Stop Telling Women That Period Pain is Normal

After seeing my 10th case of misdiagnosed Endometriosis this week, and goodness knows what else, I can say that I am well and truly over it and about to scream.

I am about to scream if I hear that one more woman, young or old, is told by their healthcare professional, GP, specialist, best friend, mother, facebook buddy etc, that period pain is normal.

Period pain IS NOT normal. It is far from normal and we all need to stop telling our daughters, sisters and women of this world that it is.

I think that anyone that says that need to come and work with me for a day and see the ramifications of women believing that period pain is normal, just because their doctor, healthcare professional, friend, or mother told them that it is.

I think I should post up some rather gruesome pics of women’s reproductive organs stuck together, their insides bleeding, and their pelvis completely obliterated. Yes, obliterated. That was the words that one of the surgeons used today to explain the insides of a woman that had been told that there is nothing wrong, just suck it up, scans havent found anything and just go on the pill and btw, period pain is normal

No it F#%$ing isnt (sorry for swearing but time for diplomacy is over). Women need a voice and need to be heard. Some of these poor women may not be able to have children, or have a healthy sex life, or be able to feel the pleasure of wonderful sex without pain, or ever hold their own baby, because they have been told to suck it up and be told that period pain is normal.

Period pain IS NOT normal and the sooner we get everyone to know this important fact the better. Sure, a little bit of discomfort can be normal. By that I mean just a tiny bit of pressure and basically knowing your period is about to come. But pain…. That is not normal. If you, your friend, your daughter, your sister, your wife, or any other woman you know, has to have days off work, days of school, is laying on the floor in pain, taking pain killers to get through the day, or beginning of their period, then that IS NOT normal.

Please get them to get a referral and see a good specialist who will listen to them and not dismiss them and may miss a gynaecological issue that could affect them for the rest of their lives. No… scans and blood test etc, do not always find the cause of period pain. Have a read on my other posts about this.

If you cant find someone that will listen and help, then book in a consult with me and I will help you get you properly investigated and properly managed moving forward

My motto is “No Stone Left Unturned”and my other motto is “Period pain IS NOT normal”. If you are in pain with your menses, or even any any other time during your cycle, or having pain with sex, or pain with ovulation, pain with bowel movements, pain for no known reason at all, then you need to get something done about it.

I think if I hear one more poor woman get told that Period Pain is normal, I am going to start sending those people gruesome pics of all the insides of women who have been told that period pain is normal, only to find out that it isnt and all the reasons why.

Sorry for the rant, but our daughters, our sisters, our wives, our female partners and women all over this world deserve better.

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-No Stone Left Unturned

-Period Pain IS NOT Normal

Ultrasounds and blood tests have limited value for diagnosing some causes of period pain and menstrual irregularities

I know I have said this often, but it seems that every day I get another email saying that “I have period pain and I have been to the GP and done scans and bloods tests and he/she says that there is nothing wrong”

The problem is that there is something wrong and the first thing wrong is that someone was told that there is nothing wrong, when they have only had very basic testing done

The second thing wrong is that most of these women are not being referred onto an appropriate specialist, which is what good sound ethical practice is. This is why some conditions like PCOS are taking up to 3 years to be properly diagnosed and conditions such as endometriosis are taking up to a decade to be properly diagnosed. It just should not happen

I can’t begin to tell you how many women I have seen over my years in practice, that have been told that there is nothing wrong with them, or that the practitioner hasn’t found anything, when really all they have done is a basic scan and a few random blood tests. Then when these women are properly investigated we end up finding all manner of issues. Yet, these women were told that there is nothing wrong

All I can keep telling people is that while ultrasounds can find some causes of gynaecological issues, there are many issues they cannot find. It also depends on the technician, or person scanning you too.

Gynaecological issues such as endometriosis, cannot be diagnosed by ultrasound and can only be diagnosed by surgical intervention, in the form of a laparoscopy. Then, as I have said many times too, it all depends on the surgeon you have seen. If your surgeon isn’t an advanced trained laparoscopic surgeon there is a very good chance you may not have been investigated properly. I have mentioned this in one of my previous posts.

Even some cysts,PCOS, polyps and other masses can be missed on scans and let’s not even talk about blood tests. Sure, some hormones levels can be a pointer to a certain issue, but they are not an accurate diagnostic. To be completely honest, many women with serious gynaecological issues will have normal hormonal levels and have completely normal blood results. This can even happen in certain cancers and why some of the cancer markers are now not being used as definitive diagnosis.

I can tell everyone that I have seen many gynaecological issues being missed, and women being dismissed over the years, and it still happens on a daily basis. If you have menstrual issues, or are in pain daily, or just with your menstrual cycle, and you are being told everything is fine, then you need to get a second opinion and a referral to a specialist.

Better still, come and book in a consultation with me and I will help you get you sorted and managed properly.

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-No Stone Left Unturned

 

Vitamin D Increases Fertility & Assisted Reproduction Success Rates.

New research has concluded that there is a relationship between a woman’s vitamin D status and the success rates of assisted reproduction therapy(ART), which includes IUI, IVF and ISCI. While this is research is nothing new, and something I have been promoting for years, finally it is now official. Women trying to conceive should be taking vitamin D supplements, eating vitamin D rich foods, and getting a healthy dose of the sun daily.

Infertility, or what we call subfertility, is becoming an increasing problem and affects millions of people worldwide. More and more people have to turn to assisted reproduction therapy (ART) which now means more and more people are having to use IUI, IVF and ICSI.

The problem is that even with assisted reproduction therapy (ART), at best the success rates are only around 25- 30% on average, and that depends on the clinics individual success rates. Some clinics are also inflating and bodgying success rates to bring in unsuspecting customers.

While there has been much advancements in assisted reproduction (ART) such as IVF and improvements in success rates, the success rates have also started to stagnate. This is why couples need to look at all options to help increase those success rates and this is why I have set up a fertility program that can boost those success rates by as much as 96.1% *. This is why what I do has helped over 12,500 babies into the world and why couples need to look at a multimodality approach to increasing their chances of conception.  I often explain to couples that it is like preparing for a marathon; because that is what doing ART can be like. You need to prepare the body (both the man and woman), get the right diet, get the right nutrients, prepare mentally, prepare physically and basically get the bodies into the best shape possible to give the best success. Nobody should ever run a marathon without adequate preparation and the same goes for assisted reproduction.

Vitamin D and reproduction

Researchers across the board know that there is room for improvement in ART success rates. A range of potential factors are being explored, and some scientists have turned their attention to the potential role of vitamin D. While vitamin D is something that needs to be explored, and something that I give to my patients, it needs to be combined with other things mentioned above. It isn’t just as simple as taking Vitamin D and all your fertility problems are gone. But, it is one of the things that can help increase your overall success rates and should be used.

Most of our vitamin D supply is generated in our skin after exposure to sunlight. We do get some from our diets as well. This means that individuals who live in colder or darker environments are more susceptible to lower vitamin D levels, or those who regularly wear clothes covering the majority of their skin, and those who rarely go outside. The problem these days, many of us have jobs that require us to be inside most of the time and therefore were aren’t getting enough sunlight. The current figures actually show that up to 97% of Australians, and most probably other countries like the US are the same, are actually vitamin D deficient. The other issue is that even though some of us do get out in the sun, it actually needs to be at a certain time of the day, for optimal absorption. The optimal times are 10am and 2pm in the afternoon. The thing is, most of us aren’t getting out in the sun at these times.

A link between vitamin D and fertility has been theorized for many years and based on a number of observations and studies.  This is one of the reasons I have been promoting the use of Vitamin D for more than 20 years now, for those who are on my fertility program. For instance, vitamin D receptors and enzymes have been found in the endometrium. This is why Vitamin D is also good for women with gynaecological issues such as endometriosis, or adenomyosis. It is good for any gynaecological issue really. Vitamin D deficiency has been shown to increase the risk of pre-eclampsia, pregnancy-induced hypertension, gestational diabetes, and lower birth weight. Vitamin D is also essential for a health immune system and reducing inflammation in the body too.  It also helps with bone health.

We have also seen that in animal studies, vitamin D deficiency causes poorer fertility and reduced function of the reproductive organs. Many of our breakthroughs in medical science, actually come from animal studies first, especially when it comes to ART and IVF. Many cows and other animals are now impregnated using ART and advancements in this area have helped with human studies.

Vitamin D deficiency and lower success rates

Getting back to the feature studies, Vitamin D was shown to help women undergoing IVF, or intracytoplasmic sperm injection (ICSI), frozen embryo transfer, or both.

All the participants’ vitamin D levels were checked by blood test. What people need to know is that many of the reference ranges still used  are actually under review and that if levels of vitamin D in the blood are under 100 Nmols\L, then you need to be supplementing. Anything under 75 Nmols/L is actually deficiency in vitamin D.

This analysis of the current research showed that when women, who underwent ART and had adequate vitamin D levels, were “one third’ more like to have a successful live birth compared to those who were deficient. When compared with women who had insufficient vitamin D concentrations, those with sufficient amounts were “46 percent more likely” to have a clinical pregnancy, and “34 percent more likely” to have a positive pregnancy test result.

Vitamin D is something that I promote and all of my fertility patients are on, as well as other beneficial supplements, diet, emotional support, medicines etc. Before you run off trying to buy vitamin D just remember it is just one thing that can help, and it isn’t a miracle cure, but, it can help. Lastly, before using any supplementations, please consult with a qualified healthcare professional and please don’t self-prescribe, or buy products of the internet. Make sure you buy practitioner dispensed supplements only, which are known to be of the highest quality and not filled with all sorts of things such as heavy metal, low levels of arsenic, toxic fillers etc, which is what some supplements off the internet can have.

 

Regards

Dr Andrew Orr

Reproductive Medicine and Women’s Health Medicine Specialist

-The International Baby Maker

-No Stone Left Unturned

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.

 

 

Alcohol Decreases Fertility & Makes Gynaecological Conditions Worse

In today’s modern society, alcohol has become the cornerstone for social engagements, business dinners and after work relaxation. It is important to realise however, that alcohol can directly impact the fertility of both males and females. In males it can decrease sperm quality, reduce testicular size, decrease libido and cause impotence, all of which can impair fertility. In females it has a more systemic response, affecting the reproductive hormones, leading to abnormalities in the menstrual cycle and an increased risk of miscarriage.

Many men and women these days are actually consuming copious amounts of alcohol and may think that their drinking habits are normal, when compared to others around them. When people do things on a regular basis, it becomes their normal. But truth be told, many people’s drinking habits, both men and women, are actually in the realms of alcoholism. The impacts of that are far reaching and fertility and gynaecological conditions are definitely impacted by alcohol consumption.

Effect of Alcohol on Conception for Men

Fecundability refers to the probability of conception during a particular menstrual cycle. It is dependent on the reproductive potential of both partners. Alcohol decreases fecundability by its effect on sperm quality and quantity. Men who continue to consume alcohol on a regular basis, can decrease their sperm motility, morphology and their DNA in the sperm. All of which are important factors in achieving fertility. While outwardly a man’s sperm may look OK, many forget that inwardly, the sperm DNA could be highly fragmented and unless this is tested every ejaculation, you will have no idea how bad the sperm actually is. A one off DNA fragmentation analysis does not mean the sperm each time is OK. It only measures the sperm from the ejaculate that was tested and sperm quality can change by as much as 20% each ejaculation.

Testicular size is also affected by alcohol intake; and can also affect sperm production. Alcohol is a depressant of the central nervous system (CNS), and can disrupt the autonomic system of the CNS. These effects are temporary and short lived. Abnormal sperm production is also temporary and also can resume after abstaining from alcohol.

One study, this one looking at couples going through IVF treatment, found that for every additional drink a man consumed per day, the risk of conception not leading to a live birth increased by 2 to 8 times. This was especially true if the drinking occurred within a month of the IVF treatment.

Effect of Alcohol on Conception for Women

In women, alcohol affects fecundability, by disrupting the delicate balance of the menstrual cycle. Clinical research data published in the “British Medical Journal” suggests that women, who drank socially, 1-5 drinks per week, were at a greater risk of decreased fecundability when compared to women who remained abstinent. These findings underscore the importance of remaining abstinent while attempting to conceive.

Alcohol disrupts the hormonal imbalance of the female reproductive system, leading to menstrual irregularities, and even Anovulatory cycles, (menstrual cycles where ovulation fails to occur). Menstrual pain can directly be linked to the amount of alcohol consumed in the lead up to the menses and consumptions of alcohol, even small amounts, exacerbates most gynaecological conditions. These changes can drastically decrease a woman’s chance of becoming pregnant and thus affect fertility.

Alcohol effects fertility in both partners, and can do so in so many ways. For couples who desire to have a baby, it is best to stay away from drinking completely. Presently there is no safe limit of alcohol intake; even socially acceptable amounts of alcohol can affect fertility potential and outcomes. Moderate drinking (1-2 drinks in one sitting) is probably okay, especially if you reserve those drinks to a few times a week, instead of daily. However, if you’re going through IVF treatment, or trying to conceive naturally, you might consider cutting out alcohol for the time being. A woman that is trying to concieve, or trying to improve a gynaecological issues, or menstrual issues, should not be consuming more than 4 standard drinks per week. A male who is trying to conceive, or have sperm quality issues, should have no more than 2 standard drinks in one sitting and be having at least 2 alcohol free days per week. These are all part of the healthy drinking set out in health department and government safe drinking guidelines.

Trying to conceive is a special time in a couple’s life, it should be filled with love, devotion and safe health practices, which means a healthy diet and lifestyle and having a healthy mind too. It also means having healthy drinking habits as well.

Decreasing alcohol, having bete foods and looking at a healthy detoxification program is also a great idea for those trying to increase their fertility and get their reproductive systems working better. Healthy eggs and health sperm make healthy babies. Healthy reproductive systems also mean better menstrual cycles and better testicular health too.

Safe drinking everyone

Regards

Dr Andrew Orr

(Reproductive Medicine & Women’s Health Specialist)

– The International Baby Maker

-Women’s and Men’s Health Advocate

– No Stone Left Unturned

Women with PCOS Have Four Times Higher Risk of Developing Type 2 Diabetes

One of the hardest things I find that is hard to get through to women with PCOS, is their risk factors for type 2 diabetes, gestational diabetes and their increased risk of cardiovascular disease. It has long been known that the major driving factor behind PCOS is insulin resistance and this also increases the risk factor of developing diabetes for those with this endocrine/reproductive disorder.

Polycystic ovary syndrome is an endocrine/reproductive disorder that affects millions of women of reproductive age worldwide, and a new study has shown that it also put these women at a significant risk of developing type 2 diabetes.

PCOS is also the leading cause of female infertility and many women with this condition are often misdiagnosed, or do not know that they have it. PCOS is also a risk factor for miscarriage too. Please see my other posts about signs and symptoms of PCOS.  (Click Here)

All women with PCOS will have insulin resistance, either hereditary insulin resistance, or purely caused by diet and lifestyle choices. Insulin resistance is a condition wherein the muscles, fat, and liver do not respond properly to the hormone, so the body keeps producing more of it. Excessive insulin production is a risk factor for type 2 diabetes and gestational diabetes. This is why it is so important for women with PCOS to follow a modified Ketogenic/low GI style diet and that the number one treatment for PCOS (as recommended by the World Health Organisation) will always be diet and lifestyle changes.

Young women with PCOS at risk

This new study investigated 54,680 women in total and found that younger women with PCOS are now more at risk of developing diabetes than older women with the disease. The study found that the risk factor for developing diabetes is four times greater for younger women. This is probably due to poor diet and lifestyle choices that many young women are choosing these days.

The increased risk of developing type 2 diabetes is an important finding and this is something that women with this disease should know, especially those who are obese and have PCOS as well. But it is important for women that are of normal weight, or even underweight to know that they are also at an increased risk as well. Just because you are underweight, or of normal weight, doesn’t mean you cannot have PCOS, or be at risk of diabetes.

This new research was carried out by Denmark-based scientists and the findings were published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

Women’s and Men’s Health Crusader

-“The International Baby Maker”

-“No Stone Left Unturned”

Could you need an Iron Infusion?

Iron infusion: Uses, benefits, and what to expect

As a reproductive medicine and women’s health specialist I am used to seeing women with really low iron, due to various gynaecological conditions.

Many women do not even know they are low in iron until they get bloods tests to show that they are. Being low in iron can be very dangerous for a woman on so many levels.

Many women who are suffering from fatigue are actually low in iron.

Symptoms of low iron can include

Fatigue

Dizziness

Fainting, or feeling of feeling faint

Pale skin

Breathless

Frequent headaches

Palpitations, or racing heart

Easily irritated

Difficulty in concentrating

Cracked, or reddened tongue

Loss of appetite

Strange food cravings

Risk Factors For Low Iron

Heavy menstrual bleeds

Endometriosis

Adenomyosis

Fibroids

Coeliac disease

Inflammatory Bowel Disease

Pregnant and Breast Feeding Women

Certain Cancers

Vegetarians and Vegans

Girls going through puberty

Certain illnesses

Sometimes when Iron gets too low, supplements just will not be enough to get iron levels up to where they should be quick enough. This is where iron infusions can be very effective.

So what is an Iron Infusion?

An Iron infusion is when iron is delivered via an intravenous line into a person’s body.

Increasing the amount of iron a person has in their blood can cure anaemia, or increase a low red blood cell count.

The body uses iron to make hemoglobin. Hemoglobin is an important part of red blood cells and helps carry oxygen around the body.

If a person does not have enough hemoglobin, they can feel tired, or have symptoms mentioned previously. An iron infusion may be used for someone with an iron deficiency when supplements do not work.

As discussed before, there are a variety of medical reasons can cause low iron levels, so your doctor, or healthcare specialist will order iron studies and other tests to see what may be causing someone to be deficient in iron.

An iron infusion may be given if a person’s blood counts are so low that taking iron supplements or increasing their daily intake of iron-containing foods would be ineffective or too slow in increasing their iron levels.

What to expect

A person will go to a doctor’s office, hospital, or another healthcare facility to have an iron infusion. This is done intravenously and the infusion will take between 15-30 minutes if it is given in amounts of 200-300 milligrams (mg). In days gone by iron infusions would take hours to do and would have to be done in a hospital setting.

The new rapid iron infusions allow iron into the body much quicker and have little to no side effects compared to the older solutions that took hours to administer and were not as good as the new versions used now.

What happens after an iron infusion?

An individual can experience some mild side effects after an iron infusion. The symptoms are usually mild side effects such as headaches, metallic taste in the mouth, or some mild joint pain. Some people can feel faint and nauseas after an infusion but this is usually people who do not tolerate having blood taken, or having needles given. Reactions to infusion are rare, but your healthcare provider will explain all this too you. There are some people who may be allergic to iron, just like people can be allergic to certain foods.

Most people will only need one infusion done, but sometimes people with very low iron may need multiple infusions done. This will be after careful monitoring and testing to see where your iron levels are.

Usually iron levels will return to normal and symptoms of iron deficiency will decrease several weeks after the infusion. A doctor will regularly check the person’s iron levels and blood counts to ensure the iron infusion is working.

Iron infusion vs. injection

Doctors can administer iron to someone via an injection or an infusion.

Iron injections are given intramuscularly, but while iron injections may be faster than iron infusions to administer, they can have some unpleasant side effects. Some of the side effects can be pain at the site of the injection, bleeding into the muscle, and permanent discoloration at the injection site. This is why more doctors are now recommending iron infusions over the injections

Before and after the Infusion

Most people do not need to fast or stop taking their medications beforehand, and can also resume their everyday activities after an iron infusion.

If a person is taking regular iron supplements, however, a doctor will usually tell them to stop taking these about a week before the procedure. This is because the supplements may prevent the body from absorbing the iron from the infusion efficiently.

A person will need to resume iron supplements at some stage after the receiving iron infusions, t ensure levels stay where they should be. Your healthcare provider will tell you when to do this.

People who have a genetic issue called haemochromatosis should not ever have an iron infusion.

Iron infusions are now being used more and more, when iron levels are low and people are not responding to supplementation and adjustments to their diet. I recommend them to many of my patient who have low iron due to many varying reasons. Like I said said before, many of my gynaecology patients, fertility patients and pregnancy patients have very low iron levels and will actually need an infusion to get their levels up quickly.

If you are feeling tired, lethargic and may be at risk of low iron, have a talk to your healthcare provider about finding out if you are low in iron and also discuss having an iron infusion if your levels are really low. Your healthcare practitioner may not know about the new iron infusions and that they are now a great option to use and have very little side effects compared to the older methods and solutions. Some GP clinics now specialise in administering iron infusions too.

Regards

Dr Andrew Orr

Reproductive Medicine and Women’s Health Specialist

-The International Baby Maker

-No Stone Left Unturned

 

What is Implantation Bleeding?


Implantation bleeding: Causes and symptoms

Implantation bleeding occurs when a fertilized egg attaches to the lining of a woman’s uterus to start the growth process of pregnancy. Some women’s lining can be more affected and be more prone to bleeding during a pregnancy. It is a normal occurrence in pregnant women, yet many women are completely unaware of what it is. Obviously it can be a bit worrying for anyone when they are bleeding during a pregnancy and I will discuss this later.

Some women may confuse the bleeding with spotting from menstruation, as the two can appear similar. What women also need to know is that getting a menstrual cycle, or the appearance of what looks like a menstrual bleed, does not mean you aren’t pregnant. You can have a bleed and still be pregnant.

Usually when it is implantation bleeding. The bleeding is very light and will usually require no medical attention. In some cases, however, implantation bleeding may require a visit to your specialist, midwife, or healthcare provider

What is implantation bleeding?

Implantation bleeding can just before the expected menstrual cycle, or around the early stages of pregnancy. It can also happen again when the embryos is growing and impacting on the lining of the uterus.  Again this is a normal part of pregnancy for many women. Some women may not get any bleeding, or signs of implantation either.

The process of implantation starts  shortly are fertilization. Once a sperm has fertilized an egg, it is called an embryo. The embryo travels through the fallopian tube towards the uterus. During this time, the embryo multiplies, becoming a blastocyst, which usually takes about 5-6 days to reach this stage. About 1-2 days after an embryo reaches blastocyst stage, it will then attach itself in the wall of the uterus and this is called implantation. During this implantation stage, the embryo can cause disruption the uterine wall and this then cause what we know as implantation bleeding. As the embryo grows even bigger, it can then cause further bleeding later on in the first trimester as well. While this is considered normal, it can cause distress for women and any bleeding should be checked by your healthcare provider.

Signs and symptoms

Implantation bleeding is one of the earliest easily identifiable signs of pregnancy. It is also a normal part of pregnancy and all women should be aware of this. As explained before, women can still have a normal menstrual bleed and still be pregnant. It is usually a lighter bleed, but some women can actually have quite heavy bleeds and still maintain a pregnancy. About 1 in 4 women actually have a bleed during their pregnancy.

Despite all that, there are some distinct signs and symptoms to help women identify implantation bleeding:

  • Early bleeding: Implantation bleeding will often occur a few days before the expected menstruation cycle. This is not always the case, however, and many women confuse the two. As discussed, it is not uncommon for women to actually get their normal menstrual bleed and still be pregnant. Never think that just because you get a period, that you cannot be pregnant.
  • Unusual coloured bleeding, or discharge: Implantation bleeding produces an unusual discharge that varies in colour from pinkish to very dark brown or black.
  • Very light bleeding: Bleeding and discharge caused by implantation will usually not last no more than about 24 hours. It can last a bit longer for some women though. Many women experience just a few hours of spotting or one spot or streak of discharge. Obviously any bleeding should still be checked by your healthcare provider.
  • Cramping: Implantation can also cause mild and temporary cramps. Some women who are doing IVF may also be on progesterone gels that can also cause bleeding and cramping too. Cramping and bleeding does not always mean a miscarriage. If you do experience this and are worried, please always consult with your healthcare provider.

Other signs

As implantation is an early sign of pregnancy, a woman may also experience other pregnancy-related symptoms. Early signs of pregnancy can vary from woman to woman and may include:

  • Mood swings
  • Fatigue and tiredness
  • Dizziness
  • Headaches and Migraine’s
  • Tender, swollen breasts
  • Nausea and vomiting
  • Changes to the bowels (constipation, or loose bowels)
  • Heightened sense of smell
  • Food cravings and aversions
  • Increased body temperature

Treating implantation bleeding

Implantation bleeding is a normal sign of pregnancy and is not usually dangerous. Because of this, there is no need for treatment. As I have stated before, if you are unsure, you should always consult with your healthcare provider.

Bleeding caused by implantation usually clears up within a couple of days with no treatment necessary. Abnormally heavy bleeding may be a sign of menstruation or a pregnancy complication. As I have previously shared, some women who are doing IVF, may be on progesterone gels and other medications, which may also cause some bleeding and cramping. Some women with signs of abnormal bleeding may need the same medications to help with hormonal levels. Some bleeding could be a sign of something more serious so please consult your healthcare provider. If you are experiencing heavy bleeding along with pain, please present to your nearest emergency centre as this may be signs of a miscarriage, or ectopic pregnancy.

Complications of implantation bleeding

Implantation bleeding is not usually a cause for concern most of the time. It is just a sign of embryo implanting into the lining of the uterus.

Women who are still uncertain about whether they have experienced implantation bleeding should consult their healthcare provider and take a blood test to see if they are pregnant, or not. Please do not rely on home pregnancy tests as these can be inaccurate in the early stages of pregnancy. The most accurate way to determine pregnancy is to do a blood test. This is very important for women undergoing IVF treatment too. Too often women will do a home pregnancy test and think they are not pregnant, when in fact they are. The issue is that the home pregnancy tests won’t pick up pregnancy hormone in the urine if it is too early. This can cause a woman much distress at the time and then when she finds out later on through the blood test, that she is actually pregnant. Please never rely on urine based home pregnancy tests.

Please note that if you experiencing heavy bleeding during any stage of pregnancy that this can be a sign of a complication and women should seek medical attention.

If you need help with irregular bleeding, miscarriage, fertility, pregnancy or any advice for Women’s health issues, please call my staff and they will be able to let you know what consultation, or program is best suited for you. Please call my clinic on +61 07 3832 8369

 

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Specialist

-The International Baby Maker

-Women’s and Men’s Health Crusader

“No Stone Left Unturned”