Cutting Edge Endometriosis Care and Research with Dr. Sallie Sarrel

Dr. Jessica Drummond (00:00:03) – Hi and welcome to the Integrative Women’s Health Podcast. I’m your host, Doctor Jessica Drummond, and I am so thrilled to have you here as we dive into today’s episode. As always, innovating and integrating in the world of women’s health. And just as a reminder, the content in this podcast episode is no substitute for medical advice, diagnosis, or treatment from your medical or licensed health care team. While myself and many of my guests are licensed healthcare professionals, we are not your licensed healthcare professionals, so you want to get advice on your unique circumstances. Diagnostic recommendations treatment recommendations from your home medical team. Enjoy the episode. Let’s innovate and integrate together. Oh. Hi, and welcome back to the Integrative Women’s Health Podcast. I’m your host, doctor Jessica Drummond. Today we have such a great show for you. I’m so excited to introduce you to my friend, my colleague doctor Sally Carroll. She has been a really strong voice in advocating for people with endometriosis for her entire career, which started with her own story.

Dr. Jessica Drummond (00:01:28) – You’re going to get to hear more of that in this episode. And now she partners with Doctor Andrea Vitali, and they have produced the Endometriosis Summit within the US, now expanded to Brazil, to Europe, to Asia. And this conversation, I want you to take some notes. As always, you’re going to hear about some of the cutting edge stuff that we’re actually working on here at the Integrative Women’s Health Institute, utilizing things like hormone therapy and GLP one low dose agonists for people with endometriosis who are transitioning through menopause. Some of the hot topic research on endometriosis in terms of not just the gut microbiome, but the vulva vaginal microbiome, the bladder microbiome, all the biofilm infections, also the uterine microbiome. And we didn’t get enough time to get into this in the episode, but we’ve been working on that for a really long time. And the other thing that we have to be careful of when we dig into optimizing those microbiota and kind of piercing those biofilms, breaking down those biofilms is helping people detox slowly and effectively so they don’t have such strong die off symptoms or reactions.

Dr. Jessica Drummond (00:02:48) – But Doctor Carroll has done such good work from a physical therapy standpoint, from a vascular standpoint, from a neurologic standpoint, and in bringing together the top most skilled endometriosis surgeons who have really radically pushed the field of endometriosis excision surgery dramatically in the last just seven years, just less than the last decade. And I really think this integrative and multidisciplinary conversation is how all endometriosis care needs to be. And so does Sally. And we recognize that that’s hard to do, impossible to do for any one practitioner. The surgeons themselves are burning out. You know, they have to understand certain things to optimize the surgeries, but they also need help. They need you. They need health coaches. They need functional nutritionists. They need physical therapists and occupational therapists. They need acupuncturists and wellness professionals, fitness professionals, mindfulness and nervous system regulation experts on the teams so that they’re surgical outcomes can be optimized, and we need to be collaborating with each other. Any one practitioner cannot do it all. We have to be working together.

Dr. Jessica Drummond (00:04:15) – So this conversation is going to be talking about how we can do that, how we can do that better. And Sally is such a delight, has so much energy, and really has lived experience of navigating endometriosis through all the phases of life. So without further ado, let’s get into the episode. Hi there and welcome back to the Integrative Women’s Health Podcast. I’m your host, Doctor Jessica Drummond, and I’m so excited to introduce you to doctor Sally Cyril. She, as you well know, is a licensed physical therapist and has really pushed forward the field of endometriosis. Welcome, Sally. I want to start by diving into your story and what have you done and what has what is like the fire behind your passion for helping women with endometriosis?

Dr. Sallie Sarrel (00:05:18) – Thank you so much for having me. It’s a pleasure to be here. My fire for working with endometriosis began because it took me 23 years to be diagnosed with endometriosis, and that was someone who had access to anything in healthcare as well, as I had an entire family in medicine, and still I waited so long to be diagnosed that I had significantly advanced disease.

Dr. Sallie Sarrel (00:05:47) – And so I felt that if that could happen to me, that I wanted to take my license and make sure it didn’t happen to someone else. So I began very simply. Also, I would have surgery and surgery would help, but. It didn’t fix everything in me and I would still have pain. I would definitely have trouble recouping after surgery. And one of the things that really helped me was the pelvic PT that I was doing. And of course, I’m fairly active and I always wanted to return to sport. And when you have surgery, you can’t just go do whatever. And of course it comes out later on down the road. I have a connective tissue disorder and you have to really optimize your system. And so first I had a physical therapy practice where I worked with people one on one, and I developed techniques as well as research in the field of physical therapy to make sure that we associate endometriosis with using physical therapy. But then physical therapy is not really enough. We have to do more to optimize our system.

Dr. Sallie Sarrel (00:06:53) – We need to be making sure we’re getting the right mental health care we need to. It’s coming out more and more. Optimize our gut. For those of us in the connective tissue world, optimize your tissue. And I wanted to make sure everybody understood that it’s a multidisciplinary approach. I looked at Doctor Andrea Vitale one day we were standing in the O.R. and I said, patients should know that good surgery matters, but a lot of other things matter. And look, maybe he didn’t want to say this, but he out of his mouth follows the word, yeah, we should have a meeting. And that’s how the endometriosis summit got started. And when we first started it, the hospital donated the room that we’re going to have this meeting in, and it only held 35 people. And now and the first year we had close to 300 people. So that room didn’t work out. And now, between in-person and online, we host close to 600 people. Yeah, but our goal is to push the envelope of what’s being offered out there, because if change is to come in endometriosis, it has to come from either the people with the disease or the people working in the disease.

Dr. Sallie Sarrel (00:08:11) – We can’t just accept what’s handed to us anymore. And then the other goal is to make sure that people understand surgery is not one and done. Your system has been through a war and we have to clean that up quite a bit.

Dr. Jessica Drummond (00:08:27) – Yeah, yeah. And I think really one of the things I love so much about your summit, having spoken there years ago, really in several times since then, was your invitation to those of us thinking about the gut microbiome and the immune system and hormone impacts of endometriosis and constipation and musculoskeletal? And so that true interdisciplinary perspective, and actually the most important piece of that from a socially from those of us with a health coaching standpoint, was that you always had a sort of equal collaboration of people living with endometriosis who didn’t necessarily have clinical degrees or licensors or were not wellness professionals. They were patients who might have any other kind of job. And then, of course, what’s been so interesting to me over the last few years is all of us in health care are also humans, patients like there’s this sort of artificial divide between people living with complex chronic illnesses, which is growing every day, including endometriosis, and people who work in the field.

Dr. Jessica Drummond (00:09:46) – A lot of times that there’s an overlap, as in your case. So hearing the voice of someone managing this in their day to day life as being equal to the top surgeon or whatever, which in conventional medicine there’s such a strong history of hierarchy, you really leveled that playing field from the first time you and Doctor Vitale launched the Endometriosis Summit.

Dr. Sallie Sarrel (00:10:13) – I don’t believe that it should be nothing for us without us. and that’s how endometriosis should, be treated. And ultimately, endometriosis is unique in that the people who have the disease or work one on one for a doctor sometimes only gets 20 minutes. But a health coach, a physical therapist, certain nutritionists, they get hours with the patient and they get to hear what the disease is really like. And we can’t push the disease forward without the actual personal narrative of those with the disease. And a good example of this is what’s coming out now about the connections between connective tissue dysfunction. So mast cell dysautonomia, not always EDS, but on that spectrum and endometriosis.

Dr. Sallie Sarrel (00:11:06) – And I don’t think if the patients hadn’t pushed and started to challenge. But why am I having all these surgeries. Why is hernia comorbidity with endometrial. We never would have started to look into that connection. And I’m seeing that more and more every year. The number one thing people ask us to look at that in menopause, it’s very tricky. Menopause.

Dr. Jessica Drummond (00:11:30) – No, absolutely. I’ve been asking all of my clients with endometriosis in the last few years, because that’s one of the most interesting things about my own history. Recent history with long Covid triggered mast cell activation syndrome, dysautonomia, hypermobility, which I may or may not have always had, but I was always strong enough to be able to exercise to maintain it. And I’ve been asking my clients with endometriosis about their experience of that, and I would say 100% in the last year of if I say something like, do you have any symptoms related to hyper flexibility? Where were you in dance as a child? Was this something that was always a part of your life? How about rashes and hives and passing out a lot when you were a kid like these? Kind of maybe not fully clinical diagnoses of dysautonomia, hypermobility or MCAS, but tendencies toward that? I absolutely see that connection with endometriosis.

Dr. Jessica Drummond (00:12:31) – And so it becomes even more complicated in an environment of increasing Post-viral syndrome and more toxicity. I’m sure we’re going to see that more and more.

Dr. Sallie Sarrel (00:12:42) – Yes. One thing that’s interesting is we moved the conferences now held in Florida, even though we are a year round entity that work nonstop. But because it’s in Florida, it’s very humid here. Yeah. And we see people being more open and honest with the pots and the disorder anemia than we ever saw in New York, because I think in New York people just think like it’s a bad day. Whereas here you have to be able to cope a day in, day out, six months of the year, 95 degrees, and your shirt is soaked through. And it’s amazing how. Yeah, I think that’s really amazing. I also had a very interesting conversation about the way the mast cell this was Friday. I’ll probably butcher this, but the way the mast cell works, a lot of people with endometriosis and I almost could say the same thing, that I had cramps from the very beginning, but I was coping with it.

Dr. Sallie Sarrel (00:13:42) – And then I had a trigger and my food allergies came. My I have red or skin, which I cover, usually with suntan lotion, but and that the issue became there is on the mast cell spectrum. It’s that that one thing that triggers the inflammatory response. So the enemy was probably there. Yeah. But it wasn’t inflamed. And taking a hold of my life until until I had the trigger.

Dr. Jessica Drummond (00:14:14) – I think that’s very true. And what I’m seeing even more and more like through that lens. We used to talk about the terrible triplets, vulvodynia and bladder pain syndrome and endometriosis, which of course still does exist. But I think deeper to that is what we’ve been trying to look at for the last couple of decades around immune dysregulation, which is that mast cell that those genetic vulnerabilities, if you will, and now being exposed to a more stressful physical environment, whether it’s more environmental toxins or, like you said, moving to a more humid environment where you might notice it more, or an environment with more mold toxicity to finally a level where it triggers that activation.

Dr. Jessica Drummond (00:15:03) – And I also think, as you mentioned briefly, a lot of conversation. I’m actually just about to release a podcast on endometriosis and perimenopause and. Enterprise because the research there. We used to think of endometriosis as this estrogen driven disease. Right. And we know clearly that’s not it’s just not that simple. It used to be also the conversation that menopause and perimenopause is a cure for endometriosis, which of course it’s not just like all the other so-called cures out there, but that could even be another trigger for some of the more complex presentations and manifestations of endometriosis that the experience of perimenopause and menopause. Have you seen much of that?

Dr. Sallie Sarrel (00:15:48) – We know that endometriosis, we know from pathology on the disease that endometriosis has receptors for both estrogen and progesterone. And while it’s not sensitive to testosterone, testosterone can go through a process that plays a role in estrogen as well. And so the issue with what I believe menopause and endometriosis is that for years and years and years and years, people are told that endometriosis will be cured by menopause.

Dr. Sallie Sarrel (00:16:22) – And then you have basically 29 to 32 year old women who are either put in surgical menopause or chemical menopause, and it doesn’t provide any help. Yeah. And if you look at what’s going on in menopause research right now, we’re seeing menopause connected to Alzheimer’s. We’re seeing menopause connected to cardiac health. We’re seeing menopause even connected or lack of estrogen, a certain types of estrogen connected to breast cancer as well. And we can’t throw out the health of the person because they have this disease. And the other issue that we see is they’re people are taught well, endometriosis makes its own estrogen. So therefore you can’t treat perimenopause or menopause. And it’s really a problem. It’s a problem for the endometriosis summit because if we take one stance then the whole world is like it’s a very patient to patient stance. Yeah for sure. And but we can’t. And that’s my thing. I had a very hard time with menopause. I was 38 years old and my biggest symptom, honestly, was the insulin resistance you get with menopause, which I can get to.

Dr. Sallie Sarrel (00:17:38) – Doctor Vidal is starting to see that quite a bit.

Dr. Jessica Drummond (00:17:42) – Absolutely.

Dr. Sallie Sarrel (00:17:43) – And because don’t forget he works on the immune side with endometriosis. And it’s torturous. It’s torturous mentally. It’s torturous physically. And to be told that your best bet is to eat a lot of broccoli and that you can’t, some people need to supplement it. I was in that boat. And it’s very hard for me because I truly believe that if you’re the person who needs to supplement, who needs the hormones, then you should be able you should get a clean excision and have the disease removed. And then use the hormones. But the rest of the world is not on board. But I have a family history of heart disease. I have. I was getting insulin resistance. We have to take we have to empower people to live life beyond the disease. And there’s some sort of this is a conversation like that’s ongoing. I’m interested to hear your podcast because many in the industry don’t want me to talk about menopause, because I will throw a little wrench into this notion that women with endometriosis can never supplement with estrogen or progesterone.

Dr. Sallie Sarrel (00:18:52) – I don’t think you should do only one, by the way. I’m the person that believes you need to do both. Actually all three. But that’s different.

Dr. Jessica Drummond (00:18:59) – I completely agree with you from our perspective and clinically, what we’re starting to do and expand a lot more because of my underlying knowledge of the integration between the immune system, the gut microbiome and the nervous system, we can’t take the hormones as just like a silver bullet, right? There’s not just going to be one hormone prescription that’s almost the top of the mountain, if you will. Under that, first we have to look at how is each individual woman with or without endometriosis metabolizing her hormones? Does she have constipation? Does she have liver issues? Before we layer on supportive supplemental hormones? And I completely agree with you in the sense that then individually, how is her cognition? How is her brain fog? How is her bone health? What is her family bone history and cancer history, and all of those individual pieces, cardiovascular history. Then the right dose of the hormone, the right delivery system, the right combination of estrogen and progesterone and potentially testosterone if someone needs that personally.

Dr. Jessica Drummond (00:20:08) – But and what we’ve started looking at even more rigorously is the metabolic. Impacts. So there’s data on endometriosis that it’s a GLP. There is a GLP one deficiency in some women with endometriosis. But again.

Dr. Sallie Sarrel (00:20:24) – I interrupt you. Doctor Vidal is obsessed. It puts it lightly on GLP ones. And the, person with infertility, not just any endometrium. Yeah. And any person with endometriosis who has been able to access the GLP ones has said this is life altering. Even if I’m not losing weight.

Dr. Jessica Drummond (00:20:47) – Yes, 100%. Yeah.

Dr. Sallie Sarrel (00:20:49) – Clinically we see that. It’s amazing to hear about the. Well I can’t wait for your podcast.

Dr. Jessica Drummond (00:20:55) – Yeah. So I’ll go more into this when we I could go on for days about this, but I definitely think it’s the exact same thing when we start thinking about GLP one peptide agonists. I’ve been taking tons of peptides since I’ve had, long Covid, and it’s a whole. The good thing about peptides is they’re they are naturally occurring within the body. There are the particular FDA approved delivery of certain peptides, but we can do them at various doses in the same way that we think about hormones.

Dr. Jessica Drummond (00:21:24) – Right? Not everyone needs huge doses of hormones. Not everyone needs huge doses of GLP one. But we have data that there are GLP one deficiencies in endometriosis. And then you combine that with perimenopause and menopause and or infertility and or PCOS. And there’s a lot we can do nutritionally, like backing up to what you said in terms of broccoli and broccoli supplements. Absolutely. We want people on nutrient dense, lower carbohydrate diets, but sometimes that’s just not enough because of the environmental toxic load that we currently live in, or just the impracticality of eating perfectly, exercising perfectly, and what that can cause in someone with endometriosis or any woman, quite frankly. But certainly with endometriosis, when food is painful in some cases is actually a path down eating disorder. So we absolutely I’m obsessed, as is Doctor Vidal, around these tools, because we can vary the dose, we can personalize it, and we have data that it makes intuitive sense. So back to like your work around this. I think that we do and I understand your challenge with kind of a the platform you have with the Endometriosis Summit and kind of any sort of one size fits all recommendation.

Dr. Jessica Drummond (00:22:56) – But I think the more that practitioners can be educated in and nuanced ways to utilize hormones and GLP one agonist for people with endometriosis, there’s so many reasons, as you said, outside of the endo, to optimize your health with these other tools.

Dr. Sallie Sarrel (00:23:15) – I also think that and your coaches that are listening to or physical therapists that are listening to one of the issues in endometriosis is in the United States. It’s different in certain countries. But the endometriosis surgeon is not only doing excision, which is a long and difficult thing. There are playing radiologists, they’re playing immunologist, they’re playing now. They’re evaluating for connective tissue disorders. And we’re trying we’re doing a lot of microbiome education. And they’re now trying to do that as well as they have to do, not as in depth as the physical therapist, but they have to do the pelvic floor and musculoskeletal examination. And I sat at this conference a couple weeks ago, and they were talking about how they don’t see their children, but they can’t do less on a case because then the person doesn’t have a shot at all.

Dr. Sallie Sarrel (00:24:12) – And I think we’re going to start seeing multidisciplinary centers arise that have a health coach, that have a physical therapist that have certainly a urologist with endometriosis, you need to be working with that, but that have everything in-house because the doctors, there’s only probably 300 extortionists in the United States, and they can’t do that on every single case and not be burnt out.

Dr. Jessica Drummond (00:24:37) – Absolutely. And I think that’s an important thing to advocate for. Sometimes people are like, why isn’t all of this happening? But the reality is there aren’t enough people with this knowledge. So everyone listening to this, who is a professional, who’s a physical therapist, who’s a functional nutritionist, who’s a health coach, here’s your opportunity to collaborate with these skilled surgeons so that they can stay focused on the piece of the puzzle that they need to focus on, which includes some of those things just for a better surgery. But the pre-op and post-op is the opportunity for. Everyone else in this field.

Dr. Sallie Sarrel (00:25:14) – Yeah. I also think that there are certain trends emerging in endometriosis right now, and in order to treat those trends, you’re either going to need very advanced training as a surgeon, or you’re going to need to develop a team that works on them.

Dr. Sallie Sarrel (00:25:33) – So to me, those trends include microbiome. We had an incredible presentation by Shanthi Maling, who is research, and I’ll just go so far. You should have her on the podcast because it was a very advanced scientific discussion on the microbiome. She’d be fabulous. I’ll get you the video footage if you need it. Great. I think the microbiome and not just the gut microbiome, which I learned to you from you, they uterine and the vaginal microbiome incredibly important. And we’re working with AOA as well. And so the bladder lining the microbiome in the bladder. These are places where if there’s inflammation that is not managed properly you’re going to feel like junk. Yeah. And so important there’s even a study. It’s not like fantastic about diagnosis of endometriosis through a microbe in the vaginal microbiome. It’s very early stages of the biofilms. And the bladder can be life altering for people. So I think that’s one area that’s emerging. And what’s nice is microbiome work is not surgical.

Dr. Jessica Drummond (00:26:44) – Absolutely.

Dr. Sallie Sarrel (00:26:45) – That from even learning movement diary every day.

Dr. Sallie Sarrel (00:26:50) – And I’m not saying I love to work out. You do too, but that’s not what I’m saying. You can alter your microbiome by just doing something you love that is moving. Could be dancing.

Dr. Jessica Drummond (00:27:01) – Yeah, absolutely. And dancing is actually one of the number one things you can do for your mental health, which is also important. Yeah.

Dr. Sallie Sarrel (00:27:08) – So I think that’s one trend. And I think the biggest trend that I’m seeing is the emergence of what’s called neuropathology. And same theology is developed by Passover. He’s in Switzerland. And it’s this science of, I would say operating, but also identifying and evaluating the nerves and also the arteries and veins that may be affected not only by endometriosis but by normal adhesions, things that we can get really from tripping over a curb. But that endometriosis creates this inflammatory process in or around, and it’s mind blowing to see that type of work. And this year when they did their they do a big thing in Saint Louis for it. Doctor Lemos does that. So a little different than Doctor Passover.

Dr. Sallie Sarrel (00:28:09) – But they Doctor Passover trained him I’m assuming. And they invited the Pts in for the first time. And who speaks nerve and derma tones better than a physical therapist?

Dr. Jessica Drummond (00:28:23) – Yeah for sure. And we know so much about those of us in functional nutrition, functional medicine. We know so much about vagus toning. We know so much about the impact of that on vascular mobility, if you will. Vascular flexibility, nitric oxide optimization. So I’m really excited to hear these trends because I feel like they’re all the they’re like a lot deeper science into all the practical stuff that we’ve been doing for almost 20 years now. And now we’re seeing the real science of the impact on women, specifically with endometriosis and their symptoms.

Dr. Sallie Sarrel (00:29:08) – Yeah. And I think this is we’re going to develop a lab for it. And I think it’s something that doctors are going to need there. They once you operate on this nerve and these are deep, deep nerves in the pelvis, you can’t just say, okay, bye bye, go home, lay in bed, watch TV, because you have to really do a very decent neural tensioning program.

Dr. Sallie Sarrel (00:29:38) – You have to it’ll it’s very interesting work. And the other thing that I find fascinating is now the Orthopedists are getting involved in this pelvic pain field, which we haven’t seen in a long time. And there’s a lot of things that the person with endometriosis will continue to go back to the gynecologist for. But it’s really neural issues that you have to reach by going through the hip or by working on the hip. I’m not talking about labrum. Terrors. I’m not talking about, a hip, dislocation, things like that. I’m talking about work on the inferior glittery gluteal arteries. piriformis syndrome really isn’t piriformis, by the way. And these things. I’m. I’m excited to see that after all these years that we beg for help, for our pain, that the Orthopedists are also getting on board.

Dr. Jessica Drummond (00:30:34) – Yeah, I so talk about that just briefly. What do you think the impact is of the fact that you started the endometriosis summit? What, like ten, 12 years ago?

Dr. Sallie Sarrel (00:30:45) – Oh nice try. No longer.

Dr. Sallie Sarrel (00:30:47) – We’re going to enter our seventh endometriosis summit March 28th through the 30th, 2025.

Dr. Jessica Drummond (00:30:55) – Okay.

Dr. Sallie Sarrel (00:30:55) – I’ve been practicing like you, for close to 20 years, and these conversations that are something I cherish there. This is how you advance the lives of people with the disease or conversations like this. No one was having these 20 years ago. True. I remember I met Amy Stein on a plane ride, one of the most well known physical therapist, and I met her on a plane. And first I almost asked for autograph because I had used feel pelvic pain when nobody knew what was wrong with me. All I did was the exercises in her book.

Dr. Jessica Drummond (00:31:27) – Oh wow.

Dr. Sallie Sarrel (00:31:28) – But I remember being on that plane with her was the first time in my entire career, and I was already probably ten years into my career. I had ever met someone that understood what I was talking about on a plane. We met in security and I was like, oh my God, one recognize me? But we have groups, right? You have your group and your team.

Dr. Sallie Sarrel (00:31:52) – We have podcasts, we have the G fam, we have Pelvic Health Academy. We didn’t have stuff like that years ago.

Dr. Jessica Drummond (00:31:59) – Yeah. And I think so. So if it’s seven years, amazing what I do think the work that we’re seeing though is the advancement is happening at an accelerated pace. And we briefly before we started recording, we’re talking about the such important work that Shannon Cohn is doing. And she’s also on a previous episode of this podcast, the awareness and quite frankly, the research dollars into this basic science research around nerves, vessels, integration with orthopedic structures of the hip of the pelvic floor and the integration of that with the bladder microbiome, the vulva, vaginal microbiome, the uterine microbiome, the gut microbiome, and the nervous system. Quite frankly. Honestly, until this conversation today, I’ve hardly ever. Other than that, the major is a summit. Talk to very many people in the field who really are thinking that broadly. And so I want to commend you and Doctor Vitale, because I think you’ve really accelerated the complexity of these conversations.

Dr. Jessica Drummond (00:33:03) – And thus the research dollars are much more being directed in the right direction.

Dr. Sallie Sarrel (00:33:09) – I think. Hats off to Shannon Cohn and Enda. What, because one of the things, look, the people working in endometriosis that are making a difference, we all had the disease. And she was masterful in being able to make the disease, to make her story and everybody else’s story personal. Yeah. So once the story was personal, we could realize it’s a bipartisan issue, right? Yeah. We this is not has, you know, although there are aspects that are partisan. But yeah, the bipartisan issue and she was able to increase national research funding for endometriosis. Now we could argue about now where did that funding go to and what. And I think listeners should understand that in endometriosis, one of the biggest issues that we fight is that the majority of research coming out about the disease is driven by the pharmaceutical company. So this isn’t an anti pharma conversation. It is a conversation that if the company is funding the research, it’s never quite independent and it’s always going to have a little shred of motivation to find something more important or not more important.

Dr. Sallie Sarrel (00:34:29) – And I think in endometriosis we would love to see microbiome research. We would love to see I would I so a lot of the good stuff comes out of Brazil because they fund it differently. and even with neurophysiology and behavioral psychologists, they have research studies on that stuff that we don’t have here. But I think that we have an issue with this bias. And our goal is to find the research, find the work people are doing, find the patient who wants a voice so that nothing is biased. And actually med tech’s been a blessing on that because they can get. In different ways.

Dr. Jessica Drummond (00:35:13) – That’s really good to hear and I hear you on that. I actually did an episode on that Washington Post article on hormonal birth control and people using it, not using it. And the reality that we have to face with any kind of health care research is that there’s, at least in the United States. And I’m going to ask you in a minute about your what you’re doing now and expanding internationally. But in the United States, it’s always profit driven at some level.

Dr. Jessica Drummond (00:35:38) – And because that’s just how the system is set up, we know there’s tons of research, even about the research in terms of like negative studies not necessarily being published, that that bias is implicit within the entire system.

Dr. Sallie Sarrel (00:35:56) – So somebody who’s out there looking for grants, the grants literally state that you have to be using whatever drug it is to qualify for the grant. And yet we have such a nice little program, we even offer our program in Spanish. We would love a grant.

Dr. Jessica Drummond (00:36:14) – Yeah, yeah, I get it. Absolutely. Which is also tricky because it requires people with this extensive interdisciplinary knowledge and the surgeons who are more well trained to often practice outside of the system, which makes it more expensive for the individual patient. I don’t have an answer for that, but I think it is an important thing for us to always be aware of.

Dr. Sallie Sarrel (00:36:40) – Yeah, I think that’s a huge issue in endometriosis. And while for years on end, the surgical codes did not even reflect where the endometriosis was located. So if the enemy was on the tube or if the endometriosis was on your your reader, it was all coded the same.

Dr. Sallie Sarrel (00:36:58) – Now we have new codes, but insurance companies aren’t necessarily using them yet. So what we’re seeing is that the doctor’s offices are having to sue the state that they’re practicing in to get reimbursement at all.

Dr. Jessica Drummond (00:37:13) – Which again, takes more time and effort away from their practice. And there certainly aren’t codes for from a nutritional and functional nutrition standpoint and functional medicine standpoint to dig into personalized hormonal use, microbiome nutrition and supplementation. This doesn’t even exist in terms of what’s recognized.

Dr. Sallie Sarrel (00:37:36) – No. And that’s we within the materials summit. Of course, we we do offer CME for certain parts of it. But in order to offer for nurses, nutritionists, physical therapists, you have to have research that cites every single thing. That said, I know I see you because you offer that with your programs. But the issue becomes sometimes what we do clinically is not matching what the research that’s out there, because I feel like people don’t want to know or the research doesn’t want to hear about the microbiome when the drug is just shutting down your hormones, regardless of what it’s doing to your microbiome, they don’t want to sponsor research.

Dr. Sallie Sarrel (00:38:19) – That might be something in the contrary. And I was talking to a patient last week and they said, oh, you’re just bitter. Trust me when I say this. I’m not just bitter. This is the environment.

Dr. Jessica Drummond (00:38:29) – Yeah, absolutely. And it’s the environment for so many things that it’s absolutely true. Okay. So we have the Endometriosis Summit. You’re on your seventh year. Your goal is to bring together an interdisciplinary conversation like this, multidisciplinary and with people living with the disease, whether or not they are practicing also as health and wellness professionals. So what’s current? What’s next for you guys? What are you doing out there? We have a date.

Dr. Sallie Sarrel (00:38:58) – So we are March 25th through March 28th through the 30th, 2025. We’re going to get fired up each year. We have a theme. This year we’re getting fired up, has a little bit of a mono theme, by the way, because we’re in Disney. So it’s.

Dr. Jessica Drummond (00:39:13) – Disney.

Dr. Sallie Sarrel (00:39:14) – Yeah it’s Monas year.

Dr. Jessica Drummond (00:39:15) – Love it.

Dr. Sallie Sarrel (00:39:16) – This year.

Dr. Sallie Sarrel (00:39:17) – Last year it was Lion King okay so but now we don’t go to over the overhead. But one thing that we’re working on very hard is to hold a lab on neuropathology. So we would have open to the entire conference some lectures and some demos. And then we’ll have a lab that’ll be MDS and Pts. And I’m going to go out on a limb probably say, and an integrative health practitioner. And then we’ll talk about neural tension in the Pet section. That’ll be really cool. And we also have coming up likely a social event in New York. We’re headed to on the world tour for Italy. We’re doing a three hour bladder course because the bladder and endometriosis is so complex and involved, and I am actually working with the American Urological Association on their patient board. And we’re going to we this will be our third year that I’m invited to speak only to urologists about what endometriosis people want you, urologists, to know, because I think if we started there, then you could go for bladder pain and actually get diagnosed versus 15 years later, not understanding what your pain is.

Dr. Sallie Sarrel (00:40:38) – We got a lot going on. Yeah. And we try to listen, you know, if there’s a topic like already I’m obsessed with the GLP one. We’re going to talk about that after. But if there’s a topic that people are craving to learn about, usually they reach out to me and I try to find that to develop that for people, because people with endometriosis have no option but to turn to something like a podcast or something like Facebook, or we have a very extensive YouTube webinar series to our conference, which we always offer in-person and virtual so that you can lay in bed on a hot pack. We have no other way of getting that information.

Dr. Jessica Drummond (00:41:21) – Yeah. Yeah, absolutely. If people want to find out more about the conference and all of your other platform, what’s the quickest link for them to go to.

Dr. Sallie Sarrel (00:41:33) – The Endometriosis summit.com? And we also have a very active Instagram at. Endometriosis summit and we have lots of fun over there. There’s a lot of this.

Dr. Jessica Drummond (00:41:45) – Yeah.

Dr. Jessica Drummond (00:41:46) – That’s great.

Dr. Jessica Drummond (00:41:47) – A lot of reels over there, a lot of energy. That’s great. And we’ll also post all of the other links in the show notes so people can find you in the summit. And I’m so glad there’s this global reach now where you’re going into Brazil and finding even better, more independent research, you’re going to Italy. And I was saying I had a patient from Italy who really was like, there’s just nothing like this here in Europe. Like there’s more expansion that needs to happen because so many women all over the world are struggling with endometriosis.

Dr. Sallie Sarrel (00:42:19) – Yeah, so we do Endo summit Brazil now once a year we have Endo Summit Asia planned, which supposedly they’ll give me dates for that soon. We are offering at the request actually of our of our followers. We’re now offering Endo Summit Spanish. So we do content in Spanish. And Italy has a very active patient group. So they’re called AP. We try to partner with them. We don’t really go in there. It’ll be interesting to see because in Italy they don’t have the roundup.

Dr. Jessica Drummond (00:42:50) – Right? Yeah, right. It is very different. Yeah. It’s in Italy. So one of my long term vision board not too long term now. So I just turned 50. So I’m getting closer to hitting my vision board but is to live at least part of the year in Spain, France or Italy and the Mediterranean coast. And I’ve been to Italy almost every year for the past five years. And most of our we took a group of our clients last year, our students to the birthplace of the Mediterranean diet, the Chileno Coast, which is still a big national park south of the Amalfi Coast. And it’s very agricultural, it’s beautiful, the food is amazing, and it’s so fascinating because I’m not a I don’t have personally endometriosis, but I do now have a pretty complicated Post-viral syndrome that has a lot of similarities from an immune microbiome neurologic standpoint. And even before I had that, I’ve had some food sensitivities and things like that. And in Italy, I can eat any food without inflammation, without pain, without digestive issues.

Dr. Jessica Drummond (00:44:04) – And it’s really interesting to see the shift when you’re in a part of the world where these hormone disruptors and these microbiome disruptors are literally outlawed. It changes the inflammatory property of the food of the water because it’s not leaking into the water. And so it changes. I really believe that it changes that inflammatory load that we deal with day to day here.

Dr. Sallie Sarrel (00:44:32) – Yeah. That’s like in Canada I can eat meat. I can’t eat meat in certain areas of Canada it’s outlawed in B.C. it’s outlawed. But I can eat. We’ll see what happens. This is my first time to Italy. What happens in terms of that. But I think it also would be interesting to like in my fantasy studies to show somebody with bowel endometriosis in Italy versus somebody with bowel, and we’d have to find hundreds of patients. Sure, sure. Versus in the United States, because in the United States, I feel like no matter and I work at it, no matter how hard you work at it, you’re getting exposure to something. Oh, for.

Dr. Jessica Drummond (00:45:09) – Sure. Absolutely can end.

Dr. Sallie Sarrel (00:45:10) – Up mentally with an eating disorder because you’re so worried about that exposure. And it’d be interesting just to see like at surgery, are they more inflamed or are they to take each lesion to analyze it? This is my fantasy. When you live in Italy, we’ll make this happen. We will, we will.

Dr. Jessica Drummond (00:45:26) – And and I do think there’s this difference in also in terms of how things are addressed. Like for example, constipation in Italy is addressed by concentrated chicory which is greens. It’s it’s essentially like dandelion greens. And so there’s a different mindset to the kinds of ways that we focus on healing. But yeah, so I think there’s a lot of questions about all of those things because globally there’s no perfect environment anymore. We do have pollution and all of those kinds of things. But certainly Cilento, the and other areas that are aligned with the science of the Mediterranean diet and lifestyle, by the way, because it’s not just the food, it’s the time outdoors, it’s the amount of walking, it’s the social connectivity.

Dr. Jessica Drummond (00:46:20) – But the entire Mediterranean and centenarian lifestyle, similar kinds of things in certain parts of Asia really impacts someone’s lifelong inflammatory load without having to work so hard, to the point where there is that disordered eating risk.

Dr. Sallie Sarrel (00:46:38) – It was interesting in the neuropathology course they talked about. Now, for people with endometriosis, we in some ways loved the pandemic because we were home now and not. But it has changed the way people’s touches are. Yeah. And so you’re seeing nerve compressions and vascular compressions. And as I sit here slumped in my chair six hours a day, and in particular that we all became peloton fans or bike fans instead of running, that we did start to see a lot of changes in the way the vasculature and the nerves were compressed. So like, sitting is not good in many ways, but you and I, let’s sit some more because that’s what our lives have become.

Dr. Jessica Drummond (00:47:25) – That’s right, that’s right. Truly, I, I sit more in this job than any other, but I do now have a little walking treadmill in my office, and now it’s warm enough, even in Connecticut, to go outside all the time.

Dr. Jessica Drummond (00:47:35) – So yeah, but thank you so much. I think I just appreciate you and your work so much, your passion for this, and you’re ultimately your care for every woman who is trying to. Find that deep care for her diagnosis and not being missed and gaslit and all of the things that you had to go through. So thank you for thank you.

Dr. Sallie Sarrel (00:48:00) – Thank you for your work. I think it’s the extra piece and it’s one big piece of the puzzle. What you do.

Dr. Jessica Drummond (00:48:08) – Yeah. Thank you so much. And go check out the Endometriosis Summit. And I just love seeing how it’s expanding. So wherever you are in the world, find your closest one or the virtual option, and you can listen to many of the top voices talking about the a very integrative and multidisciplinary approach to endometriosis.

Dr. Sallie Sarrel (00:48:32) – Thank you so much.

Dr. Jessica Drummond (00:48:38) – I hope you enjoyed that fascinating and wide ranging conversation with Sally Carroll. She is such a dynamic voice in the field of endometriosis. She has the lived experience of navigating the complexities of living with this disease, and she has done really good work in bringing together surgeons, helping them improve the surgical techniques, integrating it with physical and occupational therapies, with nutrition, with work on the microbiome, with research, and is now expanding with Doctor Vidal, her partner in the endometriosis summit, to reach much wider globally.

Dr. Jessica Drummond (00:49:23) – Brazil, Italy, Canada, Asia is coming soon, so follow their work at the Endometriosis Summit. Com will list all of the other places you can find Doctor Cyril and Doctor Vidal in the show notes. And thank you so much for joining us today. I’ll see you next week on the Integrative Women’s Health podcast. Thank you so much for joining me today for this episode of the Integrative Women’s Health Podcast. Please share this episode with a colleague and if you loved it, hit that subscribe or follow button on your favorite podcast streaming service so that we can do even more to make this podcast better for you and your clients. Let’s innovate and integrate in the world of women’s health.