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Eat nuts to help men’s ….??

Men, it is time to eat more nuts, to help your…. ummm… NUTS!

But this isn’t just about your family jewels, this is about helping with what they produce and helping you carry on your family tree.  A diet rich in nuts has been shown to improve sperm count, motility, morphology and sperm DNA.

Recent research published in the European Society of Human Reproduction and Embryology (July 4th 2018) has shown the men that regularly eat nuts have improved sperm quality and function and less DNA fragmentation in their sperm.

In many forms of traditional medicines, foods and the shapes of foods, often correlate to an organ in the human body. To give you an example, walnuts look like a lung and they also look like a brain. There are now research papers to show that walnuts may assist with brain function and help with lung function as well.

Many of the foods we eat may also assist fertility. Many of these foods may look like a reproductive organ, or contain seeds in them. Fruits such as dragon fruit and kiwi fruit look like the shape of a testicle, or an ovary and have seed in them, which traditional medicines often say are good for the seed (meaning eggs and sperm on a fertility level)

Hence it is no surprise that nuts, can help with… ummm… well….  a man’s nuts (reproductive organs)

This new research showed that the inclusion of mixed nuts (almonds, hazelnuts and walnuts) in a regular diet significantly improves the quality and function of human sperm, according to results of a randomized trial which measured conventional semen parameters and molecular changes over a 14-week study period. The findings, say the investigators, ‘support a beneficial role for chronic nut consumption in sperm quality’ and reflect a research need for further male-specific dietary recommendations.

Results firstly found significantly higher levels of sperm count, vitality, motility and morphology in the men randomised to the 60 g/day nut diet than in those following their usual diets free of nuts. Moreover, the subjects in the nut group also showed a significant reduction in their levels of sperm DNA fragmentation, a parameter closely associated with male infertility. Indeed, it was this change in the level of DNA fragmentation in the sperm cells by which the investigators explained, at least in part, the improvement in sperm count, motility and morphology.

Nuts are dense foods containing many antioxidants, omega 3 oils, amino acids and folate. This may explain why nuts are so beneficial to improving sperm quality overall. Antioxidants help with oxidative stress, which can be a big factor in DNA damage to sperm and poor sperm quality. Antioxidants and amino acids help with proper formation of sperm at the cellular stage and help prevent damage to sperm cells and help with repair and formation of the DNA of sperm as well.

There is much more growing evidence through research literature that healthy lifestyle changes such as following a healthy dietary pattern can assist conception. Healthy parents make healthy babies. It takes a sperm and an egg to make a baby and healthy men produce healthy sperm. This is why it is important for not only the woman to be healthy prior to conception, but for the man to be healthy as well. The health of the father is passed onto the child and there is growing evidence to support this now.

When it comes to fertility and trying to have a baby, males need to be an equal part of the equation. Fertility isn’t just a woman’s responsibility and fertility issues are not just related to women.

Regards

Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Normal 20 07 2016

Story Source:

European Society of Human Reproduction and Embryology. “A diet rich in nuts improves sperm count and motility: Improvements associated with better male fertility and explained by a reduction in sperm DNA fragmentation.”

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But what do I do and who is going to help me?

Many years ago I was asking this same question, “But what do I do?” and “Who is going to help me?”

Like so many others, I know all too well about having a chronic health condition and living with that daily. Yes, I too have a chronic disease state and I also know what it is like to live in that chronic disease state. That is why I understand what many of you go through daily. I may not know what it is like to live with your disease state, but I know what it feels like to live in chronic disease state and have to live with the consequences of that disease.  I also know what it is like sitting there thinking that nobody seems to be able to help me and one seems to be getting nowhere with this. Then the vicious cycle of then doing nothing, because one believes that nothing works and nobody can help, and then nothing gets done and the symptoms continue and then you get even more and more frustrated. Yes, I have been there too. This is why I do what I do now and why I want to help others get out of their rut, and help them overcome their disease and learn to manage their disease better to then have a better life.

But unlike many others, I do know the power of positivity and know that once I put my mind to something and commit to it, then I’ll do as best I can and it also helps get the process going.  I also know that in order for something to change, that I also had to be proactive and make things change. It is that old saying “If you don’t change anything, then nothing changes”

So one day I sat down and said “Right, let’s just forget about whom I have been seeing, forget the blame game etc and let’s just really look at this objectively. What do (I) need to do to create a change?” and “Can I do all these changes on my own?”

Sometimes asking these sorts of questions about yourself can be quite confronting and when you do, you also need to be completely honest with yourself and have those around you be honest with you also. Then you have to take that advice, listen to what people are saying and then go about finding someone to help you and then actually make the necessary changes that are needed. But, finding someone to help can be really hard too. Like every other profession, or industry, or workplace etc, there are good and bad people in what they do. Unfortunately finding the good people to help can often be hard, but it doesn’t mean they are not out there. There are good people out there, and people who are excellent at what they do, but it also means not being sceptical and also having an open mind, otherwise you will just give up and not do anything again. Then you end up being in the vicious ‘poor me’ cycle again and that isn’t going to help anyone. This is where a good counsellor or psychologist can help and be impartial and be objective in what you need to do to move forward.

Then I also learnt that I had to stop the blame game and had to learn to stop making excuses. I know all too well that it was much as it is easy to blame others and blame things for not working, but at the end of the day we are all in charge of our own health, our own lives and what happens to our body too. Well, to a point anyway. I do know that sometimes you just can’t help genetics and hereditary disease, but at the same time, these disease states can be managed “If” you get proper care.

I remember a good friend sitting me down and talking to me about what I should do and also some of the questions this friend asked me. Some of the things he said to me and insights he shared with me were things like these.

  1. “Are the people you are seeing good at what they do?”
  2. “Have you noticed any changes after the treatments they have prescribed?”
  3. “How long have you been seeing these people for?”
  4. “What are your expectations around the treatments they have prescribed for you?”
  5. “Have you actually been doing the treatments they have prescribed”
  6. “Have you been taking the prescribed treatments and advice seriously and doing it properly?”

This friend of mine said to sit there for a minute or so and really reflect on what he was asking and be completely honest with myself.

He said to me “You know how some people come to see you and then they go away and then don’t take on any of the recommended changes and don’t do the treatments and then expect for things to miraculously changes and you to somehow just fix them without them having to do anything….. are you one of those people too?”

Not something I wanted to hear, but I did appreciate the honesty. I could relate to what he was saying because if one doesn’t do the necessary recommendation, or do the treatment, then one isn’t going to get better and then you can’t blame the person you are seeing if it all goes pear shaped.

Then he said to me “You can’t keep doing the same thing over and over again. If it isn’t working, you can’t then expect a different outcome each time, or just hope that all of a sudden it works.”    He then went on to say “I’ll put it to you this way. If you keep running into a brick wall and then it hurts and you fall over and then get back up again and try to do it again thinking it might not hurt this time, and expect a different outcome, when you know it is going to hurt, then you need to start asking yourself some serious questions”

Then he said to me “Let’s really look at expectation versus reality. You have had this disease state for a really long time, but in your own mind you want it fixed straight away, or after a few days, or after a few weeks.  The thing is… it isn’t going to happen.” He then continued “You know all too well that if you have had a disease state for years it isn’t going to fix overnight and that it is going to take months, or may even take a year or more to fully get on top of it, depending on the severity and what is going on”

This friend also said to me “Sometimes pain levels and symptom and all a matter of expectation versus reality too. Sometimes you think you aren’t getting better, when in fact you actually are. If someone where monitoring you properly you may have started out at 10/10 pain and may now be 5/10, which is an improvement. But, because you are still in pain, you won’t see it as such until someone points out the difference. It is all relative to what you believe versus what is actually happening ”

Lastly he then put it rather bluntly to me “Who the bloody hell have you been seeing and are they any good?” then he added “Because we all know there are people out there you wouldn’t send your dog to and the good ones are few and far between. Btw, who sent you there in the first place?”

He then added one more thing in “You can’t try and do this yourself, or try and treat yourself because that isn’t going to work and this is not your area of expertise. Go and see someone for advice and help and don’t be like many others and try and (Dr Google), or try and self-manage your own disease. That will end in tears”

So, after my brutally honest, but helpful, conversation with my friend, I did have a big conversation with myself and realised some things. These same things I now share with my own patients.

  1. Not everyone you see is good at what they do and if someone isn’t helping you, then you need to find someone that will. This is why now I always say to people that never underestimate the power of a second, or tenth opinion. Never give up until you find someone who will listen and then really help you.
  2. When you get a referral to someone, do your research and make sure the person you are seeing is well qualified to be helping you and your condition. You need to ask them the big questions and don’t be scared in asking the big questions. If they don’t seem qualified to help you, then find someone else. Also make sure your surgeon is advanced trained, if one is needed and also specialises in your disease state.
  3. Look at who is referring you. Look at what their knowledge of the area you need help with. It is your friend referring that may have no idea? Is it mum, or dad referring? Make sure the person referring you has a good knowledge base of the person they are referring to and also has a good understanding of your disease. Sometimes the people referring you have no idea and then refer you to someone mediocre. It is all about perception and sometimes perception of who is good and who isn’t might be a little distorted.
  4. Look at how long you have had a disease for and look at what your expectations are around how long it may take to see some changes? Then ask the person you are seeing for an honest opinion about how long they would expect to see some changes happening. No long term health issues fixes overnight and the longer you have a disease for, the longer it is going to take to help it and see some real changes.
  5. If you are asking to make changes and do a certain treatment and management plan, then make sure you do it 100%. For changes to happen you have to follow the advice given and stick to it. Forget what Dr Google says. If a professional with years of training tells you to follow their advice, then make sure you give it a chance and actually do it. You also need regular follow-up consultations and regular management to oversee those changes and also talk about any concerns and also talk about changes as they happen. You need to document changes and actually be managed properly. If a treatment isn’t helping, or you perceive it isn’t helping, then have a chat with your healthcare practitioner about this. If something really isn’t working, then you need to change something, or change the person you are seeing until you find someone who can help you.
  6. Pain levels and symptoms and healing times can sometimes be distorted when you are in pain. When you are in pain, or have bad symptoms sometimes you don’t always realise you have had changes, because you are still in pain and have symptoms. As my friend mentioned to me, sometimes you may have started at 10/10 pain, or symptoms, but now you may actually be 5/10 pain and symptoms. That is actually a big change and means you are getting better, but because you are still in pain, or have symptoms, you may not be able to see this until it is pointed out. As long as you are progressing and moving forward then this is good and something to give you hope that your treatment is working.
  7. You are always going to have bad days. Even with the best treatments and best management, everyone will have bad days and these are the days you need to be careful about and not get negative about. Shit happens. Bad days happen for everyone and we all have to be aware that while the bad days will happen, as long as you are moving forward, even if it is step by step, then this is a good thing. Like they say “Two steps forward, one step back”, which still means you are one step ahead of where you were.
  8. Don’t try and treat yourself. It is good to be educated and good to be informed etc, but relying on Dr Google, or friends advice etc, can be a bad thing too. We don’t try and cut our own hair, or fix our own car, or make our own medicines etc, so we shouldn’t try and fix ourselves either. We need someone who can be objective and someone who is actually qualified in the area that we need help with to get the best results.
  9. Many disease states need a ‘team’ or multimodality approach to give you the best results possible. We know that despite the best medical treatments, that many people are still in pain etc and it isn’t until they incorporate other therapies, that they then start getting positive results. Be open to trying new therapies and new things that may help you.
  10. If you do ever need to go to the emergency department for your disease, just remember that the emergency department isnt there to fix your chronic disease. They are there to stabilise your pain and stabilise your symptoms and once that is done, they are more than likely to send you home, if you aren’t in any medical danger. If so they will admit you. But part of critical care should be making sure you are referred to someone who can manage you clinically moving forward. The reality is that sometimes this doesn’t always happen.
  11. Never ever let the disease own you. You are not the disease and it does not own you and we need to be careful of not buying into the label and then letting the disease and the label consume us. Take back your power and be positive and use that to help you overcome the disease and being owned by the label.
  12. Be kind to yourself. That means eating good foods, exercise, lifestyle changes and getting out into the sunshine daily. Many foods that we eat are inflammatory and only add to the inflammatory disease process you are dealing with already. Create good gut health to build up your reserves of health gut bacteria to help your body and help your immune system. Get the body moving and get the circulation and blood flow moving to nourish the body too.
  13. Last but not least, never underestimate the power of the mind, or how emotions can be a big part of a disease state and some of those disease states symptoms. We check in our tax to the accountant, we check in our health with the GP, we check in our hair to the hair dresser, but when do we actually check in our emotions and our thought processes. Never underestimate the power of talk therapy and seeing a counsellor etc. The body mind connection is a big part of many diseases. Never underestimate the power of stillness and mindfulness and bringing the body to rest and being mindful of your life and what may be needed to help your health. There are people who can help you with mindfulness and meditation and creating that positivity in your life

Having lived with a chronic disease state for most of my life, I do know how challenging it can be for people and to find that strength and courage to actually get up and do something about your health. It can also be disheartening when the people you have seen have missed and dismissed your disease too. It all just compounds and adds to the daily burden of what you are going through. But, never let those things stop you from finding someone who can help, or finding the strength to get up and make the necessary changes you need to make a better life for you. I think that having a disease is sometimes like learning to ride a horse. You may fall off many times, but you need to just get straight back on again until you master the art of staying on and being a good rider and being in control. But even the best rider is going to fall of every now and again, and that is ok too.

Just remember that there is always help out there and there are people who will listen and who do specialise in the area you need help with. Lastly, for you to get better, it also needs for you to be a big part of the driving force behind that and actually do the work needed. Don’t just sit there in ‘poor me’ mode. Get up and get yourself out there and do what you need to do for you. If something isn’t working then change it. Just remember that in order for a change to take place, something has to change. Something that means you changing your belief and your thinking too. It might also mean changing the healthcare provider you are seeing too.

As someone who has been there, I hope this helps you all get the help you so desperately deserve. Just remember that if you don’t know what to do, or where to get help, please know I am here to help you as well. You can always book in a consult (in person, or via online) and I can help assist you with your health, and also point you in the right direction too.

Regards

Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Normal 20 07 2016

Dr Andrew Orr Logo Normal 20 07 2016

Causes of bleeding in between cycles

Why am I getting bleeding between my periods?

Vaginal bleeding between periods can be common and is not generally a cause for concern. Most of the time women will get just very light pink coloured watery flow, or just some spotting. There can be many reasons why a woman would be getting bleeding between periods, which includes hormonal changes, injury, or an underlying gynaecological, or health condition.

While bleeding between your periods may not be cause for concern, on one level, the ideal situation is to not have any form of bleeding at all and if you do get bleeding between your cycle, it is a good idea to have this investigated, just to be on the safe side.

What a proper menstrual cycle should be like

I have done quite a few posts on what a proper menstrual cycle should be like, but I will go over this again just briefly

A proper menstrual cycle should be between 26-32 days in length and really only have about 3-5 days flow. Any longer than this can be too long and put a woman at risk of being low in iron, especially if this happens all the time.

The blood flow should be a nice red consistency, no clots, with no stopping and starting, and women shouldn’t have too many digestive disruptions, and really, a woman should not be getting pain with her cycle. A little bit of distention and knowing the period is coming is fine, but there should not be pain at all. If you have to reach for the pain killers and the heat pack, or are doubled up in pain, this is not normal and you need to get this checked out.

What are the causes of bleeding between periods?

As mentioned before, there can be a variety of reasons for breakthrough bleeding, some of which are no cause for concern at all. Some however do need to be investigated.

Below are some of reasons for bleeding between periods:

Ovulation

When an egg is released from the ovary, it does create a tiny wound, through which the egg will then travel through the tubes and prepare to make its way to be fertilised, or then shed with the menstrual flow. At ovulation, this tiny wound can also create a tiny amount of bleeding, which can be seen as spotting during the ovulatory phase of a woman’s cycle.

Implantation bleeding

When an embryo implants into the uterine lining and begins to grow, many women experience spotting around this time. This is called implantation bleeding. They may also experience some slight cramping at the same time and all of this is quite normal. Some women may then experience some lighter bleeding as the embryo grows further. They usually get some light spotting, which can be a light pink, or a brown colour. Sometimes it can be more like fresh blood. While this is normal, it is a good idea to get this checked out just to be on the safe side and to also put the pregnant mothers mind as ease too.

Miscarriage

Bleeding between menstrual periods can be an early sign of a miscarriage. Many women may not even know they are pregnant and may be completely unaware they are having a miscarriage.  While it is generally thought that once a woman reaches twelve weeks gestation everything is generally going to be ok, miscarriages can occur at any time during pregnancy.

Termination

After having a termination women can bleed for some time after the procedure, or taking the medication to start the abortion process. If bleeding continues and is very heavy, women need to seek medical advice.

Polyps 

Polyps are small growths that can develop in the uterus or on the cervix. They are often a cause for unexplained bleeding between the cycles. Polyps do need to be removed as they can prevent implantation happening and they can also turn cancerous if left behind. Polyps are a very common cause of bleeding between periods.

Fibroids

Fibroids, or myomas (also known as leiomyomas, or fibromyomas) are growths, or benign (non-cancerous) tumours that form in the muscle of the uterus. Up to 40% of women over the age of 40 years have fibroids and as many as 3 out of 4 women develop fibroids in their lifetime.

Fibroids can cause heavy bleeding, extended bleed and painful periods. They can also cause infertility, miscarriage and premature labour. In many women, they will not cause any problems at all. Fibroids are a very common cause of bleeding between the cycles.

Polycystic Ovarian syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) is a very common condition that can cause irregular periods, absent periods, and can also cause bleeding between periods. PCOS can also cause other issues such as acne, weight gain, infertility and hormonal and emotional disturbances.

Endometriosis or Adenomyosis

One in ten women are diagnosed with endometriosis and many more do not even know that they have it. Endometriosis and Adenomyosis are very closely related, with endometriosis usually being more superficial disease and not confined to the uterus,  and adenomyosis being deep within the uterine tissue. Chronic conditions such as endometriosis and adenomyosis, can cause bleeding or spotting between periods.  These conditions may also cause heavy or painful menstrual periods and cramps between periods. Adenomyosis will usually cause more bleeding symptoms along with pain etc.

Sexually transmitted infections (STIs)

Some sexually transmitted infections (STIs) can cause pain, vaginal bleeding and spotting. If you do suspect you may have a STI, you need to see your doctor for investigation and treatment.

Injury to the vaginal wall

During sexual intercourse the tissue of the vagina can be damaged and this can then cause bleeding. If the vagina is too dry, lack of arousal, and not lubricated enough this is more likely to happen. It can also happen if there is atrophy in the vaginal tissue as well. This is called atrophic vaginitis.  This is more likely to be seen when a woman is going into menopause, or undergoing cancer treatments, or has diabetes.

Menopause or perimenopause

The menopausal stage of life and especially the perimenopause stage, can be a cause of irregular menses and irregular bleeding. It can also cause spotting, or heavy bleeding too. Perimenopause is the period leading up to menopause. This stage of a woman’s life can last for up to 10 years as hormone levels in the body change and can be unstable.

Hormonal contraceptives

Hormonal contraceptives are a common cause of bleeding between periods. They can also cause irregular bleeding and this can be quite usual in the first 3 months of using the contraceptive. If a woman misses takin her oral contraceptive, it can also cause irregular bleeding, or a withdrawal bleed.  Intrauterine Devices (IUD’s) like the Mirena, will often cause irregular periods and irregular bleeding in the first 3 months after it have been inserted. If bleeding lasts for longer than 3 months on any contraceptive, it is a good idea to seek medical advice and get investigated and managed properly.

Emergency contraception

The morning after pill, or emergency contraceptives, may also cause bleeding. If bleeding persists, you should seek medical advice.

Certain cancers

Vaginal bleeding between periods can also be a sign of gynaecological cancers in women. Most bleeding that women get is not serious, but it still needs to be checked.  Cervical cancer can affect women of any age. Bleeding between the cycle, or after intercourse, and pain after intercourse, or unpleasant smelling discharge can be symptoms of cervical cancer and these all need to be checked by your doctor, or gynaecologist.

Uterine cancer tends to occur in women over 50 year of age. One of the early symptoms of uterine cancer can be vaginal bleeding. Uterine cancer mostly affects women are in the menopause and no longer have periods, so this is why any bleeding after menopause needs to be investigate and seen as not being normal.

Stress

Yes, stress can cause abnormal bleeding and also interfere with a woman’s cycle. Increased levels of stress can interfere with hormones and this can lead to bleeding, irregular cycles, or pain with cycles too.

When to see a doctor

If vaginal bleeding between periods is heavy, persistent, or unusual then a woman should go and see a specialist, or a gynaecologist, who is a specialist in this area of medicine. As mentioned previously, while some causes of bleeding are not serious, some are and need to be properly investigated and properly managed medically.

Treatment and prevention

All women should keep a record of their menstrual cycle and when the period starts and how long it lasts for. Any abnormal bleeding should be recorded so that you can show your healthcare specialist if need be. Any abnormal bleeding should be investigated and the treatment will depend on what the underlying cause is.

Women should try and see their healthcare specialist for regular pap smears and regular check-ups for gynaecological health.

If women are getting small tears and bleeding caused from dryness in the vagina, then there are water based lubricants that can be used to help with lubrication and to moisturise the surrounding tissue.

There is no cure for gynaecological and reproductive issues such PCOS and Endometriosis, but these disease states can be treated and managed to give women a normal life. Proper treatment of these issues needs a “Team”, or multimodality approach using medical options, surgical interventions, pelvic floor specialists, acupuncture, herbal medicines, hormone therapies, and diet and lifestyle changes. It is about using what works for the individual and not a blanket one treatment fits all approach.

Last but not least, all women should know that period pain is not normal and that irregular bleeding really isn’t normal either. While most causes of bleeding are not life threatening, they still need to be investigated and checked out properly. Never ever put off seeing a specialist if you have abnormal bleeding.

Regards

Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Normal 20 07 2016

 

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Menopause

The average Australian woman reaches menopause at 51 years of age- with a normal range from 40-55. Contrary to the popular concept, the female body does not become depleted of eggs at this time, but the remaining follicles become less and less responsive to hormonal stimulation.

Premature menopause is defined as cessation of ovarian function prior to 40 years of age. About 1% of women will experience menopause before 40.

The approach of menopause is signalled by rising LH and FSH levels as the pituitary attempts to prompt a response by the ovaries.

The menopause signals the permanent end of most ovarian function and hence the menstrual cycle in a woman’s life. Sex hormones don’t only influence reproductive tissues but also have a multitude of other functions including effects on bone and mineral metabolism, cardiovascular function, memory and cognition, effects on the breast and genitourinary system as well as nutrient absorption.

There are a variety of symptoms which are believed to be due to reduced oestrogen levels and approximately 85% of women will experience some of these symptoms to a greater or lesser degree. These symptoms can be summarised as:

Vasomotor symptoms– (these tend to be early onset):-Hot flushes ( or “flashes” as they are called in USA literature), Night sweats, Formication ( a particularly unpleasant sensation likened to ants crawling under the skin – “formica” is latin for ant)

Urogenital Symptoms– (tend to occur about 3-4 years after menopause):-Dry Vagina, Change in vaginal pH, Atrophic vaginitis/altered vaginal discharge, Dyspareunia, Urinary frequency/dysuria/aggravation of stress incontinence

Associated physical changes-these are partly the result of the normal ageing process, but may be accelerated by declining oestrogen levels. These may include decreased fitness and flexibility, changes in distribution of body fat, changes in sleep patterns

Loss of elasticity of skin and support tissues (may result in):- Worsening of uterine prolapsed, Loss of glandular breast tissue ( breast size and texture changes), Skin changes and wrinkling, Less nipple sensitivity and erectile potential, Joint and muscle pain, Skin dryness

Emotional and psychological changes– it is sometimes difficult to separate the hormonal from the personality-driven and situational as the cause for these symptoms, but women at the menopause may complain of such symptoms as:- Anxiety and/or depression, Insomnia, Lack of concentration and poor memory

Effects on Bone– (these effects may not become apparent until some years after menopause) :- Osteopenia/osteoporosis, Fracture and bone pain

There are other symptoms which have been ascribed to declining androgen levels, though the evidence is less clear-cut. These may include such symptoms as:
Change of body shape – increasing fat deposition around abdomen, less at buttocks and thighs
Loss of libido :- Many libido issues are caused by emotional issues and changes to lifestyle rather than being a hormonal issue
Change in body hair distribution– Pubic hair thins, hair on the head may thin or if woman carries the gene for male-pattern baldness may recede at temples and crown. Facial hair may increase.

Treating symptoms of Menopause

The main cause of people seeking treatment for the menopause is for relief from vasomotor symptoms, the main one being hot flushes or night sweats.

There is a lot of misinformation about the peri-menopause and menopause stage of a woman’s life. Some of the peri-menopause (meaning before the menopause) symptoms can start up to 8 years before a woman actually goes into menopause (meaning the menses stop). Then some of the actual menopausal symptoms can last many years after the menses has stopped and this is something that is not discussed enough and often poorly understood by many, including many healthcare practitioners.

Some women with menopausal symptoms do not choose to pursue any medical treatment when they experience it. However, some women have severe symptoms that affect their quality of life, and may need to have medical treatment in the form of hormone replacement. One of the biggest fears around hormone replacement therapy is the increased risk of breast cancer. You can talk to your specialist, or doctor about these risks before you start any form of treatment. There are now compounded bio-identical hormones to assist menopausal symptoms and these may not have the breast cancer risk factors of conventional hormone replacement medications.

Examples of some medical treatments available for menopause include:

  • Hormone replacement therapy, such as taking estrogen therapy at the lowest, most effective dose.
  • Vaginal estrogen, which is applied directly to the vaginal tissues to aid with elasticity and assisting with vaginal atrophy
  • Antidepressants (SSRI’s), have been shown to reduce the incidence of hot flashes in some postmenopausal women.

Traditional medical HRT can also help with bone strength and reduce the risk factors for heart disease.

Bioidentical Hormones

The Women’s Health Initiative of 2002, issued a warning against the long-term use of traditional hormone therapy (HT) because of the increased risk of breast cancer, but this study was poorly explained and created lots of panic for both practitioner and patient alike. Since then alternative methods, such as bioidentical hormone therapy, have been developed.

Bioidentical hormones  are chemically the same as those that the body produces naturally. As a result, the body should is not able to tell the difference between the hormones it produces and the bioidentical ones. Bioidentical hormones can be made from a variety of sources that span plant and animal products and are said to have less side effects than traditional hormone replacement medications. Many women get great relief from Bio-identical Hormones, but it is important to speak to your healthcare provider about these and if they are suited for you

Complementary Medicines

Women may also consider trying herbal medicines or other dietary supplements as a means to reduce the incidence of menopause symptoms. There are now many menopausal formulations on the market and anyone wishing to use complementary medicines should speak to a qualified complementary medicine practitioner about what is suitable for them. Never self prescribe natural medicines with consultation from a qualified healthcare practitioner.

Chinese Medicine and Acupuncture

Chinese medicine has been treating and assisting symptoms menopause for thousands of years very effectively. The key to Chinese medicine treatment is that a practitioner will assess and treat each person individually, not with the one treatment fix all plan. We aren’t all the same so why should we all be given the same treatment.

It must be noted that up until recent times the Chinese did not have a word for Menopause and that very few women experienced any of the symptoms of menopause. The only ones that did seem to were the rich and those of noble heritage, who ate very rich and luxurious diets. This does show that diet and lifestyle factors do affect menopausal symptoms. Many used to believe that the Chinese didn’t get menopause because of their higher consumption of phytoestrogens such as soy. This has now been proven not the case, as soy products “do not” have any benefit to menopausal symptoms, but adherence to proper diet and lifestyle improvements does.

There is also some really good evidence to show that acupuncture can assist with hot flushes and also assist with the symptoms of menopause.

Things to do at home

In addition to medical and complementary medicine treatments, there are many at-home treatments that a woman can do to reduce menopausal symptoms. These include:

  • Avoiding triggers that are know to make hot flushes worse. Examples can eating spicy foods, drinking hot beverages, acidic foods,  being in hot weather, or being in hot rooms.
  • Using water-based vaginal lubricants during sexual activity to reduce discomfort due to dryness and thinning tissues. Vaginal estrogen creams may be needed as well
  • Reduce Stress & Practicing stress-relieving techniques. Examples can include mindfulness, Tai Chi, Qi Gong, meditation, yoga,  journaling, massage, counselling and other forms of relaxation therapy
  • Do not smoke. Smoking can increase the risk of hot flushes and contributes to many other health issues such as certain cancers.
  • Do Weight Baring Exercise. Weight baring exercise is needed to keep strong and health bones and it also has other health benefits. You can also look into doing yoga and pilates to help with core strength and to help with pelvic floor strength and tone. Exercising can also help to relieve stress.
  • Pelvic Floor Exercises. Kegels exercises or use of Jade eggs (known as yoni eggs), or Ba Wen Balls, can help with pelvic floor muscles and increase blood flow into the vagina and pelvic floor area and also help with bladder control

Summary

It must be noted that menopause is a normal part of a woman’s life and menopause is not a medical condition. The main reason that women seek help in menopause for is the menopausal symptoms such as hot flushes, dryness and loss of libido etc. At my clinic I use a multi-modality and individualized approach to treating  and assisting the symptoms of menopause, using a combination of Medical science, Integrative Medicine treatments,  Chinese herbs, Diet, Nutritional supplements and Lifestyle changes and find this gives the best results in assisting my patients.

Regards
Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Retina 20 07 2016

 

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Sex During Pregnancy

It is completely safe for a woman to continue having sex throughout her pregnancy unless her doctor, specialist, or midwife has told her otherwise. Not only is it completely safe to have sex during pregnancy, having sex can have some benefits also.

Being a Reproductive Medicine and Women’s Health Medicine Specialist, I see lots of beautiful pregnant bellies. It is so nice to see all those pregnant bellies and some I have been a big part of them being able to fall pregnant. Personally I think women look their best when they are pregnant. They look so radiant and beautiful and let’s face it, everyone loves to see a pregnant belly and comment how beautiful the mum to be looks. I am sure some women may not feel that way on the inside, but I can tell you that women do get that glow and radiance when they are with child.

When a couple first gets the good news about being pregnant.one of the things I always get asked is “Can we still have sex during the pregnancy?”

The answer will always be “Of course you can”, unless there is something that may prevent that from happening. To be honest, sex during the early stages of embryo growth can actually assist implantation and sex can also help with the increase blood supply to the endometrial lining, which then helps feed and nurture the growing embryo and then later, baby.

It is important for couples to know that sex will not harm the baby at any stage during a normal, healthy, uncomplicated pregnancy. Can I just tell the guys that the uterus (womb) is closed off by the cervix and no man’s penis is ever going to get through that, or in many cases even reach it. They wish they were that big …lol

A woman may not feel like having sex in the first trimester, due to morning sickness, or some early bleeding etc, but I often have to have a joke the males that they are the ones that may be saying “No” later on in the pregnancy. A woman’s sex drive may increase at certain stages of the pregnancy, and this is important for couples to be aware of. It can also be a great time for the couple to bond and come closer together, through increase levels of intimacy. Some men become even more attracted to their partner during pregnancy as the results of different hormone, pheromones and changes to body shape, such as increased breast size.

During pregnancy sex can have many benefits for both the male and female. It can have the following benefits

  • It can help with early implantation and assisting the embryo to implant and grow
  • It can bring a greater level of intimacy and bonding for the couple
  • It can increase the libido of the couple
  • Increased hormones and increased blood flow to the genitals can mean better orgasms for women.
  • Sex can increase the couples immune system and also keep them fit and healthy
  • Sex during pregnancy can increase endorphins which make a couple more happy

The only issues couples may face is that as the belly grows bigger, they may have to adopt certain positions that are more comfortable for the woman. A pregnant woman may be more comfortable where she is in positions where she can control the speed and depth of penetration. Lastly, oral sex is completely safe during pregnancy as well.

Sex and labour

There have been many studies to show that vaginal sex during pregnancy has no increased risk of preterm labour, or premature birth. As mentioned before, if there are concerns, you can speak to your specialist, midwife, or doctor.

When trying to induce labour, sometimes a midwife, or specialist may recommend for you to have increased levels of sex to try and bring the labour on. Many people think it is about the prostaglandins in sperm, which can help ripen the cervix, but it is more about the female orgasm. When a female orgasms, not only is there increased blood supply to the female genitals and uterus etc, but it also helps with hormone activation, such as oxytocin, which is known as the love hormone. But this hormone can help to activate labour at the time a woman is due. It won’t help activate labour any other time in the pregnancy though.

It is possible that sex and orgasm could induce Braxton-Hicks contractions late in pregnancy. Braxton-Hicks are mild contractions that many women experience towards the end of their pregnancy. However, these contractions do not mean that a woman is in labour, or close to being in labour, so they really are of no concern.

When you may need to avoid sex

As mentioned before your specialist, midwife, or doctor are the best people to advise you when to avoid sexual intercourse during her pregnancy. Always consult with your specialist, midwife, or doctor if you are worried about any abnormal signs during pregnancy.The main times that sex might need to be avoided are:

  • There are problems with an incompetent cervix, or issues with early labour, or threatened miscarriage
  • Any Bleeding, or unexplained vaginal bleeding
  • Leaking amniotic fluid
  • If a woman’s waters have broken

Sex after giving birth

This will depend on many things and usually a woman will know when she is ready to have sex again. All new mothers need time to heal and recover after giving birth, or after a C-section.  Women can return to sexual activity whenever they feel they are ready to do so. Some women may not feel like sex for a while after the baby is born and partners need to be aware of this.

Just to recap

In most cases, sex is completely fine during pregnancy and poses no risk to the mother or baby. Pregnancy can be a time where the couple can enjoy more intimacy and bonding with increased sexual activity. Like I mentioned before the only thing to be aware of is that some positions might become more or less comfortable as the pregnancy progresses.  It is important for a couple to continue to have a healthy happy relationship during the pregnancy time and to continue to have a healthy sex life throughout the pregnancy as well.

Regards

Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Retina 20 07 2016

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Mediterranean Style Diet May Help to Improve Pregnancy Rates for Couples Undergoing IVF and Assisted Reproduction.

New research published in Human Reproduction, has found that those who follow a “Mediterranean” style diet at least six months before assisted reproductive treatment have a significantly better chance of becoming pregnant and giving birth to a live baby than women who did not.

As part of my Fertility Program, one of the first things I talk to couples about is the importance of a healthy diet that has adequate protein, lots of vegetables, seeds and nuts, healthy oils, adequate water intake, electrolytes and cutting out all the refined carbohydrates that cause inflammation. The hard thing is that I hardly see a couple following those health food principles, with many not even really knowing what a health diet is. The diet that I promote is a Primal based diet.

Previous studies have shown that when refined carbohydrates are cut out and replaced with proteins, essential fats and good carbohydrates, such as fruit and vegetables, that the clinical pregnancy rates shot up by 80%. (Fertility & Sterility 2012 Volume 98 issues 3 Page S47)

In this new study, researchers focussed in dietary patterns rather than individual nutrients, food, or food groups. They found that those who ate lean protein, more fresh vegetables, fruit, fish and olive oil, had a 70% greater likelihood of achieving a successful pregnancy and birth compared to women who didn’t follow this style of diet.

The research outcomes found that out of the 244 women in the study, 229 women (93.9%) had at least one embryo transferred to their wombs; 138 (56%) had a successful implantation; 104 (42.6%) achieved a clinical pregnancy (one that can be confirmed by ultrasound); and 99 (40.5%) gave birth to a live baby.

The most important message to come from the study is that women attempting to have a baby should be encouraged to eat a healthy diet, such as a Mediterranean style diet, because it may help increase the chances of successful pregnancy and successful live birth.

The researchers did note that when it comes to conceiving a baby, diet and lifestyle are just as important for men as for women. Previous studies from the same research group showed that male partners that adhered to the same sort had better semen quality.

A healthy diet is important for all couples prior to trying to conceive and should be a part of any preconception planning by all healthcare practitioners assisting couples with fertility. While this study focussed on improving assisted reproduction pregnancy rates, this style of diet should be adopted by any couple wanting to have a baby and should be implemented at least 6 months prior to conceiving. This is why it is essential for all couples to receive counselling and guidance on the importance of a healthy diet and having a healthy lifestyle as well. This is a foundation of my fertility program that has helped over 12,500 babies into the world and continues to help many more couples reach their goal of becoming parents.

Regards

Dr Andrew Orr

-No Stone Left Unturned

 

Dr Andrew Orr Logo Retina 20 07 2016

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Weeding Out Endometriosis

Explaining endometriosis to people is not always easy and sometimes you have to use analogies that seem strange at first, but once you get the gist of where I am going with it, it will all make sense. But before I start, I always like to say that please take the personal out of things and just know that what ever analogy I use, it is with good intention and always about helping others.

I just know that when I used the “Endo is like Rust” analogy, which is what it is like, a few people took it to heart as though they had a rusty uterus and this is not what I was saying. Not at all. Please know that I have loved ones with this horrible disease, so I am here to help, and my main aim now is to help as many people as possible with what I know, and how to treat people properly. I am also about getting the message out there so that women to not have to remain silent about this disease any longer. My motto is, and always will be, “Period Pain is Not Normal”

So, sit back, take out the personal and know that I am writing from a place of caring and sharing and a place of getting the message out there to help you all. Sometimes you just have to tell it how it is, in order for people to sit up and listen, so here we go J

Many of you have read my article of “Rust Never Sleeps and Neither Does Endometriosis” and the reason I wrote this is because endometriosis and how it attacks the body, is very much like how rust attacks metal. If you haven’t read the article, please do so that you can see what I am trying to convey.

I am always doing lots of speaking events and seminars on Women’s Health and also presenting for workshops on Endometriosis. It is so great to get the message out to the world, so that both the public and healthcare professionals can be educated on this subject better. We need to stop having this disease “Missed” and women being “Dismissed” as I am always saying now. This disease should not be taking 8 years from onset to definitive diagnosis. It used to be 12 years. This is disgusting, to say the least, and there is no excuse for this to be happening, except poor education, sloppy diagnosis, lack of training, negligence and dismissive egos that need an attitude adjustment.

But, in saying that, we also need to teach women to be empowered and not just put up with being told “This is normal”, or “Just go on the pill and it will fix it”. That is bullshit (sorry). But it is true. There needs to be a better way and we need to stand up and say “Enough”. But we also need to not let the disease define you and get caught up in the blame game either. We also need to get people to stop “Dr Googling” too, as this is also spreading the misinformation. It is great to be educated, but good old “Dr Google” is full of false information and research shows that up to 75% of the health information that the public can access on google, is either wrong, or only partially true.

Now that I have had my little rant about the injustices of many, I would like to share what I have been sharing to others about what endometriosis is really like and how hopefully we can prevent it from returning, hopefully for good. I do know this is possible with the right care, right follow up treatments and right team of people helping. I see it daily and know what I share to be true. But, again it requires the person to follow the advice given and then to get the information out there. It also requires people to not be defined by their disease and break free from these chains to open their minds to the possibilities of new thought, new treatments and new ways of doing things. We need to not be caught up in what may cause the disease, but what we can do to help those with it now.

Of course prevention is crucial and so important, but once the disease is expressed in the body, what caused it is irrelevant. We can argue about the hypothesis of what may be the initial causal factor until the end of time, but that isn’t helping those with the disease now. The most important factor is how we can help those with it live a normal life and hopefully one day in the future to be free of the disease completely. At least  for now, we can look at hopefully giving people a better quality of life than the one they are living each day. From my experience, I do know that this is possible with the right team of people working the help the individual.

To be honest, the most likely cause of this disease is now known to be genetic links, or chromosomal, most likely through the parental mode of inheritance. Gene therapy is probably going to provide the biggest breakthrough in this disease in the years to come. But like any breakthrough, we just have to wait and see what happens there. You heard it here first. I do believe genetics does play a big part, but like any disease, it is not the only contributing factor. But, all this aside, we need to focus on the here and now to help those who need help now. In order to make change, you need to make those changes required. If you change nothing, nothing will change. I also get how hard it is for those whom have suffered so long to pick themselves up, to make those changes. Believe me, as someone who has been through a major life threatening illness and pain and crawled their way back to good health and do what I do now, I get it. I’ve been to that point of wanting it all to just stop and I get what many women put up with on a daily basis. Pain is pain, no matter where it has stemmed from.

Getting back to the subject at hand, I have now been explaining that Endometriosis is like a weed. Why would I explain it like this?

Like a weed, endometriosis grows and spreads. You can physically remove the weed (surgically), but unless you control the regrowth, seeds have been dropped (endometriosis regrowth) and then the weeds pop up again and start to grow once more. Sound like endometriosis too you?

Like any weed, it needs certain things for its regrowth. We have just talked about the dropping of the seeds ( regrowth) but it needs a food and fuel source to make it grow (estrogens, insulin, inflammatory response from external factors, stress etc). Then once the seeds are fed, the regrowth continues and then the garden is infested with the weed plague once more. Then you need to try and physically removed the weeds again once more and so the cycle begins again. Are you seeing what I am getting at yet?

Just like these weeds, endometriosis is often removed and many people then either believe they are fixed, or they do not do anything post surgery to prevent that regrowth. Before they know it, they again have to go back for more surgery. Often when people do try to control the regrowth (Progestins, Mirena etc), they are only employing one method, for which is either not effective enough, or the weed (Endo) is now resistant too.

This is why we need to employ a multimodality approach post surgery to hopefully complete eradicate the weed regrowth and halt the life cycle of these seeds being spread and to start growing again, thus starting the horrible cycle all over again

Now that we can see how endometriosis is really like a weed that can spread throughout our garden, we need to look at what we can do to hopefully stop it coming back, or spreading into other parts of the body.

Like I said, treatment must be individualised, using a multimodality approach, taking the clinical problem in its entirety into account, including the impact of the disease and the effect of its treatment on quality of life. Pain symptoms may persist despite seemingly adequate medical and/or surgical treatment of the disease.

The real focus needs to be on prevention and treatment strategies post surgery. Even better still, lets prevent it before it starts

There is an ancient Chinese saying – “To try and treat a disease once it is fully expressed into the body is like trying to forge arms once a war has already started, or like trying to dig a well once you are already thirsty – Yellow Emperors Classics of Internal Medicine”

The same goes for endometriosis. Once the disease is there and expressed into the body, it is hard to treat, especially is known methods of treatment are failing and this individualised, multimodality approach is used.

A Multimodality Approach Needs To Include:

  • Surgery
  • Pain Management
  • Hormone Therapy
  • Counselling
  • Lifestyle changes
  • Exercise
  • Pilates/Yoga
  • Changes to Diet
  • Traditional Chinese Medicine
  • Acupuncture
  • Holistic Medicine
  • Anything people have tried and has worked for them

The Royal College of Obstetricians & Gynaecologist guidelines for the “Investigations and Management of Endometriosis” have the following quote:

“Many women with endometriosis report that nutritional and complementary therapies such as homeopathy, reflexology, traditional Chinese medicine or herbal treatments, do improve pain symptoms. They should not be ruled out if the woman feels they could be beneficial for her overall pain management and/or quality of life, or work in conjunction with more modern medical therapies.

This is why it is vital to take careful note of the woman’s complaints and to give her time to express her concerns and anxieties, as with other chronic diseases, just as I do for all of my patients. Healthcare providers actually need to listen to the woman and her concerns. Women need to be listened to and be heard and be nurtured

It is also important to involve the woman in all decisions, to be flexible in diagnostic and therapeutic thinking, to maintain a good relationship with the woman and for healthcare providers to seek advice where appropriate from more experienced colleagues. This is something that I try to educate all my patients with and something I also try to educate healthcare providers with when I do my seminars and speaking events about Women’s Health issues and diseases like endometriosis.

But while there are thing that healthcare providers need to do, there also things you must do also. These include

  • Reducing Stress
  • Look at Emotions and How They Affect You
  • Exercise
  • Get “You Time”
  • Eat more protein and less High GI Carbs
  • Eat less process and package foods that we now call “Carbage”
  • Loss some weight if you have excess fats (which spike estrogens)
  • Gain some weight if you are underweight.
  • Do Something You Love (At least once per week)
  • Laugh Often (Even if some days you feel like crying)
  • Spend Time With Friends and Loved Ones
  • Make Love J ( Climax and Oxytocin are your friends)
  • Do Not Let The Disease Define You
  • Don’t Buy Into The Label
  • You are more than this disease
  • If something is helping, then continue with it, no matter what anyone tells you
  • Just remember that “You” are uniquely “You”

Please remember these words :

  • Do Not Let The Disease Define You
  • Don’t Buy Into The Label
  • You are more than this disease
  • If something is helping, then continue with it, no matter what anyone tells you
  • Don’t buy into everything you read on the internet, social media, or “Dr Google. To be honest, I ban “Dr Google” with my patient (haha)
  • Make sure you have a good laugh each day, but remember it is also OK to have a good cry too
  • It is OK to unplug every so often
  • It is OK to take the “Superwoman” cape off every so often too.
  • Remember “You” are uniquely “You”

This is why it is so important to not get caught up in what others have done, or tried and may not now be working for you either. We need to look at you as an individual and treat you as such. What works for one person, may not work for another. This is why an individualised multimodality approach is needed to help prevent and treat this horrible disease and we often need a team of people, on the same page, to help treat this properly.

Don’t forget to “Get A Second Opinion”, or a Third, or Fourth, or Tenth one if needed

In many other areas in life we will get multiple quotes, and opinions. Yet, when it comes to our health, we often only get one quote, or maybe two.

Just because someone has your history, or is nice to you, or maybe recommended by a friend etc, does not make them a good practitioner. It does not mean that you cannot get another opinion. If someone isn’t helping you, then you need to look at changing, no matter who they are, or how well they know your history. Not every specialist you see is a good surgeon either, so please remember this. You need to have someone who specialises in endometriosis and who has done advanced surgical training, not just minimal training. There is good and bad in every profession and the medical profession is not exempt from this either. Neither is the complementary medicine profession, or allied health care profession exempt from this either. Your health is important and so is the value of another opinion. Not every practitioner has all the answers. If someone isn’t helping you, then don’t be scared to change.

Lastly please remember to know that there is always help out there. I am always here to help and I am a specialist in this area, alongside many other Women’s Health issues and Gynaecological issues. You can always come and see me in person, or make an appointment via skype, for those who live at a distance. I have a great team of people I work with to give you the best help possible. I have a team of some of the best health care professionals there is and I make sure all of them are at the top of their game in their chosen profession.

Let me be the conductor of your health issues and help you get the treatment and advice you so desperately deserve. I am here to listen to you and hear you. I make sure you don’t have things “Missed” and aren’t “Dismissed “ and why my treatment motto is “Leaving No Stone Unturned”. I am out there as a voice for women and being a crusader for women’s health everywhere. I don’t mind stepping on a few toes, and ego’s to get you the best help possible J

Take care and remember that “Period Pain Is Not Normal” and neither are and other “Menstrual Irregularities” that women face on a daily basis. I know what you go through daily and I am out there making sure you all get heard. Let’s end the silence on this horrible disease for you, and the ones close to me whom I love, adore and care about also.

Regards

Dr Andrew Orr

No Stone Left Unturned

Dr Andrew Orr Logo Retina 20 07 2016

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Genetics & Gene Sequencing May Be The Path To a Cure for Endometriosis

I have always said that the biggest inroads to the management and treatment of endometriosis will come from the area of genetics. I’ve also said that if there is going to be a cure, this will be the pathway that is comes from.

New research published in the New England Journal of Medicine has revealed that Gene sequencing has found a set of genetic mutations which may help to develop molecular tests to distinguish between mild and aggressive types of endometriosis. This is a big step forward into finding out more about endometriosis and developing better medical treatments and management strategies. Hopefully one day it will also lead to a cure for women with this horrible disease.

Endometriosis is a painful disorder in women which uterine tissue grows outside of the womb, most commonly into the abdomen, and will affect at least 1 in 10 women. It can spread to every part of the body.

Many women with endometriosis will experience symptoms of abdominal pain, migraines, pain with sex, ovulation pain, IBS like symptoms, UTI like symptoms (without infection present), menstrual cramps, abdominal distension and possible issues with infertility.

Endometriosis can affect both physical and mental health in sufferers. While a portion of women with endometriosis get pain and associated symptoms, it needs to be noted that a significant portion of women with endometriosis are asymptomatic (no symptoms) and would not even know that had it, until they are investigated for fertility purposes.

This discovery helps moves towards developing genetic based systems for classifying endometriosis to sort out which forms of the disorder needs more aggressive treatment. Presence of the unusual set of mutations suggest that while origins are rooted in normal endometrial cells mutations change their fate, the mutations identified have links to genetic mutations found in some forms of cancer. Abnormal endometriosis tissue growth will often spread throughout the abdominal cavity but rarely becomes cancerous with exception to a few cases when the ovaries are involved.

The close links to cancer have always baffled scientists, as endometriosis does behave like a cancer the way it spreads, and now they have found some of the same mutations found in cancers, in some of the endometriosis lesions. But again, endometriosis rarely turns cancerous, except if it does spread to the ovaries, but there have been some studies to suggest links that women with endometriosis may be at more risk of endometrial cancer.

In this latest research, the research scientists analysed the samples looking for mutations or abnormal changes in DNA and filtered out normal variations in genes which commonly occur. At least one or more mutations in endometriosis tissue that were not present in their normal tissue, in which the number and type of mutations varied per endometriosis lesion and each woman.The types of mutations found were among the most common mutated genes found, which are all known for DNA repair, controlling cell growth, and cell invasion.

The researchers are working on additional studies to investigate whether patient outcomes correlate with the mutations. Testing which can sort lesions into less or more aggressive has potential to help decide how to monitor progression as well as control and treat the endometriosis. It may also be possible to develop new treatments which use agents that block gene related pathways specific to an individual’s disease.

Women are normally prescribed anti-hormonal treatments, which block estrogen to shrink lesions. Endometriosis is estrogen driven and is not from estrogen dominance, as some people would have women believe. Even small amounts of estrogen can drive the disease and cause the expression of the lesions. When endometriosis occurs on the ovaries and forms a large cyst, or endometrioma, it is typically removed as it increases the risk of developing ovarian cancer in some women.

While this new development is not a cure for endometriosis, it is providing new insights into the disease, which will hopefully one day see a cure in the not so distant future. Lets help end the silence for women with this horrible disease by getting more awareness out there and let us hope that the cure will eventually come one day soon.

Regards
Dr Andrew Orr
-No Stone Left Unturned
-Period Pain IS NOT Normal
Dr Andrew Orr Logo Retina 20 07 2016

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Women with PCOS May Be at More Risk of Uterine Cancer

April 3, 2018 Researchers in the United Arab Emirates (UEA) have found that women who have Polycystic Ovaries Syndrome have an increased risk of uterine cancer, reducing their chances of fertility.

The researchers have also found that women, who are overweight, or obese, are also at increased risk of uterine cancer. Being overweight and obese also increases a woman’s chances of PCOS too, but not all women with PCOS are overweight.

A study published in the Journal of the National Cancer Institute last year has shown that  endometrial cancer diagnoses have increased in 26 of 43 countries, mainly due to increasing obesity cases which themselves have tripled in the last 40 years, according to World Health Organisation.

The experts believe that obese women are 10 times more likely to suffer from uterine cancer. Being overweight, or obese also puts women at risk of other diseases such as heart disease and diabetes.

There are other factors involves such as an imbalance in the hormones with over-exposure to estrogens can lead to endometrial cancer. This could be due to endogenous causes such as Polycystic Ovaries Syndrome, or exogenous causes such as unopposed estrogens in menopausal hormone therapy if progesterone is not prescribed.

Some women may have genetic family syndromes that is predispose to uterine cancer along with breast, ovarian and other cancers. The causes of uterine cancer may be multifactorial, but this new research does help with screening of women who are suffering from PCOS, or who maybe overweight, or obese.

The researchers did find that regular exercise and healthy lifestyle choices can serve as a protection against uterine cancer, but can also help with PCOS and obesity.

The researchers did warn that women in reproductive years should not take symptoms of endometrial cancer lightly, since early diagnosis and treatment is an essential key to fertility preservation.

Once a condition that only affected women of advanced years, increasing clinical evidence now suggests that even women below 40 years of age can be diagnosed with uterine cancer.

The cancer cases are on the rise due to higher incidence of known co-morbidities such as obesity, diabetes mellitus and hypertension.

Symptoms of the endometrial cancer include:

  • vaginal bleeding between periods
  • bleeding after menopause
  • an abnormal, watery or blood-tinged discharge from vagina
  • constant back and pelvic pain
  • unintended weight loss
  • fatigue and nausea

Early screening is essential and women can safely consider fertility preservation provided that the cancer is diagnosed in early stages.

Fact around uterine cancer

  • Early diagnosis of uterine cancer can save women from fertility loss
  • World over, an increasing number of women in reproductive years falling prey to the disease
  • Obese women are 10 times more likely to suffer from endometrial/uterine cancer, other causes include hypertension and diabetes
  • PCOS may now be a risk factor for uterine cancer

Women who have PCOS, or who are overweight, should be seeking help with dietary and lifestyle management to help prevent them from other risk factors such as certain cancers. The number one treatment for PCOS is changing to a low GI diet and doing regular exercise. One of the major causes of PCOS is insulin resistance and this is a big factor in many who are overweight, or obese, or have type 2 diabetes. All of these issues can be controlled with the right management.

Regards

Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Normal 20 07 2016

 

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Women with Endometriosis More Likely to Suffer Migraines

Besides endo belly, pelvic pain, period pain etc, one of the other symptoms I see women with endometriosis experience is migraines. While not all migraines are just related to endometriosis and can be from a variety of factors, having endometriosis could give you more of a chance of having migraines.

Recent research published in the Journal of Fertility and Sterility has shown that Adolescents with endometriosis are more likely to experience migraines than adolescents without endometriosis. While the focus was on adolescents, it would be safe to say that any woman with endometriosis may be more likely to suffer migraines as well.

In the research, it was shown that adolescents with endometriosis were more likely to experience migraines (69.3%) than those without endometriosis (30.7%)

Among those with endometriosis, age of when the period started was associated inversely with the odds of migraines. The research also found that women with endometriosis and migraines have more dysmenorrhea than those without migraines.

The research showed a linear relationship exists between migraine pain severity and the odds of endometriosis, suggesting heightened pain sensitivity for adolescents with endometriosis. Due to the strong correlation, patients who present with either condition should be screened for comorbidity to maximize the benefits of care.

While the research showed a relationship between endometriosis and migraines it is also important to rule out other factors that cause migraines too, if you have endometriosis. For sufferers of the disease, it is important not to just blame every migraine on endometriosis. Diet, additives, stress, tight muscles, sublaxations, nerve impingement, sinusitis and many other factors need to be ruled out as well, so that the actual cause of a migraine is not missed.

For sufferers of Migraines please make sure you read my article on how to banish migraines too.

https://drandreworr.com.au/banishing-headaches-and-migraines/

Regards

Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Retina 20 07 2016