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What a Proper Menstrual Cycle Should Be Like

I have travelled around this country presenting to both healthcare practitioners and as part of women’s health work shops and I am still amazed that many healthcare practitioners and the general public alike, still do not know what a proper menstrual cycle should be like.

So many women still believe that many of the abnormal symptoms they put up with daily are actually normal and believe that they just have to put up with them. There are many healthcare providers reinforcing this too.

OMG, if the healthcare providers have no idea, then how to we expect everyone else to know. This is why we are seeing so many women put up with gynaecological conditions such as Endometriosis, Adenomyosis, PCOS and many other symptoms they face on daily basis.

Every day I  get emails and Facebook messages from women, or see them in clinic, asking me “What Should a Proper Menstrual Cycle Should Be Like?”

I also get asked if PMS, menstrual irregularities and period pain is normal and I have to tell them it is not. To put it bluntly, PMS, severe PMS (known as premenstrual dysphoric disorder-PMDD), irregular cycles and period pain IS NOT normal.

Women should not experience pain during their menstrual flow, and they shouldn’t have to put up with all the horrible symptoms leading up to their menstrual cycle either.

A slight bit of discomfort may be considered normal, but pain and having to take pain killers for that pain, is not normal at all.

The fact is that only 20-25% of women actually get menstrual pain and severe symptoms of PMS. Once there are a greater number of people with a condition, medically the condition is then classed as normal, meaning that a portion of the population get it.

But the problem is menstrual pain and irregularities are not normal and these are signs of problems in the body that need to be checked out by a gynaecologist, reproductive medicine, or a women’s health specialist.

The sad thing is even then, some women are being missed, or offered the supposed quick fix, or patch, that will not fix their issues. The worse things is, in my line of work is that when these things are missed and masked and left for too long, women wake up one day and want babies, and can’t have them, or struggle to have them.

Once again menstrual pain and irregularities are not normal and no matter what mum, your best friend, or you GP says, women should not have to put up with these issues. Period pain and menstrual irregularities are not normal.

Going on the oral contraceptive pill will not fix the cause of the issue either. Sure, it can offer some symptomatic relief for some, but it usually just masks a condition and this is why women need to see a gynaecologist or a women’s health specialist for any gynaecology issue.

Masking an issue over the long term can not only make a condition becomes worse, it can also have an impact on future fertility and chances of conception, and this is what many seem to be forgetting. Masking symptoms is not the answer and women need to be informed of all their choices and the consequences of masking a gynaecological issue.

I also need women to know that the contraceptive pill does not regulate a normal menstrual cycle. It causes a withdrawal bleed and does not regulate a normal menstrual bleed. That is a fact. The withdrawal of hormones causes the bleed. The is not a normal period by any means.

So, I am going to tell you what a proper a menstrual cycle should be like and I’m going list what it should be like below. So that way if you are wondering why your menstrual cycle has gone crazy and you cant get enough Ibuprofen, or naprogesics, into your body when you get your cycle, then please remember the list below.

It is so important that I tell everyone what a proper menstrual cycle should be like. If it isn’t like the one I describe you better book in to see me soon.

But, for those who may be trying to have babies, or think that all is OK, don’t be fooled into think that you don’t have a gynaecological issue because you don’t have pain, or irregularities either.

A significant portion of women with endometriosis are asymptomatic (Meaning no symptoms). Many women with PCOS also have regular cycles and all body types can have this disease, not just overweight women.

It is so important for all women to get regular gynaecological check ups by a gynaecologist, a women’s health specialist, or a reproductive medicine specialist, especially if you are trying to have babies and nothing is happening.

What a proper menstrual cycle should be like

  • A proper menstrual cycle should be 26 –32 days in it’s length.
  • It should be 4 days flow, 5 at the most. Any shorter than 4 days is too short and any longer than 5 days is too long. This isn’t good.
  • You”Should Not” get any pain at all. Maybe a slight bit of discomfort is normal, but pain is not normal.
  • You “Should Not” get clotting, spotting, etc.
  • You “Should Not” get severe breast tenderness, lots of bloating, increased fluid retention, erratic changes to the moods, such as lots of tears or irritability.

These are all signs of irregularities and need to be addressed and many of the causes are above.

Just remember that if you do get bad period pain, or your periods are irregular there is a good chance you may have a gynaecological condition and this need to be investigated.

Don’t let people keep fobbing you off, or keep telling you that the contraceptive pill will “fix” these issues, because that is not entirely true. If there is pain, or irregularities, it means that something is wrong, or out of balance, and it needs to be investigated and managed properly.

Take Care

Regards

Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

-The Endometriosis and PCOS Experts

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Follow-Up Reply To Rust Never Sleeps & Neither Does Endometriosis

After my post on “Rust Never Sleeps and Neither Does Endometriosis” I was overwhelmed with such lovely messages from some amazing people

Wow, there really is so many people out there suffering this horrible disease. As I said, I had someone very special and dear to me that was riddled with Endometriosis and put up with it for 20-30 odd years. It was so bad and luckily I was able to help her get it sorted properly.

I help people with endometriosis everyday. I know how it effects you physically, emotionally and on every level possible. It is such a terrible disease to have. I also know many people who have it don’t know they do have it until that start to try and have a baby. Then they come and see me and we find it. Many people are asymptomatic (no symptoms).

Unfortunately when it comes to endometriosis we really only hear about those who have the really have the bad pain. Unfortunately so many of you who have read this, or have contacted me about this, have the pain side of it.

But please take heart, you can get your life back with the right treatment. I do know many of you aren’t seeing the right people, or not getting the right treatment for this. So many of you get overlooked, or passed over, or misdiagnosed, or even just plain old ignored. It is disgusting and should never happen

Endometriosis really does require a multi modality approach to treat it and help manage it properly though. There really isn’t one thing, or a magic pill. I wish there was. I wish I could give you all that.

Through many years of studying this, years of treating this and just knowing what to do and what works and what doesn’t, is why I know this disease well. Endometriosis needs a multimodality/team approach to manage it effectively.

There is no magic pill. You really do need to look at the individual, assess that individual and then use a multi modality approach with everything from diet changes, lifestyle changes, help with emotions, help with the acute pain etc and really look at what is fuelling the pain and fuelling the endometriosis. The number one diagnostic and investigation for endometriosis and to help with acute pain will always be a laparoscopy too.

I do know it is hard for you all. I really do. Not everyone knows how to treat this properly and manage the symptoms properly as well. I wish they did. I really do. I know many of you have said you have tried everything and many times I find out your haven’t, or may have only just tried a few things in combination. You need to do it all properly and at the same time.

Some of you have really just seen the wrong people, been given the wrong advice and really just seen a crappy specialist, or surgeon. It really saddens me. So sorry for you that have. I really wish I could help all of you.

I do know many women who say they got relief from the hysterectomy and I have to say I sometimes have to tell people that only they can make this decision,  if it is really affecting your life. But I do need to let women know that hysterectomy ‘Does Not’ cure endometriosis. It will cure adenomyosis, but not endometriosis. Endometriosis is not in the uterus, so taking out the uterus is only going to help adenomyosis and also stop period related symptoms.

But if you are going to have a hysterectomy you need to know the facts and know that endometriosis will still be there.Sometimes the endo has really spread to other parts of the body so hysterectomy really doesn’t solve that at all.

If you are going to do any surgical intervention, it needs to be done by a good surgeon who is an advanced trained laparoscopic excision surgeon. It also needs to be done intravaginallly and via laparoscopy. That is how I make sure my patients get it done. Sometimes that is not always possible, but when it is, that is the better option.The recovery is much better and there is less impact on them and their body. It is hard to make those decisions though.

It is hard to help from afar, but if you do want my help, I do online consults so I could help you. I do help and assist people all over the world and online platforms (zoom, skype) now offers a medium to do that.

I can’t give advice over the internet because of legal and professional ethical reasons, so I do need to see people, or at least Skype them to be able to give advice. It needs to involve a consultation.

It is so much easier if I can see you in person, especially those that live here in Australia. Flights are cheap these days and I have the best surgeons and team working with me. I really do have the best endometriosis surgeons as part of the team I work with.

I know how hard this must be for you, a very special loved one had very bad endometriosis as well. Luckily now, with the right treatment and after 30 odd years of getting nowhere, she is finally feeling better.

If you would like to book in a consultation with me, please call my friendly staff, or using the automated emails system on the website. Let me hold your hand and care for you and assist you in every step of the way to better health and a better way to live daily.

Please take heart. Know that you are not alone.Know that there really is help out there. I know this disease can be beat with the right treatment. Know that I hear you and what you are going through and will always be here to help educate people about this disease and hopefully find a cure to this horrible disease one day.

Looking forward to helping you if you need my help and pointing you in the right direction

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

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Rust Never Sleeps And Neither Does Endometriosis

Rust never sleeps and neither does endometriosis. When rust gets into a piece of metal, it starts to slowly eat away and corrode its unsuspecting host. Nobody really knows where it will pop up next. At first the tiny implants of rust cannot be seen, but underneath the layer of metal, the rust is at work, slowly devouring and eating away at the core of this metal piece.

It is like a weed. You can cut it out, poison it, and do what ever you can to prevent its return, but once it is there and those minute little seeds have shed and spread, not matter what you seem to do, it seems to just keep popping up everywhere. I have explained this in another post called “Weeding Out Endometriosis”

It is silent and can often take years to take full affect and be visualised, but once it is there and it full swing, it causes weakness, corrosion, toxicity and all manner of havoc for the piece of metal it has now invaded. Just because you cannot see it, doesn’t mean it is not there either. It is the master of stealth, but eventually is will rear its ugly head everywhere, all the while it is has been working its way underneath the surface and its endless tentacles and teeth reaching out and eating at the very core of its host. As the famous musician Neil Young once said “Rust Never Sleeps”. It is perfect assassin for it needs no sleep, and it has a mission of destruction and chaos to anyone who stands in its way.

While rust may never sleep, neither does Endometriosis. Endometriosis is just like rust. It is also like a pesky weed, with a never-ending lifecycle. It spreads; it drops seeds (implants) everywhere it goes. It causes pain, it can be silent and with stealth and at the same time, spreading without causing a single ounce of pain for a significant portion of the population. All the while it is causing havoc in other parts of the body, creating the illusion that there must be something else there.

It is the master of illusion. It makes many think it is something else (IBS, Bladder issues, UTI etc). It invades without a trace and can even be the master of disguise, evading even the most notable physician, but all the while it is feasting and causing chaos under the surface, just as rust does.

Just like rust, sometimes you can cut out a small piece of it and get every single minute part of it at the same time. Other times you can cut it out, and then underneath the microscopic, undetectable implants just pop up somewhere else and starts its vicious lifecycle in another location. Some times it can hide altogether, yet still be there under the surface causing havoc. Other times it will present itself to be seen everywhere and scatter itself so far and wide, you will never ever catch up with all of it.

While sometimes the smallest amount of it can cause immeasurable pain, sometimes the largest amounts of it will go undetected and cause no pain at all.

Actually, a significant portion of women affected with Endometriosis will have no pain at all. We only hear of the women with pain and this is totally understandable. But we also need to let people know, many have no pain at all. It isn’t until the person is investigated properly (via a laparoscopy), that they find that they may be riddled with it.

Endometriosis just isn’t in the endometrial lining. It is most outside the uterus, or embedded deep into the endometrium. It can get on your tubes, in your vagina, on your bowel, into your intestines, up into your lung, around your pericardium and heart, into your brain and they have even found it in people’s fingers. It is truly like a weed, like the rust we started talking about. It can spread everywhere and as said before, can evade even the most noted medical mind. If you don’t know what you are looking for, it will try and evade you forever.

But like rust, with the right treatment, Endometriosis can be found, captured, seen for what it is, have its true colour exposed, have its weakness exploited and have its symptoms vanquished to the nether regions of the destructive world it appeared from. Yet, many fail to explore, or implement the right treatment, choosing to mask it, or pretend it has gone, and all the while it is being allowed to inflame, fatigue, cause pain, play with your emotions and basically wish that life as you know it would magically just end. This can be the life of many who unknowingly trust that just cutting out the rust, or trying to mask the symptoms of it, without destroying and preventing the tiny implants of it underneath the surface from appearing and taking hold again.

Like any disease, prevention is the key to treatment. You cannot prevent endometriosis (not yet anyway) but you can prevent the things that can make it flare, or make it grow, or make it worse. Take away the fuel, and the fire can never take hold. The same goes for endometriosis. You need to take away the foods and substances (alcohol, smoking, chemicals is the environment) that are fuelling the endometriosis to grow in the first place.

If the endometriosis has taken hold and is causing issues, you need to then have it cut out and removed. There is a point where no matter what medications etc you take, nothing is going to settle that inflammation and pain down and well and corrective and investigative surgery. The only way you can diagnose endometriosis is through a laparoscopy. Scans and blood test do not diagnose it.

Even sometimes with surgery, endometriosis can be invisible to the naked eye, but make no mistake, it can still be there. This is why biopsies are taken to see if the microscopic implants are there causing pain and havoc, underneath he surface. But even then, it can infiltrate deep into the muscles and around the nerves to remain undetectable, even via a biopsy. But make no mistake, at some stage, it will rear its ugly head to be seen and to be heard. For those that know the symptoms, they will know it is there, when all other measures of investigations fail.

Once the visible disease is found, it needs to be removed and then you need to try and prevent its return. The only way you can do this is suppress the microscopic implants and the very thing they feed off. Never make the mistake of thinking that surgery is where all your treatment ends. It isn’t. This is where the real work begins.

While estrogenic response is a know factor and the main driver, we also know that insulin feeds inflammation and also causes problems with estrogen and hormone metabolism and distribution. If you get the diet under control, reduce the inflammation through lack of insulin and sugars, then you also help regulate the hormones and this will help with the symptoms and growth of endometriosis. You need to eat as clean as possible and this no refined foods at all. Lots of proteins, nuts and seeds, fresh fruit and vegetables, good oils, pre and probiotics and water.

Herbal medicines may assist and also help control with the control of the microscopic implants of endometriosis and also help symptoms. They can also assist and help with hormone regulation and help with insulin resistance and also help with reducing inflammation. This is why the Royal College of Obstetricians and Gynaecologists recommend women explore the use of herbal medicines and acupuncture and part of the overall treatment plan for the guidelines of treatment of endometriosis.

You also need to look at stress and emotional factors that are driving the inflammation in the first place. Learn some coping skills, learn to relax, find that quiet time, do some yoga, or some form of relaxation. Do whatever it takes to find that stillness in your daily life. You can’t treat and manage a disease without looking at the emotional and lifestyle component of it as well.

So, before you go and try and mask the symptoms of endometriosis and the actual diseases itself, with the pill, mirena, or other current medical approach, ask yourself this. What are you doing to prevent the drivers of the disease in the first place?

Endometriosis requires and multi-modality approach to treat and manage it effectively. If you don’t take this approach, then it will nearly always come back. Yes, you need to surgery, but, you still also need to prevent and treat the actual cause of the disease in the first place. This will then treat the microscopic implants from ever coming to life and causing more misery for everyone concerned.

Having a loved one riddled with endometriosis, I am going to do everything possible I can to help prevent the return of symptoms of this horrible disease for this most cherished and loved individual. A multimodality approach will be used and I hope that one day we can eventually take control and assist in vanquishing the symptoms of this disease into oblivion where they belong, like I have done for so many other people in my years of practice. But, with any disease it also requires compliance of the patient too.

There is no cure for endometriosis, but with proper assistance and the right treatments and health management, women can become asymptomatic (no symptoms) and live a normal life away from the symptoms of this horrible disease.

What are you doing to control your endometriosis?

Do you want to just mask it, or get proper help in managing it?

If so, you need to implement a multimodality approach that I mentioned above and help with having a normal life and hopefully be symptom free. I will mention some of the multimodality treatments in future posts.

Just remember, rust never sleeps and neither does endometriosis.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Crusader

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