Stop Telling Women That Period Pain is Normal

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

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

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

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

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

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

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

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

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

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

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

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

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-No Stone Left Unturned

-Period Pain IS NOT Normal

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

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

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

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

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

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

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

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

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

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

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-No Stone Left Unturned

 

Asking the Right Questions about Period Pain & Gynaecological Issues.

I didn’t know how I was going to start this post, or begin to talk about what I am about to talk about, other than I got some inspiration after a text message, and a phone call later on,  from my eldest daughter yesterday. I will talk about that soon. But let’s talk about some of the phone calls and messages I get from people every day and how some of these messages gives me a heads up into what may be going on for these people and then getting them in for a proper consult and the right help.

Every day I get phone calls, emails, Facebook messages etc, from women (young and older) who are experiencing period pain, menstrual issues, and other related symptoms and nearly all of them have the same story. I have been to the GP and I have had blood tests and scans and they say that there is nothing wrong. It happens so often and it is like there is a script written for these poor women who just want to get out of pain and get some sort of normal life back. I get so annoyed when I hear this repetitious line. Not at the people telling me, but knowing that these poor women really haven’t been investigated properly at all and probably won’t be unless they come and see me.

Yesterday I got a text that I really wasn’t expecting, as it was from my eldest daughter.

It read “Hey Dad, is endometriosis hereditary?”

To which I replied “Yes it can be, why?”

I anxiously awaited the next reply and thankfully she was asking on behalf of a friend. But this poor friend had been experiencing really bad period pain and had basically had blood tests and scans and been told that everything was normal. Apparently one of the scans showed some fluid in the Pouch of Douglas (POD), which can actually be a sign of endometriosis and inflammation. Worse still, this poor girl’s mother actually has endometriosis and nobody is putting two and two together and asking the question “I wonder if the daughter may have it too?”

Well, there is more than a good chance that she does have it and thank goodness my daughter actually knows the signs and knows that scans and bloods tests cannot diagnose many gynaecological issues, especially endometriosis. Lucky my daughter also knows that you need to see an advanced trained laparoscopic surgeon who specialises in the excision of endometriosis and has done years of extra surgical training to specialise in these disease states. The good thing is that she knows that you cannot just see a regular gynaecologist to get this done.

But, not everyone is as fortunate as my daughter to know this and help her friend to come and see me to help her see my surgeon and then I can help her with management of the disease, if found (which is highly likely) after the surgery. The other good thing is that my daughter knows there is no cure for endometriosis and that surgery isn’t going to fix the problem either. She knows it will help, and is needed, but after the surgery, the management post surgery is the most important, for disease states like endometriosis. Unfortunately not many people know this and don’t have the disease managed properly post surgery. Women with endometriosis and some other inflammatory gynaecological issues will need a team approach, or a multimodality approach  post surgery, because even with the best medical intervention, it really isn’t enough and why so many women have the disease and symptoms return, or may still be in pain and have other recurring symptoms. There is never a one treatment, one pill, fix all approach to disease states such and endometriosis. This is where so many go wrong.

One of the main issues for women can be that they really have not seen the right healthcare professions, especially the right surgeon and unfortunately this is many of the women that have had surgical intervention. This one is so important.

Whenever I get messages from women in pain, or I consult with women who have period pain and all the other associated symptoms, there are some standard questions I ask, to know if they have been given the right information, been diagnosed properly, or seen the right surgeon.

  1. I always ask “what tests have you had done?” – I know that if they have only had blood tests and some scans, then these women have not been investigated, or diagnosed properly.
  2. Then I usually ask “Have you just seen your GP, or have you seen a specialist?”– Most of the time many women have not been referred onto a specialist and have only just been seen to by a GP. This is one of the biggest issues women face when it comes to gynaecological conditions. GP’s are just general practitioners. They are not gynaecologists and definitely not advanced trained laparoscopic surgeons. The best thing any woman can do is ask for a referral to a specialist and a good GP should know to do this anyway. This is one of the biggest reasons that women from all over the world take up to a decade to be diagnosed with disease states such as endometriosis. On a daily basis women are missed and dismissed and told there is nothing wrong, go on the pill, or that they have some inflammatory bowel condition, when in fact they have endometriosis, or adenomyosis, or some inflammatory gynaecological issue. Btw, this isn’t to put GP’s down, unfortunately this is what happens to so many women and why it often takes up to a decade for women to be diagnosed with diseases such as endometriosis. This is an unfortunate fact and it needs to change.
  3. Then I ask “Have you had a laparoscopy?”– One of the most common responses is “What is a laparoscopy?” and that way I know they haven’t had one done. A laparoscopy is the gold standard investigation of the pelvis and the only way to properly diagnose disease states and causes of period pain, such as endometriosis.
  4. If the woman has had surgery I then ask “was the surgery done publically, or privately?” – This will tell me a few things. It will let me know if it was just done be a public surgeon, who probably isn’t an advanced trained laparoscopic surgeon. The issue is that there really aren’t that many advanced trained laparoscopic surgeons that do public work, and even if you strike the jackpot and do happen to get one, there is a good chance they are only in a teaching role to instruct a trainee surgeon to do the surgery anyway. But mostly women do not get an advanced trained laparoscopic surgeon in the public system. It is sad, but true unfortunately. Many times the first surgery in the public sector is purely investigative too and no excision (disease removal) is performed. This means that the woman has to come back for further surgery, or surgeries.
  5. If they the woman has had surgery done previously by a private specialist then I usually ask “Who was the surgeon that did your investigation and surgical procedure?” – Sometimes I can ask if the surgeon was an advanced trained laparoscopic surgeon and the patient usually will respond to not knowing, or even know what I was talking about. That usually gives me a clue that it most probably wasn’t, but then I can go and check the specialists qualifications online and see if they are, or most probably aren’t, an advanced trained laparoscopic surgeon who has done years of extra specialised surgical training.

All those 5 questions can tell me much about what some of these poor women have had done, or haven’t had done, and then I can formulate an appropriate treatment plan and management for these women moving forward. It is always hard explaining to the ones that have had surgery before that they haven’t seen the right surgeon and that they are going to need further surgery. The hardest thing for me is seeing women on support pages about to have their first surgery and I always worry that they aren’t seeing the right surgeon and if they don’t, there is a good chance that they are still going to be going through the same issues, over and over again, until they find the right person to help them. If only I could see all these women before they did anything, so that they can be given the right information and the facts and be managed properly.

The good thing is that when I do get to see women who chose to see me, I can explain to them the  facts and the right information and then why and how with a proper surgeon, that it can make a huge difference to how they are feeling and their recovery and management post surgery. I can also explain how surgery really is necessary, but is only a small part of their overall treatment and management of their disease moving forward. I can also explain the facts around their disease moving forward too and make sure that women under my care are given the right information, the right investigations and right management going forward.

This is why my initial consultations take about an hour and a half and we go over everything from their health history, medical history, hereditary issues, diet, lifestyle, surgical intervention, medications, natural medicines, blood tests, scans, investigations, sleep, sexual health, libido and everything that a woman needs to know about her particular issues. It is also about listening to a woman’s concerns and complaints and really hearing what she has to say and is experiencing. Then I formulate a treatment plan and management and 20 page report of findings for them for what we are going to be doing to help them moving forward. I also give them a step by step treatment plan of treatments and medicines etc they will need too. That is why my motto is “No Stone Left Unturned”, because there is no stone left unturned and I also make sure they see the right people (surgeons and anyone else that they may need to see). If there are things that I can’t do (surgery etc), I make sure that my patients only see the best people and then I can help manage the rest of their disease state for them.

I wish I could see every woman before that went for any investigation, or surgery, so I can point them in the right direction and help them manage their gynaecological condition properly. This is why I am so passionate about doing my posts on social media, or giving time for charity events to talk about women’s health issues and gynaecological issues such as endometriosis, adenomyosis and PCOS. It is why I do healthcare practitioner education and seminars to help educate them better too, so that they can help their patients better and not miss and dismiss them.

I just hope that I can help those who have not been heard and that have been missed and dismissed. I also hope we can get people to listen to the things I have presented above and also help women get a voice, be heard and get government listening and get more education to younger women too.

Lastly, I cannot say it often enough….. Period Pain “IS NOT” normal and if you, or your daughter, or your sister, or your mother, or cousin, your best friend, or anyone you know has period pain, especially bad period pain and other symptoms, please, please, do not tell them that this is normal. It is not normal and they need to come and see me, or another healthcare professional who specialises in women’s health and gynaecological conditions, so that they can be investigated properly and have their issues managed properly too.

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-No Stone Left Unturned

 

 

 

The Truth About Natural Killer Cells & Miscarriage

On a daily basis we get people, who are having failed IVF cycles, calling my clinic looking for some miracle pill, to supposedly eradicate the body of natural killers cell and wipe them off the face of the planet in some war like rage, all because they have been told this will bring an end to their fertility woes.

I wish it was that easy and when my staff go on to explain that treating natural killers cells (uterine killer cells), and especially looking at the cause of natural killer cells (uterine killer cells), is complex, there is no one miracle cure, nor some magic pill, people get annoyed and hang up the phone in a huff ,without listening to the reasons why.

One of the things I always say, when people ask me about regulating natural killer cells for fertility purposes, is “How long is a piece of string?”

This is because this subject is very complex and there are many reasons why natural killer cells may be impacting implantation. So, hence the response is always going to be “How long is a piece of string?”

While Natural killer (NK) cells have an important role in the early responses to viral infections, they have also been linked with failure of pregnancy.

Increasingly, clinics are offering blood tests, at an increased cost to the patient, to measure the number and activity of circulating NK cells. As a result of these investigations, many women are offered treatments such as steroids, intravenous immunoglobulins, and tumour necrosis factor blocking agents. The scientific rationale for these tests and treatments, however, is not always supported by our current knowledge of the function of uterine NK cells.

So, I thought it was about time I set the records straight on the BS information, that seems to being handed around as gospel, by money hungry fertility clinics run by big health conglomerates, and by the rotten Dr Google, about natural killer cells (uterine killer cells) and these supposed miracle pills, that will miraculously fix someone’s fertility issues.

Let’s Look at the Facts about Natural Killer Cells Relating to Miscarriage

  1. There is no miracle pill, or one supposed miracle treatment, or a one pill solution to treat, or get rid of natural killer cells. You do not want to get rid of NK Cells.
  2. Natural Killer Cells are a natural part of the immune system designed to target inflammation, kill of cancer cells, kill off bacteria and protect the body from harmful invasion of foreign organism
  3. There is huge difference between natural killer cells that are circulating in the blood stream, compared to uterine killer cells
  4. Uterine Killer Cells are in large numbers during a pregnancy to protect the embryo
  5. Natural Killer Cells are only in large number and are only being sent out by the immune system because there is some inflammatory process going on in the pelvis, or the rest of the body
  6. You cannot regulate Natural Killer Cells numbers unless you first address the inflammatory process that is causing them to be in high numbers in the first place (Eg- Inflammatory gynaecological conditions such as PID, Endometriosis, PCOS, Adenomyosis, Adhesions, STI’s, CIN, HPV, Herpes etc)
  7. Many people have not had the proper initial fertility investigations and testing needed to actually fall pregnant in the first place and looking at Natural Killer Cells, before all that proper testing etc is done, is actually not assessing the patient properly.
  8. If you do not treat the cause of the Natural Killer Cells being in high numbers, you will not be able to reduce the numbers of Natural Killer Cells that are actually doing the job they are meant to do, which is …. Protect the Body.
  9. Many of the so called treatments for Natural Killer Cells, regarding fertility, have never been approved for such treatment and research on it is still inconclusive.
  10. Some of the treatments being proclaimed as miracle cures (Intralipids etc) are purely money making exercises that are preying on the vulnerability of people who have been told wrong information and have this perception of some killer being inside their body attacking their embryos.
  11. Intralipids have never been proven to treat Natural Killer Cells and are derived from highly inflammatory soy based compounds, which then in turn can cause more inflammation.
  12. The drugs used in the treatment of Natural Killer Cells are steroidal based and carry many side effects and are for more harmful to the body that any natural killer cell will ever be. The steroids are also a category C drug that has been shown to have an effect on the neonate
  13. Steroids, such as Prednisone, do work on regulating NK cells, but they do so by suppressing the immune system, thus compromising a person’s immunity. There are also risk to peoples minerals by using these long term and there are also other side effects to the body.
  14. Natural Killer Cells are there to protect the body, not hurt it.
  15. Natural Killer Cells are only attacking embryos because they are seen as foreign body as well and when they are there trying to kill of the diseases and issues causing inflammation in the body, they just happen to kill of any other foreign organism and inflammatory processes at the same time
  16. Again, to address natural Killer Cells, you need to address the inflammatory process as to why they are in high numbers in the first place
  17. The perception around Natural Killer Cells being this “thing” killing off embryos in the body is misguided and is actually not a true representation of what Natural Killer Cells actually do. It is purely often used to tug on the heartstrings of unsuspecting patients, who are highly emotive and clinics use these emotions to get them to pay for treatments that have never been fully proven to work.
  18. The name “Killer Cell” is too often exploited in the wrong context by many in the fertility world
  19. Blood tests cannot measure the number of Natural Killer Cells in the Uterus, Only a biopsy can do this.
  20. A Natural Killer Cell (uterine killer cells) Biopsy has to be done between the 24th and 28th day of your menstrual cycle to give the best results.
  21. Blood tests can only measure the circulating NK cells in the body and not the uterine killer cell activity, which can be the cause of recurrent miscarriage. So, if you have had a blood test, it is not measuring what is needed. Everyone will have circulating NK cells in their blood stream.
  22. The percentage of CD56+ NK cells in peripheral blood in normal healthy individuals varies from 5% to 29% (2)Despite this, more than 12% NK cells in women with infertility or miscarriage has been arbitrarily defined as abnormally raised and used as an indication for treatment (4)
  23. The percentage of NK cells in blood can be affected by many factors including sex, ethnicity, stress, and age too.

Natural Killer cells (Uterine killer cells and other NK cells) are the main immune cell-type found in the uterus. Their numbers increase through the menstrual cycle to peak at the time of implantation. If an embryo does implant, NK cell numbers increase further to 70% of all cells.

Uterine NK numbers start to decrease at around the 20 week mark of pregnancy and are all but absent at the end of pregnancy.

Natural killer cells acquired their name as a result of the initial test used to identify them in vitro. Unlike T lymphocytes, NK cells are able to spontaneously kill cells in a non-MHC restricted manner.

Regrettably, this is a misleading name in reproduction, and the powerful image of maternal cells attacking the fetus is emotive and easily exploited. None the less, these NK cells can kill off the embryo at early stages of pregnancy, but there is nearly always a reason why. That reason is inflammation in the pelvic cavity and uterus. This needs to be addressed to regulate the number of NK cells, not some notion of killing off the “Killer Cells”.

Types of Inflammation causing high Natural Killer Cells (Uterine Killer Cells)

  • Endometriosis & Adenomyosis
  • PCOS/PCO
  • Fibroids, Myomas
  • Vaginal Infections & Bacteria
  • STI’s
  • Cancer, Trauma, Localised Lesions & Others
  • Stress

Yes, stress can lead to a compromised immune system, which then leads to high TNF (Tumor Necrosing Factor) and increase Natural Killer Cells, which then leads to prolonged increase activated T Cells, and this then causes reduced implantation of embryos.

This is also a reason why any inflammation in the uterus or pelvic cavity needs to be addressed to help fix this issue and one of the reasons why any woman having fertility issues needs to be investigated and treated properly. This needs to involve proper differential diagnosis, proper pathology testing, genetic testing and surgical investigations such as laparoscopy prior to any further fertility treatment. A laparoscopy is the gold standard for addressing and treatment of issues in the uterine and pelvic cavity.

Natural Killer Cells (Uterine Killer Cells) can be a part of recurrent miscarriage, but we need to stop the misinformation and perception of them being some killer organism that isn’t meant to be in the body. They are meant to be in the body and the name is all too often exploited by many to offer unproven treatments and medications by clinics trying to increase profits.

If you want to regulate and treat natural killer cells (relating to recurrent miscarriage) properly, you need to find out what is causing them to be there in the first place. There is no magic pill to get rid of Natural Killer Cells. You cannot rid the body of Natural Killer Cells anyway. They are meant to be there. You can only regulate the amount of killer cells doing their job and you need to find out why they are in higher numbers in the first place. This is usually because there is some sort of inflammation, infection, bacteria, or malignancy going on in the body that has not been investigated properly in the first place. Let’s not forget that stress, yes stress, increases the amount of Natural Killer Cells in the body too.

At my clinic, I have a proper Natural Killer Cell protocol and treatment plan that is individually tailored and looks at the “cause” of high number of Natural Killer Cells and makes sure that proper investigations, testing and treatment are administered to treat the person properly. This can also be done alongside current medical protocols such as the Bondi protocol, or California protocol.

Regards

Dr Andrew Orr

(Reproductive Medicine & Women’s Health Medicine Specialist)

-The International Baby Maker

-No Stone Left Unturned

References

  1. Moffett-King A. Natural killer cells and pregnancy. Nat Rev Immuol 2002;2: 656-63.[CrossRef][Web of Science][Medline]
  2. Pijnenborg R, Vercruysse L, Hanssens M, Van Assche A. Incomplete trophoblast invasion: the evidence. In: Critchley H, MacLean A, Poston L, Walker J, eds. Pre-eclampsia. London: RCOG Press, 2003: 15-2615. Parham P. NK cells and trophoblasts: partners in pregnancy. J Exp Med 2004;200: 951-5.[Abstract/Free Full Text]
  3. Hiby SE, Walker JJ, O’Shaughnessy KM, Redman CWG, Carrington M, Trowsdale J, et al. Combinations of maternal and paternal innate immune genes influence the risk of pre-eclampsia. J Exp Med 2004;200: 957-65.[Abstract/Free Full Text]
  4. Aoki K, Kajiura S, Matsumoto Y, Ogasawara M, Okada S, Yagami Y, et al. Preconceptional natural-killer-cell activity as a predictor of miscarriage. Lancet 1995;345: 1340-2.[CrossRef][Web of Science][Medline]
  5. Ntrivalas EI, Kwak-Kim JY, Gilman-Sacchs A, Chung-Bang H, Ng SC, Beaman KD, et al. Status of peripheral blood natural killer cells in women with recurrent spontaneous abortions and infertility of unknown aetiology. Hum Reprod 2001;16: 855-61.[Abstract/Free Full Text]
  6. Bisset LR, Lung TL, Kaelin M, Ludwig E, Dubs RW. Reference values for peripheral blood lymphocyte phenotypes applicable to the healthy adult population in Switzerland. Eur J Haematol 2004;72: 203-12.[CrossRef][Web of Science][Medline]
  7. Kwak JY, Kwak FM, Gilman-Sachs A, Beaman KD, Cho DD, Beer AE, et al. Immunoglobulin G infusion treatment for women with recurrent spontaneous abortions and elevated CD56+ natural killer cells. Early Preg 2000;4: 154-64.
  8. RCOG Scientific Advisory Committee. Immunological testing and interventions for reproductive failure. London: RCOG, 2003. (Opinion paper 5.)
  9. Scott JR. Immunotherapy for recurrent miscarriage. Cochrane Database Syst Rev 2003;(1): CD000112.
  10. Daya S, Gunby J, Clark DA. Intravenous immunoglobulin therapy for recurrent spontaneous abortion: a meta-analysis. Am J Reprod Immunol 1998;39: 69-76.

 

 

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

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

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

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

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

Young women with PCOS at risk

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

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

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

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

Women’s and Men’s Health Crusader

-“The International Baby Maker”

-“No Stone Left Unturned”

Adherence to a Healthy Diet a Must For Fertility Success

Is it time you that you got your diet healthier to get the baby you have been longing to have?

While eating a health diet isn’t going to be a miracle cure to having a baby, it can help you increase your fertility and chances of a healthy pregnancy. Of course, there are so many other factors to fertility and proper evaluation and assessment is crucial, but research does show that by adherence to a healthy diet can increase pregnancy rates by up to 80%.

It is well known that healthy couples produce healthy sperm and healthy eggs and healthy parents produce healthy babies. A proper healthy diet can also help with gynaecological conditions as well.

When I talk about diet, I am not talking about it in term of dieting. I am talking about it in terms of the proper way to way. Diet is such a crucial part of my highly successful fertility program that has helped over 12,500 babies into the world. So many people neglect a healthy diet and don’t try hard enough to adhere to it. Preparation for falling pregnant is just as crucial as preparing for a marathon. If you don’t put in the work, nutrients and the training, you won’t make the distance, or get a result.

It is so sad seeing people go through cycle after cycle and not doing anything to change their diet and lifestyle and then getting a failed cycle time and time again. Of course their can be other factors to take into consideration as I said before. But, you can’t go into a cycle, or try to fall naturally, if you not eating properly, or if you are overweight, or underweight for that matter. Medically we know that the risk of miscarriage, preterm delivery, complication etc is high in women who are either under, or overweight. (Lifestyle management before fertility treatment -Fertility & Sterility Journal 2007)

So many people think they have a good diet, only to find out that what they have been taught is not right. It isn’t their fault. Some people really just do not know what a healthy diet its either.

A poor diet that is high in High GI Carbohydrates causes inflammation and this has a negative impact on fertility. Inflammation is causes by high sugars, which then spikes your insulin and this causes the inflammatory response. This can also affect hormones as well. High inflammatory response then causes oxidation which then affects your egg and sperm quality and this can results in damage to the DNA of the sperm and egg.
As I shared before, a healthy diet is a part of my successful fertility program and those on it know what a good diet is supposed to be like. Yet we see many ignoring it and wondering what has gone wrong, or what else they can do.

The simple answer is, be good with your diet!
Close enough is not good enough in this case. It is all or nothing, because this is so important. This is about having a baby. But, while having a baby is one thing, we also need people to realise that a healthy diet is also important for living a long and healthy life long after baby has arrived.

If you are overweight, you need to lose weight and if you are underweight you need to put some on. Many people are looking for miracles and go looking for an answer that doesn’t exist, or blame something else, when the fix may be as simple as adhering to a healthy eating regime. Again, obviously diet is only a small piece of the puzzle when it comes to fertility, but it is an important one at that.

There is so much medical research out there showing that adhering to a low GI diet and the diet I promote at my clinic and for those of my fertility program

  1. The nurses study of 17,500 women showed that a diet with protein, full cream dairy, multivitamins and supplements, good fats etc increased fertility rates exponentially. (Journal of Obstetrics and Gynaecology, Nov 2007)
  2. Harvard medical schools study on 19,500 women showed that having full fat diary increased fertility while low fat dairy decreased it by 85 % and had an anovulatory effect. (Journal of Fertility and Sterility Feb 2008)
  3. A recent study in the Journal of Fertility and Sterility showed that diet increased embryo quality and pregnancy rates by as much as 80%. In a study presented at the American Society of Reproductive Medicine (ASRM) in 2012, IVF patients who switched to a low-carbohydrate, high-protein diet and then underwent another an IVF cycle increased their blastocyst formation rate from 19% to 45% and their clinical pregnancy rate from 17% to 83% (Fertil Steril. 2012;98[Suppl]:S47).

Even non-IVF patients with polycystic ovarian syndrome and endometriosis have improved pregnancy rates after making dietary and lifestyle changes.There are many other research papers out there showing this.

So if you are having failed cycle after failed cycle, or not being able to conceive naturally, you need to start looking at your diet and lifestyle as a major factor. If you are on my fertility program you should be doing this. If you aren’t, you need to, and if you need help again, you need to book back in with me for a consult and go back over it again. If you are overweight, or underweight, the same applies. An easy way to work out what weight should be (roughly), is take 100cms off your height and this will give you what you should be in body mass. So if you are 165cms tall, then you should roughly be about 65kgs (give or take a few kilos). All men should have a waist size of 94cm or below for good health, and all women should have a waist size of 80cms or below for good health. This is measured from the belly button around, not higher, or lower than this point.

I always tell my patients that the time for making excuses is over. If you do want to have this baby you have been longing to have, then you need to prepare the body as though you were about to train for a marathon. We always say that the ones that do everything right get the results and get that baby they have been longing for.

Is it time you got your diet and lifestyle back on track?

Take care

Regards

Dr Andrew Orr

Reproductive Medicine and Women’s Health Specialist

-The International Baby Maker

-No Stone Left Unturned

Women’s Health Consultations

Women’s Health Consultations

*Are you sick of Painful Periods?
*Are you getting pain with sex?
*Is your period irregular and messing with your life?
*Are you getting bad acne?
*Are you getting increased bladder frequency?
*Are you getting some incontinence with exercise?
*Are you sick of having to put up with mood swings and hormone imbalance?
*Sick of healthcare professionals and friends telling you that your symptoms are normal?
 
Many of these issues are not normal, but more importantly many of these issues can easily be treated quite easily with the proper investigations, treatments and proper management. 
 
Everyday I see women who are sick of being ‘missed’ and ‘dismissed’ by everyone they see and they just want to get some sort of normal life back. This is where as a Reproductive Medicine and Women’s Health Specialist, with over 20 years experience with fertility, pregnancy and women’s health, I can really help. My motto is “No Stone Left Unturned” and I apply this to every person I have helped.
 
I am proud to announce that I now have a better way of being able to doing consultations for anyone needing help with gynaecology, fertility and other health issues. It doesn’t matter where you live, now I can help more people from around the globe and get them the answers they should be getting. 
 
Before we only had skype, which had limitations of not being able to screen share the important information that I need to share in a consultation with patients
 
Well, now I can do consultations through Zoom and these are nearly the same as if you were with me in person and share the same information, just the same as if you were in person.
 
Reports and Treatment medicinals and supplements are then mailed to you.
 
This is for patients who live out of the Brisbane area, or are interstate and overseas and it gives so much more scope to help everyone who wants my help.
 
If you want to get the best advice, best care and see someone with over 20 years experience in helping people, who is a Reproductive Medicine and Women’s Health Specialist (medical) as well as having qualifications in complementary medicine, then you need to see book in with me.
 
My multi-modality approach has helped over 12,500 plus babies into the world and helped tens of thousands of women with women’s health issues and gynaecological conditions such as Endometriosis, Adenomyosis, PCOS, Fibroids, Bladder & Bowel Issues, Pelvic floor stability, Thrush, Migraines, Hormone Imbalance and so much more. I can help with all Women’s Health and Reproductive issues.
 
As a Baby Maker and Women’s Health expert my motto is “No Stone Left Unturned” and I apply that to every person I help. It is because I care and want to help care for you as well.
 
If you would like to organise an online, or in-person consultation with me, please give my staff a call on +61 7 32795697, or email info@shentherapies.com.au. You can also submit an online enquiry through my website www.drandreworr.com.au too.
 
I hope to be able to help you and care for you all soon
 
Regards
Dr Andrew Orr
Reproductive Medicine & Women’s Health Specialist
-No Stone Left Unturned
“The International Baby Maker & Women’s and Men’s Health Advocate”

Exciting New Online Consultations

Exciting New Online Consultations

*Are you sick of Painful Periods?
*Are you getting pain with sex?
*Is your period irregular and messing with your life?
*Are you getting bad acne?
*Are you getting increased bladder frequency?
*Are you getting some incontinence with exercise?
*Are you sick of having to put up with mood swings and hormone imbalance?
*Sick of healthcare professionals and friends telling you that your symptoms are normal?
 
Many of these issues are not normal, but more importantly many of these issues can easily be treated quite easily with the proper investigations, treatments and proper management. 
 
Everyday I see women who are sick of being ‘missed’ and ‘dismissed’ by everyone they see and they just want to get some sort of normal life back. This is where as a Reproductive Medicine and Women’s Health Specialist, with over 20 years experience with fertility, pregnancy and women’s health, I can really help. My motto is “No Stone Left Unturned” and I apply this to every person I have helped.
 
I am proud to announce that I now have a better way of being able to doing consultations for anyone needing help with gynaecology, fertility and other health issues. It doesn’t matter where you live, now I can help more people from around the globe and get them the answers they should be getting. 
 
Before we only had skype, which had limitations of not being able to screen share the important information that I need to share in a consultation with patients
 
Well, now I can do consultations through Zoom and these are nearly the same as if you were with me in person and share the same information, just the same as if you were in person.
 
Reports and Treatment medicinals and supplements are then mailed to you.
 
This is for patients who live out of the Brisbane area, or are interstate and overseas and it gives so much more scope to help everyone who wants my help.
 
If you want to get the best advice, best care and see someone with over 20 years experience in helping people, who is a Reproductive Medicine and Women’s Health Specialist (medical) as well as having qualifications in complementary medicine, then you need to see book in with me.
 
My multi-modality approach has helped over 12,500 plus babies into the world and helped tens of thousands of women with women’s health issues and gynaecological conditions such as Endometriosis, Adenomyosis, PCOS, Fibroids, Bladder & Bowel Issues, Pelvic floor stability, Thrush, Migraines, Hormone Imbalance and so much more. I can help with all Women’s Health and Reproductive issues.
 
As a Baby Maker and Women’s Health expert my motto is “No Stone Left Unturned” and I apply that to every person I help. It is because I care and want to help care for you as well.
 
If you would like to organise an online, or in-person consultation with me, please give my staff a call on +61 7 32795697, or email info@shentherapies.com.au. You can also submit an online enquiry through my website www.drandreworr.com.au too.
 
I hope to be able to help you and care for you all soon
 
Regards
Dr Andrew Orr
Reproductive Medicine & Women’s Health Specialist
-No Stone Left Unturned
“The International Baby Maker & Women’s and Men’s Health Advocate”

Women with PCOS often have to wait 2 years and often see multiple healthcare professionals before diagnosis is made, according to a new comprehensive study.

January 9th, 2017

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder — and most common cause of infertility — affecting 9 to 18 percent of women around the world. 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 Perelman School of Medicine at the University of Pennsylvania.

The study, published in the Journal of Clinical Endocrinology & Metabolism, is the largest to date examining time to diagnosis, and reveals what the authors say are “major gaps” in education and support for women with the condition.

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.

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.

PCOS primarily affects women of reproductive age — most often between the ages of 18 to 35. 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

If a women presents with Acne, irregular periods etc, there is a good chance that she 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.

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 greater the patient dissatisfaction.

These new results are concerning for those of us who do know hwo to deal with PCOS and other gynaecological conditions properly. These women should not be having this conditions missed. The other issue is that not only do women often wait several months or even years before care providers are able to diagnose the condition, but even after diagnosis, patients are often unsatisfied with the information and support they receive. It is such a vicious cycle.

But let’s not forget out Endo Sister’s who have endured the long road to diagnosis and management for their disease. It can often take up to 12 years for their diagnosis and again many of them have their condition missed and are dismissed. It is again such a vicious cycle of mismanagement and focus one symptoms before someone finally properly diagnoses their disease. Then many of these also complain of the management and treatment after diagnosis

Based on the study findings, the authors are calling for the development of international evidence-based guidelines, co-designed consumer and health professional resources and international dissemination to improve diagnosis experience, education, management and health outcomes.

Too right they should be calling for better diagnosis and better education and training for these healthcare professionals. If you don’t know how to do your job 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 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”

 

Journal Reference:

Melanie Gibson-Helm, Helena Teede, Andrea Dunaif, Anuja Dokras. Delayed diagnosis and a lack of information associated with dissatisfaction in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism, 2016; jc.2016-2963 DOI: 10.1210/jc.2016-2963

 

 

 

What Affects a Menstrual Cycle – Part 2 (Common Gynaecological Factors)

There are many things that can cause disturbances to a woman’s menstrual cycle and on my previous post I discussed how Non-Gynaecological factors, such as diet, lifestyle etc, can be contributing. In this post I will discuss some of the common gynaecological conditions that can cause problems with women’s menstrual cycles.

The sad thing is that many of these are often overlooked and often masked by putting women on the contraception pill. The other issue is that many are led to believe that the pill is the answer to their issues, when sadly it isn’t.

Many of these common gynaecological conditions continue to become worse while having their symptoms masked and exacerbated by these hormones. Even more disturbing is that many women are not heard when speaking about menstrual issues, menstrual pain and other factors that do in fact interfere with their daily life on both a physical and emotional level.

Lets look at the common gynaecological factors that can affect a woman’s cycle.

  1. Endometriosis– is one of the most common causes of period pain and it caused by abnormal growth of endometrial cells both inside the uterus and outside the uterine lining. The exact cause is not known. While period pain, clotting, ovulation pain, pain with sex, pain on bowel movement, IBS like symptoms etc are commonly talked about, many women with endometriosis are asymptomatic and would not even know they had it. It is commonly missed, misdiagnosed and overlooked by healthcare practitioners and is why it often takes up to 10 years for the definitive diagnosis to be made. There is no cure and now it is thought that genetic factors and parental mode of inheritance is a predominant part of this disease. We do know that estrogens make it worse also. Endometriosis can only be diagnosed by surgical intervention. For more information please read my posts on endometriosis and also visit the Endometriosis Australia website.
  2. PCO/PCOS – Polycystic Ovaries/Polycystic Ovarian Syndrome is one of the most common caused of menstrual cycle irregularities, or ceasing of the menstrual cycle. It is mainly caused by insulin resistance and it also runs in families. There are two types of presentation with this condition. One is just having the cysts on the ovaries and the other is just the syndrome without the cysts. These days it is common lobbed under the one condition called PCOS. Along with menstrual cycle disturbances, it can also cause mood swings, hair growth/hair loss, acne, ovulation pain, infertility, anovulation, weight gain/weight loss, pot belly, fluid retention and much more. Diet and lifestyle changes are the number one treatment for this condition. Scans can pick this condition up, but can also miss it too. It can be diagnosed via surgical intervention and sometimes-extreme forms of this do need surgical intervention known as “Ovarian Drilling”
  3. Fibroids – Also known as myomas are benign growths that can occur inside and outside the uterus. Up to 40% of women over 40 years old have fibroids. They can cause problems with irregular uterine bleeding, heavy long bleeding, bleeding in between cycles, anaemia, pain with sex, problems with urinating and back pain. They can also cause infertility and miscarriage. There are 3 types of fibroids (intramural, submucosal & subserosal). They are thought to be caused by excess estrogens and problems in hormone metabolism. They can be removed surgically and some small ones embolised.
  4. Polyps – Are benign overgrowths, or bulges, of the normal tissue lining the uterus into the uterine cavity. They can cause irregular bleeding, heavy bleeding, bleeding after intercourse and infertility. Some women have not symptoms at all. Polyps may also be found in the uterine cervix. Polyps are usually attached to the underlying tissue by a base or stalk, and they vary in size. They can basically act like an IUD and stop implantation and therefore need to be removed in order for a woman to fall pregnant. Polyps only rarely contain cancerous cells
  5. Adenomyosis– Is very similar to endometriosis by the fact that it causes pain, irregular bleeding, heavy bleeding, bloating, lower abdomen pain and can affect the day to day functioning of woman all over this world. Adenomyosis growth penetrates deeply into the uterine lining and also inflames the nerves inside the lining. It cannot be seen visually and some special high contrast scans and MRI can pick it up, but not always. Usually a biopsy is needed to diagnose it. Medically the only way to properly get rid of Adenomyosis is via a hysterectomy. In the meantime, mostly anti-inflammatories, some hormones and other forms of pain management are given to provide symptomatic relief.
  6. Thrush– Vaginal thrush is a common infection caused by an overgrowth of Candida albicans yeast. This yeast lives naturally in the bowel and in small numbers in the vagina. It is mostly harmless, but symptoms can develop if yeast numbers increase. Symptoms you may experience if you develop vaginal thrush include vaginal discomfort – itching or burning, a thick, white discharge with a ‘cottage cheese’ appearance and yeasty smell, redness or swelling of the vagina or vulva, stinging or burning while urinating or during sex, splits in the genital skin that can cause bleeding and irritation. The condition is mainly treated with antifungal creams, pessaries and probiotics.
  7. Cancers – In 2008, a total of 4,534 new gynaecological cancers were diagnosed in Australia; this equates to an average of 12 females being diagnosed with this disease every day. On average 4 females in Australia die each day from a gynaecological cancer each day. The most commonly diagnosed gynaecological cancers are uterine cancer, ovarian cancer, cervical cancer, vulval cancer, cancers of other female organ and placenta and vaginal cancer. All can cause irregular bleeding, but some may not present with any symptoms at all. Proper diagnosis and early intervention is the key to any gynaecological cancers. For more information on diagnosis, symptoms and treatment please refer to the cancer council website.

There are other conditions that I haven’t discussed because of focusing on the main gynaecological conditions that can affect a woman’s cycle. I haven’t gone into the treatments of these disease states and will go into this at a later date. What I will say it that early intervention is the key to any disease state in the body and seeing the right people is paramount too. Please know that many of these disease states will require a multimodality approach and please remember that there is always help out there. Never put up with period pain, or menstrual irregularities, or be told the symptoms many women face daily are normal. The value of a second, or third, or tenth opinion is crucial for some people to get help and to find the right person to help.

Please remember that period pain IS NOT normal and neither are many of the menstrual irregularities that many of you face daily. There are always treatments and help out there too. I help so many women daily, with most of these sorts of conditions, and with the right treatments, diagnosis and investigations, you can be helped too.

Take care

Regards

Dr Andrew Orr

-Leaving No Stone Left Unturned

“The International Baby Maker” and “Women’s and Men’s Health Crusader”