Endometriosis Awareness- Ending The Silence

This month is Endometriosis awareness month and I have been invited to be a guest speaker for Endometriosis Australia and their endometriosis awareness campaign called “Ending the Silence.” Our aim is to bring awareness about this disease that is often overlooked. It is an issue myself as an endometriosis expert feels very passionately about. I treat women suffering from this disease every day and I hope that one day, endometriosis can be a word of the past.

Through awareness and education, let’s try and get women the early intervention and help they need sooner, rather than later.

What is Endometriosis
Endometriosis, which is an inflammatory gynaecological disease, by which endometrial like tissue grows outside the endometrium. It can spread outside the endometrium into the pelvis, bowel and intestines. It has even been known to get into the brain, joints and around the heart.This disease affects 1 in 10 women, often causing immense pain for them.

According to the Royal College of Obstetricians and Gynaecologist Guidelines for the Management of Endometriosis, it can cause the following symptoms:

Heavy Menstrual Bleeding
Period Pain
Pain with sex
Ovulation Pain
Irritable bowel like symptoms
Bladder issues
Chronic fatigue
Pain with bowel movement

The disease can also cause other symptoms such as :

Bloated belly that looks pregnant around your period (known as endo belly)

Bloated belly that looks pregnant and you are told it is from certain foods, but it isn’t, or may be a combination of food and inflammation from endometriosis (also known as endo belly)

UTI like symptoms that aren’t a UTI

Bleeding from the bowel with your period

Low Iron with no explanation

Being told you have IBS, but you don’t have IBS

Migraines/Headaches that are worse around your period

Irrational mood swings

There are so many other symptoms that could also be pointers to endometriosis.

This disease can also play major havoc with hormones and the libido. Many women with can have pain on intercourse which further lessens the desire around sex.
Women with endometriosis often have painful periods and can’t get out of bed, so if you experience this, there is a good chance that you actually have it.
Women with endometriosis can also have other hormonal disturbances such as mood swings, fatigue, restlessness etc. They can also have other symptoms such as migraines, headaches, dizziness, constipation, pain with bowel movements, joint pains and all manner of symptoms created from the inflammation that endometriosis is caused by and also creates

How Many Women Suffer from Endometriosis?
Endometriosis has now reached an all time high in its ever-growing presence. While the current research says that 1 in 10 women are affected by endometriosis, as an endometriosis expert, I believe, as do many others, that these figures may be grossly under exaggerated. Research also shows that a significant portion of women affected with endometriosis are asymptomatic (no symptoms) and may only ever get diagnosed if they are having issues with having a baby, or they may never be diagnosed at all. In addition to this, many women diagnosed with Irritable Bowel Syndrome actually have endometriosis and not IBS.

Many women have also been told period pain is normal and hence many never seek help for a condition that can be debilitating on their life and those around them. Women who suffer period pain and other menstrual related symptoms caused by endometriosis are often ‘missed’ and ‘dismissed’ by multiple healthcare professionals and it can take up to 12 years from onset of symptoms to a definitive diagnosis being made. Women with period pain caused by endometriosis have to live a life of pain, trauma and physical and emotional torment. Many of these women are barely getting through a day, let alone a whole month of exhausting symptoms related to this disease. Some sadly even turn to suicide.

The Western Medicine Approach on the Causation and Treatment of Endometriosis
To date, Western medicine does not know how or even why it occurs. The only solution that has been offered in the past was to laser it. This usually has a recurrence rate of up to 80%. Recently many doctors have been treating this disease by excising (cutting it out), which offers better relief with less recurrence. I do need to stress that when a surgeon is needed, it needs to be done by an advanced trained laparoscopic surgeon, who has had extra specialised training, and is an expert in endometriosis excision and management, and is not just any gynaecologist. This is where many go wrong and haven’t had the disease treated properly.

Despite the increased success in treating endometriosis through a surgical procedure, it still usually recurs in a majority of women.

So why isn’t the medical option alone working?

Primarily it is because they are just treating the symptoms and not the cause. You can take away most physical symptoms very easily, but if the real cause isn’t addressed at the same time, you have no chance of a full recovery. This includes emotional factors. In addition, many of the hormones that women are put on after surgery, mask the problem and can actually make it worse. By actually stopping the period, like many of these hormones do, there is an increased risk of further endometriosis growing. Sure, while you have no period, you have no pain or symptoms, but internally it is still there waiting to flare up again. Oral contraceptive pills containing estrogen must be avoided as they only add to making the problem worse. Progesterone only options should be looked at rather than a combined pill, if using hormones. These treatments also have limitations that include side effects in some women and contraceptive action for women desiring to conceive.

The Traditional Chinese Medicine Approach on the Causation & Treatment of Endometriosis
Firstly, I can only pass on what the Chinese have known and studied for 10,000 or more years, much longer than western medicine. They had the body and its internal organs mapped out longer before medical science in the west did.
In Chinese Medicine, they believe the liver governs the menstrual cycle, and that it also governs our emotions.They believe that through poor diet, lifestyle, medicines, environment etc, that these can then cause disruption to an organ in the body. Emotions such as anger, frustration, resentment, stress, irritability etc, can also cause the liver to be in disharmony. In Western Medicine terms, we know that poor diet and emotional factors can unlock predisposed hereditary issues, or dispositions through DNA recoding. Yes, diet can affect your DNA coding and so can emotional issues. Similarly we can reverse some disease states, and reprogram DNA coding through a healthy diet and fixing our emotional health.

When the liver is in disharmony, the Chinese believe it can cause blockages in our system. Western medicine now also believes that emotions can cause physical symptoms and we often see this is psychiatric, or body-mind medicine. These blockages then cause what we call stagnation. The Chinese believe that when the Qi (energy) becomes stagnant, it causes what they call Liver Qi Stagnation, and this is the cause of many gynaecological conditions such as endometriosis and PMS. As the Qi stagnation is left long term, it then affects the blood and turns it stagnant too. Imagine damming a river and the longer the water sits, the more stagnant it becomes because it no longer flows. This is where the Liver Blood Stagnation comes from and what they believe endometriosis is manifested from. When we look at endometriosis, it does present as blood clotting and pain. Basically it is like a varicose vein that has all that old, stagnant blood in it. The circulation is no longer moving and the blood now turns dark and causes pain.

Chinese medicine believes that not only is diet and herbal medicine needed to move the stagnant blood and help prevent the disease coming back, it also believes that the emotional component behind it also needs to be addressed. In Chinese medicine they use lots of warming and blood thinning herbs that are also anti-coagulants, but are also anti-spasmotics. The Chinese medicine also has herbs to help the liver function and also help with emotional wellbeing.

Chinese VS Western Medicine
The only difference between Chinese Medicine and Western medicine is the treatment principles. Chinese medicine looks at treating the cause of the issue, which means the symptoms get sorted by addressing the cause. Western medicine only treats symptomatically and therefore the cause of the issue is often not treated. That huge difference is why Chinese Medicine does get such great results. But like anything, it also depends on who you see and their experience in that field. But, I must stress that both medicines are equally as important and both are needed to get the best results possible. It is about a team effort and using a multi modality approach. It is also about finding your right team too. I will talk about this now.

Dr Andrew Orr’s Recommended Approach to Treating Endometriosis
Endometriosis has a highly variable disease state, and thus a multi-modality approach is needed to treat it. Targeting different pathways is likely to be important to move toward precision health (personalized medicine) in endometriosis. People with endometriosis need a team of people looking after them, not just one person and one approach.
For severe cases you will need to see a good advanced laparoscopic surgeon to get as much of the endometriosis excised (cut out-not lasered). Surgery is a much needed option if the pain is severe because it helps get rid of the endometriosis that can be seen. However, it does not deal with the microscopic implants of endometriosis that can’t be seen, and this is why endometriosis is likely to occur again. This is where the Chinese Medicine can help. You then use the Chinese medicine to assist in the treatment of the microscopic implants of endometriosis and stop it progressing further and therefore treat the cause. This will be the primary treatment after surgery and help stop it from recurring. This can be done along side medical hormone treatments as well.

Following the correct diet can also aid this healing process. The modern Western diet consists of many foods with high GI levels, causing inflammation to the body and therefore fueling conditions such as endometriosis. There are all sorts of diets out there attesting to be the cure for endometriosis, but half are them are actually making it worse. Unless the diet is about reducing grains, high GI carbs, sugars, and increasing proteins, then it isn’t going to help endometriosis.

Lastly, see a good counsellor. Acupuncture and Chinese medicine may help both the physical & emotional side, but sometimes solution-based talk therapy is needed for the best results. I provide clients with a list of preferred gynaecologists and counsellors within my appointments with them.

To support my view on the treatment of endometriosis, the Royal College of Obstetricians and Gynaecologists guidelines for treating endometriosis now states that Acupuncture and Chinese Herbal Medicine is a recommended therapy. A multi modality approach really can help, but for anything to work more effectively, you too, have to make a commitment. It is also about finding your team and the team of people right for you too.

Who I am and Why this Means so Much to Me
I am a healthcare practitioner with over 20 years of experience in assisting Women’s Health Medicine and treating and managing endometriosis. I know all too well the trials and tribulations women have to go through before someone actually listens and gives these poor women a proper diagnosis. I also have loved ones with this disease and have also lived with a chronic painful disease too. While I may not fully understand and feel what women with endometriosis actually goes through, I do know what it is like to live daily life with a painful chronic inflammatory disease that can rule your life on every level.

The one thing I do want all women to know is that “Period pain IS NOT normal” and all too often women are told that period pain is normal. Nothing could be further from the truth. We need to educate women and young girls that period pain is not normal.

I have a motto of “Leaving No Stone Left Unturned” and I apply this to every patient I see with period pain, and those potentially suffering from endometriosis. I would like to see better education and awareness for the general public, but I would also like better education and awareness for healthcare professionals. I would like to see all healthcare professional use my motto and make sure that no woman is ever missed, or is dismissed with this horrible disease ever again.

I would like to conclude with one last message “ Women need to know that period pain IS NOT normal and that early detection and early intervention and treatment is the key to treating any disease properly.”

Lets end the silence about this horrible disease. Please support Endometriosis Awareness and this month please support Endometriosis Australia with their High Teas to promote endometriosis awareness. These High Teas will be run nationally on March 25th and in every capital city and some smaller cities also. Please see the Endometriosis Australia website for details (www.endometriosisaustralia.org)

Regards

Dr Andrew Orr

“Leaving no Stone Unturned”

“Period Pain IS NOT normal”

woman 2609115 1920

Time to Set The Records Straight about Endometriosis, Period Pain & Other Gynaecological Issues.

There are so many misperceptions and wrong information out there about period pain and gynaecological conditions that cause period pain and it really gets annoying hearing people get told the wrong information and false information. It is time we get people the help they need and stop people having gynaecological conditions missed and being dismissed also.

So lets set the records straight

  1. Period pain is not normal, no matter what you have been told, or who has told you this.
  1. Period pain is often the sign of gynaecological conditions such as endometriosis, adenomyosis or other gynaecological issue. It could also be a sign of something more sinister.
  1. Women who have endometriosis and other gynaecological issues,  can also be asymptomatic (meaning no symptoms) so because you do not have pain, does not mean that you do not have it.
  1. With endometriosis, symptoms do not always correlate to the extent of the disease. Some women have only small visual pockets of it and this can cause extreme pain and inflammation, while women whom are riddled with it may have little, or no pain at all. It is not about the amount of the disease when it comes to pain profiles and classifications around pain and disease management. The classification system and grading system is just for a surgeons reference only and to gauge how much was found.
  1. Scans and blood tests cannot diagnose endometriosis. There are some specialised scans that can diagnose deep infiltrating endometriosis only, but even then, they are not 100% accurate, or a definitive diagnosis. There are very few people trained in this form of ultrasound too. Most women with endometrosis have the superficial disease, which cannot be diagnosed with specialised ultrasound , or normal ultrasound at all. Blood tests will definitely not diagnose endometriosis, or many other gynaecological issues either.
  1. The definitive diagnosis for endometriosis and other pelvic pathology is a Laparoscopy ( usually combined with hysteroscopy and dye studies) combined with histology (tissue from a biopsy). At the time of laparoscopy the visual disease is usually tidied up and removed at the same time, along with any adhesions and other pelvic pathology found.
  1. Not all gynaecologists, or surgeons can perform proper surgery needed for the removal of endometriosis, or other gynaecological issues. This requires an advanced laparoscopic surgeon to do this kind of work and not every gynaecologist, or surgeon has these skills. Many gynaecologists have very limited surgical skills when it comes to major gynaecological issues such as endometriosis. Just because someone has had surgery before, doesn’t mean they have had someone specialised to deal with the disease properly. This is a big mistake many people do not realise. You also always need to ask if the surgeon has advanced laparoscopic training and they excise (cut out) the disease, not burn it. You also need to ask their experience in treating and managing the disease state that you have been diagnosed with, or suspected of having. Some endometriosis may be so widespread it may need multiple surgeons, such as bowels surgeons, and in some cases it may need a gynaecological oncologist who can excise very fine parameters because of their training of cancer removal. Many women think they have had the disease removed when in fact their surgeon was unable to fully remove all the disease because it was out of their scope of practice.
  1. Teenagers are not too young to have endometriosis, or other gynaecological conditions. Early intervention and management of the disease is crucial and should not be left until later in life under any circumstances. Please do not let teenagers put up with period pain and have someone tell them it is normal.
  1. Surgery does not cure endometriosis. But it does help to control the spread of the disease and the inflammation because of the disease.Surgery can offer great relief from pain symptoms though. But the real treatment comes from trying to suppress the regrowth of the disease and microscopic implants (not visible to the eye via surgery) post surgery and this is what I do in my treatments.
  1. Pregnancy does not cure endometriosis, or period pain. In many cases, it can make it slightly better for a while, but most of this is due to women not having their period for an extended amount of time. It does not cure endometriosis and this is a widely spread myth that needs to be corrected
  1. Endometriosis is not an auto-immune disease. Lately there has been talk that endometriosis is an autoimmune disease because of its inflammation links. Yes, it is an inflammatory disease and reducing inflammation in the body will help it, but it is not an auto-immune disease and does not fit the classifications of an auto-immune disease either.
  1. Gynaecological conditions should be seen to by a specialist in that field and not just by a GP. While GP’s are a much needed part of healthcare, but they are just a general practitioner, they are not a specialist and a referral to a properly trained specialist should be obtained for any suspect gynaecological condition, or matters pertaining to period pain, or pelvic pain. This saves conditions being missed, or overlooked, or misdiagnosed
  2. Hysterectomy does not cure endometriosis. Most of the time endometriosis is outside the uterus and can be anywhere in the pelvic cavity. It can be on the bladder, the bowel, the fallopian tubes and it can even spread to anywhere in the body. Endometriosis has been found in the joints, around the heart, the brain and even in the eyes. Taking the uterus out is not going to cure endometriosis.

Lastly, Dr Google and many of the forums people use are not usually reliable sources of information, or a diagnosis for period pain, gynaecological conditions such as endometriosis, or any other gynaecological conditions. Only a properly trained Reproductive Medicine Specialist, Gynaecologist, Fertility Specialist, or Women’s Health Medicine Specialist can give you proper advice and education about gynaecology and matters that pertain to women’s health. You next door neighbour, your friend, your Facebook buddies are not reliable sources of information, unless they are fully qualified healthcare professional. There are some good sites out there, but even so, you still need to get advice of a proper healthcare professional and not just some person on a forum, or internet site.

I hope this helps people understand the importance of the right information and education and seeing the right people and getting investigated and managed properly. I see so many people have things missed, dismissed and overlooked and I just want to help people get the right advice and right treatments and be given the right information to save people on the heartache that many I have seen have had to endure.

If you are someone who needs assistance with gynaecological issues, then please get them to come and see me,or book an online consult, or someone who specializes in this area of medicine. You can also contact Endometriosis Australia to find out who the best specialists and surgeons are. They have some great resources too. (www.endometriosisaustralia.org)

My motto will always be that “Period Pain is Not Normal” and my other motto is “Leaving No Stone Left Unturned” when it come to healthcare and helping people. If someone tells you period pain is normal, or you have to put up with it, or suck it up, you are seeing the wrong person, so please then go and see someone else.

Take care

Regards

Dr Andrew Orr

No Stone Left Unturned

 

Polycystic Ovarian Syndrome PCOS 01

Women with PCOS often have to wait 2 years and often see multiple healthcare professionals before diagnosis is made

Polycystic ovary syndrome (PCOS) is the most common endocrine/gynaecological/reproductive disorder — and most common cause of infertility — affecting 9 to 18 percent of women around the world. Despite the prevalence of this chronic condition, one-third of women diagnosed with PCOS saw at least three health professionals over the course of two years before receiving a diagnosis, according to a study from the Perelman School of Medicine at the University of Pennsylvania.

The study, published in the Journal of Clinical Endocrinology & Metabolism, is the largest to date examining time to diagnosis, and reveals what the authors say are “major gaps” in education and support for women with the condition.

As a healthcare practitioner with a special interest in this area,  I see these same issues with so many women waiting years to get a proper diagnosis and they have seen multiple healthcare professionals in both the medical and complementary medicine profession.

The signs and symptoms of PCOS are very clear and easily diagnosed, but many healthcare professionals end up focussing on one symptom, while overlooking the bigger picture and then these poor women get their condition missed. Many practitioners and public alike, do not understand the difference between PCO (Polycystic Ovaries) and PCOS (Polycystic Ovarian Syndrome) either and this creates a big issue as well. These days the two condition are actually put under the heading of the one condition, when this is not entirely true. For more information about PCO and PCOS, please click of this link (click here)

PCOS primarily affects women of reproductive age — most often between the ages of 18 to 35. The most common signs of PCOS are:

  • Absent, Irregular and Inconsistent menstrual periods,
  • Acne
  • Excess hair growth (some women can have hair loss too)
  • Central obesity

If a women presents with Acne, irregular periods, absent periods etc, there is a good chance that she may have PCOS. The problem for these women, as explained before is that healthcare providers and placing too much emphasis on only one of these symptoms, which is usually the Acne, or just that the cycle is irregular. Then women are then put on the Pill and these symptoms are masked for years, until they try and have a child and have difficulty doing so.

Women with PCOS also have an increased risk of type 2 diabetes, gestational diabetes, metabolic syndrome and anxiety and depression, and studies have shown that the longer it takes for the condition to be diagnosed, the greater the patient dissatisfaction.

These new results are concerning for those of us who do know how to deal with PCOS and other gynaecological conditions properly. These women should not be having this conditions missed. The other issue is that not only do women often wait several months or even years before care providers are able to diagnose the condition, but even after diagnosis, patients are often unsatisfied with the information and support they receive. It is such a vicious cycle.

But let’s not forget out Endo Sister’s who have endured the long road to diagnosis and management for their disease. It can often take up to 12 years for their diagnosis and again many of them have their condition missed and are dismissed. It is again such a vicious cycle of mismanagement and focus one symptoms before someone finally properly diagnoses their disease. Then many of these also complain of the management and treatment after diagnosis. We also know that many with endometriosis, also have PCOS. These two disease states can go hand in hand and both can equally be missed and dismissed.

Based on the study findings, the authors are calling for the development of international evidence-based guidelines, co-designed consumer and health professional resources and international dissemination to improve diagnosis experience, education, management and health outcomes.

Too right they should be calling for better diagnosis and better education and training for these healthcare professionals. If you don’t know how to do your job properly, or it is out of your scope of practice, get out of the way and refer these women onto people who are trained to diagnose and manage these conditions properly.

Lets, help put and end to PCOS and also put an end to Endometriosis as well. Let’s break the silence and help women get the diagnosis and care they need. Early intervention and treatment is crucial for any disease state and let’s help women get this care sooner.

Take care

Regards

Dr Andrew Orr

-Women’s and Men’s Health Advocate

-“Period Pain IS NOT normal”

-“Leaving no Stone Left Unturned”

Dr Andrew Orr Logo Normal 20 07 2016

Journal Reference:

Melanie Gibson-Helm, Helena Teede, Andrea Dunaif, Anuja Dokras. Delayed diagnosis and a lack of information associated with dissatisfaction in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism, 2016; jc.2016-2963 DOI: 10.1210/jc.2016-296

How Do Orgasms Affect The Brain?

How Do Orgasms Affect The Brain?

In the words of the late George Michael “Not everybody does it, but everybody should”, many of us forget the health benefits and relatuionship benefits of a good orgasm. Famous scenes of Meg Ryan simulating how an orgasm makes you feel and onlookers saying “I’ll have what she is having” have all of us nodding our heads in agreement.

There is no doubt that orgasm is one of the most pleaurable and intense experiences the body can enjoy on our own, or with another. Many of us try to replicate other ways to pleasure the body and induce hormone like reactions like orgasm can. This is why so many people dive into a bar of chocolate each night, trying to get some of the seretonin and oxytocin effects siimilar to a good orgasm. Maybe people should be ditching the chocolate, ditching TV, or social media and everyone elses sex life, and just heading straight to the bedroom for some action of their own. It would be more pleasureable and much healthier for the body and brain overall. Hey, you could be using the chocolate in other ways to help enhance those hormones on the bedroom.

So why does orgasm affect us in the way it does?

New research, reported in the journal Socioaffective Neuroscience and Psychology has set out to gain a better understanding of how the human orgasm affects the brain.

This new research has now shed some light on how orgasm affects the body and how it also affects the brain. When it comes to the human orgasm, research has primarily focused on how this intense feeling of sexual pleasure has evolved. In a new study, researchers have delved into a relatively understudied area of human climax: how orgasms affect the brain.

Orgasm can be described as a powerful, pleasurable release of accumulated sexual tension and is perceived as the epitome of sexual pleasure for both men and women. During orgasm, an individual may experience a rise in blood pressure, an increased heart rate, heavy breathing, and rhythmic muscular contractions. The lasting benefits on mood and ones health are often understated and many times forgotten and something that all of us need to be thinking about more.

But while the signs and sensations of an orgasm might be clear, the underlying mechanisms of this sexual response – particularly its neurophysiological effects – remain uncertain.

Previous Studies have shown that orgasm plays a role in ovulation, orgasm helps reduce depression and mood disorders, helps reduce inflammmation of gynaecological conditions, reduces certain cancers, helps you keep fit and also helps with maintaining long lasting relationships.

How orgasm can induce a ‘sexual trance’

An abundance of studies and literature were analysed by researchers, that have investigated the brain and body’s response to sexual stimulation. This information was then used to shed light on how rhythmic sexual activity affects rhythmic activity in the brain. If rhythmic sexual stimulation is intense enough and it lasts long enough it can cause the body to experience a “sexual trance,” where sole focus is on the immediate sensation experienced. These teachings are often taught by those that practice tantra.

While some of this has been known through many ancient tantric sex practice, having research to back up these practices, could change the way people view orgasm and their sexuality. Sex is a source of pleasurable sensations and emotional connection, but it is also actually an altered state of consciousness.

Brain responses to orgasms the same way it responds to dance and music

Additionally, researchers found that the way the brain reacts to rhythmic sexual stimulation is comparable to the way it responds to rhythmic music and dance. Here the study also showed that as humans, dance may have served as a test of fitness for a potential mate. Researchers added that rhythmic music and dance have served as a key part of mating for hundreds of millions of years, and these findings are consistent with this fact.

We do know that fitness and health of the body, also corresponds to ones sexual health and that exercise and keeping healthy is important to maintain healthy reporductive and sexual function. Good orgasms come from a healthy body and healthy reproductive organs.

Before this paper, we knew what lit up in the brain when people had orgasms, and we knew a lot about the hormonal and neurochemical factors in non-human animals, but we didn’t really know why sex and orgasm feel the way they do. Hopefully this sort of research paves the way for further studies in this area and helps us understand the health, emotional and physical benefits of regular orgasms.

In upcoming posts I will talk about what you can do to enhance a good orgasm and also what affects orgasms too. I will also talk about differing libidos and how to increase your libido if that is waivering, or not existant at all.

Source:- Journal Socioaffective Neuroscience and Psychology (Socioaffective Neuroscience & Psychology 2016, 6: 31763 – http://dx.doi.org/10.3402/snp.v6.31763)

Regards

Dr Andrew Orr

Women’s & Men’s Health Advocate

“Leaving No Stone Left Unturned”

“Period Pain IS NOT Normal”

 

celebrate celebration cheers 1268558

How the Christmas, New year & Easter Festive Seasons Can Affect a Woman’s Menstrual Cycle

We have not long gotten over the Christmas and New Year period and we are about to embark on the fast train into Easter holiday and festive season. While many are getting ready for the sugar fest ahead, with Easter eggs and hot cross buns galore, we need to take the time to understand how this may affect our bodies afterwards, especially for women and their menstrual cycles. Worse still it could even affect pre-existing gynaecological conditions that women live with on a day to day basis, some of which impact women’s day life terribly

Christmas and Easter times always pose great problems for women and their menstrual cycle, and year after year many women never make the correlation why. Year after year I see women coming back to see me, after Christmas and Easter,  scratching their heads as to why all of a sudden their menstrual cycle has gone haywire and they are getting the worst PMS symptoms they’ve had since starting goodness knows

So why do so many women have problems with their menstrual cycle after Christmas and Easter?

The answer is blatantly obvious. Stress, Poor diet and Lifestyle factors!

The lead up to Christmas and Easter, is always a busy time and no matter how much people try to deny it, it is very stressful. People are rushing madly to meet deadlines before everyone goes on holidays and then the mad Christmas and Easter shopping rush that follows.

Then there is the stress of what to buy everyone, followed by the mad catering panic. People litrally go mad and one would think the end of the world is imminent, with supermarkets being emptied by the marketing hype of these two festive seasons.

Then the big day arrives. Everyone forgets the basic principles of a healthy diet and engorge themselves on any food they can lay their hands on. Basically it is a licence to eat as much bad food as we can put in our mouths, and then use the basic excuse of “Its Christmas” or “It’s Easter” and “It is only just one day and it won’t really matter and I had to do it”.

Then one day leads into two, and then this leads into a week and then before we know it, it has been more than just one day of bad eating, or drinking alcohol. The sad fact of that statement is that some people eat and drink alcohol like it’s Christmas and Easter every day.

With Christmas we can have many portions of baked dinner, crackling, seafood, Christmas pudding, chocolate and any other sugar substance that can be consumed it all had to be washed down with a nice alcoholic beverage, or two. Many bottles of bubbly, or choice of poison later, and we now have a stomach full of sugar, fat, cholesterol and alcohol all churning quite nicely. Diabetes and heart disease here we come.

Then approximately 1 week later it is New Years Eve and the licence, to drink like fish and eat like a ravenous bear, is pulled from the pocket and waived around once more. “But it’s Ok”, we say.

The New Year’s resolution will be to not do it again, until next year when all resolutions are forgotten. Meanwhile the system had short circuited, the gut has gone into melt down, the cholesterol levels are rising, the sugar levels have reached diabetes status and the brain cells have been reduced yet again.

Several months later when the system has started to recover, Easter arrives and the sugar binge begins; with Easter eggs and all manner of chocolate, sugar laden delight. Let’s not forget the alcohol added to the mix, that we used to self medicate from the stress of the lead up to the Easter break. The body short circuits itself again and will take until Christmas to recover and then it starts all over again.

Now, I wonder why the menstrual cycle would be affected?

Hmmm, I wonder?

There are only a few things that will affect a menstrual cycle and cause PMS, irregularities and pain. The trouble is many of them can be unknowingly self- inflicted. Yes, many monthly menstrual related problems can be unknowingly self- inflicted.

Let’s not forget that many people do have gynaecological issues that they suffer on a daily basis though. But even still, this high amount of burden on the system will exacerbate these pre-existing conditions and make them worse, due to the resulting high levels of inflammation. What I am trying to do is just make people aware of how conditions can be worsened and how these high levels of inflammation, from high levels of sugars etc, can cause havoc with a woman’s cycle. This is not about blame. It is about education and prevention. I am here to help, not hinder. Please remember this.

As I said there are only a few things that affect, or exacerbate, a woman’s menstrual cycle and I’m going to list them below. So that way if you are wondering why you can’t get enough Naprogesic into your body, when you get your cycle, please remember the list below.

Please also read my article on “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.

What Affects a Menstrual Cycle

  1. Poor diet – Foods such as high sugars and junk foods all cause inflammation in the body and lead to hormonal irregularities and pain with the menses
  2. Alcohol – Most alcohols contain high sugars and they also cause inflammation in the body. It also interferes with your hormones and affects the liver too. In Chinese medicine the Liver governs the menstrual cycle. Excess alcohol leads to SOL ( Shit on Liver) J
  3. Poor Sleep– Sleep deprivation leads to reduction in hormones such as serotonin and then effect the moods etc. Lack of sleep also stops the body from repairing and can lead to other health issues
  4. Trauma – Things such as surgery, a virus, cold/flu etc, or where the body has to repair, can lead to menstrual irregularities. The body shuts down the menses so that it can repair itself first
  5. Weight gain or weight loss– It is a well known fact that many athletes do not get a menstrual cycle because of lack of body fat. The same goes for people who are overweight too. Too much, or too little, body fat interferes with your fertility. All your hormones are made from fats and protein.
  6. Emotional Issues– Bottled up emotions such as anger & frustration cause blockages in the system & then cause pain. Emotional issues also cause problems with hormones. Emotions can be a major issue in any health condition, or can affect hormones.

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 shouldn’t get any pain at all, you shouldn’t get clotting, spotting, breast tenderness, bloating, fluid retention or changes to the moods such as teariness or irritability. These are all signs of irregularities and need to be addressed. Some of the things that exacerbate menstrual issues are listed above.

Lastly, please know that Period Pain IS NOT Normal and neither are some of the other irregularities women have. If you are suffering pain, or irregular cycles, or any other issue that doesn’t seem right to you, you need to get it checked out by a specialist.

Regards

Dr Andrew Orr

Women’s and Men’s Health Advocate

-“Leaving No Stone Left Unturned”

-“Period Pain IS NOT Normal”

 

What Affects a Menstrual Cycle – Part 2 (Common Gynaecological Factors)

There are many things that can cause disturbances to a woman’s menstrual cycle and on my previous post I discussed how Non-Gynaecological factors, such as diet, lifestyle etc, can be contributing. In this post I will discuss some of the common gynaecological conditions that can cause problems with women’s menstrual cycles.

The sad thing is that many of these are often overlooked and often masked by putting women on the contraception pill. The other issue is that many are led to believe that the pill is the answer to their issues, when sadly it isn’t.

Many of these common gynaecological conditions continue to become worse while having their symptoms masked and exacerbated by these hormones. Even more disturbing is that many women are not heard when speaking about menstrual issues, menstrual pain and other factors that do in fact interfere with their daily life on both a physical and emotional level.

Lets look at the common gynaecological factors that can affect a woman’s cycle.

  1. Endometriosis– is one of the most common causes of period pain and it caused by abnormal growth of endometrial cells both inside the uterus and outside the uterine lining. The exact cause is not known. While period pain, clotting, ovulation pain, pain with sex, pain on bowel movement, IBS like symptoms etc are commonly talked about, many women with endometriosis are asymptomatic and would not even know they had it. It is commonly missed, misdiagnosed and overlooked by healthcare practitioners and is why it often takes up to 10 years for the definitive diagnosis to be made. There is no cure and now it is thought that genetic factors and parental mode of inheritance is a predominant part of this disease. We do know that estrogens make it worse also. Endometriosis can only be diagnosed by surgical intervention. For more information please read my posts on endometriosis and also visit the Endometriosis Australia website.
  2. PCO/PCOS – Polycystic Ovaries/Polycystic Ovarian Syndrome is one of the most common caused of menstrual cycle irregularities, or ceasing of the menstrual cycle. It is mainly caused by insulin resistance and it also runs in families. There are two types of presentation with this condition. One is just having the cysts on the ovaries and the other is just the syndrome without the cysts. These days it is common lobbed under the one condition called PCOS. Along with menstrual cycle disturbances, it can also cause mood swings, hair growth/hair loss, acne, ovulation pain, infertility, anovulation, weight gain/weight loss, pot belly, fluid retention and much more. Diet and lifestyle changes are the number one treatment for this condition. Scans can pick this condition up, but can also miss it too. It can be diagnosed via surgical intervention and sometimes-extreme forms of this do need surgical intervention known as “Ovarian Drilling”
  3. Fibroids – Also known as myomas are benign growths that can occur inside and outside the uterus. Up to 40% of women over 40 years old have fibroids. They can cause problems with irregular uterine bleeding, heavy long bleeding, bleeding in between cycles, anaemia, pain with sex, problems with urinating and back pain. They can also cause infertility and miscarriage. There are 3 types of fibroids (intramural, submucosal & subserosal). They are thought to be caused by excess estrogens and problems in hormone metabolism. They can be removed surgically and some small ones embolised.
  4. Polyps – Are benign overgrowths, or bulges, of the normal tissue lining the uterus into the uterine cavity. They can cause irregular bleeding, heavy bleeding, bleeding after intercourse and infertility. Some women have not symptoms at all. Polyps may also be found in the uterine cervix. Polyps are usually attached to the underlying tissue by a base or stalk, and they vary in size. They can basically act like an IUD and stop implantation and therefore need to be removed in order for a woman to fall pregnant. Polyps only rarely contain cancerous cells
  5. Adenomyosis– Is very similar to endometriosis by the fact that it causes pain, irregular bleeding, heavy bleeding, bloating, lower abdomen pain and can affect the day to day functioning of woman all over this world. Adenomyosis growth penetrates deeply into the uterine lining and also inflames the nerves inside the lining. It cannot be seen visually and some special high contrast scans and MRI can pick it up, but not always. Usually a biopsy is needed to diagnose it. Medically the only way to properly get rid of Adenomyosis is via a hysterectomy. In the meantime, mostly anti-inflammatories, some hormones and other forms of pain management are given to provide symptomatic relief.
  6. Thrush– Vaginal thrush is a common infection caused by an overgrowth of Candida albicans yeast. This yeast lives naturally in the bowel and in small numbers in the vagina. It is mostly harmless, but symptoms can develop if yeast numbers increase. Symptoms you may experience if you develop vaginal thrush include vaginal discomfort – itching or burning, a thick, white discharge with a ‘cottage cheese’ appearance and yeasty smell, redness or swelling of the vagina or vulva, stinging or burning while urinating or during sex, splits in the genital skin that can cause bleeding and irritation. The condition is mainly treated with antifungal creams, pessaries and probiotics.
  7. Cancers – In 2008, a total of 4,534 new gynaecological cancers were diagnosed in Australia; this equates to an average of 12 females being diagnosed with this disease every day. On average 4 females in Australia die each day from a gynaecological cancer each day. The most commonly diagnosed gynaecological cancers are uterine cancer, ovarian cancer, cervical cancer, vulval cancer, cancers of other female organ and placenta and vaginal cancer. All can cause irregular bleeding, but some may not present with any symptoms at all. Proper diagnosis and early intervention is the key to any gynaecological cancers. For more information on diagnosis, symptoms and treatment please refer to the cancer council website.

There are other conditions that I haven’t discussed because of focusing on the main gynaecological conditions that can affect a woman’s cycle. I haven’t gone into the treatments of these disease states and will go into this at a later date. What I will say it that early intervention is the key to any disease state in the body and seeing the right people is paramount too. Please know that many of these disease states will require a multimodality approach and please remember that there is always help out there. Never put up with period pain, or menstrual irregularities, or be told the symptoms many women face daily are normal. The value of a second, or third, or tenth opinion is crucial for some people to get help and to find the right person to help.

Please remember that period pain IS NOT normal and neither are many of the menstrual irregularities that many of you face daily. There are always treatments and help out there too. I help so many women daily, with most of these sorts of conditions, and with the right treatments, diagnosis and investigations, you can be helped too.

Take care

Regards

Dr Andrew Orr

-Leaving No Stone Left Unturned

““Women’s and Men’s Health Crusader”

 

 

What Affects a Menstrual Cycle – Part 1 (Non Gynaecological Factors)

After my post on “What a Proper Menstrual Cycle Should Be Like”, I have had lots of people asking what the cause of their menstrual irregularities are. Most of the causes can be broken into two causes being:

Non Gynaecological Factors– Meaning things you do, or may have done to exacerbate current conditions, or throw your cycles out of balance

Gynaecological Factors– Disease states such as Endometriosis, PCOS, Fibroids, Polyps, Adenomyosis, Cancers and other causes.

I’ll talk about the factors (Non-Gynaecological Factors) in people’s control so that they may be able to identify some of those things they may be doing on a daily basis to exacerbate current underlying issues, or just interfere with their hormones and lead to problems with their menstrual cycle.

 

These ones you can work on and be aware of in case your cycle isn’t regular, or your pain is worse in a month. This way you can look back and go “Oh….. Now I know why my cycles wasn’t so good this month”

I’ll talk about the Gynaecological Causes of irregular, or painful cycles in my next post. For now here are the Non-Gynaecological causes.

What Affects a Menstrual Cycle- Non-Gynaecological Factors.

  1. Poor diet – Foods such as high sugars and junk foods all cause inflammation in the body and lead to hormonal irregularities and can exacerbate, or cause pain with the menses
  1. Alcohol – Most alcohols contain high sugars and they also cause inflammation in the body. It also interferes with your hormones and affects the liver too. In Traditional Chinese medicine, it is believed the Liver governs the menstrual cycle and the Live also controls the emotions. Excess alcohol leads to SOL ( Shit on Liver) and thus the moods and cycle get affected.
  1. Poor Sleep– Sleep deprivation leads to reduction in hormones such as melatonin, which is a precursor to serotonin and then effect the moods etc. Lack of sleep also interferes with the other hormones in our body too. Lack of sleep also stops the body from repairing and can lead to other health issues. We know that shift works do have a lot more disturbances with their cycles and also have lower fertility rates.
  1. Trauma – Things such as surgery, a virus, cold/flu etc, or where the body has to repair, can lead to menstrual irregularities. The body shuts down the menses so that it can repair itself first. Emotional trauma can also cause the menses to shut down, or become irregular too.
  1. Weight gain, or weight loss– It is a well known fact that many athletes do not get a menstrual cycle because of lack of body fat. The same goes for people who are over-weight too. Eating disorders can also cause irregularities and infertility. Too much or too little body fat interferes with your fertility. All your hormones are made from fats and protein.
  1. Emotional Issues– Bottled up emotions such as anger & frustration cause blockages in the system & then cause pain. Emotional issues also cause problems with hormones. Emotions and stress are a major cause of menstrual irregularities. Bottled up emotions can cause SOL too ☺
  1. Drugs/Hormones– Both pharmaceutical and recreational drugs can also cause menstrual irregularities and can stop the menses completely. Recreational drugs can also lead to permanent infertility.
  1. Travel– Travelling over time lines and even just interstate can cause issues with your cycle too. The body has to cope with adjusting to different times zones, different foods and water etc and the pressures from flying can also throw the cycle out.

Hope this help explain a little bit more about how our diets and lifestyle can affect your cycles each month too. Next I will talk about the gynaecological conditions which can causes issues with your cycle. Stay tuned 🙂

Take care

Regards

Dr Andrew Orr

-“Leaving No Stone Unturned”

“Women’s and Men’s Health Crusader”

 

women 1209678 1920

What Proper Menstrual Cycle Should Be Like

I have been traveling 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.

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 also get emails and facebook messages from women, or see them in clinic, asking me What 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, and women should not experience any pain at all during your menstrual flow, and you shouldn’t have to put up with all the horrible symptoms leading up to your cycle as well. A slight bit of discomfort may be 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 it. It is 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.

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, or women’s health 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

Dr Andrew Orr

“Women’s and Men’s Health Crusader”

-No Stone Left Unturned

Dr Andrew Orr Logo Normal 20 07 2016

You May Ovulater

The traditional theory that women have the potential to ovulate at one time in the month (being around day 14) is actually been proven wrong and is something fertility specialists have known for a long time

This research was first published back in 2000 in the British medical journal and then research, published in the journal Fertility and Sterility in 2003(2003;80: 116-22 [PubMed]) could explain why the “rhythm” method of contraception is so unreliable and why women who take hormonal contraceptives sometimes become pregnant.

Researchers from these studies did daily ultrasound scans on women who apparently had normal menstrual cycles. Some were nulliparous; others had had up to three children. They found that all of the women produced at least two and sometimes 3 major waves of follicular development.

The existing theory held that at the beginning of each menstrual cycle, 15 to 20 follicles begin to grow in the ovaries and that one of them develops into a mature egg at roughly the middle of the cycle. The research showed that 40% of the subjects had the clear biological potential to produce more than one egg in a single month. Moreover, they could be fertile at any time of the month.

“These studies have actually caused the rewriting of the human reproduction textbooks” The leading researchers have explained. “It explains why natural family planning often doesn’t work, why hormonal contraception sometimes fails, and why we see fraternal twins with different conception dates.” The studies have also helped to improve assisted reproduction success rates too and why we see some women ovulate again (as part of their natural cycle) after hormone induced ovulation.

Research published back in 2000 that was published in the British medical Journal also showed that “Ovulation – Fertile days are unpredictable”

The timing of the fertile window is highly variable and to assume that ovulation occurs on day 14 or between day 10 and day 17 is based on outdated information.

Fertile days are unpredictable, and can fall anytime during the menstrual cycle-even for those women with regular Cycles. There is only a 10% probability of being fertile in the fertile window (day 10-17) as identified by Clinical guidelines and more than 70% are in the fertile window before day 10 or after day 17 of their cycle.

There is also a 1-6 % chance of being fertile during a menstrual phase of the cycle. (British medical Journal 2000 321:1259-1292)

This is why couples need to be having regular sex in a cycle, if they want to conceive and that they need to stop just trying in the so called old school thinking of the “Fertility Window” as identified as day 14, or between day 10 to day 17 of the cycle.

Like anything in life, if something isn’t working, then you need to change what you are doing. If that doesn’t help, then you need to get help from a professional.

I have helped over 12,500 babies into the world and this is part of what I teach my couples and part of my multimodality fertility program.

Take care

Regards

Dr Andrew Orr

“Women & Men’s Health Crusader”

#Ovulation #Ovulater #Ovulationisntjustmidcycle #Fertility #Infertility #Twelvethousandbabiesandcounting #DrAndrewOrr #BrisbaneBabyMaker

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 treat endometriosis everyday in my clinic. 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 beat this disease 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

Endo really does require a multi modality approach to treat 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 have so much success. I do lots of things combined. I do have my own range of medicines that I have formulated to treat endometriosis and other gynaecological issues. But they are practitioner only and do need to be prescribed by a qualified practitioner to be able to use them. You can find out more by emailing info@conceptshen.com.au

Even then you still just can’t take a 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 who to treat this properly and treat this like I would. 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 clone myself sometimes.

I do know many women do get relief from the hysterectomy and I have to say I sometimes have to tell people this is the better option, if it is really affecting your life. But, it needs to be done by a good surgeon and it also needs to be done intravaginallly and via laparoscopy. That is how I make sure my patients get it done. Much better recovery and less impact on them. It is hard to make those decisions though. Sometimes the endo has really spread to other parts of the body so hysterectomy really doesn’t solve endo all the time. It can help though.

It is hard to help from afar, but if you do want my help, I do Skype consults so I could help you. I do help people all over the world and 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 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 endo surgeon that 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 my help, please email me at info@shentherapies.com.au and also copy my patient liaison in at susan@shentherapies.com.au. That way it won’t get lost and I know she does get all my messages.

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

Dr Andrew Orr

No Stone Left Unturned

“Women’s and Men’s Health Advocate”