Category Archives: Endometriosis Facts

mother and daughter 1

Parents, Don’t Let Your Daughters Suffer With The Wait & See Approach For Period Pain

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One of the things I find myself saying to parents often is “Please don’t let your daughter suffer with the wait and see approach for period pain.”

The reason I often say this is because daily I get messages from parents, mainly mothers, asking if they should wait and see if their daughters pain (and other symptoms) is miraculously going to go away. Many of these young girls have been putting up with pain for months, or longer, and still many parents are using the “wait and see” approach.

Many of these messages often start with the story that their daughter is laying on the bathroom floor in excruciating pain. The stories usually add in that their daughters may also have symptoms of nausea, headaches, vomiting and even stories of these poor young girls passing out with pain.

Then there is the usual response of “I used to get period pain and associated symptoms like this and I just had to learn to live with it”

Then comes the question I always hear so often- “Do you think I should wait and see if this just goes away, or do you think I should take her to someone to have her checked out?”

I often have to bite my tongue when responding to questions and stories such as this. If my daughter was laying on a bathroom floor each month, and in excruciating pain, there is no way I would be waiting and seeing if her pain is going to miraculously disappear. The first time she had pain, I would be off doing something about it, and I would not be taking no for an answer.

Many parents suffered period pain themselves

There is always several ways to look at this and why I always offer an empathic response. Many parents were in pain themselves and went through similar experiences. Many of these same parents were told to suck it up and that this is what a woman has to put up with each month. So to them, this is reality. This is their norm. They suffered, so it is natural for them to believe that their daughter just has to wait and see and suffer it out too.

But, as I say to these parents, these symptoms that your daughter is experiencing are not normal. Period pain and all the other terrible associated symptoms are not normal. No woman, young or older, should have to put up with excruciating pains related to her cycle, or an undiagnosed gynaecological condition.

I then go on to explain that I have daughters and that there is no way I would wait and see, before getting help. I also explain that on a health perspective, there are many dangers in letting a young woman suffer such a horrible experience.

The cause of period pain could affect future fertility

I often have to explain the implications of leaving a disease and not intervening early enough. The explanation of by not getting early intervention could mean that they may not ever have grand children, is usually enough to spur many a mother into prompt action. But, it should not have to take these words to prompt someone into action.

Gynaecological conditions cause period pain

The facts are clear now. There is enough education out there. The simple fact is that period pain (and associated symptoms) is not normal and this usually means that there is an undiagnosed gynaecological condition causing the issue. One of the most common causes being endometriosis, or adenomyosis, or both combined. There could be other facts such as pelvic congestion syndrome, or worst still, though rare, there could be something more sinister such as cancer.

Sexually Transmitted Infections

The other thing that parents may not like to admit is that their daughter may actually be having sex and has a Sexually Transmitted Infection (STI). I often have parents interject when asking if a teenager is sexually active. Many a parent answer “No” on the teenagers behalf, only to then learn that their little girl is having sex.

Sexually transmitted diseases (STI’s) can cause permanent damage to reproductive organs and future fertility if not treated early enough. The reality is that many young girls, and boys, are having sex at a very young age, regardless of what parents may believe. Parents do need to open to the possibility that their child’s pain could in fact be related to being sexually active.

The things parents need to know

The things I am trying to educate all parents on are the following:

  1. No matter what anyone tell you, health professional included, ‘period pain is not normal’
  2. Please do not use the wait and see approach when your daughter is in pain, and has been for months.
  3. Women do not needlessly need to put up with pain each month.
  4. Early intervention is the key to treating and managing any disease or health issue
  5. Teenagers are not too young to have endometriosis, or other gynaecological issues.
  6. Many gynaecological issues are hereditary, so if a parent had period pain, or a diagnosed gynaecological issue, then there is a good chance their daughter will have the same.
  7. Parents should not feel guilty, or blame themselves for passing on hereditary issues. All of us have faulty genes.
  8. Regardless of upbringing, or moral stances, teenagers are having sex earlier these days
  9. Teenagers can have sexually transmitted diseases
  10. The earlier intervention is enacted and proper treatment and health management administered, the better the future fertility and health outcomes are for young woman.
  11. Without early intervention, some parents may never become grandparents.
  12. General practitioners are no gynaecologists, so please make sure you get referred onto a proper specialist. If not, find another GP.
  13. If you don’t get help with the first healthcare practitioner you see, please remember the value or a second, or tenth opinion.

I do get that many parent’s have been led to believe that period pain, and other associated symptoms are just part of live and something that I woman just has to put up with. I am sorry for those that were told this and then have put up with this when they didn’t have to.

Period pain is not normal

Please know that you daughter does not need to put up with these symptoms. Period pain is not normal and early intervention is the key to help your daughter live a happy and pain free life. It could really also help save her from the heartache many women have to live with daily. It could also help with her being able to have children of her own.

Do not use the wait and see approach for period pain

Never use the wait and see approach when it comes to period pain and the other associated menstrual symptoms. You daughter will thank you one day and I am sure her children will thank you too. Lead by example so that your daughter can lead by example to daughter, or daughters too.

Final word

If you do need help with your daughters period pain, and other associated symptoms, please give my friendly staff a call and find out how I may be able to help. There are in person and online consultation available. Conditions may apply with online consultations. My staff will explain all this to you when you make your enquiry, or book a consultation.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Women’s Health Experts

 

 

 

 

Adenomyosis 2

Let’s Talk About Adenomyosis

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As a healthcare practitioner with a special interest in women’s health, more and more I am seeing women presenting with all the symptoms of Adenomyosis. This is why this post is called “Let’s Talk About Adenomyosis”.

Just like endometriosis, many women have had this condition missed and dismissed and then have to suffer the consequences and think that they just have to put up with it month after month.

Some women are completely unaware that they have adenomyosis. Those that have already been diagnosed with endometriosis often believe that all their symptoms are just related to this disease only, when it fact, they could have two diseases creating all their issues.

Many of the symptoms are the same as endometriosis, except that women will usually have heavier menstrual bleeding, or irregular bleeding issues.

Women can have both endometriosis and adenomyosis at the same time and now research is showing that they are basically one in the same disease, but just in different locations.

What is Adenomyosis?

Adenomyosis is defined as the presence of endometrial glandular tissue occurring deep in the endometrial lining (myometrium). The exact cause of adenomyosis is unknown, but current research is showing that it is a similar process to how endometriosis is caused.

Histologically both endometriosis and adenomyosis are one in the same disease state, but just occurring in different locations. We know that both diseases are driven by estrogen and that they have all the same signs and symptoms. Adenomyosis and endometriosis are not caused by estrogen dominance either. Even small amounts of estrogen will drive both diseases.

The only difference between the two disease states is that adenomyosis typically causes more heavy bleeding symptoms. The abnormal bleeding occurs when the ectopic endometrial tissue induces hyperplasia and hypertrophy of the surrounding myometrium. This causes uterine enlargement and subsequent changes in vascularisation (the new vessels may also be more fragile than usual) in addition to an increase in the surface area of the endometrium.

One of the key diagnostics for adenomyosis is the presence of an enlarged uterus on ultrasound, or via MRI. The enlarged uterus can also impact the surrounding structures and often impacts the bladder, leading to urinary frequency and other bladder issues.

Adenomyosis can also have the same bleeding symptoms as fibroids but correct diagnosis and investigations, will differentiate the two and ensure correct management moving forward.

What Are the Symptoms of Adenomyosis?

As mentioned previously, adenomyosis has all the same symptoms as endometriosis. Just like endometriosis, some women often have no symptoms (are asymptomatic), and are only diagnosed when they are having issues trying to conceive.

The main symptoms of Adenomyosis are:

  • Heavy, prolonged menstrual bleeding
  • Severe pain and menstrual cramps
  • Abdominal pressure and bloating
  • Bladder issues (frequency, urge frequency, incontinence)
  • Anaemia

Other associated symptoms such are:

  • Irregular bleeding
  • Pain with bowel movement
  • Irritable Bowel like symptoms
  • Urinary Tract Infection (UTI) like symptoms
  • Fatigue
  • Mental and emotional disturbances (depression, premenstrual dysphoric disorder)
  • Pain with intercourse
  • Infertility
  • Musculoskeletal pain
  • Lack of quality of life

Diagnosis of Adenomyosis.

Ultrasound is the most common (and indeed most useful) first-line imaging tool used to diagnose adenomyosis in a women presenting with any abnormal uterine bleeding. While ultrasound cannot definitively diagnose adenomyosis, it can help to differentiate and rule out other conditions with similar symptoms.

Sometimes saline solution is injected in the uterus at the same time as ultrasound is performed to give better imaging and to help evaluate the symptoms associated with adenomyosis. This is called sono-hysterography.

While trans-vaginal ultrasound (TVU) can be used, it can also miss the disease, especially if the user doesn’t have an expert eye, or extra training, or specialises in the diagnosis of adenomyosis.

MRI is considered a much better tool for the finding of adenomyosis, but it is a more expensive option. Even though ultrasound is a cheaper option, it can be inaccurate.

Blood tests cannot diagnose adenomyosis, or endometriosis.

The only proper way to definitely diagnose adenomyosis is via surgical intervention and a biopsy, but this is rarely done prior to a hysterectomy due to risk factors of damage to the uterine lining. Unlike endometriosis, the disease cannot be excised and the only cure for adenomyosis is hysterectomy.

Treatment and Management Options For Adenomyosis

The treatment and management of adenomyosis will depend in part on your presenting symptoms, their severity, and whether you have completed childbearing.

The medical management options for adenomyosis are usually in the form of hormonal therapy (the Oral Contraceptive Pill, Mirena IUS or other types of progestogen therapy) or surgical.

The surgical options are endometrial ablation, uterine artery embolism and hysterectomy. When considering surgical therapy it must be acknowledged that endometrial ablation and uterine artery embolism is less effective compared with the more definitive but more invasive option of hysterectomy.

Research does show that a significant portion of women, who choose to do endometrial ablation, or uterine artery embolism, will end up needing a hysterectomy. Hysterectomy is not the major procedure it was years ago and many are done laparoscopically and done intravaginally. This also helps with the recovery time. It all gets back to quality of life for many women with endometriosis. This is why hysterectomy is now a better option than other surgical interventions.

While hysterectomy is not something to be taken lightly, we do need to be real about quality of life and the ongoing pain, other associated symptoms, long term bleeding and the dangers of long term anaemia that adenomyosis can cause to a woman. Many women often quote getting their life back and wished that they had the hysterectomy sooner, rather than putting up with the lack of quality of life. Hysterectomy is a cure for adenomyosis, but it is not a cure for endometriosis.

Other Management Options For Women With Adenomyosis

  • Medical treatments(pain medications, iron infusions)
  • Complementary medicines (Acupuncture, Chinese herbal medicine, vitamins and nutrient support),
  • Nutrition and diet
  • Counselling & Psychology
  • Meditation and Mindfulness
  • Pain management clinics
  • Physiotherapy
  • Exercise therapy(weight baring exercise, resistance training)
  • Core strengthening(pilates, yoga)
  • Pelvic floor management(Pilates, Kegels Exercises/Kegels balls, Vaginal stone eggs),
  • Urodynamics

For women who do not want to consider surgical options, adenomyosis requires a multimodality/team approach for ongoing management, treatment and support. In most cases it will need a combination of the therapies above, or all of them, in conjunction with medical interventions and medicines.

In nearly all cases, treatment and management is the same as endometriosis, except there needs to be more focus on the heavy bleeding symptoms. I always apply a multi-modality approach to assist all my patients who have adenomyosis, or endometriosis, or both combined.

Mild symptoms may be treated with over-the-counter pain medications, complementary medicines and supplements and the use of heating pads to ease pain and cramps. It is important to talk to your healthcare practitioner about treatment options to suit your individual needs and individual symptoms.

Outlook For Women With Adenomyosis

Adenomyosis is not a life-threatening condition, although if some symptoms, such as anaemia and emotional disturbances, aren’t managed properly, or early on, it could potential be life threatening. Many of the symptoms such as heavy bleeding, pelvic pain, pain with intercourse, anaemia and bladder and bowel issues can, and do negatively impact a woman’s life.

Women with adenomyosis are often anaemic and long-term anaemia can have serious health consequences. See my post of serious consequences of iron deficiency. Click here

Many women with adenomyosis, if not all, will need an iron infusion if their iron levels are low. See my post “Could you need an Iron Infusion?”

While surgical options such as hysterectomy can cure adenomyosis, there are both medical and complementary medicines available that may help alleviate the symptoms of adenomyosis.

Adenomyosis and associated symptoms can resolve on their own after menopause. If women have endometriosis as well, they will often require ongoing treatment and management after hysterectomy, as hysterectomy does not cure endometriosis. As mentioned previously, hysterectomy will cure adenomyosis.

Anyone with symptoms of adenomyosis should consult a medical specialist, a healthcare practitioner that specialises in adenomyosis and endometriosis.

Final Word

If you do need help and assistance with the management of adenomyosis, the please call my friendly staff to find out how I may be able to assist you. My motto is ‘no stone left unturned’ and I apply this to every person I see and help. I also have a network of other healthcare professionals I work with as well.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine and Master of Reproductive Medicine

-The Endometriosis Experts (incorporating adenomyosis as well)

 

10 Common Mistake seen with

10 Common Mistakes Seen With Endometriosis

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1 in 10 women are diagnosed with endometriosis and it often takes up to 10 years to be diagnosed. The number 10 seems to be a recurring theme. So, for this post I am going to talk about the 10 common mistakes seen with endometriosis. Hopefully this helps to create some more awareness about this horrible disease and helps those who are suffering, or have not been diagnosed yet.

Below are the ten common mistakes I see with endometriosis.

1. Believing surgery has cured their disease

Many people with endometriosis are often led to believe, or have been told, that once they have surgery that their endometriosis is cured.

There is no cure for endometriosis, so surgery is not a cure. Hysterectomy is not a cure either.

All surgery does is deal with the expressed disease and that is it. It does not prevent further regrowth of the microscopic implants of endometriosis that are waiting to express and develop into lesions again. While surgery is a very valid medical option to address acute pain caused by the disease, it is not a cure. It only helps with symptomatic relief.

2. Not doing follow-up management of the disease after surgery

We know that despite the best medical interventions that women with endometriosis often will still be in pain, or have further expression and regrowth of the disease.

As mentioned previously, surgery is a valid treatment option for acute pain and for when hormones and medications are not working. But, from my experience I do see many have the surgery and then are not doing any ongoing management, except for pain medications. This isn’t necessarily the person’s own fault either. Many are also poorly managed post surgery and are not aware that they will need ongoing management of their disease state. As mentioned, many are literally just unaware that their disease can, and will grow back without ongoing support and healthcare management. It is crucial that all women with endometriosis receive ongoing care and management of their disease from an appropriately trained endometriosis expert.

3. Endometriosis care requires a multimodality/team approach

There is no one single medicine, or modality, that can effectively deal with endometriosis and this is why a multimodality/team approach is needed.

Surgery is just one treatment approach, which is also needed to definitively diagnose the disease, and then for when the disease is acute and nothing else is working. But surgery alone is not adequate to deal with the disease as a stand alone therapy.

Endometriosis is estrogen driven so there does need to be some form of progesterone support to help suppress further expression of the disease. This can be in varying forms and something I will discuss in another post.

There also need to be support of the microbiome and working on the microcirculation to the pelvic area and reproductive organs. There also need to be ongoing emotional support and care such as counselling, or psychology

There also needs to be dietary changes (low inflammatory based diet), physiotherapy, exercise, complementary medicines, acupuncture, nutritional medicine other modalities. All of this can be done alongside ongoing medications and medical support. Each individual with the disease has different symptoms and will require different multimodality care and support, based on their individual needs.

4. Not seeing the right surgeon

I know I always talk about it, but this is because many who are suffering from endometriosis and the associated symptoms, just have not seen the right person in the first place.

In every profession there is good and bad. There are those who specialise in a certain area, and there are those who don’t. The same goes for medicine and the same goes for surgeons too.

When needing a diagnosis, or surgical intervention for endometriosis, it is imperative to see an advanced trained laparoscopic surgeon who specialises in the excision of endometriosis. This way you also know that this surgeon is not only advanced trained and highly skilled, but also specialises in endometriosis and every aspect of it.

Not all gynaecologists and surgeons specialise in endometriosis and some dabble in it and are not highly skilled in the actual surgical requirements to effectively excise the disease properly. Some surgeons do not even do excision surgery and tend to just to ablation only. This is not how you surgical deal with endometriosis.

These advanced trained surgeons also have to do a certain number of surgeries per year to attain the status of being advanced trained. Someone who does a few surgeries here and there is definitely not advanced trained. These advanced trained surgeons also do extra years of surgical training and are the best of the best and why anyone who is suspected of having endometriosis, or has endometriosis need to see these surgeons only.

Too many women are under-serviced surgical, by poorly skilled surgeons, who are not specialised in endometriosis and who are not advanced trained and this is where all the problems start. It can also lead to making the patient worse and only leads to further suffering and years of pain as a result. It also means that the advanced trained surgeons then have to fix up the mess these other surgeons created.

The hard thing is some women are limited by demographic and location when it comes to being able to see an advanced trained surgeon. Unfortunately most of them do private work, and any in the public system have long waiting lists and may only do one day a week public surgical lists. You may not even get to see them unless you see them privately first and they put you on there public waiting list.

5. Not seeking help and intervention early enough

There is two parts to this that need attention and need discussion. We know that it often takes up to 10 years (or more) to be diagnosed with endometriosis. This means that a hell of a lot of women are being missed and dismissed by GP’s, allied healthcare practitioners, complementary medicine practitioners, specialists and so forth. This isn’t meant to be negative, or an attack on any one profession. These are the facts and something that cannot be ignored. It also needs to be discussed.

Then we also have parents waiting way too long to seek help for daughters, using the wait and see if it will go away approach. I see this often and I am often getting asked if a parent should just wait and see if their daughters pain will magically disappear. I often have to point out that if my daughter was passing out, or laying on a bathroom floor crying with pain, I would not be waiting to see if it was going to go away. Early intervention is the key to any disease. The wait and see approach is often the reason many women end up with years of fertility issues and years of pain, and other associated symptoms of endometriosis. The longer a disease is left to spread, the more damage it does, and the harder it is to treat.

Teenagers are not too young to have endometriosis and we are now seeing young girls as young as 5 years old having endometriosis found.

The other issue we see if women who know that they have the disease, putting off seeing someone for fear of more surgery, or fear of being dismissed. Again, this only leads to further complications and disease growth and thing being harder to treat.

Once a woman has endometriosis, the reality is that she may need further surgical intervention. But, it is needed to help with symptomatic relief and reduce inflammatory response in the body. The other thing is that by going and seeing someone who specialises in endometriosis, they are trained to help you manage your disease properly.

There may also be some non-surgical options that can be used and help with symptoms and disease management as well. But, you need to go in the first place, to get the help you need. Please do not put off getting your health and disease state managed properly. If you are in a bad place with your disease, make sure you get on that phone and book yourself in with someone who specialises in endometriosis.

6. Trying to manage the disease by yourself

I’ve covered this a bit in the last statement, but so often I see women trying to manage endometriosis themselves. This only leads to a vicious cycle that keeps going around and around and nothing good ever comes of it. The disease does not get managed properly, the symptoms get worse and then it all becomes way harder to effectively treat and manage.

Sometimes if things are left too long, there can be permanent damage that is not repairable. This is definitely why people should not try to manage their own disease and symptoms themselves.

If your disease state and associated symptoms are out of control and you aren’t being managed properly, please get on that phone and book in to see someone as soon as possible. Do not put it off any longer. Now is the time to do something about it, not tomorrow, or next year.

7. Getting medical advice from support groups

I am a big advocator of anyone with a long-term health issue receiving emotional and physical support. It is a must. But, it needs to be via trained professionals who are specialised to help you properly.

While I am also a big fan of support groups, I am not a fan of non-medically trained, non-healthcare people giving healthcare and medical advice to people within these groups. I love seeing the emotional support in these groups, but I don’t love it when I see people getting medical advice about medications, hormones and medical procedures. This is dangerous. I’ve even seen advice given on how to take ones own IUD out and this is when I have to speak out.

By getting medication advice, medical advice, surgical advice and any other healthcare advice from someone who is not appropriately trained, you are actually putting yourself in great danger. Please do not take the advice of anyone who is not a healthcare practitioner, or a specialist in endometriosis. Sure, get the emotional support from like minded people, and people who understand what you are going through, but leave it there.

The other thing is just being careful of not getting caught up in some of the negativity of some groups, where you also then start to focus and become your disease. You are not your disease and to move forward you need proper healthcare and lots of positivity.

8. Letting pain and associated symptoms get out of hand

Some of this I’ve also spoken about, but this is one thing I see often as well. Many people are at a point of self-managing with pain medications that are not working effectively any longer. This then leads to increased reliance and dependence of pain medications and it can also lead to increase pain and associated symptoms.

I have talked about pain medications and the withdrawal affects in previous posts. I have also talked about how increased pain medication use can actually cause pain and lead to further inflammation in the body. I have also talked about the addiction of pain medications too. It is a catch 22 situation. (Click here to see previous posts mentioned)

The point I am trying to make here is that if your pain levels and associated symptoms are getting out of hand, then you need to do something about it. Please do not try and manage your pain and symptoms on your own. Increasing your medications can have detrimental effects on your body and long term health consequences.

If you have to increase your pain medications, it means something is drastically wrong and that your pain levels need urgent professional attention. Your endometriosis expert/specialist is trained to help you get your pain levels and associated symptoms managed properly.

There may also be something else going on that could be sinister and require urgent medical attention. Never presume that all your symptoms are related to your disease. Seeking proper medical health and ongoing management, could just save your life.

9. Buying into the label and letting your disease own you

Having a chronic health condition myself, I know all too well how easy it is to fall it the trap of buying into the label of the disease. I also know all too well by doing this, you are letting the disease own you.

I also understand how hard it is on the bad days, not to get down about everything and think that there is no help, and how unfair things are. Yep, I truly get it. But, I also know that the more one focuses on the negative, and constantly lives in the disease state, the harder it is to truly move forward and get better.

Our thoughts and being negative can exacerbate pain pathways and they can also disrupt the healing pathways as well. If you listen to people that have overcome and illness, or a disease, they will always tell you it was by getting the right help and being positive. Positive mental outlook is very underrated in healthcare and its healing effects.

This is why I sometimes mention about being careful in certain support groups, where the focus is constantly on the disease, the label, and the negative. It isn’t good for anyone when that is all you hear. You need support, but you need to surround yourself with positive people, see the right healthcare team and also remember that you are not your disease, and it does not own you.

10. Believing that there is no help out there

I know many people have had a hard time and some have really had a terrible journey getting to where they are now. It is one of the reasons I am so big on giving people the facts about this horrible disease and trying to help women get the proper help they need. It is also the reason I do what I do now.

Having lived with a chronic disease and having dealt with my share of really bad experiences, I know all too well what many of you have been through. I thoroughly get it and I understand on all levels.

While many people have been missed and dismissed and many have seen their fair share of terrible healthcare practitioners, I do need to point out that there are some very good ones also. Never let your last experience by carried over with you. Not all healthcare practitioners are bad. There are actually some amazing practitioners out there who are experts in endometriosis.

Like I have said before, in every profession there is good and bad and this is why it is important to do your homework. Don’t just go off a friend’s recommendation, or some recommendation from your mother. Do your homework and make sure the person you are seeing actually specialises in your disease. You also need to be realistic that you need a multimodality team approach, and that you may need to see a few practitioners within a network of specialists.

When you do find someone you think may fit the profile of a true endometriosis specialist, make sure when you see them that they take a full history, listen to all your concerns, give you appropriate care and advice and are empathetic in helping you move forward with appropriate care and health management.

The one thing I tell people is to not go in with a negative attitude based on previous bad experience either. This can then lead to further angst and anxiety and could get a good practitioner offside too. At the same time, while you need to not take your last experience with you, you do need to make sure the person you are seeing is right for you. It is all about balance and not judging each person you see as being the same.

But, if the person you do see has no idea, then don’t be scared to say “Thanks, but not thanks” and be on your merry way. There is no harm in getting multiple opinions and the honest truth is that is what you need to do. Never just take ones person’s advice and be done with it. Get a second, or third, or tenth opinion if you have too.

Last, but not least, if you are struggling and are at a point you believe there is nobody to help you, please remember there is always someone out there. Never give up hope about that. There are some amazing people out there who will know how to help you properly and get you the help and care you need. You just need to find them. There are endometriosis experts out there and when you find them, they will help you.

Final word

If you do need help and assistance with endometriosis, or need help getting diagnosed properly, please give my staff a call, or send an email, and find out how I may be able to assist you. I do consultations in person and online as well. There are some conditions with online consultations, but my staff will explain all this too you. You may also need to come and see me in person, so I can make sure you get all the appropriate investigations and testing done too. I also have a team of experts I work and refer to as well. I do see people from all over Australia, far and wide, and some from overseas as well.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-The Endometriosis Experts

 

Microbiome Restore Protocol

Dr Andrew Orr’s Microbiome Restore Protocol

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The Purpose Of The Microbiome Restore

Many inflammatory health conditions can be linked to compromised microbiome and poor gut health. There is now good research and evidence to show the importance of microbiome restore.

Within these poor health states, there is often an overgrowth of “bad” bacteria within your gut. This is a crucial part of treatment for these ailments to restore the microbiome and replenish the “good” bacteria. Ressearch has also linked poor gut health to many mental health conditions.

There are many things that impact the microbiome. Refined food commonly found in the typical Western diet, stress, alcohol, drugs, medications, hormones and many other things fosters the growth of this “bad” bacteria, causing inflammation and what we know as ‘dysbiosis’.

Dr Orr’s Microbiome Restore Protocol aims to reduce the intake of these refined foods and others things that impact the microbiome, and and instead foster the growth of “good” bacteria.

The Eating Plan

This eating plan is based on Dr Andrew Orr’s Primal Ancestral Clean Eating (PACE) diet.  It does allow quite a range of foods, so you shouldn’t have any trouble eating at home, or out anywhere. It is important to note that this is not a “diet.” This is simply the way we are supposed to eat.

2 Phase Microbiome Restore Protocol

Prior to starting the microbiome restore will also need to complete some health questionnaires and have a half hour consultation with Dr Andrew. The health questionnaire need to be fully completed and sent back prior to your consultation. All the relevant information will be supplied to you when you enquire, or book your consultation.

Alongside the PACE diet, this Microbiome Restore Protocol also involves supplementation that is set out in two phases. Both phases need to be completed in order to achieve working results.

Please note that the supplements prescribed as part of the microbiome restore protocol are practitioner only prescribed supplements which will require a consultation before they can be prescribed.

Phase 1 – Removal of Bad Bacteria & Gut Lining Repair

The first phase aims to restore the gut lining, remove bad bacteria and microbials, and create an environment in which good bacteria can thrive. Phase 1 will not need to be repeated (unless you wish you repeat the process in the future). It lasts for approximately 4 weeks, or until all of the products are finished. After that, you move on to phase 2 which then is also the maintenance phase.

Phase 2 – Replenishing the Microbiome & Good Gut Bacteria

After removing the bad bacteria, repairing the gut lining, and laying down a foundation for the good bacteria to grow, you will need to recolonise your gut with good bacteria. Strain specific bacteria are used and it will depending on the individual which probiotic strains are used.

Phase 2 aims to replenish the good gut bacteria through the use of Pre and Probiotics. This phase will be ongoing and used as maintenance for your condition. It is extremely important to continue your intake of Pre and Probiotics to ensure proper colonisation of good bacteria and restore on the microbiome.

Important Things To Note

It is important to note that the results of doing the microbiome restore could take months to come into effect and for there to be adequate good bacteria colonisation. It is likely that if you have been recommended to take part in this protocol, that your microbiome is quite compromised due to years of consistent damage. Because of this, it will likely take quite a while to properly restore the microbiome back to equilibrium. This is done by way of continuing with your prebiotics and strain specific healthy bacteria,  to get back on track and eventually feel healthier.

As mentioned previously, many things can impact gut bacteria including stress, alcohol, diet, etc. so it is important to be mindful of this and what you expose your body to on your pathway to recovery.

A good way to think of a damaged microbiome is like any other damaged organ or bone in the body. A broken bone, torn ligament, or damaged internal organ is not likely to heal overnight. It can take months or even years of recovery, rehabilitation or medicinal therapies to get on top of it. The same applies for your digestive tract. It is no exception to the rule in regards to healing time within your body. The best results come when people are consistent in sticking to their treatment plan, and are realistic about time frames and outcomes.

Next Step Is Book Your Consultation

If you need help with restoring your microbiome for better health, then please give my clinic staff a call and find out how my Microbiome Restore Protocol may be able to assist you on the pathway to better health. There are options for online, or in person consultations. Conditions may apply to online consultations.

For further information please call +61 07 38328369, or email info@drandreworr.com.au

References

  1. Walker A, et al. Phylogeny, culturing, and metagenomics of the human gut microbiota. Trends Microbiol. 2014;22:267–74.
  2. Collado MC, et al. Role of commercial probiotic strains against human pathogen adhesion to intestinal mucus. Lett Appl Microbiol. 2007;45(4):454-60.
  3. Leahy SC, et al. Getting better with bifidobacteria. J Appl Microbiol. 2005;98(6):1303-15.
  4. McFarland LV. Systematic review and meta-analysis of Saccharomyces boulardii in adult patients. World J Gastroenterol. 2010;16(18):2202-22.
  5. Jahn HU, et al. Immunological and trophical effects of Saccharomyces boulardii on the small intestine in healthy human volunteers. Digestion. 1996;57(2):95-104.
  6. Jahn HU, et al. Immunological and trophical effects of Saccharomyces boulardii on the small intestine in healthy human volunteers. Digestion. 1996;57(2):95-104.
  7. Dahan S, et al. Saccharomyces boulardii interferes with enterohemorrhagic Escherichia coli induced signaling pathways in T84 cells. Infect Immun. 2003;71:766-773.
  8. Hsieh H. Versalovic J. The human microbiome and probiotics: Implications for pediatrics. Curr Probl Pediatr Adolesc Health Care. 2008;38(10):309–327.
  9. Lam EK, et al. Enhancement of gastric mucosal integrity by Lactobacillus rhamnosus GG. Life Sci. 2007;80(23):2128-36.
  10. Seth A, et al. Probiotics ameliorate the hydrogen peroxide-induced epithelial barrier disruption by a PKC- and MAP kinase-dependent mechanism. Am J Physiol Gastrointest Liver Physiol. 2008;294(4):G1060-9.
  11. Gibson GR. Roberford M. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr. 1995;125:1401-1412.
  12. Fastinger ND, et al. A novel resistant maltodextrin alters gastrointestinal tolerance factors, fecal characteristics, and fecal microbiota in healthy adult humans. J Am Coll Nutr. 2008;27(2):356-66.
  13. Raninen K, et al. Dietary fiber type reflects physiological functionality: comparison of grain fiber, inulin, and polydextrose. Nutr Rev. 2011;69(1):9-21.
  14. Robison LE. Reeves S. EpiCor® and its immune effects on gut health. Embria Health Sciences, LLC. [Online]. No date. Available from: http://www.embriahealth.com/upload/pdf/EpiCor%20Science%20%20EpiCor%20and%20its%20Immune%20Effects%20on%20Gut%20Health_FINAL.pdf [Cited 16/02/13].
  15. Jensen GS, et al. Antioxidant bioavailability and rapid immune-modulating effects after consumption of a single acute dose of a high-metabolite yeast immunogen: results of a placebo-controlled double-blinded crossover pilot study. J Med Food. 2011 Sep;14(9):1002-10.
  16. Bartoli, C., Frachon, L., Barret, M., Huard-Chauveau, C., Mayjonade, B., Zanchetta, C., … & Roux, F. (2018, May 30). In situ relationships between microbiota and potential pathobiota in Arabidopsis thaliana. The ISME Journal. Retrieved from https://www.nature.com/articles/s41396-018-0152-7#article-info
  17. Berg, R. D. (1996). The indigenous gastrointestinal microflora. Trends in Microbiology, 4(11), 430-435. Retrieved from https://www.sciencedirect.com/science/article/pii/0966842X96100573
  18. Carpenter, S. (2012, September). That gut feeling. Monitor on Psychology, 43(8), 50. Retrieved from http://www.apa.org/monitor/2012/09/gut-feeling.aspx
  19. Clapp, M., Aurora, N., Herrera, L., Bhatia, M., Wilen, E., & Wakefield, S. (2017, September 15). Gut microbiota’s effect on mental health: The gut-brain axis. Clinics and Practice, 7(4), 987. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/
  20. NIH Human Microbiome Project. (n.d.). Retrieved from https://hmpdacc.org/
  21. Shepherd, E. S., DeLoache, W. C., Pruss, K. M., Whitaker, W. R., & Sonnenburg, J. L. (2018, May 9). An exclusive metabolic niche enables strain engraftment in the gut microbiota [abstract]. Nature, 557, 434-438. Retrieved from https://www.nature.com/articles/s41586-018-0092-4
  22. The Human Microbiome Project Consortium. (2012, 14 June). Structure, function and diversity of the healthy human microbiome. Nature, 486, 207-214. Retrieved from https://www.nature.com/articles/nature11234
  23. Ursell, L. K., Metcalf, L., K., Wegener Parfry, L., Knight, R. (2012, August). Defining the human microbiome. Nutrition Reviews, 70(Suppl 1), S38-S44. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426293/
abdomen casual close up 1415554

Endometriosis is more than just period pain

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The Australian Institute of Health and Welfare has just released a report on Endometriosis – “Prevalence and hospitalisations”. I thought it was important to talk about this and share this information in a previous post.

When I did post this information on social media, with an explanation about endometriosis being more than just period pain, someone had commented and congratulated me for acknowledging that endometriosis has other associated symptoms as well.

One of the things I see with media reporting on anything to do with endometriosis, is that they always refer to endometriosis as just being about period pain. So I wanted to talk about the importance of recognising that endometriosis is more than just period pain.

Endometriosis has many other associated symptoms and is more than just period pain, which it is often portrays it as in the media. Endometriosis flares can happen at anytime and aren’t always related to a woman’s menstrual cycle.

Have a listen to my latest video post about this subject and some other useful information to know about endometriosis.

Understanding Why Hysterectomy Does Not Cure Endometriosis

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Hey everyone. I’ve just recently put up a post about the facts about why hysterectomy does not cure endometriosis.

It seems this is a very contentious issue and many people are not understanding the facts, or how endometriosis presents in the body. I also think that some people just haven’t read the actual article, as I do explain all of the reasons why.

But, it does seem some people are still not getting the reasons why, or have been told the wrong things. As usual, I am here to give the facts and this is what I am here to do with this post.. Give the facts.

I am sorry for many of the journeys you have been on too and that some of you are not being listened too as well. That is why I am here. To raise awareness and give the facts and help women with endometriosis have a voice.

This is to also raise awareness about adenomyosis too. Many really do not realise that they have this disease state, or have it coinciding with endometriosis as well.

So, I have done up the video blog to explain things in more detail and hopefully it helps all of you understand things better. It is also so people can see a visual explanation and see why hysterectomy will not “Cure” endometriosis.

The Man-Bashing of Male Healthcare Practitioners Who Help Women’s Health Issues. It Needs To Stop

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All to often I hear some women “Man-Bash” male healthcare practitioners who specialise in Women’s Health issues. Often when male healthcare professionals are trying to bring awareness to female health issues it is now seen as the buzz word “Mansplaining”

What these individuals need to know is that there are many men at the forefront of women’s health issues and they are here to help women, not hinder them. These men do what they do because they care and they are passionate about what they do. Some do so because of partners, or family with gynaecological issues and they want to help any way they can.

These Male Specialists have had years of training and clinical experience and research behind them and actually know more about the female body than many females know about themselves. Being a female, or having a gynaecological disease does not make one an expert. The same goes for males with male health issues too.

Many of these male Women’s Health specialists are also some of our best advanced trained laparoscopic surgeons as well.  Many of these health experts also specialise in women’s diseases such as endometriosis.

We also have women specialists who are at the top of their field in male health issues. This should not be a gender thing and unfortunately some misinformed people tend to make it so. Too many people try to make it about self, rather than the bigger issue, or collective.

Many men give up their own time and are not paid for the work they do with women’s health issues. Some of  them are working at government level, media level and all sorts of areas to bring awareness to diseases that affect women.

Let’s not forget the men whose partners are affected by disease states. These men offer great support to women who suffer around the world and while they do not suffer the disease, they go through it all with their partners on differing levels.

In this video, I tackle two issue that really need to be talked about

  1. Period pain is not normal and no matter what anyone says, this is a fact
  2. We need to end the Man-Bashing of males who specialise in women’s health issues because many men are at the forefront and are trying to help women get the recognition they deserve.

Let’s end the silence for women who suffer disease states like endometriosis. Let’s end the myths around women’s health issues.

Period pain is not normal and women need to know about it.

Just like we need to end the silence about women’s health issues, we also need to end the Man-Bashing of male healthcare practitioners and educators out there at the forefront of women’s health.

Being a male does not mean we do not understand women’s disease states and it does not mean we do not understand pain. By taking away from these men’s messages and their dedication to women’s health, it is also causing damage to the bigger picture and is actually sabotaging women as well.

Have a listen to my latest video blog and explanation of this important subjects that we all need to talk about.

I myself am a male healthcare professional who helps with treatment, management and education of women’s health issues. I genuinely care about issues such as period pain, endometriosis, PCOS and fertility.  I have family with gynaecological issues and I have cared for thousands of women with gynaecological and fertility issues. It is a very special interest of mine and I want to see women get the care and help they need. Being male should not even be bought into this.

Lastly, if you are in pain and needs help, please give my clinic a call and make a time to book in a consultation.

Take care

Regards

Dr Andrew Orr

-Women’s and Men’s Healthcare advocate
-No Stone Left Unturned

-The Endometriosis Experts

01 Dr Andrew Orr 1

Endometriosis Facts Teenagers are not too young to have endometriosis

Teenagers “Are Not” Too Young To Have Endometriosis

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Teenagers are not too young to have endometriosis. Many teenagers and young women are missed and dismissed when they mention they have period pain. Period pain may be a sign that a young woman has endometriosis.

Endometriosis has been found in very young girls, especially as some are getting their period as young as 9 years old, or younger. They have found endometriosis in girls as young as 7 years old when looking for causes of abdominal pain.

Endometriosis and The Causes of Period Pain Can Be Hereditary

Just remember that endometriosis can be hereditary and if someone in your family, or yourself, has endometriosis, or has bad period pain, then there is a good chance a daughter could have this problem too.

Early Intervention and Treatment is Crucial

Early intervention is the key to treating and managing this disease. If your daughter is experiencing period pain, you need to see someone who specialises in endometriosis not just your GP. Do not ever be fobbed off by any healthcare practitioner, or just get told to put the young girl on the pill.

I often get really upset hearing stories of young girls told that they are too young to have endometriosis, or that period pain is normal and just to put up with it.

Young girls are often told to put up with the pain, go on the pill and “We will deal with it when you are ready to have children”

The problem with BS statements like this is that the longer the disease is left there the more damage it can do internally. By not getting early intervention and the right treatment early enough, it could also affect a young girl’s future fertility and potential to even have children. It makes me so angry hearing things like this.

Contraceptive Hormones Do Not Fix Endometriosis

The pill does not regulate menstrual cycles and it can mask and then exacerbate conditions such as endometriosis. The pill does not regulate a proper menstrual cycle. The pill causes a withdrawal bleed and not a proper period. Women with endometriosis need certain types of hormones to help with the suppression of the disease, but only after proper investigation, diagnosis and treatment of the disease first.

Make sure that young girls are properly assessed for the causes of period pain and then managed properly moving forward. Period pain is not normal and young women can be suffering endometriosis.

No matter what anyone tells you, teenagers are not too young to have gynaecological issues such as Endometriosis and PCOS.

We Need To Stop Telling Women That Period Pain is Normal

We need to stop telling young women that things like period pain, irregular periods and absent periods etc are normal. They are far from normal and early intervention and early management could save them a lifetime of heartache and fertility issues later on.

There Is Help Out There

If your daughter is experiencing period pain, or there is a chance that she may in fact have endometriosis and she needs help, please call my staff and find out more about how I may be able to assist you in getting your daughter the right care and management moving forward.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Endometriosis Experts

-The Women’s Health Experts

Endometriosis Facts endometriosis can only be definitively diagnosed via surgical intervention 1

The Only Way To Definitively Diagnose Endometriosis Is Via Surgical Intervention–

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The only way to definitively diagnose endometriosis and the causes of period pain is via surgical intervention. Scans, blood tests etc do not diagnose endometriosis. You cannot have a scan to diagnose endometriosis and you cannot have a blood test to diagnose endometriosis either.

The definitive diagnosis of endometriosis needs to be done via a laparoscopy

The definitive diagnose ‘is’ and ‘always will be’ via a laparoscopy/laparotomy, along with histology (biopsy) and tissue samples taken to examine. Most times a hysteroscopy is done at the same time and if there is an evaluation for fertility, dye studies for tubal patency will be done at the same time.

Women with endometriosis need to see an Advanced Trained Laparoscopic Surgeon

A laparoscopy is the goal standard investigation of examining the pelvis and for investigating gynaecological disorders such as endometriosis. The laparoscopy also needs to be done by what we call an Advanced Trained Laparoscopic Surgeon, who has extra years of surgical training, and who specialises in this disease and specialises in the excision of endometriosis.

It can’t just be done by a regular obstetrician/gynaecologist and this is where many go wrong. Many women just haven’t seen the right surgeon first up who has he proper skills to deal with endometriosis effectively. The first surgery should always be your best surgery and early intervention and management of this disease is crucial. The longer it is there, the worse it can become.

Ultrasounds and Bloods Tests etc Cannot Diagnose Endometriosis

All too often I get women telling me that they do not have endometriosis because their doctor has ruled it out via an ultrasound, or blood test. This is so distressing to hear and this is why so many women are missed and dismissed with this horrible disease that affects 1 in 10 women world wide.

Endometriosis Management Requires a Multi-modality Approach

But, please know that surgery does not cure endometriosis. It is just the first stage in the management of the disease and the active lesions that have been expressed and are present now. Endometriosis can, and will return for many suffers and this is why endometriosis needs ongoing care and a multimodality approach to treat it effectively. It needs a team to manage it properly. While surgery is an important part of evaluation, management and diagnosis of endometriosis, it is to help with symptomatic pain and then other treatments are needed to suppress the disease from further developing and also managing ongoing symptoms.

If you need help with period pain, or  assistance with endometriosis, please give my clinic staff a call and find out more about how I may be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Endometriosis Experts

Endometriosis Facts Period pain is not normal 1

Period Pain IS NOT Normal

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We need all women, and men, to know that Period Pain ‘is not’ normal and it is about time healthcare professionals knew this as well. We are getting there, but it is not quick enough for my liking.

Millions of women around the world are told that period pain is normal and then go on to endure years of suffering and even fertility issues because it. Some women have endured so much pain and been “missed” and “dismissed” by so many healthcare professionals so many times that they have ended up taking their own life because of it. It just should not happen and it needs to stop.

Endometriosis & Adenomyosis are a major cause of Period Pain

One of the major causes of period pain is Endometriosis, or its sister disease Adenomyosis. These crippling diseases can cause period pain, pelvic pain, joint pain, pain with bowel movement, irritable bowel syndrome, pain with ovulation, swollen painful belly (known as endo belly), chronic fatigue, anaemia, heavy painful menstrual flow and can lead to infertility. Some women will quite literally not even be able to work due to debilitating symptoms of this disease.

A significant portion of women with endometriosis are asymptomatic

One thing to note is that some many women with endometriosis get lots of pain and associated symptoms, a significant portion of women with endometriosis are actually asymptomatic (No symptoms at all). These women are usually diagnosed by accident or through fertility evaluation when they could be having issues conceiving. Just remember that just because a woman does not have pain and associated symptoms of endometriosis, it does not mean that she can’t have it.

Period Pain ‘is not’ Normal

Period pain ‘is not’ normal and the sooner we get everyone to know this important fact the better. Sure, a little bit of discomfort can be normal. By that I mean just a tiny bit of pressure and basically knowing your period is about to come. But pain…. That is not normal.

I’ve spoken about this many times before and if you click on the links below here, you can read my previous articles about this

  1. Stop Telling Women That Period Pain is Normal
  2. The Facts About Period Pain & Endometriosis. What Women Need to Know
  3. Period Pain IS NOT Normal and Doctors in Australia and The Rest of The World Need to Start Listening
There is help

If you, your friend, your daughter, your sister, your wife, or any other woman you know, has to have days off work, days of school, is laying on the floor in pain, taking pain killers to get through the day, or beginning of their period, then that IS NOT normal.

Period pain is not normal and if you need help and assistance with period pain, then please give my friendly clinic staff a call and find out more about how I may be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Endometriosis Experts

-The Women’s Health Experts