PCOS

Why it is important to manage PCOS properly via a multimodality approach

The one thing I see daily in practice is that many women with PCOS are not being managed properly with regards to their symptoms and future health implications.

Many women, who actually do have PCOS, have been misdiagnosed, undiagnosed, dismissed, or are not being managed properly at all. This is quite concerning as PCOS can have long and short-term term health implications and can also have an effect on fertility.

Every day I see women, who have irregular cycles and symptoms of PCOS (Acne, Hirsutism, weight issues, emotional issues etc), being told that they do not have PCO, or PCOS. Just today a colleague and myself had to call a radiology centre and get their head radiologist to go back and look over a scan of a woman who had been told she did not have Polycystic ovaries, and from the scan that we were viewing actually showed that she did have Polycystic Ovaries. There was a big rush around and a major apology and an updated scan report sent with the notation saying the patient has multiple cysts on the ovaries consistent with PCOS. This is exactly why so many women with PCO and PCOS are misdiagnosed, or not even diagnosed at all.

Just so everyone knows, scans and blood tests are not always accurate in the diagnosis of PCOS and new guidelines, published recently, for the diagnosis of PCOS now highlight this. https://www.mja.com.au/journal/2018/209/7/new-evidence-based-guideline-assessment-and-management-polycystic-ovary-syndrome

The point I am trying to make is that many women are not aware they have PCO, or PCOS and the ones that do have the diagnosis, just are not being managed properly.

The main symptoms of PCOS

  1. Irregular or absent menses
  2. Acne
  3. Hirsutism (excess hair growth)
  4. Weight issues
  5. Emotional Issues (depression, anxiety etc)

Women with PCOS may only have 1-2 of the symptoms, or may have all of the symptoms combined. Up to 90% of women with acne will have PCOS, especially when combined with menstrual irregularities.

Many women with PCO and PCOS are completely unaware of the serious future, and sometimes present, health implications as a result of their disease state.

Women with PCO and PCOS are at very real danger of the following

  1. Type 2 diabetes
  2. Gestational diabetes
  3. Cardiovascular disease
  4. Infertility
  5. Recurrent Miscarriage
  6. Mood disorders (Depression and Anxiety)
  7. Weight issues (Obesity, Eating disorders etc)

All of the above are well known health risk factors for women with PCO and PCOS and this is not often explained to the patient.

Women with PCO and PCOS need to be educated that a multimodality approach is needed to treat and manage their disease state properly. The number one treatment for PCO and PCOS should always be diet and lifestyle modifications and interventions. The main focus should be on treating the main driver, being insulin resistance. Once this is achieved, many of the symptoms of PCO and PCOS will settle down as well. If remaining symptoms do not settle, then other treatments and health care management should be used.

The Pill

While the oral contraceptive pill can offer symptomatic relief of the symptoms of PCOS, it is not going to treat the underlying cause of the disease, nor is it going to be a cure. The other issue is that many women are having their underlying symptoms being masked by the contraceptive pill and completely unaware of the future health and fertility issues that can still be present. Women need to be made aware of this and often aren’t.

Metformin

While metformin is routinely used for women with PCO and PCOS, it does have a high side effect profile. Gastrointestinal and digestive upset are one of the major reasons many women stop taking it. It is also a category C drug and should not be used in pregnancy, as it is could affect the unborn baby. Metformin also has risk factors for depleting Vitamin B 12 and can lead to anaemia if used long term. Long-term use of metformin can also damage the liver and kidneys.

There are some very effective alternatives to Metformin, without the high side effect profile, and these can be discussed with you healthcare practitioner.

Modalities that assist PCOS

As mentioned before, PCO and PCOS can be effectively managed and assisted using a multimodality approach, which could include the following:

  1. Medical treatments and interventions
  2. Hormonal Therapies
  3. Surgical Intervention (Ovarian Drilling)
  4. Diet and Nutritional advice and modification
  5. Exercise
  6. Complementary Therapies and Complementary Medicines
  7. Vitamins and nutritional supplements
  8. Acupuncture
  9. Psychology and counselling
  10. Lifestyle changes
  11. Mindfulness
  12. Relaxation and meditation

Women with PCO and PCOS may need a few of the modalities combined and some may need all of them combined together. It would all depend on the individual and how bad their presenting symptoms are. A healthcare practitioner who specialises in this area will be able to tell you which modalities and therapies will be best for your individual needs.

PCO and PCOS can have long-term and short-term health consequences and some of these can be very serious. We need for practitioners and patients to know this. Education is key for any disease state and the facts also need to be presented as part of this education as well.

New guidelines have just been published by an Australian led international collaboration, to help improve the care, health outcomes and quality of life of women with PCO and PCOS. Key changes in the new guidelines include refinement of individual diagnostic criteria focusing on improving accuracy of diagnosis; reducing unnecessary testing; increased focus on education, lifestyle modification, emotional wellbeing and quality of life; and emphasising evidence-based medical therapy and appropriate fertility management.

A multimodality approach is something that I always talk about and has always been a part of my clinical approach to assisting women with PCO and PCOS. It is also something that I educate my fellow colleagues and practitioners on as well. Women who suffer from PCOS also need to be educated about this as well and why I will always continue to write these posts.

If you do have PCOS, or suspect that you may have PCOS, please make sure you get the help and care you should be getting and do not leave it too long to get that care and assistance as well. Make sure the person that you see also specialises in PCOS as well. If not, then find somebody who does. You can always book in to see me, in person, or via online consult, as well. I help people from all over the world.

 

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Reproductive Medicine and Women’s Health Medicine Expert

01 Dr Andrew Orr 1

 

 

 

 

 

 

Daysy

Daysy Promotion

Because it is Women’s Health Week and PCOS Awareness Month, the subject of ovulation and knowing when ovulation is occurring is very important for women who are in their fertile years.

One of the companies that distributes a very high quality ovulation detection device is kindly offering my patients and people in this page a discount on a product for those trying to conceive and it can also be used for those not trying to conceive.The device is called Daysy

Many ovulation detection devices are very inaccurate and temperature charting has been shown to only be around 42% accurate (unless you see a qualified natural fertility planner).

The most reliable way to check ovulation is via Follicle Tracking done with your gynaecologist (which involves scanning and tracking your follicle development via ultrasound). This offers around a 99% accuracy rate.

But there is ovulation detection device called the Daysy, that the company boasts as having a 93% accuracy rate for detecting ovulation and some of their studies show that it may be as high as 96%. If that is the case, this is something that may help women who want to consider to help track ovulation for pregnancy and contraceptive purposes.

For Women’s Health Month the makers of Daysy have kindly offered my patients and people on my page a 15% discount when they use a special promotional code. After Women’s Health Month, the discount will be 5%.

From September 3rd until September 7th, Women’s Health Week, the promotion code to use is “DR.A15“. This will give you 15% off the retail price.

After Women’s Health Week has finished the code to use is “Dr.A” – This will give you a 5% discount.

This will apply continuously, unless they offer another promotion.

To get the discount, please follow the link on this post and then add the Daysy to your cart and then put in the promotion code.

Have a read a bit more about Daysy on their webpage by clicking the link. http://www.ladycomp.com.au/store/fertility-monitors/daysy/

Regards

Dr Andrew Orr

 

Womens Health Week

Women’s Health Week

It is so hard to keep up with all the special calendar events at the moment. We have PCOS Awareness Month and we also have Women’s Health Week from the 3rd of September until the 7th of September.

What I have been able to do for this special month is to be able to offer women a special discount on a product for those trying to conceive and it can also be used for those not trying to conceive.

Because we are talking about PCOS awareness, which can affect ovulation, and we are talking about Women’s Health this week, ovulation and knowing when ovulation is occurring is very important for women who are in their fertile years.

Many ovulation detection devices are very inaccurate and temperature charting has been shown to only be around 42% accurate (unless you see a qualified natural fertility planner).

The most reliable way to check ovulation is via Follicle Tracking done with your gynaecologist (which involves scanning and tracking your follicle development via ultrasound). This offers around a 99% accuracy rate.

But there is ovulation detection device called the Daysy, that the company boasts as having a 93% accuracy rate for detecting ovulation and some of their studies show that it may be as high as 96%. If that is the case, this is something that may help women who want to consider to help track ovulation for pregnancy and contraceptive purposes.

For Women’s Health Month the makers of Daysy have kindly offered my patients and people on my page a 15% discount when they use a special promotional code. After Women’s Health Month, the discount will be 5%.

I’ll add all the details in an upcoming post. This may assist those who want to track their cycle and do things naturally.

#WomensHealthWeek #Ovulation #PCOSawarenessmonth #DrAndrewOrr

Regards

Dr Andrew Orr

PCOS Awareness The Facts About PCOS

The Facts About PCOS

These are some of the main Facts about PCOS

Copy of PCOS Awareness Irregular Menses or Absent cycles           PCOS Awareness Obesity and weight gain can be symptoms of PCOS

 

Copy of PCOS Awareness Hirsutism and PCOS           PCOS Awareness Acne and PCOS

 

PCOS Awareness Contraceptive Pills do not cure PCOS           PCOS Awareness Depression and anxiety can be a symptom of PCOS 1

 

PCOS Awareness PCOS does not always cause infertility           PCOS Awareness

 

Copy of PCOS Awareness You dont have to be overweight to have PCOS           PCOS Awareness Menopause does not cure PCOS

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women and Men’s Health Advocate

Dr Andrew Orr Logo Retina 20 07 2016

 

Fertility Diet for website

Mediterranean Style Diet May Help to Improve Pregnancy Rates for Couples Undergoing IVF and Assisted Reproduction.

New research published in Human Reproduction, has found that those who follow a “Mediterranean” style diet at least six months before assisted reproductive treatment have a significantly better chance of becoming pregnant and giving birth to a live baby than women who did not.

As part of my Fertility Program, one of the first things I talk to couples about is the importance of a healthy diet that has adequate protein, lots of vegetables, seeds and nuts, healthy oils, adequate water intake, electrolytes and cutting out all the refined carbohydrates that cause inflammation. The hard thing is that I hardly see a couple following those health food principles, with many not even really knowing what a health diet is. The diet that I promote is a Primal based diet.

Previous studies have shown that when refined carbohydrates are cut out and replaced with proteins, essential fats and good carbohydrates, such as fruit and vegetables, that the clinical pregnancy rates shot up by 80%. (Fertility & Sterility 2012 Volume 98 issues 3 Page S47)

In this new study, researchers focussed in dietary patterns rather than individual nutrients, food, or food groups. They found that those who ate lean protein, more fresh vegetables, fruit, fish and olive oil, had a 70% greater likelihood of achieving a successful pregnancy and birth compared to women who didn’t follow this style of diet.

The research outcomes found that out of the 244 women in the study, 229 women (93.9%) had at least one embryo transferred to their wombs; 138 (56%) had a successful implantation; 104 (42.6%) achieved a clinical pregnancy (one that can be confirmed by ultrasound); and 99 (40.5%) gave birth to a live baby.

The most important message to come from the study is that women attempting to have a baby should be encouraged to eat a healthy diet, such as a Mediterranean style diet, because it may help increase the chances of successful pregnancy and successful live birth.

The researchers did note that when it comes to conceiving a baby, diet and lifestyle are just as important for men as for women. Previous studies from the same research group showed that male partners that adhered to the same sort had better semen quality.

A healthy diet is important for all couples prior to trying to conceive and should be a part of any preconception planning by all healthcare practitioners assisting couples with fertility. While this study focussed on improving assisted reproduction pregnancy rates, this style of diet should be adopted by any couple wanting to have a baby and should be implemented at least 6 months prior to conceiving. This is why it is essential for all couples to receive counselling and guidance on the importance of a healthy diet and having a healthy lifestyle as well. This is a foundation of my fertility program that has helped over 12,500 babies into the world and continues to help many more couples reach their goal of becoming parents.

Regards

Dr Andrew Orr

-No Stone Left Unturned

 

Dr Andrew Orr Logo Retina 20 07 2016

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Zinc Deficiency Affects Egg Quality and Early Stages of Egg Development

A new study shows that zinc deficiency can negatively affect the early stages of egg development, reducing the ability of the egg cells to divide and be fertilised. This may affect fertility “months” in the future and why preconception planning is so important for a couple. The researchers will be presenting their results at the American Physiological Society annual meeting at Experimental Biology 2018 in San Diego.

Millions of couples around the world struggle with fertility issues and the ability to conceive a child. While there are many factors that can make conception difficult, ovulation disorders and sperm issues are a leading cause of couples not being able to conceive. Researchers are finally looking into how vitamins, amino acids and micronutrients affect fertility and in particular the early stages of egg development.

The availability of micronutrients, through diet, amino acids, antioxidants and vitamin supplements, in the ovarian environment and their influence on the development, viability and quality of egg cells is now the focus of a growing area of research. Sperm also need micronutrients, antioxidants, vitamins and nutrients for optimal growth and development too. This is nothing new to me as this is something I have always focussed on for many years as part my fertility program and as a part of preconception planning and making sure that the couple are in optimal health before trying to conceive.

In human and mammals, the ovary is made up of thousands of structures called follicles, which consist of one oocyte surrounded by layers of support cells, known as somatic cells. At puberty, the body starts to prepare groups of oocytes for maturation, ovulation and fertilization. While a female grows groups of oocytes, which begin to mature each month, only one will be ovulated and have the chance of being fertilized. Many things can influence whether an oocyte will mature correctly and the go on to one day be ovulated, including the presence of sufficient levels of certain micronutrients. To date this has probably been poorly understood by many.

Scientists have recently found more and more evidence to show that zinc is a key player in oocyte development and have been assessing the effects of zinc on egg development extremely early on in the development and maturation of oocytes.

Previously Fertility research and treatment has primarily focused on the larger follicles, called antral follicles, which respond to signals from the pituitary gland to be ovulated. In humans, preantral follicles have to keep growing for about 90 days before they are ready to ovulate. This is why it is important to focus on egg and sperm quality months before conception is to take place, because this is when both egg and sperm are still growing and maturing and need vital nutrients to develop properly.

In this new research they have examined the smaller preantral follicles, which are still growing and don’t respond to the ovulatory signal yet. Previous studies showed that zinc levels are critical in the antral follicle, but no one had tested the effect of zinc deficiency on preantral follicle growth.

The researchers collected preantral follicles and then matured them in a special cell culture medium. They compared eggs matured in a zinc deficient environment to those grown with normal levels of zinc. The researchers found that preantral zinc deficiency:

  • Impaired the egg cell’s ability to properly divide (meiosis), which is a necessary step before successful fertilization can occur.
  • Led to smaller and more immature egg cells early in development
  • Hindered and disrupted growth of the cells
  • Caused problems with development of somatic cells and elevated certain cell markers.

The new research shows that zinc plays an important role in oocyte growth at an earlier stage than previously investigated, which is during development and before division. The research also showed why preconception nutrients are needed months before the eggs fully develop to give the best outcomes for a healthy pregnancy.

It is estimated that about 17 percent of the global population may be deficient in zinc, due to poor dietary intake their diet. But the estimate may not include cases of marginal zinc deficiency, where people may be getting zinc in their diet, but not enough for their recommended levels. People that are more susceptible to zinc deficiency are those with dietary and disease factors such as irritable bowel syndrome, Crohn’s disease, gastrointestinal disorders and liver disease, those with eating disorders, those with certain dietary restrictions, such as vegetarians or vegans, who may not then be taking supplemental zinc.

Preconception planning, care and management is so important for a healthy pregnancy to occur and should start months before trying to conceive. This is to ensure that the sperm are in optimal health and quality and also to make sure that the egg quality is optimal and in the best quality it can be as well. This is what I do for all my fertility patients and is a crucial part in the high success of my fertility program that has now helped over 12,500 babies into the world.

Regards

Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Normal 20 07 2016

belly 2473 1920

Women with PCOS May Be at More Risk of Uterine Cancer

April 3, 2018 Researchers in the United Arab Emirates (UEA) have found that women who have Polycystic Ovaries Syndrome have an increased risk of uterine cancer, reducing their chances of fertility.

The researchers have also found that women, who are overweight, or obese, are also at increased risk of uterine cancer. Being overweight and obese also increases a woman’s chances of PCOS too, but not all women with PCOS are overweight.

A study published in the Journal of the National Cancer Institute last year has shown that  endometrial cancer diagnoses have increased in 26 of 43 countries, mainly due to increasing obesity cases which themselves have tripled in the last 40 years, according to World Health Organisation.

The experts believe that obese women are 10 times more likely to suffer from uterine cancer. Being overweight, or obese also puts women at risk of other diseases such as heart disease and diabetes.

There are other factors involves such as an imbalance in the hormones with over-exposure to estrogens can lead to endometrial cancer. This could be due to endogenous causes such as Polycystic Ovaries Syndrome, or exogenous causes such as unopposed estrogens in menopausal hormone therapy if progesterone is not prescribed.

Some women may have genetic family syndromes that is predispose to uterine cancer along with breast, ovarian and other cancers. The causes of uterine cancer may be multifactorial, but this new research does help with screening of women who are suffering from PCOS, or who maybe overweight, or obese.

The researchers did find that regular exercise and healthy lifestyle choices can serve as a protection against uterine cancer, but can also help with PCOS and obesity.

The researchers did warn that women in reproductive years should not take symptoms of endometrial cancer lightly, since early diagnosis and treatment is an essential key to fertility preservation.

Once a condition that only affected women of advanced years, increasing clinical evidence now suggests that even women below 40 years of age can be diagnosed with uterine cancer.

The cancer cases are on the rise due to higher incidence of known co-morbidities such as obesity, diabetes mellitus and hypertension.

Symptoms of the endometrial cancer include:

  • vaginal bleeding between periods
  • bleeding after menopause
  • an abnormal, watery or blood-tinged discharge from vagina
  • constant back and pelvic pain
  • unintended weight loss
  • fatigue and nausea

Early screening is essential and women can safely consider fertility preservation provided that the cancer is diagnosed in early stages.

Fact around uterine cancer

  • Early diagnosis of uterine cancer can save women from fertility loss
  • World over, an increasing number of women in reproductive years falling prey to the disease
  • Obese women are 10 times more likely to suffer from endometrial/uterine cancer, other causes include hypertension and diabetes
  • PCOS may now be a risk factor for uterine cancer

Women who have PCOS, or who are overweight, should be seeking help with dietary and lifestyle management to help prevent them from other risk factors such as certain cancers. The number one treatment for PCOS is changing to a low GI diet and doing regular exercise. One of the major causes of PCOS is insulin resistance and this is a big factor in many who are overweight, or obese, or have type 2 diabetes. All of these issues can be controlled with the right management.

Regards

Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Normal 20 07 2016

 

acne 1606765 1920

Acne Can Be a Major Sign That You Have Polycystic Ovarian Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is the most common reproductive/endocrine disorder — and most common cause of infertility — affecting 9 -18% of women around the world. One of the major signs that you may have PCOS is acne on the face, or other parts of your body. Many women will have this one symptom overlooked and then have a major reproductive/endocrine disorder overlooked as well.

Despite the prevalence of this chronic condition, one-third of women diagnosed with PCOS saw at least three health professionals over the course of two years before receiving a diagnosis, according to a study from the University of Pennsylvania.

Polycystic Ovaries (PCO) is a characterised by multiple cystic growths on the ovaries. In large it is an endocrine and hormonal disorder, but it has potential to cause gynaecological and reproductive issues and these issues can be varied. Women with PCOS may not have cystic formation and just have symptoms that are part of the syndrome only (eg-acne, irregular cycle).  PCO and PCOS really are two different conditions, but now they are both put under the one title of PCOS and this actually isn’t correct. Some women only have the cysts (PCO), while others have no cysts but have the syndrome (PCOS). Some have both. The one thing that they all have in common is that they all have insulin resistance. The other thing we know is that there is usually a family member with the same condition whom has passed the condition on genetically. Often the family member passing on the genetic traits, doesn’t even know that have the condition in the first place.

Recent studies have shown that there are “major gaps” in education and support for women with these conditions (PCO and PCOS). We see the same thing with other gynaecological conditions such as endometriosis and Adenomyosis and why these conditions can take up to a decade to be diagnosed properly

As a healthcare practitioner, I see these same issues with so many women waiting years to get a proper diagnosis and they have seen multiple healthcare professionals in both the medical and complementary medicine profession. It also creates confusion and anxiety for women who just want an answer to their condition and are not being diagnosed properly and also getting conflicting advice and treatment in the interim.

The signs and symptoms of PCOS are very clear and easily diagnosed, but many healthcare professionals end up focussing on one symptom, while overlooking the bigger picture and then these poor women get their condition missed.

Acne is one of the major signs of having PCOS and many women have his overlooked, or unaware that they may have a condition that could affect their fertility later on. If a women presents with Acne, irregular periods etc, I know there is a very good chance that she could have, or actually has PCOS. The problem for these women, as explained before is that healthcare providers and placing too much emphasis on only one of these symptoms, which is usually the Acne, or just that the cycle is irregular. Then women are then put on the Pill and these symptoms are masked for years, until they try and have a child and have difficulty doing so. The other issue is that the acne is often the focus, due to vanity reasons, and this is also why the many of the treatments for the acne are not working, because they are failing to treat the root cause of the issue. It just becomes one big vicious circle that goes round and round until someone finally diagnoses the actual cause properly.

Women with PCOS also have an increased risk of type 2 diabetes, gestational diabetes, metabolic syndrome and anxiety and depression, and studies have shown that the longer it takes for the condition to be diagnosed, the longer the patients condition begins to affect both their physical, emotional and reproductive health

The most common signs of PCOS are:

  • Absent, Irregular and Inconsistent menstrual periods,
  • Acne
  • Excess hair growth (some women can have hair loss too)
  • Central obesity

But many women with PCOS are of normal body weight and can actually be underweight too. It can affect women of any shape, weight or size. Some women with PCOS have regular menstrual cycles and can be fairly asymptomatic (meaning no symptoms) too

Just like endometriosis, women with PCOS are often missed and dismissed and the impact this has can be significant psychologically and also significant on their future fertility. There needs to be better health professional resources and international dissemination to improve diagnosis, education, management and reproductive and health outcomes.

I am always saying to healthcare professionals (medical and complementary medicine) that if you don’t know how to do your job properly, you don’t know how to diagnose conditions like PCOS or Endometriosis properly, or it is out of your scope of practice, get out of the way and refer these women onto people who are trained to diagnose and manage these conditions properly.

Lets, help put and end to PCOS and also put an end to Endometriosis and other inflammatory gynaecological conditions as well. Let’s break the silence and help women get the diagnosis and care they need. Early intervention and treatment is crucial for any disease state and let’s help women get this care sooner.

Take care

Regards

Dr Andrew Orr

-Women’s and Men’s Health Advocate

-“Period Pain IS NOT normal”

-“Leaving no Stone Left Unturned”

Dr Andrew Orr Logo Retina 20 07 2016

acne 1606765 1920

Acne Can Be a Major Sign That You Have Polycystic Ovarian Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is the most common reproductive/endocrine disorder — and most common cause of infertility — affecting 9 -18% of women around the world. One of the major signs that you may have PCOS is acne on the face, or other parts of your body. Many women will have this one symptom overlooked and then have a major reproductive/endocrine disorder overlooked as well.

Despite the prevalence of this chronic condition, one-third of women diagnosed with PCOS saw at least three health professionals over the course of two years before receiving a diagnosis, according to a study from the University of Pennsylvania.

Polycystic Ovaries (PCO) is a characterised by multiple cystic growths on the ovaries. In large it is an endocrine and hormonal disorder, but it has potential to cause gynaecological and reproductive issues and these issues can be varied. Women with PCOS may not have cystic formation and just have symptoms that are part of the syndrome only (eg-acne, irregular cycle).  PCO and PCOS really are two different conditions, but now they are both put under the one title of PCOS and this actually isn’t correct. Some women only have the cysts (PCO), while others have no cysts but have the syndrome (PCOS). Some have both. The one thing that they all have in common is that they all have insulin resistance. The other thing we know is that there is usually a family member with the same condition whom has passed the condition on genetically. Often the family member passing on the genetic traits, doesn’t even know that have the condition in the first place.

Recent studies have shown that there are “major gaps” in education and support for women with these conditions (PCO and PCOS). We see the same thing with other gynaecological conditions such as endometriosis and Adenomyosis and why these conditions can take up to a decade to be diagnosed properly

As a Reproductive Medicine and Women’s Health Specialist I see these same issues with so many women waiting years to get a proper diagnosis and they have seen multiple healthcare professionals in both the medical and complementary medicine profession. It also creates confusion and anxiety for women who just want an answer to their condition and are not being diagnosed properly and also getting conflicting advice and treatment in the interim.

The signs and symptoms of PCOS are very clear and easily diagnosed, but many healthcare professionals end up focussing on one symptom, while overlooking the bigger picture and then these poor women get their condition missed.

Acne is one of the major signs of having PCOS and many women have his overlooked, or unaware that they may have a condition that could affect their fertility later on. If a women presents with Acne, irregular periods etc, I know there is a very good chance that she could have, or actually has PCOS. The problem for these women, as explained before is that healthcare providers and placing too much emphasis on only one of these symptoms, which is usually the Acne, or just that the cycle is irregular. Then women are then put on the Pill and these symptoms are masked for years, until they try and have a child and have difficulty doing so. The other issue is that the acne is often the focus, due to vanity reasons, and this is also why the many of the treatments for the acne are not working, because they are failing to treat the root cause of the issue. It just becomes one big vicious circle that goes round and round until someone finally diagnoses the actual cause properly.

Women with PCOS also have an increased risk of type 2 diabetes, gestational diabetes, metabolic syndrome and anxiety and depression, and studies have shown that the longer it takes for the condition to be diagnosed, the longer the patients condition begins to affect both their physical, emotional and reproductive health

The most common signs of PCOS are:

  • Absent, Irregular and Inconsistent menstrual periods,
  • Acne
  • Excess hair growth (some women can have hair loss too)
  • Central obesity

But many women with PCOS are of normal body weight and can actually be underweight too. It can affect women of any shape, weight or size. Some women with PCOS have regular menstrual cycles and can be fairly asymptomatic (meaning no symptoms) too

Just like endometriosis, women with PCOS are often missed and dismissed and the impact this has can be significant psychologically and also significant on their future fertility. There needs to be better health professional resources and international dissemination to improve diagnosis, education, management and reproductive and health outcomes.

I am always saying to healthcare professionals (medical and complementary medicine) that if you don’t know how to do your job properly, you don’t know how to diagnose conditions like PCOS or Endometriosis properly, or it is out of your scope of practice, get out of the way and refer these women onto people who are trained to diagnose and manage these conditions properly.

Lets, help put and end to PCOS and also put an end to Endometriosis and other inflammatory gynaecological conditions as well. Let’s break the silence and help women get the diagnosis and care they need. Early intervention and treatment is crucial for any disease state and let’s help women get this care sooner.

Take care

Regards

Dr Andrew Orr

-Women’s and Men’s Health Advocate

-“Period Pain IS NOT normal”

-“Leaving no Stone Left Unturned”

 

Stressed Uterine Cells & Inflammation Cause Miscarriage, Not Natural Killer Cells

It is stressed uterine cells and inflammation causing miscarriage and causing the embryo not to implant, not Uterine Natural Killer cells.

For the first time the functions of natural killer cells in the womb have been identified by Researchers at the University of Warwick and University Hospitals Coventry

Although it has long been known that the lining of the womb harbours dynamic uterine natural killer cells, no functions have so far been given to these cells outside of pregnancy.

The researchers have discovered that the uterine natural killer cells remodel and refresh the lining of the womb at the time of embryo implantation. This is the first time a role for uterine natural killer cells in the lining of the womb has been identified outside of pregnancy. The research was published on December 14, 2017.

In addition they discovered that this process isn’t always balanced in each cycle. The natural killer cells perform the role of targeting and clearing inflammatory stressed cells, thereby making space for the implanting embryo. However sometimes not enough of these cells are cleared away and sometimes too many are targeted and removed. Excessive inflammation or insufficient clearance by uterine natural killer cells makes miscarriage more likely.

For many years I have been trying to tell people that they need to stop trying to get rid of the natural killer cells, or reduce their numbers. I have long known that natural killer cells are meant to be in the body and their job is to protect us from infections, bacteria, cancers, tumours and inflammation. If killer cells are in high numbers, it means that there is something wrong and that is what needs to be treated, not the killer cells. But unfortunately, many clinics play on couples emotions and the use of the word “Killer”. So then we get this war on killer cells and people wanting to kill the killer cells because they think it is killing their babies. No matter how hard I have tried to explain it, people just don’t listen and now it is finally great to have the research to back up what I knew all along, plus additional knowledge of how Killer cells actually help with implantation and reducing miscarriage.

The researchers have explained what happens if the natural killer cells cannot do their job properly, or there is inflammation that they haven’t been able to target. They said that a good analogy is Swiss cheese: without holes, the embryo has nowhere to go which will cause implantation failure; but if the holes are too large, the tissue will physically collapse and lead to miscarriage. This imbalance, which may be short-lived or last for multiple cycles, explains the high rate of early pregnancy failure. It really can be a numbers game on how long that cycle could last and why it is important to make sure there are enough natural killer cells there to do their job properly. Without the natural killer cells, there is more chance of inflammation and stressed uterine cells being left behind, which will then lead to higher pregnancy loss and reduced implantation.

The researchers conducted an analysis of 2,111 endometrial biopsies, which is more than had ever been conducted previously. The research team examined the acutely stressed cells in the lining of the womb which generate tissue inflammation. They found that the natural killer cells which are in the womb perform the important function of selectively targeting and eliminating acutely stressed cells.

When there are high acutely stressed cells in the lining of the uterus, the lining of the uterus fails to sense the chemical signals from the fertilised egg and it then silences many of the genes involved in allowing the embryo to implant and embed into the uterus.

One of the chemicals needed for this process to take place is Trysin, which is a common enzyme the embryos gives off. If trysin isn’t detected the embryo is not accepted and left to disintegrate and then the cycle is reset once again. The lack of Trysin signal appears to indicate to the endometrium that the quality of the embryo is not very high and initiates a reduction of receptivity to implantation. These findings could help to improve the success rates of IVF, because one of the biggest problems with IVF is getting the embryo to implant

The research team also found that high numbers of Natural Killer cells in the endometrium are not only a sign of high inflammation and acutely stressed uterine cells, but also indicate a insufficient production of steroids, which in turn leads to reduced formation of fats and vitamins that are essential for pregnancy nutrition.

Again, this is exactly what I have been trying to say for years and why when I treat women who are having implantation issues and recurrent miscarriage I look at treating the cause of the issue, rather than masking it.

To treat miscarriage and help with embryo implantation you need to do the following

  1. Reduce inflammation in the uterine environment and pelvic cavity
  2. Make sure the pelvis, tubes and uterus have been surgically evaluated properly prior to conception, or assisted reproduction (IVF, IUI, ICSI etc)
  3. Increase blood flow and nutrients into the uterine lining
  4. Ensure adequate essential fats and nutrients are given prior to conception
  5. Reduce stress levels
  6. Increase protein and reduce inflammatory refined carbohydrates
  7. Make sure the couple in are optimum health (healthy sperm + healthy eggs=health baby)
  8. Make sure the man is being treated at the same time the woman is (up to 85% of miscarriage issues are related to chromosomal and DNA factors related to poor quality sperm, which cannot be measured by a normal semen analysis)

We need to stop blaming high NK cells as being the cause of miscarriage and embryos not implanting. We need to look at the real cause, which is inflammation, stressed uterine cells ( due to stress in the person), lack of nutrients and blood flow in the uterus and lifestyle factors that is also leading to increase miscarriage rates and reduced embryo implantation. This is why I have my own range of fertility formulas to assist the uterine environment and help with implantation.

Let’s not forget that faulty sperm and DNA damage and chromosomal issues with sperm are also a big part of miscarriage too. Miscarriage is not just a woman’s issue. To be honest, statistically it is more likely to be on the male side of the equation and often gets overlooked. But that is a whole other post in itself.

This is why I offer a comprehensive fertility program that looks at every aspect of the couple and every aspect of fertility. It is also why I have helped over 12,500 babies into the world. It is about my motto of “No Stone Left Unturned” and treating the cause of people’s issues, not just guessing and trying to treat the symptoms as you go along.

Hopefully in the future this new information will be used to screen women at risk of reproductive failure and help with new treatment options for women suffering recurrent miscarriages or recurrent IVF failure.

If you are having trouble conceiving and want answers to your fertility issues, then maybe it is time to book into my fertility program and get some real answers, real treatment and get the baby you so desperately deserve.

Regards

Dr Andrew Orr

-No Stone Left Unturned