Fertility Q&A: Endometriosis, PCOS, Ectopic Pregnancy & More

As a Woman

Natalie Crawford

Medicine, Health & Fitness

4.8 • 1.1K Ratings

🗓️ 5 April 2026

⏱️ 10 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

Dr. Natalie Crawford, board-certified OB-GYN and REI, answers your fertility questions. I’m on Lupron for suspected endometriosis and have been on suppression for almost two months, but I’m noticing vaginal cramping, ovarian pain, shooting rectal pain, and increased pain with intercourse. Is it normal to have increased pain during Lupron suppression, or does this suggest something else is going on? How long, on average, should someone with PCOS and insulin resistance stay on metformin, especially when trying to conceive or undergoing fertility treatment? I recently had an ectopic pregnancy located on my ovary. Is this typically just bad luck, or are there underlying risk factors that increase the likelihood of this happening again? After experiencing an ectopic pregnancy, is there anything specific I should do as soon as I get a positive pregnancy test in the future to ensure everything is progressing safely? When trying to conceive, when should retinol be discontinued? Is it safe to continue using it up until a positive pregnancy test, or should it be stopped earlier? I regularly take creatine (about 5–10 grams per day). Is it safe to continue using creatine while trying to conceive or during pregnancy? Pre-order Dr. Crawford's debut book, The Fertility Formula, now! https://www.nataliecrawfordmd.com/book Want your questions answered on the next episode? ⁠Ask them here! https://www.nataliecrawfordmd.com/qa-submissions Learn more about your ad choices. Visit megaphone.fm/adchoices

Transcript

Click on a timestamp to play from that location

0:00.0	Welcome back to the As-A-Women podcast. I'm your host, Dr. Natalie Crawford. And today is one of your favorite episodes. These are our fertility Q&A. And joining me today is Emily Whitlock. Hi, M. Hi. Okay, let's do it. Okay, so the first one is actually a question that we talked about on one of our Q&A episodes for the book club. Oh, okay. It's about Lupron, which I feel like we talked about a lot, and the side effects.
0:24.7	Okay. we talked about on one of our Q&A episodes for the book club. Oh, okay. Um, it's about
0:21.4	LuPron, which I feel like we talked about a lot and the side effects. Okay, so she says,
0:25.7	is it normal to have increased pain during Lupron suppression? I had a diagnosis of unexplained
0:30.9	infertility, but receptiva biopsy and pain during intercourse led my Ari to suspect endo.
0:36.1	I've been on suppression for almost two months and have
0:38.7	noticed vaginal cramping, pain with ovaries, or sorry, pain around ovaries, shooting rectal pain,
0:44.5	and increased pain during sex. Sometimes my symptoms come and go and they aren't consistent,
0:49.7	but other than that, I'm not sure if this is normal or if I'm just paying too much attention to my body now.
0:55.5	And I know that I likely the infertility is caused from the endo.
1:00.0	This is a hard one.
1:01.2	Indemetriosis, if people don't know, is a chronic inflammatory condition where you have implants of endometrial-like tissue outside the uterus.
1:08.1	And the classic symptoms are all the ones that she just talked about.
1:11.9	Pain with intercourse, deep pelvic pain, no rectal pain, even pain with bowel movements or
1:16.7	GI disturbances. And endo gets progressively worse over time. It's a top cause of unexplained
1:22.3	infertility. So number one, I'm glad you're already even thinking this. It's a hard diagnosis to get, meaning we have to do surgery to confirm you, don't have it or you do.
1:32.7	Receptiva can be a test that can suspect it.
1:35.3	It's an endometrial biopsy test, but it's not perfect.
1:38.1	And there's no blood test, and you can't always see it on ultrasound.
1:41.3	So really hard to get the diagnosis.
1:42.8	So one, props to your doctor for even being more proactive and treating you as suspected endometriosis.
1:50.5	Lupron's what we call a GNRH agonist, meaning in the brain, it binds and it causes the brain
	...

Please login to see the full transcript.

Previous episode | Next episode

Disclaimer: The podcast and artwork embedded on this page are from Natalie Crawford, and are the property of its owner and not affiliated with or endorsed by Tapesearch.

Generated transcripts are the property of Natalie Crawford and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.