Spotlight on Women's Health: An Interview with Dr Jessica Theron
Name: Dr Jessica Theron
Day job: Obstetrics & Gynaecology Registrar with NSW Health
Location: Sydney, NSW
My special interest in endometriosis and chronic pelvic pain comes from my experience with my (amazing!) sister who has stage IV endometriosis. We’ve sat in many hospital beds together over the years. We’ve listened to lots of specialists and doctors, some helpful and some less helpful. We quickly realised that the health system wasn’t designed very well for people with chronic health conditions like endometriosis. We realised that things needed to change, not just for her, but for the one in five women around the world who live with chronic pelvic pain every day.
Ella is an online platform and community making care for people with chronic pelvic pain more affordable and accessible. In the app you have access to things like daily mindfulness, meditation, relaxation and CBT audio sessions, as well as guided breath-work.
We know from research that a whole person approach to chronic pelvic pain is best; using a team of providers to address every aspect of the pain experience. This includes addressing things such as diet, pelvic floor dysfunction, anxiety, pain system hypersensitivity, and nervous system dysregulation.
We’ve partnered with some amazing clinicians to put all this good stuff in one place. Our first product is a 6-week pain program delivered via our Ella app. It’s the first of its kind in Australasia and we’re pretty proud of it!
Cycle length varies a lot between individuals, but most are between 21 and 34 days. In terms of flow, bleeding tends to last for between 2-7 days, and should not be so heavy that it interferes with your quality of life.
These are some important things to look for that may indicate your bleeding is heavier than normal:
What we don’t talk about much is the fact that having a monthly period is an incredibly inflammatory physiological process. It’s a big deal for our body. We release all kinds of inflammatory chemicals to help shed our menstrual lining; the same kind that we get when our body is fighting an infection. When we’re sick, we feel a little grumpy, tired, and generally unwell - it’s the same for many women when they get their period. You can also get a bit of diarrhoea and mild cramps as the uterus contracts.
If any these symptoms are impacting your quality of life, then this is not normal and you should chat with your doctor.
In general, some red flags would be: the pain is so severe you’re taking time off work or school, you also experience pain during sex, bowel motions or peeing, you experience e severe fatigue, the pain is starting to be there most days (not just on your period)… pretty much anything that indicates to me that your life is impacted by the severity of your period pain
A term used to describe cells growing outside the uterus that are similar to those found in the endometrial lining of the uterus. It’s thought that dysregulation of the immune system is key in allowing these cells to grow and proliferate outside the uterus.
Endometriosis is most found on the surface of the pelvis, in and around the ovaries, on the underside of the uterus, sometimes on the bowel or bladder, and can even be found under the diaphragm, in abdominal scars (like caesarean section scars), or in the lungs.
The main symptoms are period and pelvic pain, bladder or bowel pain, painful sex, infertility, belly bloating, and fatigue. Some people won’t experience any pain, and others may only experience infertility and have endometriosis diagnosed during investigation of their infertility.
Dietary triggers are really variable but common ones would be alcohol and fatty foods. Saturated fats stimulate the production of pro-inflammatory cytokines and increase inflammation. Alcohol is an irritant to the gut and affects how food moves through the gut. These can both trigger endometriosis symptoms in some people, but may not do so in others. Working with a dietitian can be super helpful in identifying your unique dietary triggers.
Certain exercises like sit-ups, crunches and planks can trigger symptoms if you suffer from things like pelvic floor dysfunction. Chronic pelvic pain can cause the muscles in and around the pelvis to tighten and contract, like the pelvic floor, which can lead to pelvic floor dysfunction. This can feel like an aching pain in the pelvis, which often radiates to the back and/or thighs. Seeing a physiotherapist can help with this.
Yes! This is where I strongly encourage people to see a psychologist if you haven’t already. Living in pain everyday can be very stressful and women with chronic pelvic pain may be more likely to experience anxiety and depression because of their symptoms and how this impacts their life. It’s important to get the help you need to navigate the emotional aspects of the condition as things like stress, anxiety and low mood can exacerbate chronic pain.
Firstly, this is a big deal and I just want to say that you’ve got this. By this point you’ve probably been in pain for a long time and are desperate for answers. You’ve also probably already seen a lot of different specialists - which may or may not have been a good experience for you. My top tips would be:
Written by Dr. Jessica Theron.
Jess is an Obstetrics & Gynaecology registrar with NSW Health, and founder of Ella Health, the first-ever holistic digital platform designed specifically to address chronic pelvic pain. Head over to ellahealth.co to join the waitlist 💛
