In this latest video post I talk about why the “No Uterus-No Comment” speech on forums needs to stop.
As someone who is a Master of Women’s Health Medicine, a Women’s Health Expert, and work tirelessly to be a voice for women’s health issues (And a Male), I have a very frank and blunt discussion about some of the male bashing hate speech comments that get thrown around various forums.
Have a listen to the latest video blog on this very important topic.
Recently I did a post on how to make good food and doing it in bulk. I talked about how making good food is not hard and it is not expensive.
I also talked about the excuses people make around foods, around exercise and all the things I hear from people about why they cannot do something. So I did a post to call them on it.
But when I call people on something, it is not meant in a bad way. It is meant in a caring way, but firm, and with healthy boundaries. I do it because I care and I want the best for people and their health.
Most people were agreeing with me, but as with any post, you also get the people who misinterpret whatever one says and there are also the naysayers.
I have done a video as a response to my last post so people understand where I am coming from and why I have chosen to do this post.
Regards
Andrew Orr
-No Stone Left Unturned
-Women’s and Men’s Health Advocate.
Many people suffer from bloating very regularly and some suffer it daily as well. While the cause of bloating if often dietary or food related, many are unaware that stress, anxiety and their busy life can actually be causing their bloating too. In many cases, when food and dietary triggers have been ruled out, a big part of peoples bloating is actually stress and anxiety, or even being overly busy. For the sake of this post, I am going to put ‘busyness’ as the same category and stress and anxiety.
Stress, anxiety and constant ‘busyness’ changes the body, not just the mind. Intense stress or anxiety can trigger stomach discomfort, including bloating. Some people may not realise that our mind and gut are linked. So with our busy, on-the-go lives, emotions we experience throughout the day, like stress, can affect our digestive system. As mentioned in a previous post, stress and anxiety can also cause and exacerbate pain in the entire body. (click here to read)
Stomach pain and bloating are more common in people who have stress as well as an underlying condition, such as irritable bowel syndrome (IBS), or other inflammatory gastrointestinal conditions such Crohn’s disease and Ulcerative Colitis. Bloating and abdominal pain is very common in women with endometriosis and is known as “Endo Belly”. This is very commonly exacerbated by stress and anxiety and also disruption to the microbiome.
While abdominal bloating is a widespread complaint, with many possible causes, unless the pain is intense or accompanied by other worrisome symptoms, it is usually safe to see if symptoms disappear on their own. But if you are ever worried, always consult with your healthcare practitioner as constant bloating can be a sign of serious health issues too.
There is now plenty of research and evidence that the brain and the gut communicate with each other via numerous systems (neural, hormonal and immunological) and do not function independently. Because of this interconnected relationship it means that if one system is ‘disturbed’, or ‘distressed ’it will result in the other system being ‘disturbed’ or ‘distressed also. In simplest terms if you have a busy day at work and it is stressful then mental stress at work = tummy upset. It really is that simple
When someone is feeling stressed and anxious, it may induce a variety of digestive issues and discomfort. Stress and anxiety produce an alteration in the contractility of the gut. This may then cause cramps or pain (increased contractility) and may influence bowel habits, which then causes constipation due to reduced GI contractions. This may then lead to someone being bloated. This could also lead to people also having loose bowels, or alternating bowel movements too.
Additionally bloating may occur without constipation and you could also experience increased heartburn as a result of your stress and anxiety. Decreased stomach emptying accompanied by increased oesophageal contractions may cause acid reflux. This increase stomach acid can then cause bloating and pain. It can also then lead to increase gut permeability and then further lead to leaky gut syndrome.
Thankfully, there are several things you can do to reduce the effects of anxiety and stress on your gut. As I have often talked about, there is a direct link between our microbiota and our stress hormone system. Any alterations in our gut microbiota may lead to a heightened or suppressed hormonal response to stressful situations. I’ve talked about the effects of dysbiotic bacteria and bloating before. You can read one of my previous posts on this (click here)
This is why it is so important to do a proper microbiome restore, to not only to help with bloating and gastrointestinal issues, but to help with inflammation, the immune system and our emotions as well. Of course one still needs to look at their diet and what they are putting in their mouths too. Let’s not forget the impact of alcohol on our gut and digestive system too. I have done a post about this and to find out more (click here).
Besides a proper microbiome restore, the best approach would be to identify the ‘stress trigger’ or ‘anxiety trigger’ and try to remove it, or alter its impact, from your daily life, where possible. This can often be hard and will require the help of a qualified counsellor, or psychologist. It is important that people identify this and are real about needing help from a trained healthcare professional.
There are things people can do on their own to reduce stress and anxiety too. Mindfulness and meditation exercises can help to alleviate stress and anxiety and something people should practice daily.
Some examples could be the following. If you may get stressed by not being prepared for some activity at work like giving a presentation, just make sure that you allow plenty of time to adequately prepare and rehearse to prevent or reduce anxiety.
Another example could be that you might get stressed by travelling to work in overcrowded public transport. You could ride sharing to work, or give cycling to work a try.
If you feel yourself getting stressed out with any task make sure you take some time out from the activity. Go and sit quietly and just breathe and reassure yourself that everything is ok. You could make yourself a cup of tea, or listen to some soothing music. All these things can help but at the same time, may not always be applicable to all stressful scenario, or where you are anxious.
There is more and more evidence now to suggest that many gut issues are affected by stress and anxiety. But, troubles with the gut can also cause stress and anxiety too. The gut-brain axis works both ways and we need for more people to know this.
This is why it is so important to look after our gut health more. We need to be managing our diets better, cut out inflammatory and refined foods, increasing pre and probiotics, managing allergies and intolerances, cutting back alcohol, managing stress and anxiety better, and avoiding foods that we know aggravate stomach issues and cause bloating and pain.
It is also important for people that experience bloating to realise that not all bloating issues are related to food, or their health condition. For many people, their daily bloating and pain is actually coming from either being overly busy, or from their high stress levels, or anxiety. It could be coming from all of these things combined too. If you do not know how to manage your bloating and stress and anxiety levels, it is best to book in a see a healthcare professional who can assist you deal with it properly.
If you do need assistance with bloating and abdominal pain, please call my friendly staff and find out how I may be able to assist you. You can also check out my posts on restoring the microbiome properly too. Something that could be very beneficial for all, especially after the Christmas and New Year festivities.
Regards
Andrew Orr
-No Stone Left Unturned
-Women and Men’s Health Expert
One of the things I find myself saying to parents often is “Please don’t let your daughter suffer with the wait and see approach for period pain.”
The reason I often say this is because daily I get messages from parents, mainly mothers, asking if they should wait and see if their daughters pain (and other symptoms) is miraculously going to go away. Many of these young girls have been putting up with pain for months, or longer, and still many parents are using the “wait and see” approach.
Many of these messages often start with the story that their daughter is laying on the bathroom floor in excruciating pain. The stories usually add in that their daughters may also have symptoms of nausea, headaches, vomiting and even stories of these poor young girls passing out with pain.
Then there is the usual response of “I used to get period pain and associated symptoms like this and I just had to learn to live with it”
Then comes the question I always hear so often- “Do you think I should wait and see if this just goes away, or do you think I should take her to someone to have her checked out?”
I often have to bite my tongue when responding to questions and stories such as this. If my daughter was laying on a bathroom floor each month, and in excruciating pain, there is no way I would be waiting and seeing if her pain is going to miraculously disappear. The first time she had pain, I would be off doing something about it, and I would not be taking no for an answer.
There is always several ways to look at this and why I always offer an empathic response. Many parents were in pain themselves and went through similar experiences. Many of these same parents were told to suck it up and that this is what a woman has to put up with each month. So to them, this is reality. This is their norm. They suffered, so it is natural for them to believe that their daughter just has to wait and see and suffer it out too.
But, as I say to these parents, these symptoms that your daughter is experiencing are not normal. Period pain and all the other terrible associated symptoms are not normal. No woman, young or older, should have to put up with excruciating pains related to her cycle, or an undiagnosed gynaecological condition.
I then go on to explain that I have daughters and that there is no way I would wait and see, before getting help. I also explain that on a health perspective, there are many dangers in letting a young woman suffer such a horrible experience.
I often have to explain the implications of leaving a disease and not intervening early enough. The explanation of by not getting early intervention could mean that they may not ever have grand children, is usually enough to spur many a mother into prompt action. But, it should not have to take these words to prompt someone into action.
The facts are clear now. There is enough education out there. The simple fact is that period pain (and associated symptoms) is not normal and this usually means that there is an undiagnosed gynaecological condition causing the issue. One of the most common causes being endometriosis, or adenomyosis, or both combined. There could be other facts such as pelvic congestion syndrome, or worst still, though rare, there could be something more sinister such as cancer.
The other thing that parents may not like to admit is that their daughter may actually be having sex and has a Sexually Transmitted Infection (STI). I often have parents interject when asking if a teenager is sexually active. Many a parent answer “No” on the teenagers behalf, only to then learn that their little girl is having sex.
Sexually transmitted diseases (STI’s) can cause permanent damage to reproductive organs and future fertility if not treated early enough. The reality is that many young girls, and boys, are having sex at a very young age, regardless of what parents may believe. Parents do need to open to the possibility that their child’s pain could in fact be related to being sexually active.
The things I am trying to educate all parents on are the following:
I do get that many parent’s have been led to believe that period pain, and other associated symptoms are just part of live and something that I woman just has to put up with. I am sorry for those that were told this and then have put up with this when they didn’t have to.
Please know that you daughter does not need to put up with these symptoms. Period pain is not normal and early intervention is the key to help your daughter live a happy and pain free life. It could really also help save her from the heartache many women have to live with daily. It could also help with her being able to have children of her own.
Never use the wait and see approach when it comes to period pain and the other associated menstrual symptoms. You daughter will thank you one day and I am sure her children will thank you too. Lead by example so that your daughter can lead by example to daughter, or daughters too.
If you do need help with your daughters period pain, and other associated symptoms, please give my friendly staff a call and find out how I may be able to help. There are in person and online consultation available. Conditions may apply with online consultations. My staff will explain all this to you when you make your enquiry, or book a consultation.
Regards
Andrew Orr
-No Stone Left Unturned
-Master of Women’s Health Medicine
-The Women’s Health Experts
Millions of women world-wide suffer from chronic pelvic pain. One of the causes of chronic pelvic pain is a condition called Pelvic Congestion Syndrome and it is not often talked about. I thought it was important to share this information to bring more awareness to this syndrome.
Pelvic congestion syndrome does share many of the same symptoms of endometriosis and adenomyosis and it important to have proper differential diagnosis and rule other causes of pelvic pain out first. Sometimes the varicose veins that cause pelvic congestion syndrome can be present alongside endometriosis and adenomyosis, or other pelvic issues.
In the past, a diagnosis of chronic pelvic pain left many women frustrated with few treatment options and a lack of available resources. Their doctors were often left perplexed, despite the endless negative laboratory test and imaging data as well as inconclusive consultations obtained.
In the last 10 years, improved medical understanding and increased awareness have lessened the confusion surrounding this condition and its distinct association with pelvic congestion syndrome (PCS). There are now more minimally invasive surgical solutions which give affected patients more treatments choices as well.
Pelvic congestion syndrome (PCS) is a chronic condition that occurs in women when varicose veins form below the abdomen within the pelvic region. Pelvic congestion is just like the varicose veins that some women have in their legs, but it affects the veins of the pelvis. Blood backs up in the veins, making them become enlarged and engorged. Pelvic congestion can also cause chronic pelvic pain in some women.
The main symptom of pelvic congestion syndrome is pelvic pain that lasts at least 6 months. The pain may be a heavy or aching feeling. Or the pain may be sharp. Usually the pain is only on one side, usually the left side. At times you may feel it on both sides. The pain is often worse at the end of the day. If PCS occurs in pregnancy it often first starts during or after a pregnancy. It may worsen after a later pregnancy.
Symptoms of Pelvic Congestions Syndrome can include the following.
The syndrome often causes a constant dull pain in the pelvic area that is said to worsen at different times of the cycle and in different situations. Experts believe it can be the source of pain in up to 30% of women who have chronic pelvic pain.
It’s more likely to develop in women who have previously given birth, but it can be found in women who have not had children. It is also hereditary so if someone in the family has it, you may be at a higher risk of having it.
It is still not fully understood what the cause of pelvic congestion syndrome is. There may be multiple factors and causes.
Enlarged veins in the pelvis seem to play a major role. These large veins do play a major role in those that have chronic pelvic pain, but many women have enlarged veins and no symptoms.
Pregnancy may increase the risk for pelvic congestion syndrome. This is because veins enlarge during pregnancy to support the increased blood flow. This can permanently enlarge the veins and lead to symptoms.
Just like endometriosis and adenomyosis, hormones may also play a role in pelvic congestion syndrome. It is though that estrogen may play a big part of this by making veins wider (dilates). We do know that estrogen does drive disease inflammatory states. We also know that PCS is less common after menopause when estrogen levels tend to be lower.. Other hormones may also cause veins to grow wider and cause symptoms.
Excess weight and increased body fat may also cause increased inflammation and estrogenic response that leads to pelvic congestion syndrome.
Other factors such as dietary and lifestyle factors may exacerbate this condition as well.
PCS can be quite difficult to diagnose, and will need a multimodality approach to be able to firstly diagnose this properly and then apply appropriate treatment. PCS often requires a multidisciplinary approach because the differential diagnosis is quite long and varied. As mentioned before, some of the symptoms are the same as other inflammatory conditions such as endometriosis and adenomyosis. Multiple diagnostic procedures are needed to eliminate other possible causes for your symptoms. These procedures can include:
Ultrasound is often preferred as the first step in diagnosing PCS, as it is possible to detect the varicosities as well as assess the blood flow. The only problem with ultrasound is that is that it may not always pick the varicosities up.
MRI may be needed, but even then, laparoscopy is the only procedure to definitely diagnose this condition. I often explain to women that if they have been in pain for a long time, the best option is a laparoscopy. This can also be used to exclude other pelvic pathology and also check to see if there is endometriosis etc too. Sometimes the varicosities may need to be tied off surgically as well and can be done via laparoscopy. Laparoscopy is the gold standard investigation of the pelvis and why it is the best option.
There may need to be input from other health professionals and modalities such as gynaecologists, anaesthesiologist, gastroenterologist, advanced trained laparoscopic surgeon, neurologist, haematologist, oncologist, psychiatrist, and urologist or urodynamic specialist may also be necessary. If someone sees a lot of this syndrome then they will be able to differentiate this without the need of involving too many other areas of medicine, but all other pathology and disease states do need to be carefully ruled out first.
When I help women with PCS, I have a very specialised team of healthcare professionals I work with that see this syndrome often and know what to look for very quickly and promptly. This is why it is very important to see the right people who know about these particular areas of women’s health conditions.
Treatment for pelvic congestion syndrome is usually aimed at reducing and alleviating symptoms. Unfortunately, like endometriosis, there is no definite cure for the condition, and it can be challenging to treat if you don’t get to see the right healthcare practitioner, or healthcare team.
There are medications available to help relieve symptoms of PCS and these can include:
The most successful treatment currently is a minimally invasive surgical procedure called pelvic vein/ovarian vein embolization (PVE/OVE). This procedure blocks off the faulty varicose veins so that they can no longer enlarge with blood, thereby relieving the pain. that are believed to be the source of pain.
Embolization (PVE/OVE) offers a safe, effective, minimally invasive treatment option that is less expensive to surgery and less invasive. It is an outpatient hospital procedure which requires only conscious sedation. Once the procedure is performed, you can return home a few hours later the same day. Medical literature shows that the procedure provides complete or partial relief in approximately 90% – 95% of the cases. As with any procedure, there are risks, and not all women may be appropriate for this treatment option.
A laparoscopy may still be needed to definitely diagnose the varicose veins first, before embolization can be performed. This is why diagnosis and treatment of PCS does require a step by step multimodality approach. This is something that needs to be clearly understood.
PCS isn’t a condition that is life threatening, but it does have the potential to significantly affect your quality of life. Symptoms such as chronic pain, pain during sexual intercourse, and dysmenorrhea can lead to a decrease in physical activity, loss of function, and depression. It can make daily life very hard and make it difficult to function in your personal and work life.
A diagnosis does not necessarily mean you will be affected to this extent and PCS varies greatly in terms of severity for each person. Not all women with PCS will have their daily life affected and some do not get pain at all.
The good thing is that there are treatments available to minimize the symptoms and help sufferers cope with this condition. It is important that you talk to your healthcare practitioner if you do have any of the symptoms of PCS.
It’s also important to talk to your healthcare practitioner about counseling, if needed, to help you cope with the significant chronic pain that can go along with having PCS. Chronic pain can impact on an emotional and psychological level and this can then lead to further exacerbation of pain. Many people just do not realise the impact the stress and emotions and mood disorders can have on pain conditions.
If you do have chronic pelvic pain and need assistance with diagnosis and management please give my friendly staff a call and ask how I may be able to assist you. I also work in with a good network of healthcare professions to help my patients get the best care possible. My motto is No Stone Left Unturned and I apply this to everyone that comes to see me for assistance with their health condition.
Regards
Andrew Orr
-No Stone Left Unturned
-Master of Women’s Health Medicine
-The Women’s Health Experts
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.
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.
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:
Other associated symptoms such are:
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.
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.
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.
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)
1 in 10 women are diagnosed with endometriosis and it often takes up to 10 years to be diagnosed. The number 10 seems to be a recurring theme. So, for this post I am going to talk about the 10 common mistakes seen with endometriosis. Hopefully this helps to create some more awareness about this horrible disease and helps those who are suffering, or have not been diagnosed yet.
Below are the ten common mistakes I see with endometriosis.
Many people with endometriosis are often led to believe, or have been told, that once they have surgery that their endometriosis is cured.
There is no cure for endometriosis, so surgery is not a cure. Hysterectomy is not a cure either.
All surgery does is deal with the expressed disease and that is it. It does not prevent further regrowth of the microscopic implants of endometriosis that are waiting to express and develop into lesions again. While surgery is a very valid medical option to address acute pain caused by the disease, it is not a cure. It only helps with symptomatic relief.
We know that despite the best medical interventions that women with endometriosis often will still be in pain, or have further expression and regrowth of the disease.
As mentioned previously, surgery is a valid treatment option for acute pain and for when hormones and medications are not working. But, from my experience I do see many have the surgery and then are not doing any ongoing management, except for pain medications. This isn’t necessarily the person’s own fault either. Many are also poorly managed post surgery and are not aware that they will need ongoing management of their disease state. As mentioned, many are literally just unaware that their disease can, and will grow back without ongoing support and healthcare management. It is crucial that all women with endometriosis receive ongoing care and management of their disease from an appropriately trained endometriosis expert.
There is no one single medicine, or modality, that can effectively deal with endometriosis and this is why a multimodality/team approach is needed.
Surgery is just one treatment approach, which is also needed to definitively diagnose the disease, and then for when the disease is acute and nothing else is working. But surgery alone is not adequate to deal with the disease as a stand alone therapy.
Endometriosis is estrogen driven so there does need to be some form of progesterone support to help suppress further expression of the disease. This can be in varying forms and something I will discuss in another post.
There also need to be support of the microbiome and working on the microcirculation to the pelvic area and reproductive organs. There also need to be ongoing emotional support and care such as counselling, or psychology
There also needs to be dietary changes (low inflammatory based diet), physiotherapy, exercise, complementary medicines, acupuncture, nutritional medicine other modalities. All of this can be done alongside ongoing medications and medical support. Each individual with the disease has different symptoms and will require different multimodality care and support, based on their individual needs.
I know I always talk about it, but this is because many who are suffering from endometriosis and the associated symptoms, just have not seen the right person in the first place.
In every profession there is good and bad. There are those who specialise in a certain area, and there are those who don’t. The same goes for medicine and the same goes for surgeons too.
When needing a diagnosis, or surgical intervention for endometriosis, it is imperative to see an advanced trained laparoscopic surgeon who specialises in the excision of endometriosis. This way you also know that this surgeon is not only advanced trained and highly skilled, but also specialises in endometriosis and every aspect of it.
Not all gynaecologists and surgeons specialise in endometriosis and some dabble in it and are not highly skilled in the actual surgical requirements to effectively excise the disease properly. Some surgeons do not even do excision surgery and tend to just to ablation only. This is not how you surgical deal with endometriosis.
These advanced trained surgeons also have to do a certain number of surgeries per year to attain the status of being advanced trained. Someone who does a few surgeries here and there is definitely not advanced trained. These advanced trained surgeons also do extra years of surgical training and are the best of the best and why anyone who is suspected of having endometriosis, or has endometriosis need to see these surgeons only.
Too many women are under-serviced surgical, by poorly skilled surgeons, who are not specialised in endometriosis and who are not advanced trained and this is where all the problems start. It can also lead to making the patient worse and only leads to further suffering and years of pain as a result. It also means that the advanced trained surgeons then have to fix up the mess these other surgeons created.
The hard thing is some women are limited by demographic and location when it comes to being able to see an advanced trained surgeon. Unfortunately most of them do private work, and any in the public system have long waiting lists and may only do one day a week public surgical lists. You may not even get to see them unless you see them privately first and they put you on there public waiting list.
There is two parts to this that need attention and need discussion. We know that it often takes up to 10 years (or more) to be diagnosed with endometriosis. This means that a hell of a lot of women are being missed and dismissed by GP’s, allied healthcare practitioners, complementary medicine practitioners, specialists and so forth. This isn’t meant to be negative, or an attack on any one profession. These are the facts and something that cannot be ignored. It also needs to be discussed.
Then we also have parents waiting way too long to seek help for daughters, using the wait and see if it will go away approach. I see this often and I am often getting asked if a parent should just wait and see if their daughters pain will magically disappear. I often have to point out that if my daughter was passing out, or laying on a bathroom floor crying with pain, I would not be waiting to see if it was going to go away. Early intervention is the key to any disease. The wait and see approach is often the reason many women end up with years of fertility issues and years of pain, and other associated symptoms of endometriosis. The longer a disease is left to spread, the more damage it does, and the harder it is to treat.
Teenagers are not too young to have endometriosis and we are now seeing young girls as young as 5 years old having endometriosis found.
The other issue we see if women who know that they have the disease, putting off seeing someone for fear of more surgery, or fear of being dismissed. Again, this only leads to further complications and disease growth and thing being harder to treat.
Once a woman has endometriosis, the reality is that she may need further surgical intervention. But, it is needed to help with symptomatic relief and reduce inflammatory response in the body. The other thing is that by going and seeing someone who specialises in endometriosis, they are trained to help you manage your disease properly.
There may also be some non-surgical options that can be used and help with symptoms and disease management as well. But, you need to go in the first place, to get the help you need. Please do not put off getting your health and disease state managed properly. If you are in a bad place with your disease, make sure you get on that phone and book yourself in with someone who specialises in endometriosis.
I’ve covered this a bit in the last statement, but so often I see women trying to manage endometriosis themselves. This only leads to a vicious cycle that keeps going around and around and nothing good ever comes of it. The disease does not get managed properly, the symptoms get worse and then it all becomes way harder to effectively treat and manage.
Sometimes if things are left too long, there can be permanent damage that is not repairable. This is definitely why people should not try to manage their own disease and symptoms themselves.
If your disease state and associated symptoms are out of control and you aren’t being managed properly, please get on that phone and book in to see someone as soon as possible. Do not put it off any longer. Now is the time to do something about it, not tomorrow, or next year.
I am a big advocator of anyone with a long-term health issue receiving emotional and physical support. It is a must. But, it needs to be via trained professionals who are specialised to help you properly.
While I am also a big fan of support groups, I am not a fan of non-medically trained, non-healthcare people giving healthcare and medical advice to people within these groups. I love seeing the emotional support in these groups, but I don’t love it when I see people getting medical advice about medications, hormones and medical procedures. This is dangerous. I’ve even seen advice given on how to take ones own IUD out and this is when I have to speak out.
By getting medication advice, medical advice, surgical advice and any other healthcare advice from someone who is not appropriately trained, you are actually putting yourself in great danger. Please do not take the advice of anyone who is not a healthcare practitioner, or a specialist in endometriosis. Sure, get the emotional support from like minded people, and people who understand what you are going through, but leave it there.
The other thing is just being careful of not getting caught up in some of the negativity of some groups, where you also then start to focus and become your disease. You are not your disease and to move forward you need proper healthcare and lots of positivity.
Some of this I’ve also spoken about, but this is one thing I see often as well. Many people are at a point of self-managing with pain medications that are not working effectively any longer. This then leads to increased reliance and dependence of pain medications and it can also lead to increase pain and associated symptoms.
I have talked about pain medications and the withdrawal affects in previous posts. I have also talked about how increased pain medication use can actually cause pain and lead to further inflammation in the body. I have also talked about the addiction of pain medications too. It is a catch 22 situation. (Click here to see previous posts mentioned)
The point I am trying to make here is that if your pain levels and associated symptoms are getting out of hand, then you need to do something about it. Please do not try and manage your pain and symptoms on your own. Increasing your medications can have detrimental effects on your body and long term health consequences.
If you have to increase your pain medications, it means something is drastically wrong and that your pain levels need urgent professional attention. Your endometriosis expert/specialist is trained to help you get your pain levels and associated symptoms managed properly.
There may also be something else going on that could be sinister and require urgent medical attention. Never presume that all your symptoms are related to your disease. Seeking proper medical health and ongoing management, could just save your life.
Having a chronic health condition myself, I know all too well how easy it is to fall it the trap of buying into the label of the disease. I also know all too well by doing this, you are letting the disease own you.
I also understand how hard it is on the bad days, not to get down about everything and think that there is no help, and how unfair things are. Yep, I truly get it. But, I also know that the more one focuses on the negative, and constantly lives in the disease state, the harder it is to truly move forward and get better.
Our thoughts and being negative can exacerbate pain pathways and they can also disrupt the healing pathways as well. If you listen to people that have overcome and illness, or a disease, they will always tell you it was by getting the right help and being positive. Positive mental outlook is very underrated in healthcare and its healing effects.
This is why I sometimes mention about being careful in certain support groups, where the focus is constantly on the disease, the label, and the negative. It isn’t good for anyone when that is all you hear. You need support, but you need to surround yourself with positive people, see the right healthcare team and also remember that you are not your disease, and it does not own you.
I know many people have had a hard time and some have really had a terrible journey getting to where they are now. It is one of the reasons I am so big on giving people the facts about this horrible disease and trying to help women get the proper help they need. It is also the reason I do what I do now.
Having lived with a chronic disease and having dealt with my share of really bad experiences, I know all too well what many of you have been through. I thoroughly get it and I understand on all levels.
While many people have been missed and dismissed and many have seen their fair share of terrible healthcare practitioners, I do need to point out that there are some very good ones also. Never let your last experience by carried over with you. Not all healthcare practitioners are bad. There are actually some amazing practitioners out there who are experts in endometriosis.
Like I have said before, in every profession there is good and bad and this is why it is important to do your homework. Don’t just go off a friend’s recommendation, or some recommendation from your mother. Do your homework and make sure the person you are seeing actually specialises in your disease. You also need to be realistic that you need a multimodality team approach, and that you may need to see a few practitioners within a network of specialists.
When you do find someone you think may fit the profile of a true endometriosis specialist, make sure when you see them that they take a full history, listen to all your concerns, give you appropriate care and advice and are empathetic in helping you move forward with appropriate care and health management.
The one thing I tell people is to not go in with a negative attitude based on previous bad experience either. This can then lead to further angst and anxiety and could get a good practitioner offside too. At the same time, while you need to not take your last experience with you, you do need to make sure the person you are seeing is right for you. It is all about balance and not judging each person you see as being the same.
But, if the person you do see has no idea, then don’t be scared to say “Thanks, but not thanks” and be on your merry way. There is no harm in getting multiple opinions and the honest truth is that is what you need to do. Never just take ones person’s advice and be done with it. Get a second, or third, or tenth opinion if you have too.
Last, but not least, if you are struggling and are at a point you believe there is nobody to help you, please remember there is always someone out there. Never give up hope about that. There are some amazing people out there who will know how to help you properly and get you the help and care you need. You just need to find them. There are endometriosis experts out there and when you find them, they will help you.
If you do need help and assistance with endometriosis, or need help getting diagnosed properly, please give my staff a call, or send an email, and find out how I may be able to assist you. I do consultations in person and online as well. There are some conditions with online consultations, but my staff will explain all this too you. You may also need to come and see me in person, so I can make sure you get all the appropriate investigations and testing done too. I also have a team of experts I work and refer to as well. I do see people from all over Australia, far and wide, and some from overseas as well.
Take care
Regards
Andrew Orr
-No Stone Left Unturned
-The Endometriosis Experts
Researchers have successfully documented not only that acupuncture is safe and effective for the relief of migraines, but also how acupuncture achieves positive outcomes.
As a past sufferer (yes past sufferer) of Migraines, I know all too well how debilitating and painful this condition can be when an attack happens. Even when the initial stage of the Migraine subsides, the aura and residual effects can last for days. While pain medication is a much needed part of the process, I also know that if you don’t administer the medication at the right time, the medication sometimes will have little, or no effect, once the migraine takes hold. Worse still, the withdrawal effects of these very strong pain medications can often then induce migraines and headaches, which then require further medication. It really can be a never-ending viscous cycle.
Migraines really do need a multimodality approach to them because the causes of them come from neck dysfunction(sublaxations), diet, blood sugars, hormones, stress and lifestyle. This is why an individual approach is always needed to properly assess, evaluate and treat migraines is needed. Too many people are just patching their condition, with a variety of treatments that really are only just getting them through to the next attack. What people need is a treatment that will not only treat the cause of their migraines, but also help prevent further migraines and give them long term relief and even cure. Acupuncture is just one component in that overall treatment and prevention, alongside medical interventions. So let’s look at how acupuncture can help.
Acupuncture has been shown to induce important biological responses to prevent and alleviate migraines. Imaging studies of the brain using fMRI technology confirm that acupuncture causes specific cortical responses to achieve lasting analgesic effects. In addition, blood level measurements document specific responses to acupuncture that play an important role in preventing and eliminating pain.
Researchers conclude that acupuncture is effective for the prevention and treatment of migraine headaches. A meta-analysis of controlled clinical and laboratory investigations are the basis for the conclusion. In analysis of recent clinical trials, they showed the effectiveness of acupuncture as a treatment for migraines, with less migraine days and less pain intensity levels when acupuncture was administered. Furthermore, no severe adverse effects occurred. A follow-up of up to three months following acupuncture treatments maintained the same results and showed that acupuncture is effective for the treatment of migraines both on the short-term and long-term basis.
In some of the investigation, researchers conducting a clinically-controlled study using fMRI (functional magnetic resonance imaging) where they found a significant decrease in the functional connectivity of the right frontoparietal network of migraine patients. This connectivity dysfunctions was found to be reversible after four weeks of treatment using acupuncture. This is another curative effect of acupuncture that is quantifiable in repeated controlled experiments.
For over 7 thousand years, people have used acupuncture in China for the treatment of various pain conditions, including migraines. It is useful, both as a supplementary treatment and as an alternative treatment, in situations where there is no response to drug therapy. Migraines are a headache disorder affecting a broad population that causes many burdens due to associated healthcare costs and people not being able to go to school and work.
Up to 25% of households in Australia and the United States have at least one member who suffers from migraines. The estimated total number of migraine patients in the United States alone exceeds 28 million and half of them have reduced work or school productivity. In Australia millions of people suffer from Migraines daily and it also affects their work, study and general day to day function, with some not even able to leave their homes due to this debilitating condition.
Scientists have uncovered some of the biochemical mechanisms responsible for acupuncture’s pain killing effects. Drugs used for the treatment of migraines not only have a analgesic action, but they also activate a reaction in the cerebral vessels. In the studies analyzed it was found that acupuncture has been found this very same analgesic action and also activated the same process in the cerebral vessels. The studies revealed acupuncture’s ability to regulate key regions of the brain affected by migraines. The areas are essentially the pain circuitry regions of the brain and cognitive components of pain processing. In addition, acupuncture also restores normal serum nitric oxide (NO) levels that have been found to be almost 55% higher in patients with migraines. Excess NO is a potent vasodilator contributing to headaches and acupuncture restores homeostasis. The regulatory effects of acupuncture can be quantified as early as the fifth acupuncture session and the effects are cumulative.
Based on these and other studies in the meta-analysis, the researchers conclude that acupuncture improves patients’ psychological profile, relieves pain, is safe and cost-effective, and has been found to be at least as effective as conventional preventative pharmacologic treatments for migraines.
At my clinic we know we see lots of people who are looking for relief from headaches and migraines. We use a multimodaility approach that also give an individualized treatment and also looks at the individuals cause of their migraines and headaches. Our aim is to assist in the with acute symptoms of migraines and headaches and assist in the prevention of them as well, along side medical interventions. With the right care, this can be done and now research is now backing up what we have known for many years.
If you need help with headaches and migraines, please call my friendly staff and find out how I may me able to assist you in your individual needs and ongoing health care.
Regards
Andrew Orr
-No Stone Left Unturned
-The Headache, Migraine and Pain Experts
References:
In this video post, I am going to talk about why you cannot manage your disease by yourself.
Many of us like to think we can treat ourselves, or manage our own disease, or even control every aspect of our lives, but the reality is.. .we can’t.
All to often I see many people trying to manage their own disease state and some of these people are actually healthcare practitioners themselves. The problem is that nobody can manage their own health issue and it is not safe to do so, because of being too close to it. Then the judgement becomes clouded and then this can lead to a vicious cycle of mismanagement and frustration too.
Have a listen to my latest video blog about this issue. I am also talking about this from personal experience and from someone who knows what many people go through too. Today was one of my bad day, so I have an open and honest talk about why you cannot manage your own disease yourself.
No matter who you are, everyone needs help from someone who specialises in the disease that they have. There is help out there. You just have to find the right people to help you.
If you do need help with managing a chronic disease, you can also give my friendly staff a call and find out how I may be able to assist you.
Take care
Regards
Andrew Orr
-No Stone Left Unturned
-Women’s and Men’s Health Advocate
Irritable Bowel Syndrome, or IBS, is a problem that affects a staggering 3million people, or more, in Australia and about 20% of people world-wide. It is a condition that has baffled doctors for years. There is no single cause, no specific treatment and, as yet, no cure.
But first let’s look at some general information on IBS.
IBS is more common in women than in men and occurs more often in younger people. IBS is usually ongoing, and there are some times when symptoms are worse than other times. Having IBS does not mean you are more likely to develop colon cancer later in life.
Symptoms of IBS
Some people with IBS mainly have constipation, others have diarrhoea. Many people with IBS alternate between periods of constipation and diarrhoea.
Symptoms include:
Some of these symptoms can also be from other inflammatory bowel diseases such as Crohns disease and Ulcerative Colitis, which sometimes get categories as IBS.
But some of the symptoms above can also be part of having endometriosis and many women who are diagnosis with IBS, in fact have endometriosis. They then have all the testing for IBS, Crohn’s, ulcerative colitis etc (colonoscopy etc) as these don’t find anything and then these women are often told by doctors they are at a loss to what is happening. This is why endometriosis often takes up to 12 years for definitive diagnosis, which is terrible.
IBS triggers
The cause of IBS is not known, but certain things can trigger its symptoms, including:
As said before some women suffer more acutely from symptoms of IBS just before, or during, their menstrual cycle. IBS symptoms can also mean that they have a condition called Endometriosis. Many times these conditions can be overlooked and they can be present at the same time, along with bladder issues as well.
Lactose and wheat intolerance and wheat may be a cause and needs to be assessed before permanent changes to diet are made. Wheat grains are inflammatory to the bowel anyway and they should be removed if anyone does have inflammatory bowel issues.
Treatments
There are a few medical treatments available but results can be varying. Many people with severe IBS end up on steroids to settle inflammation in the bowel. There are also other medications to slow bowel motility and reduce inflammation as well.
Dietary and lifestyle changes may assist with the management of endometriosis.
There are also other complementary therapies and treatments that may be assistance and combined with medical interventions, or other interventions..
Studies have shown that strain specific probiotic bacteria may assist with inflammatory bowel conditions such as ulcerative colitis and IBS. But, this needs consultation with a qualified healthcare professional to treat disease properly. Self-prescribing is not an option for this disease that affects over 3 million people here in Australia alone.
With any disease state such as IBS, there needs to be an individualised approach, not a one treatment fix all approach, because everyone is uniquely difference in their symptoms they experience and what their triggers are. There also needs to be a multimodality approach because many times IBS overlaps with conditions such as endometriosis for women, and other inflammatory conditions in men.
If you have IBS or inflammatory bowel disease and need help and assistance in managing your symptoms better, please give my friendly staff a call and they will explain how I may be able to assist you.
Regards
Andrew Orr
-No Stone Left Unturned
-Women’s and Men’s Health Advocate