When a Hysterectomy Should Be Considered

When A Hysterectomy Should Be Considered

Many times I have talked about “Why a hysterectomy does not cure endometriosis” and so I have decided to talk about “When a hysterectomy should be considered”

Now, before you go any further, I need people to sit back, listen objectively and also take the personal out of this. This is a very personal topic and yes, I am a man and a male healthcare practitioner all in one, with over 20 years experience in helping women with women’s health conditions and being a voice for them also. But regardless, this topic does need to be talked about. Any negative comments, or rudeness will get the delete button immediately. Constructive discussion is always welcome.

The long and short of it is this. There are times when a hysterectomy should be considered (lack of quality of life, cancers etc) and we need to be able to give women the facts so that they can make informed choices, and also not be judged for those choices either. The fact is that for some conditions, women actually get their life back after having a hysterectomy and I talk about all of this and more in this video blog.

 

Adenomyosis 2

Let’s Talk About Adenomyosis

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)

 

Understanding Why Hysterectomy Does Not Cure Endometriosis

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.

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Is it Endometriosis, or Adenomyosis, or both?

Endometriosis and Adenomyosis can often present with the same symptoms and many now believe they may be one in the same disease, just in different locations.

Despite both of them sharing similar symptoms, there are pointers for properly trained professional to which disease may be presenting. Both diseases are often missed and dismissed as well. To learn more about Endometriosis, or Adenomyosis please click on the hyperlinks.

I have previously put up posts about hysterectomy not being a cure for endometriosis. It often causes lots of people to question this statement, because some uneducated healthcare practitioner has told them differently. Some may have had some relief from having a hysterectomy and now believe their endometriosis has gone.

Before I go any further, I do need people to know the facts. Hysterectomy does not cure endometriosis, but is can help Adenomyosis. There is no cure for endometriosis. I have explained the reasons why in my resent post Hysterectomy does not cure endometriosis. Please click on the hyperlink to find out the facts.

Many women who have Endometriosis, or Adenomyosis are often missed and dismissed for up to 10 years or more, before a diagnosis is made. This is due to the fact that many healthcare practitioners do not know the symptoms of these disease states, or dismissed them as being normal. That is a fact. This is why it is important to see someone who has a special interest in Endometriosis, or Adenomyosis.

With both Endometriosis and Adenomyosis, they share many common symptoms such as:

  • Painful periods
  • Pain with intercourse
  • Ovulation Pain
  • Dark and clotted menstrual blood
  • Digestive upset
  • Pain on bowel movement
  • Bowel or bladder issues
  • IBS like symptoms
  • Pelvic pain and rectal pressure
  • Infertility

What is the difference between Endometriosis and Adenomyosis?

The one thing that usually sets them apart is that Adenomyosis usually has more heavy menstrual bleeding, abnormal uterine bleeding and more flooding symptoms. Endometriosis can have this too, but usually adenomyosis presents with more blood loss symptoms and abnormal bleeding.

Endometriosis ‘cannot’ be definitively diagnosed via ultrasound, or MRI, but adenomyosis can be diagnosed via both of those methods. Endometriosis can only be definitively diagnosed via surgical intervention (laparoscopy). This is the biggest difference with the two disease states. The other thing is that both disease states can be present at the same time and quite often do.

The biggest issue for many women is that when one disease state it found, the other one is quite often overlooked, or misdiagnosed. Many women, and healthcare professionals, are unaware that both the disease states can be present at the same time and this is a real issue.

Hysterectomy will help Adenomyosis, but it ‘will not’ cure Endometriosis.

As I have mentioned earlier, hysterectomy does not cure endometriosis, but it can help adenomyosis. Many women have been led to believe that hysterectomy will cure their endometriosis and associated symptoms, but this is not true.

Some women who have had a hysterectomy and then think they are getting relief from symptoms of endometriosis, but are actually getting relief from adenomyosis not being there anymore. It is just that they did not know it was there, they have never been diagnosed, and then believe their endometriosis is cured. Once the uterus is removed, the adenomyosis is removed too. Then all the adenomyosis abnormal bleeding, period pain and period related symptoms are usually gone as well.

The only trouble is, if a woman has been diagnosed with endometriosis, the endometriosis will still be there. That is a fact. Endometriosis does not miraculously go away after a hysterectomy. Endometriosis is not in the uterus. Some symptoms (usually the menstrual related symptoms) can settle for some people, but for many it does not. Regardless the endometriosis will still be there and can continue to grow and cause havoc elsewhere in the body too.

Proper investigation is important

When women come to see me for help with Endometriosis, or Adenomyosis, I always make sure they are investigated for both disease states. If a women has abnormal uterine bleeding, or heavy menstrual bleeding and they have only been diagnosed with endometriosis, I will always make sure that they are investigated to see if they have Adenomyosis as well. I will also screen for genetic issues such as Von Willebrand’s Disease and other pelvic pathology that may cause bleeding as well.

It is also very important that women with both Endometriosis, or Adenomyosis, or both are are also screened for iron deficiency too.

Hope this explains a little bit more about Endometriosis and Adenomyosis and a bit more about which disease state hysterectomy will, or won’t help.

If you do need help and assistance in managing endometriosis, or adenomyosis, or both, please give my friendly staff a call and find out how I may be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-The Endometriosis Experts

-The Women’s Health Experts

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Are we really doing enough for women with Endometriosis?

I often myself “Are we really doing enough for women with Endometriosis?”

That is a hard question to answer in one way, but easy to answer in others. But, the bottom line is that we really aren’t doing enough for women with this terrible disease.

Now, before I continue and start with what I am about to stay and before anyone takes this the wrong way and gets upset (which isn’t my intent), let’s look at the positives around endometriosis.

There has been more awareness of the disease than ever before and awareness brings about change. But unfortunately that change can also be slow. But, it is a step forward in the right direction. At least there is now some government recognition is some countries like Australia. It is about time though and we need all countries to step up on this front. Governments also need to do more, including ours here.

Yes, we have surgical interventions, pain killers and hormones to help those who suffer the disease. All of these things, either in isolation, or in combination can help women with the disease. Some women even become asymptomatic (meaning no symptoms), after certain interventions, or a combination of all interventions combined. That is what we would like for all women with endometriosis.

Surgical intervention can control active lesions and the inflammation and symptoms they cause. Pain meds can help control pain, but after a while women will need stronger pain meds to control the pain. The body will get used to the level of pain meds and there are also high side effect profiles. Hormones such as progestins and GnRH agonists can help with the control of symptoms, help with pain and inflammation and also help with the suppression of microscopic and active lesions. But, again it isn’t enough.

We know that despite the current medical model of treatment that women are still being missed and dismissed, women are still in pain, women are still having numerous symptoms, women are having high levels of anxiety, basic bodily functions are being denied or hard to achieve, and women are being offered multiple surgeries, because that is all that the medical model can provide for them. That is the pinnacle and once that is reached, then this leaves very little options left.

Women are then offered radicle treatments and removal of body parts and that is not the answer to their often horrible daily journey either. Hysterectomy does not cure endometriosis, not at all. But it is still being offered as such by the ignorant, ego driven and uneducated out there still. Sure, it can stop you having a menstrual cycle. Sure it can help with symptoms associated with the menses.

The trouble is that many women that get relief from hysterectomy actually have adenomyosis as well, or in isolation (usually missed diagnosed or missed completely), which a hysterectomy will help, and these symptoms are then controlled permanently by this procedure. But, the problem then is that these women think that their endometriosis is gone and cured. Not so.

If endometriosis has been diagnosed, it will still be there and it can still cause inflammation, and flares, and gastrointestinal symptoms, destabilise moods, causes endo belly, still spread throughout the body, still wreak havoc on bodily functions and most likely still need interventions of some sort.

Many women with the disease are at the point on suicide some days; let alone asking them to undergo reproductive suicide. I am sorry to put it so bluntly, but that is what it is. I have seen young women who have being told that the only way to cure their endometriosis is to undergo reproductive suicide and permanently halt their chance at having a family, all due to ignorance and being told BS, heartless, unethical statements like that.

Just go and chop out your uterus and you will feel better they say. No woman should ever be faced with that option because there are ways to manage this disease that many have not even been told about, or even begun to explore.

I want every woman to know that hysterectomy does not cure endometriosis and that is a fact. I also want women to know there are options for a normal life, outside the current medical model, or to be used in conjunction with the medical model.

The other issue is that like the fashion industry and their assault of women through marketing, we also have pharmaceutical companies trying to mislead women to believe they have the latest and greatest “fix all” pill for their endometriosis. Again, much of that is just over marketed hype and remarketing of medications and hormones that we already have and are just being sold under another patent and another name.

Many women work out very quickly that the benefits being marketed are not forthcoming and are again left with the feeling of despair. I would love to see a new medication to help women. I would love to see the cure all pill appear on the market, but unfortunately there is no such thing, it does not exist and probably will not exist in the near future either.

We also now have women basically addicted to pain medication, because without them, they cannot function in a day to day life. This then leads to judgment by many and we are now seeing women being viewed as ‘druggies’ so to speak. Many women are also being questioned at pharmacies, even when they have a doctor’s script.

We also have medical centre GP’s refusing women pain medication because they just have not listened to the women and her symptoms and that she in fact has endometriosis. All they hear is “Here is another addict trying to get pain meds”.

No, this woman is in pain and you are not listening to her, or even able to understand the level of distress and pain she is in daily. Sure, pain meds are addictive and they have side effects, but what other options do we have for these poor women? Until someone comes up with a better solution, on a medical level, then this is what women with endometriosis have to do in order to survive their day.

So, yes, while we have come far in awareness and recognition etc, which we desperately need, but we are still stuck in the dark ages as far as medical diagnosis, disease classification, interventions and true clinical and overall health management of the disease.

What women with endometriosis need is an individualised, case by case, individualised, multidisciplinary approach to fully treat and manage the disease but this is not happening.  Much of this is due to ego, certain marketing, suppression of research by pharmaceutical interests, lack of funding, lack of education, lack of awareness and people not willing to research or explore new ideas around this disease that don’t fit the model they want to explore, or believe.

There are ways to treat this disease effectively and it requires a multi-modality approach to do so. It requires the team approach that I always talk about. There is good research and evidence out there to suggest that there are some great treatments and management options outside the medical model, which can also be used alongside medical options to enhance treatments and overall health for those with endometriosis.

We just need more education, more research, more funding, more open mindedness, less suppression of research and education by those with monetary interests in certain areas of medicine, more subsidisation for affordable treatment options and certain people letting go of old belief systems and ego so that new thought processes and education can occur.

While awareness is great and it brings recognition to those with the disease, we also need to then give those same people ways to manage and treat the disease as well and stop viewing these women and druggies, or hypochondriacs, just because the medical system hasn’t caught up with what these women actually go through and what they need to live on a day to day basis.

I’ll talk about some other options for the treatment and management of endometriosis in some upcoming posts. In the meantime please know there are better ways to manage this disease and while I would love for there to be a “one pill” or “one treatment fix all’ approach, I am sorry but that does not exist and we will probably not see that exist either. We can hope, but please don’t hold your breath waiting. Sorry for the rant, but it need to be said and more needs to be done.

Regards

Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

-The Endometriosis Experts

Weeding out endo

Weeding Out Endometriosis

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

I just know that when I used the “Endo is like Rust” analogy, which is what it is like, a few people took it to heart as though they had a rusty uterus and this is not what I was saying. Not at all.

Please know that I have loved ones with this horrible disease, so I am here to help, and my main aim now is to help as many people as possible with what I know, and how to treat people properly. I am also about getting the message out there so that women to not have to remain silent about this disease any longer. My motto is, and always will be, “Period Pain is Not Normal”

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

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

I am always doing lots of speaking events and seminars on Women’s Health and also presenting for workshops on Endometriosis. It is so great to get the message out to the world, so that both the public and healthcare professionals can be educated on this subject better.

We need to stop having this disease “Missed” and women being “Dismissed” as I am always saying now. This disease should not be taking 8 years from onset to definitive diagnosis. It used to be 12 years. This is disgusting, to say the least, and there is no excuse for this to be happening, except poor education, sloppy diagnosis, lack of training, negligence and dismissive egos that need an attitude adjustment.

But, in saying that, we also need to teach women to be empowered and not just put up with being told “This is normal”, or “Just go on the pill and it will fix it”. That is bullshit (sorry). But it is true. There needs to be a better way and we need to stand up and say “Enough”. But we also need to not let the disease define you and get caught up in the blame game either.

We also need to get people to stop “Dr Googling” too, as this is also spreading the misinformation. It is great to be educated, but good old “Dr Google” is full of false information and research shows that up to 75% of the health information that the public can access on google, is either wrong, or only partially true.

Now that I have had my little rant about the injustices of many, I would like to share what I have been sharing to others about what endometriosis is really like and how hopefully we can prevent it from returning, hopefully for good.

I do know this is possible with the right care, right follow up treatments and right team of people helping. I see it daily and know what I share to be true. But, again it requires the person to follow the advice given and then to get the information out there. It also requires people to not be defined by their disease and break free from these chains to open their minds to the possibilities of new thought, new treatments and new ways of doing things. We need to not be caught up in what may cause the disease, but what we can do to help those with it now.

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

To be honest, the most likely cause of this disease is now known to be genetic links, or chromosomal, most likely through the parental mode of inheritance. Gene therapy is probably going to provide the biggest breakthrough in this disease in the years to come. But like any breakthrough, we just have to wait and see what happens there. You heard it here first. I do believe genetics does play a big part, but like any disease, it is not the only contributing factor.

But, all this aside, we need to focus on the here and now to help those who need help now. In order to make change, you need to make those changes required. If you change nothing, nothing will change. I also get how hard it is for those whom have suffered so long to pick themselves up, to make those changes. Believe me, as someone who has been through a major life threatening illness and pain and crawled their way back to good health and do what I do now, I get it. I’ve been to that point of wanting it all to just stop and I get what many women put up with on a daily basis. Pain is pain, no matter where it has stemmed from.

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

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

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

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

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

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

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

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

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

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

A Multimodality Approach Should Include:

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

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

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

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

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

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

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

Please remember these words :

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

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

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

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

Just because someone has your history, or is nice to you, or maybe recommended by a friend etc, does not make them a good practitioner. It does not mean that you cannot get another opinion. If someone isn’t helping you, then you need to look at changing, no matter who they are, or how well they know your history.

Not every specialist you see is a good surgeon either, so please remember this. You need to have someone who specialises in endometriosis and who has done advanced surgical training, not just minimal training. There is good and bad in every profession and the medical profession is not exempt from this either.

The complementary medicine profession, or allied health care profession exempt from this either. Your health is important and so is the value of another opinion. Not every practitioner has all the answers. If someone isn’t helping you, then don’t be scared to change.

Lastly please remember to know that there is always help out there. I am always here to help people as well. I have a special interest in endometriosis and do a lot of education and research into this disease. I also have masters level post graduate training in this disease and other women’s health and reproductive conditions.

You can always come and see me in person, or make an initial online consult (zoom) for those who live at a distance. I have a great team of people I work with to give you the best help possible. I have a team of some of the best health care professionals and I make sure all of the team I work in with, are at the top of their game in their chosen profession.

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

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

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Endometriosis Experts

Dr Andrew Orr Logo Retina 20 07 2016

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Stop Telling Women That Period Pain is Normal

After seeing my 10th case of misdiagnosed Endometriosis this week, and goodness knows what else, I can say that I am well and truly over it and about to scream.

I am about to scream if I hear that one more woman, young or old, is told by their healthcare professional, GP, specialist, best friend, mother, facebook buddy etc, that period pain is normal.

Period pain IS NOT normal. It is far from normal and we all need to stop telling our daughters, sisters and women of this world that it is.

I think that anyone that says that need to come and work with me for a day and see the ramifications of women believing that period pain is normal, just because their doctor, healthcare professional, friend, or mother told them that it is.

I think I should post up some rather gruesome pics of women’s reproductive organs stuck together, their insides bleeding, and their pelvis completely obliterated. Yes, obliterated. That was the words that one of the surgeons used today to explain the insides of a woman that had been told that there is nothing wrong, just suck it up, scans haven’t found anything and just go on the pill and btw, period pain is normal.

No it bloody well isn’t (sorry for swearing but time for diplomacy is over). Women need a voice and need to be heard. Some of these poor women may not be able to have children, or have a healthy sex life, or be able to feel the pleasure of wonderful sex without pain, or ever hold their own baby, because they have been told to suck it up and be told that period pain is 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. 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.

Please get them to get a referral and see a good specialist who will listen to them and not dismiss them and may miss a gynaecological issue that could affect them for the rest of their lives. No… scans and blood test etc, do not always find the cause of period pain. Have a read on my other posts about this.

If you cant find someone that will listen and help, then book in a consult with me and I will assist you in getting you properly investigated and properly managed moving forward

My motto is “No Stone Left Unturned”and my other motto is “Period pain IS NOT normal”. If you are in pain with your menses, or even any any other time during your cycle, or having pain with sex, or pain with ovulation, pain with bowel movements, pain for no known reason at all, then you need to get something done about it.

I think if I hear one more poor woman get told that Period Pain is normal, I am going to start sending those people gruesome pics of all the insides of women who have been told that period pain is normal, only to find out that it isn’t and all the reasons why.

Sorry for the rant, but our daughters, our sisters, our wives, our female partners and women all over this world deserve better.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Period Pain IS NOT Normal

-The Endometriosis Experts

Incontinence and bladder issues

Incontinence, Bladder issues and Weak Pelvic Floor

Incontinence is often an embarrassing condition that will have more than a third of people suffering in silence because they are too embarrassed to seek treatment. Both men and women can suffer incontinence.

Although patients don’t die of incontinence, they often can’t live a fully productive life, they may have to curtail their workload or change jobs. Many factory workers and school teachers are only allowed set times for toilet breaks, so patient with urge incontinence may have to change jobs.

Patients who work in the military or the police force may have to resort to desk jobs. Too many women with incontinence stop having sexual intercourse, either because they are afraid they will leak during sex, or else they actually do leak, either at penetration, or at time of orgasm, which can be very disastrous. While men can also suffer incontinence, I am mainly going to focus on the causes of incontinence in women for this post.

Many people do not seek treatment

Many people don’t seek treatment because they also believe that surgery is their only option. Nothing could be further from the truth and surgery should only be used as a last resort once conservative methods have been used and aren’t working.

Even then, the surgical approaches used today are less invasive, are very effective and the recovery is very quick. It is not like it was 10-20 years ago. Keyhole surgery has really made major changes in this area and new surgical techniques are so highly effective.

I know people want to avoid any surgery, but sometimes it is needed and these days the recovery rates are so quick. A few days out of your life for recovery, can actually change your whole life. I just do not understand why anyone would put up with a life with incontinence, prolapse, or weak pelvic floor, when these issues are so easily fixed these days. I know many patients are so amazed at how easily their incontinence issues was fixed and how amazing they feel in getting their life back again. No more leakage when they laugh, cough, or exercise.

Incontinence does not have to be a normal part of life

Some people never seek treatment believing that incontinence is just a normal part of life. Again, this is not true and all and I encourage anyone with incontinence to talk to Urodynamic/Pelvic floor specialist, so they can help treat you and can also refer you to the right people for treatment and management if needed.

I know the pelvic floor/urodynamic surgeon I work closely with is amazing and what he can do for women and these issues is amazing too. Then I just help with the management on a more multimodality approach, moving forward.

Surgery may be necessary, but not always

Like I said before, surgery isn’t always needed. Many times conservative measures such as pelvic floor exercises, core strengthening, bladder toning, topical estrogen therapy, internal TENS (electrostimulation) and pulse magnetic therapy can all product fantastic long term treatment to this often debilitating condition, without the need for surgery.

There are also some special rings and other devices that can be used to prevent leakage and support prolapsed bladder and also vaginal prolapse causing incontinence. Men with incontinence also have options at hand and these can also be explored well before surgery is needed.

What people need to be aware of too, is that if you have been doing all the conservative treatments, and they aren’t helping, then it is time to get some surgical intervention. I think people think that pelvic floor exercises with fix all bladder and pelvic floor issues, and this doesn’t work, then there is nothing that can be done to help them. I need for all women (and men) to know that there is always help for bladder and pelvic floor issues and you just need to see a specialist, not just your GP.

Natural Medicines

On a natural medicine level, acupuncture and chinese herbal mediciness may assist in the treatment and management of pelvic pain, and incontinence, alongside medical treatments and interventions.

Yoga and Pilates may also help toning of the pelvic floor and help managing incontinence, pelvic floor and post-surgical management of prolapse too.

How incontinence and other bladder issues is defined

Incontinence and bladder issues are defined as needing to pass urine more than 8 times per day, leakage of urine through cough, sneeze, urge, or without cause. It is important to seek help if you notice damp underwear, need to use pads because of leakage or are constantly running to the loo to pass urine.

The different types of incontinence

There are many different types of incontinence with the main ones defined as stress incontinence, urge incontinence and voiding dysfunction/incomplete emptying.

There is also mixed incontinence (mix of the 3 main ones) and also a term called overactive bladder syndrome which can be a mixture of all forms of incontinence. There are also inflammatory bladder conditions that cause incontinence such as bacterial cystitis and interstitial cystitis.

Physical issues such as previous surgery, childbirth and prolapse can also cause incontinence too.

The first task for the clinician is to find out how severe the incontinence is, based on the frequency of leakage, whether the woman finds it necessary to use incontinence pads, and if so how many pads. Some patients may prefer to change their underwear more frequently, while others may tuck tissue paper inside their underwear, and just throw away the tissues whenever they are damp.

The classic feature of stress incontinence is that the patient leaks with coughing, sneezing, laughing, running, playing sport or lifting heavy objects

The classic feature of urge incontinence is that the patient rushes to the toilet with an urgent desire to pass urine, but as she gets to the loo and is taking down her trousers, the urine comes away from her- sometimes before she has even sat down. Unfortunately these patients cannot predict when these bladder spasms will come upon them, and therefore can’t really tell when they are likely to leak.

Nocturia is defined as being woken up by your bladder needing to go to the toilet- as opposed to being woken up by a crying baby, a snoring husband, or menopausal night sweats. However nocturia is age dependent. Nocturia is defined as waking 1 or more times per night if under 60 years of age

Typically a patient with Voiding dysfunction/ Emptying difficulty has to strain to commence voiding (called “hesitancy”). They may also have observed that when they compares themselves to other women urinating in the toilets at the movies or in airports, her stream seems poorer than others with the urine dribbling out more slowly. These women will often also describe the sensation of incomplete emptying and may need to go back to the toilet within a relatively short time to re-void. Sometimes these women will leak as they get off the toilet, which is how the realise that they are not empty. This is called post-micturition dribble incontinence.

Incontinence in males

In males these symptoms most commonly occur when the prostate gland is enlarged- causing a relative urethral obstruction and making it more difficult for the urine to get out. These men have chronic high residual urine, so they end up going to the toilet very frequently in a vain attempt to empty out. They often dribble urine onto their clothes. When such men have prostatic surgery they usually find that their urine flow rate returns to normal and they usually stop dribbling.

Inflammation in the bladder leading to pain

We will also need to explore how inflammation of the urinary bladder leads to suprapubic pain, and consider the two main causes of this, Bacterial Cystitis and Interstitial Cystitis .It often feels difficult to treat incontinence in the presence of bacterial cystitis, because such patients are overwhelmed by frequency and urgency of micturition and they may experience disabling suprapubic pain. It is fixable with the right treatment though. It all gets back to who is managing you.

On the other hand, a separate cause of Urinary Pain, called Interstitial Cystitis, does not usually cause much incontinence at all- it just causes suprapubic (bladder) pain with severe frequency and urgency of micturition. You can read my post about Interstitial Cystitis

The overactive bladder (OAB) is a clinical syndrome, not a urodynamic diagnosis. It comprises frequency, urgency, and nocturia, with or without urge incontinence.

Gynaecological conditions such as Endometriosis and Adenomyosis etc can also cause issues with bladder and pelvic floor.

Please read my post on Atrophic vaginitis as this is also another cause of weakness in the pelvic floor and bladder and could be a cause of incontinence.

Solutions for incontinence, bladder issues, & pelvic floor issues

No matter what sort of incontinence you have, there is always an answer and a solution to your problem. Not all solutions are surgical either. More often than not some conservative treatments, some exercises and some complementary therapies is all that is needed.

Sometimes all some women need is some treatments with estrogen creams to help with tone in the vagina, bladder and pelvic floor

Surgery and now bionic devices are always an option for those whom have tried conservative options and aren’t getting the desired results. Surgery is often used because of quality of life issues. Again surgery these days is so effective and less invasive and the recovery is so much quicker due to keyhole surgery and new surgical interventions.

See a Urodynamic Specialist

If you are experiencing incontinence or bladder issues, please talk to your healthcare practitioner and please book in to see a good pelvic floor/urodynamic specialist, This way  you can be evaluated properly and see what is going on and implement the right treatment strategies to get your quality of life back again.

Many times there may be an easy non-invasive treatment for your particular issues. Even when surgical intervention is needed, these days even this is less invasive than it used to be and the recovery and results are very quick.

Please read my post of Atrophic Vaginitis as well as this all ties into this area too, especially for those women in the menopause and post menopausal time of their life.

Regards

Andrew Orr

-No Stone Left Unturned

– Women’s & Men’s Health Advocate

-The Women’s Health Experts

Copy of Endometriosis Facts There is no cure for endometriosis

Hysterectomy “DOES NOT” Cure Endometriosis

Many women are led to believe that hysterectomy is a cure for endometriosis and this is probably one of the most non-factual statements that many healthcare professionals are guilty of telling women. This is because they lack the understanding of the disease and lack knowledge of how the disease can spread to other areas of the body outside the uterus.

For the record, and this is fact, Hysterectomy does not cure, never has cured, and never will be a cure for endometriosis.

Most endometriosis is found outside the uterus and can be found in the pouch of douglas, utero-sacral ligaments, ovaries, intestine, pelvic wall, bladder and it can even spread up into the diaphragm, thoracic cavity, liver, pericardium, rectum and other parts of the body. It has even been found in the brain and distal joints such as the fingers.

All women with endometriosis need to know that endometriosis will still stay in the places mentioned above, irrespective if the uterus is removed, or not.

Many women will often comment that hysterectomy has cured their endometriosis and this is because they have been led to believe what their doctor has told them, they lack the understanding of the disease and they may have had some relief of pain usually associated with their menstrual cycle.

All hysterectomy will do for a woman with endometriosis is stop their menstrual cycle and any associated symptoms and pain associated with her menstrual cycle. Some women are also just lucky to become asymptomatic after hysterectomy too.

The type of hysterectomy may also help to slow the progression of the disease too. What many people do not understand it they there are two types of hysterectomy. One is a full hysterectomy, where the uterus and ovaries are removed and the other is a partial hysterectomy, where only the uterus is removed and the ovaries are left behind. It may be possible that a full hysterectomy, where the ovaries are removed, may in fact reduce some of the estrogen that is driving the disease and make someone asymptomatic.

The other gynaecological issue that many healthcare practitioners misdiagnose and overlook is Adenomyosis. Adenomyosis is an inflammatory disease deep within the wall, muscle and tissues of the uterus. Many now believe that Adenomyosis and endometriosis are one in the same disease, except Adenomyosis is deep within the muscles and tissues, where as endometriosis tends to be more superficial.

Removal of the uterus will in fact help Adenomyosis and help with the associated symptoms, such as heavy bleeding and pain.

Many women actually have Endometriosis and Adenomyosis at the same time and many do not even know they have both diseases. Then when the uterus is removed, women experience less pain and symptoms, or no pain and symptoms, that was actually caused by the Adenomyosis rather than the endometriosis.

Then these women are led to believe that they have been cured of endometriosis due to the resulting levels of pain and symptoms that are now gone. But, while their Adenomyosis may be cured (and I use this term loosely due to context), their endometriosis still remains.

But if they are now asymptomatic, which many women are, they many not know that the endometriosis is actually still there. If you are one of these people I do need you to know that the hysterectomy has not cured your endometriosis at all and it is still there in your body. If a hysterectomy has cured your pain and associated symptoms is because of everything I have mentioned above. Again, hysterectomy DOES NOT cure endometriosis.

I also see the opposite of this in practice too. Many women whom have had a hysterectomy are still getting lots of abdominal pain, intestinal pain, bladder pain, rectal pain and others pains in the body. It is often hard for them to hear that their pain they are experiencing is actually from endometriosis, which they have been previously diagnosed with, yet believe has been cured due to the removal of the uterus and sometimes ovaries are well (partial, or full hysterectomy).

The only way that many will actually fully believe you is after they have had further surgery and the disease is found and excised and their symptoms are stopped, or reduced. It is not until then, that these women will know what you have said to be true and that they have been sold the biggest lie on the planet.

The reason I wanted to speak about this is because I see so many women believing that hysterectomy (partial or full) will cure their endometriosis and have been sold the lie.

Unfortunately many of these women are still suffering greatly and are often left wondering why, or are told it can’t be endometriosis as the uterus has been removed. It is so terrible to hear this and see this statement being spread as gospel by healthcare practitioners and even surgeons who know no better and do not understand endometriosis as a disease state.

It is also hard to hear other women tell their fellow sisters the same lie, even though it is not really their fault and they actually do not know any better. I am writing this so the truth is out there and we get to stop this misinformation from spreading any further.

I hope this has helped you with getting some of the facts and see why so many women are told the one of the biggest lies in healthcare.

Oh and remember one more thing….  Period Pain is not normal, no matter what anyone tells you!

Take care

Regards

Andrew Orr

-Women’s and Men’s Health Crusader

-“No Stone Left Unturned”

-Period Pain is not normal

What Affects a Menstrual Cycle Part 2 Common Gynaecological Factors

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 drive the disease and 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.

Take care

Regards

Andrew Orr

-Leaving No Stone Left Unturned

-Women’s and Men’s Health Crusader