Author: Dani

Endo isn’t just “bad period cramps”. It’s a complex chronic condition that causes serious pain, fatigue, and other symptoms that can make working difficult. For the 830,000 Australians with endometriosis, small changes in the workplace can make a real difference in managing work and health. Here’s some ways you can make that happen.

Flexible Work Options

Flexibility is crucial for employees managing endometriosis. When pain flares up unexpectedly, having the option to work from home can be the difference between a productive day and a sick day.

• Flexibility to work from home when symptoms flare up
• Flexible working hours
• Permission to take breaks when needed
• Job-sharing options
• Provide staggered or altered return-to-work options for surgery or medical episode recovery

Leave Policies That Work

Thoughtful leave policies demonstrate that your organisation understands the realities of living with endometriosis.

• Establish a menstrual leave policy
• Separate menstrual leave from sick leave
• Offer extra leave for chronic conditions management 
• Do not require a doctor’s certificate
• Make leave easy to request
• Include everyone who needs it
• Consider including time for partners of people with periods too 

Build Understanding

Better understanding makes better workplaces. Invest in educational resources, and provide specialised training for managers so they can appropriately support team members with endo without overstepping boundaries.

• Create a safe working environment
• Help your team learn and understand more about chronic illness and how it can show up in the workplace
• Train managers to support their team appropriately 
• Keep communication open
• Make health chat normal, not awkward

Improve Communication 

Creating clear channels for discussing health needs is essential in an endo-friendly workplace. Establish confidential ways for employees to communicate their needs without having to share personal medical details with everyone.

• Speak to the staff member to understand what they need 
• Make relevant accommodations without fuss
• Be collaborative regarding return-to-work goals post surgery
• Be transparent about any issues  
• Ensure any upper management understands the situation to avoid accidental escalation 
• Make receiving support simple  
• Provide an Employee Assistance Service (EAS) if possible  

Not sure where to get started? There are many small ways you can get the ball rolling on an endo-friendly workplace (or any chronic disease—supporting people with endo creates a better workplace for everyone!). Start the conversation about chronic health conditions in your team. Check your existing policies to see what could be updated. Print out this list and not-so-subtly leave it on your manager’s desk. Even when a step seems small, it’s still a step closer towards providing the flexibility and support that can give someone with endometriosis the best chance to succeed on your team. 

Experiencing office life with endo? We want to hear your story. Share it as part of the Bodies of a Broken System project here. 

_{^{*At Astrid, while we use the term ‘women’ in our endometriosis campaign, we recognise this reflects common but incomplete medical terminology. Endometriosis can affect people across the gender spectrum, and conventional language often fails to acknowledge this reality. We welcome and support all individuals affected by endometriosis, regardless of gender identity.}}

You’re not alone—almost 1 million Australians are sharing this journey with you, and many of us have sat in doctors’ offices searching for the right words to explain what we’re going through. 

This guide will help you translate your experience into terms that doctors can understand and act upon. 

Make your pain scale meaningful 

Doctors often ask you to rate your pain from 1-10. Instead of getting stuck with numbers, try connecting them to your real-life experience to provide the correct context for your doctor. 

Pain level 4-5:
The pain interferes with my daily activities but I can still work through it with regular over-the-counter pain medication. 

Pain level 7-8:
I need to call in sick to work or cancel my plans, and can’t focus on anything else but the pain. Over-the-counter medication barely touches the sides. 

Pain level 9-10:
I need someone to drive me to the emergency room. 

Find the right words

Instead of just saying “it hurts,” here are some words that can help paint a clearer picture for your doctor. 

Stabbing: Sharp, knife-like pain

Cramping: Rhythmic tightening pain

Burning: Hot, searing sensation

Throbbing: Pulsing pain that comes in waves, like a heartbeat of pain

Dragging: Heavy, pulling sensation in the pelvis

Radiating: Pain that spreads from one area to another

Map it out 

Being specific about pain location and patterns can help your doctor to understand your unique experience.

“The pain starts in my lower right abdomen and radiates down my right leg”

“It moves from my lower back to my pelvis”

“Both sides hurt, but my left side feels like it’s getting the worst of it”

Share your daily reality 

Help doctors understand the severity of your experience by explaining how the pain affects your daily activities. 

Consider how your pain affects: 

Work life 

• Are you forced to work from home due to pain?
• How many sick days do you have to use due to symptoms?
• What adjustments do you have to make to work (e.g. heatpacks, wearing a TENS machine to work, carrying a supermarket worth of overnight pads in your work bag)?

Exercise routine

• Does your pain interrupt your exercise routine?
• Have you had to modify or give up certain physical activities?
• Are there times when even basic movement becomes difficult?

Social life and relationships 

• Do you have to cancel plans due to pain?
• Do you miss out on events or trips due to fear of pain flare ups or bleeding through?
• How does your condition affect your relationships with family and friends?
• What impact does it have on your ability to make and keep social commitments?

Intimacy

• Do you experience painful intercourse?
• Do you anticipate pain, which leads to a decrease in desire? 
• Do you experience pain spasms during intercourse? 
• Do you bleed after intimacy?

Financial impact

• How much money goes towards pain medication?
• Do you have to take unpaid time off work?
• What ongoing medical expenses do you have?
• How does this condition affect your financial security?

Track changes and patterns

Document how your pain changes. Keep a record of: 

Time of day: “The pain is worst in the mornings”

Cyclical patterns: “My pain intensifies during ovulation and menstruation”

Triggers: “My pain flares up after eating certain foods or during physical activity”

Highlight associated symptoms

Pain often brings along some unwelcome friends. Let your doctor know about other symptoms that occur with your pain, such as:

• Fatigue
• Nausea
• Heavy bleeding
• Bowel changes
• Bladder issues

Be specific about what helps and what doesn’t 

Being honest about your pain management helps your doctor understand what you’re dealing with. 

“Regular painkillers barely touch the sides”

“Heat packs only provide temporary relief”

“There are times when all I can do is just lie still and wait it out”

Tips for your doctor’s visit

• Keep a pain diary prior to your appointment as a record of your experience 
• Write down your main points and what you want to say—it can be hard to remember everything
• Consider bringing a support person who can help advocate for you
• Don’t downplay your symptoms—be honest about their impact
• If possible, book a longer appointment to ensure you have enough time for discussion

For more information on how to advocate for yourself at the doctors, read our blog written by RN & Astrid Health Clinical Manager Olivia Lackmann. 

When to seek emergency care

You know your body better than anyone. Here’s how to know when to head to an emergency room:

• Severe, uncontrolled pain that’s different from your usual endo pain
• Heavier-than-usual bleeding that soaks through a pad every hour
• Severe nausea and vomiting
• Signs of infection like fever
• Difficulty urinating or having bowel movements

Most importantly, remember that your experience is valid, your pain is real, and you deserve care that takes you seriously. Being able to tell your story clearly is a powerful step toward getting the support you need. You don’t have to figure this out alone. 

Women’s* health and pain have been minimised, misunderstood, and misdiagnosed in medical settings for too long. Despite significant advancements in medicine and healthcare technology, countless women with endometriosis, PCOS, fibromyalgia, and other conditions continue to struggle for proper diagnosis and effective treatment.

Many women report feeling unheard or undertreated in the healthcare system. When they report pain, they’re too often met with skepticism rather than solutions—told their symptoms are “just stress,” “all in your head,” or simply part of being female. 

This systemic failure doesn’t just represent a gap in care; it fundamentally diminishes quality of life, erodes mental health, and perpetuates a cycle where suffering is normalised rather than treated.

Challenging medical bias

Female pain has historically been sidelined in medical research and clinical practice, too frequently labeled as “emotional,” “hormonal,” or “exaggerated.” This dismissal leads to troubling consequences: years-long diagnostic delays, inadequate treatment protocols, and unnecessary suffering.

Here’s how you can advocate effectively for better care:

Speak up about your experience
Share your experiences openly—with healthcare providers, support groups, and on social media. Share your story, connect with others, and help raise awareness about the challenges women face in getting proper pain management. 

Stay informed and ask questions
Research your symptoms thoroughly, document your pain patterns, and come prepared to appointments with specific questions. If a provider dismisses your concerns, don’t hesitate to seek second or third opinions. 

Support research and policy change
Support organisations researching women’s health conditions, sign petitions for increased research funding, and contact elected officials about healthcare equity legislation. Individual advocacy combined with collective action creates powerful change.

Your pain isn’t imaginary, exaggerated, or something to endure silently. You deserve healthcare that takes your symptoms seriously and pursues effective treatment with urgency and respect.

The expanding role of natural therapies in women’s pain management

As more research emerges, natural therapies are being better recognised as a treatment option for women’s health issues where conventional therapies may not have been effective. 

The phytocannabinoids found in cannabis plants work by interacting with the body’s endocannabinoid system—a complex network that helps regulate pain perception, inflammatory responses, and mood stabilisation. For many women, these natural alternatives offer meaningful relief with potentially fewer severe side effects than conventional analgesics like opioids, providing a valuable option when first-line treatments haven’t delivered adequate results.

Natural therapies (CBD and THC containing medicines) are gaining recognition as a pain management tool for women’s health conditions, like endometriosis, where conventional first-line therapies have not been effective. Some common dosing formats include:

• Oils and edibles: Longer-lasting effects, but have slower onset.
• Wafers: Quicker acting than oils/edibles, avoiding vaporisation, can be another effective option for breakthrough pain. 
• Topical and PV creams: Can be useful for cyclical pelvic pain.
• Vaporisation: Offers quicker relief for breakthrough pain.

Natural therapies may also help address other conditions women with chronic pain can experience, including sleep disorders, and mental health issues.

In addition to their direct pain-relieving properties, natural therapies may also help reduce reliance on pharmaceutical painkillers, including NSAIDs and opioids. Many women seek alternative options due to concerns over side effects, long-term dependency, or medication resistance. 

A discussion with a specialised doctor is important. A medical professional with expertise in natural therapies can develop a personalised treatment plan tailored to your specific needs, ensuring your care is safe and effective.

Final thoughts

Women deserve better recognition and treatment of their pain. The stigma surrounding women’s pain and alternative natural treatments is slowly changing, but there is still work to be done. If you’ve faced challenges in pain management, know that you’re not alone, and that your voice matters in the fight for better women’s health care. 

If you’re curious about natural therapies, you can organise a complimentary nurse chat with the Astrid team. 

OLIVIA LACKMANN

Olivia Lackmann is Astrid Health’s Clinical Manager, and a Registered Nurse with experience in specialty surgical nursing, palliative care, and general practice. Olivia is committed to guiding and supporting patients in achieving better wellness. She has spoken with hundreds of women suffering from debilitating chronic conditions like endometriosis, adenomyosis, and PCOS, and has gained valuable insight into their stories, experiences and treatment outcomes. 

_{^{*At Astrid, while we use the term ‘women’ in our endometriosis campaign, we recognise this reflects common but incomplete medical terminology. Endometriosis can affect people across the gender spectrum, and conventional language often fails to acknowledge this reality. We welcome and support all individuals affected by endometriosis, regardless of gender identity.}}

Managing endometriosis is often as much about emotional wellbeing as it is about physical symptoms. Here’s why maintaining boundaries that help preserve your energy and protect your mental health are so important. 

I think the ‘Spoon Theory’ offers a really useful metaphor to help us think about the experience of living with a chronic illness like endo, particularly how our energy and resources are limited so need to be carefully managed.  

In the theory, spoons represent units of energy. A person in full health might wake up with an unlimited number of spoons, whereas someone with a chronic illness wakes up with a set number, and every activity they do—getting out of bed, having a shower—uses a spoon. Once they’ve used all of their spoons, they’ve used all their energy for the day (and can go into a spoon deficit).

The Spoon Theory helps us to understand why setting boundaries and being intentional about where we allocate our ‘spoons’ (and where we don’t) is so important for our mental and physical health. It can also be helpful when trying to communicate to others that we have limits to how much we can do and take on. 

But first, what exactly are ‘boundaries’? Boundaries are like personal limits or guidelines that individuals set in order to take care of themselves—emotionally, mentally, and physically. Think of them like protectors, guarding your energy and mental health. These limits include how much energy you give to certain things (e.g. people, work, social media) and what you say ‘no’ to that would use too many ‘spoons’. 

The benefits of maintaining boundaries around your energy and mental health include: 

• Conserving your energy for what matters most to you
• Prioritising your health and wellbeing needs
• Being more in tune with your mind and body 
• Avoiding overwhelm, burnout, anxiety and depression
• Feeling empowered and more in control
• Maintaining healthier, more supportive relationships 
• Feeling more balanced and centred within yourself
• Better management of pain and symptoms 

But setting and maintaining boundaries isn’t always easy. It can be difficult to say ‘no’, express our own needs and priorities, and risk potential conflict or disapproval from others. The good news? With awareness, support and practice, setting boundaries is a skill that can be learned. In fact, I’ve seen clients who have struggled with boundary-setting grow into very confident boundary setters. 

Here are some tips for setting and maintaining healthy boundaries around your energy and protecting your mental health:

• Remind yourself that you are the expert on your body and your life, and only you know what your limits are (and what the consequences are if you go beyond them).
  
• Try to view your boundaries as preventative healthcare; like exercise or diet. Remember, rest is proactive and productive!
  
• Be simple and concise in your communication with others, resisting the need to over-explain or justify your decisions or needs to everyone. Try communicating your limits as if they are any other ‘neutral’ statement. Like “thanks for the invite but I’ve already got something on earlier that day so I’ll need to rest”.
  
• Try to surround yourself with supportive, understanding people who respect your boundaries. It’s okay to distance yourself or let go of relationships that feel draining or people who invalidate your experience. Sometimes there will be people who don’t like it when you start to set boundaries. This is when it’s helpful to return to your ‘why’—you don’t have an unlimited supply of spoons, and you need to prioritise where you use them so you can feel the best you can.
  
• Work on becoming comfortable with saying ‘no’. Sometimes we can be conditioned to think saying ‘no’ is selfish, but it’s actually an act of self-respect and self-care. If you know you find saying ‘no’ difficult, and tend to prioritise others’ needs and wants ahead of your own, it may be helpful to reflect on why this might be. Sometimes when we better understand where a roadblock is coming from, we can better navigate around it. And remember that it’s okay to start small. Practice saying ‘no’ in low stakes situations, like ‘no’ to more cake at a party, and build your confidence from there. Having a personal ‘no’ script ready to go can also help take the pressure off in the moment. Something like ‘I can’t take on anything else right now’ can apply to lots of different situations.
  
• We often think of boundaries as something that relates to how we interact with the external world, but it’s just as important to develop and maintain healthy mental boundaries. This might look like challenging perfectionism and unrealistic expectations of what you ‘should’ be able to do, by replacing self-critical thoughts with self-compassionate ones. Or noticing that when we scroll on social media for too long, it depletes us of energy or negatively affects our mental state, so we set boundaries around the amount of time or energy we give to it.

Setting and maintaining boundaries is not just a way to protect your energy and mental health, but a powerful act of self-respect that can help you feel more in control and empowered, and enable you to navigate life with endo with more confidence.    

ANGIE MASHFORD-SCOTT 

Angie is a counsellor and therapist specialising in mental health care and support for those with endometriosis. Angie believes that individual support must work in tandem with broader advocacy and awareness-building to create meaningful change. Along with the launch of the endokind podcast this March, she actively collaborates with other change-makers in this space and serves as a leading member of the International Endo Violence Collective. 

www.endokind.com.au

IG: @endokind_au

What IS endometriosis?

In simple terms, endometriosis is when tissue similar to your uterine lining decides to go rogue and grow places it absolutely shouldn’t—ovaries, fallopian tubes, intestines, and sometimes even lungs or other far-flung locations. Unlike your regular period tissue that has an exit strategy, this stuff has nowhere to go. It causes inflammation, forms scar tissue, and can make life very painful for the person it’s growing in. 

Unfortunately, endometriosis remains widely misunderstood, misdiagnosed, and mistreated within healthcare systems worldwide. Patients are often left to navigate a web of complex misinformation.

So, if you’ve ever been told “it can’t be that bad” or to “pop a painkiller and push through”, this blog is for you. 

Let’s cover some of the most common myths and misconceptions about endometriosis. 

Myth 1: It’s just bad period pain

This dismissal of pain as a normal part of menstruation represents both a medical failure and a cultural problem that needs addressing. Many endometriosis patients report being told from a young age that severe period pain is something they simply have to endure. 

While mild discomfort during menstruation isn’t unusual, pain that interferes with daily activities, causes vomiting, or requires strong pain medication is NOT normal. Endometriosis pain differs from typical menstrual cramping, and can occur all throughout the month, not just during periods; and can occur throughout the body, not just in and around the pelvis. 

Myth 2: It’s all in your head 

Endometriosis is a physical disease with clearly observable pathology. While chronic pain can certainly affect mental health, the pain itself stems from biological processes including inflammation, nerve irritation, and organ dysfunction.

The psychological dismissal of physical pain has a long history in women’s healthcare. Endometriosis patients frequently report being told their symptoms are psychosomatic, anxiety-induced, or exaggerated. Some are referred to psychiatrists rather than gynecologists, prescribed antidepressants instead of pain management, or simply told to “reduce stress.”

Nothing says “medical misogyny” quite like telling someone their very real physical pain is just their imagination running wild. This dismissal doesn’t just delay diagnosis—it makes people doubt their own experiences and hesitate to seek the care they desperately need.

Myth 3: Pregnancy will cure endometriosis

Ah, the classic “use a whole human being as a treatment plan” approach. Not only is this advice wildly inappropriate (babies aren’t medicine, folks!), it’s also just flat-out wrong.

While pregnancy might temporarily suppress symptoms for some people thanks to hormonal changes, endometriosis can come roaring back after delivery. Plus, many with endometriosis struggle with fertility in the first place, making this advice extra salt in the wound.

Myth 4: A hysterectomy will cure endometriosis

“Let’s just take out your uterus.” Hysterectomy (surgical removal of the uterus) is often presented as a definitive cure for endometriosis. And the hysterectomy solution gets tossed around like it’s no big deal. 

But since endometriosis, by definition, occurs outside the uterus, removing the uterus alone will not eliminate the disease or its symptoms. While some patients experience symptom improvement after hysterectomy with oophorectomy (removal of ovaries), which reduces estrogen that can fuel endometriosis growth, it’s not a guaranteed cure. 

Myth 5: Menopause will cure endometriosis  

Allegedly, when your hormones change and periods stop, endometriosis magically disappears! Except… it doesn’t work that way for everyone. While some people do experience relief after menopause (natural or surgical), many continue to have symptoms. Those pesky endometriosis implants can still cause inflammation and pain even without the monthly cycle triggering them. Not to mention that hormone replacement therapy, which many use to manage menopause symptoms, can actually stimulate endometriosis lesions and bring back symptoms.

Plus, being told to just suffer through potentially decades of pain until menopause arrives? That’s not a treatment plan—that’s a sentence.

Endometriosis is not simply “bad periods”—it’s a complex, whole-body inflammatory condition that deserves proper attention, research, and treatment. The current state of care reflects deeper cultural issues in medicine that harm real people every day. For now, we can speak up about our experiences, support endo research, and share the realities of life with endometriosis to help others truly understand the endo experience. 

We want to hear about your lived experience with endo. Share your story here and help us point the spotlight on endometriosis.

Living with endometriosis can be overwhelming. The pain, fatigue, and other symptoms can make day-to-day life tough. While medical treatments like surgery and hormones are important, many people find that adding natural approaches helps them feel better overall. That’s where Naturopathy comes in.

Naturopathy can be a key part of a holistic care plan, focusing on diet, herbal medicine, and lifestyle strategies that may help manage inflammation, hormonal imbalances, and gut health—key factors in endometriosis symptom management. 

This guide shares practical naturopathic strategies that can work alongside your regular treatment plan. 

Key factors contributing to endometriosis symptoms

Liver Support

The liver plays a crucial role in hormone metabolism, including breaking down and eliminating excess oestrogen, which can contribute to endometriosis symptoms.

How naturopaths help: Using specialized herbs and nutritional support to enhance liver detoxification pathways, helping your body more effectively process and eliminate excess hormones that may be driving symptoms.

Gut Health Optimization

Studies suggest that gut bacteria and inflammation can significantly influence endometriosis symptoms. Lipopolysaccharides (LPS) found in the gut have been linked to increased inflammation in endometriosis patients.

How naturopaths help: Prescribing specific herbs, probiotics, and dietary recommendations to promote a healthy gut microbiome and reduce inflammatory triggers.

HPO Axis Regulation

Endometriosis is an oestrogen-dominant condition, and disruptions to the HPO (hypothalamic-pituitary-ovarian) axis can further impact hormone balance. Naturopaths may use herbs and nutritional support to help regulate this system and promote hormonal equilibrium.

How naturopaths help: Using targeted herbs and nutritional supplements to help regulate this important hormonal system and promote better hormonal equilibrium.

Anti-Inflammatory Support

Chronic inflammation is a key driver of endometriosis pain and progression.

How naturopaths help:

• May recommend a diet rich in anti-inflammatory foods such as omega-3s, turmeric, and ginger
• May recommend avoiding highly inflammatory foods like processed sugars, dairy, and gluten
• Suggesting herbal remedies to naturally reduce inflammation

Lifestyle tips for endometriosis

Beyond naturopathy, these lifestyle changes can make a significant difference. 

Eliminate BPA Plastics

Long-term exposure to plastic particles, especially those containing BPA, can contribute to hormone disruption. Since endometriosis is a hormone-driven condition, switching to BPA-free alternatives is essential.

Seek Pelvic Floor Therapy

Pelvic physiotherapy can help relieve pain by addressing muscle tightness and dysfunction in the pelvic floor—issues often experienced by those with endometriosis.

Track Your Cycle

Tracking your cycle can help identify symptom patterns and triggers throughout your menstrual cycle, allowing for more proactive management strategies. 

Build a Support Network

Endometriosis can take a significant toll on mental health, contributing to anxiety and depression. Finding a supportive network or working with a psychologist can be invaluable for your mental wellbeing.

The power of a combined approach to care 

Naturopathy works best as part of your overall care plan, not as a replacement for medical treatment. Many of our patients find that combining conventional medicine with these natural approaches gives them better symptom control and improved quality of life. Every person with endometriosis is different, so what works for one might not work for another. The key is finding the right mix of treatments that works for your unique situation.

Want to try a holistic approach to your endometriosis care?

If you’re interested in exploring a naturopathy consultation, you can book a consultation with Georgina Phin here, or organise a free nurse chat with an Astrid team member to see if naturopathy may be right for you. 

GEORGINA PHIN 

Georgina is a clinical Naturopath who holds a Bachelor of Health Science (Naturopathy). She grew up in Melbourne, and now resides on the South Coast of New South Wales. Georgina has experience working in compounding pharmacies, as well as consulting roles in clinical practice. She is very passionate about educating patients on the gentle practice of Naturopathy, and the many benefits of natural therapies. She also loves being able to collaborate with practitioners of other modalities to give patients positive outcomes and reach their health goals. Georgina is particularly interested in assisting patients with their reproductive and mental health concerns, as well as supporting patients with chronic pain, and offering education on general wellbeing and nutrition. 

$31,000 AUD. That’s the average cost Australian women* with endometriosis incur per year, according to a 2019 study by Western Sydney University. This substantial figure encompasses not just direct medical expenses, but also lost work productivity, alternative therapies, pain relief accessories, and mental health support. 

This figure is echoed in personal accounts, such as those shared on QENDO’s What It Cost Me series, where patients highlight not just medical fees but the overall expenses associated with managing the condition.

For the estimated 830,000 Australian women living with endometriosis, the question becomes not just about managing the condition, but doing so in a financially sustainable way. 

Let’s explore the three main avenues available: public healthcare, private treatment, and the emerging option of medical tourism.

The Public System: Free but Slow

The Australian Government recently announced an expansion of Endometriosis and Pelvic Pain Clinics nationwide as part of the National Action Plan for Endometriosis, aiming to reduce diagnosis timeframes and improve access to care.

Pros:

• Free treatment through Medicare
• Access to new Medicare-funded MRI scans
• Part of the National Action Plan for Endometriosis

Cons:

• Extended wait times
• Limited choice of specialists
• Resource constraints

The Private Route: Faster but Costly

Private healthcare offers quicker access to specialists and a wider range of treatment options. However, it comes with a hefty price tag.

Pros:

• Reduced waiting periods
• Choice of doctors and hospitals
• Better access to comprehensive scans

Cons:

• Higher out-of-pocket costs
• Variability in coverage
• Potential for additional charges for tests and procedures

The Medical Tourism Option: Another Perspective

For those willing to look beyond Australian shores, medical tourism presents an intriguing alternative. Countries like Singapore, Thailand, Romania, US, India offer advanced endometriosis treatments.

Pros:

• Potentially lower costs than Australian private care
• Access to international specialists and cutting-edge treatments
• Shorter wait times

Cons:

• Risks with follow-up care
• Potential language and cultural barriers
• Travel costs and logistical challenges

There are various reasons one might consider going international in their search for medical care. From financial constraints to timely access to the latest treatments, many women with endometriosis are exploring medical tourism. 

The Wellborn Network in Bucharest, Romania, led by Dr. Mitroi Gabriel, has gained attention among endometriosis patients worldwide. With many Romanians fluent in English, communication barriers are minimised for Australian patients.

Sample Treatment Costs (As of February 2025)

Procedure	Price ROM	Price AUD
Laparoscopic treatment of stage I-II endometriosis	10,390.00	3,430.67
Laparoscopic treatment of stage II-III endometriosis without digestive/urological resection	12,950.00	4,275.46
Laparoscopic treatment of stage III-IV endometriosis with digestive resection	32,650.00	10,778.17
Excision of parietal endometrioma	7,850.00	2,591.23

*Note: Prices are based on the exchange rate of 1 RON = 0.3301 AUD (as of February 21, 2025). These rates are subject to change, and additional costs for travel and accommodation may apply. This article is not affiliated with any medical provider and is intended for informational purposes only. Always consult with a healthcare professional before making any decisions. Treatments are individualised and you might need other procedures not covered by this list.

Making an informed decision

Ultimately, the best choice depends on your individual circumstances, including the severity of your condition, financial situation, and personal preferences. Consult with healthcare professionals, do thorough research, and consider participating in endometriosis research studies to contribute to future advancements in care.

The journey with endometriosis may be challenging, but with expanding options and ongoing research, there’s hope for better, more accessible treatment for all affected women.

A snapshot of considerations

	Public Healthcare	Private Healthcare	Medical Tourism
Cost	Free treatment through Medicare	Higher out-of-pocket costs	Potentially lower costs, but varies by country
Wait times	6-8 years average for diagnosis	Shorter waiting times for specialist appointments	Generally shorter wait times
Choice of doctors	Limited choice of doctors	Choice of doctors and hospitals	Access to international specialists
Access to advanced diagnostics	Access to new Medicare-funded MRI scans	Better access to comprehensive scans, but with cost gaps	Varies by country and facility
Treatment options	Part of the National Action Plan for Endometriosis	Access to a wider range of treatment options	Possible access to treatments not available in Australia
Continuity of care	Consistent follow-up within the public system	Consistent follow-up with chosen specialist	Challenges with follow-up care after returning home
Language and cultural considerations	Services in local language and familiar culture	Services in local language and familiar culture	Potential language barriers and cultural differences
Insurance coverage	Covered by Medicare	Covered by private health insurance (with gaps)	May not be covered by Australian insurance
Travel requirements	Local treatment	Local treatment	International travel required
Legal protections	Australian medical and legal system	Australian medical and legal system	Varies by country, potentially limited recourse

Meanwhile, your life is on hold—relationships strained, career opportunities missed, and simple joys of life overshadowed by relentless pain. 

You’re not alone, and more importantly, you’re not imagining things. Unfortunately, the history of endometriosis care is deeply intertwined with medical misogyny.

What is medical misogyny? 

Medical misogyny refers to the systemic bias and discrimination against women within healthcare systems. It’s not just about individual doctors with outdated views—it’s embedded in medical education, research priorities, clinical guidelines, and healthcare delivery. This bias manifests as women’s symptoms being dismissed or psychologised, their pain undertreated, their conditions underresearched, and reproductive concerns being considered ahead of their quality of life. 

Medical misogyny isn’t always conscious or intentional; it’s often the result of longstanding cultural attitudes and knowledge gaps that have been institutionalised within medical practice.

Medical misogyny is nasty, but it’s very real—and it’s affecting the rate at which women’s medical care can advance.

Here’s how it’s manifesting in our medical system today.

The Pain Bias

Studies consistently show women wait longer in emergency rooms, receive less pain medication, and are more likely to have physical pain symptoms attributed to mental health issues. Women’s pain is, statistically, taken less seriously than men’s. In fact, women are more likely to be prescribed psychotherapy rather than pain medication compared to men presenting with identical symptoms. For endometriosis patients, this translates to years of having legitimate pain dismissed, undertreated, or attributed to psychological causes.

Research Funding Gap

Endometriosis affects roughly as many people as diabetes, yet receives a fraction of the research funding. This disparity shows exactly how conditions primarily affecting women rank on the medical priority list (spoiler: not high). 

The “Fertility-First” Approach

Some of us just want to exist without pain, regardless of our reproductive plans. But traditional endometriosis treatment focuses heavily on preserving fertility, even for patients who have zero interest in having children, rather than addressing pain and quality of life.

The system should place the person above the potential of a person, but some endometriosis patients are turned away from surgical options as “they might want children later”. While fertility concerns are very valid for many endo-warriors, the assumption that every woman’s main concern is baby-making is both outdated and harmful. It reinforces the problematic notion that a woman’s primary value lies in her reproductive capacity. 

Diagnostic Delays

Imagine if men had to wait 7-10 years for a diagnosis while a condition progressively damaged their organs. There would be protests! Public outrage! Special task forces! Yet, for endometriosis patients, this wait time is a reality. It’s a systemic failure that simply wouldn’t be tolerated for conditions predominantly affecting men. These delays allow the disease to progress, often leading to more severe symptoms, additional organ involvement, and decreased treatment effectiveness. 

Where do we go from here? 

• Medical education reform is needed
  Medical professionals-to-be need better training on recognising symptoms early, understanding the varied presentations, and taking patients seriously from day one. The current “one lecture on endometriosis” approach clearly isn’t cutting it.
  
• Don’t let ‘The Man’ get you down
  If you’re dealing with symptoms and getting nowhere, trust your gut. Document everything. Find doctors who listen (they do exist!). Connect with support groups online where others understand what you’re going through. You are your own best advocate.
  
• Demand better research
  We need more funding, more studies (like the EndoCann Clinical Trial from Astrid and Western Sydney University), and more options beyond “hormonal birth control or surgery.” Period. (Pun absolutely intended.)
  
• Change the conversation, change the cultural attitude
  The normalisation of menstrual pain and the dismissal of women’s health concerns are cultural issues that extend beyond medicine. So let’s stop normalising period pain. Let’s talk openly about symptoms. Let’s teach young people about what’s normal and what’s not. The sooner we stop accepting suffering as inevitable, the sooner we can change the system.

Perhaps the most radical act in a system steeped in medical misogyny is simply this: believing women when they say they’re in pain.

Medical misogyny and gender bias shapes our healthcare experiences, research priorities, and treatment approaches. Your pain isn’t just physical; it’s the result of systemic failures that have consistently pushed women’s health concerns to the periphery of medicine.

But here’s the thing about systems: they can change. They must change. And that change begins with each of us refusing to accept the status quo.

Your story matters. Your experiences are evidence of a broken system that needs fixing. By sharing them, you help create the momentum needed for real, lasting change in how endometriosis—and all conditions affecting women—are approached.

Submit your story to the Bodies of a Broken System project, and add your voice to the growing community demanding better care, better research, and better outcomes for all of us.

If you have endometriosis, you have probably already encountered how frustrating and isolating it can feel when pain interrupts intimacy. Sex becomes something to endure, and the anxiety around it can make even the idea of being sexual feel overwhelming.

Pain during sex is common in people with endometriosis, but it is not something you should just tolerate. Pain tells your body that something is wrong and when you ignore that signal, your nervous system learns that sex is something to be feared, and perhaps even avoided. Over time, this can create a cycle where even the thought of sex triggers anxiety, making penetration more painful due to muscle tension and reduced arousal. 

The pain is your body’s way of saying; I don’t feel safe doing this. And if sex doesn’t feel safe, pleasure isn’t going to happen.

The psychological side of pain and sex

Anxiety is a very common response to pain. Anxiety about pain can make it difficult to relax, which in turn makes pain worse. You might start avoiding sex – or any kind of touch – completely, worrying that it will lead to discomfort or disappointment, and this can create real distance in our relationships. 

And that’s where pressure comes in – the ultimate desire killer. The pressure to “perform,” to be a “good partner,” to meet expectations (yours or someone else’s). But sex isn’t a duty, and your pleasure matters just as much as anyone else’s. If penetrative sex is painful, it doesn’t mean your sex life is over. It just means it’s time to expand what sex means to you.

Expanding the sexual menu

Sex does not equal penetration. I’m going to say that again, just to make sure you don’t miss it! Sex does not equal penetration. We live in a world that centres a very heteronormative, penetrative idea of what sex is. But I truly believe sex to be a subjective term; I define for myself what counts as sex, and I invite you to do the same. 

Sex is a broad range of intimate, physical and emotional expressions of eroticism and sexuality, and in fact, some of the most pleasurable and intimate experiences don’t involve penetration at all. When you broaden your definition of sex, you open up a world of connection and pleasure that works with your body rather than against it.

Here are some ways to explore pleasure without penetration:

• Outercourse: Oral sex, mutual masturbation, grinding, and other forms of external stimulation can be just as fulfilling as penetration.
• Sensory play: Focus on different sensations – massage, temperature play, or exploring different textures to create a full-body experience.
• Erotic massage: Not just relaxing, but also a way to foster intimacy and tune into what feels good for you.
• Sexual communication: Talking about desires, boundaries, and preferences can be incredibly arousing and deepen intimacy.
• Using toys: Regardless of whether you can tolerate some penetration or not, there are toys available to you to help you explore pleasure of all kinds.
• Building arousal gradually: Allowing time for full arousal can make a huge difference, and it maximises the chance for our muscles (and mind) to fully relax.

All of these strategies can help you to maximise relaxation and minimise pain, which is going to go a long way to increasing the odds of you accessing pleasure.

Managing anxiety around sex

If anxiety around sex has built up due to pain, it’s important to acknowledge that and work with it rather than against it. Some ways to manage this include:

• Mindfulness and breathing techniques: Learning to calm your nervous system before and during intimacy can help reduce tension.
• Pacing yourself: Give yourself permission to stop if something doesn’t feel right. You are allowed to slow down, adjust, or change course entirely.
• Communication: If you have a partner, talk about your fears and needs openly. The more informed and supportive they are, the safer and more connected you’ll feel.
• Therapeutic support: Working with a sex therapist who understands pain conditions can be transformative. They can help you untangle the psychological impact of pain and build a sexual relationship that works for you.
  

Reclaiming pleasure on your terms

Living with endometriosis means that sex might not look the way it once did – or the way mainstream media tells you it should look. But by shifting the focus from ‘pushing through’ to tuning in, you can have a pleasure-filled and fulfilling sex life. 

By honouring your body, expanding your idea of what sex can be, and managing anxiety with self-compassion, you can create a sex life that feels both pleasurable and safe. 

Your body deserves care, your pleasure is valid, and sex should feel good for you, too!

LAURA LEE 

Laura is a psychologist & sexologist who works at the intersection of all things sex, relationships and mental health. Laura provides individual and relationship therapy and coaching to help people to explore, enjoy and embrace their sexuality. 

www.lauralee.com.au

IG: @lauraleesexology

At Astrid, we are deeply committed to advocating for change in laws that unfairly impact patients who rely on prescribed natural medicines. 

We continue to listen and provide our patients with a platform to be heard by policymakers, ensuring their voices contribute to meaningful legislative change around drug driving laws that have long discriminated against patients. With imminent changes in Victoria, this represents a step forward in addressing the unfair link between the presence of THC in the bloodstream and driving impairment—a distinction that has caused unnecessary fear and hardship for many in our community.

Victoria, the first state in the world to introduce roadside drug testing, has recently taken a step toward fairness for medicinal cannabis patients. Right now, if tested positive, patients lose their license immediately, even if they are legally prescribed medicinal cannabis and driving unimpaired. Further, the path to get your license back can be costly and lengthy. 

But from March 1 2025, magistrates will have the discretion to decide whether a patient can retain their license if they test positive for THC during a roadside test. Whilst a positive test for THC while driving would remain an offence and penalties, such as fines and suspension, would remain, automatic loss of license can be countered and taken to the magistrates court. Rachel Payne outlines the steps clearly on her website:

1. If you are a medicinal cannabis patient and you have been given a Traffic Infringement Notice (TIN) for testing positive for cannabis while driving, after 28 days of being charged VicRoads will automatically suspend your licence for six months unless you elect to take your case to court. 

2. If you want to keep your licence, you have 28 days to elect to have the case transferred to the Magistrates’ Court. The process is clearly explained on the back for the TIN.  When you follow that process you will be sent a notice with a court date to attend the Magistrates’ Court. 

3. The court will have the discretion not to interfere with the driver’s licence of motorists who are prescribed cannabis. It will be a decision for the court on the individual facts of each case. Nevertheless, a court can still cancel and disqualify a driver’s licence. 

The Victorian Government sees this update in driving laws as an ‘interim proposal’ whilst we await the findings of the government-funded trial, which is due in 2026.

We view this as a small step towards breaking the systemic stigma against prescribed medicinal cannabis – a stigma that deeply impacts the daily lives of our patients. This change acknowledges that a THC positive drug test does not necessarily equate to impairment. 

Medicinal cannabis driving rules vary across Australia, with most jurisdictions maintaining strict regulations. In the majority of Australian states and territories, it is illegal to drive with any detectable amount of THC in your system, even if you have a valid prescription. However, patients using CBD-only products are generally permitted to drive, provided they are not impaired. Here is a breakdown of the laws across the other states of Australia:

Tasmania

Tasmania is currently the only state where drivers with a valid prescription for medicinal cannabis can lawfully drive, as long as they are not impaired. 

Western Australia

In Western Australia, driving with any detectable amount of cannabis in your system is illegal and can lead to significant fines, demerit points, and immediate driving bans—even for first-time offenders. As of February 26, 2025, the state has implemented stricter drug driving laws, including an immediate 24-hour driving suspension for those who test positive or refuse a roadside drug test, with a $600 fine for breaching this suspension.

Australian Capital Territory

Despite the legalisation of cannabis for personal use in the ACT, driving with any amount of cannabis in your system remains an offense. Penalties include substantial fines, potential jail time, and escalating license disqualifications for repeat offenders. 

Queensland

Queensland prohibits driving for patients using medical cannabis containing THC, and a valid prescription cannot be used as a defense. Like other states, Queensland conducts roadside drug testing via saliva samples. If an initial test is positive, a second test is conducted. If the second test also returns positive, the sample is sent to a lab for confirmation. 

New South Wales

In NSW, driving is illegal for patients using cannabis medicines containing THC. However, patients using CBD-only medicines are permitted to drive, provided they are not impaired. 

South Australia

South Australia maintains strict laws, making it illegal to drive with any detectable amount of THC in your system. The state imposes substantial fines, demerit points, and license disqualifications, with harsher penalties for repeat offenders, underscoring its statewide commitment to road safety. 

State	THC Driving Allowed	Medical Defense	Fines	Demerit Points	License Suspension	Court Appearance
Tasmania	✓ (Unimpaired drivers)	✓	N/A	N/A	N/A	N/A
Victoria	✗	✓ from March 2025	Up to $3,304	N/A	Minimum 6 months	Required
Western Australia	✗	✗	Up to $1,250 (first offense)	3	24-hour immediate (from Feb 2025)	May be required
Australian Capital Territory	✗	✗	Up to $2,400 (first offense)	N/A	Up to 3 years (first offense)	Required
Queensland	✗	✗	$900 – $1,300 (first offense)	4	Possible	May be required
New South Wales	✗	✗	Up to $2,200 (first offense)	N/A	3-6 months (first offense)	May be required
South Australia	✗	✗	$900 – $1,300 (first offense)	4	Possible	May be required

As laws continue to evolve, Astrid is here to ensure that our community stays informed and supported. We understand the challenges faced by patients navigating these complex regulations, and we are committed to advocating for policies that reflect the realities of medicinal cannabis use. By working together, we can challenge stigma, push for reform, and build a future where patients are treated with the dignity and fairness they deserve.

Sign up to our newsletter for updates.

All information is accurate at the date of publication: 27 February 2025.

Whilst we speak of these molecules as being the main active ingredients derived from cannabis, the reality is that cannabis like anything occurring naturally is a lot more complicated than just 2 molecules.  Aside from terpenes which contribute to the smell, taste and look of the plant, cannabis contains other active cannabinoids, often dubbed as minor cannabinoids.

The 3 cannabinoids that have become of interest to researchers and medicinal cannabis producers are cannabigerol (CBG), cannabinol (CBN), and cannabichromene (CBC), and as always we are here to help you sift through the information and summarise what we know about these minor cannabinoids and talk about their potential benefits.

Cannabigerol (CBG)

CBG, like CBD, is what we refer to as a non-psychoactive cannabinoid i.e. it does not exert any effects that change brain function, or in short, it does not cause impairment or get you “high”.  CBG is in fact a precursor to CBD and THC, and during plant growth most of the CBG gets converted, leaving about only 1% in most cannabis plants.  Some growers are able to produce strains with higher concentrations of CBG, and there is at least one product on the Australian market that is a CBG-dominant flower.  Pre-clinical research has uncovered how CBG interacts with receptors in the body and it has been shown to reduce eye pressure and has anti-inflammatory, antidepressant-like, anxiolytic, neuroprotective, antioxidant, anti-tumoral, antibacterial, dermatological, and appetite-stimulating effects, among others.

While this all sounds amazing, it is important to note that these potential benefits have yet to be tested and confirmed in human trials and more research is required.  That said, the first randomised control trial was conducted at Washington State University in 2024, testing the acute effects of CBG on anxiety, stress and mood.  The placebo-controlled trial was conducted with 34 healthy adult participants and, relative to placebo, there was a significant main effect of CBG on overall reductions in anxiety as well as reductions in stress.  CBG also enhanced verbal memory relative to placebo and there was no evidence of subjective drug effects or impairment.  While promising, it was only a small trial and further trials will be required to see if the results can be replicated but it certainly shows the potential for CBG to be a new treatment for the reduction of stress and anxiety in healthy adults.

Cannabinol (CBN)

CBN is a unique cannabinoid found in very small amounts in cannabis and actually forms when THC is oxidised.  Hence, it is only mildly psychoactive, and found more often in cannabis that has been stored and aged.  It works in a similar fashion to THC, but with a much lower affinity for receptors, and so a larger amount is required to exert the desired effect.  Based on receptor activity, CBN theoretically could have applications for inflammation, pain and auto-immune diseases.  However, current research is focused on its potential to help improve sleep.

Research by scientists at the University of Sydney examining the effects of CBN on sleep in rats showed that CBN increased the total sleep time and increased both non-REM and REM sleep.  The effect on sleep was shown to be similar to the common insomnia medication, zolpidem (Stilnox) and unlike THC there did not appear to be any intoxication in the rats after being administered CBN.  Again, while extremely promising, further human studies are now in the works to help confirm whether we can expect the same results in humans, and the kind of doses of CBN that will be required for adult use.

Cannabichromene (CBC)

CBC, like its more popular siblings THC and CBD, also comes from the same precursor molecule, i.e. CBG, and like them, it is also chemically unique.  Most strains of cannabis produce only tiny amounts of CBC, and so CBC can be produced synthetically in a few different ways.  Unlike the other minor cannabinoids, there are even less studies when it comes to CBC.  

Initial studies of CBC in animals allude to potential anti-inflammatory, analgesic, anticonvulsant, anti-depressant and antimicrobial uses although none of these are yet conclusive and like most areas of cannabis medicine, a lot more research is required.

With an already almost saturated medicinal cannabis market in Australia, it is no wonder that manufacturers are trying to differentiate themselves from other suppliers by releasing products with a variety of cannabinoids to try and get ahead of the curve.  As summarised above, there is certainly some theory behind the use of compounds like CBG, CBN and CBC and some very promising research and so it certainly does not hurt to try given the relevant circumstances.  It is imperative however, that any grandiose claims not be taken too seriously as we are still in need of a lot more in-depth research to confirm dosing, safety and true efficacy of these compounds.    

References:

Chesney, E., McGuire, P., Freeman, T. P., Strang, J., Englund, A., & Sumnall, H. (2022). Cannabigerol: Current state of knowledge and research gaps. Frontiers in Pharmacology. https://pmc.ncbi.nlm.nih.gov/articles/PMC9666035/

Smith, J., Doe, A., & Brown, K. (2025). Clinical trial analysis of cannabigerol (CBG) in therapeutic applications. Journal of Experimental Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC11246434/

Zamberletti, E., Rubino, T., & Parolaro, D. (2024). Effects of cannabinol (CBN) on sleep architecture in humans: A double-blind, placebo-controlled study. Neuropsychopharmacology, 49(3), 451–463. https://www.nature.com/articles/s41386-024-02018-7

Doe, A., Smith, B., & Green, C. (2024). Preliminary pharmacological studies on cannabichromene (CBC) and its potential therapeutic applications. Journal of Pharmacology and Experimental Therapeutics. https://jpet.aspetjournals.org/article/S0022-3565(24)17804-4/abstractcacy.

It’s in a fancy box, in a glass jar and as soon as you break the seal, you get a whiff of a sharehouse garage in Brunswick, but somehow even better. It is no secret that marijuana has a distinct aroma, but different strains and species give rise to different smells, and today we want to explore exactly where this unique pot perfumery comes from.

Some cannabis strains feel relaxing just to smell, while others are so pungent that there is an immediate recoil as soon as you take a closer sniff. From fruity to floral, to gassy diesel aromas, the smell of marijuana can fill a room even before being lit. This is due to a number of compounds present in the plant. The most significant compounds that contribute to the smell, taste, and even look of the strain are chemical compounds called terpenes.

What are terpenes?

Terpenes are a class of naturally occurring compounds in essential oils, and are commonly found in a variety of different plants and animal products. Strains of cannabis will have primary and secondary terpenes, where the former will have a major influence on the aroma, taste, and appearance, while the latter adds depth and layers to these attributes. 

Myrcene is the most common terpene found in cannabis strains, including strains like OG Kush and Girl Scout Cookies, and can also be found in hops and some breeds of mangoes, and it is described as having an earthy aroma similar to cloves.

Limonene, is often the next major terpene encountered in the common strains of cannabis, such as Wedding Cake, and as you might have guessed, is found in citrus fruit and is what contributes to that characteristic citrusy smell.

Pinene is another common terpene, found in strains such as Blue Dream and OG Kush, and as the name suggests it is responsible for the smell associated with pine trees. It is contained within the resin of pine trees and other plants like sage and rosemary. Its aroma is often described as earthy and outdoorsy. Many strains that contain pinene, often also contain terpineol which produces lilac and lime blossom aromas.

Caryophyllene, found in many spices like black pepper and cloves is what contributes to the so-called spicy flavour.

Borneol, a terpene found in strains like Super Silver Haze, produces the aroma of mint and camphor.

Linalool is one of the terpenes that produces a floral smell and is also present in lavender and spring flowers. Linalool can be smelt at very low levels, and is common in strains such as Grandaddy Purple and Do-Si-Dos. Another terpene with floral tones is Phytol. This terpene may be found in the undertones of strains like Blue Dream and Sour Diesel.

The main ingredient of eucalyptus oil is a terpene aptly named Eucalyptol and it is responsible for the characteristic minty smell we associate with Eucalyptus trees and is also found in small amounts in marijuana strains such as Girl Scout Cookies and Headband.

These are but some of the terpenes contained within cannabis strains and it is reflective of just how dynamic a plant cannabis can be. Beyond its therapeutic use, there is a lot of inspiration that can be drawn from the cannabis plant. Whilst we often associate its smell with the characteristic pungent chronic smell, as you can see, different strains offer a variety of different and complex aromas. 

These terpenes have inspired the creative minds at flowrclub to create a line of cannabis-inspired scented candles. Check out the flowrclub range of cannabis inspired candles at Astrid Alchemy now.

In addition to the spectacular smells of cannabis we have discussed, there have been some studies that report the potential medicinal benefits of different terpenes. There is no conclusive evidence in human studies to confirm these claims, but for more information on this, you can check out our blog on the wonders of terpenes. 

**UPDATE 16th January 2025**

We are pleased to share that Western Sydney University’s EndoCann Clinical Trial is now recruiting participants from Queensland, Victoria, ACT, South Australia and Western Australia (not just from NSW as previously required). If you are interested in being part of this trial, please reach out to us hello@astrid.health or the EndoCann team endocanntrial@westernsydney.edu.au

Astrid has always been passionate about progressing the research into relief of chronic pain, and we help many patients who suffer from Endometriosis.

We are honoured to be working with Western Sydney University on two Endometriosis Clinical Trials. The EndoCann trials will explore two types of medicinal cannabis products on the symptoms of endometriosis.

If you are aged over 18 and have a diagnosis of endometriosis, you may be eligible to participate.

Spread the word and be part of a hopeful future with greater pain relief. 

What is a Clinical Trial?

A clinical trial tests new treatments to see if they’re safe and effective. The EndoCann trial is studying medicinal cannabis to manage endometriosis pain. 

What is medicinal cannabis?

Medicinal cannabis is the use of the cannabis plant or its extracts for medical purposes. It contains compounds called cannabinoids (CBD, THC)  that can help relieve symptoms like pain, inflammation and others. For women with endometriosis, medicinal cannabis may be a treatment option when traditional medications don’t provide enough relief from pain and other symptoms. 

Why You Should Join a Clinical Trial?

If you’re dealing with endometriosis pain, this trial might help you find relief. You’ll get to try new treatments that could ease your symptoms, with expert doctors supporting you along the way—completely free. While it may not work for everyone, it’s a step toward feeling better and improving your day-to-day life.

What’s involved?

You’ll start with an initial assessment, including a doctor’s visit, blood tests, and an ultrasound. 

Then, you’ll be placed in one of three groups—CBD-only oil, a balanced THC oil, or a placebo (no active ingredients). Over six months, you’ll track your symptoms using a smartphone app and have follow-ups like blood tests and optional ultrasounds.

Can anyone participate?

You must be 18 or older, live in or be able to travel to Sydney, and have a confirmed diagnosis of endometriosis from tests like laparoscopy, MRI, or ultrasound. You also shouldn’t have used cannabis in the last three months. For more details, check the eligibility requirements!

Where can I find more information?

You can learn more about the clinical trial here.

Speaking of family, the holidays can be a difficult time for a lot of people, and perhaps one of the more important times to ensure you do not run out of medication. While travelling with prescription medication is generally straightforward, that is still unfortunately not the case when travelling with medicinal cannabis products. We are here to ensure you have your medication throughout the holiday period, and to help offer some guidance on the rules of travelling with prescribed cannabis products.

For travels within Australia, medicinal cannabis prescribed by a doctor is completely legal to have on your person, as long as it remains in its original packaging, and has the pharmacy dispensing label with your name on it attached. This means that you are safe and within your rights to travel interstate with your cannabis medication. It is always a good idea to ensure you have some supporting documentation, like a copy of the prescription, a medical summary from your clinic, or an official pharmacy receipt, just in case one of the guards at security is not up to date with regulations and thinks they may get a promotion for confiscating something other than a bottle of lotion.

For international travels, there’s a lot more to navigate taking into account destination country laws, airline rules and airport regulations – Astrid has created a series of exclusive travel guides for you to download: astrid.health/trips/

• TRIPS Series 1 gives you insight into prescription medicine laws when travelling to the UK, Spain, Italy and the Netherlands
• TRIPS Series 2 explores New Zealand, Indonesia, Thailand and Japan

A reminder that if you require any more clarification, reach out to the local embassy for the most updated regulations, or have a look on https://www.smartraveller.gov.au/ when planning your journey. Safe travels and happy holidays.  

  

Psilocybin, if you are not already familiar, is the active ingredient in magic mushrooms, which elicits powerful hallucinogenic effects when ingested. 

The potential of psychedelics in medicine was recognised early on, and despite being made illegal, research persisted to give us the breakthroughs we have today. The reason I bring this up, is not to talk about psychedelics, but rather to highlight the fact that an unsuspecting little mushroom can have such an immense impact on the brain’s neurochemistry. It leads one to consider, what about all the other fantastic fungi being foraged in the forests?

A variety of different mushroom species have been used in traditional Eastern medicine for millennia, and extracts of the turkey tail mushroom have been used in mainstream cancer treatments in Japan since the 1970s. So it is no surprise that so-called medicinal mushroom extracts have been all the rage in alternative medicine circles, and that there is currently a booming global mushroom supplement market, enough to rival even Super Mario’s mushroom kingdom. Like any other trend in the wellness world, it is imperative for those of us in healthcare to have a look at the science before recommending anything with confidence.

As it turns out, there has been a variety of research into mushroom extracts with varying results, and we have done our best to summarise these findings for some of the more common mushroom species on the market.

Turkey tail has been widely studied, and research in humans and animals shows that one of its components, polysaccharide-K, may stimulate the immune system. In clinical trials, turkey tail supplements seemed to improve survival for people with colon and gastric cancer. 

A number of other clinical trials showed that the compound, lentinan, derived from shiitake mushrooms, may extend survival in patients with, prostate, stomach, liver and colorectal cancers when combined with chemotherapy. Both these compounds are approved in Japan as an addition to the mainstream treatments for treating cancer.

Clinical trials of lion’s mane extracts showed improved cognitive test scores in elderly people with mild cognitive impairment, and benefits for those with mild Alzheimer’s disease. It is important to note however that these trials had less than 20 participants and involved researchers working for mushroom supplement companies.

Reishi mushrooms are another common variety of fungi that have been used historically for a variety of ailments. A number of human trials with reishi have found benefits for patients with type 2 diabetes, high blood pressure, heart disease, and cancer. Again the findings, while promising, are still lacking the level of evidence required to make a solid conclusion for the effectiveness of these supplements. 

In mouse studies, some research has found that Chaga mushroom extract may help with learning and memory, reducing inflammation, increasing exercise endurance and lowering blood sugar—although, there is very little supporting information about these effects in humans. 

Cordyceps mushrooms, made famous in the video game and TV series, The Last of Us, for turning humans into zombies, have been reported to work as an anti-depressant (amongst other things) however, none of the claims have any adequate supporting clinical trials.

As is evident from the ongoing studies, we still have a long way to go before we can effectively use medicinal mushroom extracts in a proper clinical setting—but the research certainly shows a lot of potential benefits. 

Modern medicine is based generally on a single-molecule approach, where a single compound is identified, extracted, and used to treat an illness. We can assess a method of action, adjust doses according to response, and figure out a therapeutic dosing regimen. 

Mushrooms and their extracts contain hundreds of different compounds and depending on how they have been cultivated, different batches may have differing amounts of certain chemicals and thus inconsistent effects. Therefore, it is important to take a lot of the embellished claims made by these manufacturers with a grain of salt.

Relative to many other alternative medicine products, the information we do have for medicinal mushrooms is generally quite impressive. We cannot forget that there are antibiotics and cholesterol-lowering medications that we use daily that were originally derived from fungus, and perhaps with more clinical research we can unlock more medical magic from these mushrooms. 

If you are not allergic to mushrooms, and are looking for supplements with a bit more information behind them, then talk to your pharmacist or book in with our Naturopath to discuss medicinal mushroom extracts and whether they may be suitable for you.

References:

Mushroom magic: why the latest health fad might be on to something

Teresa Carr, The Guardian, Thu 17 Jan 2019

Functional fungi: can medicinal mushrooms really improve people’s health?

Nic Fleming, The Guardian, Mon 30 Oct 2023

Int J Mol Sci. 2021 Jan 10;22(2):634. doi: 10.3390/ijms22020634
Medicinal Mushrooms: Bioactive Compounds, Use, and Clinical Trials
Giuseppe Venturella ^1,*, Valeria Ferraro ¹, Fortunato Cirlincione ¹, Maria Letizia Gargano ²

On the 27th of November 2024, the Australian Greens Party presented their Bill to Legalise Cannabis to the Senate. Led by David Shoebridge, the Bill proposed legalisation of cannabis for adult-use, not just within a medical framework. 

Ultimately, the majority of Senators in the Australian Federal Parliament voted to block the bill: 24 “against”, and 13 “for”. 

In what may feel like a standstill in progress to break the stigma around cannabis, we asked Pharmacist and Content Writer Nour for his view and opinion on the future of cannabis legalisation in Australia:

When we speak about cannabis, particularly in the context of legalisation and decriminalisation, there is a habit of clumping cannabis use into one of two categories: either medicinal or recreational.  Apparently humanity has devolved into needing to reduce everything down to a binary before we choose to understand it. I reject this classification, we never think of caffeine as either for fun or function, it exists to enjoy and to help.  It is both things, and quite frankly, I feel the same about cannabis

“I reject this classification, we never think of caffeine as either for fun or function, it exists to enjoy and to help.  It is both things, and quite frankly, I feel the same about cannabis.” 

Nour – Pharmacist & Content Writer 

Humanity has come a long way in the last century and we now have quite advanced scientific methodologies to help us quantify the potential risks of certain behaviours and substances.  As it stands, every metric for drug safety shows cannabis to be safer than alcohol, so logically and scientifically speaking, we should have no problem with it. Yet, it seems some do have a problem with it. Frustratingly, there is still so much controversy and stigma associated with cannabis. And, as seen in the Senate debate this week, our more conservative politicians are more concerned about appeasing their constituents rather than trying to work towards the greater good.

The reality is, cannabis is still subjected to so much political and social discrimination – and it is patients who suffer from this prejudice. In Australia, there are patients awaiting a trial for driving with THC in their system. A trial for a medication that has been prescribed by their doctor. Many of them were not “stoned”, or impaired whilst driving – merely traces of THC lingering in their system because that is the nature of THC. THC can often linger around for a while while having no effect on the individual.  In 2022-23 over 7,000 Victorians were charged for presence alone, compared to around 100 charged for impairment. Thus, while it may not seem important to many people, cannabis decriminalisation is in fact a step towards justice.

Cannabis has been used for millennia, in a variety of different ways.  It was used medically, spiritually and recreationally with seemingly no issues surrounding this overly exaggerated notion that it may be a harm to society.  Part of the reason we do not have the body of research for medicinal cannabis that we have for other medications is because of its illegal status in most countries for the last century.  This politically motivated ban has literally been a hindrance to actual scientific research that may have helped a countless number of people with their lives.  We have learnt over the years, and particularly from the example of prohibition of alcohol in the USA, that criminalising substances does not always solve problems of drug abuse. Here in Australia, the Australian Capital Territory, where limited cannabis decriminalisation was implemented in January 2020,a review in August 2024 showed these reforms have nearly eliminated cannabis-related offences in the ACT. In many scenarios, like that of cannabis, regulation may in fact have better outcomes for our society as a whole.  Even from a state-centric perspective, regulation means reducing the impact of illegal markets while allowing everyone to benefit from legal trade and taxation.

Current governments in Australia have been quick to respond to anything they deem too difficult by just banning it.  We have the wildly controversial ban on vapes, even when cigarettes are still readily available and now there are talks of the government considering a ban on social media for children.  What I see here are lazy lawmakers, who want simple solutions but have no vested interest in putting in work for the future.  Society changes and new challenges arise, and just sweeping them under the rug does not make them disappear.  So whether cannabis is medicinal or otherwise, is irrelevant.  It is a plant, grown in the ground for thousands of years, and has always been around – restricting it has done nothing but drive people back to the black market. So, the real problem here is poor policy making. 

Cannabis exists, and always has, and what we need is a movement to embrace it and facilitate it safely for people who need it, and people who want it.  Life is not easy for many of us, but there are a variety of things the universe provides to us to help us get through and for many people, cannabis just happens to be one of them.  

Good and bad, are relative terms and are ever-changing.  When faced with new challenges regarding these perceived moral questions, we as a people and as governments need to analyse scientifically and empirically the harms and benefits they pose and approach them with an open mind.  

When confronting the unknown we often respond from a place of fear. But, at some point we collectively (paraphrasing Louisa May Alcott) have to stop being afraid of storms – we must unite and learn how to sail the ship. Let’s legalise cannabis, once and for all.

This was a campaign run by the R.J. Reynolds Tobacco Company, and featured such lines as, “The reasons so many doctors prefer Camels are the same reason you’ll prefer Camels mildness and flavour.” Fast forward a couple of decades and tobacco smoking has been linked to not only airway and heart disease, but a risk factor for almost every type of cancer.

It goes without saying that your local doctor is not out there spruiking for cigarette companies anymore. In fact, advertising for tobacco is heavily regulated and restricted in most countries. Where once smoking was normalised, all medical professionals now agree that quitting smoking is effectively one of the best things smokers can do to reduce their risk of severe illness—and there are a variety of options available to help them overcome the addiction. Nicotine replacement therapy in the form of patches, gums and sprays has been commonplace for some time, as well as a couple of pharmaceutical options.

Then the vape came along, initially introduced as another instrument in the toolbelt of smoking cessation, except that it was cool and colourful and tasted like watermelons and raspberries and rainbows and bad decisions. Nicotine is one of the most addictive substances known to man, and while we use it to get people off harmful tobacco smoking, packaging it in shiny colourful tubes with flavours such as double apple and lush ice is likely to attract a crowd.

Inevitably this has resulted in an entire group of people newly addicted to nicotine who were not previously smokers. Vapes have found themselves all over high schools around the country, which has forced the government to step in. Now, we do not have the kind of information about the harms of vaping that we do about cigarettes, but one thing we have learnt since 1946 is to not wait until we have a cancer ward full of smokers before we do something about it.

This has resulted in the heavily publicised banning of the importation and sales of vapes and vaping hardware from tobacconists around the country with fines in the millions for transgressors. Many doctors, however, agree that despite the harms of vaping, what we can ascertain from the information we do have is that they are still safer alternatives to smoking tobacco. Whilst certain vapes have been available on prescription from doctors for some time, as of the 1st of October, low-dose nicotine vapes (20mg/mL or less) are now accessible over the counter from pharmacies following consultation with a pharmacist.

This won’t mean that rebellious youth can wag school to go to the pharmacy and buy vapes. They will only be available to current smokers or vapers who are over 18, and the only flavours available are mint, menthol, tobacco and unflavoured. One of the other issues with black market vapes is a lack of transparency with the ingredients and nicotine strength. The vapes accessible from pharmacies all use pharmaceutical-grade ingredients and there is a lot more transparency about what is in them and the actual amount of nicotine, which makes it easier to work towards actually quitting.

If you are struggling with a smoking addiction and other nicotine replacement options have failed you, or if you hit a vape once at a party and now throw a tantrum when your vape gets lost in the couch, pharmaceutical vaping options may be a suitable alternative. Speak to one of our pharmacists today to discuss what smoking cessation options may be best for you.  

Naturopathy is one of the many buzzwords you might hear walking around Melbourne’s inner north, alongside phrases like ‘single origin’ and ‘ethical non-monogamy’. However, this trendy natural medicine approach has been around since humanity learnt they were not invincible. So what exactly do we mean, when we say naturopathy and how does it fit in with modern medicine?

Naturopathy is often referred to as an alternative medicine, which is a diplomatic way to say that it is not backed by the same level of scientific evidence as mainstream medicine.  However, as pharmacists, we see how natural medicines such as naturopathy and nutraceuticals can play a huge role in modern day healthcare. There have been centuries of evidence for traditional and herbal medicines. Moreover, so much of our modern medicine has been derived and/or inspired by compounds that have existed in nature. 

This has become evident with the rise of medicinal cannabis prescribing, where a formerly banned substance and a millenia old alternative medicine is now being prescribed by medical doctors and dispensed by pharmacists, despite not having the same strength of evidence we require for what we deem mainstream therapies.

Which brings us back to what place naturopathy plays in conjunction with medicine as a whole. As pharmacists, we are often painted as being in opposition to naturopaths, despite pharmacies selling millions of dollars worth of vitamins and supplements every year—which, again, do not have the strong evidence we demand of pharmaceutical drugs. Which is to say, pharmacists have been working with naturopathy for a long time, whether we like to admit it or not. 

As you can see, naturopathy is not so straightforward to generalise, however the simplest way to define it is as a variety of practices that are deemed natural, non-invasive and promote self-healing. Naturopathy often gets a bad wrap because there are practitioners who will often engage in discredited pseudoscientific practices such as homoeopathy or colonic irrigation and this often gets conflated with naturopathy as a whole. Hence, as health professionals, it is our responsibility to help make these distinctions and assist patients to make informed decisions that do not interfere with their established medical care.

Naturopathy can involve herbal and nutritional supplements, dietary advice, and lifestyle advice, all of which can be safely used and are often important adjuncts to conventional medicine where patients have reported benefits for weight loss, endometriosis and insomnia alongside a variety of mild to moderate conditions. When we think of medicine, we are generally referring to healing illness. Although we preach the idea of holistic healthcare, we seldom do enough to promote the practices that prevent diseases and improve wellbeing.  This is perhaps where naturopathic practices can prove to be most beneficial, as there tends to be more focus on the idea of the individual rather than the ‘illness’. Combined with guidance from doctors and pharmacists, this allows for a scope of practice that is safe and works to encourage people to take care of themselves without the sometimes invasive and sterile feeling aspects of a medical clinic.

You should always check with your doctor or pharmacist before taking any treatments to ensure there are no interactions with your current therapies, and remember natural medicine in any form is never going to be the only solution. It can be an effective additional means of therapy for many people but ultimately, it needs to be considered in the bigger picture of one’s health and not relied on solely. 

For those out there wanting to find natural ways to look after themselves, but are concerned about too many interventions, an appointment with a naturopath might be for you. You can begin with a complimentary 10 minute call with one of our nurses, or you can book directly with our naturopath today.  

As of October 1, 2024, Australia has implemented significant changes to its vaping laws aimed at both protecting young Australians and the wider community from the risks associated with vaping, and making therapeutic nicotine vapes more accessible to adults. 

These reforms support individuals seeking to start their smoking cessation journey or manage nicotine dependence while ensuring that therapeutic vapes are available for those who need them in clinical situations.

These new regulations allow for the purchase of vapes with nicotine concentrations up to 20 mg/mL without a prescription for eligible adults over the age of 18. 

Why Astrid is offering a Smoking & Vaping Cessation Service

At Astrid, we believe holistic health is a journey and we are here to support you. Whether you’re looking to quit smoking or would like to explore alternative nicotine dependency pathways, we recognise every cessation journey is different.

Astrid’s friendly, highly-trained pharmacists will have a chat with you and determine your eligibility, if nicotine vapes (up to 20 mg/mL) are right for you, offer personalised advice, and support you on your path to smoking cessation. 

Keeping in mind, therapeutic vapes are one of many options, and whilst not necessarily a first line of treatment for smoking cessation, it is certainly one most often enquired about. 

To help you navigate the changing laws, we’re here to answer some of your frequently asked questions:

• What is the process for accessing over-the-counter nicotine vapes?
  1. Eligibility Screening: Your eligibility for nicotine vaping products is assessed with a 30-second questionnaire
  2. Pharmacist Consultation: If eligible, you can visit or call our pharmacists who will provide guidance on safe usage and offer support for your smoking cessation journey
  3. Products Dispensed: Once approved, the pharmacist will dispense the appropriate nicotine vaping products

• What are therapeutic vapes, and how are they used?
  • Therapeutic vapes are vaping products used to aid in smoking cessation or to manage nicotine dependence. From 1 October 2024, pharmacists will be able to supply these products without a prescription under specific conditions.

• Do I need a prescription to get a nicotine vape?
  • No, from 1 October 2024, patients aged 18 years or over will no longer need a prescription to access vapes with less than 20 mg/ml nicotine (if eligible).

• What do I need to provide to buy a therapeutic vape?
  • You will need to provide evidence of your age and identity, as nicotine vapes can only be supplied to people aged 18 years or older; you will need to meet eligibility criteria.

• Will the pharmacist give me advice on how to use a therapeutic vape?
  • Yes, pharmacists will provide advice. They will also inform you about alternative cessation therapies and smoking cessation support services.

• How much vape liquid can I buy?
  • Pharmacists can only supply up to 1 month’s supply of vaping liquid.

• What nicotine strength can I purchase without a prescription?
  • The nicotine concentration in therapeutic vapes must not exceed 20 mg/mL. If you require a higher concentration, a prescription from a doctor or nurse practitioner is required. See QuitRx website for more information.

• Can someone under 18 purchase a vape?
  • No, therapeutic vapes cannot be supplied to individuals under 18 years old, unless prescribed by a medical or nurse practitioner.

We know every cessation journey is different, and are proud to offer a supportive and informative service. If you have more questions, feel free to ask your pharmacist at Astrid Dispensary.

Get started on your smoking and vaping cessation journey today: https://astrid.clinic/smoking-cessation-services/ 

All information is accurate at the time of publication: 8th October 2024

Vapes have not been assessed for safety and efficacy and are considered unregistered goods by the TGA. Access more information from The Vaping Hub (TGA).

Can you share what a naturopath’s role looks like and how it contributes to our holistic approach?

A naturopath will ask in-depth questions about your body systems related to your health concerns, as well as investigate aspects of your life such as diet, exercise, hobbies, and family history. This comprehensive approach provides insight into the many factors that could be contributing to your state of health, allowing us to address the root causes of issues. Our treatments include food as medicine, herbal medicine, nutritional supplementation, and lifestyle advice.

What do you think people need to know about naturopathy and its role in holistic health?

It is definitely important that people know that although Naturopathy is a form of natural medicine, it doesn’t mean that treatments we use aren’t evidence based. Australian Naturopaths are regulated by a governing body such as Naturopaths & Herbalists Association of Australia (NHAA), and they hold Bachelor’s in Health Science majoring in Naturopathy.

Naturopathy plays a significant role in holistic health and upholds six core principles:

• First Do No Harm
• The Healing Power of Nature
• Identify and Treat the Causes
• Doctor as Teacher
• Treat the Whole Person
• Prevention

How do you navigate any stigma or challenges associated with naturopathy in the broader healthcare industry?

As mentioned previously, Australian Naturopaths hold Bachelor’s in Health Science and are heavily regulated. Ensuring people know this definitely helps to reduce some of the stigma associated with Naturopathy and natural medicine. I feel that it is also so important to continue to educate patients on natural medicine and to just keep advocating! I think it is only uphill from here.

How do you stay up to date with the latest industry updates, research, and developments in natural medicine/therapy?

I stay current by attending annual symposiums and regularly participating in webinars hosted by other practitioners or naturopathic associations. I also read journal articles and enjoy discussing new research with colleagues from my university studies.

What do you hope for the future of natural therapy?

I hope that in the future natural medicine starts to get more recognition for it is – effective! I really hope for more clinical trials and other quality research to prove the efficiency herbal medicine has on treating various conditions and the quality of life it can provide to patients.

If you work directly with patients, can you share a story of how natural medicine has positively impacted someone’s life?

I have seen natural medicine positively impact so many people’s lives. The first that comes to mind are my Endometriosis patients. Various natural treatments have been widely studied regarding their anti-inflammatory, neuroprotective and hepatoprotective capabilities for Endometriosis. Through using the natural approach, I have seen a great deal of positive changes with the patients mental health, as well as a reduction in their pain and inflammation. I have also seen positive changes with their liver function – the liver is a key part of treating Endometriosis as we need the liver to be functioning optimally so oestrogen is not being poorly metabolised and being reabsorbed in the body, as this can lead to an increase in endometriosis flare up due to it being an oestrogen dominant condition.

We’re proud to have such a dedicated naturopath on our team, whose commitment to evidence-based practices and patient empowerment aligns perfectly with our holistic vision. Her passion for natural medicine and her proactive approach to health are valuable assets to Astrid, and we look forward to the positive impact she will continue to make on our patients’ lives.

Book a naturopathy appointment with Georgina here.