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

-The Brisbane Baby Maker

-Women’s and Men’s Health Advocate

 

-“Period Pain IS NOT normal”

-“Leaving no Stone Left Unturned”

 

Early Intervention & Early Management Is Vital For Gynaecological Conditions & Menstrual Issues

By now many of you would know my stance on Period Pain not being normal and that the sooner you get the cause treated and managed the better one is going to be in their day to day life.

Unfortunately not everyone knows that Period Pain is not normal and neither are some of the other symptoms women get each month with the onset of their menstrual cycle. Having heavy bleeding, bleeding in between cycles, menstrual cramps, severe pain, irritable bowel like symptoms, dark clotting, ovulation pain, bowel and bladder pain and urgency etc, are all not normal symptoms that a woman should endure with her cycle. Getting these symptoms at any time of your cycle is not normal either.

Early intervention and early management is the key to any disease state in the body and this definitely applies to menstrual issues and gynaecological disorders. Once a disease is expressed into the body, it can be very hard to treat, especially if it is left a long time and then inflammation spreads to other parts of the body, or in close proximity to where the initial disease was first expressed.

One of the reasons that prompted me to do this post was after a young woman, now in her 30’s, had contacted me and thanked me for helping her back when she was in high school. Since then I have known all of her family well and helped with maintaining their health. At the time she was about 14 years old and showed all the signs and symptoms of endometriosis. She was in so much pain each month, when her cycle came, and she was often curled up on the floor with nausea and vomiting from the pain. Everyone, including GP’s etc, had told her this is normal and that she needed to get used to it. They also told her that she is too young to have endometriosis, or any major gynaecological condition.

That is so bad. Please, please know that period pain IS NOT normal and that teenagers are not too young to have endometriosis. To be honest, they are now finding endometriosis in young girls under 10 years old. Many gynaecological issues can start very early on in a woman’s life, especially if there are hereditary factors involved.  Gynaecological and menstrual issues can be passed from generation to generation, so if mum, or your grandmother, or someone in your family tree had menstrual issues, or a gynaecological condition, there is a good chance that you may inherit this as well.

The long and short of it all was that her mother was also getting frustrated at everyone not helping and somehow ended up finding out about me and ended up in my clinic. From there I got her into one of the advanced trained laparoscopic surgeons I work closely with as soon as possible and this is where stage 4 endometriosis was found and excised properly.  Without coming to see me, this poor girl would never have found the cause of her menstrual pain and associated symptoms. I then did all her management of her disease moving forward. The main thing that this young girl and her mother were worried about was how this was affecting her education and daily life, but how this could also affect her future fertility.

The one thing I know is that the sooner there is intervention and treatment, the better the prognosis for a woman’s future fertility is. The one thing I do know is that endometriosis doesn’t always cause infertility, but it can make it harder to fall pregnant, if it isn’t managed early enough. The longer you leave a disease in the body untreated, the worse it gets, and then the symptoms get worse and the worse the future outcomes may be.

Lucky for this young lady is that she did have early intervention and management and she has proudly messaged me to tell me that she has had her 3rd child and that she puts it all down to me helping her when she was younger. I have many women message me and tell me much the same thing. It is so important not to leave these things just because you are being told it is normal. What the hell is normal about being in so much pain that you feel like you could die?

All too often I see women having gynaecological conditions, like endometriosis, missed and dismissed and that the longer that the disease has been dismissed, the harder it is going to be to treat. That is a sad fact for many women and some will have to endure repeated surgeries due to being missed and dismissed and have a life of issues, if their issue isn’t managed properly either. Many have not seen the right healthcare professionals, or the right surgeon either.

I have discussed in many of my previous posts.  Please have a read of my previous posts about this subject and the seeing the right team of people. This is why it is so important to have early intervention and also see a proper advanced trained laparoscopic surgeon who specialises in the excision of disease states like endometriosis. Then there needs to be proper management and treatments and lifestyle changes administered to help with suppression of the disease state, helping with inflammation and improving quality of day to day life.

There needs to be a multimodality/team like approach to the management of women with gynaecological issues, as there is no one single fixes all approach, with any medicine. While surgery may be a necessary part of the overall management of disease states such as endometriosis, it isn’t the saviour that many perceive it to be. Surgery does not sure endometriosis and there is no cure for the disease at present time. Once you have it, it is there for good.

Surgery is a necessary but small part of the overall picture that needs to combine many other treatments and modalities to give the best outcome for a woman overall. Once the surgery is done you need to look at managing and suppressing the disease and this is done by lifestyle changes, dietary changes, acupuncture, physio, herbal medicines, hormone therapies, pilates, yoga, pelvic floor and core exercises and many other modalities depending on one’s individual symptoms.

When I treat women with gynaecological conditions, or menstrual issues, I make sure they all get an individualised, person centred, caring approach tailored to how they are presenting rather than a one treatment for all approach that many seem to get. You won’t get the results you need that way because we are all individuals with different needs and different symptoms overall.

Lastly, please remember that period pain and menstrual irregularities are not normal and that the earlier you get onto it and get it treated and managed, the better your future outcomes will be.

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-No Stone Left Unturned

-Period Pain IS NOT Normal

Can we always blame hormones being out of balance, for women’s health issues?

Often I see people posting that the source of all women’s issues is their hormones being out of balance. While sometimes this may be true, saying that the source of all women’s health issues is hormones being out of whack is not completely true. Sure, hormones may have a bit to do with it, but is it all erratic hormones?

Hey, it is good to blame something, but is it really fair to keep saying that women are all just an imbalance of hormones, when they are just having a bad day, or just don’t know why they are feeling the way they do?

The fact is that when I consult with women and they tell me that they, or their partner, or family etc, think they are a hormonal mess, I always have to tell them that this may not necessarily be so. More often than not, when I do my work ups on women, their hormones are actually normal and not out of balance at all.

So why would a woman be feeling like she is out of balance if her hormones are all in normal range?

Well, the answer to that is…. “How long is a piece of string?”

Yes, this is one of my favourite saying because, with any health issue, or imbalance in the body, you need to look at the individual and what the individual has been doing.

When I consult with women about these issues I will always go through a thorough history and testing with them and find out the following

  1. Are they stressed?
  2. Are they sleeping?
  3. Have they had a major upset in their immediate environment?
  4. Are they eating well?
  5. Are they drinking too much alcohol?
  6. Are you taking medications, or recreational drugs?
  7. Are they having too much sugar?
  8. Are they exercising?
  9. Are they taking time out for self?
  10. Is their partner the source of their moods and ill health?
  11. Do they have a gynaecological condition that has, or hasn’t been diagnosed?
  12. Have you had a health condition, or virus, or some other long standing health issue?

There are so many things that can affect a woman’s moods and wellbeing. Stress is probably the biggest factor, followed by lack of sleep and poor diet. High sugar intake also causes inflammation and can affect hormones, but it can just affect your moods. Poor diet and high sugars can also affect gynaecological conditions and affect an upcoming menstrual cycle too. Having a big drinking session on the weekend, or just a few drinks during the week can seriously affect your health, moods and motivations. Try not drinking for a month and see just how much better you will feel and how much better you wake up in the morning. A big binge drinking session on the weekend can affect you for a week afterwards

Lack of exercise can be another big factor in feeling tired. It is a catch 22 situation. When you are tired you don’t feel like exercising, but sometimes you are tired because you aren’t exercising. Exercise keeps the body feeling fit and moods better and your menstrual cycle better too. Not getting enough sleep can seriously affect your body on all levels.

Lack of sleep will not only make you feel tired, grumpy and teary, but it affects everything. Lack of sleep and too many bright lights in your room can affect your melatonin levels too. Melatonin is also responsible for conversion to serotonin, which is what helps moods as well

Too much stress and running on adrenalin does not help the body either. The body goes into this hyper-activated state and that can cause low grade anxiety and also affect the moods and the body’s energy levels. We also need to check if a woman is suffering depression and this is the cause of her health issues, or why she may seem out of sorts.

Then, you could have a gynaecological issue that is causing inflammation in the body and then being exacerbated by things you are doing in your life too. Some gynaecological issues are asymptomatic, but can cause issues with your health, your moods, your energy and yes, your hormones. But, many women with gynaecological issues actually have normal hormone levels, so it isn’t always hormones causing gynaecological conditions either.

At certain times of the year, we are more prone to colds and flu’s and viruses and these can affect our health, our energy, our moods and our systems as a whole. Some post viral symptoms are worse than the actual virus and can last long after the virus symptoms have subsided.

Chronic pain can also throw the body into a state of shock and affect both the moods and the bodies ability to function. Inflammation can play real havoc with a woman’s body and her health.

There are so many things that can affect a woman’s body and it as we can see, it can’t always be blamed on hormones. There are so many other factors to consider, which can affect a woman’s energy, her moods, her concentration and her daily life. So next time you are feeling a bit off, or a bit moody, or teary, or tired, don’t be so quick to dismiss it as just being hormonal. It may have nothing to do with hormones at all. If someone else tries to dismiss you as being hormonal, maybe it is time to be hormonal like and tell them where to go. Politely, but firmly of course.

If you are feeling like there is something wrong with your body, or you feel out of balance, it is a good idea to see your healthcare provider and get some basic testing done and delve a little deeper into why your body isn’t feeling the best it could be. I always make sure I get a thorough history off women and listen to all of their concerns so that they aren’t just dismissed as just having their hormones out of whack. They may be, but it is best to check first and that isn’t hard to do. I think too many women are just dismissed as being hormonal, or that it is hormones out of balance. Nine times out of ten, it is often something else. Let’s not forget that as we get older, we do start to slow down more too. But, let’s not talk about that one as that could be a whole post on its own.

Take care

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-No Stone Left Unturned