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.
Ovarian cancer often has no symptoms in the early stages. Later stages are associated with symptoms, but they can be non-specific, such as loss of appetite and weight loss.
Ovarian cancer often goes undetected until it has spread within the pelvis and stomach. At this late stage, ovarian cancer is more difficult to treat and can be fatal. This is why early intervention is something I am very big on and why we all need to not put things off when they present themselves.
Ovarian cancer is the 9th most common cancer diagnosed in Australian women.
Ovarian cancer is the 6th most common cause of cancer death in Australian women.
The present life expectancy of Australian women is 84 years. One in 77 women will be diagnosed with ovarian cancer before the age of 85.The risk of ovarian cancer increases with age. About 83% of all new cases of ovarian cancer diagnosed in 2005 were in women 50 years or older. The median age of first diagnosis is 64 years.
The five year survival rate for ovarian cancer is 45%.
Most women with ovarian cancer experience at least one symptom of the disease in the year prior to their diagnosis. The following can all be signs of ovarian cancer:
- Abdominal bloating
- Abdominal or back pain
- Appetite loss or feeling full quickly
- Changes in bowel habit
- Urinary frequency or incontinence
- Pain during intercourse
- Menstrual irregularities
- Unexplained weight loss or gain
- Indigestion or heartburn
Why is bloating a sign of ovarian cancer?
Ascites (a build-up of fluid in the abdomen and a sign of advanced ovarian cancer) is probably the major cause of bloating in women with ovarian cancer. Therefore, waiting for bloating as a key ‘sign’ is too late and we want to encourage all women to ‘know your normal’ and if this changes, to seek medical help. This is why any changes in the body need to be looked into. Many may think that they are reacting to foods, or they have a gut issue etc, but it may actually be the signs of ovarian cancer. This is why proper investigations and proper differential diagnosis by a trained professional is so important.
While having a family history of ovarian cancer increases a woman’s risk of developing ovarian cancer, 90-95 per cent of all ovarian cancers occur in women who do not have a family history.
Key factors associated with increased risk include:
- Multiple relatives on the same side of the family affected by breast cancer (male or female) or ovarian cancer
- Younger age at cancer diagnosis in relatives
- Relatives affected by both breast and ovarian cancer
- Relatives affected with bilateral breast cancer
- An increase in age
- Inheriting a faulty gene (called a gene mutation) that increases the risk of ovarian cancer
- Being Caucasian (white) and living in a Western country with a high standard of living having few or no full-term pregnancies
- Starting your menstrual cycle early (before the age of 12) and beginning menopause after the age of 50
- Taking hormone therapy (HT) after menopause. Some studies suggest this may increase your risk of developing ovarian cancer, but others don’t make this connection
- Never having taken the contraceptive pill – the pill has been found to reduce the risk of cancer of the ovaries and uterus
- Only five to 10 per cent of all ovarian cancers are associated with a family history. The risk of developing ovarian cancer increases with the number of affected first degree relatives (parents, siblings, children)
- Ashkenazi Jewish ancestry.
Diagnosis for Ovarian Cancer
There is currently no evidence to support the use of any test, including pelvic examination, CA125 or other biomarkers, ultrasound (including transvaginal ultrasound), or a combination of tests, to screen for ovarian cancer. The only way to properly screen for it is through histology done at the time of laparoscopy.
While CA126 can be a diagnostic, it really has limited value and I have to let people know that it isn’t the best diagnostic at all. 50% of ovarian cancers will actually have a normal CA125 reading.
The cancer council’s guidelines are quite clear about this after numerous research studies show that CA125 has limited diagnostic value for Ovarian cancer. If markers and symptoms are suggestive of Ovarian Cancer, the only true diagnostic is Laparoscopy with histology to really get an accurate diagnosis.
Treatment for Ovarian Cancer
At such an advanced stage, the cancer is more difficult to cure. As ovarian cancer advances, cells from the original tumor can spread (metastasize) throughout the pelvic and abdominal regions and travel to other parts of the body. Cancer cells are carried through the body through lymph vessels and the bloodstream.
If a woman is suspected of having ovarian cancer, she should be referred to a gynaecological oncologist. Research shows survival for women with ovarian cancer is improved when their surgical care is directed by a gynaecological oncologist.
Treatment for ovarian cancer usually involves surgery and chemotherapy. It may also include radiotherapy.
Usually your healthcare practitioner, or GP, will generally arrange for initial tests and looks after your general health as well as coordinating with your specialists. Depending on your treatment you will be seen by several specialists, such as: medical oncologist, radiation oncologist, radiologist, gynaecological pathologist, cancer nurses and other health professionals such as a dietitian, physiotherapist, social worker and a counsellor.
With any condition that affects the body, we often get early warning signs and this is why early intervention and making sure you are investigated and management properly is so important.
Dr Andrew Orr
-Women’s and Men’s Health crusader
-No Stone Left Unturned
The only way to definitively diagnose endometriosis and the causes of period pain is via surgical intervention. Scans, blood tests etc do not diagnose endometriosis. You cannot have a scan to diagnose endometriosis and you cannot have a blood test to diagnose endometriosis either.
The definitive diagnosis of endometriosis needs to be done via a laparoscopy
The definitive diagnose IS and ALWAYS WILL BE via a laparoscopy/laparotomy, along with histology (biopsy) and tissue samples taken to examine. Most times a hysteroscopy is done at the same time and if there is an evaluation for fertility, dye studies for tubal patency will be done at the same time.
Women with endometriosis need to see an Advanced Trained Laparoscopic Surgeon
A laparoscopy is the goal standard investigation of examining the pelvis and for investigating gynaecological disorders such as endometriosis. The laparoscopy also needs to be done by what we call an Advanced Trained Laparoscopic Surgeon, who has extra years of surgical training, and who specialises in this disease and specialises in the excision of endometriosis.
It can’t just be done by a regular obstetrician/gynaecologist and this is where many go wrong. Many women just haven’t seen the right surgeon first up who has he proper skills to deal with endometriosis effectively. The first surgery should always be your best surgery and early intervention and management of this disease is crucial. The longer it is there, the worse it can become.
Ultrasounds and Bloods Tests etc Cannot Diagnose Endometriosis
All too often I get women telling me that they do not have endometriosis because their doctor has ruled it out via an ultrasound, or blood test. This is so distressing to hear and this is why so many women are missed and dismissed with this horrible disease that affects 1 in 10 women world wide.
Endometriosis Management Requires a Multi-modality Approach
But, please know that surgery does not cure endometriosis. It is just the first stage in the management of the disease and the active lesions that have been expressed and are present now. Endometriosis can, and will return for many suffers and this is why endometriosis needs ongoing care and a multimodality approach to treat it effectively. It needs a team to manage it properly. While surgery is an important part of evaluation, management and diagnosis of endometriosis, it is to help with symptomatic pain and then other treatments are needed to suppress the disease from further developing and also managing ongoing symptoms.
If you need help with period pain, or assistance with endometriosis, please give my clinic staff a call and book in a consultation.
Dr Andrew Orr
-No Stone Left Unturned
-Women’s and Men’s Health Advocate
-The Endometriosis Experts
Sometimes the body is like a well sprung spring, and over time the spring gets stretched, but , bounces back to its original shape, but overtime, one day, it will get to a point where it is slower to recoil to its original state, or, will no longer spring back to its original shape and have no more spring to recoil to its original state. No matter what you do to it, it just will not recoil and will in essence become to a state of non-repair.
As everyone knows, I always use a very integrative medicine/ multi-modality approach to treating people and getting the best for people’s health. I always believe that preventative medicine is the best approach to any health problems, but sometimes medical intervention, in the form of surgery, is needed for some acute complaints.
It is always hard when someone comes into the clinic and they are doubled over in acute pain from endometriosis, or an acute skeletal issue, and while I can help them, I know that the best thing for their long term health would be intervention in the form of surgery. That is not saying I cannot help and assist people with acute pain, but sometimes the best thing to do is get the person in for surgery to help with the acute pain, and then follow up with preventative and rehabilitation care.
Often it can take several months to help regulate hormonal issues and pain from conditions such as endometriosis, or pelvic inflammatory disease, with more conservative forms of treatments such as pharmaceutical medicines and hormones, complementary medicines, acupuncture, supplements etc. While the outcome after treatment is always great, is it really beneficial for people to endure constant pain for months, when surgery could produce a faster result, for the pain?
In saying that some of these conditions have a high rate of return, so that is where an integrative medicine/multi-modality approach can help post surgery.
I was talking to a medical specialist last week, who promotes complementary medicine for all his patients, and he explains it to his patients like this; “Sometimes the body is like a well sprung spring, and over time the spring gets stretched, but , bounces back to its original shape, but overtime, one day, it will get to a point where it is slower to recoil to its original state, or, will no longer spring back to its original shape and have no more spring to recoil to its original state. No matter what you do to it, it just will not recoil and will in essence become to a state of non-repair.”
I see people in my clinic just like this spring. Some are well oiled, and well sprung, and bounce back into shape very quickly. Some are showing the signs of starting to lose their spring, and then others have just pushed their body to the point or no spring, or worse still to the point of non-repair. Obviously I like seeing people do the right things and use preventative health so that they stay well oiled and well sprung. I do like to see people coming into the clinic when they get the first signs of ill health and the spring is starting to recoil slowly.
The sooner you get onto any health complaint the easier it is to treat. Early intervention is the key to any disease state, or health issue. But, we all know people who push through pain and say “She’ll be right mate” and get to that point where they just can’t recoil anymore. Then we get the ones that have gone beyond that and unfortunately no matter what they do you will never be able to get them back to what they used to be like. So, please don’t ever let your body get to this point if you can.
The reason for this blog was to not only inform people to be proactive with their health but to also make sure people are covered if they do need surgery. It is always such a shame and I always feel sorry for people who need urgent medical attention, but they don’t have private health cover. I know that not everyone can afford it, and I am not pushing it either. But, it is worth considering for anyone who have a long term health issue, or especially for women trying to conceive.
Every woman is going to need to see a gynaecologist at some stage in their life and you don’t want to be relying on a failing public health system that could have you waiting months, or even years, for an appointment, or much needed surgical intervention. Those experiencing fertility issues will need some investigation at some stage so it’s almost necessary to be prepared and well covered.
I’ve seen so many people over the years that come into my clinic, for so many different ranges of acute conditions, that actually do require some sort of urgent surgical intervention, but only to find out they can’t get the necessary treatment they need because they aren’t covered.
The public health system is in such a mess at the moment and wait times are becoming increasingly long. If you have an acute condition, you don’t want to be waiting months, or years for treatment. The other issue is that you don’t get to see a surgeon of your choice and can then end up with the lucky dip of whomever is there on the day. The other issue is that this person may not specialise in the disease state, or issue you are there to have treated. This is what happens to many and this can then have long term health consequences if you aren’t given the right care that you need, or they actually miss crucial issues as well. It is a big issue.
Then when you finally get to having the surgical intervention, it may require multiple surgeries, and the first surgery may be just for investigation only. I’ll give you an example. I had a friend, with acute period pain that got nausea, vomiting and even fainted, (from severe endometriosis) go on a 12 month wait list for surgery in the public system. Finally she got in for surgery only to wake up and find that the operation was one of many to come and the first one was only for investigation purposes only. She would need ‘three’ more surgeries spaced at months apart. So nothing was done with the first surgery, she was still in pain and now had to prepare for further surgeries.
Yet, a similar friend who had a private cover, got to chose the gynaecologist of her choice, got someone who specialised in her disease state, was an advanced trained excision surgeon, had no wait time, had not out of pocket expenses, had everything tidied up and the endometriosis removed on the first surgery. This same lady could then come back to see me straight away to prevent the endometriosis from returning and was now not getting that acute pain anymore. There is a huge difference in the time, the surgeon who this the surgery, the treatment and the amount of surgery needed.
As I said, it is a hard topic to talk about and is by no means a push for private health cover. I am only talking about this to educate people that sometimes it may be a necessary part of your overall health. It just distresses me seeing people who need desperate immediate help, not being able to get it. I know that not everyone can afford it and believe me you have to shop around when you do start looking at it. The big companies are usually the worst to deal with and the smaller companies are usually the best to deal with, and give you better rebates.
In saying that, private health is a sometimes necessary part of overall health care, especially for those with ongoing health concerns and especially those that may require some form of medical intervention. There are some great smaller funds out there that don’t cost that much and give you full hospital cover with an outlay of a couple of dollars per day. You can also look into having extra’s cover as well, which will cover part of the treatments with us also. Again some of the smaller funds provide better rebates and the best thing would be to give us a call and we can tell you who those funds are. I hate talking about these sorts of things but at the end of the day I care when people aren’t getting the right help and am here to help people with every area of their overall health. It is a very important issue that we all need to consider and that we all need to discuss too.
If you do need help with pain, or any health condition, or need someone who cares and can help you get the right advice and health management, please give my clinic staff a call. Just book in an initial extended consultation and let’s get you feeling like you again.
Dr Andrew Orr
-No Stone Left Unturned
-Women’s and Men’s Health Expert
Research published in the Journal of Family Planning and Reproductive Health Care found that endometriosis affects women’s sex lives, personal relationships, work life, and emotional well-being.
Endometriosis often takes a long time to be diagnosed and affects all areas of a women’s life, a study has found. Endometriosis is a chronic, recurring disease that is experienced by approximately 10 per cent of women worldwide. This number could be greatly understated as many women have not being diagnosed properly and many women still think period pain is normal.
But, while period pain is part of endometriosis, a significant portion of women with endometriosis are asymptomatic (meaning no symptoms) and only get diagnosed when there is a need for fertility treatment.
Common symptoms include of Endometriosis
• Painful menstruation,
• Heavy menstrual bleeding,
• Painful sex
• IBS like symptoms
• Bladder issues (UTI like symptoms)
• Ovulation Pain
• Pain with bowel movement
• Chronic Fatigue
The Research Unit at the School of Public Health and Preventive Medicine, reviewed a number of papers that documented women’s experiences of endometriosis. The most common theme was that women had experienced delays in diagnosis.
Many women feel they are being dismissed and this is evident in the fact that it often takes up to “10 years, or more” for women to be diagnosed properly.
The study found that women were more likely to be diagnosed sooner when they approached their doctor describing symptoms as fertility-related rather than a menstrual issue.
The study showed that some women initially delayed seeking help for their symptoms because they believed all women had painful periods. When women revealed their symptoms to a family member, friend or medical professional their experiences were typically normalised as being what all women must endure. Period pain is not normal and all women need to know this.
The study also found that women often felt frustrated and angry at unsatisfactory experiences with healthcare providers, and had concerns about the effectiveness and side effects of treatments.
Women want their doctors to really listen to their experience and concerns. They want to explain the true impact of the condition on their lives, rather than simply rank their pain on a scale from one to 10, or be dismissed each time they try to have their doctor listen to what they are going through on a daily basis.
The study found that further research was needed to gain a comprehensive understanding of endometriosis as experienced by diverse groups of women.
This research will contribute to the improved health care of women with endometriosis in Australia, and around the world.
Too many women being ‘missed’ and ‘dismissed’
I see so many women who have been misdiagnosed, had symptoms missed and been dismissed for years and seen multiple healthcare practitioner, both medical and complementary.
There are clear-cut signs and symptoms that point to endometriosis and we need for healthcare practitioners to start to know this. We also need for practitioners and the public to know that endometriosis can only be diagnosed by a laparoscopy (surgical intervention) and that scans and blood tests, do not diagnose endometriosis.
Lastly, my message to all women is ….. “Period Pain IS NOT Normal” and people need to stop telling women it is.
There is too much BS out there about endometriosis and we need all women and all healthcare practitioners to start knowing the facts. 10 years, or more, to a diagnosis is unacceptable for any health condition. It means many women are being ‘missed’ and ‘dismissed’ along the way. Let’s put an end to Endometriosis.
If you do need help with period pain, or help managing endometriosis properly, then please book in a consultation with me and I can help you get the help and proper care you need.
Dr Andrew Orr
-Women’s Health Expert
-No Stone Left Unturned
I know I have said this often, but it seems that every day I get another email saying that “I have period pain and I have been to the GP and done scans and bloods tests and he/she says that there is nothing wrong”
The problem is that there is something wrong and the first thing wrong is that someone was told that there is nothing wrong, when they have only had very basic testing done.
The second thing wrong is that most of these women are not being referred onto an appropriate specialist, which is what good sound ethical practice is. This is why some conditions like PCOS are taking up to 3 years to be properly diagnosed and conditions such as endometriosis are taking up to a decade to be properly diagnosed. It just should not happen.
I can’t begin to tell you how many women I have seen over my years in practice, that have been told that there is nothing wrong with them, or that the practitioner hasn’t found anything, when really all they have done is a basic scan and a few random blood tests. Then when these women are properly investigated we end up finding all manner of issues. Yet, these women were told that there is nothing wrong.
All I can keep telling people is that while ultrasounds can find some causes of gynaecological issues, there are many issues they cannot find. It also depends on the technician, or person scanning you too. I know that there are not that many specialised gynaecological radiologists and this is why many things do get missed. I have viewed scans that show abnormalities and the report says that everything is fine. This is why I will only ever read scans and not just reports.
Gynaecological issues such as endometriosis cannot be diagnosed by ultrasound and can only be diagnosed by surgical intervention, in the form of a laparoscopy and with histology. Then, as I have said many times too, it all depends on the surgeon you have seen. If your surgeon isn’t an advanced trained laparoscopic surgeon there is a very good chance you may not have been investigated properly. I have mentioned this in many of my previous posts.
Even some cysts, PCOS, polyps and other masses can be missed on scans and let’s not even talk about blood tests. Sure, some hormones levels can be a pointer to a certain issue, but they are not an accurate diagnostic. To be completely honest, many women with serious gynaecological issues will have normal hormonal levels and have completely normal blood results. This can even happen in certain cancers and why some of the cancer markers are now not being used as definitive diagnosis.
I can tell everyone that I have seen many gynaecological issues being missed, and women being dismissed over the years, and it still happens on a daily basis. If you have menstrual issues, or are in pain daily, or just with your menstrual cycle, and you are being told everything is fine, then you need to get a second opinion and a referral to a good specialist.
Better still, come and book in a consultation with me and I will help you get you sorted and managed properly.
Dr Andrew Orr
-Women’s Health Expert
-No Stone Left Unturned
Recently I posted a story about endometriosis being aired on SBS television. I am sure many people watched it and it is great to see that sufferers are finally being recognised. It is important that sufferers are finally being recognised and that there is more education about this disease.
But, is education and awareness enough?
Well, ‘yes’ and ‘no’. I always say this when I am asked this question. Yes, it is great to get education and awareness out there, but what are we doing to support those who are struggling daily?
Any education and awareness about this horrible disease is great. It is a huge win for sufferers when we do see programs go to air and aren’t scared to ask people their experiences of living with a disease state.
I do think those that were involved and those that are driving this awareness need to be applauded. Getting media to listen is one of the best ways to bring awareness to the disease states such as endometriosis.
While there was lots of information shared, I do believe more could have been talked about. I was a little disappointed to hear that the opening line was more about associating endometriosis and periods. We know endometriosis and its symptoms can be there daily, not just around the menses. But, it does open up discussion for more programs and media recognition for those with endometriosis, or any gynaecological condition really.
I’ll talk about the good things, the not so good things and everything in between. Let’ have a look what was talked about and some of the things that should have been talked about as well. I do realise time constraint mean that not everything can be talked about either.
The important things that were talked about
- Millions of women world-wide suffer this disease
- Millions of suffers do have a wide range of symptoms that vary with each individual
- Period Pain IS NOT Normal
- There is no cure for endometriosis
- Millions of women world-wide have been led to believe their symptoms are normal, when they aren’t
- Women are being missed and dismissed daily and told to basically suck it up
- Many women take more than 10 years to be diagnosed
- GP’s and other healthcare people are missing the disease and also failing to refer on
- Many women are misdiagnosed for other disease states such as IBS, gastro etc
- When presenting for medical help, many women are told they just have a gastro virus, or it may be an ectopic pregnancy
- Endometriosis affects the daily life of sufferers and their partners and family as well
- Partners can be affected by watching their loved one go through this disease state
- Intimacy and a happy healthy sex life can be hard for sufferers due to pain and associated symptoms
- Many endometriosis sufferers have to take pain killers daily, just to get through their day
- Endometriosis requires a laparoscopy to be diagnosed
- Scans and blood tests cannot diagnose endometriosis
- Women need a highly specialised surgeon when needing to have the disease diagnosed and cut out
- Despite the best medical treatments available, women are still in pain daily
- Many women will require multiple surgeries to deal with endometriosis
- Despite multiple surgeries, women are still in pain and have all the associated symptoms of endometriosis.
- Women will need hormones, pain medications, pain management and psychiatric help dealing to be able to deal with endometriosis
- Often pain and associated symptoms are not managed well at all
- Women who suffer endometriosis are holding down jobs and many people are unaware they are suffering this disease
- Many women with endometriosis cannot hold down fulltime employment either
- Women are not being told the facts about endometriosis
- Many healthcare practitioner do not know the facts about endometriosis
- Women of all shapes, sizes and colour have endometriosis
- Endometriosis is just as common as many other well-known disease states, yet little is known about it.
- Complementary medicines such as acupuncture and Chinese medicine may help women with endometriosis (although this was brushed over very quickly)
- Genetics/hereditary links are now known to be a big part in the disease expression
Important things that were not talked about
- Endometriosis pain and associated symptoms do not just happen around the menses
- A significant portion of women with endometriosis are asymptomatic (meaning no symptoms) and are only diagnosed through needing to assess for other issues such as fertility investigations
- Not all women with endometriosis will experience fertility issues
- Pregnancy does not cure endometriosis
- Hysterectomy does not cure endometriosis
- Endometriosis is Estrogen driven and not caused by estrogen dominance
- Progesterone in suppressive to the disease
- Pain levels are not related to the extent of the disease
- Teenagers are not too young to have endometriosis
- Certain combined contraceptive Pills that contain estrogen, could be making the disease worse, or in fact helping mask and then drive the disease
- The facts around endometriosis need to be standardised and more freely available
- Despite the best medical treatment not working for some women, we need to educate about other alternatives, including complementary therapies
- Women with endometriosis do need a multimodality (team) approach to manage their disease state and daily symptoms
- There needs to be better funding to help women access all services they need for endometriosis and the associated symptoms
- Too much surgery can be just as bad as not having surgery
- The first surgery should always be a sufferer’s best surgery
- Women with endometriosis need to see and advanced trained laparoscopic surgeon who specialises in endometriosis and is an excision specialist.
- Not all gynaecologists are advanced trained and not all gynaecologist will be able to effectively manage endometriosis
- Most of the good advanced trained surgeons do not do public work. Some do limited work, most don’t.
- Women and healthcare practitioners need to be educated about the facts are endometriosis
- GP’s and other healthcare providers who are the first point of call for women, should be better educated about endometriosis and the associated symptoms
- Women with endometriosis can have adenomyosis, PCOS and other gynaecological diseases at the same time
- Women who suffer bad symptoms of endometriosis have contemplated suicide, or had suicidal thoughts
- Women with endometriosis will require help with depression, anxiety and other mood disorders
- Many women with endometriosis are addicted to pain medications and opiates and are not monitored , or managed well
- Many women cannot function without some of the pain medications and the alternatives that are not as addictive need to be discussed
- Diet and lifestyle changes can help with reducing the symptoms of endometriosis and may help with reducing some of the inflammation driving the disease
- Healthy gut bacteria and restoring the microbiome can help with some of the symptoms associated with endometriosis and the inflammatory processes around endometriosis
- Exercise may assist with the symptoms of endometriosis
There are probably many other things that need to be discussed, but, for now this is a great start. Any awareness is a great outcome and again those that were involved need to be applauded and commended. The sufferers, the specialists, the partners, the families, the media people and everyone involved deserve to be praised for this story. We now just need to take it to the next level of education and awareness for the sake of those and their families that suffer from this horrible disease.
There is no cure for endometriosis and even with surgery and the best medical interventions; women will still suffer the daily consequences of the disease. The best way to treat and clinically manage endometriosis is with a multimodality (team) approach that requires many different modalities and medicines. While there is no cure, with the right interventions and management women can become asymptomatic (meaning no symptoms). We now just need governments to provide better funding to this with endometriosis and those who will ultimately be involved in their care.
Let’s hope that with awareness and education, this brings further funding and changes. We also need for more programs to be aired on the media to talk about what women with endometriosis can do to manage their disease better and where to access the help they so desperately need.
Dr Andrew Orr
– No Stone Left Unturned
– Endometriosis Expert
– Women’s and Men’s Health Advocate
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 recently 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 specialises 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
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.
Dr Andrew Orr
-No Stone Left Unturned
-Women’s Health Expert
One of the things I get asked to comment on often by women, colleagues, media etc, is “Will Hysterectomy Cure Endometriosis?”
Every time I hear the question asked, or hear of women being told that hysterectomy will cure their endometriosis, I almost cringe and have to stop myself from swearing. The fact is this, and I want everyone to know this. Hysterectomy “DOES NOT” cure endometriosis. It never has and it never will and I am going to explain why.
Endometriosis is typically not found in the uterus as it is endometrial like tissue that grows outside the uterus. Endometriosis is really normal tissue, growing in abnormal areas. It can grow on the bowels, bladder, pelvic wall, utero-sacral ligaments (USL’s) and it can spread to nearly every part of the body. It is also one of the most misdiagnosed disease states in women and can take up to 10 years to diagnose on average. Some women are never diagnosed and many take up to 20 years, or more, to be diagnosed. This means that a hell of a lot of healthcare people miss it along the way. That is a fact. It also means a hell of a lot of healthcare people do not know much about the disease as well. Another fact as well. Let’s not get started on the surgical side of this either. I have explained this in other posts (Click Here)
The other fact is there is a lot of BS (Bullshit) put out there about endometriosis by uneducated healthcare practitioners, media and general public alike. Again this is a fact.
One of the biggest pieces of misinformation is women being told that hysterectomy will cure endometriosis and is the solution to all the symptoms they are getting. Not only is this not true, but it is downright reckless, misleading and bordering on negligence. It is also causing women to have a healthy uterus removed and many to undergo a procedure that is not even going to cure their disease. There is no cure for endometriosis at this present time.
Why Won’t Hysterectomy Cure Endometriosis
Firstly, there is no cure for endometriosis. That is a fact.
Secondly, endometriosis is outside the uterus. As I have said before it can grow on the pelvic wall, the bowels, the bladder, the ovaries, the fallopian tubes, the USL’s and it can spread to the diaphragm, the lungs, the pericardium, the heart and nearly every part of the body. That is the truth.
Now, if the disease is not in the uterus, how is taking the uterus out going to be a cure for the disease?
Well, it isn’t a cure and this is what we need for people to know. Sure, menstrual related symptoms like period pain, heavy bleeding, clotting etc may be stopped due to a hysterectomy and not getting a period anymore. But, that is it really. Endometriosis will still be there and so will many of the non-menstrual related symptoms. Worse still many then think, or have been told, that the endometriosis is gone and that the symptoms they are experiencing post hysterectomy are not from endometriosis. The fact is, the endometriosis is still there and those symptoms are still from endometriosis. Many women are then led to believe the symptoms are in their head, or then told to go and see pain specialist and suck it up basically. That is what happens.
The other thing is, many women who have pain with their menses and heavy bleeding may have another condition called Adenomyosis and may not even know they have it. Hysterectomy will help adenomyosis, because this is confined the uterus. So when women say they got relief from having a hysterectomy, they may have just had adenomyosis and not even known they had it. They may also just be having symptomatic relief from menstrual related symptoms from not having their period. Adenomyosis and endometriosis often go hand in hand too and many do not know they have both disease states. Many now believe they are one in the same disease, but just in different locations. But, regardless, endometriosis will still be there regardless of whether a woman has a hysterectomy, or not.
No matter what anyone tells you, hysterectomy will not cure endometriosis. If endometriosis has been diagnosed, then it will still be there regardless of the uterus being taken. This is what we need all to know. Many women are told hysterectomy will be the cure to their endometriosis only to find the symptoms come back again after the procedure is done. The women I feel sorry for are the ones led to believe that hysterectomy will be the great savior for all their symptoms, only to find out it isn’t.
Let’s not forget that endometriosis symptoms don’t always relate to the menses either. Women with endometriosis can be in constant pain at anytime in their cycle and pain can also be cyclic, regardless whether the period is due or not. “Endo Belly” can strike at anytime. Women can go from having a flat stomach one minute, to looking like they are pregnant the next minute, and then back again. Then we have all the other physical and emotional symptoms as well. Hysterectomy is not going to fix any of that. Again hysterectomy will only help with the menstrual related physical and functional symptoms and endometriosis will still be there.
There is only one way to deal with endometriosis and that is via a multi-modality approach and manage the disease properly. I have written many articles about this and spoken about it at many seminars and events. If you want to find out more about how to manage endometriosis please click here
I need every woman with this horrible disease to know that Hysterectomy WILL NOT cure endometriosis. No matter what anyone says to you, it won’t cure the disease. That is a fact and we need to start getting this information out there and stop those spreading the misinformation to be educated properly. If anyone tells you that hysterectomy will cure endometriosis, tell them they are misinformed. The endometriosis will be there still. If you, or someone else, needs to know the facts about Endometriosis, you can always direct them to my Endometriosis Facts Page or visit Endometriosis Australia’s page as well.
Let’s end the silence and also put an end to the misinformation as well. Lastly, always remember that Period Pain IS NOT normal either.
Dr Andrew Orr
-No Stone Left Unturned
-Women’s and Men’s Health Expert