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We talk about what it feels like when your body becomes unpredictable and you stop feeling safe inside it. With pelvic health occupational therapist Karla Ehlers, we share how nervous system support and pre-surgery planning can create steadier recovery and more confidence.
• naming the link between unpredictability, fear, and nervous system dysregulation
• building safety in the body as an individualized skill
• preparing for excision surgery by finding baseline movements that feel good
• avoiding random new exercises post-op by using familiar go-to tools
• using vagus nerve strategies while also addressing what still feels unsafe
• leaning on predictability as a form of nervous system support

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“Unexplained infertility” can feel like a dead end, especially after you’ve done everything you were told to do and the embryo transfers still don’t stick. We sit down with Dr. Sadikah Behbehani, a double board certified fertility doctor and minimally invasive gynecologic surgeon, to talk through a reality many patients never hear clearly: endometriosis is frequently the hidden cause behind infertility, recurrent implantation failure, miscarriages, and years of confusion, even when pain is mild and imaging looks normal.

We get practical about the decision points patients face every day. How do you screen for endometriosis when fertility workups focus on sperm, tubes, ovulation, and “normal” ultrasounds? Why is laparoscopy with expert excision still the only definitive diagnosis, and why does surgeon skill change what gets found, treated, and prevented from recurring? Dr. Behbehani explains how inflammation and scarring can interfere with fertilization and implantation, how endometriomas can affect ovarian response, and why age and timing often matter more than any single lab result, including AMH.

We also tackle the hardest planning questions: whether to do IVF before surgery or after surgery, why IVF medications can flare endometriosis pain without clear evidence of worsening disease stage, and when GnRH agonists like Lupron make sense for embryo transfer versus egg retrieval. We discuss symptom management when surgery has to wait, plus nuanced medication decisions including cannabis use, SSRIs, and newer weight loss drugs, with an emphasis on individualized care rather than rigid rules.

If you’re trying to protect your fertility while living with endometriosis or adenomyosis, share this with someone who needs clearer options, then subscribe and leave a review so more patients can find it. What decision are you facing right now: surgery first, IVF first, or egg freezing as a backup?

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Your pelvic floor might be doing its job a little too well. When stress hits, many of us brace without noticing and that tension can land deep in the core, shaping everything from pelvic pain to how safe we feel in our own body. We sit down with Karla Ehlers, a pelvic health occupational therapist and founder of Ocupelvic Health and Wellness, to connect the dots between nervous system states and pelvic floor dysfunction in a way that feels practical, human, and doable.

We talk about the pain cycle: fear and past trauma can trigger a protective “guarding” response, which ramps up the sympathetic nervous system, which then feeds more pain and more threat. Karla explains why fight or flight is not the villain, we need it for energy and everyday function, but we also need an off-ramp back to parasympathetic regulation. You will hear concrete examples of where people hold tension most, including pelvic floor tightening, jaw clenching, upper ab gripping, and glute squeezing, plus how sensory stress like constant noise can push the body further into dysregulation.

We also dig into interoception, the skill of sensing what is happening inside your body. Chronic pelvic pain, chronic stress, and neurodivergence can make those signals either harder to read or so loud that everything feels like danger. Carla offers a steadier approach: build functional awareness first, notice early signals before they reach 10 out of 10, and practice small releases that support lasting change.

If this quick, focused conversation helps, subscribe for more expert insights, share it with someone who needs it, and leave a review so more people can find support.

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Website endobattery.com

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