Could your health issues be coming from your Thyroid?

Posted on October 26, 2017August 25, 2019 by Andrew Orr

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

When Your Thyroid Goes Awry

Does fatigue drag you down day after day?

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

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

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

What Is the Thyroid Gland?

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

Symptom: Weight Gain or Loss

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

Symptom: Swelling in the Neck

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

Symptom: Changes in Heart Rate

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

Symptom: Changes in Energy or Mood

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

Symptom: Hair Loss

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

Symptom: Feeling Too Cold or Hot

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

Other Symptoms of Hypothyroidism

Hypothyroidism can cause many other symptoms, including:

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

Other Symptoms of Hyperthyroidism

Hyperthyroidism can also cause additional symptoms, such as:

Muscle weakness or trembling hands
Vision problems
Diarrhea
Irregular menstrual periods

Thyroid Disorder or Menopause?

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

Who Should Be Tested?

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

Thyroid Neck Check

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

Diagnosing Thyroid Disorders

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

Hashimoto’s Disease

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

Other Causes of Hypothyroidism

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

Graves’ Disease

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

Other Causes of Hyperthyroidism

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

Thyroid Disorder Complications

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

Treating Hypothyroidism

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

Treating Hyperthyroidism

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

Surgery for Thyroid Disorders

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

What About Thyroid Cancer?

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

Complementary Medicine For Thyroid Issues

There are complementary medicines that may assist thyroid issues and it is important that you have a consultation and talk to a qualified healthcare practitioner about these options.

There are also supplements and other herbal medicine that may assist thyroid function, or balancing the thyroid hormones.

Diet and lifestyle changes are also very important for thyroid health, as is working on the gut and microbiome to reduce inflammation in the body and assist the immune system as well. There are also compounded natural thyroid medications that may assist thyroid issues as well.

Please make sure you see your healthcare practitioner, or endocrinologist for help with thyroid issues and ongoing management and never try to manage things on your own.

If you need assistance with thyroid management and management of other hormonal issues, please call my friendly clinic staff and they will be able to book you in for a consultation and explain more.

Regards

Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

Are you Stressed? … or are you in Denial?

Posted on October 19, 2017August 25, 2019 by Andrew Orr

Most people suffer from stress at some point in their lives. There is good stress and there is bad stress and how people cope with these stresses in different for each and every individual. It is all about how you cope with it. Showing signs of stress does not mean that you are a weak person, just human like everybody else.

But, the word stress is probably not used correctly at times. Many people are actually suffering anxiety, or running on adrenalin and then say they are stressed .The word stress is such a broad term. These days the word stress probably means either you have anxiety, or you are busy being busy.

What do we now define as stress?

Stress is the description used for strain, pressure or force on a system. That system may be you. Stress can be the result of trivial annoyances like driving in heavy traffic, or a life-altering major crisis such as the death of a loved one. Stress can also be someone being busy, or someone running on adrenalin too much. Like I said before, stress could also be someone who is suffering from anxiety and then terms it as stress.

Stress can be used both to refer to the event that is causing the disturbance or the effects of that event on your body. Usually when we say we are feeling stressed we are talking about the symptoms caused by our body’s stress response.

There are different forms of stress

There is no doubt that there are different forms of stress and probably the biggest issue for people these days is actually realising that their body is in distress. It is that constant low grade stress that affects so many people and causes so many issues in the body. That low grade stress is the one that eventually catches up with people and can sometimes have very detrimental effects.

Stress can be a cause of many health issues

The one thing we know for sure is that stress is a cause of a lot of our health issues, immune system issues, reproductive issues, gynaecological issues, mental health issues, respiratory and cardiovascular issues, sleep issues and so on.

Nobody is born stressed, or is predisposed to being stress. It is a learnt behaviour that can be unlearnt and that is why seeing someone to help with coping strategies around stress is so important. There are also supplements and medicines that can help to deal with stress more effectively too.

What are the Symptoms and effects of stress?

Some of the symptoms and health problems that can be caused or exacerbated by high levels of ongoing stress include:

migraine or tension-induced headaches;
insomnia, fitful sleeping or nightmares;
anxiety, anger or irritability;
low, irritable or unstable mood;
memory lapses;
shoulder, neck or back pain;
fatigue;
rapid heartbeat;
high blood pressure;
skin eruptions and worsening of conditions such as eczema;
heartburn, nausea (feeling sick), diarrhoea or constipation;
reduced libido;
shortness of breath;
problems with your immune system;
heart disease; and
chronic pain.

Like I mentioned before, stress can also affect the reproductive system, cardiovascular system, nervous system, immune system and so much more.

How stress affects your body

At the first sign of alarm, certain sensory nerves in your body are stimulated and hormones are released that automatically trigger physical reactions to stress. Your heart rate increases, blood is diverted to your muscles and brain, breathing rate increases, digestion slows down, saliva production stops (your mouth feels dry), perspiration increases and your pupils widen. You feel tense, you startle easily and your attention narrows to focus on possible threats.

This is the ‘fight or flight’ phenomenon, which makes your body tense, alert, and ready for action. After this reaction to a real or perceived threat, your body stays on alert until you feel the danger has passed. When the stressor is gone, the brain signals an ‘all clear’, and your body gradually returns to normal.

While some short-term stress is thought to be good for you, pushing you to make that extra effort in a sporting event or game, chronic or long-term stress can be harmful to your health. This kind of stress is when you feel under constant, intense pressure, or you just cannot see a way out of a terrible situation. The problem for some people is that they do not realise they are stressed, or they actually have anxiety, and their body is in the state of constant adrenal overload that eventually catches up with them and their whole body shuts down completely. We see this with adrenal fatigue and chronic fatigue

Dealing with stress

Dealing with stress effectively can be complicated, but usually involves:

general measures to improve your overall wellbeing; and
learning coping skills and setting healthy boundaries
specific steps to deal with stress and particular challenging situations.
learning what your triggers may be
learning ways to deal with stress and how to be more relaxed

It is about getting coping skills to deal with the body having to deal with stress, or at point of perceived crisis.

The word that we term “Stress” commonly results when you feel your resources — for example, time, money or skills — are insufficient to deal with your responsibilities. Take check of what is causing you stress and where you examine your demands and resources can be a useful first step in dealing with stress. There is where the practice of mindfulness is very useful and also talking to a counsellor/psychologist can help you identify triggers for stress and have coping skills to deal with stress.

Problem solving techniques and coping skills may help you with problems and issues creating stress. You may also need to work on limiting your obligations, or asking for extra resources to help you cope with stress better. You may need to accept that there are times in life where you simply can’t do everything that others in your life, or you yourself are expecting.

One way to help deal with stress is to maintain a healthier mind and body. Here are some of the things you can do to deal with stress better.

Ways to Deal With Stress Better

Regular exercise to help with stress and tension in the body. It also helps with moods.
Make sure you get at least 1-4 hours “You” time per week. Treat yourself to sufficient relaxation time so that you can switch off from you daily routine. This will help to give you a refreshed and energetic outlook on life. Learn yoga, meditation or other relaxation exercises such as mindfulness. There are some great mindfulness courses available now.
Make sure you get enough sleep. Melatonin is the hormone that helps you sleep and lack of sleep and stress depletes it. Lack of sleep also puts the body into distress.
Maintain a balanced diet. Without a balanced and health diet, your body will have inflammation and this will cause stress and disharmony in the body too.
Learn to accept what you cannot change but also learn to be more assertive, especially if you are one of those people who always say ‘yes’. Healthy boundaries are so important. Assertiveness training, setting clear boundaries and learning to say no can be very helpful in avoiding overload.
Make sure you do something that you love at least 1-2 times per week. Spend time with people you enjoy seeing, listening to music, playing sport, reading a book, watching a funny movie, gardening etc.
Talk therapy and coping skills: Talk therapy with a trained professional that can help you deal with stress and help you with coping skills is very important.
Avoid the use of drugs or alcohol as a means of coping with stress.
Acupuncture and Chinese Medicine can help with stress and studies have shown that it is as effective as some medication and equal to talk therapy in its effect. ( http://doi.org/10.1371/journal.pumed.1001518)
There are natural medicines that may assist you deal with the effects of stress and please talk to a qualified healthcare professional how best these can help and what to use. Do not self prescribe ever.

How do I know if I need help?

Many people think that they can deal with stress on their own, but the truth is it is better to get a trained professional to help you deal with it properly. This way you commit to actively doing something too and you are also learning coping skills at the same time. You should consider seeking help if:

you constantly worry and have trouble concentrating;
you feel a lot of guilt;
your sleep, energy and motivation is poor;
you can’t be bothered doing things anymore;
you experience several of the physical symptoms associated with stress;
you recognise that you are turning to self-destructive behaviours for temporary relief;
everything and everybody around you is being affected by the way you feel; or
you feel as though there’s nowhere to turn.
Friends keep telling you that you look stressed, or look like you need to slow down

There are qualified professionals who can help you with dealing with stress. It is important that you do see the right person to help you and your individual situation. You can always speak to your doctor or healthcare practitioner and ask them for a referral to someone. There are also mindfulness courses and relaxation courses you can do also. Exercise it important and again, it is a good idea help from a professional to get started and keep going.

Please take the risk of burnout and running on Adrenalin tests below and see how you are fairing (see below)

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

Risk of Burnout Challenge

Do you feel let down by other people around you?
Are you too busy for close friends and family?
Are you too busy to do even routine things like send out thank-you notes, return phone calls or mail birthday cards?

Do you tire more easily than you used to?
Are you working harder but accomplishing less?
Are you increasingly cynical and disenchanted?
Are you often invaded by a sadness that you can’t explain?
Do you forget appointments, deadlines, possessions?
Are you increasingly irritable? More short tempered?
Does you body ache or are you having trouble shaking a cold?
Are you finding it harder to be happy and joyful?
Have you lost your sense of humour?
Have you lost interest in sex or have a low libido?
Are you less talkative than you used to be?
Do you think of work all the time, even at rest?
Do you find it hard to say ‘no’ to people or things that require your own personal time?
Do you take time-out for others but do not take time-out for yourself?

Your score

To find your total , add up your “yes” answers.

(0 – 5) >> Cruising along nicely

(5 – 10) >> Borderline burnout

(10 – 17) >> Burnout candidate

Running on Adrenalin Challenge

I feel there isn’t enough time in the day to do all the things need to do.
I speak more quickly than other people, even finishing their sentences for them.
My relatives and friends say I eat too quickly.
I would rather win than enjoy a game.
I am very competitive at work, sports or games.
I tend to be bossy and dominate others.
I prefer to lead than follow.
I feel pressed for time even when I’m not doing something important.
I become more impatient when I have to wait for something or when I’m interrupted.
I tend to make decisions quickly and compulsively.
I take on more than I can accomplish.
I become irritable and even angry, more than other people.
I feel a strong compulsion to be doing something while at home or even on holidays.
I fidget often and become restless, pacing, leg kicking, or fast gum chewing.
I get a vague sense of depression whenever I stop an activity.
I have forgotten how to, or don’t know, how to relax.

Score description

0 – This does not apply to me

1 – This statement applies to me less than once per month

2 – This statement applies to me on a regular basis

Total score

Out of a possible score of 32 you would have fallen into one of the 4 following categories…

(0 – 10) >> Relaxed

(10 – 15) >> Typical

(15 – 20) >> On the edge

(20 +) >> Adrenalin Junkie!

How to cope with endometriosis and manage it moving forward

Posted on October 17, 2017April 27, 2020 by Andrew Orr

Endometriosis can be a challenging condition to deal with, both physically and emotionally. But with proper interventions and proper management and treatments after diagnosis, you can be shown how to deal with the associated symptoms of endometriosis and improve your quality of life. Please have a read of some of the best ways to cope with endometriosis.

What is Endometriosis?

Endometriosis can be painful disorder that is characterized by tissue that behaves like the lining of the uterus but that grows outside the uterus. Endometriosis is really normal tissue growing in abnormal places. This tissue can be found in various places, such as the ovaries, fallopian tubes, and pelvic lining, and even in or around the bladder and bowel.

Endometriosis affects around 1 in 10 women and girls and those are only the ones diagnosed. This mean these figures are grossly under-diagnosed and downplayed with many women not being diagnosed properly and those that do not even know they have the disease. Endometriosis can cause symptoms during the reproductive years, between the ages of 12 and 60, but it can show up in young girls under 10 years old too. Many people with the condition remain undiagnosed and many more and missed and dismissed with many taking up to ten years or more to be diagnosed.

What are the symptoms of Endometriosis?

The main symptom of the condition is usually pelvic pain typically associated with the menstrual period. While women can experience some discomfort during their menstrual period, some of those with endometriosis describe pain that is worse than usual. For some it is actually unbearable.

There are also other symptoms such as painful periods, pelvic pain, ovulation pain, pain with sex, chronic fatigue, irritable bowel like symptoms, bladder issues and pain and bleeding on bowel movement. This is why all women need to know that period pain is not normal, because many times, period pain can actually be a sign that a woman has an underlining gynaecological conditions such as endometriosis.

We also need for everyone to know that endometriosis is not just about period pain. There are many other symptoms women face when dealing with endometriosis.

There is no cure, but there ways to manage Endometriosis

There is no cure for endometriosis (not yet anyway), but there are treatment options and lifestyle changes that can ease your symptoms so that the condition does not interfere with your day-to-day life.

The main thing with endometriosis is to manage the disease and try and create a quality of life moving forward. While there is no cure for endometriosis, it is possible for women to become asymptomatic (meaning having no symptoms) and this requires the right treatments and management of the disease and to see the right people from the beginning.

Again, it all gets back to who you are seeing and their experience with knowing about endometriosis. This is one the biggest issues women face when trying to get treatment. Many just do not know much about the disease at all and why women are left to deal with the horrible symptoms. But with the right treatment and management, women can have a better life and be able to cope with this horrible disease.

Before we look at proper management for women with endometriosis, it is important that all understand the facts because there is so much misinformation out there and this is part of the bigger issue for women with this disease.

Surgical intervention and medications alone are not enough

While surgical interventions are hormones/medications are needed for women with endometriosis, alone, or in combination are not enough. We know that despite the best surgical and medical intervention that women are still in pain and still having the associated symptoms of endometriosis. This is why women do need a multimodality/team approach, and a combination of different modalities to effectively manage endometriosis.

The problem for many is that once they have the surgery, they believe their endometriosis is gone, or that they don’t have to do anything else. This is where many go wrong and why they end up having to have multiples surgeries. Women need proper ongoing management after surgery, which includes medications, hormones, other therapies, counselling, physiotherapy, mindfulness, exercise, diet and lifestyle interventions and so much more. Without this, endometriosis cannot be effectively managed.

The Facts About Endometriosis

Period Pain IS NOT Normal
A significant portion of women with Endometriosis are asymptomatic
Symptoms DO NOT correlate to the extent of the disease
The only way to diagnose Endometriosis definitely is via surgical intervention
There is NO cure for Endometriosis
Having a baby will not cure endometriosis
Endometriosis does not always cause infertility
Endometriosis is Estrogen Driven and is not caused by Estrogen dominance
The Pill, or Contraceptives DO NOT fix endometriosis
You can have Endometriosis at a Young, or Older Age
Hysterectomy does not cure endometriosis
Endometriosis requires a multi-modality approach to be managed properly. You need a team for proper management
Endometriosis IS NOT an autoimmune disease
There Are Hereditary and Genetic links
Endometriosis can cause many other issues in the body
The first line approach for hormone therapy should be the use of progesterone only options
Endometriosis needs to be excised (cut out) by an advanced laparoscopic surgeon, who has had extra years of specialised surgical training, and who specialised in the excision of the disease and specialised in the disease itself. Surgery should be performed by anyone other than an advanced laparoscopic surgeon and not by just a regular gynaecologist
Not all women with endometriosis have suffered sexual abuse

What Women Can Do To Help Manage Endometriosis

1.Seeing the Right Specialist & Surgeon

First and foremost make sure you have seen someone who specialises in endometriosis and the management and treatments moving forward. You also need to make sure that your first surgery is your best surgery and that you have seen an advanced laparoscopic surgeon to ensure you have had the proper surgical intervention. This is many women’s biggest issue as they have not seen the proper surgeon initially and they aren’t seeing someone who specialises in the management of the disease moving forward.

2.Watch your diet

Eating the right foods may provide some protection from the symptoms of endometriosis. The role of diet in endometriosis has been investigated in recent years due to the influence of diet on some of the processes linked to the disease, such as inflammation, prostaglandin metabolism, and estrogen activity. Many of the so called endometriosis diets out there are now outdated and have outdated nutritional and dietary advice that don’t really help much at all. Women need to adopt an anti-inflammatory diet (grain free, non-refined food ) to help with settling any inflammation in the body and also helping the immune system. This also needs to include prebiotic and probiotic bacteria to help with digestive function, immunity and gut health.

Certain environmental estrogens such as preservatives, plastics, pesticides and insecticides that can be ingested through certain nutrients have been suggested as risk factors for exacerbating endometriosis too.

Excess body fat, now known as obestrogens (because it is estrogenic) needs to be controlled and managed through diet and exercise too. We know that estrogen drive endometriosis and that any estrogens (dietary, body fats, environmental etc) needs to be regulated and controlled.

3.Boost intake of omega-3 fatty acids

Researchers have also found that the type of fat included in your diet makes a difference in your risk of endometriosis. Studies have shown that people whose diets were heavily laden with trans fats increased their risk of the expression of endometriosis by 48 % when compared with individuals who ate the least of these. By comparison, women whose diets were rich in omega-3 oils lowered their risk of endometriosis by 22 % compared with those who consumed the least amount.

Eating foods high in omega-3 fatty acids, such as salmon, flaxseeds, almonds, and walnuts, may be helpful for endometriosis. Women should also be supplementing with Omega 3 oils too. Just remember, it is all about reducing inflammation.

4.Exercise

Often, people who experience pain fear exercising, in case it causes more problems for them. But over time, regular physical activity may decrease the pain and discomfort that you feel. High-intensity exercise and resistance training can help to reduce the symptoms of endometriosis.

Exercise may help those with endometriosis in many ways, including:

encouraging the circulation of blood to your organs
maintaining nutrients and oxygen flow to all your body systems
decreasing estrogen production
reducing stress
releasing endorphins in the brain, which are pain-relieving, “feel good” chemicals

Women who regularly exercise may be likely to have the symptoms associated with endometriosis. Research has shown that those who engage in frequent high-intensity physical activity have fewer symptoms of endometriosis than women who do not participate in regular exercise. High-intensity physical activity, such as running, swimming, weight training etc, may be beneficial for reducing your symptoms.

Low-intensity exercise, including Yoga and Pilates may provide some relief in endometriosis, too. Yoga and Pilates can stretch and strengthen your muscles, help with core strength, help with circulation, which all may be beneficial for pelvic pain management and stress reduction.

5.Managing Stress Levels

Stress is a big factor in any disease and can make any disease worse. Not only can stress be exacerbated by endometriosis, but so can endometriosis symptoms be exacerbated by stress, in a never-ending cycle. Endometriosis could contribute to making your stress levels worse, due to the impact that the associated symptoms have on all aspects of your life, including family and personal relationships and work.

Stress management, Counselling, Mindfulness and Relaxation techniques can help to reduce stress that exacerbates endometriosis-related symptoms and pain.

Women with endometriosis need to manage stress by using mindfulness and relaxation techniques. These can help you to increase your awareness of your body, refocus on something calming, and reduce the activity of stress hormones and inflammation in the body. It is all about learning coping mechanisms and what works best for you, not what works best for others.

6.Try complementary medicine and therapies

Many women with Endometriosis find symptom relief from using a range of different complementary and alternative medicines. The Royal College of Obstetricians and Gynaecologists also recommends that women try natural medicines to help with the management of endometriosis and the associated symptoms. There is now some good research to support many natural medicines treatments such as acupuncture, Chinese herbal medicine, vitamins, omega 3 oils, probiotics, chiropractic/osteopathy, yoga, pilates and more, alongside medical interventions.

Acupuncture and Chinese medicines has some good research around period pain and pelvic pain and may be beneficial to those suffering this disease and its associated symptoms, alongside medical interventions.

Certain strains of prebiotics and probiotics have also been shown to help with the immune system, microbiome, bowel, and digestive associated symptoms of endometriosis. Probiotics have also been shown to not only help with digestive and immune function, but also with the psychological function as well. It does need to be specific strains of probiotics though.

Just like with medical treatments, when it comes to complementary medicines, it is important to find someone who is a qualified practitioner and who specialises in endometriosis. Just like in the medical model, this can also be hard to find.

7.Medications

Your endometriosis specialist can provide you with a list of treatment options for endometriosis and outline the risks and benefits of each. They will take into account your age, your symptoms, whether you want to become pregnant, and any treatments that you have had previously. It is important to manage pain and inflammation so that you can have a life and to be able to function daily.

You may need to use different forms of pain medications on script, as well as those that can be purchased over the counter. Please ensure you speak to your healthcare provider about setting up a pain management plan when using medications

You will also need to look at hormone therapy to help slow down the growth and expression of the disease and microscopic implants and also help with the associated symptoms of the disease. Hormones will usually be in the form of progesterone only medications and gonadotropin-releasing hormone antagonists and agonists. You may be prescribed other hormones depending on your individual case and symptoms.

Although all of these hormone therapies are effective at treating endometriosis, but, they all have different side effects. You need to talk to your doctor and pharmacists about the side effects and risk factors of any medications and hormones that you are taking.

In Summary

It is important to know that women with endometriosis will need a multi-modality, or team approach to deal with this disease. The team you need and modalities that you will need will be dependent on your individual symptoms.

Try and find healthcare professionals that can offer you a multi-modality approach for ongoing care and support and who also have a team of other people who are experts in the disease too. Again, the approach that you and your healthcare profession choose to take will vary depending on your signs and symptoms, and whether or not you would like to become pregnant in the future.

Before starting any treatment, it is important to know all of your options and the potential outcomes of all of them and to know that the people that you are seeing are and expert in endometriosis and know how to manage the disease properly. That can often be the hardest thing to find and why you need to do your homework and see people who are experts in this area of medicine.

Regards

Andrew Orr

-No Stone Left Unturned

-Period Pain IS NOT Normal

-The Endometriosis Experts

Incontinence, Bladder issues and Weak Pelvic Floor

Posted on October 17, 2017September 6, 2021 by Andrew Orr

Incontinence is often an embarrassing condition that will have more than a third of people suffering in silence because they are too embarrassed to seek treatment. Both men and women can suffer incontinence.

Although patients don’t die of incontinence, they often can’t live a fully productive life, they may have to curtail their workload or change jobs. Many factory workers and school teachers are only allowed set times for toilet breaks, so patient with urge incontinence may have to change jobs.

Patients who work in the military or the police force may have to resort to desk jobs. Too many women with incontinence stop having sexual intercourse, either because they are afraid they will leak during sex, or else they actually do leak, either at penetration, or at time of orgasm, which can be very disastrous. While men can also suffer incontinence, I am mainly going to focus on the causes of incontinence in women for this post.

Many people do not seek treatment

Many people don’t seek treatment because they also believe that surgery is their only option. Nothing could be further from the truth and surgery should only be used as a last resort once conservative methods have been used and aren’t working.

Even then, the surgical approaches used today are less invasive, are very effective and the recovery is very quick. It is not like it was 10-20 years ago. Keyhole surgery has really made major changes in this area and new surgical techniques are so highly effective.

I know people want to avoid any surgery, but sometimes it is needed and these days the recovery rates are so quick. A few days out of your life for recovery, can actually change your whole life. I just do not understand why anyone would put up with a life with incontinence, prolapse, or weak pelvic floor, when these issues are so easily fixed these days. I know many patients are so amazed at how easily their incontinence issues was fixed and how amazing they feel in getting their life back again. No more leakage when they laugh, cough, or exercise.

Incontinence does not have to be a normal part of life

Some people never seek treatment believing that incontinence is just a normal part of life. Again, this is not true and all and I encourage anyone with incontinence to talk to Urodynamic/Pelvic floor specialist, so they can help treat you and can also refer you to the right people for treatment and management if needed.

I know the pelvic floor/urodynamic surgeon I work closely with is amazing and what he can do for women and these issues is amazing too. Then I just help with the management on a more multimodality approach, moving forward.

Surgery may be necessary, but not always

Like I said before, surgery isn’t always needed. Many times conservative measures such as pelvic floor exercises, core strengthening, bladder toning, topical estrogen therapy, internal TENS (electrostimulation) and pulse magnetic therapy can all product fantastic long term treatment to this often debilitating condition, without the need for surgery.

There are also some special rings and other devices that can be used to prevent leakage and support prolapsed bladder and also vaginal prolapse causing incontinence. Men with incontinence also have options at hand and these can also be explored well before surgery is needed.

What people need to be aware of too, is that if you have been doing all the conservative treatments, and they aren’t helping, then it is time to get some surgical intervention. I think people think that pelvic floor exercises with fix all bladder and pelvic floor issues, and this doesn’t work, then there is nothing that can be done to help them. I need for all women (and men) to know that there is always help for bladder and pelvic floor issues and you just need to see a specialist, not just your GP.

Natural Medicines

On a natural medicine level, acupuncture and chinese herbal medicines may assist in the treatment and management of pain, alongside medical treatments and interventions.

Yoga and Pilates may also help toning of the pelvic floor and help managing incontinence, pelvic floor and post-surgical management of prolapse too.

How incontinence and other bladder issues is defined

Incontinence and bladder issues are defined as needing to pass urine more than 8 times per day, leakage of urine through cough, sneeze, urge, or without cause. It is important to seek help if you notice damp underwear, need to use pads because of leakage or are constantly running to the loo to pass urine.

The different types of incontinence

There are many different types of incontinence with the main ones defined as stress incontinence, urge incontinence and voiding dysfunction/incomplete emptying.

There is also mixed incontinence (mix of the 3 main ones) and also a term called overactive bladder syndrome which can be a mixture of all forms of incontinence. There are also inflammatory bladder conditions that cause incontinence such as bacterial cystitis and interstitial cystitis.

Physical issues such as previous surgery, childbirth and prolapse can also cause incontinence too.

The first task for the clinician is to find out how severe the incontinence is, based on the frequency of leakage, whether the woman finds it necessary to use incontinence pads, and if so how many pads. Some patients may prefer to change their underwear more frequently, while others may tuck tissue paper inside their underwear, and just throw away the tissues whenever they are damp.

The classic feature of stress incontinence is that the patient leaks with coughing, sneezing, laughing, running, playing sport or lifting heavy objects

The classic feature of urge incontinence is that the patient rushes to the toilet with an urgent desire to pass urine, but as she gets to the loo and is taking down her trousers, the urine comes away from her- sometimes before she has even sat down. Unfortunately these patients cannot predict when these bladder spasms will come upon them, and therefore can’t really tell when they are likely to leak.

Nocturia is defined as being woken up by your bladder needing to go to the toilet- as opposed to being woken up by a crying baby, a snoring husband, or menopausal night sweats. However nocturia is age dependent. Nocturia is defined as waking 1 or more times per night if under 60 years of age

Typically a patient with Voiding dysfunction/ Emptying difficulty has to strain to commence voiding (called “hesitancy”). They may also have observed that when they compares themselves to other women urinating in the toilets at the movies or in airports, her stream seems poorer than others with the urine dribbling out more slowly. These women will often also describe the sensation of incomplete emptying and may need to go back to the toilet within a relatively short time to re-void. Sometimes these women will leak as they get off the toilet, which is how the realise that they are not empty. This is called post-micturition dribble incontinence.

Incontinence in males

In males these symptoms most commonly occur when the prostate gland is enlarged- causing a relative urethral obstruction and making it more difficult for the urine to get out. These men have chronic high residual urine, so they end up going to the toilet very frequently in a vain attempt to empty out. They often dribble urine onto their clothes. When such men have prostatic surgery they usually find that their urine flow rate returns to normal and they usually stop dribbling.

Inflammation in the bladder leading to pain

We will also need to explore how inflammation of the urinary bladder leads to suprapubic pain, and consider the two main causes of this, Bacterial Cystitis and Interstitial Cystitis .It often feels difficult to treat incontinence in the presence of bacterial cystitis, because such patients are overwhelmed by frequency and urgency of micturition and they may experience disabling suprapubic pain. It is fixable with the right treatment though. It all gets back to who is managing you.

On the other hand, a separate cause of Urinary Pain, called Interstitial Cystitis, does not usually cause much incontinence at all- it just causes suprapubic (bladder) pain with severe frequency and urgency of micturition. You can read my post about Interstitial Cystitis

The overactive bladder (OAB) is a clinical syndrome, not a urodynamic diagnosis. It comprises frequency, urgency, and nocturia, with or without urge incontinence.

Gynaecological conditions such as Endometriosis and Adenomyosis etc can also cause issues with bladder and pelvic floor.

Please read my post on Atrophic vaginitis as this is also another cause of weakness in the pelvic floor and bladder and could be a cause of incontinence.

Solutions for incontinence, bladder issues, & pelvic floor issues

No matter what sort of incontinence you have, there is always an answer and a solution to your problem. Not all solutions are surgical either. More often than not some conservative treatments, some exercises and some complementary therapies is all that is needed.

Sometimes all some women need is some treatments with estrogen creams to help with tone in the vagina, bladder and pelvic floor

Surgery and now bionic devices are always an option for those whom have tried conservative options and aren’t getting the desired results. Surgery is often used because of quality of life issues. Again surgery these days is so effective and less invasive and the recovery is so much quicker due to keyhole surgery and new surgical interventions.

See a Urodynamic Specialist

If you are experiencing incontinence or bladder issues, please talk to your healthcare practitioner and please book in to see a good pelvic floor/urodynamic specialist, This way you can be evaluated properly and see what is going on and implement the right treatment strategies to get your quality of life back again.

Many times there may be an easy non-invasive treatment for your particular issues. Even when surgical intervention is needed, these days even this is less invasive than it used to be and the recovery and results are very quick.

Please read my post of Atrophic Vaginitis as well as this all ties into this area too, especially for those women in the menopause and post menopausal time of their life.

Regards

Andrew Orr

-No Stone Left Unturned

– Women’s & Men’s Health Advocate

-The Women’s Health Experts

What Is Lichen Sclerosis?

Posted on September 5, 2017September 5, 2021 by Andrew Orr

Lichen sclerosis is a long-term problem of the skin. It mostly affects the genital and anal areas. Sometimes, lichen sclerosis appears on the upper body, breasts, and upper arms.

For this article I am just going to talk about Lichen Sclerosis of the genital region (Vulva) and more around how this affects women and how it can be treated and managed.

Lichen sclerosis can cause itching, pain and scarring of the affected areas, but there are treatments available that can relieve symptoms and prevent and treat scarring.

Much of the information out there is also outdated and it all seems to be doom and gloom, so I wanted to do a post and put some positive options up for sufferers. With the right treatment and management, women with Lichen Sclerosis can get their lives back.

Who Does Lichen Sclerosis Affect?

Nobody knows exactly how many women are affected, but it is thought that as high as 1 in 30 women could suffer from Lichen Sclerosis. While anyone can get lichen sclerosis at any age, women after the menopause have the highest risk. In fact, it is about 10 times more common in women than in men. It is possible, but rare, for children to be affected.

What Are the Symptoms?

Early in the disease, small white spots appear on the skin. The spots are usually shiny and smooth. Later, the spots grow into bigger patches. The skin on the patches becomes thin and crinkled. The skin may also be inflamed and red or ulcerated from scratching.

Skin affected by lichen sclerosis can tear easily, and there may be tiny fissures (cracks in the skin). When severe, there may be bleeding and blistering.Sometimes, the skin becomes scarred. If the disease is a mild case, there may be no symptoms.  Other symptoms are:

Itching (very common)
Discomfort or pain
Bleeding

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

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

Some women may have lichen sclerosis, atrophic vaginitis and thrush combined and this is why differential diagnosis is so important and women need to see someone who knows about how to diagnose these issues correctly.

Women need to see someone who specialises in this area and treats these conditions often. With correct treatment and management, women can live very normal lives.

Genital lichen sclerosis

Lichen sclerosis that affects the vulva usually feels intensely itchy. There may also be pain, stinging, burning or discomfort, especially during sex or when urinating.

Lichen sclerosis is a chronic, or ongoing, condition, and over time it can lead to scarring. If this affects the vulva, it may narrow the entrance to the vagina, interfering with sexual intercourse.

Women with severe lichen sclerosis in the genitals may not be able to have sex. The disease can cause scars that narrow the vagina. Also, sex can hurt and cause the patches to bleed.

However, treatment with creams or ointments can help. Women with severe scarring in the vagina may need surgery, but only after lichen sclerosis is controlled with medication. When the skin around the anus is affected, pain when emptying the bowels can lead to constipation.

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

What Causes Lichen Sclerosis?

Doctors don’t know the exact cause of lichen sclerosis. Some doctors think a too active immune system and hormone problems may play a role. In women, lichen sclerosis also seems to be associated with autoimmune diseases (conditions where the immune system attacks the body), such as lupus , alopecia and thyroid disease.

It is also thought that people inherit the likelihood of getting the disease.

There may also be a hormonal involvement as It is also more common after menopause, when there is less oestrogen in the body. This is why careful differential diagnosis is so important, so that other conditions are not overlooked as well. This is something that I see happen to women often.

Lichen sclerosis is more likely to appear on skin that has been damaged or scarred from some other previous injury. Importantly, lichen sclerosis is not infectious and your partner cannot catch it during sex.

How Is It Diagnosed?

Lichen sclerosis can often be diagnosed from the appearance of the affected skin. It is important that your GP refer you to a pelvic floor/urodynamic specialist, or women’s health specialist that specialises in conditions affecting the female reproductive organs. Sometimes a referral to a dermatologist may also be needed also.

Besides visual diagnosis, a biopsy may be recommended to confirm the diagnosis. This involves taking a small sample of affected tissue for a pathologist to examine under a microscope. This allows specialists to make sure that it is not a different disease.

Treatment of lichen sclerosis

Treatment of lichen sclerosis is aimed at:

Relieving symptoms of itch and discomfort;
Healing the lesions (returning the affected skin to its normal colour and texture);
Preventing the development of scar tissue; and
Treating any scar tissue that has developed.

Medical Treatments for Lichen Sclerosis

Lichen sclerosis is usually treated by applying a strong steriod cream, or ointment to the affected area. This is usually applied daily for several weeks, or months, and then less frequently (once or twice per week) long-term to prevent a recurrence.

Corticosteroid ointment or cream should be applied only to the white patches and gently rubbed in. Try to avoid applying steroid to the normal surrounding skin to help prevent side effects.

Symptoms such as itch may improve within a couple of days of starting corticosteroid treatment. Healing of lesions generally takes longer.

Women with Lichen Sclerosis will need regular follow up consultations and management with their specialist while using these creams and ointments for a long time because they can cause the following

Thinning and redness of the skin
Stretch marks where the cream is applied
Genital yeast infections.

Sometimes, women just do not get better using this medication and there could be other things that could be stopping symptoms from clearing up. This could be from the following:

Low estrogen levels
Infection
Allergy to the medication.

Other treatments

If topical steroid treatment is not effective, your specialist may recommend other medications and treatments that target the immune system and help control inflammation.

Sometimes other medications such as Retinoids, or vitamin A-like drugs are used and your specialist may also recommend laser treatment.
If scarring has occurred, this does not usually improve with steroid treatment. Scarring in females that is affecting sexual intercourse or urination may be helped by surgery
There are also some new medical treatments that are presently being researched and providing some amazing results options and I will discuss at a later date. They are actually natural medicines that are being used as a medical treatments. All I can say is that I have seen the results of this new treatment option and I think it is going to help many people. At present on of my colleagues is using this treatment to help women as part of a research project. I will update people when I am allowed to say more about this new treatment.

Natural Medicine Treatments

There are natural medicine treatments that may assist in the management of Lichen Sclerosis, alongside medical interventions.

Self-care measures for genital lichen sclerosis

The following self-care measures may help in the treatment of lichen sclerosis that affects the genital area.

Gently wash the area daily with warm water and pH neutral soap cleanser.
Try not to rub or scratch the area. This can sometimes be really hard when it is itchy and inflamed
Avoid tight clothing and any activities that may aggravate itching and discomfort, such as bike riding.
Your specialist may recommend you apply cream to gently moisturise and protect the area.
Women should use a mirror to become familiar with the location and appearance of their genital lesions, and to apply cream or ointment to the affected area of the vulva.

Complications and follow-up

If you have been diagnosed with lichen sclerosis then it is advisable to have regular follow-up appointments with your specialist every 6 to 12 months.

In addition, genital lichen sclerosis is associated with a small, but important, increase in the risk of cancer developing at the affected site. As mentioned before 4 out of 100 will go on to develop cancer of the vulva.

This is why frequent check-ups are important to detect any cancers early on, when they can be more easily treated. This is why I always say that early intervention and proper treatment and management of any disease and the same goes for lichen sclerosis.

I have helped and assisted many women with Lichen Sclerosis in my years in practice and I do find that a multimodality approach is the best way to assist and manage this disease effectively.

Sometimes you need to have a team to help treat this, just like many other diseases women endure.So many women are are at their wits end with this disease and all sorts of treatments that have not worked. The problem is that they have just seen the wrong people and haven’t been properly looked after.

Women with Lichen sclerosis can be helped if they see the right people and get the right help and proper clinical health care and management. You just need to find the right people who know about this disease and how to treat it properly.

I can say this, if this disease is treated and manage properly, it can give women their quality of life back. Instead of all the doom and gloom and negatives things, let’s get some positivity back and give women with this disease some hope. There always hope and you just need to know where to find it.

Take care

Regards

Andrew Orr

Women’s & Men’s Health Advocate

-“No Stone Left Unturned”

-The Women’s Health Experts

Hysterectomy “DOES NOT” Cure Endometriosis

Posted on August 29, 2017August 22, 2019 by Andrew Orr

Many women are led to believe that hysterectomy is a cure for endometriosis and this is probably one of the most non-factual statements that many healthcare professionals are guilty of telling women. This is because they lack the understanding of the disease and lack knowledge of how the disease can spread to other areas of the body outside the uterus.

For the record, and this is fact, Hysterectomy does not cure, never has cured, and never will be a cure for endometriosis.

Most endometriosis is found outside the uterus and can be found in the pouch of douglas, utero-sacral ligaments, ovaries, intestine, pelvic wall, bladder and it can even spread up into the diaphragm, thoracic cavity, liver, pericardium, rectum and other parts of the body. It has even been found in the brain and distal joints such as the fingers.

All women with endometriosis need to know that endometriosis will still stay in the places mentioned above, irrespective if the uterus is removed, or not.

Many women will often comment that hysterectomy has cured their endometriosis and this is because they have been led to believe what their doctor has told them, they lack the understanding of the disease and they may have had some relief of pain usually associated with their menstrual cycle.

All hysterectomy will do for a woman with endometriosis is stop their menstrual cycle and any associated symptoms and pain associated with her menstrual cycle. Some women are also just lucky to become asymptomatic after hysterectomy too.

The type of hysterectomy may also help to slow the progression of the disease too. What many people do not understand it they there are two types of hysterectomy. One is a full hysterectomy, where the uterus and ovaries are removed and the other is a partial hysterectomy, where only the uterus is removed and the ovaries are left behind. It may be possible that a full hysterectomy, where the ovaries are removed, may in fact reduce some of the estrogen that is driving the disease and make someone asymptomatic.

The other gynaecological issue that many healthcare practitioners misdiagnose and overlook is Adenomyosis. Adenomyosis is an inflammatory disease deep within the wall, muscle and tissues of the uterus. Many now believe that Adenomyosis and endometriosis are one in the same disease, except Adenomyosis is deep within the muscles and tissues, where as endometriosis tends to be more superficial.

Removal of the uterus will in fact help Adenomyosis and help with the associated symptoms, such as heavy bleeding and pain.

Many women actually have Endometriosis and Adenomyosis at the same time and many do not even know they have both diseases. Then when the uterus is removed, women experience less pain and symptoms, or no pain and symptoms, that was actually caused by the Adenomyosis rather than the endometriosis.

Then these women are led to believe that they have been cured of endometriosis due to the resulting levels of pain and symptoms that are now gone. But, while their Adenomyosis may be cured (and I use this term loosely due to context), their endometriosis still remains.

But if they are now asymptomatic, which many women are, they many not know that the endometriosis is actually still there. If you are one of these people I do need you to know that the hysterectomy has not cured your endometriosis at all and it is still there in your body. If a hysterectomy has cured your pain and associated symptoms is because of everything I have mentioned above. Again, hysterectomy DOES NOT cure endometriosis.

I also see the opposite of this in practice too. Many women whom have had a hysterectomy are still getting lots of abdominal pain, intestinal pain, bladder pain, rectal pain and others pains in the body. It is often hard for them to hear that their pain they are experiencing is actually from endometriosis, which they have been previously diagnosed with, yet believe has been cured due to the removal of the uterus and sometimes ovaries are well (partial, or full hysterectomy).

The only way that many will actually fully believe you is after they have had further surgery and the disease is found and excised and their symptoms are stopped, or reduced. It is not until then, that these women will know what you have said to be true and that they have been sold the biggest lie on the planet.

The reason I wanted to speak about this is because I see so many women believing that hysterectomy (partial or full) will cure their endometriosis and have been sold the lie.

Unfortunately many of these women are still suffering greatly and are often left wondering why, or are told it can’t be endometriosis as the uterus has been removed. It is so terrible to hear this and see this statement being spread as gospel by healthcare practitioners and even surgeons who know no better and do not understand endometriosis as a disease state.

It is also hard to hear other women tell their fellow sisters the same lie, even though it is not really their fault and they actually do not know any better. I am writing this so the truth is out there and we get to stop this misinformation from spreading any further.

I hope this has helped you with getting some of the facts and see why so many women are told the one of the biggest lies in healthcare.

Oh and remember one more thing…. Period Pain is not normal, no matter what anyone tells you!

Take care

Regards

Andrew Orr

-Women’s and Men’s Health Crusader

-“No Stone Left Unturned”

-Period Pain is not normal

Atrophic Vaginitis

Posted on August 25, 2017August 22, 2019 by Andrew Orr

Atrophic vaginitis is a vaginal disorder that usually happens after menopause, but it can happen long before this time as well. When estrogen levels fall, the vaginal walls can become thin, dry, and inflamed. This then causes the surrounding tissue to lose its elasticity and become atrophied.

This can be uncomfortable and it can make sex uncomfortable, or extremely painful. Gynaecological conditions such as endometriosis, adenomyosis and fibroids can make someone more prone to atrophic vaginitis as well.Many women that have atrophic vaginitis may not even know that they have it.

As many as 40% of postmenopausal women experience symptoms of atrophic vaginitis after menopause, but only 20 to 25 percent will seek medical help.

Many women will not seek treatment because they feel embarrassed due to the sensitive nature of the condition. Some women just put up with it believing it is normal.

Untreated, it can affect a woman’s quality of life and even lead to increased risk of prolapse and other gynaecological and urological conditions. Many of the treatments are non-invasive and are very effective in a short amount of time.

Symptoms of Atrophic Vaginitis

vaginal dryness
pain during sexual intercourse, or dyspareunia
thin, watery, yellow or gray discharge
paleness and thinning of the labia and vagina
irritation when wearing certain clothes, such as tight jeans, or when on a bike seat
more frequent urinary tract infections (UTIs), or urinary tract like infections(which is from inflammation, with no infection present)
Vaginal Prolapse

Symptoms can also present in issues with the bladder and urination

painful urination
blood in the urine
increased frequency of urination
incontinence
increased likelihood and occurrence of infections, or irritation to the bladder that may feel like an infection

There may also be a reduction in pubic hair, and the vagina may become narrower and less elastic, which may cause a condition called vaginismus.

Causes

During perimenopause, menopause and post-menopause, a woman can have decreased levels of estrogen. When the ovaries stop making estrogen after menopause, the walls of the vagina become thin, and vaginal secretions are reduced. Similar changes can happen to women after childbirth, but these changes are temporary and less severe.

These same changes can happen for women with endometriosis and adenomyosis and often why there can be changes to the wall of the vagina. Some of the medications used to help these conditions can also cause thinning of the vaginal wall and surrounding area. Many women with endometriosis, adenomyosis, fibroids etc, will have increased risk of atrophic vaginitis during the perimenopause, menopause and post-menopausal period.

Medications, or hormones, can be used as part of the treatment for breast cancer, endometriosis, adenomyosis, fibroids, or infertility to reduce estrogen levels. This decrease in estrogen can lead to atrophic vaginitis.

Other causes of atrophic vaginitis include:

severe stress
depression
Surgery, or treatment to the pelvic area
uncontrolled diabetes
rigorous exercise
chemotherapy

Other substances that can cause further irritation to the vagina are:

smoking
soaps
laundry detergents
lotions
perfumes
douches
tampons
yeast infections
condoms (due to latex allergy)

Diagnosis

The best person to see for this condition is a pelvic floor/urodynamic specialist, or a women’s health specialist. While you GP can help with diagnosis of this condition, it is preferable to see a specialist who has more training in this condition and can help manage this moving forward. A specialist will carry out proper examinations, be able to diagnose this correctly and ask about medical history. They may ask about the use of agents that can irritate the area and cause or aggravate symptoms, such as soaps or perfumes.

Your specialist will also do tests to rule out STI’s and other possible causes of infections such candidiasis, bacterial vaginosis etc. Atrophic vaginitis can make the area more susceptible to becoming infected. It can occur alongside an infection. A diabetes test may be performed to rule out diabetes. A biopsy may be taken to rule out cancer.

Treatment

The first line treatment is usually conservative treatments with topical estrogen creams inserted into the vagina and focuses treatment on the affected area. A low-dose estrogen cream can be used to stimulate rapid reproduction and repair of the vaginal wall, tissue and cells. Women should be shown how to insert the creams with an applicator and then use their finger to help disperse the cream properly to get good coverage of the vaginal wall.

Creams are much better than pessaries, because pessaries often do not disperse well and may only give coverage to a small area. These creams are also safe to use for those at risk of certain cancers, or who have had hormone dependent tumors.

Some women may also need to take Hormone Replacement Therapy (HRT), in the form of a tablet, gel, patch, or implant to supply estrogen to the whole body. These estrogens are effective, but there may be side effects. Patients should discuss the risks of long-term HRT (especially breast cancer risk) with their healthcare practitioner.

Some women may also need to use a water-soluble vaginal lubricant may help to provide relief during intercourse, for mild cases.

Regular exercise is important, as it keeps blood flow and genital circulation high. Pilates and yoga may be beneficial for the pelvic floor and core stability and should be part of a woman’s overall lifestyle management. Women in the perimenopause and menopausal periods of their life should be doing some form of weight baring and strengthening exercise regularly.

There are also natural medicines that may assist in the treatment of atrophic vaginitis. Acupuncture and Chinese herbal medicine may help and assist with the symptoms of atrophic vaginitis (such as pain), alongside medical treatments.

Prevention

Regular sexual activity and stimulation of circulation to the vagina can help prevent atrophic vaginitis. It is more around climax helping, rather than just sexual activity, or intercourse. Some women have pain during intercourse, or experience dryness, so foreplay and being well lubricated can help this. Using a water-soluble vaginal lubricant can soothe mild cases during sexual intercourse. Masturbation and stimulation without intercourse to produce climax may help those women who have pain with intercourse, or who may not have a partner.

Regular climax and sexual activity can also show benefits for both the elasticity and flexibility of the region. Women who have regular climax and are sexually active report fewer symptoms of atrophic vaginitis when compared to women who do not regularly climax, or have regular sexual intercourse.

Regular exercise, such as Pilates and Yoga may assist in helping with the pelvic floor, vaginal tone, bladder and reproductive organs. Kegels exercises, and vaginal eggs/stones may also assist with atrophic vaginitis, alongside medical interventions.

There are natural medicine which may assist with the prevention of atrophic vaginitis and assist with circulation and hormone regulation. To find out more, please consult your healthcare provider.

Fast facts on atrophic vaginitis

Atrophic vaginitis refers to dryness of the vagina.
Symptoms include painful intercourse and an increase in urinary tract infections (UTIs), or urinary tract like infections (due to inflammation of the bladder, not from infection).
It is caused by a reduction in estrogen, normally following menopause or treatment with anti-estrogen drugs. It can also be caused from gynaecological conditions such as endometriosis, adenomyosis and fibroids.
Topical treatments and hormone replacement therapy (HRT) may help relieve symptoms
Around 40 percent of postmenopausal women experience symptoms of atrophic vaginitis, but many do not seek treatment.

If you do need help with suspected atrophic vaginitis,please see your healthcare provider, or see a specialist in this area.

Take care

Regards

Andrew Orr

– Women’s and Men’s Health Advocate

-“No Stone Left Unturned”

-The Women’s Health Experts

What is Implantation Bleeding?

Posted on August 3, 2017August 22, 2019 by Andrew Orr

Implantation bleeding: Causes and symptoms

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 and growing foetus 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.

Other signs

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
Dizziness
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.

Regards

Andrew Orr

-Women’s and Men’s Health Crusader

“No Stone Left Unturned”

-The International Fertility Experts

Why Sperm Is The 51st Shade of Grey

Posted on June 25, 2017August 22, 2019 by Andrew Orr

Sperm is something that is very little talked about and why sperm is the 51st shade of grey. Men always think they are born with super sperm, when in fact it is the complete opposite now. Many fertility clinics are letting men use substandard sperm and are not holding men accountable for their sperm health. No wonder so many couples are failing to fail pregnant.

Over the years I have put up some serious posts about sperm and sperm quality and the importance of maintaining sperm health. While my post are intended for people trying to actually have a baby, but many of those not trying for babies loved the posts as well.

It is still good to promote healthy sperm production and reproductive function, even if you aren’t trying to have a baby. Healthy lifestyle promotes health bodies, which then helps promote healthy sexual and reproductive function.

In many of my posts about sperm, I also talk about the importance of regular ejaculation to help with better quality sperm and also healthy reproductive function. These posts always raise a few eye bows, and caused a few giggles, or “There you go dear, I told you we need to have sex more often”.

However, I did see that there were some major misperceptions around the topic of sperm. So, I thought I’d better educate you all on the finer details of sperm

Biology 101 tell us that it takes a sperm and an egg, not just an egg (as many people seem to forget), to make a baby. The trouble is, over 50% of fertility issues are related to poor quality sperm and up to 85% of miscarriage issue are related to men’s defective swimmers. So what do guys do when they hear this?

Well, they bury their heads in the sand and say “My boys are fine, I just know they are” and guzzle some more alcohol, that has their swimmers having two heads, two tails and swimming around like a drunk man in a pool. Guys are shockers when it comes to keeping their sperm healthy and why I will always be in business for fertility services.

But besides the downside of men and sperm, there are some good points to sperm, but most of the time Dr Google has you all believing things that just aren’t true at all.

So lets look at the facts about Sperm.

Sperm can help fight depression in women– Research has shown that have oral sex, or unprotected sex (not that I advocate this unless in a healthy relationship), have less depression, have healthier moods and have healthy immune systems and are happier in general. Sperm helps increase oxytocin, prostaglandins and seretonin in women according the The State University of New York study.
Sperm can make you more fertile – Semen isn’t just vehicle for carrying sperm – it also plays a crucial role in triggering ovulation, according to a new study.Scientists have discovered the protein in the sexual fluid acts as a hormonal signal on the female brain.This triggers the release of other hormones that signal the ovaries to release an egg.
Sperm can help Embryo Implantation– Studies have shown that sperm actually assist in embryo implantation via several chemicals and hormones. Yet many people are told refrain for having sex after IVF. I can tell you that you need to have more sex and not listen to the BS and listen to the research that proves otherwise.
Storing up sperm does not make it better– Research has shown that regular ejaculation improves sperm quality and the resulting transport of seminal fluids. (as was told to you in previous posts). Storing it up, does not make it better, it makes it worse. Regular ejaculation also helps the prostate.
Sperm do not last for days– On ejaculation into a woman, most of the 300-500 million sperm that set off are dead within an hour and only about 5-10 single sperm actually survive the journey to the tubes, where many more half of those die off once more. Sperm are killed by acids,killed by the woman’s immune system, die in the uterus, get lost in the uterus, die on the tubes and so on. Only the fittest survive the race to pregnancy. (The human body series BBC)
You can cook with it– Yep, there are cooking books that use semen to cook recipes with. (Natural Harvest – A Collection of Semen-Based Recipes). Where semen is described as “Semen is not only nutritious, but it also has a wonderful texture and amazing cooking properties. Like fine wine and cheeses, the taste of semen is complex and dynamic” Well there you go, crack open the bottle of grange now.
Sperm is good for your skin– Sperm contains minerals such and zinc, vitamin C, prostaglandins, collagen, vitamins, amino acids and many other health things to help with skin. Bioforskning, a Norwegian company, has synthesized the compounds into a facial cream. According to Bioforskning, the cream Spermine is 30 times more effective than vitamin E and can delay the aging process by 20 percent. However, nature’s most natural facial cream can cost you a whopping $250. I’d like to see them try to market that at Myer 🙂
The first sperm under a microscope– Antonie van Leeuwenhoek was the person to view sperm under a microscope. It’s a bright day in 1677, in the city of Delft, and Antonie van Leeuwenhoek is making love to his wife. But moments after he shudders with orgasm, he hurries out of bed to grab his microscope. After all, he’s not just spending time with his wife: he’s running an important scientific experiment at the request of the Royal Society in London. Sounds like nothing much has changed for some men. Now some are just rushing to watch the footy.

Well, there you go. 8 things Wikipedia can’t tell you about sperm. The good, the bad and the down right outrageous. You heard it hear first. The doc provides you news that other people are to scared to report. I hope all of you have a great up and coming week. Pardon the pun. Life is too short to be serious, about a serious topic.

References

1.http://www.dailymail.co.uk/health/article-2190863/Semen-good-womens-health-helps-fight-depression.html

2.http://www.dailymail.co.uk/health/article-2191495/Does-having-sex-make-women-fertile-Semen-trigger-ovulation-mammals.html

3.http://humrep.oxfordjournals.org/content/15/12/2653.short?rss=1&ssource=mfr

4 & 5. World Health Organization. WHO Laboratory Manual for the Examination of Human Semen and Sperm – Cervical Mucus Interaction (4th Edition). Cambridge University Press, Cambridge, UK (1999)

6. Human Body Series (BBC) – Conception

7.http://cookingwithcum.com

8. http://www.medicaldaily.com/extraordinary-things-you-can-do-sperm-242190

9.http://rstl.royalsocietypublishing.org/content/9/101-111/121.full.pdf+html

Regards

Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

-The International Fertility Experts

Exercises For Better Sex

Posted on May 28, 2017June 2, 2020 by Andrew Orr

As a practitioner with a special interest in the area of reproductive and sexual health, I thought it’s was time to talk about what you can do to have better sex. While good food, healthy lifestyle, mindfulness and reducing stress can help with improving the sex life and your libido, many exercises can also benefit your sexual health too. These exercises also have other benefits, while making feel good and feel healthier at the same time.

1. Cardio – Getting physical can ramp up the pleasure for you and your partner. Any activity that gets your heart beating faster and you breathing harder, from brisk walking to cycling, can boost blood flow — including to your nether regions. That’s a plus for both genders: stronger erections for men, and greater arousal for women (a whopping 169% more in one University of Texas study).

2. Weight training– Using compound lifts such as dead lifts, squats, bench press etc, all add to strengthening your core, burning fats and strengthening your whole body. They also increase testosterone and other hormones, which help with improving sex drive; increasing orgasm intensity and making you feel good at the same time.

3. Swimming– Harvard researchers found that male and female swimmers in their 60s had sex lives similar to people 20 years younger. Swimming builds endurance, boosts blood flow, improves flexibility and strength, and slashes stress. It also burns some serious calories, a plus for anyone who’s overweight (extra pounds lower libido), especially obese men with erectile dysfunction.

4. Core & Abs Work– A strong, flexible core underpins most everything you do. That includes performing between the sheets. Bonus: You may be one of the lucky people who can have an orgasm while exercising — sometimes called a “coregasm.” It tends to happen during core-strengthening workouts like crunches. Pilates is a great way to work on core and abs.

5. Kegels, Ba Wan Balls and Yoni eggs– Kegels was developed to treat urinary incontinence, these strengthen your pelvic floor muscles, and that means explosive orgasms. Yoni eggs and Ba wen balls have been around for centuries to help with developing muscles in the vagina and pelvic floor and also helping with lubrication, increased circulation and also stimulation of certain hormones such as oxytocin (the love hormone). These exercises and eggs/balls may also help with gynaecological conditions such as Adenomyosis and endometriosis too, alongside medical interventions, by increasing blood flow and assisting with pain. Women may be more familiar with Kegels balls, but probably less familiar with Yoni Eggs and Ba wen balls. Kegels exercises may also help men prevent premature ejaculation. (Always consult with your healthcare practitioner before using kegels balls, yoni eggs and ba wen balls)

6. Plank– This is a perfect way to strengthen the deepest layer of your ab muscles (transversus abdominis), along with your upper arms, thighs, and buttocks. These muscles help stabilize you so you can stay close to your partner when and where it counts most. Do it once a day, and build up to 60 seconds or longer. If it’s too challenging on your toes, try balancing on your knees instead.

7. Cat/Cow Stretch– Think of this yoga pose as another form of foreplay. It limbers your spine, helps get you into an even breathing rhythm, and improves focus — so your mind stays in the moment. Move with a steady flow, so that each rounding up (the cow part) takes a full breath out and each arching downward (the cat part) takes a full breath in.

8. Pelvic Thrusts – Whether your favourite position is missionary or cowgirl, this move is a key part of it. But powerful pushes can be exhausting when you’re out of shape. Work your glutes, calves, and hamstrings to build stamina and flexibility. Pelvic thrusts also sculpt your booty, so you feel good and look good.

9. Better Together– Couples who sweat together stay together; so make an exercise date with your significant other. Studies show that challenging physical activities spark arousal. You’ll be more attracted to your partner post-workout, too. Coordinate your actions (for example, run at the same pace) to strengthen your emotional connection even more.

As I always say to couples, is that having a healthy sex life is so important to a relationship and so vital to connection for the couple. Healthy couples have healthy sexual function and healthy libidos, so healthy diet, mindfulness and a healthy lifestyle is so important to maintaining a healthy sex life. Healthy couples also have healthy babies.

Regards

Andrew Orr

-Leaving No Stone Unturned

-Women’s and Men’s Health Advocate

-Master of Women’s Health

-The Women’s Health Experts