Causes of bleeding in between cycles

Why am I getting bleeding between my periods?

Vaginal bleeding between periods can be common and is not generally a cause for concern. Most of the time women will get just very light pink coloured watery flow, or just some spotting. There can be many reasons why a woman would be getting bleeding between periods, which includes hormonal changes, injury, or an underlying gynaecological, or health condition.

While bleeding between your periods may not be cause for concern, on one level, the ideal situation is to not have any form of bleeding at all and if you do get bleeding between your cycle, it is a good idea to have this investigated, just to be on the safe side.

What a proper menstrual cycle should be like

I have done quite a few posts on what a proper menstrual cycle should be like, but I will go over this again just briefly

A proper menstrual cycle should be between 26-32 days in length and really only have about 3-5 days flow. Any longer than this can be too long and put a woman at risk of being low in iron, especially if this happens all the time.

The blood flow should be a nice red consistency, no clots, with no stopping and starting, and women shouldn’t have too many digestive disruptions, and really, a woman should not be getting pain with her cycle. A little bit of distention and knowing the period is coming is fine, but there should not be pain at all. If you have to reach for the pain killers and the heat pack, or are doubled up in pain, this is not normal and you need to get this checked out.

What are the causes of bleeding between periods?

As mentioned before, there can be a variety of reasons for breakthrough bleeding, some of which are no cause for concern at all. Some however do need to be investigated.

Below are some of reasons for bleeding between periods:

Ovulation

When an egg is released from the ovary, it does create a tiny wound, through which the egg will then travel through the tubes and prepare to make its way to be fertilised, or then shed with the menstrual flow. At ovulation, this tiny wound can also create a tiny amount of bleeding, which can be seen as spotting during the ovulatory phase of a woman’s cycle.

Implantation bleeding

When an embryo implants into the uterine lining and begins to grow, many women experience spotting around this time. This is called implantation bleeding. They may also experience some slight cramping at the same time and all of this is quite normal. Some women may then experience some lighter bleeding as the embryo grows further. They usually get some light spotting, which can be a light pink, or a brown colour. Sometimes it can be more like fresh blood. While this is normal, it is a good idea to get this checked out just to be on the safe side and to also put the pregnant mothers mind as ease too.

Miscarriage

Bleeding between menstrual periods can be an early sign of a miscarriage. Many women may not even know they are pregnant and may be completely unaware they are having a miscarriage.  While it is generally thought that once a woman reaches twelve weeks gestation everything is generally going to be ok, miscarriages can occur at any time during pregnancy.

Termination

After having a termination women can bleed for some time after the procedure, or taking the medication to start the abortion process. If bleeding continues and is very heavy, women need to seek medical advice.

Polyps 

Polyps are small growths that can develop in the uterus or on the cervix. They are often a cause for unexplained bleeding between the cycles. Polyps do need to be removed as they can prevent implantation happening and they can also turn cancerous if left behind. Polyps are a very common cause of bleeding between periods.

Fibroids

Fibroids, or myomas (also known as leiomyomas, or fibromyomas) are growths, or benign (non-cancerous) tumours that form in the muscle of the uterus. Up to 40% of women over the age of 40 years have fibroids and as many as 3 out of 4 women develop fibroids in their lifetime.

Fibroids can cause heavy bleeding, extended bleed and painful periods. They can also cause infertility, miscarriage and premature labour. In many women, they will not cause any problems at all. Fibroids are a very common cause of bleeding between the cycles.

Polycystic Ovarian syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) is a very common condition that can cause irregular periods, absent periods, and can also cause bleeding between periods. PCOS can also cause other issues such as acne, weight gain, infertility and hormonal and emotional disturbances.

Endometriosis or Adenomyosis

One in ten women are diagnosed with endometriosis and many more do not even know that they have it. Endometriosis and Adenomyosis are very closely related, with endometriosis usually being more superficial disease and not confined to the uterus,  and adenomyosis being deep within the uterine tissue. Chronic conditions such as endometriosis and adenomyosis, can cause bleeding or spotting between periods.  These conditions may also cause heavy or painful menstrual periods and cramps between periods. Adenomyosis will usually cause more bleeding symptoms along with pain etc.

Sexually transmitted infections (STIs)

Some sexually transmitted infections (STIs) can cause pain, vaginal bleeding and spotting. If you do suspect you may have a STI, you need to see your doctor for investigation and treatment.

Injury to the vaginal wall

During sexual intercourse the tissue of the vagina can be damaged and this can then cause bleeding. If the vagina is too dry, lack of arousal, and not lubricated enough this is more likely to happen. It can also happen if there is atrophy in the vaginal tissue as well. This is called atrophic vaginitis.  This is more likely to be seen when a woman is going into menopause, or undergoing cancer treatments, or has diabetes.

Menopause or perimenopause

The menopausal stage of life and especially the perimenopause stage, can be a cause of irregular menses and irregular bleeding. It can also cause spotting, or heavy bleeding too. Perimenopause is the period leading up to menopause. This stage of a woman’s life can last for up to 10 years as hormone levels in the body change and can be unstable.

Hormonal contraceptives

Hormonal contraceptives are a common cause of bleeding between periods. They can also cause irregular bleeding and this can be quite usual in the first 3 months of using the contraceptive. If a woman misses takin her oral contraceptive, it can also cause irregular bleeding, or a withdrawal bleed.  Intrauterine Devices (IUD’s) like the Mirena, will often cause irregular periods and irregular bleeding in the first 3 months after it have been inserted. If bleeding lasts for longer than 3 months on any contraceptive, it is a good idea to seek medical advice and get investigated and managed properly.

Emergency contraception

The morning after pill, or emergency contraceptives, may also cause bleeding. If bleeding persists, you should seek medical advice.

Certain cancers

Vaginal bleeding between periods can also be a sign of gynaecological cancers in women. Most bleeding that women get is not serious, but it still needs to be checked.  Cervical cancer can affect women of any age. Bleeding between the cycle, or after intercourse, and pain after intercourse, or unpleasant smelling discharge can be symptoms of cervical cancer and these all need to be checked by your doctor, or gynaecologist.

Uterine cancer tends to occur in women over 50 year of age. One of the early symptoms of uterine cancer can be vaginal bleeding. Uterine cancer mostly affects women are in the menopause and no longer have periods, so this is why any bleeding after menopause needs to be investigate and seen as not being normal.

Stress

Yes, stress can cause abnormal bleeding and also interfere with a woman’s cycle. Increased levels of stress can interfere with hormones and this can lead to bleeding, irregular cycles, or pain with cycles too.

When to see a doctor

If vaginal bleeding between periods is heavy, persistent, or unusual then a woman should go and see a specialist, or a gynaecologist, who is a specialist in this area of medicine. As mentioned previously, while some causes of bleeding are not serious, some are and need to be properly investigated and properly managed medically.

Treatment and prevention

All women should keep a record of their menstrual cycle and when the period starts and how long it lasts for. Any abnormal bleeding should be recorded so that you can show your healthcare specialist if need be. Any abnormal bleeding should be investigated and the treatment will depend on what the underlying cause is.

Women should try and see their healthcare specialist for regular pap smears and regular check-ups for gynaecological health.

If women are getting small tears and bleeding caused from dryness in the vagina, then there are water based lubricants that can be used to help with lubrication and to moisturise the surrounding tissue.

There is no cure for gynaecological and reproductive issues such PCOS and Endometriosis, but these disease states can be treated and managed to give women a normal life. Proper treatment of these issues needs a “Team”, or multimodality approach using medical options, surgical interventions, pelvic floor specialists, acupuncture, herbal medicines, hormone therapies, and diet and lifestyle changes. It is about using what works for the individual and not a blanket one treatment fits all approach.

Last but not least, all women should know that period pain is not normal and that irregular bleeding really isn’t normal either. While most causes of bleeding are not life threatening, they still need to be investigated and checked out properly. Never ever put off seeing a specialist if you have abnormal bleeding.

Regards

Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Normal 20 07 2016

 

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Genetics & Gene Sequencing May Be The Path To a Cure for Endometriosis

I have always said that the biggest inroads to the management and treatment of endometriosis will come from the area of genetics. I’ve also said that if there is going to be a cure, this will be the pathway that is comes from.

New research published in the New England Journal of Medicine has revealed that Gene sequencing has found a set of genetic mutations which may help to develop molecular tests to distinguish between mild and aggressive types of endometriosis. This is a big step forward into finding out more about endometriosis and developing better medical treatments and management strategies. Hopefully one day it will also lead to a cure for women with this horrible disease.

Endometriosis is a painful disorder in women which uterine tissue grows outside of the womb, most commonly into the abdomen, and will affect at least 1 in 10 women. It can spread to every part of the body.

Many women with endometriosis will experience symptoms of abdominal pain, migraines, pain with sex, ovulation pain, IBS like symptoms, UTI like symptoms (without infection present), menstrual cramps, abdominal distension and possible issues with infertility.

Endometriosis can affect both physical and mental health in sufferers. While a portion of women with endometriosis get pain and associated symptoms, it needs to be noted that a significant portion of women with endometriosis are asymptomatic (no symptoms) and would not even know that had it, until they are investigated for fertility purposes.

This discovery helps moves towards developing genetic based systems for classifying endometriosis to sort out which forms of the disorder needs more aggressive treatment. Presence of the unusual set of mutations suggest that while origins are rooted in normal endometrial cells mutations change their fate, the mutations identified have links to genetic mutations found in some forms of cancer. Abnormal endometriosis tissue growth will often spread throughout the abdominal cavity but rarely becomes cancerous with exception to a few cases when the ovaries are involved.

The close links to cancer have always baffled scientists, as endometriosis does behave like a cancer the way it spreads, and now they have found some of the same mutations found in cancers, in some of the endometriosis lesions. But again, endometriosis rarely turns cancerous, except if it does spread to the ovaries, but there have been some studies to suggest links that women with endometriosis may be at more risk of endometrial cancer.

In this latest research, the research scientists analysed the samples looking for mutations or abnormal changes in DNA and filtered out normal variations in genes which commonly occur. At least one or more mutations in endometriosis tissue that were not present in their normal tissue, in which the number and type of mutations varied per endometriosis lesion and each woman.The types of mutations found were among the most common mutated genes found, which are all known for DNA repair, controlling cell growth, and cell invasion.

The researchers are working on additional studies to investigate whether patient outcomes correlate with the mutations. Testing which can sort lesions into less or more aggressive has potential to help decide how to monitor progression as well as control and treat the endometriosis. It may also be possible to develop new treatments which use agents that block gene related pathways specific to an individual’s disease.

Women are normally prescribed anti-hormonal treatments, which block estrogen to shrink lesions. Endometriosis is estrogen driven and is not from estrogen dominance, as some people would have women believe. Even small amounts of estrogen can drive the disease and cause the expression of the lesions. When endometriosis occurs on the ovaries and forms a large cyst, or endometrioma, it is typically removed as it increases the risk of developing ovarian cancer in some women.

While this new development is not a cure for endometriosis, it is providing new insights into the disease, which will hopefully one day see a cure in the not so distant future. Lets help end the silence for women with this horrible disease by getting more awareness out there and let us hope that the cure will eventually come one day soon.

Regards
Dr Andrew Orr
-No Stone Left Unturned
-Period Pain IS NOT Normal
Dr Andrew Orr Logo Retina 20 07 2016

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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

 

What causes a burning sensation in the vagina and around the vulva?

A burning sensation in and around the vaginal, vulva area is a relatively common complaint that many women experience and something that is seen in practice very often. There are so many different causes of vaginal and vulva burning, including irritants, sexually transmitted diseases, atrophic vaginitis, thrush, lichen sclerosis, climates changes and is very common in peri-menopause and the menopause period. Each of the causes has its own set of symptoms and the treatments can all vary, depending what the cause it.

In this article we will look at the common causes of having a burning sensation in the vagina and around the vulva area. We will also look at treatments and management of these as well.

Before we start, it is important that women know that often people use the wrong term for the vagina and the surrounding area and often refer to a woman’s genitals as just being the vagina. It is important that we use the correct terms for a woman’s anatomy so that we can correctly identify were problems are.

The vagina is more the internal part of the female genitals and the vulva is the external part. Th Vulva is an umbrella term for the various parts of the external female genitals. These parts include:

  • Mons pubis – the fatty ‘pad’ that’s covered in pubic hair
  • Labia majora – outer lips
  • Labia minora – inner lips
  • Clitoris – small organ that’s packed with nerve endings
  • Urethral opening – which allows the passage of urine
  • Vestibule – area around the opening of the vagina
  • Perineum – area between the vagina and anus

Now that we understand the proper terms for the anatomy, lets have a look at what some of the common causes of burning sensation are.

Common causes of vaginal and vulva burning sensation

1.Skin Irritation

There are many things that can irritate the skin of the vulva and vagina when they come into direct contact with it. This is known as contact dermatitis.

Irritants that can cause contact dermatitis, inflammation and burning symptoms include non pH neutral soaps, certain fabrics, perfumes, vaginal hygiene sprays, some lubricants and allergens. As well as burning sensations, women may experience the following:

  • severe itching
  • redness and rawness and sometimes bleeding
  • stinging feelings and sensations of heat
  • pain and sometimes

The main way to treat irritation is to avoid whatever has caused the irritation in the first place. Avoiding the irritant and allowing the inflamed area and the skin to heal is one of the best things to do. Sometimes, a woman may require medications to settle the inflammation, or dermatitis down.

2. Candidiasis (Thrush, Yeast infections)

An overgrowth of bad bacteria in the vagina can lead to a burning, stinging sensation and one of the common causes of issues for women. Candidiasis, or thrush is very common in women and is causes through changes in the gut and vaginal flora and this then leads to overgrowth of bacteria, which causes many of the following symptoms

  • itching
  • soreness
  • pain during sex
  • pain or discomfort when urinating
  • discharge from the vagina (either white, or coloured)

Women are more likely to be prone to getting thrush if they are taking antibiotics, using certain form of hormones and contraceptives, have a weakened immune system, live in humid climates, have diabetes, are pregnant, or not cleaning themselves properly. High stress can also lead to changes in the gut and vagina flora and this can also lead to thrush.

Thrush is usually an antifungal medicine called azoles. Azoles can either be used internally into the vagina, or taken orally as a capsule, or both at the same time. Pre and Probiotics should be taken to help build up the good bacteria and women should take care with personal hygiene. Partners may also need to be treated to prevent further reintroduction of thrush via sexual intercourse.

3. UTI- Urinary tract infection

When a woman has a urinary tract infection (UTI), she will be likely to feel burning in and around the vagina when urinating. There may be other presenting symptoms such as:

  • needing to urinate more frequently, or have urgency to urinate
  • pain with urination
  • smelly, or cloudy urine
  • blood in urine
  • pain in lower stomach and radiating pain into the back and kidney area
  • feeling tired or unwell

When a woman has a urinary tract infection antibiotics will be needed and the antibiotics needed will depend on what the cause of the infection is. Usually an infection will clear up in around 5 days after starting a course of antibiotics.Repeat medication may be required if an infection returns.

4. Bacterial Vaginosis (BV)

Bacterial Vaginosis (BV) is the most common vaginal infection in women aged 15 to 44. Bacterial Vaginosis (BV) is a condition that occurs when there is too much of certain kinds of bad bacteria in the vagina, affecting the balance of good bacteria and flora. One of the main symptoms of BV is a burning sensation in the vagina, which can also occur when urinating.

BV does not always cause symptoms but when it does cause symptoms, besides a burning sensation, it can cause the following:

  • white or gray vaginal discharge
  • pain and irritation
  • itching and redness
  • strong fish-like odor, especially after sex (one of the key symptoms)

Having BV can increase a woman’s risk of STI’s and it can also increase her risk of miscarriage, once she is pregnant. If you think that you may have the symptoms of BV, you need to have it check by your doctor as soon as possible. BV is usually treated with antibiotics and you can use complementary medicines to assist in the treatment as well. It is a good idea to restore the good bacteria into the gut and vagina as well. This can be done through the use of prebiotic and probiotic bacteria combined.

5. Trichomoniasis

Trichomoniasis is a common STI and is caused by a parasite that is passed from one person to another during sexual intercourse. Many people may not know that have Trichomoniasis, but symptoms can present with a burning sensation and may  also present with  the following:

  • itching, redness, or soreness
  • discomfort when urinating
  • women can have vaginal discharge that can be clear, white, yellow, or green and with a fishy smell

Trichomoniasis can increase a woman’s risk of miscarriage, so it need to be treated asap. Trichomoniasis is treated by using certain forms of medicines called azoles.

6. Gonorrhea

Gonorrhea is an sexually transmitted infection where bacteria called Neisseria gonorrheae infect mucous membranes, such as the cervix, uterus, and fallopian tubes. If a woman is infected with gonorrhoea she can experience vaginal burning when urinating, as well as the following symptoms:

  • pain when urinating
  • vaginal discharge
  • vaginal bleeding between periods

Gonorrhea can be cured with the right medical treatment and it needs to be treated with specific medications. Often dual forms of medication are used for effective treatment.

7. Chlamydia

Chlamydia is a common STI caused by the bacteria Chlamydia trachomatis and is  transmitted through sexual intercourse with someone who has the infection.

If a woman comes in contact with chlamydia through intercourse, many times she may be asymptomatic (meaning no symptoms) and this is why it is often known as a silent infection. When symptoms do occur it can cause a burning sensation in the vagina and surrounding area. There can be other symptoms which include:

  • increased vaginal discharge
  • pain with urination and pain during sex
  • bleeding during sex and between periods

Chlamydia can cause damage to a woman’s reproductive organs and can affect her fertility, so it is important to have this treated as soon as possible.  Chlamydia is treated using specific high dose antibiotics. Treatment may also require IV antibiotics and for someone to be admitted to hospital while these are being administered.

8. Genital herpes

Genital herpes is a common sexually transmitted disease caused by skin-to-skin contact with a person with the herpes virus. Once a person has the virus, it stays with them for life. Sometimes the virus can remain dormant and then at certain stages of life (during stress, illness etc), it can become active and start producing symptoms.

If the virus becomes active, they might experience a burning sensation in the vagina, along with some of the following symptoms:

  • an itching or tingling sensation
  • flu-like symptoms
  • swollen glands
  • pain in the vaginal area, particularly when urinating
  • change in vaginal discharge

Painful sores, blisters, or ulcers may also develop after a few days. The symptoms of genital herpes can be treated with antiviral medication but once you have herpes, it cannot be cured. You just need to manage it and its symptoms.

9. Lichen sclerosus

Lichen sclerosus is a skin condition that affects the vulva area in women. Lichen sclerosus can cause burning sensation around the vulva area. It can also cause the following symptoms:

  • itching and tenderness.
  • Pain
  • Scarring
  • Wrinkling and white patches

Postmenopausal women are most susceptible to have lichen sclerosus. The cause is thought to be an autoimmune response of some kind, since the condition is associated with autoimmune disorders such as Graves’ disease and vitiligo. Treatment includes topical steroid creams, other medications, silica cream, zinc cream and regular medical monitoring. Lichen sclerosus is linked to an increased risk of vulvar cancer.

10. Menopause

Vaginal and vulva burning can be as a result of the perimenopause, or menopause stages of life. The shifting levels of hormones in a woman’s body before she enters menopause can affect the vagina and surrounding area. Burning sensations, in the vagina and around the vulva area is one possible result of these changes, especially during sex.

Some of the common symptoms of the perimenopause/menopause period are:

  • hot flushes & night sweats
  • difficulty sleeping
  • reduced sex drive
  • vaginal dryness
  • headaches
  • mood changes
  • Pain with sex
  • Atrophic vaginitis.

Not all women entering menopause have treatment to relieve symptoms, but there are often options available that a doctor, or healthcare practitioner, can outline, including hormone therapy. There are also many natural therapies that can help during peri-menopause and menopause stages of life.

What you can do to help yourself

Many causes of vaginal burning require medical treatment. If you are concerned, the best you can do is to see your healthcare practitioner. There are things you can do before seeing your doctor. Sometimes a ice pack or cold compress to the affected area can help reduce the burning sensation. You can also try some over the counter soothing creams, or antifungals.

Make sure you are practicing proper hygiene and cleaning the outer area of the vulva properly. Women should avoid using douches, which can affect the good bacteria and internal flora of the vagina.  Wearing cotton underwear and avoiding tight-fitting clothes can help reduce irritation in the vaginal area. It is also important to avoid products that could irritate the area further, such as perfumed soap, scented toilet paper, and sanitary products with deodorant, or a plastic coating.

Possible complications

Some causes of vaginal burning, such as urinary tract infections, BV, STI’s, lichen sclerosis can have some serious complications if left untreated. Cancer also needs to be ruled out so this is why it is important to have any symptoms of burning checked out by your doctor.

STI’s can affect future fertility and are also harmful to women who are pregnant, as they can affect their baby, or pregnancy. Many STI’s can cause preterm delivery and also increase the risk of miscarriage.

While some causes of vaginal and vulva burning may go away on their own over time, it is still important to go and get your doctor’s advice just to be safe. If your symptoms aren’t going away, are becoming worse, or are of a concern, then the woman should go and see a doctor as soon as possible. The longer you leave something, the worse it can get and the more issues it can cause, if left untreated. Many of the cases of burning sensation in the vagina and around the vulva will be relieved once the underlying cause is treated properly and with the appropriate medicines.

While medical options will be needed for some conditions, there are complementary medicines and complementary medicine modalities that may be able to assist your particular issue, or alongside medical treatments. Please always see a qualified healthcare practitioner and not use Dr Google, or take advice from friends or family for any medical advice.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

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Blue Berries Help To Fight Cervical Cancer & Enhance Medical Treatments

Researchers have shown that combining blueberry extract with radiation may be the next treatment in the war against cervical cancer. Plus, Blueberry extract also offered normal cell protection from the radiation at the same time

Worldwide, cervical cancer is the third most common cancer among women and the second most frequent cause of cancer-related death, accounting for nearly 300,000 deaths annually. In developing nations, it is often the most common cause of cancer-related death among women and a leading cause of death overall.

One of the most common treatments for cervical cancer is radiation. While radiation therapy destroys cancer cells, it also destroys nearby healthy cells. University of Missouri School of Medicine researchers studied in vitro human cancer cells to show that combining blueberry extract with radiation can increase the treatment’s effectiveness.

When Radiation therapy is needed it uses high-energy X-rays and other particles such as gamma rays to destroy cancer cells. For some cancers, such as late-stage cervical cancer, radiation is a good treatment option. However, collateral damage to healthy cells always occurs. Because of the damage to healthy cells researchers studied blueberry extract to verify if it could be used as a radiosensitizer.

Radiosensitizers are non-toxic chemicals that make cancer cells more responsive to radiation therapy. In a previous studies research has shown that resveratrol, a compound in red grapes, could be used as a radiosensitizer for treating prostate cancer. It is also know that Blueberries also contain resveratrol. In addition to resveratrol, blueberries also contain flavonoids, which  are chemicals that may have antioxidant, anti-inflammatory and antibacterial properties.

The researchers used human cervical cancer cell lines to mimic clinical treatment. The cell lines were divided into four groups that included a control group, a group that received only radiation, a group that received only blueberry extract, and a group that received both radiation and the extract.

Researcher found that on its own, radiation decreased cancer cells by approximately 20 percent. Interestingly, the cell group that received only blueberry extract had a 25 percent decrease in cancer. However, the biggest decline in cancer cells occurred when the radiation was combined with the blueberry extract. There was a 70 percent  decrease in cancer cells in the group the blueberry and radiation group.

The other interesting observation was that the blueberry extract also reduced the abnormal explosion of cell growth, which is what cancer is. While the blueberry extract inhibits the birth of cancer cells it also tricks the cancer cells into dying. So the extract inhibits the borth and promotes the death of cancer cells.

Blueberries are an amazing food source with antioxidant properties and many health benefits. They are also found all over the world and it is great to see this super food doing a super job of boosting the effectiveness of existing medical therapies to save women’s lives around world.

Regards

Dr Andrew Orr

-No Stone Left Unturned

 

 

Super Sperm Could Save Women’s Lives

Worldwide, cervical cancer is the third most common cancer among women and the second most frequent cause of cancer-related death, accounting for nearly 300,000 deaths annually. In developing nations, it is often the most common cause of cancer-related death among women and a leading cause of death overall.

While the treatment of cervical cancer has improved considerably, there still needs to be better solutions and more effective treatments found. There are also many side effects of these treatments and scientists may have found the answer in one of the strongest swimmers on the planet…. Sperm.

Over the years, scientists have tried to find delivery systems into cancer cells to minimize the side effects of drugs, but to target tumor and cancer directly. They have looked at many delivery systems from Stem Cells to Bacteria and none have shown the promise of the mighty sperm.

In a latest scientists report from the journal ACS Nanothat, scientists have harnessed the swimming power of sperm to carry a cancer drug directly into a cervical tumor.

The challenge for many drugs is that they do not penetrate far enough into the tissue of a cancer cell. So scientists have been trying to find a self propelled system that can penetrate another organism and carry a drug deep into the heart of it. Well, guess what?         That is exactly what sperm is designed to do and these mighty swimmers are having a back pack full of drugs strapped to the back and through the influence of magnetic fields, are being successfully guided into tumor cells.

The researchers packaged a common cancer drug, into bovine sperm cells and outfitted them with tiny magnetic harnesses. Using a magnetic field, sperm were guided into a lab-grown tumor of cervical cancer cells. When the harness arms pressed against the tumor, the arms opened up, releasing the sperm. The sperm then swam into the tumor, fused its membrane with that of a cancer cell, and released the drug. When unleashed by the thousands, drug-loaded sperm killed more than 80 percent of a cancerous ball while leaking very little of their payload en route.

Further work is needed to ensure the system could work in animals and eventually humans, but researchers say the sperm motors have the potential to one day treat cancer and other diseases in the female reproductive tract.

We don’t often look at sperm other than something that is needed to make a baby. But this tiny mighty swimmer could be used to one day treat inflammatory gynaecological conditions such as endometriosis, adenomyosis and other inflammatory gynaecological diseases.

I have written quite a few posts on some of the uses of sperm to help treat depression, help trigger ovulation and also assist with implantation of the embryo. Sperm may just become the next saviour in the attack on diseases many women face and help save women’s lives all over the world. Hail to the mighty super sperm.

Just remember that to have super sperm, you also need to be super healthy. Poor health and lifestyle choices leads to poor quality sperm. Things like alcohol, smoking, drugs, poor diet etc, all lead to poor quality sperm. There are also essential nutrients, antioxidants and amino acids that help sperm quality too.

Take care

Regards

Dr Andrew Orr

-Women’s & Men’s Health Advocate

-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

-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.

 

 

Do you suffer pain with sex? (dyspareunia)

Pain with sex, Intercourse pain, or dyspareunia, can cause problems in a woman’s life and it can be a cause of problems in couple’s sexual relationship. In addition to the physically painful sex, there is also the possibility of negative emotional effects. Then even when a woman may feel aroused and wanting sex, the fear of the pain can cause the whole process of wanting sex to stop.

How many people get Pain with Sex

It is estimated that about 20%-25% of women suffer vaginal pain with foreplay or intercourse. Pain can be acute, intermittent or chronic and can stem from a wide variety of causes that will be covered shortly. Unfortunately when women complaining of pain during sex, they are often dismissed as being inhibited, having psychiatric issues, or merely just making it up to get out of having sex. Many men would like to boast that it is them being well endowed that is causing the problem (they wish) but in fact if your partner is in pain, then you need to actually stop and listen to the reasons why. The fact is most of the time, their symptoms are related to legitimate medical issues that need to be investigated and treated accordingly. So guys, get your hand of it and start listening to your partner if she says she is getting pain.

What causes pain with Sex (Dyspareunia)?

In many cases, a woman can experience painful sex if there is not sufficient vaginal lubrication. There could be many reasons for this and one that is commonly seen in menopause. When this occurs, the pain can be resolved if the female becomes more relaxed, if the amount of foreplay is increased, or if the couple uses a sexual lubricant. Issues like this can easily be overcome, but there are some medical and gynaecological issues that could be causing the pain and being very much overlooked.

So what are the other causes of Pain with Sex

Endometriosis – This is a condition in which the endometrial like tissue (lesions) that lines the uterus grows outside the uterus. It can cause all sort of pain in the pelvis, bowel and rest of the body, but it can cause pain with sex. It is one of the leading conditions that does cause pain with sex. Many women with endometriosis may not have symptoms of it, or may only have one symptoms like pain with sex. Symptoms do not correlate to the extent of the disease either. Some people with small amounts get lots of pain, while others can have lots of it and have no pain. Endometriosis can only be properly diagnosed via surgery (laparoscopy)

Adenomyosis – is a condition which is very similar to endometriosis. It is a conditions in which the inner lining of the uterus (the endometrium) breaks through the muscle wall of the uterus (the myometrium). Adenomyosis can cause menstrual cramps, lower abdominal pressure etc, before the menses and can result in heavy periods.  It can also cause pain with sex. The condition can be located throughout the entire uterus, or localized in one spot

Vaginismus-  This is a common condition. It involves an involuntary spasm in the vaginal muscles, which closes up the vagina and prevents penetration from happens. It is sometimes caused by fear of being hurt.

Vaginal Infections-  These conditions are common and include yeast infections such as thrush and candida and these can cause inflammation to the vagina and cause pain with sex and also localized bleeding.

Vaginal skin conditions– Dermatitis around the vulva and also a condition called Lichen Sclerosis can all cause pain with sex due to the inflammation of the skin.

Problems with the cervix (opening to the uterus). In this case, the penis can reach the cervix at maximum penetration. So problems with the cervix (such as infections) can cause pain during deep penetration.

Problems with the uterus. These problems may include polyps, cysts, fibroids etc that can cause deep intercourse pain.

Problems with the ovaries – Problems might include cysts on the ovaries, or tubal disease.

Pelvic Inflammatory Disease (PID) – Often referred to as penis injected disease. With PID, the tissues deep inside become badly inflamed and the pressure of intercourse causes deep pain.

Ectopic Pregnancy – This is a pregnancy in which a fertilized egg develops outside the uterus, or into the tubes. It can cause immense pain and even death if not death with properly.

Menopause- With menopause, the vaginal lining can lose its normal moisture and tone and become dry. The vagina, uterus and surrounding organs can all suffer atrophy, which can cause bleeding and pain. It can also cause prolapse.

Intercourse too soon after childbirth, or surgery – Trying to have sex too soon after childbirth, or a surgery,  can cause pain during sex.

Sexually Transmitted Infections (STI’s) – These may include chlamydia, genital warts (HPV), genital herpes, or other STI’s.

Injury to the vulva or vagina- These injuries may include a tear from childbirth or from a cut (episiotomy) made in the area of skin between the vagina and anus during labor.

How Can Painful Sex In Women Be Treated?

Some treatments for painful sex in women do not require medical treatment. For example, painful sex after pregnancy can be addressed by waiting at least six weeks after childbirth before having intercourse, or when a women feels she is ready again. Make sure to practice gentleness and patience. In cases in which there is vaginal dryness,  or a lack of lubrication,water-based lubricants will help. In the cases of some conditions such as menopause, topical estrogen creams may be needed to bring tone back into the vaginal wall, along with lubricants during sex.

Some of the conditions such as endometriosis, PID, fibroids, or trauma to the vagina and will require surgery and adjunct therapies such as hormones and other medications.

Other issues such as vaginal infections, bacterial infections, skin conditions, STI’s etc may just need medications such as antibiotics, antifungals, steroids and other medications for their treatment

Some conditions like vaginismus, or psychological traumas (sexual abuse), may require a person to see a counselor, psychologist, psychiatrist, or sex therapist.

There are also natural medicines such as Acupuncture, Chinese Herbal medicine, naturopathy, herbal supplement etc that may help with pain, either on their own, or in combination with medical treatments and talk therapy

If you do have pain with sex, you need to go and speak to your healthcare provider, or seek the help of a gynaecologist, or women’s health specialist.

Pain with sex is not normal, and you need to find out the cause of these issues and not put it off. At my clinic, I can help you if you are having pain with sex.

Regards

Dr Andrew Orr

-No Stone Left Unturned

Could your health issues be coming from your Thyroid?

E5PRGR Doctor examining the thyroid gland of a patient.

Thyroid issues are common, especially in women and especially if there is a family history of thyroid disorders in your family. When your thyroid goes out of balance, it can cause all sorts of symptoms and issues in your body. You need to know what to look for.

When Your Thyroid Goes Awry

Does fatigue drag you down day after day?

Do you have brain fog, weight gain, chills, or hair loss?

Or is the opposite true for you: Are you often revved up, sweaty, or anxious?

Your thyroid gland could be to blame. This great regulator of body and mind sometimes goes haywire, particularly in women. Pregnancy and postpartum is when it can also go haywire too. Getting the right treatment is critical to feel your best and avoid serious health problems.

What Is the Thyroid Gland?

The thyroid is a butterfly-shaped gland in the front of the neck. It produces hormones that control the speed of your metabolism — the system that helps the body use energy. Thyroid disorders can slow down or rev up metabolism by disrupting the production of thyroid hormones. When hormone levels become too low or too high, you may experience a wide range of symptoms.

Symptom: Weight Gain or Loss

An unexplained change in weight is one of the most common signs of a thyroid disorder. Weight gain may signal low levels of thyroid hormones, a condition called hypothyroidism. In contrast, if the thyroid produces more hormones than the body needs, you may lose weight unexpectedly. This is known as hyperthyroidism. Hypothyroidism is far more common.

Symptom: Swelling in the Neck

A swelling or enlargement in the neck is a visible clue that something may be wrong with the thyroid. A goiter may occur with either hypothyroidism or hyperthyroidism. Sometimes swelling in the neck can result from thyroid cancer or nodules, lumps that grow inside the thyroid. It can also be due to a cause unrelated to the thyroid.

Symptom: Changes in Heart Rate

Thyroid hormones affect nearly every organ in the body and can influence how quickly the heart beats. People with hypothyroidism may notice their heart rate is slower than usual. Hyperthyroidism may cause the heart to speed up. It can also trigger increased blood pressure and the sensation of a pounding heart, or other types of heart palpitations.

Symptom: Changes in Energy or Mood

Thyroid disorders can have a noticeable impact on your energy level and mood. Hypothyroidism tends to make people feel tired, sluggish, and depressed. Hyperthyroidism can cause anxiety, problems sleeping, restlessness, and irritability.

Symptom: Hair Loss

Hair loss is another sign that thyroid hormones may be out of balance. Both hypothyroidism and hyperthyroidism can cause hair to fall out. In most cases, the hair will grow back once the thyroid disorder is treated.

Symptom: Feeling Too Cold or Hot

Thyroid disorders can disrupt the ability to regulate body temperature. People with hypothyroidism may feel cold more often than usual. Hyperthyroidism tends to have the opposite effect, causing excessive sweating and an aversion to heat.

Other Symptoms of Hypothyroidism

Hypothyroidism can cause many other symptoms, including:

  • Dry skin and brittle nails
  • Numbness or tingling in the hands
  • Constipation
  • Abnormal menstrual periods

Other Symptoms of Hyperthyroidism

Hyperthyroidism can also cause additional symptoms, such as:

  • Muscle weakness or trembling hands
  • Vision problems
  • Diarrhea
  • Irregular menstrual periods

Thyroid Disorder or Menopause?

Because thyroid disorders can cause changes in menstrual cycle and mood, the symptoms are sometimes mistaken for menopause. If a thyroid problem is suspected, a simple blood test can determine whether the true culprit is menopause or a thyroid disorder — or a combination of the two.

Who Should Be Tested?

If you think you have symptoms of a thyroid problem, ask your doctor if you should be tested. People with symptoms or risk factors may need tests more often. Hypothyroidism more frequently affects women over age 60. Hyperthyroidism is also more common in women. A family history raises your risk of either disorder.

Thyroid Neck Check

A careful look in the mirror may help you spot an enlarged thyroid that needs a doctor’s attention. Tip your head back, take a drink of water, and as you swallow, examine your neck below the Adam’s apple and above the collarbone. Look for bulges or protrusions, then repeat the process a few times. See a doctor promptly if you see a bulge or lump.

Diagnosing Thyroid Disorders

If your doctor suspects a thyroid disorder, a blood test can help provide an answer. This test measures the level of thyroid stimulating hormone (TSH), a kind of master hormone that regulates the work of the thyroid gland. If TSH is high, it typically means that your thyroid function is too low (hypothyroid). If TSH is low, then it generally means the thyroid is overactive (hyperthyroid.) But just measuring TSH levels is not enough. People with thyroid disorders can have normal TSH levels and the other thyroid hormone levels and this is why thyroid antibody testing is probably the most important testing to be done. High thyroid antibodies mean you have a thyroid condition and your thyroid gland is under attack. Hopefully doctor will want to check all the other thyroid hormones in your blood. If he/she doesn’t, make sure they do. They should always check TSH, Free T3, Free T4, Reverse T3 and Thyroid antibodies. In some cases, imaging studies are used and biopsies are taken to evaluate a thyroid abnormality.

Hashimoto’s Disease

The most common cause of hypothyroidism is Hashimoto’s disease. This is an autoimmune disorder in which the body attacks the thyroid gland. The result is damage to the thyroid, preventing it from producing enough hormones. Hashimoto’s disease tends to run in families. This is why thyroid antibodies needs to be checked because people with Hashimotos disease can actually have normal TSH levels and normal Free T3, Free T4 and reverse T3 levels.

Other Causes of Hypothyroidism

In some cases, hypothyroidism results from a problem with the pituitary gland, which is at the base of the brain. This gland produces thyroid-stimulating hormone (TSH), which tells the thyroid to do its job. If your pituitary gland does not produce enough TSH, levels of thyroid hormones will fall. Other causes of hypothyroidism include temporary inflammation of the thyroid or medications that affect thyroid function.

Graves’ Disease

The most common cause of hyperthyroidism is Graves’ disease. This is an autoimmune disorder that attacks the thyroid gland and triggers the release of high levels of thyroid hormones. One of the hallmarks of Graves’ disease is a visible and uncomfortable swelling behind the eyes. Again this is why testing thyroid antibodies is so important.

Other Causes of Hyperthyroidism

Hyperthyroidism can also result from thyroid nodules. These are lumps that develop inside the thyroid and sometimes begin producing thyroid hormones. Large lumps may create a noticeable goiter. Smaller lumps can be detected with ultrasound. A thyroid uptake and scan can tell if the lump is producing too much thyroid hormone.

Thyroid Disorder Complications

When left untreated, hypothyroidism can raise cholesterol levels and make you more likely to have a stroke or heart attack. In severe cases, very low levels of thyroid hormones can trigger a loss of consciousness and life-threatening drop in body temperature. Untreated hyperthyroidism can cause serious heart problems and brittle bones.

Treating Hypothyroidism

If you are diagnosed with hypothyroidism, your doctor will most likely prescribe thyroid hormones in the form of a pill. This usually leads to noticeable improvements within a couple of weeks. Long-term treatment can result in more energy, lower cholesterol levels, and gradual weight loss. Most people with hypothyroidism will need to take thyroid hormones for the rest of their lives.

Treating Hyperthyroidism

The most common treatment for hyperthyroidism is antithyroid medication, which aims to lower the amount of hormones produced by the thyroid. The condition may eventually go away, but many people need to remain on medication for the long term. Other drugs may be given to reduce symptoms such as rapid pulse and tremors. Another option is radioactive iodine, which destroys the thyroid gland over the course of 6 to 18 weeks. Once the gland is destroyed, or removed by surgery, most patients must begin taking thyroid hormones in pill form.

Surgery for Thyroid Disorders

Removing the thyroid gland can cure hyperthyroidism, but the procedure is only recommended if antithyroid drugs don’t work, or if there is a large goiter. Surgery may also be recommended for patients with thyroid nodules. Once the thyroid is removed, most patients require daily supplements of thyroid hormones to avoid developing hypothyroidism.

What About Thyroid Cancer?

Thyroid cancer is uncommon and is among the least deadly. The good thing with thyroid cancer is that it is encapsulated, so it won’t spread. Once the thyroid gland is removed, the cancer is removed also. The main symptom is a lump or swelling in the neck, and only about 5% of thyroid nodules turn out to be cancerous. When thyroid cancer is diagnosed, it is most often treated with surgery followed by radioactive iodine therapy or, in some cases, external radiation therapy

Complementary Medicine For Thyroid Issues

There are many complementary medicines that may assist thyroid issues and Acupuncture and Chinese Herbal medicine has successfully assisted thyroid disorders for centuries.

There are also supplements and other herbal medicine to assist thyroid function, or balancing the thyroid hormones. Diet and lifestyle changes are also very important for thyroid health, as is working on the gut to reduce inflammation in the body and assist the immune system as well. There are also compounded natural thyroid medications we can discuss with you also

At my clinic,  I can help with all hormone issues and can assist you with thyroid testing, blood tests etc and thyroid management.

Regards

Dr Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

Lichen Sclerosus

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?

Nobody knows exactly how many women are affected, but it is thought that as high as 1 in 30 women could suffer from Lichen Sclerosus. 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

Many women with lichen sclerosus are often misdiagnosed as having thrush because it too can also causes itchiness around the vulva.

Many women I see also have vaginal atrophy, which can be missed due to the focus on the lichen sclerosus. Women who have  vaginal atrophy can also have pain with intercourse, and atrophic vaginitis can also exacerbate the symptoms of lichen sclerosus. It can be a vicious cycle if it isn’t properly diagnosed.

Some women may have lichen sclerosus, atrophic vaginitis and thrush combined and this is why differential diagnosis is so important and women need to see someone who knows about how to diagnose these issues correctly. Women need to see someone who specialises in this area and treats these conditions often. With correct treatment and management, women can live very normal lives.

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.

Four out of 100 women will go onto develop cancer of the vulva and this is why early intervention and management is so important.

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. This is why careful differential diagnosis is so important, so that other conditions are not overlooked as well. This is something that I see happen to women often.

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 health 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  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. As mentioned before 4 out of 100 will go on to develop cancer of the vulvar. This is why frequent check-ups are important to detect any cancers early on, when they can be more easily treated. This is why I always say that early intervention and proper treatment and management of any disease and the same goes for lichen sclerosus.

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, assist 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. The problem is that they have just seen the wrong people and haven’t been properly looked after.

Women with Lichen sclerosus can be helped if they see the right people and get the right help and proper clinical health care and management. You just need to find the right people who know about this disease and how to treat it properly.  I can say this, if this disease is treated and manage properly, it can give women their quality of life back. Instead of all the doom and gloom and negatives things, let’s get some positivity back and give women with this disease some hope. There always hope and you just need to know where to find it.

Take care

Regards

Dr Andrew Orr

Women’s & Men’s Health Crusader

-“No Stone Left Unturned”