Natural Ways to Manage Endometriosis Beyond Surgery

Dr. Brighten: [00:00:00] Women with endometriosis wait on average seven to ten years for a diagnosis. I waited twenty-nine, and as a teenager who couldn't get out of bed due to pain and who was missing school, I was told what millions of women hear every single day, that debilitating period pain is normal, to just take the birth control pill.

I was told at fourteen that pregnancy would fix it. Like, thanks. That was super helpful. There was also a time when I was told that stress was the problem. If I could just stop stressing so much, my period pain would get better. Meanwhile, the disease was progressing inside my body, and while I was able to get pain-free and live that way for almost two decades with some of the things that we're gonna talk about today, it didn't mean that the disease wasn't there.

And listen I will not disagree that surgery can be life-changing for some women when it's done well. But even with surgery, women are left asking questions about what they can do to manage the disease, because the [00:01:00] inflammation and the immune dysregulation can still persist. The nervous system changes that happen because of endometriosis aren't magically just addressed with surgery, and I know this because I've lived it.

But also because I've helped so many women with endometriosis as well. And I wanna be clear, I'm not dissing surgery. If you've been on the Dr. Brighten show with me for a while, you know I've interviewed many endometriosis excision specialists, but the thing that I'm hearing, and you all have been loud, and I hear it, so I'm here today to give you something different, because what I've been hearing is, " I'm so sick of hearing, 'Just have surgery.'

All I'm being told is just have surgery." Now, medicine treats endometriosis like it's a surgical condition. That means that the goal is to have surgery to treat the disease. That's how medicine is focusing on it, but it neglects some really serious issues we have in women's healthcare. One, there's a lot of incompetent doctors who should not be doing [00:02:00] endometriosis surgery.

They'll probably come for me in the comments, but listen, if you wanna out yourself, raise your hand and say, "Yeah, I'm basic. I do mediocre medicine, and I shouldn't be doing it," then go off. Then go off. But that's a problem, is that not everybody's competent to treat this disease, so the access to surgeons is limited.

A lot of women have to travel for surgery, and it's expensive. I had to choose to pay cash for my endometriosis surgery and save up for that, because that was more affordable than using my insurance. My insurance co-pay and then the, like, who knows what they're gonna actually charge you from the anesthesiologist and the IV bag and the, and whatever else they're giving you in the hospital, you know?

And the, like, $10,000 they have to charge for, like, a- an Advil, right? Like, that unknown cost plus the known cost was more than what it was gonna cost me to just go to a surgeon who was cash pay only. But not everybody has the means to do that, the access to do that, the flexibility to do that, the ability to [00:03:00] recover from their job.

So I wanna acknowledge all of that in this episode as we move into natural ways to address your endometriosis. And look, before somebody jumps in and says, "Diet is not a cure," I am not claiming cure, okay? Let's just, like, be straight up about that. At this point in time I don't see anything that's a cure for endometriosis.

What I see is the need for a multidisciplinary team and a holistic approach to your body, and the limitations of every single one of the things we're gonna talk about, plus surgery have to be acknowledged because when we say to women, "Hey, just have surgery, everything's better," and then it's not, they feel like they failed.

They feel like there's something wrong with them, and that's not the truth. The truth is this is a complex inflammatory condition that affects your entire body. We have to then address your entire body, not just the lesions.

Okay, so where are we going in this episode? In this episode, I'm gonna walk you through the six biological systems that [00:04:00] influence endometriosis symptoms and simple things that you can start doing to get day to help you support those systems. These are the exact foundations I teach inside my endometriosis program because women deserve a roadmap.

They don't deserve guesswork and Dr. Google late at night, which by the way, I'm a fan of you researching your own conditions, make no mistake, but it can be scary on Dr. Google sometimes. Now, stick around until the end because I'm gonna share one supplement that I do think every woman with endometriosis should consider taking.

And before we dive in, you've been asking. I wanna share something exciting. Last week I asked you all if you wanted me to teach the exact strategies I use with my patients to help them get relief for endometriosis, and more than two thousand of you said yes, so I'm building it. I'm creating the first endometriosis reset, and it is officially open for you to sign up.

In this program, I'm gonna walk you through the [00:05:00] exact systems that we target in clinic to help reduce flares, calm inflammation, support your body, so you're not constantly living in survival mode and to support you whether you are pre-surgery, you just had surgery, you never wanna have surgery. I wanna support everyone that's on the spectrum.

And listen, because this community is the reason this program exists, I am including early bird pricing and special bonuses, which is gonna include biweekly group calls with me, so that I can help guide you through the process. Now, if you wanna get in on this, drbrighten.com/endocourse. That's D-R-B-R-I-G-H-T-E-N.com/E-N-D-O-C-O-U-R-S-E.

You can claim your seat. We start April fourth. So if this is something that you've been waiting for, you saw my post, you, you saw my email, you're like, "I'm in," now is the time. All right. So with all of that said, let's not hold up this podcast any longer. Let's get into it.

Now, let me just say, uh, real quick, if you don't know who you're [00:06:00] listening to because this is your first time with me, I'm Dr. Jolene Brighten, board-certified in naturopathic endocrinology, nutrition scientist, endometriosis, adenomyosis gal. It took me twenty-nine years to get diagnosed. I had a whole lot of heartache, um, and had a whole lot of miscarriages through this.

So, um, this is something that... I like to say I'm in my villain era. I'm in my villain era because when it comes to ACOG, mediocre medicine, the way doctors have been dissing this disease, I'm gonna be a thorn in your side. Because I'm gonna educate so many women to take care of their bodies and to question you that, like, you're gonna see me as problematic.

So welcome to my villain era if you're new.

Now, the first thing that I wanna say to you, take a deep breath, but women with endometriosis have a higher long-term risk of cardiovascular disease, and I'm gonna tell you one nutrient you need to prioritize in your diet to address this. But first, I wanna talk to you about why this is because we're not talking about it enough.

Endometriosis is associated with chronic systemic inflammation. Heart disease is the number c- one killer of women, and now we gotta start questioning [00:07:00] how much endo have we been missing that's been leading to this. So if you're not aware, endometriosis lesions release inflammatory compounds. That's what's driving our pelvic pain.

That's what's driving our fatigue, the most reported symptom among all of us. The brain fog, we're literally seeing brain changes in women who have endometriosis, and then increased pain sensitivity that persists even after we have the lesions removed. So one of the most powerful natural strategies is going to be lowering the body's inflammatory load, and I...

Here are three places I want you to consider starting. First Prioritize omega-3 fatty acids daily. Omega-3s help counterbalance inflammatory prostaglandins, and that is gonna help with the pain, but we also know this is gonna support brain health and heart health. Now, you can get omega-3s from fatty fish, so salmon, sardines, mackerel, they're the winners.

Anchovies, if you can eat 'em, do it. Chia seeds, flaxseeds, walnuts, [00:08:00] um, those, those are pretty good, but they're not, like, the highest, most bioavailable sources of omega-3s, but they have other nutrients. They're definitely worth eating. And then considering high-quality omega-3 supplements. Nothing from a big box store because if they don't cut it with canola oil, it may be rancid.

Like, there's a lot of problems in the supplement industry. Um, and as you guys know, I have Dr. Brighten Essentials. I have a supplement company, and our omega-3s, I insisted on the EPAX omega-3s because I was like, "I got endo. I, I don't need any risk of rancid, nasty fish oil making anything worse." So check how the company manufactures it.

Check for third-party testing. Make sure they're doing smaller batch. If they are just pumping out huge bast- batches to send it to your favorite box store, like, uh, that's not worth your money.

Now, the other thing that we wanna do is we wanna build your meals around protein and fiber, and you may be thinking, [00:09:00] like, "Everybody's always talking about protein and fiber." So I call it the PFF, protein, fat, fiber. You want the healthy fats, so those omega-3s. We want protein. We want lots of plants. That's gonna help stabilize blood sugar, and that actually helps with inflammatory spikes.

So, um, there's a whole lot of reasons to make sure you're getting protein, fat, and fiber at every meal. Now, the third is sleep consistency. Sleep deprivation increases inflammatory signaling dramatically. So you gotta go to bed within the same 60-minute window each night. And list- if you have a night out with your girls, like, no big deal, but for the most part, we wanna keep it consistent because that's been shown to help lower inflammatory markers.

And if you're having trouble sleeping, and you're like, "Oh, easier said than done," I will link in the show notes at drbrighten.com the episodes I have done on sleep to help you get a better night's sleep Now, I know all of these might seem simple, but it's the consistency of these foundations that [00:10:00] make a real difference here.

Now, as we're, we're talking about food, I wanna, I wanna switch into the gut and estrogen metabolism conversation because endometriosis lesions can actually produce their own estrogen. I'm gonna give you some tips to get around this, but I first need you to understand what this means for your endo. So estrogen signaling can continue even when your ovarian hormones are suppressed or you enter menopause, and one of the biggest regulators of estrogen metabolism is the gut microbiome.

Yes, your liver, but most of the time people forget about the gut microbiome. Now, I don't know if you're no-- aware of this, but, like, up to sixty percent of women with endometriosis also meet the criteria for IBS, and that is because the prostaglandins, the lesions, the stress, the way we have to change our eating 'cause we're in pain, that can all shift the gut microbiome, gut function, gut motility, [00:11:00] and then it looks a lot like IBS.

and doctors just love to call things IBS, but not everything is IBS. And if somebody has IBS, and they have period pain, pain with sex, pain with urination, they have pain with a bowel movement, they have severe fatigue, uh, we gotta start asking questions. Is this endo?

We also need to take into account that, like, seventy percent of your immune system is in your gut, so we need to improve gut function to help reduce inflammation and support hormone metabolism. Now, here are three things you can start doing today. So we talked about fiber. We want diversity of fiber, so not just more fiber, but diversity of fiber.

Your gut bacteria, they're gonna thrive on fiber. So if you can, you wanna aim for, like, twenty to thirty different plant foods per week. Herbs totally count. You grinded up some turmeric, you add in some fresh oregano, like, that counts. And so I don't want you to get overwhelmed that like, "Oh my God, that's, like, so many plants to be [00:12:00] eating," and start-- first take inventory.

How many plants are you eating? You'd probably be surprised. It's more than what you would think. And then you look at, okay, can I just add two to three different things in my week so that I can improve the microbiome, I can improve diversity of fiber? And you just do that until you work yourself up to that twenty to thirty different plants in a week.

So when you do your inventory- Look at herbs, spices, fruits, vegetables, nuts, seeds, they all count. Now, the second thing is we gotta support regular bowel movements. If you are not pooping daily, estrogen metabolites have the potential to recirculate in the body. Gastroenterologists, cancer researchers, they've been well aware of this.

I don't know why in women's health they've been slow, so slow to, like, recognize this. Now, how can we support daily bowel movements? Hydration, 'cause we also move estrogen out through our urine. N-- you might need to use something like magnesium citrate to get [00:13:00] things moving. We already talked about fiber, but one of the biggest things you can do is movement, and if all you can do is walk five to ten minutes after meals, that can help with gut motility.

Now, the third thing I want you to do is pay attention to foods that personally trigger your symptoms. Not everyone with endometriosis needs to be gluten-free or dairy-free. Everybody does need to be alcohol-free as much as possible. We know this from the research. One alcoholic drink can bump your estrogen by, like, sixty-six percent.

So when we talk about, um, an estrogen-dependent condition, we gotta, we gotta look at, like, dialing back on the alcohol.

Now, alcohol is one, but people also notice significant improvements when they reduce ultra-processed food and highly refined sugar, and we've seen this in the research. I've seen it clinically. And inside the Endometriosis Reset Course, we're gonna walk through how to improve gut health and address the underlying cause of inflammation without creating [00:14:00] restrictive food rules.

Because the last thing women with endometriosis need is to feel like they, they can't even go out to eat, right? 'Cause, like, this disease takes enough of our life. We already are planning around our periods sometimes. So I want to help you stop the guesswork, stop the restriction, and eat in a way that actually supports your body, that works for the majority of women with endometriosis without feeling like they've lost all joy of life.

And you guys know I'm a foodie. I love to eat. I love good food, so I don't, I don't like to be super restrictive with people's diets.

Okay, so we've covered two. Now the third one is stress physiology and the HPA axis. We gotta talk about this because women with endometriosis have significantly higher rates of anxiety and depression, which is why there is one thing I recommend you never do, or at least try to avoid if you have endo.

Now, before I explain what that is, I want to explain what is happening with the HPA axis. So [00:15:00] chronic inflammation in the body affects the body's stress response. The hypothalamic pituitary adrenal axis is how your brain and your adrenal glands speak. That cortisol that this system controls actually helps dampen inflammation.

So this system's about cortisol, energy levels, immune signaling, pain sensitivity. We're supposed to get a cortisol pulse. It's supposed to put our immune system in check. And so what I need you to understand about endometriosis is when the body is constantly in stress mode, because that's what inflammation is, it's a chronic stressor, it becomes harder to regulate.

So I wanna give you some simple ways to support the stress response. I want to make this podcast actionable for you. And the first thing I would say is never skip breakfast if you are the type whose energy crashes later in the day. Protein-rich breakfast helps stabilize cortisol rhythms, it helps your blood sugar, it helps send a safety signal.

The other thing I would [00:16:00] never do is push through exhaustion, and I say I would never do it, but I've done it, and it's horrible. And now that I have entered my forties I can no longer do it. So like if I can give you any advice, don't do that.

Because when your body is tired, it's asking for recovery. It's giving little signals of like, "Hey, something's going on. We need rest. We need recovery." So pacing your energy is a super important skill when you are living with chronic illness, and that might mean scheduling rest before your body forces it.

Please, like learn from Dr. Brighten's example, because if you don't choose to rest, your body will force you to rest and then it takes way longer, way longer to recover. Now, the third thing I'd encourage you to do, this is not a never, this is a let, let's try to do this, is a nervous system reset every single day.

Maybe it's five minutes of slow breathing. Maybe it's going out into nature. Maybe it's taking a short walk. Maybe it's grounding, you go out in some grass barefoot for a while. Gentle [00:17:00] stretching, meditation, whatever helps you. Just do a little nervous system reset throughout the day is going to reduce the cumulative stress load.

So if you imagined that you had a cup Your cup is three-quarters of the way full when we're talking about stress load just by having endometriosis. So every drop in there is filling up that cup. What you need to do is consider how to empty out that cup just a little bit every day so that you don't spill over.

When we spill over, we get a flare, we get depressed, we get anxious, we stop sleeping, our bowel movements change, we get flatline fatigue, like you're crawling out of bed in the morning and just being like, "IV drip me some caffeine 'cause I can't even function." I wanna help you prevent that. So that's one thing that I would recommend doing, is just looking at the stressors in your life, recognizing some of them are just non-negotiable, like, you know, when endometriosis decides to pop off, and then thinking about how can you support your [00:18:00] nervous system, 'cause you absolutely deserve that.

And just a quick reminder, everything we're talking about today is actually a preview of what is inside the Endometriosis Reset. So if you're feeling overwhelmed, I want you to know the program will break this down, little tiny steps, very actionable, helping you reset and helping you create change because honestly, the biggest challenge women face isn't lack of information, it's like what to actually do with that information, what information actually applies to you, and how to implement it into your life.

So before I move on to the next one, if you want to join the course, if you just wanna check it out, enrollment is open right now, drbrighten.com/endocourse.

Now I wanna talk about another system that plays a huge role in endometriosis symptoms and can be why, even after excision surgery, your pain persists, you still just feel like things are not quite right, and that is the nervous system and the way it's involved in pain [00:19:00] amplification. So up to seventy percent of women with endometriosis experience chronic pelvic pain, not just pain with their period.

There's one therapy that every woman with endometriosis should consider, in my opinion. I'll let you know what that is. I wanna talk first, though, about what's going on with the nervous system and, and pain and the repeated inflammation. So-- well, let me just put that together. So pain, repeated inflammation can lead to central sensitization.

That means your nervous system becomes more reactive to pain signals, and it's almost like you just have a memory of pain, and even when there is no pain signal, like there's nothing causing the pain, you can still have pain. So y- I'm gonna give you three ways that you can support your nervous system.

Now, the first, the therapy I think every woman should have is pelvic floor physical therapy. Many women with endometriosis develop pelvic floor tension [00:20:00] for years of guarding against pain. Uh, they can sometimes also have concomitant Ehlers-Danlos syndrome, uh, EDS, Ehlers-Danlos syndrome, that when you have that condition, you're sometimes more likely to have endometriosis, and if you have that condition, you can develop more trigger points and muscle hypertonicity, super tight muscles, because you're protecting all the time.

So often I feel like medicine looks at women's bodies and is like, "Your body's betraying you. Your body's the problem. Your body, like, has to, like, you know, get out of the way so that we can fix you." And the reality is, is that your body's often protecting you. It's a protection response.

And so pelvic PT, if you've had surgery, if you've not had surgery, it's a good idea to consider it. Starting pelvic PT, like, months before surgery can result in better outcomes. If you've had surgery, you still have pain, I would definitely meet with a pelvic floor physical therapist because there are doctors out there who will say, " Recurrent endometriosis, it just [00:21:00] came back," but they never think about, well, maybe there are trigger points that haven't been addressed.

They don't think about all the other things that could be going on, and that we should address those things before we just jump to another surgery.

I would also say that if you have pain with sex, pelvic PT can dramatically help with that. So improving pain across the board throughout the body and definitely sexual function is something that PT, pelvic PT shines at. Now, the second thing is doing breathwork for pelvic floor relaxation, so doing diaphragmatic breathing, inhaling into your belly and then exhaling very slowly.

These are connected to your pelvic floor. It can help relax your pelvic floor just doing that type of breathing. Thirdly, gentle movement instead of super intense workouts when you have flares is something I'd recommend considering. So walking, yoga, mobility work to help maintain circulation without triggering more inflammation.

[00:22:00] So, um, you know, I will say, like, you know- When I'm not feeling well around my period, um, you know, especially as I was going through IVF, I would go, like, intense, so, like, he-heavier weights and, um, I would do, you know, um, cardio, but I would never do HIIT. What is so interesting to me is that I see exercise physiologists out there saying there's absolutely no reason whatsoever every woman, like, can't do HIIT, and that's a little bit of an exaggeration, right, because disabled people exist, like, clearly there's people who can't.

But, but they'll say, like, you can't just tell women they can't do high-intensity interval training, so that's what I'm talking about when I say HIIT. Every endometriosis surgeon that I have interviewed has said, " My patients who do HIIT, their inflammation's so much worse, their pain is so much worse," and I have also seen this, and I echo this.

I'm not saying high-intensity interval training's bad. I don't think it is. I think it's great. But what I am saying is that [00:23:00] if you're in a flare, your body needs more restorative work than it needs to go, like, pushing full throttle. So when we do HIIT, that can be a great way-- like, when you're feeling great, a great way to, like, help with cortisol, reset the immune system.

But if you're not feeling well already, you definitely don't want to, uh, be engaging in that. But the other thing is, if you have a chronic inflammatory condition, if you're, you know, one of the women who also has autoimmune disease, because that goes along with endometriosis, and then you're pushing most days of the week as hard as you can, you are setting yourself up for burnout, and that is not because you are weak, it is because your needs are different than what-- I mean, these exercise physiologists that are out there talking about this stuff and these researchers, do you think they're studying endometriosis women?

No, they're not. It's something I always say I get really freaking pissed off about, endometriosis, neurodivergent women like ADHD, [00:24:00] autism, like, none of the protocols in women health are, like, really thinking about us. And so they're going out there and they're saying all this stuff and they're putting these blanket statements out into the world, but they never stop to ask us what is our experience like, what are our actual needs like.

And I'm sick of it because it, I, I don't think they're trying to do harm, but it does do harm because then it leaves women thinking, "Oh, I'm the problem. It's me," like, "Something's wrong with me." Like, "Oh, this person said that I should be able to do HIIT training and I can't, and I'm, I'm just weak." And, and we have enough mental health struggles with this condition.

We don't need to add shame and guilt on top of it.

Okay, I wanna talk now more about blood sugar and energy stability because more than fifty to eighty percent of women with endometriosis are reporting severe fatigue. One of the biggest drivers of energy crashes can be unstable blood sugar, and we know that there are lots of women out there with PCOS and [00:25:00] endometriosis, and blood sugar instability is definitely a crux of the PCOS experience. So if you are someone who is struggling with fatigue, energy crashes, especially after meals, here are three things that I'd say you should start looking at. So number one is we wanna pair carbohydrates with protein and fat. We wanna eat slow carbs, so like fiber-rich carbs as often as possible.

We wanna try to eat every three to four hours if we're struggling with energy dips and we think we have blood sugar instability, and especially for the person who forgets to eat. Taking long gaps between meals can worsen fatigue. Now, third, get your protein in the morning. So if you can hit thirty grams of protein, that's when research tells us the most important meal to have protein.

That's gonna help stabilize blood sugar, keep you full. It's gonna support your energy levels throughout the day.

Now, something that's a little more next level in this protocol is supporting mitochondrial energy production. So when we get [00:26:00] inflamed, that increases oxidative stress, and that can impair mitochondria, which is the part of your cell that produces energy. So supporting mitochondrial health can make a noticeable difference in women.

And, you know, there's a lot of things that you can do dietarily, like e-everything we've, like, talked about so far is gonna support mitochondrial health, especially getting the plant variety, but also including things in your routine like CoQ10, magnesium, which is required for making energy, creatine, and we could do a whole episode about creatine and endometriosis at, at, like, three to five grams.

Research so far is probably fine, but that can help with regenerating cellular energy in both your muscles and your brain. And I think the, it-- creatine's interesting because it shows support for both physical and cognitive fatigue. The other thing that I would say, you know, just as we're talking about, uh, supplements, is iron.

So eval-evaluating iron and [00:27:00] ferritin. If you've been having heavy bleeding, which is really common with endometriosis, adenomyosis, uh, you know, and it gets ignored sometimes. Um, and sometimes women are told their ferritin is normal, but that ferritin is, like, fifteen, and you're like, "That's not, that's not normal.

Thanks." Usually labs won't even call it until it's, like, under thirty. But we need to see a ferritin above fifty because when it gets below fifty, hair loss, fatigue, shortness of breath, um, anxiety, restless leg syndrome, exercise intolerance, all those things can start. So if you are someone, even if you're a meat eater, but if your ferritin's low and e-- so, okay, so if you have a low ferritin, even if you're a meat eater, you may need to supplement with, like, ferrous bisglycinate.

I don't recommend, uh, sulfate form 'cause that's constipating, that causes bowel issues and, I mean, we got enough digestive problems with endometriosis, okay? All right, let's shift gears into talking about the immune system a little bit more because [00:28:00] endometriosis is associated with immune dysfunction. The immune system doesn't properly clear the misplaced endometrial cells.

I wish it would just, like, Pac-Man gobble all that up and get it out of there. It's not doing it because those cells are still genetically you. And we know there's a lot of immune chaos that can go on because these endometrial lesions, they are producing cytokines, so those are like chemical messengers for the immune system, but histamine as well.

So we have to be focusing on things. So we, we've talked about nutrient-dense whole foods are important. Adequate vitamin D. If your vitamin D isn't at least fifty nanograms per milliliter, we need to get those levels up. Omega-3s, I said that at the top of this, those are gonna help your immune system. Gut health, focusing on that, and restorative sleep, those are all things that are foundations to regulating the immune system and inflammatory response.

There's not just, like, one magic thing that you can take that will make your immune system act [00:29:00] right. It has to be a layered approach. Sometimes we use supplements, but we are always looking at nutrition and lifestyle because if you are stressed out, you're over-exercising, you're under-eating, you're, uh, you got a bad boss who's always yelling at you all the time, you're not sleeping, like, all of those factors, if those factors aren't addressed, then we, we don't expect much in the system to get better, even if you have surgery, you take pharmaceuticals, or you take nutraceuticals like supplements.

We have to be going deeper and really addressing the foundations of how you live your life because the reality is, is the things you do every day that are consistent have the biggest impact on your health. And I think in medicine, we too often disempower women by thinking that real change only happens if you are, you know, going to the doctor and they're writing a prescription for something, or you're going to the physical therapist and, and you're [00:30:00] seeing them once a week.

Like, those things are important, but it's the day in, day out, how are you living your life that can really move the needle.

And I just wanna be clear in saying all this, you didn't cause your endometriosis. You didn't cause this. You didn't bring this on yourself. If you made bad choices as a teenager and in your twenties when it comes to food and lifestyle, join the club. It's been all of us, and we literally will not change our health for the better in the future by judging our past selves.

Now, I will also say that the biggest mistake I see is when people try to do everything all at once, and that can be overwhelming as well. And usually, you try to do everything all at once, three to five days later, you're doing nothing What actually works is addressing the systems that influence the disease.

So what we've talked about, inflammation, gut health, hormone metabolism, stress physiology, what's going on with your HPA axis, nervous system regulation, immune resilience. How is your immune system operating? [00:31:00] This is exactly what I am putting into the Endometriosis Reset course, because I don't think we need more random advice.

We need clear step-by-step framework for supporting all these systems in the context of our real life. Now, if you want that full roadmap, including flare protocols, nutrition guidance, we're gonna have supplement strategies in there. I have a whole quiz for you to understand which of these like systems are the primary drivers, because all of these systems contribute, but what I see time and again in patients is that one of them is the leading lady out there just wrecking our life.

So I've put this framework together in the program so that you can individualize this for your needs. And listen, I, I also want to say that if you know someone who's struggling with endometriosis, please share this episode with them. Whether or not they join the program, I want women to get access to this information and start thinking about this disease differently than how doctors are framing it.

Because if we can get one more woman to understand this disease, it becomes very, very hard for one more doctor to dismiss us. 

Now, what we covered today is really just a preview of the framework that I'm teaching inside the Endometriosis Reset course. In this course, I'm gonna guide you through the exact strategies we use in-clinic to support the systems that influence endometriosis, the things that we've talked about in today's podcast, like inflammation and gut health, hormone metabolism, stress physiology, what's going on with your nervous system.

But more importantly, I'm gonna show you how to actually put it all into practice, so you're focusing on the things that actually matter for you instead of trying everything and feeling overwhelmed. I've put together a quiz so that you can determine what's driving your endometriosis symptoms, because all of these things influence endometriosis, but there tends to be a [00:32:00] lead driver, at least that's what I see in my clinical practice.

So if you want a roadmap, enrollment is open now, and for a limited time, I'm also including the early bird pricing, the special bonuses, which include the biweekly group calls with me, so I can support you through the process. If you wanna check it out, drbrighten.com/endocourse. That's D-R-B-R-I-G-H-T-E-N.com/E-N-D-O-C-O-U-R-S-E.

We start April 4th, and I would love to see you inside. And as always, thank you for being a part of the Dr. Brighten Show. I appreciate your support. If you can like, comment, subscribe, leave me a review, that helps this information get out to so many women. And as always, you drive the conversation, so if there's something you'd like to hear more of, like so many of you asked for this episode, please let me know, and I'd be happy to provide it.

I will see you next time.