Endometriosis takes an average of 12 years to diagnose, according to Dr. Jessica Drummond, DCN, CNS, PT, NBC-HWC. She is the founder and CEO of The Integrative Women’s Health Institute and the author of Outsmart Endometriosis. She is a licensed physical therapist, a clinical nutritionist, and a board-certified health coach with more than two decades of experience working with women facing complex pelvic pain, hormonal transitions, autoimmune conditions, and chronic illness patterns. In this episode of the VNEW Health Podcast, Robert Greer talks with Dr. Drummond about why pelvic pain gets dismissed, how she approaches diagnosing the condition, and why she believes surgical recovery care in women’s health lags behind other specialties.
Key Takeaways From Dr. Drummond
- The average wait for a real endometriosis diagnosis is still around 12 years
- Endometriosis is at least partly genetic, so severe pain often looks normal within a family
- Pain that causes a girl to miss school, practice, or activities is a red flag, not a normal period
- Onset typically falls between ages 8 and 12, before most patients ever see a gynecologist
- Labs are usually normal, and a clean ultrasound or MRI does not rule endometriosis out
- There is no single blood test for endometriosis, and no validated biomarker yet
- Lesions can grow anywhere in the body, including the lungs and joints, and produce their own hormones and inflammation
- Excision surgery removes lesions, but surgery alone does not address a chronic systemic condition
- An ACL repair comes with a full nutrition and rehab protocol; endometriosis surgery usually does not
- Roughly 87% of women in perimenopause and menopause carry another underlying or new chronic condition
Why Pelvic Pain Gets Minimized
Dr. Drummond outlines three primary reasons she sees severe pelvic pain routinely treated as normal.
First, she notes a widespread cultural assumption that painful periods are expected. Second, because she observes a strong genetic pattern in her practice, multiple women in the same family often share severe pain, making it feel baseline. She frequently sees histories involving an aunt with unexplained infertility, a grandmother who had a hysterectomy, and a mother with chronic pain. Third, she highlights that primary care providers seeing young girls between ages 8 and 12 rarely receive specialized training in identifying early pelvic pain.
In her view, a healthcare system accustomed to dismissing women’s pain combines with normalized family histories, meaning endometriosis is rarely considered until a patient eventually reaches a specialist.
When Period Pain Is Not Normal
Dr. Drummond sets a clear threshold for evaluating pain. While endometriosis symptoms can overlap with ordinary period discomfort, she advises that pain is abnormal whenever it forces a young girl to miss school, skip athletic practice, or limit daily function.
She notes that clinical presentation varies widely. Pain does not need to align strictly with the menstrual cycle; some patients experience constant discomfort, while others face mid-cycle flares or irregular symptoms.
In her practice, symptoms frequently begin between ages 8 and 12 during early puberty. Beyond pelvic pain, she flags digestive issues (such as severe nausea or stomach upset during ovulation or menstruation) as common secondary indicators.
Why an Endometriosis Diagnosis Takes an Average of 12 Years
Dr. Drummond attributes the typical 12-year diagnostic timeline to systemic challenges in medicine.
Beyond gaps in provider education and historical biases in evaluating female pain, she points to a structural misalignment in healthcare. Standard medical workflows are built around acute issues with straightforward diagnostic tests and direct treatments.
Because chronic pelvic pain involves complex, overlapping drivers without a single diagnostic test, Dr. Drummond emphasizes that patients often need to proactively advocate for themselves and seek clinicians who specialize in complex pelvic conditions.
Her advice to women in the meantime is direct. You do have to be proactive and self-advocating, but there are more and more practitioners who understand this. Keep asking the questions and keep finding new practitioners to ask.
How Endometriosis Is Diagnosed
When evaluating potential endometriosis, Dr. Drummond notes that standard diagnostic tests frequently appear clear:
- Labs: Standard blood work is generally normal, though heavy bleeding can lead to low ferritin or anemia. She sometimes observes mild inflammatory markers, such as elevated CRP or subtle white blood cell shifts.
- Imaging: While advanced imaging like specialized MRI mapping has improved over the last five years, Dr. Drummond cautions that a negative transvaginal ultrasound or MRI does not rule out the condition, as detection depends heavily on technician expertise.
- Blood Tests: She notes that no definitive diagnostic blood test or biomarker currently exists, though research into menstrual blood markers is ongoing.
- Surgical Evaluation: When non-invasive workups are inconclusive, diagnostic surgery often remains necessary to confirm the presence of lesions.
Endometriosis Is a Systemic Disease, Not a Pelvic One
Dr. Drummond describes endometriosis as a systemic disease of inflammation rather than a condition confined to the pelvis. She characterizes it as a benign but cancer-like condition, in that there are benign growths that could be located anywhere in the body. Those growths can produce their own hormones and their own inflammation.
How it presents
Pelvic pain and pain with sex are the most common differentiating symptoms. Beyond those, she lists urinary frequency, urinary urgency, and bladder pain.
Beyond the pelvis
She notes that endometriosis has been seen in the lung and in joints, and that some women have pain with breathing. She also mentions diaphragm issues.
Overlapping conditions
Dr. Drummond’s clinical experience is that the women she works with are rarely dealing with one thing. She describes patients navigating fatigue and overlapping immune, autoimmune, and dysautonomia disease states alongside the pelvic pain. She also cites 87% of women in perimenopause and menopause carrying another underlying or new chronic condition, with endometriosis affecting roughly 10% of women.
Excision Surgery and the Recovery Care Women Do Not Get
Dr. Drummond advocates for laparoscopic excision surgery to remove lesions rather than superficial ablation. Because these lesions consist of tissue similar to the endometrial lining, complete surgical removal is critical.
However, she highlights a major disparity in perioperative support.
She points out that while patients undergoing cancer or orthopedic surgeries routinely receive pre- and post-operative physical therapy and nutritional support, pelvic surgery patients are rarely provided comprehensive rehabilitation protocols.
In her practice, Dr. Drummond recommends addressing several core areas for recovery, whether or not a patient undergoes surgery:
- An anti-inflammatory diet as a general baseline
- Good quality sleep
- Nervous system regulation through slow deep breathing and mindfulness
- Appropriate strength and conditioning
- Soft tissue, fascia, and circulation work around the pelvis and the whole body, which is where pelvic floor physical therapy fits
- Support from family and employers, and enough financial margin to actually rest
She uses skier Lindsey Vonn as the comparison. Vonn’s surgeries were complicated by the severity of her injury, but her cardiovascular condition, nutrition, and strength made recovery far more likely than for someone with osteoporotic bones, a decade of fast food, and no strength training history. Her point is that women do not need to train at that level. The difference shows up anyway, in surgical outcomes, in long-term outcomes, and potentially in how many surgeries a woman needs at all.
Some women are not surgical candidates. Some decide against surgery. She says the same whole-body approach applies either way.
If you are researching surgical options for pelvic floor conditions, see pelvic floor conditions and treatment options.
How to Find a Practitioner Trained in This Approach
To help patients access comprehensive care, Dr. Drummond founded the Integrative Women’s Health Institute, which has trained nearly 4,000 healthcare professionals across more than 60 countries. The digital curriculum covers perimenopause and menopause care, endometriosis management, functional lab interpretation, and hormone therapy.
She advocates for expanding this training beyond gynecology to include physical therapists, nurse practitioners, dietitians, and health coaches.
Patients can locate trained providers through the Institute’s online directory or by contacting their support team for regional referrals.
Dr. Drummond’s book, Outsmart Endometriosis, is available on Amazon in e-book and audiobook formats.
Episode Timestamps
| Time | Topic |
| 00:55 | Introduction: Dr. Jessica Drummond and the Integrative Women’s Health Institute |
| 01:59 | Why women’s pain gets minimized and normalized |
| 02:44 | Family history and how severe pain becomes the baseline |
| 03:27 | Endometriosis as a systemic disease, not a pelvic one |
| 04:04 | The symptoms that should not be normalized |
| 05:06 | How she describes endometriosis to patients |
| 06:34 | Presentation at puberty and what to look for in family history |
| 06:55 | What the labs and imaging actually show |
| 07:59 | When the diagnosis has to be surgical |
| 08:34 | Excision surgery and what the lesions are |
| 09:05 | The inspiration behind Outsmart Endometriosis |
| 09:52 | What ACL and cancer patients get that women’s health patients do not |
| 10:50 | Supporting women with or without surgery |
| 11:23 | The Lindsey Vonn comparison |
| 13:01 | Rotator cuff repair versus women’s health |
| 13:46 | Patients as their own advocate |
| 15:14 | Building the Integrative Women’s Health Institute |
| 16:20 | Taking the training digital |
| 16:43 | The three professional programs |
| 17:29 | Why every discipline needs the wider lens |
| 19:22 | Close to 4,000 practitioners in more than 60 countries |
| 20:22 | What the curriculum covers |
| 21:34 | Hormone therapy, peptides, and GLP-1s |
| 22:01 | Longevity tools and the evidence question |
| 22:51 | Why sauna and cold therapy data does not transfer between men and women |
| 23:59 | How patients find a trained practitioner |
| 25:15 | Advice for women still searching for answers |
| 26:02 | Advice for practitioners |
FAQS
At least in part, according to Dr. Jessica Drummond. She describes seeing whole families of women who struggled with endometriosis whether or not they were ever formally diagnosed, with a great aunt who had infertility, a grandmother who had a hysterectomy, and a mother who had pelvic pain. She notes that this family pattern is one of the reasons severe pain becomes normalized, because it looks like what is normal for that family.
Dr. Jessica Drummond describes endometriosis as a systemic disease of inflammation rather than an autoimmune disease. She explains that the growths can produce their own hormones and their own inflammation. She also notes that the women she works with are frequently navigating overlapping immune, autoimmune, and dysautonomia conditions alongside endometriosis, which is part of why she considers a single-system treatment approach inadequate.
Sometimes, but a clear scan does not rule it out. Dr. Jessica Drummond says imaging mapping using MRI has improved, with significant work on imaging-related diagnostics over the last five years. She cautions that endometriosis not appearing on a transvaginal ultrasound or MRI does not mean it is absent, because the person capturing or reading the images may not be skilled enough to identify it. In some cases the diagnosis is surgical.
Not at present, according to Dr. Jessica Drummond. She says there is currently no single blood test that can tell you whether you have endometriosis. Labs generally come back normal, though some women trend toward anemia and low ferritin from heavy bleeding, and some show elevated inflammatory markers such as CRP or mild inflammation-related shifts in white blood cells. She notes ongoing research into menstrual blood as a possible biomarker, but no biomarker exists yet.
Dr. Jessica Drummond says it remains common to wait an average of 12 years before receiving a real diagnosis. She attributes the delay to a lack of education among practitioners, a longstanding cultural pattern of not taking women’s pain seriously, and a healthcare system built around conditions that have a clear diagnostic test and a single fix. Chronic pain conditions have many potential drivers, no simple diagnostics, and no simple solutions.
Dr. Jessica Drummond says endometriosis tends to present roughly between ages 8 and 12 as girls move from pre-puberty into puberty. The red flag is pain severe enough that a girl misses school, sports practice, or another activity she wants to do. She adds that digestive symptoms and headaches are among the most common presentations, so vomiting or significant stomach upset around a period or ovulation is another signal.
Yes. Dr. Jessica Drummond lists urinary frequency, urinary urgency, and bladder pain among the ways endometriosis can present. She also notes that endometriosis commonly overlaps with other chronic pelvic pain conditions including bladder pain syndrome and myofascial pelvic pain.
Dr. Jessica Drummond says endometriosis has been seen in the lung and in joints, and that some women experience pain with breathing. She describes the lesions as benign growths that can appear anywhere in the body, though they most commonly grow in the abdominal and pelvic region, which is why she characterizes the condition as systemic rather than confined to the pelvis.
Dr. Jessica Drummond describes excision surgery as cutting out the lesions, which she explains are tissue similar to the lining of the inside of the uterus but not exactly the same. She compares the approach to a cancer surgery in that the lesions have to be genuinely removed, and notes that there are increasingly skilled excision surgeons in the United States and worldwide.
Dr. Jessica Drummond argues that endometriosis surgery should receive the same before, during, and after support that an ACL repair or cancer surgery receives, including nutrition and physical therapy. She points to an anti-inflammatory diet, good quality sleep, nervous system regulation through slow deep breathing and mindfulness, appropriate exercise, and support from family and employers. She says these factors influence both surgical outcomes and long-term outcomes, and may reduce the number of surgeries a woman ultimately needs.
