Category Archives: Dr Andrew Orr

The Top 23 Things That Will Cause A Flare In What You Thought Was Endometriosis Adenomyosis Symptoms But Maybe Isnt 13 23 webpage

The Top 24 Things That Will Cause A Flare In What You Thought Was Endometriosis & Adenomyosis Symptoms, But Maybe Isn’t (13-24)

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In the second part of my posts about the top 24 things that will cause a flare in what you thought was endometriosis and adenomyosis symptoms, but may isn’t, I continue with the next 12 causes of what you think is endometriosis, or adenomyosis symptoms, may just be caused by something else?

In this post I continue to bring awareness to the fact that sometimes it is not always Endometriosis, or Adenomyosis causing your current symptoms. It may be one of the following facts only, or in combination. What we need to remember is that many women with endometriosis, and adenomyosis, often have other issues that are flaring their current symptoms, and often present the same as endometriosis and adenomyosis, in their symptomology.

We also know that many other causes of flares of symptoms are often overlooked, and even dismissed, just as endometriosis and adenomyosis is often missed and dismissed.

Many women may have other issues going on at the same time as having endometriosis, or adenomyosis, and it is possible to have both endometriosis and adenomyosis combined and well as having other health issues in combination as well. Just remember that not all your symptoms may be endometriosis, or adenomyosis, and why it is so important to see and expert in these conditions.

If you do need and expert and need help with endometriosis and adenomyosis, please give my friendly staff a call and find out how I may be able to assist you.

 

Let’s have a look at the next 12 causes of “What You Thought Was Endometriosis and Adenomyosis Symptoms, But Maybe Isn’t”

 

Causes of a Flare of What You Thought Was Endometriosis and Adenomyosis Symptoms, But Maybe Isn’t ( 13-24)

13.Tight pelvic floor muscles – Pelvic floor hypertonus occurs when the muscles in the pelvic floor become too tight and are unable to relax. Many women with an overly tight and non-relaxing pelvic floor experience pelvic health issues such as constipation, painful sex, urinary urgency, bladder issues and pelvic pain. Women with pelvic floor hypertonus may also have musculoskeletal issues that cause tightness and tension in surrounding hip, sacrum and pelvic muscles. Have a read on my previous post about this. (Click here to read)

14.Interstitial cystitis– Interstitial cystitis (IC) is a chronic inflammatory bladder condition in which there is persisting chronic pelvic pain, urinary frequency and urgency, bladder pain or pressure, and it can also resemble the symptoms of a urinary tract infection, but there will be no infection present. The pain can range from being mild to severe. Women with interstitial cystitis may experience many of the same symptoms as those with endometriosis. Women can have both Interstitial Cystitis and endometriosis at the same time. Some people with IC may also have irritable bowel syndrome (IBS), Fibromyalgia and other pain syndromes. This is why proper differential diagnosis is very important as this can be missed very often, or completely overlooked. Have a read of my previous post about IC (Click here to read)

15.Pelvic Congestion Syndrome– Pelvic congestion syndrome (PCS) is a chronic condition that occurs in women when varicose veins form below the abdomen within the pelvic region. Pelvic congestion is just like the varicose veins that some women have in their legs, but it affects the veins of the pelvis. Blood backs up in the veins, making them become enlarged and engorged. Pelvic congestion can also cause chronic pelvic pain in some women. Pelvic congestion syndrome does share many of the same symptoms of endometriosis and adenomyosis and it important to have proper differential diagnosis and rule other causes of pelvic pain out first. Sometimes the varicose veins that cause pelvic congestion syndrome can be present alongside endometriosis and adenomyosis, or other pelvic issues. Have a read of my previous post about PCS (Click here to read)

16.Constipation and full bowel- A common cause of pelvic pain and abdominal pain and bloating and caused by constipation and a full bowel that is slowly backing up and starting to compact. In serious cases, the bowel can compact and even perforate if not addressed soon enough. When the bowel is not fully voided, it can lead to backing up of the bowel. Many people are still moving their bowel each day, but just do not realise, it is not being voided properly. This can lead to pain, gastrointestinal issues and also feeling unwell, due to not voiding waste from the body. It is a very commonly overlooked issue. This is why women need look at restoring the microbiome properly and also drinking enough water, eating enough fibre and also creating good bowel habits and not holding on too long at work.

17.Lack of sleep – Lack of quality sleep is a major issue for many women and is a common cause of their fatigue, increased pain, and exacerbation of symptoms, interference of moods, and a whole range of health issues physically and mentally. Sleep deprivation leads to reduction in hormones such as melatonin, which is a precursor to serotonin and then affect the moods etc. Lack of sleep also interferes with the other hormones in our body too. Lack of sleep also stops the body from repairing and can lead to increased inflammation within the body. We know that shift works do have a lot more disturbances with their menstrual cycles and also have lower fertility rates.

18.Over-exercising– Over-exercise can lead to tight pelvic floor muscles and hypertonus, but it can also lead to decrease body fats as well. Body fat plays a regulatory process with hormones and fertility. A significant decrease in body fact (10-15%) can lead to decreased hormone production and actually stop the menses and interfere with fertility. Over exercise can also cause stress and inflammation in the body and can also lead to adrenal exhaustion and fatigue. It is all about balance.

19.Lack of exercise– Lack of exercise if a big factor in a lot of people’s health issues. Lack of blood flow and lack of circulation to muscles and tissues, especially the uterus and vagina, can have some serious consequences for women’s health and gynaecological conditions. Without proper microcirculation into the uterus, and vagina and reproductive organs, these areas can become highly stressed, lack vital nutrients and then leads to inflammation, pain and other irregularities. It is a catch 22 situation. Too much exercise is not good, but similarly, not enough exercise is just as bad for us. While sometimes we may not feel like exercising, the fact is, research has shown that regular exercise can, and does help with pain, and other symptoms of endometriosis and adenomyosis.

20.Environmental Estrogens– According to a landmark US study published by the US department of environmental health, there are 87,000 plus environmental estrogens we are exposed to in all countries around the world, some being worse than others. These can be anything from plastics, detergents, petroleum products, chemicals and even the contraceptive pill ending up in our water ways. These endocrine disruptors (AKA as environmental estrogens) can interfere with hormones within our body and also lead to inflammation and many health issues. They have also been linked to the increase in lower fertility rates and the increase in expression of genetic mutations within the body. Endometriosis and adenomyosis is driven by estrogen and this may be a big factor in the increase in women with endometriosis and adenomyosis.

21.Lack of blood/increase of blood circulation– The microcirculation of the uterus, vagina and reproductive organs is a very important one and one of the reasons getting proper blood flow and improving microcirculation into these areas is important. I talked about this in the lack of exercise part. It is also important to check women for hereditary blood clotting and also bleeding disorders. All women with gynaecological and fertility issues should be screened for blood clotting disorders via prothrombotic studies and also bleeding disorders such as Von Willebrands Disease, when suspected.

22.Musculoskeletal issues– Women with postural issues, or their spine out of alignment can also experience referral pain, and pelvic pain due. It is important to have musculoskeletal causes of pain assessed by a qualified healthcare professional (physio/chiropractor/osteopath). When muscles are too tight, it can cause sublaxations, which can then impinge on nerves and also cause referral pain and other health issues within the body. Damage to nerves and tissue, such as pudendal nerve neuralgia can also cause pain and referral pain in the lower abdomen, pelvis and vagina.

23.Excess weight and body fat– At present up to 70% (or more) of Australians, and Americans, are either overweight, or obese, so we can no longer ignore what the consequences of these statistics mean. We know that excess weight and excess body fat is linked to serious health consequences. Excess body fat in men and women leads to higher levels of the hormone leptin. Excess body fat is also now referred to as obestrogens, as they cause the same health consequences as environmental estrogens (known as endocrine disruptors). These excess body fats and higher levels of leptin do impair production of sex hormones and also reduces fertility. It can also lead to poorer sperm quality, poorer egg quality and can also increase the risk of miscarriage. Excess body fat, especially excess abdominal fat, is also linked to insulin resistance, metabolic syndrome and other health issues. It also interferes with the regulation of sex hormones and sex hormone binding globulin (SHBG).  This can then increase the risk of irregular cycles, PCOS, endometriosis, adenomyosis, miscarriage and other factors affecting fertility. Excess body fat can also be a major driving factor of endometriosis and adenomyosis, due to the estrogenic effects it has. This is why reduction in body fat and a healthy diet and healthy lifestyle is imperative in the management of women’s health and fertility.

24. Iron Deficiency– Iron deficiency can be a very serious issues, and many women do not realise the health risk associated with it, and how often it goes undiagnosed. It can lead to disruption of hormones, and can lead to fatigue and exacerbation of pain and emotionally generated symptoms. Let’s face it, without iron, you aren’t going to be transporting oxygen around your body and then your muscles, brain, hormones and circulation suffer as a result of this. Women with endometriosis and adenomyosis are nearly always iron deficient from the heavy blood losses they suffer, or the internal bleeds they get from flares of endometriosis lesions. Have a look at my previous past on the serious consequences of low iron and why managing iron levels is so important (Click here to read)

 

The Top 22 Things That Will Cause A Flare In Endometriosis Adenomyosis Symptoms 1 11 for webpage

The Top 24 Things That Will Cause A Flare In What You Thought Was Endometriosis & Adenomyosis Symptoms, But Maybe Isn’t (1-12)

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Many people often talk about how they get flares of their endometriosis and adenomyosis symptoms often. While in some cases it may actually be the endometriosis, or adenomyosis causing their flare, in truth, many times it is other things actually causing their flare and it is so important to understand this. Maybe what you think is endometriosis, or adenomyosis symptoms, may just be caused by something else?

In this post I want to bring awareness to the fact that sometimes it is not always Endometriosis, or Adenomyosis causing your current symptoms. It may be one of the following facts only, or in combination. What we need to remember is that many women with endometriosis, and adenomyosis, often have other issues that are flaring their current symptoms, and often present the same as endometriosis and adenomyosis, in their symptomology.

We also know that many other causes of flares of symptoms are often overlooked, and even dismissed, just as endometriosis and adenomyosis is often missed and dismissed.

Many women may have other issues going on at the same time as having endometriosis, or adenomyosis, and it is possible to have both endometriosis and adenomyosis combined and well as having other health issues in combination as well. Just remember that not all your symptoms may be endometriosis, or adenomyosis, and why it is so important to see and expert in these conditions.

If you do need and expert and need help with endometriosis and adenomyosis, please give my friendly staff a call and find out how I may be able to assist you.

 

Let’s have a look at the first 12 cause of “What You Thought Was Endometriosis and Adenomyosis Symptoms, But Maybe Isn’t”

 

Causes of a Flare of What You Thought Was Endometriosis and Adenomyosis Symptoms, But Maybe Isn’t ( 1-12)

1.Stress – Stress is the one of the biggest causes of ill health, or in exacerbating current health issues and their symptoms. Stress also heightens pain pathways, it increases inflammation, interferes with moods, disrupts hormone pathways and also increases acidity in the body. This then leads to increase in symptoms such as pain, gastrointestinal issues, fatigue, and increase in emotionally generated symptoms. Have a read of my previous article of this (Click here to read)

2.Anxiety– Anxiety is also a big cause in aggravating and exacerbating symptoms of endometriosis/adenomyosis. When control issues are heightened, the body spirals out of control and anxiety kicks in and exacerbates symptoms. This also heightens pain pathways like stress does, and also disrupts hormone pathways as well. This then drives pain pathways, upsets the gastrointestinal system, disrupts sleep and also creates fatigue. I have done a previous post of anxiety and pain pathways previously (Click here to read)

3.Busyness– Busyness is one of the number one drivers of stress and anxiety issues. Lack of time out and on the go, pushes the body to exhaustion, and also activates adrenalin and cortisol levels, which in turn interfere with hormone pathways. Busyness is really stress under another name, and can produce all the same symptoms as stress does. Busyness can also be a big factor with fertility and pregnancy too. See previous post (Click here to read)

4.Alcohol– One of the number one things to flare endometriosis/adenomyosis symptoms and any gynaecological issue is alcohol, especially excess alcohol. Alcohol can also be a big factor in period pain and also irregular cycles. It can also exacerbate heavy bleeding, especially with adenomyosis. Alcohol is full of sugars and it really is a drug and a toxin, especially in higher doses. Alcohol is also inflammatory and will exacerbate inflammatory conditions in the body. Alcohol also adds to fluid retention and body fat, and can interfere with moods.

5.Smoking – Smoking not only adds to inflammation in the body, but it also increases the risk of certain cancers, including gynaecological The byproducts of cigarette smoke have been found in the cervical mucus of women and these toxins are literally leaching into your uterus, your vagina, and surrounding tissues and organs. Ewwwww. Smoking definitely increases inflammatory processes in the body and leads to increases symptoms.

6.Refined foods– Highly refined foods increase blood sugar levels, which then makes the body store fat, and stops the burning of fat.
Excess body fat also drives inflammation, and is also estrogenic. Estrogen drives endometriosis/adenomyosis.
Excess refined carbs also cause increase insulin, which in turn causes inflammation in the body too. This increase inflammation exacerbates pain pathways and other symptomatic responses in the body.
A lot of refined foods are from grains, which also contain gluten. Gluten causes gut irritation and inflammation – a lot of people won’t even realise that their problems are caused by gluten. Have a listen to my video blog about a proper diet (Click here to read)

7.Too much sugar– Excess sugars and things such as chocolate (big one) is a big driver of inflammation in the body. The excess sugars also make the body store fat, and they also increase pain and exacerbate pain pathways. The excess sugars also disrupt the gut microbiome and increase bad bacteria, which also drive inflammation and increase gastrointestinal issues such as bloating and abdominal pain. It can also affect bowel function. Have a read of my post about the toxic consequences of sugar ( Click here to read)

8.Legumes (chickpeas, lentils, soy etc)- Lentils, beans (i.e. kidney, pinto, broad etc),peanuts (they aren’t nuts, despite the name), soy beans, garbanzos and chickpeas are alllegumes. Like grains, legumes too contain harmful substances such as lectins and phytates, inhibiting nutrient absorption and causing inflammation. They also cause gas and bloating and many people do not realise the reactions they can cause in the body.
Raw legumes are toxic, so they need to be prepared (by soaking,rising, cooking, sprouting or fermenting) – however, preparation doesn’t entirely negate the harmful effects of the lectins. Despite soaking and activating, many people still react badly .
Soy is particularly bad, since the phytoestrogens content acts like the female sex hormone estrogen. This has been shown to have some damaging effects with healthy hormone functions. Endometriosis and adenomyosis is estrogen driven and women should stay away from soy and soy based products where possible.

9.Excess bad bacteria – Buildup of bad bacteria, called dysbiotic bacteria can cause inflammation and ill-health, physically and emotionally. A buildup of bad bacteria is a common cause of abdominal pain and bloating in women with endometriosis and adenomyosis. I have discussed dysbiotic bacteria is a previous post (Click here to read)

10.Acidic foods– Acidic foods may cause or aggravate certain digestive disorders, such as acid reflux gastroesophageal reflux disease, otherwise known as GERD. Acidic foods can also add to inflammatory processes in the body and why there is now mounting evidence to use a more alkaline diet for those with chronic inflammatory disease states. Common acidic foods are alcohol, certain citrus fruits, soft drinks, processed foods, refined foods, junk foods, and tomato based products.

11.Junk foods – Junk foods contain all sorts of nasty things, from trans fats(carcinogenic fats), additives, preservatives, saturated fats, acid, gluten, soy, refined grains, processed foods, environmental estrogens, high sugar and a whole lot of others things that can create inflammation in the body and add to exacerbating someone’s symptoms. This one goes without saying, yet some many people do not realise that just one serving of junk food could exacerbate symptoms for days, or longer.

12.Certain medications– Medications can be both friend and foe, depending on the length of time someone has taken them, and also the side effect profile of a certain medication. Certain medications can also cause withdrawal effects each day, and they can exacerbate symptoms of your health issue, including pain. This can also go for natural medicines taken wrongly, or taken for too long a period. This is why it is always important to be properly managed and monitored by a qualified healthcare professional. Have a read about this issue in a previous post (click here to read)

Post surgery care

The facts you need to know about surgery, and everything that should happen afterwards- Part 2

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The second part to “The facts you need to know about surgery, and everything that should happen afterwards”

In this new video blog I talk about the most important part of helping a chronic health issues, and that is the management of an issue post surgery.

All too often people have surgical intervention, but then do nothing as part of the follow up, and this is where many go wrong, and end up back at where they started from

Have a listen to my latest post of this very important subject.

 

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Experts Program

what if they dont find anything

Surgical Intervention- “But what if they don’t find anything?”

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One of the things I often gets asked is “If I have surgery, what if they don’t find anything?”
All sorts of things go around in people head, and rightfully so, but may think that if nothing is found that that their symptoms are all in their head. Not so.
Just because there is nothing found via surgical intervention, does not mean that there is nothing there, or there is no disease state. It just means it cannot be visually seen.
Here in this video I explain all this and more.
Stress and fertility

Busyness, Stress and Anxiety Affecting Fertility & Pregnancy Outcomes

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It is now known that modern day busyness, stress, anxiety and depression can significantly impact a couples chances of conceiving. When helping couples with fertility and achieving a pregnancy, one of the biggest issues I see overlooked is a couple’s emotional health. During the assessment of anyone’s fertility, depression, anxiety and stress scores (DASS) should be taken into consideration. Other assessment methods to look at anxiety and heightened adrenalin should also be utilised. It is so important to touch base on the topic of emotional health and make couples (or those who are single) aware of emotional factors that may be affecting their chances of conceiving.

I always recommend seeing a counsellor/psychologist

I always recommend that everyone should check in regularly with a counsellor/psychologist, but less than 10% of people do. What many do not realise is that their underlying stress, anxiety and other emotional concerns are actually a big part of them not being able to conceive, and that looking after our emotional health is just as important as looking after our physical health. There is research to suggest that a parent’s emotional state can be passed onto a child via the sperm, eggs and the parental mode of inheritance. Everything we put in our body, physically and emotionally, can be passed on to the unborn child. This is crucial to understand before considering having children because at the end of the day, it could affect them greatly.

Identifying the impacts of busyness, stress and anxiety

Another common observation I see when people are trying to conceive is they are adamant that they are not stressed, yet their mood/stress scores say otherwise. Many people have normalised their busyness and running on high levels of adrenaline to the point where they do not equate their heightened emotional states as being stress or anxiety. From an outside perspective, I can physically see how anxious and stressed some people are, but it is often hard for people to self-reflect and understand their emotional state.

Control issues exacerbating anxiety and stress levels

Statistically speaking, women have a higher likelihood of being the driving force behind wanting a baby/family so it is easy to see why they may be more focussed or driven in this regard. This also means that they carry a lot of the stress that comes with that. Unfortunately it is becoming more common to see said people struggle with letting go of control and feeling out of control which leads to underlying stress and anxiety. Occasionally this too leads to stress and instability in their relationships, especially if their partner isn’t stepping up.

The one thing I try to explain to all couples is that when it comes to IVF or assisted reproduction, nobody is in control. Everything is timed and controlled by hormones and medications and nobody can control that. Trying to control everything leads to high stress levels, activated adrenalin, heightened anxiety, and a vicious cycle of feeling like more control is needed. The only thing people can control is what they put in their mouths (food, medications, and supplements), how much they exercise, and how well they care for their emotional health. That is it.

Making the changes you need to do now

So many people try to justify their actions and behaviours with statements such as, “I will slow down and make time for myself once I am pregnant, or once I have the baby.” Any parent will tell you that once a child is born, there is hardly any time for yourself and things get a lot busier. The reality is that you need to work on yourself now, while you have the chance. It is not only important for you, but also for your child.

One of the things I say to future parents is this: “If I gave you your baby right now, what would you have to do to ensure its survival and yours? What changes in your life would you have to make?”

I then let them sit and think carefully about it because in reality, it would mean many changes to one’s life. The honest truth is that despite change often being uncomfortable, changing your life is exactly what you have to do right now to create the baby as well. I also tell parents that if you don’t have time for yourself, to do self-care, or to work on yourself, then you really need to question if you have time to have a child too. I don’t mean this in a bad way. I say it with absolute care and understanding of how demanding life gets when one is a parent.

Counselling needs to be mandatory

This is why it is so important to do counselling whether you are going through IVF or trying to conceive naturally. It is my personal belief that for the benefit of the parent/s and the child, counselling should be mandatory as many issues of not falling pregnant actually stem from high stress levels, anxiety, adrenaline, and an inability to slow down. It all stems back to control, and then lack of control, which then creates anxiety and stress. There can also be relationship dynamic issues that need to be addressed prior to having a baby. All this and more is not a good recipe to make a baby, or achieve a successful pregnancy outcome.

Stress animals don’t conceive and it applies to humans as well

The one thing we know from basic biology is that stressed animals do not conceive or will not carry a pregnancy. Many of our breakthroughs in fertility medicine actually come from vet science, where animals have undergone IVF or forms of assisted reproduction. We often forget as humans, that we too really are just animals.

Numerous studies have indicated how anxiety, stress and heightened adrenaline (common states of existence for many people) have a detrimental effect on egg quality, sperm quality, embryo quality, implantation, and overall pregnancy rates.

How busyness, stress and anxiety affect fertility and pregnancy outcomes

Going through IVF, or just trying to fall pregnant, is often described as the most stressful event in the lives of some couples. This is even more heightened if there are difficulties in achieving a pregnancy. There is increasing evidence that psychological factors, such as busy lifestyle, stress, anxiety and depression, have a negative impact on IVF and pregnancy outcomes.

Research studies have shown that the high levels of stress, anxiety and depression are significantly related to the treatment outcome in IVF and also achieving a natural pregnancy (Expert Review of Obstetrics & Gynaecology.2008- See diagram for how stress affects pregnancy outcomes).

Stress pathway

The autonomic nervous system is affected by busyness, stress, anxiety and depression. This also leads to increased neuroepinephrine and increased epinephrine, which then leads to vasoconstriction and decreased blood flow into the uterus. It can also lead to increased stress within the uterus itself.

The immune system is also affected by increased Tumour Necrosis Factor (TNF), which is a cell signalling protein (cytokine) involved in systemic inflammation. The immune system is also affected by increase in Natural Killer Cells and increased activated T cells, which then lead to reduced implantation and a stressed uterine environment.

The indirect effects of stress are that people will drink more alcohol, smoke, exercise less, sleep less, eat more junk foods and generally have a poor diet and lifestyle, all of which have a direct effect on fertility also.

In summary

In summary, lifestyle interventions and taking care of one’s emotional wellbeing can help reduce stress, anxiety and adrenaline. This should be a priority for all couples trying to conceive, or for those having difficulties conceiving. Body-Mind Medicine and Traditional Chinese Medicine have long understood that stress, diet, lifestyle and emotional factors are a huge cause of infertility. Modern medicine and research is now validating this and advocating for proper preconception care. By addressing the known possible emotional and lifestyle factors that affect fertility by utilising preconception care and a multimodality approach (including counselling and psychology), people can greatly improve their fertility, successful pregnancy outcomes, as well as improve their overall health.

Final Word

If you are having trouble conceiving please call our friendly staff and find out how our fertility program may assist you in having a baby. Our fertility program uses a multimodality, ‘no stone left unturned’ approach which looks at both the male and female aspects of fertility, is used alongside medical interventions, and also gives you access to counsellors and psychologists who have a special interest in fertility.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-The International Fertility Experts

-The Experts Program

References

  1. Paulson JF, Bazemore SD. Prenatal and Postpartum Depression in fathers and its association with maternal depression: a meta-analysis. JAMA. 2010;303(19):1961-1969. doi:10.1001/jama.2010.605
  2. Effects of caffeine, alcohol and smoking on fertility, http://yourfertility.org.au/resource/effects-of-caffeine-alcohol-and-smoking-on-fertility/
  3. Evans J, Heron J, Francomb H, Oke S, Golding J. Cohort study of depressed mood during pregnancy and after childbirth. BMJ. 2001;323(7307):257-60.
  4. Akioyamen LE, Minhas H, Holloway AC, Taylor VH, Akioyamen NO, Sherifali D. Effects of depression pharmacotherapy in fertility treatment on conception, birth, and neonatal health: A systematic review. Journal of Psychosomatic Research. 2016;84:69-80.
  5. Cesta CE, Viktorin A, Olsson H, Johansson V, Sjolander A, Bergh C, et al. Depression, anxiety, and antidepressant treatment in women: association with in vitro fertilization outcome. Fertility and Sterility. 2016;105(6):1594-602 e3.
  6. Sejbaek CS, Hageman I, Pinborg A, Hougaard CO, Schmidt L. Incidence of depression and influence of depression on the number of treatment cycles and births in a national cohort of 42,880 women treated with ART. Human Reproduction. 2013;28(4):1100-9.
  7. Ververs T, Kaasenbrood H, Visser G, Schobben F, de Jong-van den Berg L, Egberts T. Prevalence and patterns of antidepressant drug use during pregnancy. Eurpean Journal of Clinical Pharmacology. 2006;62(10):863-70.
  8. Grigoriadis S, VonderPorten EH, Mamisashvili L, Tomlinson G, Dennis CL, Koren G, et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. Journal of Clinical Psychiatry. 2013;74(4):e321-41.
  9. Deave T, Heron J, Evans J, Emond A. The impact of maternal depression in pregnancy on early child development. BJOG. 2008;115(8):1043-51.
  10. Ross LE, Grigoriadis S, Mamisashvili L, VonderPorten EH, Roerecke M, Rehm J, et al. Selected pregnancy and delivery outcomes after exposure to antidepressant medication. A systematic review and meta-analysis. Outcomes after antidepressant use in pregnancy. JAMA Psychiatry. 2013:1-8.
  11. Rich-Edwards JW, Spiegelman D, Garland M, Hertzmark E, Hunter DJ, Colditz GA, Willett WC, Wand H, Manson JE. 2002. “Physical activity, body mass index, and ovulatory disorder infertility.” Epidemiology 13:184-190.
  12. Palomba, S, Falbo A, Valli B, et al. 2014. “Physical activity before IVF and ICSI cycles in infertile obese women: an observational cohort study.” Reproductive Biomedicine Online, 29(1): p. 72-9.
  13. Ferreira RC, Halpern G, Figueira Rde C, Braga DP, et al. 2010. “Physical activity, obesity and eating habits can influence assisted reproduction outcomes.” Womens Health [Lond Engl] 6:517-524.
  14. Kucuk M, Doymaz F, Urman B. 2010. “Effect of energy expenditure and physical activity on the outcomes of assisted reproduction treatment.” Reproductive Biomedicine Online 20:274-279.
  15. Morris SN, Missmer SA, Cramer DW, Powers RD, McShane PM, Hornstein MD. 2006. “Effects of lifetime exercise on the outcome of in vitro fertilization.” Obstetrics and Gynecology 108:938-945.
  16. Green BB, Daling JR, Weiss NS, Liff JM, Koepsell T. 1986. “Exercise as a risk factor for infertility with ovulatory dysfunction.” American Journal of Public Health 76:1432-1436.
  17. Gudmundsdottir SL, Flanders WD, Augestad LB. 2009. “Physical activity and fertility in women: the North-Trondelag Health Study ” Human Reproduction 24:3196-3204
Menstrual issues traced back to age 13

Many Fertility & Women’s Health Issues Could Be Traced Back To Mismanagement At Around Age 13

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Early this week,  I was talking with a colleague about how I would love to be able to see all women before they head into IVF, or see them when they were a teenager to educate them and help the with a better future for their fertility and gynaecological health.

My colleague then said to me “The issue is that most women are mismanaged at around age 13 and this is why they end up having fertility issues and ongoing gynaecological and menstrual related issues later on.”

The truth is, if we really to trace back the cause, or start of a woman’s fertility, gynaecological, or menstrual related issues, it would most likely be due to mismanagement at around age 13 when she first got her period. In this video I bring light to this very introspective, and very interesting topic that many probably have not thought about. It isn’t always mismanaged by the people you think it is either.

Let’s bring better education and awareness to women’s health issues because we know that early intervention and early management if the key to better future outcomes. It all starts with education first. Have a listen to my video on this very important topic (click on the youtube video link to watch

If you, or your daughter needs help with a menstrual issue, or period pain etc, please give my friendly staff a call and ask how I may be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-Master of Reproductive Medicine

-The Endometriosis Experts

-The Experts Program

Lets talk about sex 1

Let’s Talk About Sex- How often, what’s normal & how to boost that libido

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Sex is something that nearly every human on this planet gets to experience, and for each person, the experience of sex can be different. Many people have different perceptions on this important topic, so lets talk about sex, how often, what’s normal and how to boost that libido in those having issues.

As a healthcare practitioner who is a Master in Women’s Health Medicine and a Master of Reproductive medicine, I have to talk about the topic of sex on a daily basis. A lot of people come into my clinic (both men and women) with varying expectations and thoughts on what is normal, when concerning sex. Unfortunately a lot of people are way off the mark when it comes to a healthy sex life and what a healthy libido should be.

Libido is influenced by our health

If you do not have a healthy libido, there could be something wrong with your health. Yes, what you eat, think, do etc, all plays a part in your sexual appetite. But, we can all have differing libido’s and it is important to understand this and seek help if you are having issues. A healthy libido is a sign of a health body and healthy mind.

What defines a healthy sex life

The average healthy human being in a healthy relationship should be having sex at least 1-3 times per week, depending on age etc. I know a lot of you are lucky to be having sex 3 times per month.

What’s concerning about this is, some of these people are trying to have a baby and can’t understand why they aren’t falling pregnant. The answer is obvious, but, I’ll say it anyway, you have to have sex regularly to fall pregnant and it has to be at the right time. You need to be trying every day, or every second day of your cycle as we now know ovulation just doesn’t take place mid-cycle only.

Clinical research shows that more than 70% of people are ovulating before day 10 and after day 17 of their cycle. So if you are just trying it that small window of day 10-16, this could be the reason you aren’t falling. Btw, don’t stop having sex just because you are doing IVF. Sex (climax in particular) helps with implantation so stopping having sex is only hindering your chances of conception. I have talked about this is a previous post (click here to read)

We also now know that sperm also play a part in a health menstrual cycle as they help to trigger certain hormones to trigger ovulation and thus help with regulation of the menstrual cycle. It may explain why women using barrier methods of contraception have more issues with irregular cycles and menstrual issues. Not that we are promoting unsafe sex mind you. This is for couples in a healthy relationship. I have spoken about this is a previous post too (click here to read)

Why is climax/orgasm so important

Climax also stimulates blood flow into the uterus; helps trigger certain hormones and also helps with implantation. Climax also helps ones libido and it can even help in the treatment of depression.

We also hear the jokes about men and their ever-constant desire to have sex, but most of the time this is greatly exaggerated. In practice I am actually seeing that women are now the ones with the higher libidos and it is the men that are having all the problems. Stress is a big factor these days. We are also seeing many men with testosterone deficiency. Being overweight and unhealthy physically and mentally can be a factor also.

It has also been shown that regular sex, even if scheduled, actually helps with the libido and helps with the desire around wanting more sex.

Understanding differing libido’s

Men and women are different when it comes to libido and the desire around sex. Men need to understand that it can often take all day for a woman to arouse her desire around wanting sex. Men need to know that women need to be wooed, given playful thoughts, mind play and a place to feel safe to get her into the mood for sex. Guys, apparently helping out around the house also helps (hint, hint)

Intimacy is more than just sex

Remember sex is a healthy part of a relationship and a healthy libido shows good health. Sex is also a way of connecting with your partner and couples should find way to prioritise each other so that this connection happens regularly. It is also about intimacy and that sacred intimacy, which is on a whole other level to the physical act of just having sexual intercourse.

What affects a libido?

Many people do talk about having differing libido’s, or having trouble with libido, and it is important to understand what may be affecting ones sex drive.

So, what are some of the main things that effect libido?

  • The Pill – First and foremost, the pill for women. Anything that decreases fertility can decrease your sexual desire. The pill also turns off certain receptors responsible for conception, which can then turn off the libido.
  • Stress – Constant low grade, or high grade stress, is a big problem when it comes to loss of libido. It can cause impotence & erectile dysfunction in men and loss of libido and menopausal symptoms in women.
  • Medications – Drugs such as anti-depressants, the pill, anti-inflammatories, and lots of other medications can ruin your sex life. They can also delay or stop orgasm. There are some that can improve it too. Not many!
  • Alcohol and recreational drugs– This one is pretty self explanatory. We’ve all heard the saying ‘Fosters flop’ from drinking too much beer. Drugs such as marijuana, speed, and other illicit drugs can all impair libido
  • Sexual Abuse– A history of sexual abuse can definitely affect the sex life. This needs to be dealt with by speaking to a counsellor, psychologist or sex therapist.
  • Health Problems– Health problems such as Low Thyroid, Diabetes, being overweight, depression, eating disorders, can interfere with your libido and sex life.
  • STD’s– Some STD’s are often undetected and cause pain and discomfort during sex, which leads to not wanting to have sex. Many of these can be cleared up with medication so that your sex life can return to normal. Some STD’s are there for life but can be controlled. STD’s such as herpes and HIV don’t have to stop your sex life.
  • Gynaecological issues – Some gynaecological disease states such as Endometriosis and Adenomyosis can make sex painful and cause a lack of desire. Have a read of my article about painful sex. Women with PCOS can have low libido as a result of hormonal fluctuations and insulin resistance.
  • Diet– This is a big one. If you eat the wrong foods the body will respond accordingly. Your sex life can be ruined by what you put in your mouth to sustain your body.
  • Exercise– Over-exercising can stop you getting a period and cause fertility issues in both men and women. Reduce the exercise and the libido will respond accordingly. Exercise can also increase libido. It is about moderation.

Final Word

If you are having trouble with your libido there are many medical and natural products that have been shown to assist with low libido and help with a healthy sex life for both men and women. It is important that you talk to a qualified healthcare practitioner about issues to do with sex and libido. You need to see an expert who is trained to know issues that may be causing your particular issues. The can also give you dietary and lifestyle advice to help in this area too.

If you do need help with issues around sex and libido, please give my friendly staff and call and find out how I can assist you. I also have a great network of sex therapists, psychologists and medical specialists I work in with as well.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-Master of Reproductive Medicine

-The Women’s Health Experts

 

 

couple in love

Sex Around The Time of Embryo Transfer Increases The Likelihood of Successful Early Embryo Implantation and Development.

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Research has now shown that sex around the time of embryo transfer increases the likelihood of successful early embryo implantation and development.

Intercourse during an IVF cycle has the potential to improve pregnancy rates and there is adequate research to now back this up. We know that in animal studies, exposure to semen is reported to promote embryo development and implantation.

Intercourse may assist implantation

This is actually good news for humans as well as it shows that intercourse may act to assist implantation. Animal studies reveal that exposure to seminal plasma, the fluid component of the ejaculate, is particularly important for achieving normal embryo development and implantation. Animals that become pregnant through artificial insemination or embryo transfer without being exposed to seminal plasma have substantially lower rates of implantation than those exposed to seminal plasma (Pang et al., 1979; Queen et al., 1981; O et al., 1988; Flowers and Esbenshade, 1993), while rodents inseminated with spermatozoa prior to blastocyst transfer also have a higher rate of implantation compared with those not exposed to spermatozoa (Carp et al., 1984).

Intercourse may influence pregnancy success rates

A multicentre prospective randomised controlled trial was conducted through IVF centred around the world, including Australia. The study was conducted to determine if intercourse around the time of embryo transfer, or just before and embryo transfer in an IVF cycle, actually has the potential to have any influence on pregnancy success rates.

Participants in Australian IVF clinics underwent frozen embryo transfer (FET) and participants in Spain IVF clinics did fresh embryo transfer. Participants were randomised to either have intercourse, or to abstain from intercourse around the time of embryo transfer.

The study showed that there was no significant difference in the pregnancy rates between those couples that abstained and those that had intercourse. However, the portion of transferred embryos that made it to 6-8 weeks gestation was significantly higher in the women exposed to semen compared to those who abstained.

This landmark multi-centre international study showed that women who had sex around the time of embryo transfer, and who were exposed to semen around the time of embryo transfer, had increased likelihood of successful early embryo implantation and development.

Couples need to be having more sex during IVF cycles

One of the things that I always promote as part of my fertility program, is that regular sex is so important for our fertility patients, on many levels. Sometimes the obvious eludes some people though.

One of the things we see quite regularly is that couples doing Assisted Reproduction (ART) are abstaining from sex fearing it will affect their chances of conceiving. Actually the opposite is true. By not having sex during ART cycles (IUI, IVF etc) you are affecting your chances of conception.

I have spoken about the importance of sex and orgasm assisting implantation in other posts and there is so much medical research to back this up. This is seen in the research I have talked about above.

Let’s be real and look at the facts

Let ask the question “If you were trying naturally, would you stop having sex for fear that conception has taken place?”

Then why would you stop having sex around an ART cycle?

Let’s face the facts, implantation takes place in the uterus, and not the vagina, and no man is that well endowed to even penetrate the cervix, so…. Let’s get a grip here

The question to ask is “What does an embryo feed off and need to successfully implant?”

The answer is blood!

Think of a tick borrowing into skin to feed off its host.

How do you get blood flow into the uterine lining?

The answer is that sex and climax stimulate blood flow to the lining to assist implantation and also prepare the lining for implantation. Nature has given us all the tools for healthy conception to take place, and yet many of us just aren’t using them.

Sex is more than just and egg and a sperm

Don’t forget that regular sex during this time not only helps assist implantation, but it also helps with the bonding process and physical connection process during this stressful time. Many couples split up because of losing this connection during the ART process and sex is a way of keeping that physical and emotional connection. Sex also tells your body you are also preparing to conceive on another level too.

For those doing IVF etc, next time you are doing an ART cycle maybe it is time to start doing things the way nature intended to give you that boost you so desperately are needing. Go get busy people

Final Word

If you are struggling to fall pregnant, or need advice with preconception care, please give my friendly staff a call and find out how my fertility program, which has helped over 12,500 babies into the world, may be able to assist you too.

Regards

Andrew Orr

– No Stone Left Unturned

-Master of Reproductive Medicine

-Master of Women’s Health Medicine

-The International Fertility Experts

References:

  1. http://humre.oxfordjournals.org/content/15/12/2653.short…
  2. Bellinge, B.S., Copeland, C.M., Thomas, T.D. et al. (1986) The influence of patient insemination on the implantation rate in an in vitro fertilization and embryo transfer program. Fertil. Steril. , 46, 252–256.
  3. Carp, H.J.A., Serr, D.M., Mashiach, S. et al. (1984) Influence of insemination on the implantation of transfered rat blastocysts. Gynecol. Obstet. Invest. , 18, 194–198.
  4. Coulam, C.B. and Stern, J.J. (1995) Effect of seminal plasma on implantation rates. Early Pregnancy , 1, 33–36.
  5. Fishel, S., Webster, J., Jackson, P. and Faratian, B. (1989) Evaluation of high vaginal insemination at oocyte recovery in patients undergoing in vitro fertilization. Fertil. Steril. , 51, 135–138.
  6. Franchin, R., Harmas, A., Benaoudia, F. et al. (1998a) Microbial flora of the cervix assessed at the time of embryo transfer adversely affects in vitro fertilization outcome. Fertil. Steril. , 70, 866–870.
  7. Franchin, R., Righini, C., Olivennes, F. et al. (1998b) Uterine contractions at the time of embryo transfer alter pregnancy rates after in-vitro fertilization. Hum. Reprod. , 13, 1968–1974.
  8. Marconi, G., Auge, L., Oses, R. et al. (1989) Does sexual intercourse improve pregnancy rates in gamete intrafallopian transfer? Fertil. Steril. , 51, 357–359.
  9. Pang, S.F., Chow, P.H. and Wong, T.M. (1979) The role of the seminal vesicles, coagulating glands and prostate glands on the fertility and fecundity of mice. J. Reprod. Fertil. , 56, 129–132.
  10. Qasim, S.M., Trias, A., Karacan, M. et al. (1996) Does the absence or presence of seminal fluid matter in patients undergoing ovulation induction with intrauterine insemination? Hum. Reprod. , 11, 1008–1010.

 

Sperm meets an egg

Regular sex found to trigger ovulation in females & make them more fertile.

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Regular sex isn’t just beneficial for ones health, physical and mental well being and happiness.  Researchers have now found that regular sex and a protein in seminal fluid actually helps to trigger ovulation in females and make them more fertile to sustain a pregnancy.

Semen isn’t just a vehicle for carrying sperm

Semen isn’t just a vehicle for carrying sperm and studies actual now show that it also plays a crucial role in triggering ovulation. Researchers have discovered the protein in the seminal 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.

The international team of researchers at the University of Saskatchewan, found this protein in a variety of mammals and say it plays an important role in reproduction in all mammals.

Male mammals have accessory sex glands that contribute seminal fluid to semen, but the role of this fluid and the glands that produce it are not well understood. From the results of the research, it is now understood that these glands produce large amounts of a protein that has a direct effect on the female brain and reproductive organs.

Ovulation Inducing Factor (OIF)

The protein, which was dubbed the ‘ovulation-inducing factor’ (OIF), works through the hypothalamus of the female brain. This part of the brain links the nervous system to the endocrine system (a system of glands that secrete hormones into the blood stream) via the pituitary gland.

The idea that a substance in mammalian semen has a direct effect on the female brain is not a new one, but now there is research to back these theories up. The scientists also discovered it is the same molecule that regulates the growth, maintenance, and survival of nerve cells.

OIF affects ovulation and fertility

In this study, they also looked at how OIF not only affected ovulation in females, but how it also affected their fertility and chances of a pregnancy.

For the purposes of the study, the research team looked at two species of mammals, that being llamas and cattle. They did this because Llamas are ‘induced ovulators, meaning that they ovulate only when they have been inseminated. Cows and humans on the other hand are ‘spontaneous ovulators,’ meaning that a regular build up of hormones stimulates the release of an egg.

Using a variety of techniques, the researchers found OIF present in semen samples taken from both animals. However, when they injected the llamas with this protein it caused them to ovulate. The same effect wasn’t seen in cattle.

While OIF didn’t appear to induce ovulation in spontaneous ovulators, such as cows and human, it did affect fertility in different ways. The protein was found to effect the timing of when cattle developed follicles (fluid-filled sacs in the ovary which carry the eggs). The researcher also found that OIF promoted the development of a temporary endocrine structure needed to sustain pregnancy.

Research has broaden our understanding of ovulation and fertility

This research definitely helps to broaden our understanding of the mechanisms that regulate ovulation and also helps to raises some interesting insights into fertility. More research is needed to see what role OIF plays in human fertility, as the researchers suspect it will be exactly the same. The study appeared in the Proceedings of the National Academy of Sciences.

It is great to see this research getting out there and this is something that I have promoted and taught for ages. It is great to see actual research to back up what I have teaching for years. Let’s face it, many of our advancements in fertility have actually come from veterinary science through use of IVF in cattle.

Couples undergoing IVF need to be having more sex

This is also great research that showed why couples trying to have a baby, or undergoing fertility treatments (IVF etc) need to still be having sex. It isn’t rocket science, yet so many people forget basic biology and that we are actually still an animal.

The problem is that so many couples actually stop having sex when doing assisted reproduction such as IVF. While I can totally understand the whole emotional aspect of why, it is still hindering their chances of conception and having a successful pregnancy. It is a truth that must be talked about and also get couples to understand.

Regular sex also helps with connection for the couple

I am always telling them how important it is to still have an active sex life, for the benefit of a happy, healthy relationship. It is also about the connection and not just about having sex. We do see so many couples split up while undergoing IVF and assisted reproduction, and some of this is purely due to lack of bonding and connection with their partner.

But even so, regular sex and intercourse also gives the chance of a natural pregnancy too, no matter how slim the chance for some couples. We still see couples that have done multiple cycles of IVF still conceiving naturally, but you actually have to have sex for this to happen.

Now we have research, which shows that a protein in seminal fluid actually acts as a hormonal signal that actually triggers ovulation, improves egg quality and may in fact make a woman more fertile for a pregnancy to take place. Again, when you look at this logically, it really is not rocket science and really is easy to understand.

Regular sex while doing IVF improves pregnancy rates.

This is why it is so important for all our couples using ART (Assisted Reproduction Therapy) and IVF to still keep having sex. Regular sex and more importantly regular climax, increases your sex hormones, helps regulate hormones, increases blood flow to the uterine lining, helps with libido, helps with egg quality, helps for better ovulation and most of all improves your fertility and the chance of sustaining a pregnancy. There is also research to show that regular sex before and after IVF transfer, improves pregnancy rates and I will talk about this research in another article on it’s own.

Final Word

If you are struggling to have a baby, and need help with fertility issues, then talk to my friendly staff about how our fertility program might be able to assist you. It has helped over 12,500 babies into the world… and counting.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-Master of Women’s Health Medicine

-The International Fertility Experts

 

 

Frequently asked questions about ovarian cancer screening 2

Frequently asked questions about screening for ovarian cancer

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I have recently put up a post about ovarian cancer and as usual lots of people had question about the symptoms and also about proper screening. Just like many other serious health issues, there are lots of myths out there and why it is important to talk about the facts only.

Before I go into the frequently asked questions about screening for ovarian cancer, I do need to say this. If you do have bloating, or some of the other common symptoms of ovarian cancer, please don’t get all anxious and run off thinking you have ovarian cancer.

Many of these symptoms can be indicative of endometriosis and adenomyosis too. This is why it is important to talk to your healthcare practitioner, or specialist about any concerns you have around any of the symptoms you may be getting. Early intervention and detection is the key to any disease, and ovarian cancer is exactly the same. Either way it is worth seeing someone a specialist in this field.

If you do have any of the symptoms from my post on ovarian cancer, please talk to your healthcare practitioner about a referral to an expert, or specialist in this field and get assessed properly.

Frequently asked questions about ovarian cancer screening

This information covers screening for ovarian cancer i.e. the testing of women at population risk who have no symptoms that might be ovarian cancer. This information has been developed to support discussion with a woman about screening for ovarian cancer. Most of this can be found at the Australian Cancer Council (www.cancer.org.au)and the National Breast and Ovarian Cancer Centre (www.nbocc.org.au)

Is there a screening test for ovarian cancer?

No. There is currently no evidence to support the use of any test, including pelvic examination, CA125 or other biomarkers, ultrasound (including transvaginal ultrasound), or a combination of tests, to screen for ovarian cancer.

A Pap test does not detect ovarian cancer; it is only used to screen for cervical cancer.

What about the CA125 blood test?

CA125 is a protein found in the blood. It is known as a tumour or cancer marker. Increased levels of CA125 may indicate ovarian cancer. However, there are many other conditions that can affect CA125 levels such as ovulation, menstruation, endometriosis, benign ovarian cysts, liver or kidney disease, and other cancers such as breast or lung cancer.

If CA125 levels are not raised, this does not completely rule out ovarian cancer, as about 50% of women with early-stage ovarian cancer have normal CA125 levels.

For these reasons, the CA125 test alone should not be used as a screening test for ovarian cancer. It can be used in the assessment of symptoms that may be ovarian cancer.

Can an ultrasound be used as a screening test?

A transvaginal ultrasound (TVUS) gives the best picture of the ovaries but while able to detect the presence of ovarian disease, a TVUS cannot distinguish between benign and malignant disease.

For this reason, transvaginal ultrasound should not be used as a screening test for ovarian cancer.

What if a woman decides she still wishes to have a CA125 blood test or ultrasound?

She should be informed that if either a CA125 or an ultrasound test is abnormal, it may be necessary to repeat the test, or to undertake further tests, which may include surgery to investigate the abnormal result.

The discovery and investigation of abnormal findings can result in unnecessary anxiety and the investigations can carry significant risks.

Final word

I hope this explains a few of the fact around screening for ovarian cancer and helps people understand why some perceived screening methods are not reliable. For more information, you should always talk to your healthcare practitioner, or specialist, and never ever diagnose yourself based on some stupid google search. Always see a qualified healthcare professional for all your healthcare advice. Your life could depend on it.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-Master of Reproductive Medicine

-The Women’s Health Experts