These are some of the main Facts about PCOS
Dr Andrew Orr
-No Stone Left Unturned
-Women and Men’s Health Advocate
The word “Barren” comes originates from the French word ‘Brehaigne’, which means not producing, incapable of producing offspring, infertility, infertile; sterile.
Sounds terrible doesn’t it?
Fortunately very few women are ‘sterile’ and the word “infertility” is often misused in our modern society. Nobody is truly infertile, unless they actually have reproductive organs missing, or have genetic abnormalities that will actually prevent conception from happening etc. When a couple is having trouble conceiving, we should really use the word “sub-fertility” instead of “infertility”
The problem with talking fertility, sub-fertility, or infertility is that we often reference, target, or even blame the woman. Yes, women are often the blame of not being able to conceive a child and therefore the myth of the barren woman still runs deep and is very much in existence and kept alive by all concerned today in our modern world.
But is conception and the ability to conceive a child inherently the fault, or responsibility of the woman?
The answer to that is “No!”, but there is still this expectation, or focus, that not being able to conceive all falls back on a woman. Sometimes women actually wrongly blame themselves, or wrongly take on that responsibility too. Some women will even take on that burden, to protect a partner, who may actually be the main issue. Then we now have an area of medicine that has its focus as being the woman, because women are the primary driving force for wanting to have a child. Hence the vicious cycle continues in this terrible loop and then many, practitioners included, buy into the myth of the barren woman and so the cycle continues over and over again.
Well, I am here to tell you that women are not the only part of having a child and that men play just as big a part when it comes to fertility issues and not being able to conceive.
No matter what you get sold, or what BS (bullshit) you are sold, while pulling on your ‘I need a baby heartstrings’, to make you part with your hard earned money, the fact remains, and will always remain, that it takes a sperm and an egg to make a baby. That is basic biology 101 and no matter what someone tries to tell you, sperm quality is just as important as egg quality in this equation.
Every day I see practitioners, both medical and in complementary medicine, focussing in on women as the primary focus of fertility and actually feeding the myth of the barren women by their very actions. Many times the men are overlooked, or ignored, or completely disregarded in the fertility equation. Not only is this unethical, to just treat and focus on the women when it comes to fertility treatment, but it is highly negligent as well. Men are not born with an inherent right to automatically be able to conceive and worse still, the male sperm levels have fallen by as much as 60% in the last 70 years, with sperm quality levels said to be dropping at an alarming rate.
So why is the focus, the burden, the guilt and the whole emotional baby roller coaster left solely to women?
Well, I have explained that practitioners are to blame, the fertility profession is to blame, society is to blame, guilt is to blame and last of all men are a big part of the issue too.
Men are often to reluctant passengers in the fertility journey and are often very happy to bury their heads in the sand and pass the responsibility of not being able to conceive onto a woman. Then many men are told their sperm is fine, when in fact it is far from being fine.
Over 50% of fertility issues are related to male factors and up to 85% of miscarriage issues may be related to male chromosomal, or DNA issues related to sperm. As I said before, research has now shown that the male sperm quality has fallen by up to 60% over the last 70 years and is actually on the decline. Men are often the bigger part of the fertility picture and it isn’t just the woman at all.
Semen analysis parameters are based on what is needed for Assisted Reproduction (IVF, IUI, ICSI) , not based on what is needed for natural conception and this is where some of the biggest issues lay. Misinterpretation of semen analysis and misinterpretation of parameters have many men believing they have OK sperm, when in fact it is far from being OK. With modern procedures such as ICSI, we only need a few single sperm to be able to fertilise eggs and this can still be considered ok, because at least there was some sperm to fertilise the egg in the first place. A few single sperm, or a few hundred sperm, or even a few thousand sperm is not OK when it comes to natural conception. We actually need a few hundred million sperm for it to be OK and even then they need to be motile and they need to be swimming properly (rapid progressive) and actually be of good shape (morphology)
While a semen analysis is often the first part of male fertility evaluation, it is also very limited. While we can look at morphology, motility, concentration, count etc, it does not tell us about the actual quality of the sperm inside. Many sperm may look ‘OK’ via a semen analysis, but inside their DNA integrity is poor and there are high amounts of DNA fragmentation and this can only be measured by a DNA fragmentation analysis. Even then, each time a man ejaculates, the quality of the sperm will be different and can differ by up to 20% in each ejaculate.
We also know that what a man eats, drinks and even his physical and emotional health will affect his sperm quality and that a man’s physical, dietary and emotional health can be passed onto his offspring through the sperm. This is why it is important for a man to get his physical and dietary and emotional health in check way before he tries to conceive a child with his partner.
We always say that the healthier a man is, the healthier his sperm is and the healthier the woman is, the healthier her eggs will be also. A healthy man and a health woman produce healthy babies.
I have been assisting couples with fertility and pregnancy for over 20 plus years now, and helped over 12,500 plus babies into the world, and I can tell you that conception is not just about the woman. It gets back to basic biology 101 that it takes a sperm and an egg to have a baby. Even when couples are having issues trying to conceive, or doing IVF, or however they are trying to conceive, there will be some issue on the man’s side and the woman’s side. Unless there is absolute infertility on one side, or the other, there will always be a bit of both the man and woman to work on to assist in being able to conceive.
While the myth of the barren woman runs deep in society, fertility clinics and through the guilt handed down from their fellow sisters and mothers, fertility issues and the right to be able to conceive ‘does not’ fall solely into the hands of a woman, far from it. Men are an equal part in the fertility equation and men need be held just as accountable when it comes to trying to have a baby, or if there are difficulties in conceiving. No matter what anyone tells you, a man needs to be part of treatment, management and support of the journey to have a baby. This is a big part in my multi-modality fertility program being so successful in assisting over 12,500 babies into the world. Fertility isn’t just the responsibility of the woman, it is the responsibility of the man as well and I make sure both the man and the woman are properly investigated, clinically managed and helped with treatments as well.
Dr Andrew Orr
-No Stone Left Unturned
-The Brisbane Baby Maker
Explaining endometriosis to people is not always easy and sometimes you have to use analogies that seem strange at first, but once you get the gist of where I am going with it, it will all make sense. But before I start, I always like to say that please take the personal out of things and just know that what ever analogy I use, it is with good intention and always about helping others.
I just know that when I used the “Endo is like Rust” analogy, which is what it is like, a few people took it to heart as though they had a rusty uterus and this is not what I was saying. Not at all. Please know that I have loved ones with this horrible disease, so I am here to help, and my main aim now is to help as many people as possible with what I know, and how to treat people properly. I am also about getting the message out there so that women to not have to remain silent about this disease any longer. My motto is, and always will be, “Period Pain is Not Normal”
So, sit back, take out the personal and know that I am writing from a place of caring and sharing and a place of getting the message out there to help you all. Sometimes you just have to tell it how it is, in order for people to sit up and listen, so here we go J
Many of you have read my article of “Rust Never Sleeps and Neither Does Endometriosis” and the reason I wrote this is because endometriosis and how it attacks the body, is very much like how rust attacks metal. If you haven’t read the article, please do so that you can see what I am trying to convey.
I am always doing lots of speaking events and seminars on Women’s Health and also presenting for workshops on Endometriosis. It is so great to get the message out to the world, so that both the public and healthcare professionals can be educated on this subject better. We need to stop having this disease “Missed” and women being “Dismissed” as I am always saying now. This disease should not be taking 8 years from onset to definitive diagnosis. It used to be 12 years. This is disgusting, to say the least, and there is no excuse for this to be happening, except poor education, sloppy diagnosis, lack of training, negligence and dismissive egos that need an attitude adjustment.
But, in saying that, we also need to teach women to be empowered and not just put up with being told “This is normal”, or “Just go on the pill and it will fix it”. That is bullshit (sorry). But it is true. There needs to be a better way and we need to stand up and say “Enough”. But we also need to not let the disease define you and get caught up in the blame game either. We also need to get people to stop “Dr Googling” too, as this is also spreading the misinformation. It is great to be educated, but good old “Dr Google” is full of false information and research shows that up to 75% of the health information that the public can access on google, is either wrong, or only partially true.
Now that I have had my little rant about the injustices of many, I would like to share what I have been sharing to others about what endometriosis is really like and how hopefully we can prevent it from returning, hopefully for good. I do know this is possible with the right care, right follow up treatments and right team of people helping. I see it daily and know what I share to be true. But, again it requires the person to follow the advice given and then to get the information out there. It also requires people to not be defined by their disease and break free from these chains to open their minds to the possibilities of new thought, new treatments and new ways of doing things. We need to not be caught up in what may cause the disease, but what we can do to help those with it now.
Of course prevention is crucial and so important, but once the disease is expressed in the body, what caused it is irrelevant. We can argue about the hypothesis of what may be the initial causal factor until the end of time, but that isn’t helping those with the disease now. The most important factor is how we can help those with it live a normal life and hopefully one day in the future to be free of the disease completely. At least for now, we can look at hopefully giving people a better quality of life than the one they are living each day. From my experience, I do know that this is possible with the right team of people working the help the individual.
To be honest, the most likely cause of this disease is now known to be genetic links, or chromosomal, most likely through the parental mode of inheritance. Gene therapy is probably going to provide the biggest breakthrough in this disease in the years to come. But like any breakthrough, we just have to wait and see what happens there. You heard it here first. I do believe genetics does play a big part, but like any disease, it is not the only contributing factor. But, all this aside, we need to focus on the here and now to help those who need help now. In order to make change, you need to make those changes required. If you change nothing, nothing will change. I also get how hard it is for those whom have suffered so long to pick themselves up, to make those changes. Believe me, as someone who has been through a major life threatening illness and pain and crawled their way back to good health and do what I do now, I get it. I’ve been to that point of wanting it all to just stop and I get what many women put up with on a daily basis. Pain is pain, no matter where it has stemmed from.
Getting back to the subject at hand, I have now been explaining that Endometriosis is like a weed. Why would I explain it like this?
Like a weed, endometriosis grows and spreads. You can physically remove the weed (surgically), but unless you control the regrowth, seeds have been dropped (endometriosis regrowth) and then the weeds pop up again and start to grow once more. Sound like endometriosis too you?
Like any weed, it needs certain things for its regrowth. We have just talked about the dropping of the seeds ( regrowth) but it needs a food and fuel source to make it grow (estrogens, insulin, inflammatory response from external factors, stress etc). Then once the seeds are fed, the regrowth continues and then the garden is infested with the weed plague once more. Then you need to try and physically removed the weeds again once more and so the cycle begins again. Are you seeing what I am getting at yet?
Just like these weeds, endometriosis is often removed and many people then either believe they are fixed, or they do not do anything post surgery to prevent that regrowth. Before they know it, they again have to go back for more surgery. Often when people do try to control the regrowth (Progestins, Mirena etc), they are only employing one method, for which is either not effective enough, or the weed (Endo) is now resistant too.
This is why we need to employ a multimodality approach post surgery to hopefully complete eradicate the weed regrowth and halt the life cycle of these seeds being spread and to start growing again, thus starting the horrible cycle all over again
Now that we can see how endometriosis is really like a weed that can spread throughout our garden, we need to look at what we can do to hopefully stop it coming back, or spreading into other parts of the body.
Like I said, treatment must be individualised, using a multimodality approach, taking the clinical problem in its entirety into account, including the impact of the disease and the effect of its treatment on quality of life. Pain symptoms may persist despite seemingly adequate medical and/or surgical treatment of the disease.
The real focus needs to be on prevention and treatment strategies post surgery. Even better still, lets prevent it before it starts
There is an ancient Chinese saying – “To try and treat a disease once it is fully expressed into the body is like trying to forge arms once a war has already started, or like trying to dig a well once you are already thirsty – Yellow Emperors Classics of Internal Medicine”
The same goes for endometriosis. Once the disease is there and expressed into the body, it is hard to treat, especially is known methods of treatment are failing and this individualised, multimodality approach is used.
A Multimodality Approach Needs To Include:
- Pain Management
- Hormone Therapy
- Lifestyle changes
- Changes to Diet
- Traditional Chinese Medicine
- Holistic Medicine
- Anything people have tried and has worked for them
The Royal College of Obstetricians & Gynaecologist guidelines for the “Investigations and Management of Endometriosis” have the following quote:
“Many women with endometriosis report that nutritional and complementary therapies such as homeopathy, reflexology, traditional Chinese medicine or herbal treatments, do improve pain symptoms. They should not be ruled out if the woman feels they could be beneficial for her overall pain management and/or quality of life, or work in conjunction with more modern medical therapies.
This is why it is vital to take careful note of the woman’s complaints and to give her time to express her concerns and anxieties, as with other chronic diseases, just as I do for all of my patients. Healthcare providers actually need to listen to the woman and her concerns. Women need to be listened to and be heard and be nurtured
It is also important to involve the woman in all decisions, to be flexible in diagnostic and therapeutic thinking, to maintain a good relationship with the woman and for healthcare providers to seek advice where appropriate from more experienced colleagues. This is something that I try to educate all my patients with and something I also try to educate healthcare providers with when I do my seminars and speaking events about Women’s Health issues and diseases like endometriosis.
But while there are thing that healthcare providers need to do, there also things you must do also. These include
- Reducing Stress
- Look at Emotions and How They Affect You
- Get “You Time”
- Eat more protein and less High GI Carbs
- Eat less process and package foods that we now call “Carbage”
- Loss some weight if you have excess fats (which spike estrogens)
- Gain some weight if you are underweight.
- Do Something You Love (At least once per week)
- Laugh Often (Even if some days you feel like crying)
- Spend Time With Friends and Loved Ones
- Make Love J ( Climax and Oxytocin are your friends)
- Do Not Let The Disease Define You
- Don’t Buy Into The Label
- You are more than this disease
- If something is helping, then continue with it, no matter what anyone tells you
- Just remember that “You” are uniquely “You”
Please remember these words :
- Do Not Let The Disease Define You
- Don’t Buy Into The Label
- You are more than this disease
- If something is helping, then continue with it, no matter what anyone tells you
- Don’t buy into everything you read on the internet, social media, or “Dr Google. To be honest, I ban “Dr Google” with my patient (haha)
- Make sure you have a good laugh each day, but remember it is also OK to have a good cry too
- It is OK to unplug every so often
- It is OK to take the “Superwoman” cape off every so often too.
- Remember “You” are uniquely “You”
This is why it is so important to not get caught up in what others have done, or tried and may not now be working for you either. We need to look at you as an individual and treat you as such. What works for one person, may not work for another. This is why an individualised multimodality approach is needed to help prevent and treat this horrible disease and we often need a team of people, on the same page, to help treat this properly.
Don’t forget to “Get A Second Opinion”, or a Third, or Fourth, or Tenth one if needed
In many other areas in life we will get multiple quotes, and opinions. Yet, when it comes to our health, we often only get one quote, or maybe two.
Just because someone has your history, or is nice to you, or maybe recommended by a friend etc, does not make them a good practitioner. It does not mean that you cannot get another opinion. If someone isn’t helping you, then you need to look at changing, no matter who they are, or how well they know your history. Not every specialist you see is a good surgeon either, so please remember this. You need to have someone who specialises in endometriosis and who has done advanced surgical training, not just minimal training. There is good and bad in every profession and the medical profession is not exempt from this either. Neither is the complementary medicine profession, or allied health care profession exempt from this either. Your health is important and so is the value of another opinion. Not every practitioner has all the answers. If someone isn’t helping you, then don’t be scared to change.
Lastly please remember to know that there is always help out there. I am always here to help and I am a specialist in this area, alongside many other Women’s Health issues and Gynaecological issues. You can always come and see me in person, or make an appointment via skype, for those who live at a distance. I have a great team of people I work with to give you the best help possible. I have a team of some of the best health care professionals there is and I make sure all of them are at the top of their game in their chosen profession.
Let me be the conductor of your health issues and help you get the treatment and advice you so desperately deserve. I am here to listen to you and hear you. I make sure you don’t have things “Missed” and aren’t “Dismissed “ and why my treatment motto is “Leaving No Stone Unturned”. I am out there as a voice for women and being a crusader for women’s health everywhere. I don’t mind stepping on a few toes, and ego’s to get you the best help possible J
Take care and remember that “Period Pain Is Not Normal” and neither are and other “Menstrual Irregularities” that women face on a daily basis. I know what you go through daily and I am out there making sure you all get heard. Let’s end the silence on this horrible disease for you, and the ones close to me whom I love, adore and care about also.
Dr Andrew Orr
No Stone Left Unturned
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
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
- 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.
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.
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.
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.
- 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.
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
- 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.
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.
Dr Andrew Orr
-No Stone Left Unturned
Consuming just one sweetened soft drink a day reduces a couples’ chances of conceiving by more than 30 per cent, according to new research published in the journal of epidemiology in February 2018.
Men who drink at least one sugary softdrink/soda a day reduce their chances of fathering a child by 33 per cent, research has found.
Women who drink just one sugar-sweetened softdrink/soda beverage a day are 25 per cent less likely to become pregnant in any given month, the research adds.
Before you think about switching to diet soft drinks, or diet soda, you may want to think again. Studies have shown that diet drinks of any kind are actually worse than the ones containing real sugar. These diet drinks contain aspartame, which then gets converted to phenylalanine in the body. Phenylalanine is toxic and what we use to preserve dead bodies with. It can have a detrimental effect on fertility.
Previous research has also shown that eggs and embryos may fail to thrive in high blood glucose environments. Sugar and highly refined foods has also been linked to erectile dysfunction in men.
The researchers analysed 3,828 women and 1,045 of their male partners, who enrolled in the study between June 2013 and May 2017, and were followed until pregnancy or for up to 12 menstrual cycles. The couples were not using fertility treatments and had only been trying to conceive for six months or less.
The researchers from Boston University found positive associations between intake of sugar-sweetened beverages and lower fertility, which were consistent after controlling for many other factors, including obesity, caffeine intake, alcohol, smoking and overall diet quality.
Couples planning a pregnancy should be looking and lifestyle and diet before trying to conceive and consider limiting their consumption of these beverages, especially because they are also related to other adverse health effects.
In my comprehensive fertility program, diet and lifestyle choices are all covered along with everything a couple needs to conceive. No stone is left unturned with my multi-modality approach to fertility, where everything on a medical level, as well as a complementary medicine level is covered, alongside dietary and lifestyle management. This truly integrative fertility program has helped over 12,500 babies into the world and those numbers are increasing everyday
Dr Andrew Orr
-No Stone Left Unturned
A study published December 19th in the journal Immunity shows that part of the uterine Natural Killer cell population helps to optimize maternal nourishment of the fetus at early stages of development, not hinder it. These Natural Killer Cells have actually been shown to secrete growth promoting factors that can also reverse impaired fetal growth and help prevent miscarriage, not cause it.
For many year now I have had people contact me and trying to kill the killer cells, or treat high natural killer cells, or wipe out these cells that they are being told is causing them to miscarry, or not be able to hold an embryo. For those same amount of years I always said that Natural Killer Cells are meant to be there and the reason they are there is because of inflammation and are doing their job. Now finally, what I have been saying has been proven to be true and now we have an explanation of what these immune cells actually do and the mechanism behind it. They don’t harm the embryo at all. They are there to protect it, nourish it and help it grow.
Natural killer cells are among the most abundant immune cells in the uterus during the first trimester of pregnancy, but their numbers decline substantially after the placenta forms. Up until recently many in the fertility profession have led people to believe that Natural Killer Cells are the cause of all their issues and these new findings may have them eating their words. Not only have women been offered hormones, steroids and the likes that have never been proven to do they say they do, but they not only have major side effects, but could actually be trying to regulate the very thing that is meant to help a pregnancy.
The results of these new findings not only reveal new properties of natural killer cells during early pregnancy, but also point to approaches for therapeutic administration of natural killer cells in order to reverse restricted nourishment within the uterine environment
Acting as our bodies’ frontline defense system, natural killer cells guard against tumors and launch attacks against infections. This is something that I have been trying to explain for years. If natural killer cells are in high amounts, they are there for a reason and that reason needs to be treated, not the high killer cells. There has been much research on how Uterine natural killer cells promote immune balance and the growth of blood vessels in the placenta, having a positive impact on birth weight as well as fetal growth. But until now, it was not clear which subset of natural killer cells in the uterus are responsible for promoting fetal growth, or whether these cells help to optimize fetal nourishment at early developmental stages.
In the new study it was discovered that a specific subset of natural killer cells in the human uterine lining secretes growth-promoting factors, which are involved in wide-ranging developmental processes. This subset of cells made up a smaller proportion of natural killer cells in the uterine lining of patients who experienced recurrent spontaneous miscarriage and reduced implantation (42%) compared to healthy females (81%). These findings suggest that insufficient secretion of growth-promoting factors by a specific subset of natural killer cells may be responsible for restricted fetal development in humans.
The studies also showed that a deficiency in this subset of natural killer cells resulted in severe fetal growth restriction and defective development of the fetal skeletal system. The studies also showed that the transfer of uterine natural killer cells reversed fetal growth impairments. For the purpose of promoting fetal growth in humans, it may be possible to transfer natural killer cells via intravenous infusion or the administration of a vaginal suppository to mothers, avoiding the need for invasive procedures. Moreover, uterus-like natural killer cells are a much safer alternative to many of the methods used in immunotherapy and safer that steroids, or other immunosuppressant’s.
Obviously more study is needed, but these findings are about to turn part of the fertility profession upside down and make it re-evaluate itself
I’ve always said it isn’t the natural killer cells killing off embryos and always said it was from inflammation and inflammatory gynaecological conditions that weren’t being treated. We now know that stress uterine cells are also a big part of the issue too. I always say treat the cause to treat the symptoms and now we know that Natural Killer cells aren’t part of the cause, they are actually there to help.
If you are having troubles not conceiving, or having troubles with miscarriage, it might be time to book in and be a part of my fertility program that has helped over 12,500 babies into the world
Dr Andrew Orr
-No Stone Left Unturned
It is stressed uterine cells and inflammation causing miscarriage and causing the embryo not to implant, not Uterine Natural Killer cells.
For the first time the functions of natural killer cells in the womb have been identified by Researchers at the University of Warwick and University Hospitals Coventry
Although it has long been known that the lining of the womb harbours dynamic uterine natural killer cells, no functions have so far been given to these cells outside of pregnancy.
The researchers have discovered that the uterine natural killer cells remodel and refresh the lining of the womb at the time of embryo implantation. This is the first time a role for uterine natural killer cells in the lining of the womb has been identified outside of pregnancy. The research was published on December 14, 2017.
In addition they discovered that this process isn’t always balanced in each cycle. The natural killer cells perform the role of targeting and clearing inflammatory stressed cells, thereby making space for the implanting embryo. However sometimes not enough of these cells are cleared away and sometimes too many are targeted and removed. Excessive inflammation or insufficient clearance by uterine natural killer cells makes miscarriage more likely.
For many years I have been trying to tell people that they need to stop trying to get rid of the natural killer cells, or reduce their numbers. I have long known that natural killer cells are meant to be in the body and their job is to protect us from infections, bacteria, cancers, tumours and inflammation. If killer cells are in high numbers, it means that there is something wrong and that is what needs to be treated, not the killer cells. But unfortunately, many clinics play on couples emotions and the use of the word “Killer”. So then we get this war on killer cells and people wanting to kill the killer cells because they think it is killing their babies. No matter how hard I have tried to explain it, people just don’t listen and now it is finally great to have the research to back up what I knew all along, plus additional knowledge of how Killer cells actually help with implantation and reducing miscarriage.
The researchers have explained what happens if the natural killer cells cannot do their job properly, or there is inflammation that they haven’t been able to target. They said that a good analogy is Swiss cheese: without holes, the embryo has nowhere to go which will cause implantation failure; but if the holes are too large, the tissue will physically collapse and lead to miscarriage. This imbalance, which may be short-lived or last for multiple cycles, explains the high rate of early pregnancy failure. It really can be a numbers game on how long that cycle could last and why it is important to make sure there are enough natural killer cells there to do their job properly. Without the natural killer cells, there is more chance of inflammation and stressed uterine cells being left behind, which will then lead to higher pregnancy loss and reduced implantation.
The researchers conducted an analysis of 2,111 endometrial biopsies, which is more than had ever been conducted previously. The research team examined the acutely stressed cells in the lining of the womb which generate tissue inflammation. They found that the natural killer cells which are in the womb perform the important function of selectively targeting and eliminating acutely stressed cells.
When there are high acutely stressed cells in the lining of the uterus, the lining of the uterus fails to sense the chemical signals from the fertilised egg and it then silences many of the genes involved in allowing the embryo to implant and embed into the uterus.
One of the chemicals needed for this process to take place is Trysin, which is a common enzyme the embryos gives off. If trysin isn’t detected the embryo is not accepted and left to disintegrate and then the cycle is reset once again. The lack of Trysin signal appears to indicate to the endometrium that the quality of the embryo is not very high and initiates a reduction of receptivity to implantation. These findings could help to improve the success rates of IVF, because one of the biggest problems with IVF is getting the embryo to implant
The research team also found that high numbers of Natural Killer cells in the endometrium are not only a sign of high inflammation and acutely stressed uterine cells, but also indicate a insufficient production of steroids, which in turn leads to reduced formation of fats and vitamins that are essential for pregnancy nutrition.
Again, this is exactly what I have been trying to say for years and why when I treat women who are having implantation issues and recurrent miscarriage I look at treating the cause of the issue, rather than masking it.
To treat miscarriage and help with embryo implantation you need to do the following
- Reduce inflammation in the uterine environment and pelvic cavity
- Make sure the pelvis, tubes and uterus have been surgically evaluated properly prior to conception, or assisted reproduction (IVF, IUI, ICSI etc)
- Increase blood flow and nutrients into the uterine lining
- Ensure adequate essential fats and nutrients are given prior to conception
- Reduce stress levels
- Increase protein and reduce inflammatory refined carbohydrates
- Make sure the couple in are optimum health (healthy sperm + healthy eggs=health baby)
- Make sure the man is being treated at the same time the woman is (up to 85% of miscarriage issues are related to chromosomal and DNA factors related to poor quality sperm, which cannot be measured by a normal semen analysis)
We need to stop blaming high NK cells as being the cause of miscarriage and embryos not implanting. We need to look at the real cause, which is inflammation, stressed uterine cells ( due to stress in the person), lack of nutrients and blood flow in the uterus and lifestyle factors that is also leading to increase miscarriage rates and reduced embryo implantation. This is why I have my own range of fertility formulas to assist the uterine environment and help with implantation.
Let’s not forget that faulty sperm and DNA damage and chromosomal issues with sperm are also a big part of miscarriage too. Miscarriage is not just a woman’s issue. To be honest, statistically it is more likely to be on the male side of the equation and often gets overlooked. But that is a whole other post in itself.
This is why I offer a comprehensive fertility program that looks at every aspect of the couple and every aspect of fertility. It is also why I have helped over 12,500 babies into the world. It is about my motto of “No Stone Left Unturned” and treating the cause of people’s issues, not just guessing and trying to treat the symptoms as you go along.
Hopefully in the future this new information will be used to screen women at risk of reproductive failure and help with new treatment options for women suffering recurrent miscarriages or recurrent IVF failure.
If you are having trouble conceiving and want answers to your fertility issues, then maybe it is time to book into my fertility program and get some real answers, real treatment and get the baby you so desperately deserve.
Dr Andrew Orr
-No Stone Left Unturned
Implantation bleeding occurs when a fertilized egg attaches to the lining of a woman’s uterus to start the growth process of pregnancy. Some women’s lining can be more affected and be more prone to bleeding during a pregnancy. It is a normal occurrence in pregnant women, yet many women are completely unaware of what it is. Obviously it can be a bit worrying for anyone when they are bleeding during a pregnancy and I will discuss this later.
Some women may confuse the bleeding with spotting from menstruation, as the two can appear similar. What women also need to know is that getting a menstrual cycle, or the appearance of what looks like a menstrual bleed, does not mean you aren’t pregnant. You can have a bleed and still be pregnant.
Usually when it is implantation bleeding. The bleeding is very light and will usually require no medical attention. In some cases, however, implantation bleeding may require a visit to your specialist, midwife, or healthcare provider
What is implantation bleeding?
Implantation bleeding can just before the expected menstrual cycle, or around the early stages of pregnancy. It can also happen again when the embryos is growing and impacting on the lining of the uterus. Again this is a normal part of pregnancy for many women. Some women may not get any bleeding, or signs of implantation either.
The process of implantation starts shortly are fertilization. Once a sperm has fertilized an egg, it is called an embryo. The embryo travels through the fallopian tube towards the uterus. During this time, the embryo multiplies, becoming a blastocyst, which usually takes about 5-6 days to reach this stage. About 1-2 days after an embryo reaches blastocyst stage, it will then attach itself in the wall of the uterus and this is called implantation. During this implantation stage, the embryo can cause disruption the uterine wall and this then cause what we know as implantation bleeding. As the embryo grows even bigger, it can then cause further bleeding later on in the first trimester as well. While this is considered normal, it can cause distress for women and any bleeding should be checked by your healthcare provider.
Signs and symptoms
Implantation bleeding is one of the earliest easily identifiable signs of pregnancy. It is also a normal part of pregnancy and all women should be aware of this. As explained before, women can still have a normal menstrual bleed and still be pregnant. It is usually a lighter bleed, but some women can actually have quite heavy bleeds and still maintain a pregnancy. About 1 in 4 women actually have a bleed during their pregnancy.
Despite all that, there are some distinct signs and symptoms to help women identify implantation bleeding:
- Early bleeding: Implantation bleeding will often occur a few days before the expected menstruation cycle. This is not always the case, however, and many women confuse the two. As discussed, it is not uncommon for women to actually get their normal menstrual bleed and still be pregnant. Never think that just because you get a period, that you cannot be pregnant.
- Unusual coloured bleeding, or discharge: Implantation bleeding produces an unusual discharge that varies in colour from pinkish to very dark brown or black.
- Very light bleeding: Bleeding and discharge caused by implantation will usually not last no more than about 24 hours. It can last a bit longer for some women though. Many women experience just a few hours of spotting or one spot or streak of discharge. Obviously any bleeding should still be checked by your healthcare provider.
- Cramping: Implantation can also cause mild and temporary cramps. Some women who are doing IVF may also be on progesterone gels that can also cause bleeding and cramping too. Cramping and bleeding does not always mean a miscarriage. If you do experience this and are worried, please always consult with your healthcare provider.
As implantation is an early sign of pregnancy, a woman may also experience other pregnancy-related symptoms. Early signs of pregnancy can vary from woman to woman and may include:
- Mood swings
- Fatigue and tiredness
- Headaches and Migraine’s
- Tender, swollen breasts
- Nausea and vomiting
- Changes to the bowels (constipation, or loose bowels)
- Heightened sense of smell
- Food cravings and aversions
- Increased body temperature
Treating implantation bleeding
Implantation bleeding is a normal sign of pregnancy and is not usually dangerous. Because of this, there is no need for treatment. As I have stated before, if you are unsure, you should always consult with your healthcare provider.
Bleeding caused by implantation usually clears up within a couple of days with no treatment necessary. Abnormally heavy bleeding may be a sign of menstruation or a pregnancy complication. As I have previously shared, some women who are doing IVF, may be on progesterone gels and other medications, which may also cause some bleeding and cramping. Some women with signs of abnormal bleeding may need the same medications to help with hormonal levels. Some bleeding could be a sign of something more serious so please consult your healthcare provider. If you are experiencing heavy bleeding along with pain, please present to your nearest emergency centre as this may be signs of a miscarriage, or ectopic pregnancy.
Complications of implantation bleeding
Implantation bleeding is not usually a cause for concern most of the time. It is just a sign of embryo implanting into the lining of the uterus.
Women who are still uncertain about whether they have experienced implantation bleeding should consult their healthcare provider and take a blood test to see if they are pregnant, or not. Please do not rely on home pregnancy tests as these can be inaccurate in the early stages of pregnancy. The most accurate way to determine pregnancy is to do a blood test. This is very important for women undergoing IVF treatment too. Too often women will do a home pregnancy test and think they are not pregnant, when in fact they are. The issue is that the home pregnancy tests won’t pick up pregnancy hormone in the urine if it is too early. This can cause a woman much distress at the time and then when she finds out later on through the blood test, that she is actually pregnant. Please never rely on urine based home pregnancy tests.
Please note that if you experiencing heavy bleeding during any stage of pregnancy that this can be a sign of a complication and women should seek medical attention.
If you need help with irregular bleeding, miscarriage, fertility, pregnancy or any advice for Women’s health issues, please call my staff and they will be able to let you know what consultation, or program is best suited for you. Please call my clinic on +61 07 3832 8369
Dr Andrew Orr
-Women’s and Men’s Health Crusader
“No Stone Left Unturned”