The Truth About Natural Killer Cells & Miscarriage

On a daily basis we get people, who are having failed IVF cycles, calling my clinic looking for some miracle pill, to supposedly eradicate the body of natural killers cell and wipe them off the face of the planet in some war like rage, all because they have been told this will bring an end to their fertility woes.

I wish it was that easy and when my staff go on to explain that treating natural killers cells (uterine killer cells), and especially looking at the cause of natural killer cells (uterine killer cells), is complex, there is no one miracle cure, nor some magic pill, people get annoyed and hang up the phone in a huff ,without listening to the reasons why.

One of the things I always say, when people ask me about regulating natural killer cells for fertility purposes, is “How long is a piece of string?”

This is because this subject is very complex and there are many reasons why natural killer cells may be impacting implantation. So, hence the response is always going to be “How long is a piece of string?”

While Natural killer (NK) cells have an important role in the early responses to viral infections, they have also been linked with failure of pregnancy.

Increasingly, clinics are offering blood tests, at an increased cost to the patient, to measure the number and activity of circulating NK cells. As a result of these investigations, many women are offered treatments such as steroids, intravenous immunoglobulins, and tumour necrosis factor blocking agents. The scientific rationale for these tests and treatments, however, is not always supported by our current knowledge of the function of uterine NK cells.

So, I thought it was about time I set the records straight on the BS information, that seems to being handed around as gospel, by money hungry fertility clinics run by big health conglomerates, and by the rotten Dr Google, about natural killer cells (uterine killer cells) and these supposed miracle pills, that will miraculously fix someone’s fertility issues.

Let’s Look at the Facts about Natural Killer Cells Relating to Miscarriage

  1. There is no miracle pill, or one supposed miracle treatment, or a one pill solution to treat, or get rid of natural killer cells. You do not want to get rid of NK Cells.
  2. Natural Killer Cells are a natural part of the immune system designed to target inflammation, kill of cancer cells, kill off bacteria and protect the body from harmful invasion of foreign organism
  3. There is huge difference between natural killer cells that are circulating in the blood stream, compared to uterine killer cells
  4. Uterine Killer Cells are in large numbers during a pregnancy to protect the embryo
  5. Natural Killer Cells are only in large number and are only being sent out by the immune system because there is some inflammatory process going on in the pelvis, or the rest of the body
  6. You cannot regulate Natural Killer Cells numbers unless you first address the inflammatory process that is causing them to be in high numbers in the first place (Eg- Inflammatory gynaecological conditions such as PID, Endometriosis, PCOS, Adenomyosis, Adhesions, STI’s, CIN, HPV, Herpes etc)
  7. Many people have not had the proper initial fertility investigations and testing needed to actually fall pregnant in the first place and looking at Natural Killer Cells, before all that proper testing etc is done, is actually not assessing the patient properly.
  8. If you do not treat the cause of the Natural Killer Cells being in high numbers, you will not be able to reduce the numbers of Natural Killer Cells that are actually doing the job they are meant to do, which is …. Protect the Body.
  9. Many of the so called treatments for Natural Killer Cells, regarding fertility, have never been approved for such treatment and research on it is still inconclusive.
  10. Some of the treatments being proclaimed as miracle cures (Intralipids etc) are purely money making exercises that are preying on the vulnerability of people who have been told wrong information and have this perception of some killer being inside their body attacking their embryos.
  11. Intralipids have never been proven to treat Natural Killer Cells and are derived from highly inflammatory soy based compounds, which then in turn can cause more inflammation.
  12. The drugs used in the treatment of Natural Killer Cells are steroidal based and carry many side effects and are for more harmful to the body that any natural killer cell will ever be. The steroids are also a category C drug that has been shown to have an effect on the neonate
  13. Steroids, such as Prednisone, do work on regulating NK cells, but they do so by suppressing the immune system, thus compromising a person’s immunity. There are also risk to peoples minerals by using these long term and there are also other side effects to the body.
  14. Natural Killer Cells are there to protect the body, not hurt it.
  15. Natural Killer Cells are only attacking embryos because they are seen as foreign body as well and when they are there trying to kill of the diseases and issues causing inflammation in the body, they just happen to kill of any other foreign organism and inflammatory processes at the same time
  16. Again, to address natural Killer Cells, you need to address the inflammatory process as to why they are in high numbers in the first place
  17. The perception around Natural Killer Cells being this “thing” killing off embryos in the body is misguided and is actually not a true representation of what Natural Killer Cells actually do. It is purely often used to tug on the heartstrings of unsuspecting patients, who are highly emotive and clinics use these emotions to get them to pay for treatments that have never been fully proven to work.
  18. The name “Killer Cell” is too often exploited in the wrong context by many in the fertility world
  19. Blood tests cannot measure the number of Natural Killer Cells in the Uterus, Only a biopsy can do this.
  20. A Natural Killer Cell (uterine killer cells) Biopsy has to be done between the 24th and 28th day of your menstrual cycle to give the best results.
  21. Blood tests can only measure the circulating NK cells in the body and not the uterine killer cell activity, which can be the cause of recurrent miscarriage. So, if you have had a blood test, it is not measuring what is needed. Everyone will have circulating NK cells in their blood stream.
  22. The percentage of CD56+ NK cells in peripheral blood in normal healthy individuals varies from 5% to 29% (2)Despite this, more than 12% NK cells in women with infertility or miscarriage has been arbitrarily defined as abnormally raised and used as an indication for treatment (4)
  23. The percentage of NK cells in blood can be affected by many factors including sex, ethnicity, stress, and age too.

Natural Killer cells (Uterine killer cells and other NK cells) are the main immune cell-type found in the uterus. Their numbers increase through the menstrual cycle to peak at the time of implantation. If an embryo does implant, NK cell numbers increase further to 70% of all cells.

Uterine NK numbers start to decrease at around the 20 week mark of pregnancy and are all but absent at the end of pregnancy.

Natural killer cells acquired their name as a result of the initial test used to identify them in vitro. Unlike T lymphocytes, NK cells are able to spontaneously kill cells in a non-MHC restricted manner.

Regrettably, this is a misleading name in reproduction, and the powerful image of maternal cells attacking the fetus is emotive and easily exploited. None the less, these NK cells can kill off the embryo at early stages of pregnancy, but there is nearly always a reason why. That reason is inflammation in the pelvic cavity and uterus. This needs to be addressed to regulate the number of NK cells, not some notion of killing off the “Killer Cells”.

Types of Inflammation causing high Natural Killer Cells (Uterine Killer Cells)

  • Endometriosis & Adenomyosis
  • PCOS/PCO
  • Fibroids, Myomas
  • Vaginal Infections & Bacteria
  • STI’s
  • Cancer, Trauma, Localised Lesions & Others
  • Stress

Yes, stress can lead to a compromised immune system, which then leads to high TNF (Tumor Necrosing Factor) and increase Natural Killer Cells, which then leads to prolonged increase activated T Cells, and this then causes reduced implantation of embryos.

This is also a reason why any inflammation in the uterus or pelvic cavity needs to be addressed to help fix this issue and one of the reasons why any woman having fertility issues needs to be investigated and treated properly. This needs to involve proper differential diagnosis, proper pathology testing, genetic testing and surgical investigations such as laparoscopy prior to any further fertility treatment. A laparoscopy is the gold standard for addressing and treatment of issues in the uterine and pelvic cavity.

Natural Killer Cells (Uterine Killer Cells) can be a part of recurrent miscarriage, but we need to stop the misinformation and perception of them being some killer organism that isn’t meant to be in the body. They are meant to be in the body and the name is all too often exploited by many to offer unproven treatments and medications by clinics trying to increase profits.

If you want to regulate and treat natural killer cells (relating to recurrent miscarriage) properly, you need to find out what is causing them to be there in the first place. There is no magic pill to get rid of Natural Killer Cells. You cannot rid the body of Natural Killer Cells anyway. They are meant to be there. You can only regulate the amount of killer cells doing their job and you need to find out why they are in higher numbers in the first place. This is usually because there is some sort of inflammation, infection, bacteria, or malignancy going on in the body that has not been investigated properly in the first place. Let’s not forget that stress, yes stress, increases the amount of Natural Killer Cells in the body too.

At my clinic, I have a proper Natural Killer Cell protocol and treatment plan that is individually tailored and looks at the “cause” of high number of Natural Killer Cells and makes sure that proper investigations, testing and treatment are administered to treat the person properly. This can also be done alongside current medical protocols such as the Bondi protocol, or California protocol.

Regards

Dr Andrew Orr

(Reproductive Medicine & Women’s Health Medicine Specialist)

-The International Baby Maker

-No Stone Left Unturned

References

  1. Moffett-King A. Natural killer cells and pregnancy. Nat Rev Immuol 2002;2: 656-63.[CrossRef][Web of Science][Medline]
  2. Pijnenborg R, Vercruysse L, Hanssens M, Van Assche A. Incomplete trophoblast invasion: the evidence. In: Critchley H, MacLean A, Poston L, Walker J, eds. Pre-eclampsia. London: RCOG Press, 2003: 15-2615. Parham P. NK cells and trophoblasts: partners in pregnancy. J Exp Med 2004;200: 951-5.[Abstract/Free Full Text]
  3. Hiby SE, Walker JJ, O’Shaughnessy KM, Redman CWG, Carrington M, Trowsdale J, et al. Combinations of maternal and paternal innate immune genes influence the risk of pre-eclampsia. J Exp Med 2004;200: 957-65.[Abstract/Free Full Text]
  4. Aoki K, Kajiura S, Matsumoto Y, Ogasawara M, Okada S, Yagami Y, et al. Preconceptional natural-killer-cell activity as a predictor of miscarriage. Lancet 1995;345: 1340-2.[CrossRef][Web of Science][Medline]
  5. Ntrivalas EI, Kwak-Kim JY, Gilman-Sacchs A, Chung-Bang H, Ng SC, Beaman KD, et al. Status of peripheral blood natural killer cells in women with recurrent spontaneous abortions and infertility of unknown aetiology. Hum Reprod 2001;16: 855-61.[Abstract/Free Full Text]
  6. Bisset LR, Lung TL, Kaelin M, Ludwig E, Dubs RW. Reference values for peripheral blood lymphocyte phenotypes applicable to the healthy adult population in Switzerland. Eur J Haematol 2004;72: 203-12.[CrossRef][Web of Science][Medline]
  7. Kwak JY, Kwak FM, Gilman-Sachs A, Beaman KD, Cho DD, Beer AE, et al. Immunoglobulin G infusion treatment for women with recurrent spontaneous abortions and elevated CD56+ natural killer cells. Early Preg 2000;4: 154-64.
  8. RCOG Scientific Advisory Committee. Immunological testing and interventions for reproductive failure. London: RCOG, 2003. (Opinion paper 5.)
  9. Scott JR. Immunotherapy for recurrent miscarriage. Cochrane Database Syst Rev 2003;(1): CD000112.
  10. Daya S, Gunby J, Clark DA. Intravenous immunoglobulin therapy for recurrent spontaneous abortion: a meta-analysis. Am J Reprod Immunol 1998;39: 69-76.

 

 

What Is Lichen Sclerosus?

Lichen sclerosus is a long-term problem of the skin. It mostly affects the genital and anal areas. Sometimes, lichen sclerosus appears on the upper body, breasts, and upper arms. For this article I am just going to talk about Lichen Sclerosus of the genital region (Vulva) and more around how this affects women and how it can be treated and managed. Lichen sclerosus can cause itching, pain and scarring of the affected areas, but there are treatments available that can relieve symptoms and prevent and treat scarring.

Who Does Lichen Sclerosis Affect?

While anyone can get lichen sclerosus at any age, women after the menopause have the highest risk. In fact, it is about 10 times more common in women than in men. It is possible, but rare, for children to be affected.

What Are the Symptoms?

Early in the disease, small white spots appear on the skin. The spots are usually shiny and smooth. Later, the spots grow into bigger patches. The skin on the patches becomes thin and crinkled. The skin may also be inflamed and red or ulcerated from scratching.

Skin affected by lichen sclerosus can tear easily, and there may be tiny fissures (cracks in the skin). When severe, there may be bleeding and blistering.Sometimes, the skin becomes scarred. If the disease is a mild case, there may be no symptoms. 
Other symptoms are:

  • Itching (very common)
  • Discomfort or pain
  • Bleeding

Genital lichen sclerosus

Lichen sclerosus that affects the vulva usually feels intensely itchy. There may also be pain, stinging, burning or discomfort, especially during sex or when urinating.

Lichen sclerosus is a chronic, or ongoing, condition, and over time it can lead to scarring. If this affects the vulva, it may narrow the entrance to the vagina, interfering with sexual intercourse.

Women with severe lichen sclerosus in the genitals may not be able to have sex. The disease can cause scars that narrow the vagina. Also, sex can hurt and cause the patches to bleed. However, treatment with creams or ointments can help. Women with severe scarring in the vagina may need surgery, but only after lichen sclerosus is controlled with medication. When the skin around the anus is affected, pain when emptying the bowels can lead to constipation.

What Causes Lichen Sclerosus?

Doctors don’t know the exact cause of lichen sclerosus. Some doctors think a too active immune system and hormone problems may play a role. In women, lichen sclerosus also seems to be associated with autoimmune diseases (conditions where the immune system attacks the body), such as lupus , alopecia and thyroid disease. It is also thought that people inherit the likelihood of getting the disease. There may also be a hormonal involvement as It is also more common after menopause, when there is less oestrogen in the body.

Lichen sclerosus is more likely to appear on skin that has been damaged or scarred from some other previous injury. Importantly, lichen sclerosus is not infectious and your partner cannot catch it during sex.

How Is It Diagnosed?

Lichen sclerosus can often be diagnosed from the appearance of the affected skin. It is important that your GP refer you to a pelvic floor/urodynamic specialist, reproductive medicine specialist or women’s healthy specialist that specialises in conditions affecting the female reproductive organs. Sometimes a referral to a dermatologist may also be needed also.

Besides visual diagnosis, a biopsy may be recommended to confirm the diagnosis. This involves taking a small sample of affected tissue for a pathologist to examine under a microscope. This allows specialists to make sure that it is not a different disease.

Treatment of lichen sclerosus

Treatment of lichen sclerosus is aimed at:

  • Relieving symptoms of itch and discomfort;
  • Healing the lesions (returning the affected skin to its normal colour and texture);
  • Preventing the development of scar tissue; and
  • Treating any scar tissue that has developed.

Medical Treatments for Lichen Sclerosus

Lichen sclerosus is usually treated by applying a strong steriod cream, or ointment to the affected area. This is usually applied daily for several weeks, or months, and then less frequently (once or twice per week) long-term to prevent a recurrence.

Corticosteroid ointment or cream should be applied only to the white patches and gently rubbed in. Try to avoid applying steroid to the normal surrounding skin to help prevent side effects.

Symptoms such as itch may improve within a couple of days of starting corticosteroid treatment. Healing of lesions generally takes longer.

Women with Lichen Sclerosis will need regular follow up consultations and management with their specialist while using these creams and ointments for a long time because they can cause the following

  • Thinning and redness of the skin
  • Stretch marks where the cream is applied
  • Genital yeast infections.

Sometimes, women just do not get better using this medication and there could be other things that could be stopping symptoms from clearing up. This could be from the following:

  • Low estrogen levels
  • Infection
  • Allergy to the medication.

Other treatments

If topical steroid treatment is not effective, your specialist may recommend other medications and treatments that target the immune system and help control inflammation.

  • Sometimes other medications such as Retinoids, or vitamin A-like drugs are used and your specialist may also recommend laser treatment.
  • If scarring has occurred, this does not usually improve with steroid treatment. Scarring in females that is affecting sexual intercourse or urination may be helped by surgery
  • There are also some new medical treatments that are presently being researched and providing some amazing results options and I will discuss at a later date. They are actually natural medicines that are being used as a medical treatments. All I can say is that I have seen the results of this new treatment option and I think it is going to help many people. At present on of my colleagues, Dr Philip Hall, is using this treatment to help women as part of a research project. I will update people when I am allowed to say more about this new treatment.

Natural Medicine Treatments

  • There are natural medicine treatments that have been shown to help Lichen Sclerosus
  • Traditional Chinese Medicine
  • Acupuncture
  • Homeopathy
  • Herbal Medicine
  • Nutritional Supplements
  • Diet and nutritional changes ( to help reduce inflammation)
  • Counselling ( to help with dealing with the long term affects of dealing with this disease)

Self-care measures for genital lichen sclerosus

The following self-care measures may help in the treatment of lichen sclerosus that affects the genital area.

  • Gently wash the area daily with warm water and pH neutral soap cleanser.
  • Try not to rub or scratch the area. This can sometimes be really hard when it is itchy and inflamed
  • Avoid tight clothing and any activities that may aggravate itching and discomfort, such as bike riding.
  • Your specialist may recommend you apply cream to gently moisturise and protect the area.
  • Women should use a mirror to become familiar with the location and appearance of their genital lesions, and to apply cream or ointment to the affected area of the vulva.

Complications and follow-up

If you have been diagnosed with lichen sclerosus then it is advisable to have regular follow-up appointments with your specialist every 6 to 12 months. In addition, genital lichen sclerosus is associated with a small, but important, increase in the risk of cancer developing at the affected site. Frequent check-ups are important to detect any cancers early on, when they can be more easily treated.

I have treated many women with Lichen Sclerosus in my years in practice and I do find that a multimodality approach is the best way to treat and manage this disease effectively. Sometimes you need to have a team to help treat this, just like many other diseases women endure.So many women are are at their wits end with this disease and all sorts of treatments that have not worked. I can say this if this disease is treated and manage properly, it can give women their quality of life back.

Take care

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

Women’s & Men’s Health Crusader

-“No Stone Left Unturned”

 

 

 

 

Coffee intake can make you live longer

Coffee is usually the first thing to go when people go on a health kick, as many think that coffee is bad for you. Quite the contrary and recent research has actually shown that coffee has many health benefits and can prevent and reduce many cancers and disease states. It is always amusing to see people ditch the coffee and still keep the alcohol, which can be very bad for ones health. After all coffee actually does have a substantial amount of vitamins, nutrients, amino acids and bioactive compounds.

It has to be good bean coffee, not the instant variety, which is full of colours and additives

In new research from two very large studies coffee intake has been shown to significantly lower risk for certain cancers, cardiovascular disease, strokes and some digestive cancers that affect people world wide.The benefit was found in diverse European populations, as well as across different racial/ethnic groups, researchers report in articles published online in Annals of Internal Medicine.

In the study of over 451,000, from ten different countries world wide, men and women who drank coffee lived up to 12% longer than non-coffee drinkers. The study also showed that there was a significant reduction in death (59%) from digestive disease, circulatory disease and cerebrovascular disease.

The study showed that those who drank good coffee ( bean coffee, not instant) lower risk for all-cause death and death from heart disease, cancer, respiratory disease, stroke, diabetes, and kidney disease.

Obviously coffee intake does need to be in moderation (1-3 cups per day), especially those with adrenal issues and it needs to be incorporated into a healthy diet along with lifestyle changes. You can’t have a bad diet and lifestyle and expect to drink coffee to make you live longer.

So before you ditch the coffee in favour of other vices like alcohol on your next health kick, maybe you might need to rethink your choices. It is time for a coffee yet?

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Specialist

Women’s and Men’s Health Crusader

-“The International Baby Maker”

-“No Stone Left Unturned”

Women’s Health Consultations

Women’s Health Consultations

*Are you sick of Painful Periods?
*Are you getting pain with sex?
*Is your period irregular and messing with your life?
*Are you getting bad acne?
*Are you getting increased bladder frequency?
*Are you getting some incontinence with exercise?
*Are you sick of having to put up with mood swings and hormone imbalance?
*Sick of healthcare professionals and friends telling you that your symptoms are normal?
 
Many of these issues are not normal, but more importantly many of these issues can easily be treated quite easily with the proper investigations, treatments and proper management. 
 
Everyday I see women who are sick of being ‘missed’ and ‘dismissed’ by everyone they see and they just want to get some sort of normal life back. This is where as a Reproductive Medicine and Women’s Health Specialist, with over 20 years experience with fertility, pregnancy and women’s health, I can really help. My motto is “No Stone Left Unturned” and I apply this to every person I have helped.
 
I am proud to announce that I now have a better way of being able to doing consultations for anyone needing help with gynaecology, fertility and other health issues. It doesn’t matter where you live, now I can help more people from around the globe and get them the answers they should be getting. 
 
Before we only had skype, which had limitations of not being able to screen share the important information that I need to share in a consultation with patients
 
Well, now I can do consultations through Zoom and these are nearly the same as if you were with me in person and share the same information, just the same as if you were in person.
 
Reports and Treatment medicinals and supplements are then mailed to you.
 
This is for patients who live out of the Brisbane area, or are interstate and overseas and it gives so much more scope to help everyone who wants my help.
 
If you want to get the best advice, best care and see someone with over 20 years experience in helping people, who is a Reproductive Medicine and Women’s Health Specialist (medical) as well as having qualifications in complementary medicine, then you need to see book in with me.
 
My multi-modality approach has helped over 12,500 plus babies into the world and helped tens of thousands of women with women’s health issues and gynaecological conditions such as Endometriosis, Adenomyosis, PCOS, Fibroids, Bladder & Bowel Issues, Pelvic floor stability, Thrush, Migraines, Hormone Imbalance and so much more. I can help with all Women’s Health and Reproductive issues.
 
As a Baby Maker and Women’s Health expert my motto is “No Stone Left Unturned” and I apply that to every person I help. It is because I care and want to help care for you as well.
 
If you would like to organise an online, or in-person consultation with me, please give my staff a call on +61 7 32795697, or email info@shentherapies.com.au. You can also submit an online enquiry through my website www.drandreworr.com.au too.
 
I hope to be able to help you and care for you all soon
 
Regards
Dr Andrew Orr
Reproductive Medicine & Women’s Health Specialist
-No Stone Left Unturned
“The International Baby Maker & Women’s and Men’s Health Advocate”

Exciting New Online Consultations

Exciting New Online Consultations

*Are you sick of Painful Periods?
*Are you getting pain with sex?
*Is your period irregular and messing with your life?
*Are you getting bad acne?
*Are you getting increased bladder frequency?
*Are you getting some incontinence with exercise?
*Are you sick of having to put up with mood swings and hormone imbalance?
*Sick of healthcare professionals and friends telling you that your symptoms are normal?
 
Many of these issues are not normal, but more importantly many of these issues can easily be treated quite easily with the proper investigations, treatments and proper management. 
 
Everyday I see women who are sick of being ‘missed’ and ‘dismissed’ by everyone they see and they just want to get some sort of normal life back. This is where as a Reproductive Medicine and Women’s Health Specialist, with over 20 years experience with fertility, pregnancy and women’s health, I can really help. My motto is “No Stone Left Unturned” and I apply this to every person I have helped.
 
I am proud to announce that I now have a better way of being able to doing consultations for anyone needing help with gynaecology, fertility and other health issues. It doesn’t matter where you live, now I can help more people from around the globe and get them the answers they should be getting. 
 
Before we only had skype, which had limitations of not being able to screen share the important information that I need to share in a consultation with patients
 
Well, now I can do consultations through Zoom and these are nearly the same as if you were with me in person and share the same information, just the same as if you were in person.
 
Reports and Treatment medicinals and supplements are then mailed to you.
 
This is for patients who live out of the Brisbane area, or are interstate and overseas and it gives so much more scope to help everyone who wants my help.
 
If you want to get the best advice, best care and see someone with over 20 years experience in helping people, who is a Reproductive Medicine and Women’s Health Specialist (medical) as well as having qualifications in complementary medicine, then you need to see book in with me.
 
My multi-modality approach has helped over 12,500 plus babies into the world and helped tens of thousands of women with women’s health issues and gynaecological conditions such as Endometriosis, Adenomyosis, PCOS, Fibroids, Bladder & Bowel Issues, Pelvic floor stability, Thrush, Migraines, Hormone Imbalance and so much more. I can help with all Women’s Health and Reproductive issues.
 
As a Baby Maker and Women’s Health expert my motto is “No Stone Left Unturned” and I apply that to every person I help. It is because I care and want to help care for you as well.
 
If you would like to organise an online, or in-person consultation with me, please give my staff a call on +61 7 32795697, or email info@shentherapies.com.au. You can also submit an online enquiry through my website www.drandreworr.com.au too.
 
I hope to be able to help you and care for you all soon
 
Regards
Dr Andrew Orr
Reproductive Medicine & Women’s Health Specialist
-No Stone Left Unturned
“The International Baby Maker & Women’s and Men’s Health Advocate”

What Affects a Menstrual Cycle – Part 2 (Common Gynaecological Factors)

There are many things that can cause disturbances to a woman’s menstrual cycle and on my previous post I discussed how Non-Gynaecological factors, such as diet, lifestyle etc, can be contributing. In this post I will discuss some of the common gynaecological conditions that can cause problems with women’s menstrual cycles.

The sad thing is that many of these are often overlooked and often masked by putting women on the contraception pill. The other issue is that many are led to believe that the pill is the answer to their issues, when sadly it isn’t.

Many of these common gynaecological conditions continue to become worse while having their symptoms masked and exacerbated by these hormones. Even more disturbing is that many women are not heard when speaking about menstrual issues, menstrual pain and other factors that do in fact interfere with their daily life on both a physical and emotional level.

Lets look at the common gynaecological factors that can affect a woman’s cycle.

  1. Endometriosis– is one of the most common causes of period pain and it caused by abnormal growth of endometrial cells both inside the uterus and outside the uterine lining. The exact cause is not known. While period pain, clotting, ovulation pain, pain with sex, pain on bowel movement, IBS like symptoms etc are commonly talked about, many women with endometriosis are asymptomatic and would not even know they had it. It is commonly missed, misdiagnosed and overlooked by healthcare practitioners and is why it often takes up to 10 years for the definitive diagnosis to be made. There is no cure and now it is thought that genetic factors and parental mode of inheritance is a predominant part of this disease. We do know that estrogens make it worse also. Endometriosis can only be diagnosed by surgical intervention. For more information please read my posts on endometriosis and also visit the Endometriosis Australia website.
  2. PCO/PCOS – Polycystic Ovaries/Polycystic Ovarian Syndrome is one of the most common caused of menstrual cycle irregularities, or ceasing of the menstrual cycle. It is mainly caused by insulin resistance and it also runs in families. There are two types of presentation with this condition. One is just having the cysts on the ovaries and the other is just the syndrome without the cysts. These days it is common lobbed under the one condition called PCOS. Along with menstrual cycle disturbances, it can also cause mood swings, hair growth/hair loss, acne, ovulation pain, infertility, anovulation, weight gain/weight loss, pot belly, fluid retention and much more. Diet and lifestyle changes are the number one treatment for this condition. Scans can pick this condition up, but can also miss it too. It can be diagnosed via surgical intervention and sometimes-extreme forms of this do need surgical intervention known as “Ovarian Drilling”
  3. Fibroids – Also known as myomas are benign growths that can occur inside and outside the uterus. Up to 40% of women over 40 years old have fibroids. They can cause problems with irregular uterine bleeding, heavy long bleeding, bleeding in between cycles, anaemia, pain with sex, problems with urinating and back pain. They can also cause infertility and miscarriage. There are 3 types of fibroids (intramural, submucosal & subserosal). They are thought to be caused by excess estrogens and problems in hormone metabolism. They can be removed surgically and some small ones embolised.
  4. Polyps – Are benign overgrowths, or bulges, of the normal tissue lining the uterus into the uterine cavity. They can cause irregular bleeding, heavy bleeding, bleeding after intercourse and infertility. Some women have not symptoms at all. Polyps may also be found in the uterine cervix. Polyps are usually attached to the underlying tissue by a base or stalk, and they vary in size. They can basically act like an IUD and stop implantation and therefore need to be removed in order for a woman to fall pregnant. Polyps only rarely contain cancerous cells
  5. Adenomyosis– Is very similar to endometriosis by the fact that it causes pain, irregular bleeding, heavy bleeding, bloating, lower abdomen pain and can affect the day to day functioning of woman all over this world. Adenomyosis growth penetrates deeply into the uterine lining and also inflames the nerves inside the lining. It cannot be seen visually and some special high contrast scans and MRI can pick it up, but not always. Usually a biopsy is needed to diagnose it. Medically the only way to properly get rid of Adenomyosis is via a hysterectomy. In the meantime, mostly anti-inflammatories, some hormones and other forms of pain management are given to provide symptomatic relief.
  6. Thrush– Vaginal thrush is a common infection caused by an overgrowth of Candida albicans yeast. This yeast lives naturally in the bowel and in small numbers in the vagina. It is mostly harmless, but symptoms can develop if yeast numbers increase. Symptoms you may experience if you develop vaginal thrush include vaginal discomfort – itching or burning, a thick, white discharge with a ‘cottage cheese’ appearance and yeasty smell, redness or swelling of the vagina or vulva, stinging or burning while urinating or during sex, splits in the genital skin that can cause bleeding and irritation. The condition is mainly treated with antifungal creams, pessaries and probiotics.
  7. Cancers – In 2008, a total of 4,534 new gynaecological cancers were diagnosed in Australia; this equates to an average of 12 females being diagnosed with this disease every day. On average 4 females in Australia die each day from a gynaecological cancer each day. The most commonly diagnosed gynaecological cancers are uterine cancer, ovarian cancer, cervical cancer, vulval cancer, cancers of other female organ and placenta and vaginal cancer. All can cause irregular bleeding, but some may not present with any symptoms at all. Proper diagnosis and early intervention is the key to any gynaecological cancers. For more information on diagnosis, symptoms and treatment please refer to the cancer council website.

There are other conditions that I haven’t discussed because of focusing on the main gynaecological conditions that can affect a woman’s cycle. I haven’t gone into the treatments of these disease states and will go into this at a later date. What I will say it that early intervention is the key to any disease state in the body and seeing the right people is paramount too. Please know that many of these disease states will require a multimodality approach and please remember that there is always help out there. Never put up with period pain, or menstrual irregularities, or be told the symptoms many women face daily are normal. The value of a second, or third, or tenth opinion is crucial for some people to get help and to find the right person to help.

Please remember that period pain IS NOT normal and neither are many of the menstrual irregularities that many of you face daily. There are always treatments and help out there too. I help so many women daily, with most of these sorts of conditions, and with the right treatments, diagnosis and investigations, you can be helped too.

Take care

Regards

Dr Andrew Orr

-Leaving No Stone Left Unturned

“The International Baby Maker” and “Women’s and Men’s Health Crusader”