10 minutes of Self Care is designed to be a guided grounding activity encouraging you to reflect, wonder and consider. Topics are wide-ranging and will include emotional intelligence, anxiety, self-reflection, relationships, panic, self-esteem, sex, body issues, and many more. Today’s topic: When are you most productive? This 10 minutes of Self Care will create time and space to reflect on you and productivity.
I’ve been wanting to write a blog on endo for a while. They (whomever “they” are) say the guideline for choosing a blog topic is to pick something you have mentioned to at least 3 clients. I talk about endo so much, I forget that most people have never heard of it. I can talk about endo with 3 clients in one afternoon. I, a master’s level therapist in a teeny, tiny practice in the middle of the country, know more about endo than at least half of the primary care doctors. So yeah, I should probably write a blog about it.
Let’s start off with explaining what endometriosis (or endo) is. Endo is a disease in which endometrial tissue (which belongs inside the uterus) ends up in other areas of the body as lesions and internal bleeding, impacting multiple systems. The most common being gastrointestinal, bladder, ovaries, nerves, abdominal muscles, pelvic muscles, and diaphragm. It can lead to dysfunction to all the body parts I just listed above and chronic pain.
Now, when I titled this blog, I should have added an asterisk. Periods are uncomfortable. I should amend that too and say, the 
entire menstrual cycle is uncomfortable, because ovulation and the luteal phase (roughly the week prior to your period) can come with their own annoying symptoms. We are told in health class, by our mothers and grandmothers, by culture that periods are painful, and it is normal. Normal is being uncomfortable and treating the symptoms with ibuprofen. Normal IS NOT being unable to work, attend classes, participate in hobbies, vomiting, shitting yourself, being unable to get out of bed, or having suicidal thoughts because nothing else will stop the pain.
And yet, at least 1 in 10 women not only experience what is not normal but will have multiple doctors tell them there is nothing wrong with them. It takes 8-10 years, on average, for people to receive an endo diagnosis. And in that decade, they have seen doctor after doctor, had multiple trips to the ER, been unable to work, drop out of college, lose friendships, and are not believed by family members. And even once someone receives a diagnosis, the treatment options are outdated, harmful, and can result in multiple surgeries, including unnecessary hysterectomies. The most effective option for treating the pain and the multiple systems dysfunctions is excision surgery. Which is often denied by insurance companies and is only performed by a handful of surgeons. Even with excision surgery, due to the delay in receiving a diagnosis and being unable to access (or afford) the surgery, many people are still left with chronic pain, infertility, and other dysfunctions because the damage done by the endo is so severe.
If you suspect you may have endometriosis because you experience period pain that isn’t addressed with OTC pain meds, have GI issues that doctors haven’t been able to explain, issues with urination, or pain with sex, let me be the first person who likely has said this to you: Your pain is real. Your suspicion that something is wrong is right. What you are experiencing is not normal. You are the expert of your body and I believe you.
Because it isn’t the fact that endo impacts over 190 million people worldwide and yet is grossly under researched. It is also not because women learn more about the disease from Facebook, Instagram, and TikTok than their doctors. It is not even the gaslighting women receive from those same doctors, making them believe they are crazy and need psych meds and a therapist. All of that is par for the course in women’s health. No, I am passionate and angry about endo because the economic cost of this disease is up to $119 billion in the U.S. Most of that number is due to productivity loss. Every week I meet with women who can’t work, who miss work, who forgo promotions, who can’t attend college, who struggle to graduate high school. These women are fucking brilliant, creative, hard-working, passionate, and think in ways that could change the world. And yet, are forced to devote all that energy to getting through to the next day because the medical system is broken.
For more information, check out these links below. They not only have information, resources, passion, but also ways you can help those who are living with invisible disease.
Any information provided about medical matters is purely educational and the author is not a medical professional and is not recommending any specific intervention for any specific person or giving medical advice. Please consult your own medical provider for information about your own situation
This blog post is for informational purposes only and does not create any type of therapeutic relationship. For specific assistance, please consult your own medical and/or mental health provider.
10 minutes of Self Care is designed to be a guided grounding activity encouraging you to reflect, wonder and consider. Topics are wide-ranging and will include emotional intelligence, anxiety, self-reflection, relationships, panic, self-esteem, sex, body issues, and many more.
Today’s topic: Dysregulation
Part 3 Dysregulation is a word I use that encompasses the human experience of uncomfortable emotions. It happens when our nervous system, or mammalian brain, senses a threat and activates our fight/flight system. This 10 minutes of Self Care will focus on how to recognize when you are dysregulated by noticing body sensations.
A couple of weeks ago, I received a Facebook friend request from a name that was vaguely familiar. I looked at the woman’s profile and saw she was from my hometown. I saw we had a bunch of FB friends in common, including my sister. So, I texted my sister…
Me: Who is (insert woman’s name here) and why is she sending me a FB friend request?
My sister: She is (insert family context) and she is on a MLM selling some herbal (expletive) that makes you less bloated, glowy skin all that (expletive).
Me: Ahh, so she is trying to sell me (expletive).
My sister: Yup
Me: I am currently eating cold Panda Express at 7:30pm. Pretty sure herbs aren’t going to make me less bloated.
My sister: #truth
Every day I work with women who are living with chronic conditions which usually include chronic pain. Regularly, these women tell me stories of medical providers who attribute pain and other symptoms to their weight. Often women trust doctors and blame themselves for their situation, leading to low self-esteem and hopelessness. What surprises them is my reaction to this because I get pissed off.
I will not get into the history of why the medical community continues to perpetuate these myths about weight and body size. It would only end up being a million-word blog, and at least 1/3 of those words being swear words and threats of violence. But to summarize it in a sentence… this delightfully broken system is confusing correlation with causation.
So, I want to explain some reasons (besides the all-popular “lack of self-control/discipline”) people, particularly women, can gain weight and then struggle to try to lose it.
But before I do, I will jump ahead and explain how people lose a lot of weight in a short period, and it isn’t some magic MLM drink. It’s weight-loss surgery. And I am confident in that answer because of one basic “if, then” statement. If some product/service caused a person to lose 80-100 lbs. in a year, then some richer-than-me person would have bought up the rights to that product and sold the shit of out it. Google “Ozempic” to see this in real time.
The inability to lose weight is not a character flaw. Read that last sentence again, but this time out loud. How’d that feel? I’m guessing it possibly felt fake because it is in direct conflict with the messaging we get about weight-loss in our culture.
There are reasons why meal prepping, protein shakes, and social media weight loss secrets may not work for you.
The body creates the hormone as part of our fight-or-flight response and its function is to reduce inflammation (i.e. pain). To reduce inflammation, cortisol suppresses the immune system. It also controls metabolism by controlling our body’s use of fat, proteins, and carbs. It also affects our sleep-wake cycles, regulates blood pressure and blood sugar.
Ten Effects of Excessive Cortisol
High-levels of cortisol results in body-wide dysfunction. It reduces pain by suppressing the immune system, but too much can lead to a weaker immune system and more inflammation. (Increased inflammation and a dysfunctional immune system are markers of autoimmune diseases.)
Cortisol triggers your liver to release glucose (blood sugar) for a quick energy boost. If your body doesn’t use the glucose, it helpfully stores it for later…as fat. Which means if you begin a fat-burning program, the glucose is released back into the body. And again, if your body doesn’t use the glucose, it helpfully stores it for later…as fat. Rinse and repeat. Weight gain tied to glucose is incredibly hard to lose. The body holds onto these pounds like (insert inappropriate, probably political, joke here).
Some of you may be thinking that high levels of cortisol must be linked to a rare disease or syndrome. Nope…well mostly…
Chronic stress, particularly childhood stress, is one cause. Adverse Childhood Experiences (ACEs) is a list of potentially traumatic events that occur in childhood/adolescents and, in the U.S., about 64% of adults report they have experienced at least one of them. Research has connected ACEs to an overwhelming list of consequences that affect us as adults. Including diabetes, weight gain, heart disease, depression, anxiety, cancer, autoimmune disease, suicide, substance misuse, etc. Research attribute chronic stress and activation of the fight/flight response to causing healthy body functions to become dysfunctional. This is also why you crave sweets when you are stressed. It’s the body’s way of encouraging you to give it sugar so it can turn it into glucose for energy.
PCOS: Polycystic ovary syndrome is a condition that is very common and affects 5-6 million (likely an underestimate) people in the U.S. And is the most common cause of infertility, which means the doctor most likely to diagnosis it is the gynecologist at a fertility clinic. This means that individuals who don’t seek fertility treatment are unlikely to receive an accurate diagnosis.
If you google PCOS, you will probably read that it is caused by the ovaries producing too much androgen. However, we don’t know definitively what causes PCOS. The medical community is quick to point to androgen because they find high levels in 60-80% of cases. PCOS is characterized by irregular periods, excess weight, facial hair, and thin hair. The unseen symptoms are ovarian cysts, high androgen levels, insulin resistance, diabetes, and high cholesterol.
The specific symptom I want to pull out is “insulin resistance.” Insulin is what the body uses to reduce glucose (blood sugar) in the blood by shipping it off to the cells. This relationship between glucose and insulin is important to understand because we are about to see it referenced several times. “Insulin resistance” means this relationship isn’t working, resulting in an excess of glucose in the blood because the insulin receptors burnout, producing high levels of insulin in response to high levels of glucose.
And by now, I hope it’s been well established that the body takes excess glucose and turns it into fat.
I’ve heard from dozens of women with PCOS and hear story after story about how their doctor will lecture them why they need to lose weight. Other women working with endocrinologists or fertility specialists are told that weight-loss surgery is the only way to lose weight because it’s difficult to lose body fat created by glucose.
The researchers who believe high androgen levels cause PCOS also state it is the androgen levels that cause insulin over-production, leading to dysfunctional insulin receptors leading to insulin resistance. However, other researchers suggest it is the dysfunctional insulin levels that cause androgen to increase too. Suggesting androgen isn’t causing PCOS, rather insulin resistance is.
A quick recap before we jump forward. Cortisol causes excess glucose because it triggers the liver to pump it into the bloodstream. PCOS results in excess glucose because the insulin receptors begin to dysfunction because they are overworked trying to keep up with the glucose levels.
Diabetes: I am guessing most of you have read all this information about glucose and insulin resistance and have thought about diabetes. And you would be correct to do so. Type 2 diabetes is caused when the pancreas does not produce enough insulin to keep the glucose in check and/or insulin resistance.Whereas we categorize Type 1 diabetes as an autoimmune disease, Type 2 is an endocrine dysfunction. Now, if you were to google “What causes Type 2 diabetes” the answer you will get is obesity. This is because the medical community is jumping ahead of you and answering, “What causes insulin resistance?”
I really hope that by now, you are very confused because this is where I get confused too.
And here is why, we have:
I am not a researcher, so I may be missing a very vital step, but it seems like obesity doesn’t cause insulin resistance, but insulin resistance and obesity are both caused by chronic excessive glucose levels in the bloodstream.
And if cortisol is released when the body is under stress or threatened and one of the primary effects of cortisol is causing the liver to release glucose into the bloodstream. It seems reasonable to conclude chronic stress leads to a high level of glucose.
So…wouldn’t chronic stress possibly be a cause of insulin resistance? And when doctors point to family members having the same diagnoses as being proof of a genetic component, couldn’t the same proof point to intergenerational trauma?
You now have all this information, but not an obvious answer on how to lose excess body fat. Good nutrition and being physically active are fantastic at helping the body function at its best and is great for your mental health, but not if the thought of it causes you stress because you aren’t losing weight. I recommend you find a doctor who can talk to you and conceptualize your situation in the terms I listed above. Most often I recommend functional medicine doctors, endocrinologists, or clinics that specialize in weight-loss. There are supplements, vitamins, mental health support, and pharmaceutical drugs available. However, it all may still lead to weight-loss surgery and if it does, it doesn’t mean you should feel shame, or its proof of your lack of self-control. This is for your physical and mental health, fuck all the haters who make you feel you are less than and weight-loss medication or surgery is the “easy” way out.
What are your thoughts? How are you viewing your own weight gain through this lens? Have you tried weight-loss medication or surgery and kept it a secret?
Any information provided about medical matters is purely educational and the author is not a medical professional and is not recommending any specific intervention for any specific person or giving medical advice. Please consult your own medical provider for information about your own situation
This blog post is for informational purposes only and does not create any type of therapeutic relationship. For specific assistance, please consult your own medical and/or mental health provider.
