Infertility and Endometriosis | Is Surgery The Answer? | Dr. Naomi Whittaker, MD | Ep. 582

Episode 582

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Friday Podcast, episode number 582.
If you’ve ever felt frustrated by the limitations of conventional medicine, especially
when it comes to women’s health, I think you’ll find today’s episode both informative
and extremely eye -opening. In today’s episode, I’m sharing my interview with Dr.
Naomi Whitaker. She is an OBGYN fertility surgeon. She’s fellowship trained in napro
technology and the Creighton model fertility care system. And she specializes in
restorative reproductive surgery. Not only does she share about some of the challenges
to receiving a diagnosis and finding an experienced surgeon, She also shed some light
on why many American women struggle to get their surgeries covered by insurance,
obviously making it a huge barrier for many women to get the treatment that they
need, especially when their condition or symptoms are quite extreme. And before we
jump in, I’m just going to share a little bit more about Dr. Whitaker. Dr. Naomi
Whitaker is the founder of RRMacademy .org. And as I mentioned, she’s a board
-certified OBGYN fertility surgeon specializing in women’s restorative reproductive
medicine. She is fellowship -trained in the Creighton model fertility care system and
NAPRO technology, offering compassionate care that treats underlying causes of
gynecologic issues like endometriosis and PCOS. So without further ado, let’s go ahead
and jump into today’s episode.
– And I’m excited to be here today with Dr. Naomi Whitaker. Thank you for being on
the show. – Truly an honor and a privilege. So thank you so much for having me.
– Well, thank you so much for being here. I feel like we should have met by now.
So this is the first– – I know, it just feels overdue. – Totally overdue. I reached
out to you ’cause I was like, it’s about time that we have a conversation. So,
really, really glad to have you. And of course, I talk a lot, especially in my
offline life, in my practitioner program with my clients. I talk a lot about NAPRO
technology. We’ve had a variety of NAPRO technology practitioners in the background
who’ve done presentations for us and training sessions. And I always say that NAPRO
technology is kind of like the perfect version of allopathic medicine because it
really does use the menstrual cycle as a vital sign. So I’d love to start by
hearing a little bit about your story. So what drew you into medicine in general
and then what drew you further into this other area of reproductive health,
particularly NAPRO? Sure. As a child, I always was drawn to healing and I wanted to
do something big and I wanted to change lives. I wanted to save lives. I’ve always
just been someone drawn to that, to healing. And so this started when I was really
young and my parents are immigrants, they’re actually refugees. And so they always
taught me to dream big dreams. And I really took that to heart. And my family
doctor did help us as a family, emotionally and physically with our health.
And that was my exposure to medicine, just as a patient and to me there was just
so much opportunity to heal my body and soul and that was my introduction and so
family medicine was what I thought I was going to do and in a sense I am but in
a very different way in that I’m really focusing on the health of a woman and her
fertility as a precursor to the family and as a strong foundation for a healthy
family. And yeah, I accidentally stumbled upon all of this. I definitely not
interested in women’s health. So I thought at first, I actually said, OBGYN was the
one field of medicine I didn’t want to do because I thought it would be boring. I
thought it would be pap smears and STDs. And I just, that didn’t sound very
intellectually stimulating whatsoever. And so it was my experience as both a patient
going through my own women’s health, trying to figure out family planning and what I
was comfortable with there and trying out different things and really exploring things
on my own personal journey where I stumbled upon this cycle charting thing that
totally blew my mind. And I didn’t learn this until a lunch session in medical
school. It wasn’t a formal class. It was just an optional session with free lunch.
And I thought, okay, well, I’m gonna show up. I couldn’t believe that I didn’t know
any of this. I wasn’t ever taught about the physiology, the basics of the menstrual
cycle and how this opened up a whole new window into women’s health and treatment
options and and restoring health. And that drew me in. And after that,
I couldn’t look away. I kept trying to because I didn’t want the 24 hour shifts
and being up all night delivering babies, really. That was not something I was
wanting to fully embrace that work -life balance fear, but I couldn’t look away.
I did my rotation with a restorative approach alongside just the standard model.
And I kept trying to do something else and be drawn to something else and I kept
thinking, but here I could make such a difference. I could offer something more.
Yes, women can choose the standard model if they’re happy but women were flying in
from all over the world from like Poland where my parents immigrated from to Omaha,
Nebraska, of all places to get these really intricate surgeries that exposed all
these answers to all these problems that these women were experiencing for decades,
and it restored their fertility and their health. And clearly,
it spoke for itself as people were coming. That is amazing. I was,
I did myself, but I was fully laughing when you were like, “Well, I came for the
free lunch.”
I looked what happened from the free lunch. There’s a couple things I want to ask.
I always make a point of asking some of these questions whenever I get the pleasure
and opportunity to interview a doctor. But you did share that somewhere in the midst
of your training, you had this session that wasn’t even part of your official
training, and that’s where you learned all of this information about the menstrual
cycle. Could you share with us just so that everyone understands like what is kind
of the standard level of information that is part of medical school so that people
can understand? Because I think one of the hardest things for someone like myself
and for our practitioners who start working with women who want those answers is how
to explain why they can’t always get them from their regular doctors. Honestly, I
don’t think there is a standard physiology curriculum of women’s health. What I was
taught, what I remember, and I don’t know what other medical schools teach around
the country. I can’t speak for that. What I can tell you is what’s typically on
the tests, and you study for the test. So the test studies, when you take a test,
If the answer is IUD, you choose IUD, you know, like that’s kind of where you
study, study for the test.
So what I remember in my introduction to women’s health 101 in medical school was
ovulation is a risk factor for cancer. And that was my introduction.
That’s honestly what I remember, I don’t know if they said that verbatim, but it
was absolutely implied. And so that suggested that birth control was the default
better state than physiology. That was the underlying tone that I do feel like
persisted throughout my medical school and OB /GYN residency training. So I think
because we see ovulation as a dysfunction, right,
it’s hard to even describe. It doesn’t make sense that for some reason this event
that only happens to women that you would think is typically Healthy is determined
to be unhealthy. It just doesn’t make any sense. It didn’t make sense to me and it
made me question a Lot of everything that I learned after that and so to me we
don’t really have to understand it if our options are mainly suppressive and
as I’ve dove deeper over the years in this space and listen to podcasts like yours
and read naturopathic literature and books, really understanding the naturopathic
approach and integrating that into the gifts of regular good quality medicine and
healthcare and the allopathic model. If we could combine those together,
we could really advance women’s health? Absolutely. Even before we started recording
and we were talking a little bit, I shared that NAPRA technology, it’s really,
it’s such an interesting field. I only know about it because of my background in
menstrual cycle health and fertility awareness. I wouldn’t have necessarily known about
it otherwise, but it kind of is that perfect, I’m not saying it’s perfect, but it’s
like that perfect mix of allopathic medicine and actually understanding a woman’s
cycle. So, if you want to share a little bit, then how did this happen? How did
you wind up getting the, like in the surgical fellowship with the macro technology,
like share a little bit about how that all came about? Well, I really was intrigued
by the options that these gave women and the healing and the window into the body
through the menstrual cycle. And because I saw this corrective type of care and I
saw the outcomes, and I saw how there are very few people that approach women’s
health in this way, I felt a duty to serve in this way. How could I treat asthma
and pneumonia the same way everyone else does when I could have these women that
clearly desperately want this type of care. How could I do anything else? I felt
like I had no choice. Plus I was obsessed with it. I loved reading everything about
fertility and obstetrics. It was so fascinating and to have two patients in one and
now I’ve really come to a deeper appreciation of how this is just so impactful for
generations. You invest in one woman and you invest in a healthy pregnancy and
healthy offspring and that will affect epigenetics in many generations. And so it’s
just opened this beautiful doorway to just transforming human beings as a whole
through a single woman. That is amazing and very inspiring. And so for anyone who
doesn’t talk about natural technology, I’m realizing that people are like what the
heck is she talking about. So maybe share a little bit about what that is so that
people understand what it is and what that’s all about. And also introduce us to
the idea of restorative medicine and surgery and how that is different to the
standard of care for women. – Yeah, so what restorative reproductive medicine is? It’s
just good medicine. It’s just good quality medicine to restore physiology. For
example, ovulation. We’re going to support ovulation and and not suppress it,
ovulation is actually extremely healthy, a sign of health, and it’s an event that’s
the critical event of the menstrual cycle that promotes health. So we really want to
embrace ovulation and we want to support it where it needs help. So there are
different flavors of approaches that would fall under restorative medicine. Basically
anything that isn’t going to suppress or override the hormones that the body so
beautifully should be releasing and promoting health with. And so they’re different
flavors. NAPR technology is one and that stands for natural procreative technology.
And this subsection of restorative medicine really focuses on the surgical approach
and there’s also benefits to menstrual cycle tracking. So that’s the foundation.
So that’s called the Creighton Model System, and the beauty of the Creighton Model
System is that it objectively quantifies the biomarkers that a woman is observing.
So she’s educated on the menstrual cycle, more than I was in medical school, about
the physiology, about what she can observe herself, and she has this wonderful
knowledge that she observes and tracks, because women are the experts of their body.
And so we trust this woman and we entrust her with the knowledge to understand her
own body which she deserves. And we use this data to run specific tests for
hormones and then hopefully we can use that to optimize for hormones. And if we
still see biomarkers that are off, then perhaps there’s something even more going on
such as endometriosis or other women’s health diseases or reproductive issues that we
need to address surgically potentially. And so it’s a window into the body. For
example, we can see signs of inflammation and evidence of PCOS. As soon as a woman
walks in the door, if she’s charting her cycles within minutes, I know pretty much
what’s going on. Obviously, I have to confirm that and speak with her and run
tests. But I have a good idea of how to counsel her and what her cares are going
to look
It’s just, it’s, you really put into words this, it’s like I’ve been beating the
dead horse for the past however many years, that the menstrual cycle is a vital
sign and you can use it to gather information. And I mean, I am not an MD, I am
not diagnosing anybody, but what I can see can help this woman to then advocate for
herself with her healthcare professional. Because what I hear in my world is women
going from doctor to doctor to doctor with the same menstrual problems being told
that it’s just normal and sent home. And so it’s like someone like me who can read
that menstrual cycle, who’s been studying it for years, then again, I’m not
diagnosing anything, but I’m telling her, okay, ask these questions, look at these
things. This is what this is. This is the definition of this and that. It’s just
so interesting how you said because you’re saying like when she comes in with her
chart, I can look within minutes and then the tests just confirm your suspicions as
opposed to just throwing around a barrage of tests without really knowing what’s
going on.
Did you know that you can listen to real food for fertility for free with your 30
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That’s fertilityfriday .com /realfood.
So I’m kind of like thinking like where do I go next here? But maybe share with
us a little bit about, I think one of the things that fascinates me about just the
concept of NAPR technology, one of them is how few people have ever heard of it.
That’s one thing that really fascinates me. But another aspect of it is the really
high pregnancy rate that is boasted, rivaling IVF.
So why don’t you talk about that? Because not only are people not aware of this,
but they don’t even know that there’s an alternative to the traditional IVF. Yeah.
There’s so many layers unpack and you, I want to go back to what you’re talking
about, the vital signs. So if this is true, which I totally agree, and egg
carbohydrates, we’re all on the same page, no one can deny the menstrual cycle is a
vital sign. This is fact. Do doctors understand that? They don’t.
I mean, we have to know and neither do researchers. So we have systematic ignorance
of the vital basic vital sign. And so Most of women’s health research, most of
medical treatment options are so limited because they don’t truly work with the
physiology. They’re overriding it because that’s what they know, unfortunately.
The key event of this menstrual cycle is ovulation and you have to be able to
identify that and you can’t do that with any just calculator or I don’t know,
like the calendar method, we know that that’s not accurate. So it’s this elusive
ovulation. So we really, if we have a way to identify that on a reproducible scale
and make it scientific, which is what we have with the greater model system, then
we can restructure research. Research is poorly designed all over women’s health.
actually, if it’s even existing at all. And when it does, I just assume it’s poorly
designed. And typically, when I read the study, my suspicions are confirmed. And so
the question was, why do people not know about it, right? Was the first one? Yeah.
Yeah, I mean, gosh, that’s a good question. It’s there’s not a lot of money behind
it. There’s not a big pharma behind it. Unfortunately, we use bioidentical hormones,
right? So that’s the body’s hormones. You can’t really patent that very well. And
there’s a lot of competition when you can go to a compounding pharmacy anywhere in
the country. So you can’t really slap an expensive patent on it. That’s how you get
something in women’s health. That’s how you get something advertised and funded for
the FDA. That’s how you get a new gadget, Right or medication and so what we see
in the current model That’s designed in this way is repatting of the same thing
over and over in women’s health So if you see a new advertisement for a new
medication for women, it’s typically either a new form of birth control combined oral
contraceptive with a little different chemical structure or a new version of Lupron,
which is suppressing the woman’s cycle completely in a perimenopausal state,
that are menopausal state, actually menopausal. And so they’re easily able to rebrand
these, and how would women know any better that this is not new?
This is the same thing, with a more pretty label, millions and millions of dollars
behind it. So this is just good quality medicine that doesn’t have a marketing
agency. And on top of that, our healthcare system is designed for that FDA model or
medications that have millions of dollars to get approved. And for a healthcare model
that gives a pill quickly and gets people through the door quickly. And so both of
those are driven by health insurance companies and pharmaceutical companies.
So unfortunately they have the power and they don’t have any incentive with what I
do. Unfortunately, I mean, they should, I guess they haven’t been convinced. And so
most women’s health surgeries reimburse very poorly and there’s a whole history behind
that and that has to deal with how the RVU system for credits were allotted
originally in the design of the current medical model that needs to be revisited.
There’s a lot of systematic laws that hurt women built into the system right now.
That incentivizes cash pay options, organ removal procedures,
and suppressive medications. Essentially, there’s no one really rooting for the
underdog, which
Mm -hmm. The way that you explain that is just really enlightening because,
of course, what you said makes a lot of sense. There’s not a lot of money. You
did say something that I’d love for you to elaborate a little bit on, women’s
health surgeries reimbursed poorly. I would love for you to explain what that means.
And in terms of, I suppose it would be like, how do surgeons make money or how do
companies make money from surgery so we can understand why certain surgeries for
women might not be part of what they care about doing. Yeah. So unfortunately, you
don’t get reimbursed for the outcome of your surgery, the quality of your surgery,
the patient’s happy. You get reimbursed for the more things that you do and how
much that’s weighted. Technically, you want to get people in and out the OR and
turn and do as many cases a day as possible. And the quickest way to get money
that way would be organ removal. So a uterus, tube, ovary. And so this has kind of
perpetuated myths for things like endometriosis, which are very challenging to treat
surgically, which endometriosis by definition is tissue outside of the uterus that
acts like the lining of the uterus. It grows in spreads and acts like cancer needs
to be treated surgically like cancer, but it’s not reimbursed that way. So if you
actually treat it appropriately, you technically will not be able to keep your doors
open unless you charge cash. So surgeons who are thorough and cut the disease all
the way are penalized in the current system for giving good care, even though the
patients have better outcomes, now better fertility rates, better pain, improve pain,
improve quality of life, fatigue. I mean, completely transforming their ability to
function. Oftentimes, I saw one today. She said, I had a horrible times.
One week out of the cycle, she was completely bedridden. She just had surgery and
her whole life already is improved. She’s doing so much more. And so unfortunately,
surgeons to do good quality excision. First of all, it’s hard to get that training.
It does take extra training. They tend to have to go to a cash pay model because
for example, especially things like Medicaid reimbursed very poorly. So for example,
my hospital sent a charge to Medicaid for $40 ,000 for surgery I did.
And there’s a whole explanation as to why that’s a very inflated number, but they
keep inflating their number in hopes they can get any money back. Medicaid decided
to pay them back $200 for a surgery. And the laser alone that I use is $1 ,100.
So I’m not sure how this is ever sustainable right now in the current model without
major change, except if we have a cash pay system, which I don’t think is fair for
women. I don’t think it’s how many women are going to be left without proper care
if we have a cash pay model. Well, so I’m just going to ask at least one or two
more questions on this because I want to make sure I really understand. And I live
in Canada as well, so it’s a little bit different here. I don’t know how that
works. So it sounds like what you’re saying is that if someone is needing surgery,
then for other surgeries that are dealt with differently, If they do have insurance
coverage, they are likely to actually receive a reimbursement or compensation that is
at least somewhat near what the actual surgery costs. Because you mentioned cancer,
it’s different. Sorry, you’re asking if – Like outside of the women’s surgeries,
they’re not like what you’re the endo surgery example. If I needed cancer surgery or
something, and that was within or model, they wouldn’t give me $200. – Correct,
so gynecologic oncology surgery does reimburse better, and according to the stage,
for example. But you can’t upcharge for level of complexity for endometriosis, even
though it can be an extremely complicated multi -disciplinary disease. Does that make
sense? – Yeah, so again, just excuse me if these are stupid questions. I’m sure the
audience is also curious about this, though, so I don’t feel that bad. But if you
have a cancer surgery based on the stages you said that’s very complex, you said
you could upcharge, meaning that there would be a fee for that level of complexity
of surgery, because it would be acknowledged that this type of cancer is actually
difficult. But as you said, and in the research, endometriosis acts like cancer.
It creates its own blood vessel. It just establishes itself. It does all this stuff.
However, it’s not malignant. Even though it’s basically acting as cancer, and the
surgeries would be similar to a complex cancer surgery, you’re saying that they’re
just like, “Oh, no. We’re just going to pretend like it’s…” Right. They do not
recognize that. They would incentivize removing a uterus for that disease, even though
that’s not the proper
is very important information. This is, I’m actually really irritated to hear this.
It actually helps someone like me who didn’t know that, and I’m sure a lot of
women who didn’t understand, now we kind of know, it’s not even just like you’re up
against your doctor, like your doctor wouldn’t even get paid. – Right, if honestly,
just doing what they have to do to survive and how they were trained and doing the
best they can to save lives, that’s what they’re there for. They’re there to save
lives. If you’re hemorrhaging, remove your uterus. If you have a baby in distress,
do an emergency C C section. And they’re amazing people that want to do that. And
perhaps they were taught the myths about endometriosis, which is systemic in medical
training. So what, I mean, they don’t have time to go and read the latest studies
and really talk to people like endo advocates and try to figure out what’s right
and what’s wrong. They have to go with what they’re doing because they’re working so
much really dealing with major crises still births and things like that.
So we do need to give them grace and support them and kindly educate them about
the menstrual cycle about what restorative medicine looks like. And I do think that
the change will happen from the women that understand it, because they’re living it,
and there’s nothing more powerful and impactful than a person who is living with a
very debilitating disease that understands their body, that has done all the research
and tells their story. – Yes, I agree. Well, and one of the key kind of themes you
touched on it when you said that the doctor’s role is to save lives
This is not a quote, life -threatening illness. It’s a chronic debilitating illness,
but it’s not cancer and death if it just is left unchecked and it keeps growing,
whereas ENDO just destroys your life, but it doesn’t actually take it. – Correct, and
exactly. The model is designed for life -saving procedures, not quality of life,
unfortunately, right now. I would love to see that change. This is just, yeah,
I mean, I’m hanging out here because this is, it’s that explanation. And this is
one of the reasons why I think when I’m working with a client and they proudly
announced that they haven’t seen a doctor in 10 years, I’m like, wait a minute.
Like this is one of the problems because we can’t get so like, I hate that because
no one goes into med school because they want to like hurt people and like, you
know what I mean? Like if you think about it, people generally are going into this
profession to help. And so even for yourself, how did you feel when you discovered
that even though you went to med school, there was this whole other side that
wasn’t included that you had to opt to do on your own independently. You wouldn’t
have had this knowledge and experience and fellowship had you just went with what
you were taught in your initial training? – Every day is a battle. Every day is a
battle to explain this to employers, to patients that haven’t been exposed to this
understanding and break through all the misconceptions that are out there. And so
I’ve been a fighter since… I guess I was born one ’cause my parents were refugees
in the womb. They were fleeing communism. So I guess ever since the womb, that’s
kind of what my life is here for, to fight for good quality, for truth and what’s
good quality healthcare. So yeah, I would just say, that’s just been kind of my
everyday now, is that not accepting the status quo is okay. And the more I find
out, the more yes I am shocked, but the more motivated I am, especially as I have
women come to me in my practice, but also in my inbox on social media and telling
me, wow, this information changed my life. And it’s sometimes so simple. Are you
validated me? And you listen to me, you know, those kinds of things are what keep
me going. Not, I don’t ever expect to win any awards or make a lot of money this
way. But that’s not why I’m here. And so, yeah, I hope though that this kind of
medicine can be more accessible.
Well, so going back to endometriosis, you did mention that there’s certain myths that
are really prevalent in the fields held by medical professionals. Did you want to
talk about what some of those myths are? So many. It’s a disease of the uterus,
so you should remove the uterus. Clearly, that’s not. Historicomy doesn’t cure
endometriosis because it’s tissue by definition outside of the uterus. Oh my gosh,
so many, where do we begin? That stage correlates to disease severity. Oh,
a big one is infertility is a symptom of endometriosis that’s not recognized. For
some reason, every other symptom, well, pain matters only if you can’t get out of
bed. But for some reason, your three, four, five years of emotional trauma and pain
doesn’t matter in seeking that diagnosis of endometriosis. And what I did is I’m
trying to bring more access and awareness to the public. So one thing I did was I
developed a three -tier endometriosis symptom self -survey so that women can see the
symptoms for themselves on paper that I see often associated when I go in with a
camera at the time of surgery and see endometriosis. And that’s another myth.
Anemitriosis, unfortunately, is a surgical disease. That’s the only way to definitively
diagnose and treat this disease. So to me, an anemitriosis suspicion score that I
made with my survey is my brain on paper when someone walks in with their symptoms.
It includes cycle charting symptoms on there actually. You would like that. But
really listening to the woman and she knows something’s wrong, there’s a reason she’s
coming to the doctor. There’s a reason She’s interested in a significant surgery,
a significant intervention.
– Yeah, so many important ones. I don’t remember who I was speaking to recently, but
I was mentioning, well, it can be anywhere. It can be in the lungs. I interviewed
a woman who had endometriosis on her lungs and her symptoms were breathing issues in
her luteal phase consistently. – I had one coughing at blood during her period it
was there. Yeah and you mentioned infertility and so infertility in and of itself
that’s quote -unquote unexplained should certainly warrant because I know when I was
researching for real food for fertility I was looking at some studies there was a
really high correlation with infertility and endometriosis that was asymptomatic in the
sense that they or necessarily having pain, which I would fully put in there that
that’s a myth that if you don’t have pain that it couldn’t be endo because it’s
insane that women could have stage four endo with no pain just based on where it’s
located. – And yeah, I would question that narrative, right? That’s a narrative we’ve
all been told. It’s asymptomatic endo. No, what it is is our medical model has not
identified all those symptoms of enemy trials. So that’s what my survey is supposed
to do is supposed to help that, to help break that barrier of asymptomatic because
if infertility is a symptom, then clearly that’s not asymptomatic, for example. But
typically they have some other things going on, like tail and brown bleeding, low
cervical mucus, short luteal phases, luteinized -unrupted follicle syndrome, which is a
population disorder. We see these types of things with endometriosis, also family
history of endometriosis. They’re in fatigue, nickel sensitivities. There’s a lot of
things that are there. We just don’t know to look for them. We haven’t put these
dots together because, again, our foundational knowledge of women’s bodies and women’s
specific disorders is very limited, very narrow -minded,
and we should be really understanding. We need to restructure our knowledge from the
foundation up, which starts with the menstrual cycle. I’m so glad that you went into
that, because it’s just so powerful to hear that. At the end of the day, as women,
do we even notice our own symptoms after so many years of being dismissed? Exactly.
So I mean, there’s a lot of things. So it’s an invisible disease. So then we do
gaslight ourselves, too, what I’ve noticed. I’ve learned so much doing the survey and
how I brought my biases into it. So one thing I’ve noticed is women underplay their
own symptoms because they have to get through the day and they’re doing the best
they can so they’re like I’m gonna get through it and then they forget because that
day was yesterday and now they’re on to something new and they’re like so women
sometimes we do this to ourselves where we undermine our sentence or something like
well I’m just weak, I just need to push through it. And so some of it we do,
that’s one thing I’ve noticed with the survey is that we downplay it ourselves. And
then the system does the same. And so that reinforces just this whole model of,
well, it must be that not be that bad. So maybe I shouldn’t get treatment. And
then they show up for surgery. And they’re like, should I really be doing this?
That’s one of the most common questions right before we’re about to do surgery. I
hope you find something. Am I crazy for doing this? And that’s a very common thing
to say before enemy trace of surgery. Yeah, it’s that does not surprise me.
I know that over the years I’ve certainly had to expand my questionnaire to ask
very specific questions have to be very specific because I think there’s just so
much there. So many women experienced pain with menstruation were told that it’s
normal, and I was speaking with a past client a few weeks ago,
and she told me that I was the first person that ever told her that her periods
shouldn’t be ridiculously painful. She was not 20. She was a grown woman.
Yeah, it’s incredible. It reminds me of something you said earlier, which is You’re
doing lots of education on the socials and all of the work that you’re doing and I
do education and sometimes you think that it’s going to be this profound study that
you share that’s going to make this big difference, but often it’s those basic
things like giving a woman permission to acknowledge her pain, her pain that she’s
experiencing or her discomfort or recognizing that it could be cyclical, where this
weird thing that she’s experiencing happens five days before her period every time,
and no one ever picked up on that.
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episode.
And going back to the medical model and what we’re taught. We’re taught what’s
abnormal. We’re in medical school. What do we, we don’t, in general, we do a bad
job in in medical school curriculum of what’s normal. I don’t remember being taught
how often patients should be having bowel movements. What a beautiful menstrual cycle,
what the ideal menstrual cycle looks like. What is an ideal thyroid? Like we don’t,
or optimal or decent. And also the studies for thyroid were very messed up as well.
So as far as science, but we did a very bad job. We really need to understand
what’s normal before we can treat what’s abnormal. And somehow we miss that in our
curriculum. – Well, and given that it’s not in the curriculum, it’s also not in even
the minds of regular women who are trying to live their lives. So it’s interesting
because going through like the normal parameters of, I’ve had flack. I’ve had people
come at me when I say things like, oh, periods should be painful. Like, wait a
minute, you’re saying like, right? Because again, we’re I mean, it’s not only
normalized, we’re clinging to it. Don’t tell me that it’s not normal or to have
pain. Don’t tell me that that’s not normal, right? Because I had this conversation
on a podcast interview some time recently and I was sharing that the average age of
menstruation is about 13 years old and when a woman is 16 and she hasn’t had her
period yet, we should be looking at it. I got, someone came at me for that.
Some families just have later menstruation and I was like, well, I’m not saying that
just because someone’s 16 and they haven’t that they’re automatically having a
problem, we should screen it, shouldn’t we? Yeah. And then she kind of backed off.
But this is what I’m saying. We don’t even know it’s normal and we cling to this
nonsense. And women are suffering. Yeah. And we see that.
If your mother had painful periods, she’s going to tell you that’s normal and you’re
going to cling to that. Like you said, you’ve been living with it that long. How
could you have been wrong that whole time? So we have a lot of work to do and
awareness for sure. We have extra obstacles with that because it’s a very deeply
personal issue that affects us on such a cultural level,
political level. And so unfortunately, that makes women’s health messier. It’s a lot
easier to discuss how to manage a heart attack than how to manage endometriosis
because you add an endometriosis, then you add the fertility aspect pain and, you
know, it’s not life and death. It’s quality. And so that’s, you know, how much is
this woman worth technically and her ability to function. So these are cultural
phenomenons that were opening in women’s health. So it’s a very messy space to be
in. in, like you’re saying, and there’s a lot of emotions. There’s a lot of pain,
there’s a lot of trauma too. – Well, in shifting, again, like Bandometriosis
conversation is of course linked to fertility, but shifting back to those high
fertility rates of women who seek alternative care through NAPRO technology restorative
medicine, alternatives where they’re having, whether it’s a surgical procedure or other
types types of interventions outside of IVF. Talk a little bit about that because I
don’t think people know about that or even, I mean, I know that when I share this
information with clients, they’ve never heard of it. I’ll encourage them to look into
if there’s an apro doctor close to them that could provide them with more detail to
understand what’s going on in their cycle. I try to explain why it might be harder
to get a series of ultrasounds at the correct time with a doctor who hasn’t been
train that way to safe ovulations happening normally, things like that. So I’d love
for you to share a little bit about just this alternative world for women who’ve
never heard of it. – Yeah, so I would say this success rates are very difficult to
study, but I would say that the IVF success rates are not that great, okay? And
that’s for women who are lumped in this diagnosis of unexplained infertility. And now
we’re adding more and more women to that pool that likely don’t need it. Really
young women who were not given a workup, very easy to get low hanging fruit.
So IVF statistics should be very robust as far as success. But if you look at
Cochrane database, there is no strong evidence that IVF is better than expectant
management for unexplained infertility. Dive deep into different treatments such as
IUI. If you compare IUI to expectant management without properly educating even on
timed intercourse, there is no benefit to doing nothing versus IUI. Expected
management is basically not doing a medical intervention. Doing nothing and not even
teaching them about timed intercourse. They know nothing. They just random intercourse
versus IUI, there is no benefit to IUI, which is a very expensive way to time
something similar to an active intercourse. So the question is, how do we brand
these studies? They haven’t been done, proper in my opinion. What you can do is you
can look at literature reviews at specific medical conditions and compare that medical
condition of doing nothing versus this medical treatment option versus IVF,
for example. So one such example would be tubal reversal has been shown in women
without infertility that had a tubal ligation to be superior to IVF, for example.
So to me, that is not better than nature. So we do need to acknowledge that
because I have had IVF doctors come at me and say, well, perhaps I could, they
said, I could argue that egg retrieval is safer than ovulation. They just said that.
Okay, like, so that is the literal argument. Again, wow, are human interventions
better like the pill or egg retrieval? Are those better than nature? I mean, I
think we’re walking dangerous ground if we’re saying it’s better. Okay, so let’s just
say infertility is a culmination of multiple health issues stacked on each other.
It’s rarely just one. but just if we could just look at one single condition such
as something called proximal tubal occlusion. So the tube is blocked where it inserts
into the uterus. I’d use something called selective hysterosalpingogram. So it’s like
a regular HSG or tube test with dye and I have a pressure gauge to see if there’s
a partial occlusion. I can open up the tubes. This has a very high success rate
for pregnancy just that alone without addressing all the other health issues,
optimizing male side or endometriosis, just that alone we see a 30 % success rate
within three months. And this is a very, very easy short procedure that all of us
should be doing. And that’s a 30 % success rate versus IUI, which is 0 to 10%. And
I compare this to my IUI. I’m like, well, this is my less involved intervention,
because that’s how people speak now. That’s how common IUI and IVFR said, well,
infertility equals IUI IVF. Well, let me reframe that. My version of IUI is,
let me open your tubes. Let me make sure your tubes are wide open. And that’s
gonna give you 30 % versus zero to 10 % IUI success.
So you have to really, the analysis is very complicated because no two cases of
infertility are the same. So it’s very hard to study, technically think about all
the things that are not only does a woman technically have often about five things
wrong, you add the man, he’s going to have a few things wrong. And then you have
the mechanical and the hormonal component for both the man and the woman. So that’s
a lot of moving parts that are going to be very hard to put in a randomized
controlled trial. But if you piece each specific medical condition together,
When you give good medicine to it, it just makes sense. You’re going to have a
better outcome. It may take a little more time up front in some cases, depending on
the issue. But long -term, we’re not looking at a three -month view. We’re talking
six to 12 months, really, after you correct something. If you’re really looking at
the big picture, overall pregnancy rates will like, “I would be confident if the
studies were done appropriately, which again we have a whole bunch but they’re just
kind of scattered all over, and we list them at rmacademy .org /library, 2 ,500 plus
articles that you could reference for your specific condition. I would argue that if
it was done appropriately and we need better research to show this, there would be
great success. And we do see some IVF see identifying this and they do sometimes
treat specific conditions in certain cases such as enemy triosis prior to IVF so and
they see improve IVF rates from that so they’re definitely I mean there is a
widespread acknowledgement that these issues such as PCOS and enemy triosis lead to
infertility the question is how do we want to go about this And success rate is
only part of the picture. That’s not actually the most important technically, by the
way, because it’s gonna be hard to prove that. And for each case, you’re not gonna
be able to predict success, okay? But what you can control in such a difficult
situation is the impact and the outcome on their finances and on their health.
With the goal of a baby, obviously, we’re never saying we wouldn’t support someone
in that. It’s saying let’s restore health, let’s treat your disease appropriately.
This is a true medical condition and let’s support you emotionally. What helps them
financially, emotionally and physically to that outcome and then sets them up for a
healthier pregnancy really is treating the underlying medical issues head on.
And if Someone says, “Well, I have this diagnosis and I choose to do X, Y, or Z.”
I mean, that’s fine. But we really should be giving that more power to the patient
with that knowledge to truly make an informed consent. And I think we know that
that’s missing in women’s health period, but it’s missing even more in infertility.
And that’s why we see this elusive diagnosis of unexplained infertility. Mm -hmm.
Well, One, you tie this together by talking about the financial impact, the emotional
impact, and often the restorative medicine approach, it depends if it’s cash pay,
maybe not, but often it does result in a lower fee, obviously, than the IVF,
which is astronomical and not necessarily sustainable for a lot of women. However,
it’s still done, right? But then again, we are not necessarily addressing whatever
the health issue is. I think people really overestimate the IVF success rate, so
it’s really good that you point out. They’re not as high as people think, and they
certainly don’t address male factor. That is how they address male factor. >> Oh my
gosh, that’s a sore spot when we make women go through this huge process for a
male issue, and that’s hurting everyone. That’s hurting the man, it can impact his
health. If we’re ignoring his report card of health, which is the seminal fluid
analysis, is just like a cycle chart for women. Window into what’s going on in the
body and this little sperm, they’re very susceptible to oxidative stress. They tell
us when they’re in distress very quickly. It’s an opportunity for improving his
health. But how easy is it for a urologist to just say, “I wipe my hands clean.
I don’t want to deal with this fertility stuff. Just have your partner do IVF. To
me, this, this is very concerning and very upsetting. So, and that’s a whole nother
episode. But male fertility is totally, there’s no not many people doing that.
Extremely, just an abandoned field of medicine is trying to figure out male
fertility. I mean, it’s that’s there’s a crisis there as well. – Oh yeah, that’s a
whole, you’re right. That’s a whole podcast. Well, Naomi, we have covered a lot of
ground and obviously we could keep talking for the rest of the day.
But as we, I would love to end on a bit of a positive note. I mean, this is a
lot of information, this is heavy. I feel like for, especially, like for me, I’m in
this world. This information isn’t necessarily new to me, although I definitely
learned a lot from you today, But I can just imagine some of the listeners who are
now just like what is wrong with our medical system so for Women listening who are
wanting to find a good supportive doctor or practitioner For women’s health
professionals who are listening who want to help their clients advocate for themselves
and help them to find The practitioners that can support them. What would you want
us to know? What, where do we start? What do we do?
– We start with cycle chart, right? Truly understanding the science behind the
menstrual cycle, what is normal, what is going on in you and what you suspect and
doing all the research you can. And so that’s what I do with my page and what
you’re doing is getting information out there and truly trying to find answers for
yourself and be your own best advocate. And so working through your cycle chart
instructor to find the doctors that are curious. That’s basically what you need,
supportive, curious, and open to working with you and your desires. You definitely
can be an advocate for yourself and get this type of care. I’ve helped women online
get this type of care within their reach. They don’t have to have a certain label
such as natural technology. They could be a naturopath doing this or you know, a
midwife. Midwives absolutely love. I would love to teach midwives how to do this.
I’ve had people at work trying to learn from me that are midwives. They love this
type of medicine. So increase awareness through your advocacy for your own care,
sharing your stories, understanding as much as you can about the menstrual cycle. I
would say and holding your doctor accountable too for, hey, risk benefit alternatives
and offering choices, being a voice on social media, starting a ground -up movement
with what we’re calling uterus allies. We’re going to get people together and
activate them to do things like that, to feel empowered, to try to get resources so
that we can be a force from the ground up to help each other feel empowered, to
advocate for good care. Love it. Love it. Love it. Well, tell us where We could
find you on socials where your practice is if anybody happens to be fortunate enough
to be able to come into your office and anything exciting that you have on the
horizon. Sure. So I’m most active on Instagram. You can find me at NAPRO for Tilly
Surgeon. I have a website NaomiWhittaker .com. I practice in Central Pennsylvania. And
gosh, this new uterus allies club is going to be just so exciting. There’s so many
opportunities that we’re going to, things moving forward. That’s my next big project.
And I also just, I really highly recommend the three -tier enemy choices symptom self
-survey. And I wanna do more things like that, that women can identify issues for
themselves and really advocate for good care. – Well, we will be sure to link all
of those things in the show notes. Thank you so much for being here, Naomi. It was
my pleasure. And I’m so excited to share this episode. – I went by too fast.
– Totally, thank you for listening. If you enjoyed today’s episode and you’re wanting
to share it with a friend or you’re wanting to grab any of the links that we
talked about, head over to fertilityfriday .com /582. I hope that you enjoyed today’s
interview with Dr. Whitaker. As I mentioned, I found our conversation extremely
informative and I really appreciated that we touched on some topics that I hadn’t
really thought about before. And her explanation of endometriosis surgery, how it’s
more similar to an invasive cancer surgery because you’re actually going in and
carefully removing all of the diseased tissue in a way that is when you’re doing a
restorative medicine approach in a way that is less likely to create opportunity for
recurrence. And in that situation, it requires a lot of time and care,
as she said, and learning that the insurance providers really prioritize a different
type of surgery for non -life -threatening conditions shows just one of the built -in
challenges related to this specific issue. And really shed some light on why so many
women are directed to hysterectomy, not necessarily because it’s the best possible
option for them individually, but because in many cases that’s what the insurance
will cover. And that’s really the tip of the iceberg because there were just so
many important takeaways from today’s interview. So with that said,
I hope you have a wonderful week weekend whenever you’re tuning into the show. And
of course, as always, until next time, be well and happy charting. If you haven’t
had a chance to grab a copy of my first book, “The Fifth Vital Sign,” did you
know that you can read the first chapter completely free? Head over to
TheFifthVitalSignBook .com for details. That’s TheFifthVitalSignBook .com.