Ep 11: Insights from an Excision Specialist - talking endo lesions, ultrasound, ovarian cysts and a new gold standard with A/Prof Mathew Leonardi

In this episode, we’re joined by clinical psychologist and sex therapist Dr Hilary Lindberg to talk about painful sex, pelvic pain and the myths many of us have absorbed about what sex is supposed to look like. We unpack the idea that good sex has to be spontaneous, penetrative, effortless and orgasm-focused, and explore what happens when pain, endometriosis, chronic illness, neurodivergence, changing bodies or simply life get in the way of that script. Hilary introduces us to the “buffet” approach to sex: broadening the menu, taking penetration off its pedestal, and focusing instead on pleasure, connection, curiosity and flexibility. We also talk about responsive desire, why pushing through pain can make things worse, learning what your own body enjoys, masturbation, ADHD and autism, communication with partners, shame, and how to start rebuilding intimacy when sex has become something you avoid. Resources mentioned Magnificent Sex: Lessons from Extraordinary Lovers by Peggy J. Kleinplatz and A. Dana Ménard

POTS is often introduced with the same advice: drink more water and eat more salt. What happens when that isn’t enough? In this episode, we welcome back cardiologist Dr Alexis Cutchins for a practical deep dive into diagnosing and managing POTS. We talk through what can be done in primary care, when further cardiac investigation is useful, how to make salt, fluid and compression actually work, and how to approach exercise without triggering a crash. Then we go beyond the basics, covering medications including midodrine, fludrocortisone, desmopressin, ivabradine and beta blockers, how blood pressure can help guide treatment, and why finding the right combination often takes some trial and error. We also discuss orthostatic intolerance that doesn’t quite meet the textbook POTS criteria, the importance of early treatment, and why people shouldn’t have to wait a year for specialist review before anyone starts helping them feel better. A practical episode for people living with POTS, the people who care about them, and health professionals wanting more confidence about what to do next.

Waiting for a pelvic pain appointment can feel like being stuck in limbo. But there are a few useful things you can get underway now, from organising some basic tests and screening to finding the right GP and starting to understand what might be contributing to your symptoms. In this episode, Alecia and Cherie talk through practical things that may help while you wait, including what your bowels may be telling you, why breathing mechanics matter, whether hypermobility could be part of the picture, menstrual hibernation, and the value of finding a GP who can help coordinate your care. There are 10 ideas in total, but this is not another giant to-do list. Pick one thing; start there.Resources mentioned in this episode: 💩 Bristol Stool Chart⁠https://www.england.nhs.uk/publication/constipation-resources-for-carers/⁠ 🚽 Constipation Scoring System / Cleveland Clinic Constipation Score⁠https://thepelvicfloorsociety.co.uk/_userfiles/pages/files/Cleveland%20constipation%20score.pdf⁠ 🦓 Hypermobility: Beighton Score + Five-Part Questionnaire⁠https://www.ehlers-danlos.com/assessing-joint-hypermobility/⁠ 💳 Medicare Safety Net⁠https://www.servicesaustralia.gov.au/medicare-safety-nets⁠ 🧪 Cervical screening and self-collection⁠https://www.health.gov.au/resources/collections/self-collection-for-the-cervical-screening-test⁠ As always, this podcast provides general information and is not a substitute for individual medical advice.

What happens when you add ADHD to an already complicated pelvic pain picture? Dr Emilie Staehr joins us to unpack ADHD through a female lens: why it’s so often missed in women, how hormones can change the way symptoms show up, and what happens when executive dysfunction collides with the demands of managing chronic pain. We talk periods, pregnancy and perimenopause, masking and burnout, and why asking someone to manage medications, appointments, physio, sleep, movement, bowel and bladder strategies can become almost impossible when ADHD is part of the picture. And perhaps most importantly: what changes when you realise you’ve been living life on hard mode?

Is it really okay to skip periods? Do you need to have a bleed every month? Every few months? And what do you do when the pill that’s meant to stop your bleeding… doesn’t? Dr Jess Floreani is back for a practical follow-up to our episode Is the Pill Just a Band-Aid? We talk about why suppressing periods can be useful for people with painful periods, pelvic pain and endometriosis, and tackle some of the common worries about whether it’s safe to skip periods and what happens when you eventually stop the pill. Then we get into the practical stuff: Slinda versus the combined pill, when to start, whether to take the sugar pills, how to skip periods, what to expect in the first few months, and how to troubleshoot breakthrough bleeding. We also cover the four-day “reset”, and when ongoing bleeding or pain might mean it’s time to try something different. And we introduce a new way of thinking about period suppression: menstrual hibernation. The bear isn’t gone. She’s just having a well-earned sleep.