If you’ve struggled with irregular periods, you might have noticed it can be a little tricky to figure out exactly what’s going on—and, therefore, exactly what you need to do to get your period back.

In this episode, Lara discusses:

• the two most common explanations for irregular periods,
• how to tell them apart, and
• how hypothalamic amenorrhea is frequently misdiagnosed as PCOS.

Links:

• Prof Jerilynn Prior's paper about hypothalamic suppression
• PCOS cannot be diagnosed by ultrasound
• Cyclic progesterone therapy for PCOS
• Lara's metabolism book

If you’ve been diagnosed with endometriosis, the big question is: What type of lesions?

In this episode, Lara challenges long-held assumptions to explore:

• the three types of endometriosis lesions,
• emerging evidence that superficial lesions may not explain pain or other symptoms,
• alternative explanations for pelvic pain and infertility, including pelvic congestion, immune dysfunction, and gut microbiome imbalance, and
• an update on the bacterial contamination hypothesis.

Links:

• Could pelvic congestion syndrome explain your pelvic pain?
• Prevalence of endometriosis in asymptomatic women (1991 study)
• Surgical removal of superficial peritoneal endometriosis for managing women with chronic pelvic pain: time for a rethink? (2019 BJOG article)
• Bacterial contamination hypothesis (2018 paper)
• Fusobacterium infection facilitates the development of endometriosis (2023 paper)
• ANZCA 2024 Statement on pelvic pain and endometriosis

Is your low blood sugar a symptom of insulin resistance or mild dysfunction of the autonomic nervous system?

In this episode, Lara returns to the topic of hypoglycemia to discuss:

• the difference between insulin resistance and dysautonomia,
• why unstable blood sugar does not automatically mean insulin resistance, and
• her concerns about continuous glucose monitoring.

Links:

• Dr Andrew Maxwell's presentation about dysautonomia, hypermobility, and mast cell activation.