Endometriosis affects at least 1 in 10 women, yet the average patient waits years for a diagnosis — often after being told their pain is normal. In this episode, Dr. Sasha Hakman sits down with board-certified OB/GYN and endometriosis surgeon Dr. Mallory Stuparich to break down what endometriosis actually is, why it's now understood as a systemic immune and neuro-inflammatory condition rather than a purely hormonal one, and how patients can push back when they're being dismissed. If you've ever been told your pain is "just part of being a woman," this episode is for you.
In this episode, we cover:
What endometriosis actually is — and why "endometrial-like tissue" outside the uterus is now understood as part of a systemic neuro-inflammatory and neuro-immune disorder, not just a hormonal one
Why endometriosis so often overlaps with mast cell activation, POTS, Ehlers-Danlos syndrome, autoimmune conditions, and migraines
The leading theories on what causes endometriosis, and why retrograde menstruation alone doesn't explain it
Normal period pain vs. abnormal period pain — and the questions to ask yourself to know the difference
Red flag symptoms beyond pelvic pain: GI issues (painful bowel movements, incomplete emptying, bleeding), bladder urgency, pelvic floor dysfunction, painful sex, and brain fog
Why the amount of pain a patient feels doesn't always correlate with how much disease is actually present
What a real diagnostic workup looks like, and why a "normal" ultrasound or MRI does not rule out endometriosis
Post-surgical hormone therapy — why suppression after excision matters, and who isn't a candidate
Adenomyosis explained: what it is, how it differs from fibroids, and treatment options including adenomyomectomy, uterine artery embolization, and microwave ablation
The links between endometriosis, infertility, and miscarriage — including why 50% of women with endo do not experience infertility
Recurrence after excision surgery, and why what looks like "recurrence" is often incomplete removal the first time around
Lightning round: Is endometriosis genetic? Can you have it with completely normal labs and imaging? Does a hysterectomy cure it? Can it still affect you after menopause?
Follow Dr. Mallory Stuparich! Instagram/social: @MalloryStuparichMD
Follow Dr. Sasha! TikTok: @sashahakmanmd Instagram: @sashahakmanmd @tryingpod YouTube: @sashahakmanmd
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