Category Archives: Dr Andrew Orr

The link between endometriosis and cancer

The Link Between Endometriosis & Cancer

Posted on by

One of the most common questions that I get asked from women with endometriosis is “Is there a link between endometriosis and cancer?”

There has been many research papers on this and there is some evidence to suggest that women with endometriosis may have a higher risk of certain cancers such as endometrial cancer and also ovarian cancer.

We all know that Endometriosis is a debilitating disease, but many people don’t realise the possible future implications of this disease, mixed with our highly inflammatory diets and lifestyle. Unfortunately it is a recipe for any inflammatory disease, and for expression of cancer cells.

There have been many reputable studies to date showing the link between inflammation and cancer and endometriosis is definitely an inflammatory disease that needs proper management otherwise some studies are now suggesting it could be a precursor to certain cancers.

This isn’t meant to scare anyone either. It is just to help people realise the possible implications of this disease and to be more proactive around getting yourself and your body healthier and also being properly managed by a qualified health professional. When it come to cancerous states, prevention is key and early intervention is also.

Better education is needed

Given that, we need to really take this disease more seriously than many people with the disease and many in the medical community probably realise. Prevention is always the key to any disease and even though endometriosis cannot be prevented, early intervention and ongoing management of the disease is crucial. This is why I think all young girls should be educated about what a proper menstrual cycle should be like and that period pain is not normal. There also needs to be proper education about diet and lifestyle interventions with inflammatory diseases, such as endometriosis, and how it also needs a multimodality approach to be managed properly.

Endometriosis is like cancer in many ways

Endometriosis, like cancer, is characterised by cell invasion and unrestrained growth. Furthermore, endometriosis and cancer are similar in other aspects, such as the development of new blood vessels and a decrease in the number of cells undergoing apoptosis. In spite of these similarities, endometriosis is not considered a malignant disorder.

The possibility that endometriosis could, however, transform and become cancer has been debated in the literature since 1925. Mutations in the certain genes have been implicated in the cause of endometriosis and in the progression to cancer of the ovary (Swiersz 2006). There is also data to support that ovarian endometriosis could have the potential for malignant transformation. Epidemiologic and genetic studies support this notion. It seems that endometriosis is associated with specific types of ovarian cancer (endometrioid and clear cell) (Vlahos et al, 2010). The relationship between endometriosis and ovarian cancer is an intriguing and still poorly investigated issue. Specifically, histological findings indicate a definitive association between endometriosis and endometrioid/clear cell carcinoma of the ovary (Parihar & Mirge 2009).

Women with endometriosis may be more prone to certain cancers

There are recent studies which have shown that mutations in the certain genes found were identified in 20% of endometrial carcinomas and 20.6% of solitary endometrial cysts, played a part in the development of ovarian cancers. In addition to cancerous transformation at the site of endometriosis, there is recent evidence to indicate that having endometriosis itself may increase a woman’s risk of developing non-Hodgkin’s lymphoma, malignant melanoma, and breast cancer (Swiersz 2014).

Women with endometriosis appear to be more likely to develop certain types of cancer. Brinton, PhD, Chief of the Hormonal and Reproductive Epidemiology branch at the National Cancer Institute has studied the long-term effects of endometriosis, which led her to Sweden about 20 years ago. Using the country’s national inpatient register, she identified more than 20,000 women who had been hospitalised for endometriosis.

After an average follow-up of more than 11 years, the risk for cancer among these women was elevated by 90% for ovarian cancer, 40% for hematopoietic cancer (primarily non-Hodgkin’s lymphoma), and 30% for breast cancer. Having a longer history of endometriosis and being diagnosed at a young age were both associated with increased ovarian cancer risk (Brinton et al, 1997).

Farr Nezhat, MD, Chief of Gynecologic Minimally Invasive Surgery and Robotics at St. Luke’s and Roosevelt Hospitals in New York City and Professor of Obstetrics and Gynecology at Columbia University, spoke on the pathogenesis of endometriosis and ovarian cancer. According to a 2000 study of women with ovarian cancer by Hiroyuki Yoshikawa and colleagues, endometriosis was present in 39% of the women with clear cell tumours and 21% of those with endometrial tumours. The studies clearly suggest that Endometriosis may be the precursor of clear cell, or endometrial ovarian cancer (Yoshikawa et al, 2000).

Inflammation and Estrogens are a big factor in many cancers

If you combine inflammation with oestrogen as with both endometriosis and ovarian or uterine cancers, it’s going to be a vicious circle, as the 2 diseases share numerous other characteristics. For example, both are related to early menstrual cycles and late menopause, infertility, and inability to fall pregnant. Any factors that relieve or offer protection against both conditions need to be explored, including dietary and lifestyle changes etc.

Some authors also suggest that there is an also increased risks of colon cancer, ovarian cancer, thyroid cancer non-Hodgkin’s lymphoma and malignant melanoma in women with endometriosis when compared with the general population (Brinton et al, 2005).

Proper management and early intervention is crucial

If you do have patients with endometriosis you do need to take into consideration the future implications of this disease, not only the pain and turmoil it causes on the way, but also the future possibility that endometriosis could also lead to cervical cancer, ovarian cancer, or many of the other cancers that can be found in the body.

There are certain medications, both natural based and medical that can great assist in the treatments and management of endometriosis and microscopic endometriosis implants. These do need to be explored and we now have the Royal College of Obstetricians and Gynaecologists recommending diet and lifestyle changes and to use complementary medicine such and Chinese Herbal Medicine and Acupuncture for the the management and treatment of endometriosis. This is recommended alongside medical interventions and it does get back to a multimodality approach is the key factor in proper management of this disease.

Diet and lifestyle changes are crucial in cancer prevention

There have been numerous studies showing the benefits of a low inflammatory based diet and reduction in lifestyle factors such as stress. These things are also crucial in any inflammatory disease and certainly in cancer prevention.

Anyone with endometriosis does need to be following anti-inflammatory diet, with reduced refined foods and increased whole foods. This is something I promote whole-heartedly and see great results with on a daily basis. It is also part of my PACE- Diet and Lifestyle program. PACE meaning (Paleo/Primal Ancestral Clean Eating) .

This style of diet is very much like the mediterranean diet which is now shown to be one of the best diets in the world to help with cancer prevention and reduction of cardiovascular disease. It is something that has been shown to assist with inflammatory diseases such as endometriosis. This can be done alongside supplements such as omega 3 oils and antioxidants that also offer protection and prevention against inflammatory diseases too. You should also talk to a qualified healthcare professional about diet and lifestyle interventions and supplementation.

See an Endometriosis Expert

Hope that helps everyone to understand why it is so important to really make some proactive changes if you do have endometriosis. You really need to explore as many options as you can when trying to manage this disease and halt its progression. It is also important to see an endometriosis expert and not try and manage this disease yourself. You just should not be doing this and it is not effective management. Always see an appropriately trained healthcare professional who is trained in endometriosis and other disease states in women. We don’t want to see it end up as cancer later on and this is why it is so important to make sure you are being appropriately managed now.

Final Word

If you do need help with endometriosis, and the associated symptoms of endometriosis, give my friendly staff a call and find out how I can help you. Always remember that early intervention is the key and being managed properly is also crucial.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-Master of Women’s Health Medicine

-The Endometriosis Experts

Untitled design 10

Breast Cancer Awareness

Posted on by

Breast cancer awareness is something that everyone should know about. Mankind has known breast cancer since ancient times. In 460 B.C. Hippocrates explained breast cancer as a disease caused by an excess of black bile, or “Melancholia”. He named the condition ‘Karkinos’- (Cancer)- the Greek word for crab and the astrological constellation. This was because the tumor seemed to have tentacles which reached out into the surrounding breast tissue, resembling the legs of a crab.

The history of Breast Cancer

This theory of Hippocrates held for many centuries until 1680, when the French physician Francois de la Boe Sylvius suggested that Breast Cancer developed from an increase in the disruptions of the acidity of local lymphatic fluids.

There were many theories that followed including celibacy causing breast cancer, too much rigorous sex causing disruption to the local lymph drainage and thus causing breast cancer and others linking breast cancer to mental disorder-the melancholia references again.

In 1757 Dr Henri Le Dran was the first person to suggest that the surgical removal of the tumor was the most effective treatment, provided all the lymph nodes in the armpits were removed. This must have been a horrific prospect prior to anaesthetic and proper sterilised surgical procedures. The survival rates were appalling, due to immediate death post surgery from the high infection rates. It wasn’t until 1976 that advancement in radiation and chemotherapy actually took place. This really isn’t that long ago and the first mammogram trails showing reduction of breast cancer due to early screening, where only initiated in 1989. To think that in such a short spam of time, we now have this as a routine screening tool that can save lives.

It wasn’t until 1994 that scientist have isolated the first of the genetic mutations associated with breast cancer and these genetic screening for the gene mutations and being predisposed to breast cancer. This screen has led to Angelina Jolie having a double mastectomy when testing revealed she had the BRCA1 gene mutation which predisposed her to both ovarian and breast cancer. It was estimated that Jolie had an 87% risk of breast cancer and a 50% risk of ovarian cancer. Jolie’s mother died at 59 from the disease in 2007.

Since Angelina Jolies decision, there was a surge in enquiries around genetic testing and medical evaluation as to breast cancer risks across all parts of the world.

Breast cancer remains the most common malignancy in women, comprising 18% of all female cancers and there is 1 million cases of breast cancer diagnosed worldwide. Most women will know someone who has had the diagnosis, based on these figures.

Despite all the testing and screening it is estimated that about 40% of women have never discussed their risk factors with there doctor, or health care practitioner.

So what can you do to reduce your risks?

The first thing anyone can do is check yourself for any noticeable signs of changes to the breast. You can also have a routine breast examination at your doctor.

Next is regular mammogram, or ultrasound screening, followed by biopsy if anything suspicious is found. Screening for genetic predisposition is another tool that should be used by all women too. About 10% of breast cancer in developed countries is due to genetic predisposition. Certain populations of people have higher genetic risk factors with the Ashkenazi Jewish population having the highest risk factors and well as risk factors for some rare genetic diseases.

The good thing with early screening and detection is that we have now seen in increase in survival rates with the increase between 72-89%.

There are also other risk factors that people need to take into consideration. Women who have their menstrual cycle too early and those who go into menopause later in life are at increase risk of developing breast cancer. Having a baby later in life also increases the risk factor for cancer. Having a baby after 35 years old doubles the risk, while having children earlier reduces the risk. Breast-feeding also reduced the risk of breast cancer too.

Obesity and lifestyle factors increasing breast cancer risks

Obesity and increased alcohol intake also increases a woman’s risk and doubles the chances of having breast cancer. Obesity doubles a woman’s risk factors in postmenopausal women and increased alcohol intake (3-6 standard drinks per day) also doubles the risk factors.

Women on the combined pill also have in increased risk of breast cancer, while progesterone only options do not increase the risk.

Lifestyle modifications

Since there is compelling evidence alcohol and obesity increase the risk of breast cancer, women do need to reduce their alcohol intake and also aim to keep their weight within a healthy range.

This is why we all need to be looking at anti-inflammatory based diets, free from inflammatory wheat grains, excess refined soy products, alcohol, refined foods and refined sugars. These highly inflammatory based foods all lead to excess blood sugars, which in turn spike insulin product. This then causes interference to hormone metabolism (namely estrogens) and also causes the body to store fats and stops the burning of fats, again interfering with estrogen metabolism. This is turns causes inflammation, which is he cause of many of our disease states and leading causes of death.

This is why I always promote a Primal based, low inflammatory, clean eating diet. This is the basis for my PACE-Diet and Lifestyle program (Paleo/Primal Ancestral Clean Eating) that I promote to my patients. This style of diet promotes leans meats, fresh fruits, nuts, seeds, good fats, fresh vegetables and salads, clean water etc. This is very similar to the famous Mediterranean diet, which has to date never been scrutinized and has lot of research behind it. Eating this way will not only make you healthier for it, but will be reducing your risk factors around any inflammatory disease state. Just remember that 90% of breast cancers come from non-hereditary factors related to lifestyle and the way we eat in the modern world.

Early detection and awareness is vital

It is well known that early detection and treatment is vital to survival rates in women with breast cancer. It is so important to regularly check for lumps and bumps and talk to your doctor about regular screening. If you have hereditary risks then talk to your healthcare provider, or specialist about genetic screening for breast cancer.

Let’s all raise awareness for breast cancer and support more research into finding a cure for this disease that affects millions of women world wide each year.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Women’s Health Experts

 

 

Cancers in women 1

Bringing Awareness To Cancers In Women

Posted on by

Over the next week I am going to focus on a very serious subject – Cancers in women.

Having recently focusses on the awareness of endometriosis and adenemyosis, I thought I should bring some awareness to the topic of cancers in women as a whole. This isn’t to scare people either. It is to bring awareness to a very serious topic and to help people understand the importance of early intervention and changes to diet and lifestyle can greatly reduce the risks of this horrible disease.

With cancer rates increasing I am going to focus on the cancers that affect the female reproductive system and impact of reproductive health. This will also include those cancers that increase after menopause too. Whenever I talk about fertility and reproduction, it is referring to the stage in life when women are fertile and are of reproductive age. Menopause is also including because that still comes under the reproductive system.

Cancer has been around a long time

Humankind has been dealing with the impact of cancer and malignancy for its entire history and the first clear description of any cancer is found in the Ebers Papyrus, dating from nearly 3500 years ago. The cancer was very accurate described by the Egyptian writer and what was described was in fact breast cancer. Chinese Medicine has texts dating back for further than that, describing the different forms of cancers and their treatments. Modern medicine does tend to only reference Greek, Egyptian and Roman text.

When these Greek physicians first cut the surface of a breast cancer, it did in fact resemble a crab, because of it solid central body, with extensions into the surrounding tissue resembling legs.

The ancient Greek word for crab is “Karkinos” which in Latin is translated into ‘cancer’- as in the astrological sign. This term was then extended into all cancers and malignancies, not just breast cancer.

Genetic, hereditary and hormonal links to cancer

It is believed that cancer is predominantly caused by a failure in the regulation of genes which govern cell growth and differentiation. Malignant change is most typically the result of a cascade of changes in a number of genes.

These changes in genes can be bought on by hereditary genetic genetic changes, while others may be the incorporation of foreign viral DNA, or a compound that may act as the primary trigger for malignant change. Some cancers and malignancies are also caused by hormonal stimulation both internally and by injection, or ingestion of hormones from an outside source (Drugs, Hormone Replacement etc).

Diet and lifestyle links to cancer

Other cancers are plain and simply caused by the highly inflammatory foods we eat and the lifestyle we live. Obesity and being overweight increases our cancer risks and there are no many studies proving these links. Having excess fat stores, eating highly processed foods, high GI foods and over 3-4 glasses of alcohol per week can increase your cancer risks exponentially. This why we all need to adopt a clean eating approach to foods and look at eating less refined foods and more whole foods.

The incidence of cancers in women is highest in developing western countries and lowest in countries such as Africa and Asia. The difference has more to do with diet than it does genetics. Since there is compelling evidence that alcohol, highly refined foods and obesity increase the risk of cancers in women (and men) I will be focusing greatly on the need for us all to look at changing our diets to not only help in the prevention of certain cancers, but to also help prevention of other disease states that are leading causes of our lives being cut short.

The most common cancer in women

Since breast cancer remains the most common malignancy in women, comprising of 18% of all female cancers, most women will know someone who has had this diagnosis.

I’ll focus on breast cancer firstly and then go into the other cancers so that we can all be educated about how we can prevent these disease states from increasing. If you have any questions, or topics you want discussed around this topic, please let me know

Take care and remember prevention is better than cure. Always talk to your doctor, or healthcare practitioner about cancer risks and always seek early intervention if you find any lumps and bumps that were not there before.

Hope you the topics help you all. If I can save just one person with this information, then I am happy. Lets try and save more than one, so please like and share to spread the word.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Women’s Health Experts

pelvic floor hypertonus 1

What The Hell is Pelvic Floor Hypertonus?

Posted on by

Pelvic floor hypertonus is a condition that not many people hear about, or even know about. Often when we talk about pelvic floor dysfunction many people will automatically think of weak pelvic floor muscles often created from having children, or part of the aging process. This is where the pelvic floor muscles are too relaxing and need tightening and strengthening.

However more and more we are now seeing women, especially young women, with pelvic floor muscles that are too tight and non-relaxed and this is leading to chronic pelvic pain and other pelvic health and sexual health issues. This is called Pelvic Floor Hypertonus. For this article I will be talking about how Pelvic Floor Hypertonus affects women, even though men can have this as well.

What is Pelvic Floor Hypertonus?

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.

Pelvic floor hypertonus is not widely recognized and can often go on undiagnosed. It is certainly on the missed and dismissed list. Unlike in pelvic floor disorders caused by muscles too relaxed and are easily identified (such as pelvic organ prolapse or urinary incontinence etc), women affected by pelvic floor hypertonus may present with a broad range of nonspecific symptoms mentioned previously and below. All these related symptoms require relaxation and coordination of pelvic floor muscles and urinary and anal sphincters. Many of these symptoms can really affect the quality of woman’s life.

The signs and symptoms of pelvic floor hypertonus

The main and typical symptom of pelvic floor hypertonus is pelvic pain, or pelvic muscular pain. There can be a wide range of other symptoms including the following:

  • Urinary issues such as urge frequency, frequent urination or painful urination
  • Incontinence
  • Slow flow, hesitancy, or delayed start of urination
  • Constipation and straining when emptying the bowels.
  • incomplete emptying of the bowels
  • pressure feeling in the pelvis and rectum
  • pain in the pelvis, genitals or rectum
  • chronic pelvic pain
  • muscles spasms in the pelvis, or pelvic floor
  • low back pain
  • hip pain
  • coccyx pain
  • painful sex
  • vaginismus

If left untreated pelvic floor hypertonus can lead to long term health issues, colon and bladder damage and can also cause infection.

What causes pelvic floor hypertonus?

There is no one defining cause of pelvic floor hypertonus. Many things can cause non-relaxing pelvic floor muscles ranging from sitting too much, exercising too much, obesity, stress and also chronic inflammatory disease states. Here are some of the causes of pelvic floor hypertonus:

  • Endometriosis
  • Adenomyosis
  • Interstitial cystitis
  • Irritable Bowel Syndrome
  • Pudendal Neuralgia
  • Vulvodynia
  • History of holding onto the bowels, or bladder too long
  • Over exercising and over exercising the core muscles
  • Being sedentary, or over-sitting too long
  • High levels of stress, fear and anxiety
  • Obesity or being overweight
  • Child Birth, or Birth Trauma
  • Injury to the pelvic floor
  • Sexual and emotional abuse
  • Surgery
  • Nerve Damage

It is very important to identify the cause of pelvic floor hypertonus individually and why it is so important to see a healthcare expert, or pelvic floor specialist that specialises in this area. As with many other inflammatory conditions, a multimodality treatments approach is needed and may involved several modalities, or practitioners working together to help the individual. A pelvic floor physiotherapist may also be needed to help with exercises to relax the pelvic floor along with other modalities such as acupuncture to help with pain, relaxation and stress relief.

What are some of the things that can benefit pelvic floor hypertonus?

As mentioned before, it is important to see a healthcare expert who can identify what the cause of the pelvic floor hypertonus is and recommend a management and treatment plan moving forward. This will usually require a multimodality treatment approach, which could involve the following:

  • Pelvic floor muscle relaxation techniques
  • Mindfulness and meditation techniques
  • Breathing techniques
  • Pilates and yoga to help with stretching
  • Advice on better bladder and bowel habits
  • Pelvic floor and core muscle releasing abdominal massage
  • Specific stretches for the pelvis, hips and sacrum
  • The use of vaginal dilators, and/or vaginal eggs to help with relaxing and stretching the pelvic floor muscles
  • Acupuncture to help with pain, stress and relaxation, alongside medical interventions.
  • Massage to help with internal scar tissue (done by a pelvic floor physiotherapist)
  • Warm baths and self care
  • Use of TENS and electro-neuro stimulators to help with pain
  • Biofeedback therapy
  • Pain medications and muscles relaxants
  • Complementary medicines (prescribed by a qualified healthcare professional)
  • Surgery

Outlook and importance of seeing an expert

The main goal of treating and managing pelvic floor hypertonus is to relax the muscles of the pelvic floor to relieve pain and other associated symptoms.

Although living with pelvic floor hypertonus embarrassing or sometimes painful, non relaxing pelvic floor dysfunction is a highly treatable condition. It is important that you talk to a healthcare expert in this area, or a pelvic floor specialist. It’s important not to self-diagnose your symptoms, or try to Dr Google your symptoms, because left untreated pelvic floor hypertonus can lead to long term pain and health issues and also irreparable damage.

There are many conservative management approaches that can be used before resorting to hard-core pain medications, muscle relaxants and surgery. Your healthcare expert will be able to discuss all these options and ongoing healthcare management and treatments with you. The main thing is booking a consultation with a proper healthcare expert to get a proper diagnosis.

If you need help and assistance with pelvic floor hypertonus, or pelvic pain, please give my friendly staff a call and find out how I can assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Women’s Health Experts

 

 

Let’s talk about fertility and reproduction what couples can do do during this time

Posted on by

There are many people trying to have a baby, and without success. Many now are stressed about what they can do to improve their fertility, during the times of COVID 19.

Many are also stressing thinking that they cannot access fertility treatment, when in fact some fertility clinics are providing full services, including IVF.

In this latest video blog, I talk all things fertility and some of the cold hard facts, especially about seeing a fertility expert.

There are many things couples can do at this time and one of them is get your body and mind ready for trying to have a baby. In this video also talk about the importance of preconception care and the importance of using this COVID 19 time to work on couples health, to help with their fertility.

serious complications of low iron

The Serious Health Complications Of Low Iron

Posted on by

In the last couple of weeks I have been talking about the serious complications of people not having their health managed properly. It seems to be a big issue and with my latest post, the issue of unmanaged, or undiagnosed low iron is also becoming a very serious issue indeed. So for this post I will be talking about the serious health complications of low iron.

Two thirds of body iron is present in circulating red blood cells known as haemoglobin. Each gram of haemoglobin contains about 4gms of iron and each ml of blood lost from the body results in a loss of about half a milligram of iron.

Bleeding is the most common cause of iron deficiency.  This could be from either a diagnosed, or undiagnosed gynaecological issues (endometriosis, adenomyosis, fibroids, polyps, other) or it could be from a parasite infection. It could also be from bleeding as part of a gastrointestinal issue, or part of inflammatory bowel diseases (IBS, Crohn’s Coeliac disease).

There could be other reasons for blood loss in the body, or reduction of iron and many of these conditions, and the conditions above, can go unrecognised and then cause iron deficiency anaemia. Some of these issues can be very serious, or even fatal.

Excessive menstrual losses are often overlooked with many women. This is something that should not happen and should be part of the questioning with any low iron status. The problem is, unless the menstrual flow changes, patients typically do not seek medical attention for heavy menstrual bleeding. Sometimes when a healthcare practitioner asks, these patients generally report that their menses are normal. It may be normal to them, but we need to educate women that heavy blood loss is not normal and can lead to anaemia.

Because of the marked differences among women with regard to menstrual blood loss (10-250 mL per menses), patients meed to be asked about their menstrual history and about a specific history of bleeding, blood flow, abnormal bleeding in between cycles,  clots, cramps, and the use of multiple tampons and pads. These are very important questions to ask and sadly many women are not being asked these questions, or having further questioning about their menstrual, or overall health, including dietary intake etc.

What is iron deficiency anemia?

Anaemia occurs when you have a decreased level of haemoglobin in your red blood cells (RBCs). Haemoglobin is the protein in your red blood cells that is responsible for carrying oxygen to your tissues.

Iron deficiency anaemia is the most common type of anaemia that women present with, and it occurs when your body doesn’t have enough iron. Your body needs iron to make haemoglobin. When there isn’t enough iron in your blood stream, the rest of your body can’t get the amount of oxygen it needs. Today in a recent post I talked about iron being like trucks, or the transporters of oxygen around the body.

While iron deficiency may be common, many people don’t know they have iron deficiency anemia. It’s possible to experience the symptoms for years without ever having it diagnosed, or the cause of the iron deficiency diagnosed either. It is a very serious issue that needs some serious attention.

In women of childbearing age, the most common cause of iron deficiency anemia is a loss of iron in the blood due to heavy menstruation or pregnancy. A poor diet or certain intestinal diseases that affect how the body absorbs iron can also cause iron deficiency anemia. Women who adopt a vegan diet will also be prone to being iron deficient and vitamin B12 deficient.

Disruption to the microbiome and leaky gut syndrome can also cause iron deficient anaemia too.

One of the best ways to treat the condition is through iron infusion, and also with iron supplements, or changes to diet. We also need to make sure the cause of the iron deficiency is addressed as well.

Symptoms of iron deficiency anaemia

The symptoms of iron deficiency anaemia can be mild at first, and some people may not even notice them. Many people are completely unaware that they may be low in iron, or are actually iron deficient.

The symptoms of moderate to severe iron deficiency anaemia include:

  • general fatigue
  • weakness
  • pale skin
  • Bruising easy
  • shortness of breath
  • Palpitations
  • dizziness
  • Strange cravings to eat items that aren’t food, such as dirt, ice, or clay
  • Tingling or crawling feeling in the legs
  • Tongue swelling or soreness
  • Cold hands and feet
  • Tachycardia
  • Brittle nails
  • Headaches and migraines
  • Sore joints
  • Brain fog and lack of concentration.

The serious complications of unmanaged iron deficiency.

Undiagnosed, or unmanaged iron-deficiency may cause the following severe complications:

  • Heart problems.If you do not have enough hemoglobin-carrying red blood cells, your heart has to work harder to move oxygen-rich blood through your body. When your heart has to work harder, this can lead to several conditions: irregular heartbeats called arrhythmias, a heart murmur, an enlarged heart, or even heart failure.
    Severe anemia due to any cause may produce hypoxemia and enhance the occurrence of coronary insufficiency and myocardial ischemia.
  • Increased risk of infections- Research has shown that iron deficiency anaemia can affect your immune system (the body’s natural defence system), making you more susceptible to illness and infection.
  • Motor or cognitivedevelopment delays- This mainly occurs in children. Children deficient in iron may exhibit behavioral disturbances.
  • Behaviour issues and mood disorders- Behavioral disturbances may manifest as an attention deficit disorder, or mood disorder such as : Depression Unipolar depressive disorder, Bipolar disorder, Anxiety disorder, Autism spectrum disorder, Attention-deficit/hyperactivity disorder, Tic disorder, Delayed development and other some other psychiatric issues.
  • Pregnancy complications- Iron deficiency can lead to preterm delivery or giving birth to a baby with low birth weight.
    The neurologic damage to an iron-deficient foetus results in permanent neurologic injury and typically does not resolve on its own, or by supplementation.
  • Chronic Health Conditions worsened- In people with chronic conditions, iron-deficiency anaemia can make their condition worse or result in treatments not working as well.
  • Dysphagia (Difficulty swallowing)- This may occur with foods due to abnormal muscle and nerve control. This could result in choking. It can also lead to throat cancers.
  • Atrophic gastritis – This occurs in iron deficiency with progressive loss of acid secretion, and causes inflammation of the gastric mucosa with loss of the gastric glandular cells and replacement by intestinal-type epithelium, and fibrous tissue
  • Tiredness- As iron deficiency anaemia can leave you tired and lethargic (lacking in energy), you may be less productive and active at work. Your ability to stay awake and focus can be reduced, and you may not feel able to exercise regularly.
  • Fainting– Low iron can cause fainting and this could be dangerous in many situations, especially at work places, or working on machinery, or driving a car.
  • Cold Intolerance– Cold intolerance develops in one fifth of patients with chronic iron deficiency anaemia and is manifested by neurologic pain, vasomotor disturbances, or numbness and tingling.
  • Issues with Brain and Optic Nerve– Rarely, severe iron deficiency anaemia is associated with papilledema (optic disc swelling), increased intracranial pressure, and the clinical picture of pseudotumor cerebri. These manifestations are all corrected with iron therapy.
  • Migraines– Research has now shown that there are certain types of migraines caused by iron deficiency
  • Death – Caused by some of the issues mentioned above

The importance of proper management

Hopefully now everyone can see why iron is so important and that people with iron deficiency need to see their healthcare practitioner for proper help and proper management .  Iron deficiency anemia isn’t something to self-diagnose or treat. It needs to be diagnosed, treated and managed properly. In many cases an iron infusion is the best and quickest way to get iron levels back up. Have a read of my post about iron infusions. Click here

Iron infusions are the quickest way of getting iron levels back up

In the case of low, or severely low iron, supplements just are not enough. They take too long to get levels up and the damage to your body in waiting too long can also be serious.  Always see your healthcare practitioner, or specialist, for a diagnosis rather than trying to manage low iron on your own, or just taking iron supplements on your own. Overloading the body with too much iron can be dangerous too, because excess iron accumulation can damage your liver and cause other complications.

Final Word

This is why everyone needs to be managed by a properly trained healthcare professional with any health issue, especially low iron. If your practitioner is not able to assist you, please make sure you get a second or third opinion. Some practitioners may not be well versed in the serious complications of low iron, or know much about iron infusions etc.

If you do need help with managing the symptoms of low iron, you can call my friendly staff and find out how I can assist you. For more information please call +61 07 38328369 or email info@drandreworr.com.au

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicince

-Master of Reproductive Medicine

-Women’s and Men’s Health Advocate

 

 

Consequences of PCOS

The Serious Health Complications Of Unmanaged PCOS

Posted on by

Just like endometriosis, there is a lot of the information about PCOS, but it is more about the symptoms, time to diagnosis and future fertility outcomes.

While it is necessary to educate people about these things, nobody is really talking about the serious health complications of unmanaged PCOS.

There have been some big changes to the diagnosis of PCOS, but still it can often take up to 3 years or more to get a proper diagnosis. While it may not take as long as endometriosis to be diagnosed, it still means that many women are being missed and dismissed in those year before they are finally diagnosed.

Like Endometriosis, some women with PCOS are never diagnosed and some women do not have any symptoms and can have very regular cycles etc. Women can have PCOS and endometriosis together, alongside other issues such as adenomyosis as well.

There are serious health consequences with unmanaged PCOS

The main thing I am trying to bring to everyone’s attention is that it doesn’t matter what disease you have, if it is left unmanaged, or not managed properly, it can have some pretty serious consequences of ones fertility, and mental and physical health.

PCOS is not exception. While the symptoms of PCOS are not as bad as those suffered with endometriosis, or adenomyosis, women can still suffer in many other ways. The long-term consequences of unmanaged PCOS can be very serious and can also lead to early death (cardiovascular disease, stroke etc.) and also lead to certain cancers.

Risk factors

PCOS is thought to have a genetic component. People who have a mother or sister with PCOS are more likely to develop PCOS than someone whose relatives do not have the condition. This family link is the main risk factor.

Then there is the insulin resistance factor with PCOS as well. Insulin resistance is a primary driver of PCOS and there is now evidence to show that most, if not all, women with PCOS have insulin resistance by default. Again this appears to be through genetic or family links of someone having PCOS, or having diabetes in the family tree etc.

Excess insulin is thought to affect a woman’s ability to ovulate because of its effect on androgen production. Research has shown that women with PCOS have low-grade inflammation that stimulates polycystic ovaries to produce androgens.

This is why diet and lifestyle interventions are so important in the overall management of PCOS. It is because these changes help with the insulin resistance.

There are other risk factors such as obesity, stress, nutritional deficiencies and sedentary lifestyle. Have a look at my page about more information on PCOS and risk factors etc (Click Here)

The Common Symptoms of PCOS

It is important to know what the common symptoms of PCOS are, so that women and healthcare professionals alike know what to look for.

The common symptoms of PCOS include:

  • irregular menses
  • excess androgen levels
  • acne, oily skin, and dandruff
  • excessive facial and body hair growth, known as Hirsutism
  • female pattern balding
  • skin tags
  • acanthosis nigricans, or dark patches of skin
  • sleep apnea
  • high stress levels
  • depression and anxiety
  • high blood pressure
  • infertility
  • Increased risk of miscarriage
  • decreased libido
  • high cholesterol and triglycerides
  • fatigue
  • insulin resistance
  • type 2 diabetes
  • pelvic pain
  • weight management difficulties including weight gain or difficulty losing weight

Early Intervention and management is crucial

The causes of PCOS are unclear, but early intervention, early diagnosis and early management, can help relieve symptoms and reduce the risk of complications. Anyone who may have symptoms of PCOS should see their healthcare provider, women’s healthcare specialist, or PCOS expert.

Coping with the symptoms of PCOS and managing the treatments can be demanding ands sometimes stressful. But, to then learn there can be serious complications and added risks to your health from PCOS not being managed properly can be distressing.

Be educated and get proper help

Just like any disease state just being aware, and being educated there are added risks is an important first step. Once you have the common symptoms of PCOS under control then you can turn your mind to thinking about ways to prevent further complications.  The good news is that many of the treatments and management strategies you will use for your PCOS will also help to prevent many of the serious complications. A qualified healthcare professional, or a healthcare practitioner who is an expert in PCOS should be managing anyone with PCOS. Nobody should be trying to manage PCOS on their own without some form of professional help.

The serious complications of PCOS

Women with PCOS are thought to be at higher risk of having future heart disease or stroke. They are also at higher risk of diabetes, endometrial cancer and other cancers too.

What are the serious complications of unmanaged PCOS?

Besides the risk factors already mentioned, the serious complications of unmanaged PCOS are as follows:

  • Weight gain or obesity
  • Prediabetes
  • Type 2 diabetes
  • Cardiovascular disease
  • Metabolic syndrome (generally having at least two of high blood pressure, high cholesterol, obesity, high fasting blood glucose)
  • Endometrial cancer
  • Other cancers (breast, ovarian)
  • Sleep apnoea
  • Inflammation of the liver
  • Infertility
  • Increased Pregnancy induced hypertension and pre-eclampsia
  • Increased gestational diabetes
  • Increased risk of stroke
  • Increased risk of sudden death
  • Atherosclerosis
  • Psychological disorders
  • Mood disorders (anxiety, depression)

What you can do

If you are worried about the serious complications of unmanaged PCOS it is helpful to:

  • Get your symptoms of PCOS under control as a first step
  • Discuss any concerns with your healthcare practitioner, or women’s health/PCOS expert.
  • Learn about and understand your risks
  • Learn that early intervention and early healthcare management is the key to assisting any disease state.
  • Have your blood pressure, blood glucose and cholesterol checked regularly
  • Seek guidance and support to help with weight management and dietary and lifestyle management.
  • Remember that all body types can have PCOS, not just those who are overweight.
  • Do not try to manage the symptoms of PCOS on your own.

Final word

If you do need assistance with PCOS and would like my help, please call my friendly staff and found out how I may be able to assist you. There are options for online consultations and consultations in person.

As mentioned before the key to any disease is early intervention and early healthcare management and you taking the first steps to get the help you need. PCOS also needs a multimodality approach. There are many facets to it. Don’t put off your health. Just pick up the phone and make that appointment today. There can be some very serious consequences if you do, especially for some conditions such and PCOS.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicines

-The PCOS Experts

References
  1. Ehrmann D et al. Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2006 Jan;91(1):48-53
  2. Meyer C et al. Overweight women with polycystic ovary syndrome have evidence of subclinical cardiovascular disease. J Clin Endocrinol Metab. 2005 Oct;90(10):5711-6
  3. McCartney CR, Marshall JC. Polycystic Ovary Syndrome. N Engl J Med 2016;375:54-64
  4. Hull MG. Epidemiology of infertility and polycystic ovarian disease: endocrinological and demographic studies. Gynecol Endocrinol. 1987;1:235–245. [PubMed] [Google Scholar]
  5. Balen AH, Conway GS, Kaltsas G, et al. Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Hum Reprod. 1995;10:2107–2111. [PubMed] [Google Scholar]
  6. Tian L, Shen H, Lu Q, Norman RJ, Wang J. Insulin resistance increases the risk of spontaneous abortion after assisted reproduction technology treatment. J Clin Endocrinol Metab. 2007;92(4):1430–1433. [PubMed] [Google Scholar]
  7. Jungheim ES, Lanzendorf SE, Odem RR, Moley KH, Chang AS, Ratts VS. Morbid obesity is associated with lower clinical pregnancy rates after in vitro fertilization in women with polycystic ovary syndrome. Fertil Steril. 2009;92(1):256–261. [PMC free article] [PubMed] [Google Scholar]
  8. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19–25. [PubMed] [Google Scholar]
  9. Palomba S, de Wilde MA, Falbo A, Koster MPH, La Sala GB, Fauser CJM. Pregnancy complications in women with polycystic ovary syndrome: new clinical and pathophysiological insights. Hum Reprod Update. 2015 Jun 27;:dmv029. [PubMed] [Google Scholar]
  10. Anderson SA, Barry JA, Hardiman PJ. Risk of coronary heart disease and risk of stroke in women with polycystic ovary syndrome: a systematic review and meta-analysis. Int J Cardiol. 2014;176(2):486–487. [PubMed] [Google Scholar]
  11. Hardiman P, Pillay OC, Atiomo W. Polycystic ovary syndrome and endometrial carcinoma. Lancet. 2003;361(9371):1810–1812. [PubMed] [Google Scholar]
  12. Genazzani AR, Gadducci A, Gambacciani M. Controversial issues in climacteric medicine II. Hormone replacement therapy and cancer. International Menopause Society Expert Workshop. Climacteric. 2001;4(3):181–193. [PubMed] [Google Scholar]
  13. Barry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2014;20(5):748–758. [PMC free article] [PubMed] [Google Scholar]
  14. Broekmans FJ, Knauff EAH, Valkenburg O, Laven JS, Eijkemans MJ, Fauser BCJM. PCOS according to the Rotterdam consensus criteria: change in prevalence among WHO-II anovulation and association with metabolic factors. BJOG. 2006;113(10):1210–1217. [PubMed] [Google Scholar]
  15. Haoula Z, Salman M, Atiomo W. Evaluating the association between endometrial cancer and polycystic ovary syndrome. Hum Reprod. 2012;27(5):1327–1331. [PubMed] [Google Scholar]
  16. Chittenden BG, Fullerton G, Maheshwari A, Bhattacharya S. Polycystic ovary syndrome and the risk of gynaecological cancer: a systematic review. Reprod Biomed Online. 2009;19(3):398–405. [PubMed] [Google Scholar]
  17. Giovannucci E. Metabolic syndrome, hyperinsulinemia, and colon cancer: a review. Am J Clin Nutr. 2007;86(3):s836–s842. [PubMed] [Google Scholar]
Endometriosis complications

The Complications That Can Result From Unmanaged Endometriosis

Posted on by

A lot of the information about endometriosis, is more about it’s symptoms, time to diagnosis and future fertility outcomes. While it is necessary to educate people about these things, nobody is really talking about the serious complications of unmanaged endometriosis. This is not to scare people, or create fear, but at the same time it does need to be talked about and for all concerned to know how serious this disease state can be at its worst.

We know that many women are missed and dismissed when it comes to endometriosis. It often takes up to 10 years, or even more for some women, before they are definitively diagnosed. Some women are never diagnosed and end up suffering a terrible life because of it. Some women with endometriosis are asymptomatic (meaning no symptoms) and often only get diagnosed as part of fertility evaluation, when they may be having trouble conceiving.

The symptoms of endometriosis are easy to see

The symptoms of endometriosis are very easy to see, if someone knows what they are looking for and knows the right questions to ask. Sure, a definite diagnosis via laparoscopy is still needed, but there are some very clear-cut pointers that a woman may have the disease. But due to lack of education and lack of true experts in this area means that lots of women are missed and dismissed, and that is a fact.

The vicious cycle of mismanagement

But while there are inadequacies in the healthcare profession when it comes to endometriosis, not all mismanagement can be blamed on healthcare professionals. There are people who are not seeking proper help soon enough, and some not at all, and this can lead to long-term complications too. We also have women trying to manage their own disease through advice of friends, social media groups and Dr Google as well. This then creates one hell of a mismanaged cycle that does not help anyone.

I can see the issues from all points of view, especially those who suffer the disease. But as a healthcare professional with a special interest in Endometriosis, I have had my fair share of non-compliant patients too.

While many have been let down through mismanagement, lack of funding and education, being missed and dismissed etc, there are many women who are self sabotaging as well. I have seen many not take on advice, recommendations and proper management of their disease, that could help them, then these same people scream high and low that the system has let them down. There are some who are just happy to live with the disease, as it is their only way of seeking attention. This is a fact also and we need to talk about it.

This is what has prompted me to do this post so that all concerned get to know what the serious side of mismanaged endometriosis is. Sometimes it is only via the serious harsh side of reality, that all concerned may actually get some help and some serious attention be bought to this disease state.

The common symptoms of endometriosis

We know that many women suffer greatly at the hands of this disease. Women with endometriosis can get the follow common symptoms:

  • Period pain
  • Pain with intercourse
  • IBS like symptoms
  • Gastrointestinal issues
  • Chronic constipation
  • Chronic diarrhoea
  • Pain on bowel movement
  • Bleeding from the bowel
  • Chronic abdominal pain
  • Severe bloating (endo belly)
  • Chronic bloating
  • Aversion to foods (even if they are not the trigger)
  • Ovulation Pain
  • Ovary pain
  • UTI like symptoms (with no infection present)
  • Migraines and headaches
  • Chronic pelvic pain
  • Pelvic and rectal pressure feeling
  • Musculoskeletal pain
  • Chronic nerve pain
  • Fluid retention
  • Iron deficiency
  • Mood swings
  • Anxiety
  • Depression
  • Mood disorders
  • Infertility
  • Other symptoms

Early intervention and management is crucial

Women’s lives are greatly impacted by this disease and it is important that not only healthcare professionals understand this but also sufferers of the disease. Early intervention and proper ongoing management is the key to helping this disease and everyone needs to be aware of this. Being missed and dismissed, or waiting too long to help, can really have some serious consequences if this disease is left to grow and spread and cause serious damage in the body

The serious consequences of mismanaged/unmanaged endometriosis

While we have talked about the common daily symptoms that many can put up with, we also need to bring attention to just how serious this disease can get. Let’s face it, it can and does spread like cancer and it can spread to every organ in the body. It has been found in the joints of bones, fingers, in the liver, around the lungs, around the diaphragm, around the heart, on the bowels, on the bladder, on the ovaries, on the pelvic, in the fallopian tubes, one the retina in the eyes and it has even found in the brain.

There is no doubt that this disease can be very devastating for anyone who has it, but what happens in the worst cause scenario, if it is left unmanaged.

The following can be serious complications of unmanaged endometriosis:

  • Haemorrhage from the ovaries
  • Ruptured ovaries
  • Ovarian torsion
  • Obliterated fallopian tubes
  • Ruptured endometrioma
  • Endometrioma infection
  • Pelvic infection
  • Obliteration of the pelvic cavity
  • Peritonitis
  • Sepsis
  • Compacted bowel
  • Obstructed bowel
  • Perforated bowel
  • Bowel haemorrhage
  • Torsion of the bowel and intestines.
  • Ureteral Obstruction (Blocked ureters)
  • Renal infection
  • Bladder obstruction
  • Painful bladder syndrome
  • Severe adhesions
  • Significant scar tissue build up
  • Significant fluid build up in the pelvic cavity.
  • Multiple organs adhered together
  • Diaphragmic adhesions
  • Liver damage
  • Perihepatic adhesions
  • Pericardial endometriosis
  • Cardiovascular events
  • Stroke
  • Chronic nerve pain
  • Pudendal nerve neuralgia.
  • Chronic musculosketal, or spinal pain
  • Arthritic like pain and associated symptoms
  • Chronic Migraine and neurological events.
  • Malignancies and cancers (rare but more research being done)
  • Hysterectomy
  • Recurrent miscarriage
  • Absolute infertility
  • Opioid dependency and addiction
  • Death from opioids medications
  • Complications from medications and hormonal treatments
  • Psychotic disorders
  • Mania
  • Incapacitation
  • Suicidal tendencies and thoughts
  • Suicide
  • Death (rare from endometriosis directly, but can be from associated factors related to endometriosis and also taking ones own life)
  • Other

Women with endometriosis need to see an “Endometriosis Expert”

This is why endometriosis needs to be managed properly and managed by a healthcare professional that specialises in the management of endometriosis and associated symptoms. You need to see and Endometriosis Expert.

People cannot treat, or manage the symptoms of endometriosis on their own. This is why it is so important to have the right care and also have a multimodality/team approach to endometriosis. No amount of google searching is going to help people treat endometriosis on their own. You need to find an endometriosis expert.

At the same time more education needs to be given to GP’s and other healthcare professionals about endometriosis. Too many women are being missed and dismissed because of lack of practitioner understanding and education at the front line. Women need to see healthcare professionals that specialise in endometriosis and endometriosis experts for this disease, not just a GP. Women also need access to advanced trained laparoscopic surgeons who specialise in excision surgery, not just a regular gynaecologist who is not advanced trained. I have talked about this often.

Endometriosis is not just about period pain

Lastly, we need to educate ‘all’ that endometriosis is not just about period pain. Endometriosis can present with many different signs and symptoms ranging from gastrointestinal symptoms, extreme bloating, bladder issues, bowel issues, IBS symptoms, migraines, fluid retentions, pain with intercourse, pain on bowel movement and so many other symptoms mentioned before. There is also the long-term impact on fertility for up to 50% of women too.

This is why early intervention and management of teenagers presenting with the disease symptoms is crucial. The longer the disease is left, the more damage it can do and all women deserve to be mothers (if they chose) and deserve a normal happy life. We also need to recognise the psychological impact of the disease and how this can present in someone with the disease as well.

Women are dying because of being mismanaged/unmanaged

Let’s face it, there are women dying because of this disease. Maybe not as direct result, but definitely indirectly. No woman should ever be pushed to the point where she cannot handle her pain and symptoms any longer and be only left with the choice of taking ones own life. This is exactly we need to bring more education to all about this disease. This means both healthcare practitioners and people with the disease itself too.

People need to be managed properly and by professionals. We need to start bring education and attention to this, so that people do not try to manage this disease on their own, and practitioners are held more accountable for dismissing women as well. Because if we don’t the complications of this can be very severe and sometime they can be fatal also.

Endometriosis awareness month is next month and I want to see all women with endometriosis being managed properly and seeking the right help. There are endometriosis experts out there who can help you if you have the disease and the associated symptoms. No woman should be doing this on their own.

Let me help you

If you so need help with managing endometriosis and the associated symptoms of endometriosis, please give my staff a call and find out how I can assist you. I have options for in-person consultations and online consultations. I use a multimodality/team approach and I also work in with some of the best medical healthcare professionals and surgeons in the country. I will always make sure you get the best care, best support and best management possible. I will also hold your hand every step of the way and make sure your every concern is listened to as well.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Endometriosis Experts

 

 

 

 

 

healthy food

The Difference Between The Proper Way To Eat Versus Dieting

Posted on by

The word diet is often misused and people often use it in the context of weight loss and food restriction. In this latest post I talk about the difference between the word ‘Diet’, as in dieting, versus “Diet”- meaning the proper way to eat.

I also show people the wellness pyramid and explains what good nutrition is and that all carbs are not bad carbs. I also talk about waist size, body fat and the perception people have around weight and weight loss. Have a listen to my latest post to here this and so much more.

fertility 1

Fertility- Before you go any further, you are forgetting one thing…….. The Male

Posted on by

In this video blog I explains how I often get emails from patients and practitioners, needing assistance with fertility issues. The only thing is, it is often only from the female perspective and I have to then explain this to people, or these practitioners. So often, as I am hearing their case study, or patients telling their story, I have to politely stop them and explain “Fertility Before you go any further, I can see what the issue is, you are forgetting one thing…… The Male”

Being completely honest, 95% of the time it is the full female history I am hearing and absolutely no mention of the male. The male is always 50% of the fertility picture, unless there is absolute infertility with the female (medically diagnosed infertility)

Fertility issues require proper evaluation of both the male and female, otherwise crucial things get overlooked. It takes a sperm and an egg to make a baby, not just an egg. Besides that it is a legal and ethical requirement to investigate the female and male. You cannot just investigate and treat the female. Have a listen to the latest video (below) of this very important subject.

If you do need assistance with fertility and reproductive issues, please give my staff a call and find out how my fertility program may be able to assist you and your partner.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-The International Fertility Experts