For 16 years, Dr. Iris Kerin Orbuch woke in the middle of the night in pain.
“I’d crawl into the bathroom,” she says. “Nothing relieved the pain. Eventually, I’d turn on an Epsom salt bath at two or three in the morning, and that took the edge off of it to a degree.”
She was a fellowship-trained endometriosis excision surgeon. She had trained under pioneers Dr. Harry Reich and Dr. C.Y. Liu. She could diagnose the disease in her patients with over 90 percent accuracy.
Dr. Iris Kerin Orbuch in Victoria Beckham.
And yet, “There I was sitting face to face with my patients,” she recalls, “and I’m like, do I have Endo? Do I have Endo? This is me. This is me. This is me.”
Dismissed by doctors and those close to her, the beloved doctor, revered by her patients, credited with changing their lives for the better, didn’t think her own pain was real. “There was so much gaslighting,” she says. “Even though I was waking up in the middle of the night in debilitating pain, I didn’t believe it because a man was telling me, ‘You don’t have it. Your pain is not real,” she recounted.
She was a mother of two. Running a practice, building a reputation, and carrying her patients’ trauma… alongside her own.
“I was just like — I didn’t believe my own pain.”
Endometriosis affects roughly 10 percent of women. That’s 1 in 10 women. If you’re in a room of 100 people, she says, about 10 have it — most don’t know they do.
Dr. Kerin Orbuch says some major misconceptions about endometriosis need to be cleared up. “It is not ‘just a period problem.’ The brain, muscles, and of course, all the reproductive organs, diaphragm — In just about every organ of the body,” she says. “That’s where endometriosis can live.”
The disease occurs when tissue similar to the uterine lining grows outside the uterus, triggering inflammation, scarring, adhesions, infertility, bladder dysfunction, bowel symptoms, and chronic pain. But it’s chronically missed.
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“Ultrasounds are usually normal,” she explains. “We don’t pick up endo typically on ultrasounds. Even though there’s the capacity to pick it up on MRIs — and it’s better these days — most MRIs are still reported as normal.”
And so the cycle begins.
“Doctors are under more and more pressure to see more patients. You can’t get too in-depth into their history. The doctor’s hand is on the door, and the patient says, ‘Oh, I’m having painful sex,’ or ‘My period pain is really bad.’ They’ll say, ‘Go for an ultrasound.’ Then they call them and say, ‘Your ultrasound’s normal. You’re totally fine.’”
Dr. Kerin Orbuch explains that endometriosis is an invisible disease. It’s hidden in plain sight. “It’s so obvious,” she says. “But everything I learned in residency about endo was incorrect. I learned more in my first week of fellowship than I did in four years of medical school plus four years of residency.”
Most general gynecologists, she explains, recognize only two visual appearances of endometriosis during surgery. In reality, it can be blue, yellow, white, red, clear — morphing in texture and form.
Her mentor, Dr. Harry Reich, had a name for superficial, uninformed surgeries. “He called it a ‘peakoscopy,’” she says. “They put the scope in, don’t know what they’re looking at, and tell the patient, ‘You’re normal.’”
The medical gaslighting compounds.
“There’s no correlation between stage and pain,” she explains. “Quantity of disease does not correlate with severity of symptoms.”
So when a generalist misses lesions or ablates (burns) rather than excises them, patients are sent home still suffering. “And then they’re denying their pain even more. ‘Oh, I had surgery. They fixed it.’ It’s devastating.”
So, why does it take seven to ten years, sometimes decades, to diagnose? Because the symptoms are siloed.
Gynecological: period pain, pelvic pain, infertility.
Gastrointestinal: constipation, diarrhea, and painful bowel movements, often mislabeled as IBS or small intestinal bacterial overgrowth.
Urological: urinary urgency, bladder pain, feeling of constant UTI.
Autoimmune overlap: rheumatologic symptoms.
“In medicine, we’re taught to think in silos,” she says. “Not big picture.” Add hormonal suppression (like birth control pills — which temporarily mask symptoms while the disease progresses), and the picture becomes even murkier.
Dr. Kerin Orbuch notes that the familial risk is profound. It’s something that’s not always taken into account when doctors are diagnosing. “If your mom, aunt, grandmother, or sibling has endo, you have a 70 to 100 percent likelihood of having it yourself,” she points out. “It’s huge. But most people don’t know that link.”
The only definitive diagnosis happens on the operating table. “At the time of surgery, you remove the tissue, send it to pathology, and under a microscope, they confirm endometriosis.”
But Dr. Kerin Orbuch can often tell before then. She spends countless hours with her patients and puts the puzzle pieces together like a detective. “Between my line of questioning and my physical exam, I can tell with over 90 percent likelihood.” She feels asymmetry. Muscle guarding. Tender nodules. A story that repeats.
For a decade, she had been building what she calls an “East-meets-West approach.”
She partnered with pelvic floor physical therapists, like Dr. Amy Stein, with whom she wrote her 2019 book, Beating Endo: How to Reclaim Your Life from Endometriosis. “That’s important because the muscles tighten in response to pain and anatomical distortion,” she explains.
Dr. Iris Kerin Orbuch, with endometriosis advocates Corinne Foxx (left) and Courtney Ford (right).
She also collaborated with urologists to address the “evil triad” of endometriosis, tight muscles, and interstitial cystitis. She also became “obsessed with the gut.”
Finally, when a patient of hers began seeing an integrative physician and healing her microbiome, Dr. Kerin Orbuch had a realization. She knew she had to do the same. Her own microbiome testing revealed a severe imbalance. “It was so off from all of the inflammation.” She then began pelvic floor therapy weekly for two years.
“My muscles were in a state of contracture,” she explained. She modified her diet. Addressed bladder triggers. Pursued integrative care. “Mind you,” she says, “this is what I’ve done for my patients for 10 years, and I’m finally just doing it for me.”
And still — she doubted.
The turning point came in 2020 through her daughter, when she underwent excision surgery. Deep down, she knew what they would find. When the surgeon called from the OR to confirm the diagnosis of endometriosis, something shifted.
“If she had it,” Dr. Kerin Orbuch says, “chances are it was coming from me.” In January 2021, she underwent surgery herself. “The surgeon said, ‘Iris, everywhere you thought you had endometriosis — that’s exactly where it was.’”
Finally, there was validation. “It was like, Iris, I believe you,” Dr. Kerin Orbuch shares. But there was grief too — especially after undergoing a hysterectomy for suspected adenomyosis.
“I counsel my patients about grief,” she says. “But I didn’t do it for myself.”
Dr. Kerin Orbuch traces her passion to help others back to her father. He was a beloved cardiologist, respected for his skill and admired for his kindness to everyone, who was the one who had urged her for a decade to write a book. He was her inspiration.
“He’d say, ‘Don’t do tomorrow what you can do today.’” He’s the reason she wrote Beating Endo.
“The way to change the narrative isn’t through physicians,” she finally realized. “It’s through patients.”
On her mission to help others, Dr. Kerin Orbuch joined forces with filmmaker Shannon Cohn, appearing in Endo What? and later 2023’s Below the Belt, bringing endometriosis to Washington and earning bipartisan attention.
“With the help of Senator Orrin Hatch and Senator Elizabeth Warren, we let Congress know we needed help with funding and told them we need to put the power in the patients.”
Patients are her priority, which is why her consultations now last 90 minutes. “I listen,” she says. “I read every record.” She explains the disease. Identifies pelvic floor dysfunction. Screens for gut dysbiosis. Evaluates bladder symptoms. Addresses trauma. Discusses cortisol and fight-or-flight.
“Surgery is the most important part,” she tells patients. “But we have to undo everything.” Prehab. Excision. Post-op integration. Microbiome repair. Somatic therapy. Mental health support.
Her office is intentionally calm — waterfalls, soft lighting, soothing voices. Everything she wished she’d had, she now builds for others.
Dr. Kerin Orbuch urges, “To trust your gut. Trust your pain. Trust your intuition. Don’t let anyone deny your truths. If you’re experiencing any of these symptoms, find an endometriosis excision specialist. Believe in yourself.”
Dr. Iris Kerin Orbuch in Victoria Beckham.
It took her 21 years — from stepping into an operating room in 1999 to her own diagnosis in 2021 — to fully trust her intuition.
Now she ensures her patients don’t have to wait that long.
Endometriosis is hidden in plain sight. But so is knowing.
And this time, she believes it.
Dr. Iris Kerin Orbuch is the Founder of Iris Wings Sanctuary for Endometriosis Surgery & Wellness in Los Angeles. She specializes in Laparoscopic and Robotic Gynecologic Surgery, and operates primarily as a referral practice.
