Why do so many people with pelvic pain feel like they have constant UTIs… even when the tests keep coming back negative?
In this episode, we sit down with urogynecologist and pelvic floor expert A/Prof Tanaka Dune to unpack the incredibly complex world of bladder pain, urgency, frequency, pelvic floor dysfunction and the nervous system.
We talk about:
• why bladder pain is so often misunderstood
• the overlap between pelvic floor tension, endometriosis, bowel symptoms and bladder symptoms
• what urogynecologists actually do
• why some people may have “UTI symptoms” without a standard urine test showing infection
• the emerging science around the bladder microbiome
• interstitial cystitis/bladder pain syndrome
• how stress, trauma, posture, gait, back pain and the pelvic floor all connect
• common bladder irritants including caffeine, alcohol and carbonated drinks
• why pelvic floor exams can be such a lightbulb moment for patients
• and the surprisingly powerful role of mirrors in helping women reconnect with and understand their anatomy
Tanaka brings a deeply compassionate and systems-based approach to pelvic pain care, and this conversation completely shifts the way you think about the bladder.
This episode is for anyone living with bladder symptoms, recurrent “UTIs”, pelvic pain, painful sex, urgency/frequency, or clinicians wanting a better framework for understanding these presentations.
You can find A/Prof Tanaka Dune online as “Dr Pelvic Floor”.
Endo Untangled is hosted by Dr. Alecia Macrow and Cherie Noble. New episodes released fortnightly.
Why do we have periods at all, when most mammals don’t? In this episode we catch up with Dr. Deena Emera, evolutionary biologist and author of A Brief History of the Female Body, and look at menstruation through an evolutionary lens that shifts the usual framing. We unpack what’s actually happening between the brain, ovaries and uterus, and why menstruation may be less about a monthly inconvenience and more about an active, coordinated process.
One of the more interesting ideas is the uterus behaving less like a passive lining and more like a kind of checkpoint, responding to what’s happening upstream. We also get into how far modern cycles have drifted from what the body likely evolved for. More cycles across a lifetime, higher hormone peaks, and a different symptom burden. That context matters when you’re thinking about pain, PMS, and conditions like endometriosis.
If you work in this space, or you’re trying to make sense of your own cycle, have a listen to this great hour of evolutionary insight. Find Dr Emera's great book here: https://www.amazon.com.au/Brief-History-Female-Body-Evolutionary/dp/1728275156 More on Prof Beverly Strassman: https://sites.lsa.umich.edu/bis/
We call it the “swinging balls” problem. Because pelvic pain isn’t driven by one thing. It’s multiple systems hitting each other and keeping pain in motion.
In this episode, we zoom out and examine some of the main drivers of persistent pain and how they interact, in particular, our key swinging balls: menstrual cycling, bowels, pelvic floor and the nervous system.
If you’ve tried everything and you’re still stuck, this is the episode to listen to.
So much of pelvic pain care focuses on finding and fixing a single cause.
But what happens when the system itself becomes part of the problem?
In this episode, we’re joined by psychologist Laura Grace to explore:
This is about making sense of pain, not dismissing it.
Laura Grace is a Brisbane-based registered psychologist with a focus on pelvic pain, chronic illness, and women’s health. She has training in both health and clinical psychology and works with patients navigating complex, long-standing conditions.
Her approach is trauma-informed and centred on the nervous system, helping patients understand pain, build safety in the body, and make sense of their experiences.
She supports people with persistent pelvic pain, medical trauma, neurodivergence, and the broader impacts of chronic illness.
Laura Grace Psychology: https://www.lauragracepsychology.com.au
Pelvic Pain Foundation of Australia: https://www.pelvicpain.org.au
NOI Group (pain science resources): https://www.noigroup.com
Is the pill just a band-aid for pelvic pain and endometriosis? It’s a question many patients ask, and one that comes up again and again in clinics and online.
In this episode of Endo Untangled, Dr Alecia Macrow and Cherie Noble are joined by women’s health GP Dr Jessica Floreani to unpack how hormonal treatments actually work. From the basics of the menstrual cycle through to combined pills, progestogen-only options, ovulation suppression and withdrawal bleeds, this conversation explores why these treatments are used and what they are trying to achieve. They also tackle some common misconceptions around “synthetic hormones”, why one pill can feel completely different from another, and why finding the right option is often a process of trial and adjustment.
A practical, thoughtful episode for anyone navigating pelvic pain, endometriosis or heavy periods.
In this episode we discuss:
Our guest Dr Jessica Floreani is a specialist women’s health GP and director of Aware Women’s Health in Adelaide. She has extensive experience in contraception, endometriosis care and women’s health education, and has previously worked with SHINE SA as a LARC coordinator and medical educator. More about Dr Jess: https://www.awarewomenshealth.com.au/jessica-floreani
If you've got pelvic pain, you probably know it's not just about the endometriosis lesions. But did you know how much your muscles are contributing to your symptoms?
Pelvic health physio Caz Berry is back to explain the anatomy that matters. She's brought her pelvis model and she's not afraid to use it.
In this episode, we're covering the three things Caz wishes every patient knew before walking into her clinic: understanding your core (spoiler: it's not about abs), why breathing actually matters for pelvic pain, and yes—how to poo properly.
Caz explains why that "just breathe" advice isn't a brush-off, why pushing on the toilet is working against you, and why that deep stabbing pain might not be your ovary at all—it could be a cranky hip muscle called the obturator internus.
We also get into the nitty gritty: tight activewear as a pain trigger, why sitting with your knees together isn't helping, and how trauma and stress literally change what's happening in your pelvis.
Practical, honest, and genuinely useful information for anyone dealing with pelvic pain, endometriosis, or bowel and bladder issues.
Pelvic pain doesn’t exist in isolation — and neither does the nervous system that processes it. In this episode, world-renowned pelvic health physio and storyteller Michelle Lyons explains why what happens in the vagus nerve shows up everywhere. We explore persistent pelvic pain through a nervous-system lens, unpacking how the vagus nerve connects pain with the gut, bladder, pelvic floor, immune system and stress response. Michelle breaks down why pain can persist even when scans are normal or tissue has been treated, and how an upregulated nervous system can keep the body stuck in protection mode. This episode offers a compassionate, science-based reframing of pelvic pain — moving beyond “just the pelvis” toward understanding the whole person. If you’ve ever felt like your symptoms don’t make sense, or that your body is reacting bigger than expected, this conversation may finally connect the dots.
Michelle's website: https://celebratemuliebrity.com/Michelle's
podcast: https://podcasts.apple.com/au/podcast/celebrate-muliebrity-with-michelle-lyons/id1689238440
Book we discussed:Why Zebras Don't Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping . https://www.amazon.com.au/Why-Zebras-Dont-Ulcers-Stress-Related-ebook/dp/B0037NX018
Forget the candles and face masks. This episode gets real about what self-care actually looks like when you live with endometriosis or chronic pelvic pain. Dr Alecia Macrow and exercise physiologist Cherie Noble break down the Circle of Control and why so much energy gets wasted on things you can’t change.
They explore how pain, sleep, work stress, and relationships all feed into each other, and share practical ways to take back a sense of control. You’ll learn why “no” is a complete sentence, why most people are either in turbo mode or wiped out, and how to take small, meaningful steps without piling on pressure. If you’re navigating chronic illness, invisible symptoms, or just the overwhelm of life, this episode offers real, practical strategies that actually work.
What does a physio educator wish you knew about pain? In this episode of Endo Untangled, Alecia and Cherie sit down with Emma, a physiotherapist and pelvic pain educator, to break down the complexities of pain, especially pelvic pain. Discover the different types of pain, why pain isn’t always a sign of damage, and how understanding your body can help you manage discomfort. Emma shares practical tips, movement strategies, and resources to empower young people and anyone living with ongoing pain.
Emma Kirkaldy is an educator with PPEP Talk, the Periods, Pain and Endometriosis Program run by the Pelvic Pain Foundation of Australia. PPEP Talk:.
In this quick-fire chat, Dr Alecia Macrow and Cherie Noble speak with Michelle Neilson, manager of the Pelvic Pain and Education Program rolling out in schools across Australia. We unpack what teens really understand about periods and pelvic pain, why so many think severe pain is “normal,” and how early education can change the trajectory of young lives. Michelle also shares why country kids are hit hardest — and what’s being done to close the gap. Follow for more bite-sized insights that untangle pelvic pain and empower young people to thrive.
In this episode, we talk with Professor Louise Hull, a reproductive medicine specialist and world-leading researcher in endometriosis. Louise shares her story, from IVF training at Cambridge to leading national research and policy here in Australia.
She gives one of the clearest explanations of how endo causes pain, inflammation and damage, and how this links to fertility. We explore:
This is a grounded and compassionate conversation that will be useful for patients, GPs, and anyone supporting someone with endo. Louise is also the lead investigator behind EndoZone, a national digital platform that gives patients and clinicians access to evidence-based, user-friendly information about endometriosis. Check out this excellent resource at www.endozone.com.au
In the second episode of our endometriosis imaging arc, we sit down with world class excision surgeon and leading pelvic sonologist Dr Matthew Leonardi to explore how high quality pelvic ultrasound transforms the way we understand endometriosis.
We break down the full spectrum of ovarian cysts, from follicular and haemorrhagic cysts to dermoids and endometrioma, and unpack why the term “complex cyst” causes unnecessary fear and needs to disappear. Matthew also shares how recognising an endometrioma is often just the start, and how detailed ultrasound guides safer, more precise surgical planning.
We finish with his interdisciplinary Endometriosis 360 model, where imaging, pelvic physio, dietetics and psychology work together to support better long term endo care.
Join us on Endo Untangled as Dr Alecia Macrow and Cherie Noble sit down with Alison Deslandes, a clinical academic sonographer and endometriosis researcher to explore how advanced imaging is reshaping the diagnostic landscape for people living with endometriosis and pelvic pain. We discuss:
In this episode of Endo Untangled, Dr Millie Mardon PhD shares how her long trips from Port Augusta to Adelaide as a teenager shaped her work in pain science. She explains how understanding what pain really is can help us change it, slowly but surely.
We talk about where pain discussions go wrong, how what we think, feel and see can shift the way pain shows up, and why personal stories matter in research and recovery.
This one will change how you think about pain.
In Episode 08, we dive deep (no pun intended) with specialist colorectal and pelvic floor surgeon Dr. Chris Gillespie as he lifts the lid on everything your bowels don’t want you to ask. From the anatomy and reflexes behind a good poop, to what’s going on when your colonoscopy is “normal” but symptoms persist, we cover it all.
We unravel the role of anorectal manometry, bust common myths (do laxatives really make your bowel “lazy”?), and get his go-to strategies for managing bowel dysfunction in real life. Whether you’re a clinician, patient, or just poop-curious — this one’s for you. Tune in, flush away the stigma, and get the inside track on what your gut’s been trying to tell you.
Our collaboration grew out of a cloud of plaster dust, a half-finished practice, a fire engine out the front, and someone quite literally glued to the floor. Out of that chaotic, hilarious day came connection, trust, and the start of a long partnership with pelvic health physiotherapists Alycia Scannell and Carolyn Berry.
In this episode, we talk about what pelvic health physiotherapy actually is, what happens in a consult for someone living with pelvic pain, and why the pelvis can get “cranky.”
In this episode of Endo Untangled, pain-titled physiotherapist Sophie Sheppard shares her lived experience of chronic fatigue (ME-CFS) as a teenager and later discovering she is autistic and ADHD. We unpack the science of persistent pain and how it reverberates through the nervous, endocrine and the immune systems (NEI ensemble) and explore how understanding the whole system impact changes care.
When one episode is not enough! We extended our recording with Dr Marie-Claire Seeley: researcher, lived experience advocate, CEO Australian POTS Foundation and dead-set legend, to talk POTS overlaps including endometriosis, pelvic pain, neurodivergence and hypermobility. We discuss investigation for POTS, how to do and interpret active stand test, what to rule out incl discussing heart tests, and discuss management.
see the POTS foundation website for resources: https://potsfoundation.org.au/
Unwell in central Asia. Dismissed as "just anxiety". Four kids, nursing shifts, and a fight to be believed. Today Dr Marie-Claire Seeley is CEO of the Australian POTS Foundation, using her PhD and lived experience to change care for people with POTS.
see the POTS foundation website for resources: https://potsfoundation.org.au/
Why do so many endo appointments leave patients feeling unheard and doctors feeling stuck? In this episode, GP Dr Alecia Macrow and EP Cherie Noble sit down with Prof Susan Evans and Dr Carmel Reynolds to unpack why care can feel like control, why “they just want to put me on the pill” is such a common refrain in forums, and how sharp “ovary pains” aren’t always what they seem.
This is a constructive, honest conversation for patients, clinicians, and anyone wanting to better navigate endo care.
Why the fatigue? Why the headaches? Why the lightning arse?!
In this episode, we dive into the messy overlap of gut issues, pelvic floor dysfunction, heavy periods, and crushing fatigue, and why these symptoms so often show up together.
Exercise Physiologist Cherie Noble and Endo GP Dr Alecia Macrow talk through the 'why' of Endo Untangled, their personal stories, and what they're most looking forward to in the podcast.
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