doesn't define whether it's a tumor or a benign growth. It actually has to be removed and analyzed by a pathologist to say that this lesion looks like the endometrium and it shouldn't be growing in this location, and that's how it is defined as a disease. So that's why I say definitive diagnosis requires laparoscopic surgery to remove those lesions and have them actually seen by a pathologist and defined as an endometriosis lesion and not as some other kind of growth.
Carol: And what would you characterize the pathway to getting that procedure to take place for most women, as you mentioned, it's different based on where you live in this country. But I would imagine you walk in and you're like, I have a lot of pain around my period. And they're like, okay, well, here's some birth control pills. It's totally normal. Buy stock and motor and you're good to go. And that seems like what I hear most often is the first problem visit around something like this. How sort of aggressive do you have to be as a person dealing with symptomatic issues that might be endometriosis in order to get that definitive diagnosis?
Dr.Metz: This is exactly the story we hear from our participants that they have been blown off for getting an official diagnosis. I had a phone call two months ago from a Pulitzer Prize-winning journalist who called me, who's actually 45 years old and has been suffering for 20 years. She was just diagnosed 45 years old.
Carol: Oh, my gosh. So obviously a journalist knows how to advocate that's somebody who has a leg up on the average person going into a problem appointment in 20 years. This individual has dealt with this.
Dr.Metz: And she told me that she begged physicians for the definitive diagnosis, and they kept telling her, oh, I don't think you have that. You don't need to undergo that. So most Gynecologists do not do the surgery, this minimally invasive laparoscopic surgery. You need a person who is trained in minimally invasive diagnostic surgery to perform that particular diagnosis. So you need a referral to find the right person for you. And that's sometimes where the problem lies. The other problem seems to be that many of these people end up in a GI DOX office with gastrointestinal issues. It's unaware to them that it could be endometriosis.
Carol: So connecting the dots, that is something that is so hard to do around uterine conditions, because every time you try to connect the dots, it seems that there's a person there telling you that you're crazy.
Dr.Metz: Yes. I've been told by our participants that they were called pill seekers that they couldn't get treatment in this emergency room because of pain. They will have to go somewhere else. I've been told that they have pain that's in their heads. That's what they've been told by doctors. Pain in your head. It's really in your head.
Carol: Unbelievable. Yes. Awesome. That's not destructive at all.
Dr.Metz: It's incredibly destructive. Luckily, many of these people have some support in their families that help them move on and continue. But I've heard very sad stories that when you miss a day or two of work every single month, well, guess what? You could lose your job.
Carol: For sure.
Dr.Metz: When you lose your job, what do you lose in this country?
Carol: Your health care.
Dr.Metz: Your health insurance. Yeah. So it's a double jeopardy for many of these women that are seriously hurting. There are also too few dedicated physicians caring for these women. Many of the expert physicians caring for these women don't take insurance. We had a young woman in our study who told me that her father didn't retire because she needed surgery that wasn't going to be paid for by insurance.
Carol: Oh, my gosh.
Dr.Metz: She felt so guilty that her father couldn't retire, but he felt like he had to keep working in order to pay for her medical expenses.
Carol: I'm going to seriously cry right now. It's incredibly sad.
Dr.Metz: That's what keeps us motivated, even without any money. Sometimes you just feel like you absolutely have to do this. I've had mothers called me my 16 year old daughter, my 20 year old daughter. Their doctors won't take them seriously. Who can they go to? It is such a symptom of a large problem. It's like a web that is across not just this country, but the entire globe, really. I think at the root of it is an inability to empathize with the other species.
Carol: Right. So you don't have a Uterus. Like, how could you even fathom what this is like? As a matter of fact, I want to ask you, can you describe, like if you were going to describe to a man what endometriosis feels like, how would you describe it to them?
Dr.Metz: Oh, boy. I think through our participants, I have learned that it seems as though no two people's pain is the same. The pain can come and go. The pain can be persistent. The pain can keep you in bed and keep you from doing all of your social activities. And I think that being balled up in bed with a hot water heater, one of the heating pads wrapped around your belly, taking medication, not feeling great. How many people had their covert vaccine and didn't feel good for a day? Right. And it was rotten. It was lousy not to feel good for a day. Right. Body aches and everything. Well, think of all that in one little spot of your body and your abdomen. And it doesn't just last day. Right. And it comes every single month and you have to put your life on hold. Yeah. And then it starts to affect other aspects of your life. So if you're in a partnership, your intimacy is taking a hit, your mental health is taking a hit. Honestly, I would imagine just your willingness to live, to live through that experience. If you think about some of the stories that we heard about long coveted where people chose not to continue, it's incredibly sad. And hopefully these women find someone who listens to them. It's just so critical to find either a network or a person that actually listens and understands. I had a childhood friend of my daughter contact me. My daughter just turned 21, and she was a student at NYU, and her mother believed she was told that she may have ovarian cancer and she had surgery and she didn't have ovarian cancer. She had endometriosis. So the young girl who's my daughter's age said since she was twelve, she's had terrible pain, and now she believes that that's what she had all this time. And she never actually put two and two together. So for eight years, she's been suffering and she just finally got diagnosed. But it was because she realized her mother actually had Endo that really opened her eyes to getting surgery. And it took her a while. She made an appointment with a physician. She's a student at NYU, and she made an appointment with a physician in the city who then told her the day before her surgery that they don't accept insurance. So she had to cancel the surgery and find another physician to actually do the surgery, which took like four months to find someone and actually have the surgery done. But she was finally diagnosed, and I don't think she would have done it if she thought if she didn't learn that her mother actually had Endo all these years something to kind of inspire you to press on.
Carol: Imagine the people who to me, it was like her mom had a Lantern and she was following after her mom. But there are so many people who don't even have the ability to have a conversation about what they're experiencing, and then they have no other support network there.
Dr.Metz: The symptoms of Endo can be pelvic pain that could be related to sexual intercourse, very difficult to talk to with people. It could be pain with urination, it could be pain with defecation. These are all issues that some women may have an inability to speak to other people about. And if a physician doesn't ask them to describe their pain, they might not. Right. And they usually don't. They say, has anything changed?
Carol: Right. Has anything changed last year? No. Yeah. My life still sucks. Okay. And all because of my period. So no, nothing's changed. Okay, good. Well, then let's go ahead and do your pop smear. That's another thing that really I find remarkable is the lack of standards in uterine care. Like, we start here at step one, and we go to step three every single time, and that doesn't happen. You could go to one doctor on First Street and have one experience and go over to Second Street and have a completely different experience.
Dr.Metz:: The women that I've talked to in our study, I always encourage them to write down their questions and their comments for the physician before they go there so that if they're feeling dismissed, like, oh, nothing's changed, oh, you're good to go that they actually can refer to this piece of paper and say, oh, I have some questions about this, and can I talk about this with you? I think they really need encouragement.
Carol: They do. And then they need to have the space there to ask and get answers. Right. And that's hard to find. I read a study recently of healthcare professionals specifically Gynecologists about their pet peeves in a period. And the one that killed me was asking a complicated question at the end of the appointment. You mean after I've had the PAP smear and I've gone through all that and you say, well, I saw a polyp or something, right? Like, whatever they say. And then you say, okay, can you explain to me how that might contribute to my period? I'm sorry. That's a complicated question. So we can't have that now. Wait a second. Isn't that why I'm here? That, to me, is really amazing. The whole consultation in a gynecologist office is ripe for overhaul.
Dr.Metz: Complete overhaul. I agree. And I feel that the curriculum in the nursing schools, the physician assistant schools, and medical schools needs to be tuned up for understanding pain in women. I feel that very strongly that they spend too little time learning about female conditions. You don't have to be a gynecologist to be treating a female who has complaints that may be vague and not so specific. That should be listened to.
Carol: Yeah. Maybe we need to do a campaign now. I'm going to monopolize more of your nonexistent free time. Do a campaign on connecting the dots. Being able to understand that abdominal pain or something that you perceive as being, like a stomach issue could actually be endometriosis. And also just even having an awareness of what the inside of our body looks like. You mentioned pain with urination could be an example of a symptom of endometriosis. Can you zero in on that and explain why that would be like, connect the dot back to the anatomy?
Dr.Metz: Yeah. Endometriosis is described by these lesions that grow, and those lesions are made out of tissue from the endometrium. When the hormones are raging through the body, those lesions grow and they Slough off and they bleed just like the endometrium bleeds. So if you had a lesion on your rectum, for example, that lesion could cause problems with the functioning of the rectum. If there's a lesion on the outside of your uterus or your fallopian tubes or ovaries, it could affect your fertility. If the lesion is growing on your bladder, it can affect your bladder function. So that's how these lesions can cause problems throughout the body. I met one woman in our study who actually had lesions in her lung, and she was having a lung collapse for several years, several times a year during her period. But there was never a connection made between the period and this lung collapse until they found out she was viewed by someone in an Er who actually put two and two together and realized that it was related to their endometriosis. We've also heard about it with nosebleeds, that there are actually lesions in the nose that could bleed with your monthly period. Unbelievable. And that most Ents. Do not put this together. Those are rare. Endometriosis in the lung is rare, but it could affect maybe two to 5% of people with endometriosis. Yeah. Which is those two to 5%, right? Exactly. Yeah. Same with the nosebleeds. We've heard about it through our study. I've met two people. Two people in our study.
Carol: Amazing. It has to come down to the fact that it's a women's issue. Right. I think it's a woman's issue that is also linked to menstruation. Something that people don't want to talk about.
Dr.Metz: Bingo. Yeah, right. We don't want people talking about that. That's not something society was ever pushing in my generation. Nobody talked about their periods. No, I totally agree. I read an article about a woman who put a box of tampons on her kitchen table. She only had boys and her husband, and she put a $20 bill in the box of tampons, and she waited for somebody to actually open them and they didn't. And she would make reference to the box on the kitchen table and still nobody would open it.
Carol: Unbelievable. I mean, how many mothers have told their sons, oh, you should have a couple of tampons in your backpack in case your girlfriend gets her period. Yeah. I don't know why, because I'm not really fast on the uptake on much in life. I'm definitely a late bloomer. But when my sons were six and seven, I had my kids late. So I was done with my period. But I talk to them about it all the time, walking through the house, and I'll stop them and I'll say, hey, guys, we have to have a learning moment here and now. They're 16 and 14, and they know everything about the uterus. I know it's a special situation because I'm talking about it all day long in our house, but they think it's wild. They're like, Tell me more. And that's the way it should be. It's a fascinating organ. Why aren't more like that. They'll be much more understanding and much more empathetic beings to their friends, their colleagues. Yeah. And I also think it adds to their own level of walking around informed makes you feel more comfortable on this planet. If there are giant black holes of knowledge, like just voids, especially specific to the body, then to me, it seems like you're kind of off kilter because you're walking in a body that you don't understand or your fellow humans are walking in a body that you don't understand.
Dr.Metz: And to me, that should be our sort of 101 in life is that we should understand the thing that we're occupying. I have to tell you that sometimes I'm flabbergasted by our own participants who are talking to our nurse coordinator about the use of the menstrual cup, and they'll ask questions that clearly they do not understand their own anatomy. Will I be able to urinate with the menstrual cup in? I mean, this just goes to show you that whatever education people are getting, it's very limited in the things that we actually need to know. And that's about the functioning of our bodies.
Carol: Exactly. If you don't have that knowledge, it makes it really hard for you to connect the dots with symptoms. Right. So forever until I started working in this industry, in this space of uterine health, I imagined that the uterus had a circular cavity. It had a space in there for stuff. Right. So it's like, imagine people say it's like an upside down pair, but what they forget to remind you is that the pair is not hollowed out. So if you have a fibroid that's the size of a golf ball, that's going to hurt. Which reminds me, I want to ask you a question about infertility and endometriosis. How is it that the lesions on the outside of the uterus are affecting fertility?
Dr.Metz: So there are multiple theories about how that works. The one that seems fascinating to me is that the endometrial cells growing outside of the uterus actually communicate with the endometrial cells growing inside the uterus, that there's some kind of a relationship between those two things. And it's been mocked up in a nonhuman primate model of endometriosis, where they actually inject menstrual blood into the peritoneal cavity to speed up them getting endometriosis. And that does cause the nonhuman primates to get endometriosis. So that's one way that it's just strange for endometrial cells to be growing outside of the uterus. And when they do, there's some weird communication that occurs. And then, of course, the other that's probably the more commonly understood is that lesions tend to grow around the fallopian tubes and the ovaries, and they could actually just choke those organs and prevent them from their normal functioning.
Carol: Okay. Now that instantly makes me wonder about miscarriages or. I'm sorry, not miscarriages. Well, that too. But ectopic pregnancies. Does it have an effect on that?
Dr.Metz: There is some evidence that women with Endo have an increased likelihood of miscarriages. Not necessarily. Ectopic pregnancies, to my knowledge. And a lot of this data is just not great because a lot of women don't know they have endometriosis. So how can they respond to the question? We only get that information from the people who are definitively diagnosed.
Carol: Right. And it's unfortunately too small a number to really understand the full implications of the problem. If you had all the power and all the money to study chronic uterine conditions, what would be your priority?
Dr.Metz: Well, clearly, I'm dedicated to understanding endometriosis, but there are other conditions of the uterus that are equally important to understand. There's something called chronic endometritis. And what that is, is an infection in the uterus, an inflammation in the uterus. It's typically caused by an infection. And believe it or not, it's just like endometriosis in that one out of ten women supposedly have chronic endometritis, but we don't diagnose it here except in the setting of infertility. So if you were infertile and you went to a fertility specialist, they might do an endometrial biopsy. And in that endometrial biopsy, if they did it, they would find an increased number of plasma cells, and that's typically how it is diagnosed. Most women are put on doxycycline, which is an antibiotic, for two or three weeks. And 70% of those women then conceive. So it's believed that it improves their outcome. Now the symptoms are very, very vague. You could have kind of a bad period. You could have unusual cramps not related to your period or related to your period. They're very vague symptoms. So it's not well understood or studied or diagnosed in this country. I got the emphasis there when you were talking about the fertility exam. It would seem that if a fertility doctor started there, then some percentage of their business would fall off. We're just not sure why it isn't done routinely. There must be reasons that the infertility specialists could share with us why they don't do an endometrial biopsy on all women. But we believe that menstrual blood could be incredibly informative about chronic endometritis. Interestingly, people who have chronic endometritis are three times more likely to get endometriosis. So we think there's a very strong link there that we could better understand what's going on. And that's one of our theories is that the problem is not necessarily in the pelvic cavity, but the problem may actually be in the uterus. Transforms these cells into something different. So then when they leave, they don't function normally and can't be easily cleared. That's kind of our big hypothesis that inflammation or infection in the uterus contributes to the disease. But there's no treatments related to that kind of observation.
Carol: If you were to undergo a hysteroscopy, would there be any visual indicator that you have this infection?
Dr.Metz: Sometimes they could see some evidence, but I think with the naked eye, it's very difficult. Just like with laparoscopic surgeries. I've heard many, many times that people undergo the diagnosis, laparoscopic surgery, and they had microscopic disease, and no one could see it. And they undergo it multiple times before a physician actually finds the lesions. And a lot of these lesions are like icebergs. They grow in. It's not like they grow out, so it's some obvious bump. They grow inward. So when they actually do the surgery to remove them, they have to scoop it out with really wide margins. Otherwise they may have left some in. It's incredibly tricky disease.
Carol: Yes. Which is all the more reason why we really have to keep the pressure on, to keep the attention on this. What is the day like for you in the laboratory? I have this wildly romanticized vision in my head that it's kind of like a cross between CSI and NASA. And so I want you to set me straight.
Dr.Metz: It's actually very exciting, and I hardly miss a day of work, even with this crazy cop and pandemic. We're there every day receiving samples. Samples are received by coordinators. Usually FedEx drops them off between ten and eleven in the morning. Of course, FedEx has also had problems because of the pandemic and have had trouble delivering things in a timely manner. And we have suffered with that because it's important for us to receive the sample. Just like the bakery, fresh is best. When samples arrive, we review them, and I work with the texts in the lab who process them. And some samples are put directly into a processing method for the single cell RNA sequencing. Other samples are put into methods for growing cells so we can do downstream analyses related to the decidualization defect that the cells and endometriosis patients have. And to study this progesterone resistance, which is not clinically tested for, but we believe it could be. And we've been looking at progesterone resistance in patients. And then, of course, we're trying to translate what we learn from our single cell sequencing data into an actual diagnostic. So some samples are prepped for that type of thing as well. So coordinating what's going to be done with each and every sample that comes in is an important warning component. And then, of course, at the end of the day, we review what's happened with the processing, the status of cell growth, and the various samples. We have several projects that are ongoing. We collaborate with a group that is actually looking at the levels of toxins, environmental toxins in the menstrual Effluent, which is also incredibly interesting.
Carol: Wow. That is.
Dr.Metz: And we've set up some samples for that. So that's kind of interesting because most of the toxins that we're exposed to, they stay in our bodies forever. Most of them get into our fat and they're there for your whole life. But Interestingly, what toxins end up in the uterus could be shed in menstrual blood every single month. And they would tell you what your exposure the month earlier actually was. So we've done a proof of concept study with a doctor at Harvard, Dr. Shruthi Ballingaya, who is very interested in understanding the role of environmental toxins in uterine health.
Carol: That's somebody for me to follow, for sure.
Dr.Metz: Yeah. And then we have a collaboration with an investigator at the NIH who has been interested in vitamin D and its role in reproductive health. And we've been studying menstrual Effluent from a group of women who are in a vitamin D supplementation study because they were vitamin D deficient. So we got their menstrual blood before they got their vitamin D, and then we get the sample after they've been supplemented with vitamin D to do additional analyses on. So we're really all into uterine health from a variety of angles. It's very exciting to collaborate with others to kind of push the concept of studying menstrual Effluent as a thing so that it will catch on.
Carol: Yeah, we're going to make a catch on. This is so exciting to me. And what you just described there kept saying I collaborated with someone who's interested in it reminds me, and correct me if I'm wrong here, but we have to rely upon people like you to point at something and say, this is what I'm going to spend my life studying, or this is where my focus is for the next, however, period of time rather than this sort of societal agreement that we deem this important. Let's gather resources, let's identify people. I'm already thinking, how do kids know to go into this kind of research? First of all, thank you for taking that step. And then how do we get other people to take that step? It relies upon. It's like crossing your fingers, right? We're crossing our fingers and we're going, Gee, I really hope somebody decides to study endometriosis. And that seems nuts to me.
Dr.Metz: Actually, that was something I addressed in the Scientific American opinion piece. That is it because Big Pharma doesn't want to promote menstrual blood for their next biologic that it seems to be so under studied. They show the blue dye on the tampon or the pad on television. They can't even show red dye on it. It's like, oh, we got to hide this from everybody or sugarcoat it in some way. Why are we doing that? Right? Why don't we just talk about it and discuss it like teenagers and adults should? Who knows? We don't understand it.
Carol: Yeah, well, the undercurrent of shame around all of this is really big. Literally. Remember the very first time I bought a box of tampons on my own? I was at the shop right in New Jersey. I remember the aisle. I have a bad memory, but this stands out, and that box was there, and I was mortified. And where did all that come from? My mom. She was raising the kids. She didn't have time to say, Honey, you should be ashamed of your period. So it happens. I know we all felt the same. We were, like, in and out of the drugstore. Or I put it on my mother's grocery list and hope she'd buy it for us. Right. But then, of course, we went off to College. You had to buy your own stuff. It was the same thing all over again. Who knows? Nobody told us to be ashamed. It was just an unspoken thing. Yeah. And even among girls, we ourselves didn't talk about it openly. We talked about it like, I'm making an announcement. So maybe, like, you passed a note in class and you put a red dot on the note so that you would alert your friend that you had your period. And typically, it was just like, just let me know. Stand behind me when I'm walking down the hall in case I missed and I leaked and whatever. Actually, I think the time is prime to do that because I just look at my own sons, and I know that they've grown up in an environment that maybe isn't across the board, but I think they were open to it because they could have shut me down as a matter of fact, the only time they ever did shut me down. And this is kind of hilarious. I think they were seven and five. My one son was in the shower, and my other son was going to the bathroom, and I was standing at the door, and my son in the shower said, mom, why don't you have a penis? And I was like, all right, that's as good a time as any. We're going to have a conversation, right? So just while he's in the shower and the other one is around the corner so neither one of them can look at me, right? I thought it was just this is, like the perfect time because they'll take it in and they won't be, like, looking at me for queues or anything. So I run them through the whole thing, and I don't make up any weird words, and I just, you know, tell them the straight scoop. So when I talk about intercourse, my son in the shower goes, oh, I don't EW. And I said, well, it might seem like now, but at some point in time, you're going to meet someone and you're going to have feelings for them, and it's going to open up this desire in you to be physically intimate. It's about the emotions. And as soon as I said emotions, my other son was like, that's good, mom, I'm out. It was like he could handle all the physical stuff. But as soon as I started tapping into, like, you might fall in love, he was out. We have a lot to look forward to. And I have to thank you for again being like the Lighthouse out there shining a light on the condition, but also not just the work that you're doing with Endometriosis. But I think that what's really powerful that's going on here is the identification of menstrual blood as a source of information. We don't know what it can tell us. And wouldn't it be amazing if it actually tells us everything that we've ever wanted to know, like, about life? That would make perfect sense to me.
Dr.Metz: That's kind of our dream, that it is like gold, that it has a lot of answers and could tell the inner biology of your uterus. I just think that it seems obvious that it is going to tell us about the health of our uteruses.
Carol: Definitely. Well, thank you, Dr. Metz, for being here today, for launching Rose, for caring, for fighting the battles to get Rose off the ground, for giving us the opportunity to get excited about a non invasive diagnostic test for Endometriosis. This has just been, for me, the kind of conversation that inspires action. Certainly some of the things that you shared with me today just enraged me. But I'm left feeling like, wow, there is real stuff being done. And I think that's the thing that's missing for most people who are suffering with this condition is that the experience that they get with the people that they look to for clinical direction for health information is not a great experience. And then, I don't know, maybe we should have a gynecology appointment and then followed by an appointment with the closest researcher that lives near you. Because to me, this is where it's at. You're making it happen. And you give people straight information. That's actionable. And I'm just so delighted to have found you. I'm so delighted that you made time for us because I can't imagine how slammed you are. So thank you. Thanks for hosting me. And actually, the point is to give people action items that they can take with them and help improve their lives. And participating in the study is one way to get involved. Another is to simply understand that your questions are important and that you have to consider changing a position to find people who will take care of you better. And don't take no for an answer. Talk to your friends about what you think you're experiencing versus what they're experiencing to find out whether yours are actually different from others. There's a lot for us to learn, and our bodies are ourselves. And who is the better caregiver of our bodies other than ourselves? Which is really important. Yes, absolutely. Well, you did a tremendous service today because you've provided so much information that people can take in and start to connect the dots with their symptoms and their experiences and architect a cleaner path for them to wellness without delay, which is what we need. It's been great. I hope you'll come back and keep us updated on your team's progress. Sure. Might be excited, too. I think there should be like they had a kitchen camera in the Bon Appetite test kitchen. I think that you guys need to have a lab camp because I'm going to be waking up on Monday thinking, I wonder what they're up to. I wonder what they're discovering today. You can come for a visit any time. Okay. You're talking to a person who will stop at every manufacturing thing. I love tours like that. Come to the lab. I can. I'm going to take you up on it. That would be amazing. And then I'll report back. So thank you, Doctor Metz. I could talk to you all day. I'm sure you have other things to do. We are so grateful. I can't thank you enough. It's been fantastic. Thank you for the podcast. Thank you for coming to stay on with us for the after show. And best of luck in your research.
Dr. Metz: Thanks for hosting me. It was most enjoyable.
Carol: I am both exhilarated and exhausted. I think Dr. Metz might be exhausted, too. We could not let her go. We couldn't quit her, as they say. Also, definitely read the blog@helenutarus.com. We'll include links there to the study. If you are menstruating and you fall into any one of the three cohorts that Dr. Matt's described in our conversation and you would be open to doing this. I will Cook you dinner. I will do whatever it takes other than I don't have unlimited cash. If I did, I'd give it all Dr. Meth to get her more menstrual blood. Okay? That's what we need to do. We need a menstrual blood drive and we're going to do it. We're going to help make that happen. Make it so that FedEx is delivering more menstrual blood to her than she can even test. There you have it. A lot of information about endometriosis and the power of menstrual blood and the secrets that it holds and thank you for listening. Thank you for being here. I'm so glad that we had the opportunity to have this conversation and get this information into your hands and come back next week for more because this is what we do every week at Helen Uterus and during the after show. Have a great week.