Endometriosis complications

The Complications That Can Result From Unmanaged Endometriosis

A lot of the information about endometriosis, is more about it’s symptoms, time to diagnosis and future fertility outcomes. While it is necessary to educate people about these things, nobody is really talking about the serious complications of unmanaged endometriosis. This is not to scare people, or create fear, but at the same time it does need to be talked about and for all concerned to know how serious this disease state can be at its worst.

We know that many women are missed and dismissed when it comes to endometriosis. It often takes up to 10 years, or even more for some women, before they are definitively diagnosed. Some women are never diagnosed and end up suffering a terrible life because of it. Some women with endometriosis are asymptomatic (meaning no symptoms) and often only get diagnosed as part of fertility evaluation, when they may be having trouble conceiving.

The symptoms of endometriosis are easy to see

The symptoms of endometriosis are very easy to see, if someone knows what they are looking for and knows the right questions to ask. Sure, a definite diagnosis via laparoscopy is still needed, but there are some very clear-cut pointers that a woman may have the disease. But due to lack of education and lack of true experts in this area means that lots of women are missed and dismissed, and that is a fact.

The vicious cycle of mismanagement

But while there are inadequacies in the healthcare profession when it comes to endometriosis, not all mismanagement can be blamed on healthcare professionals. There are people who are not seeking proper help soon enough, and some not at all, and this can lead to long-term complications too. We also have women trying to manage their own disease through advice of friends, social media groups and Dr Google as well. This then creates one hell of a mismanaged cycle that does not help anyone.

I can see the issues from all points of view, especially those who suffer the disease. But as a healthcare professional with a special interest in Endometriosis, I have had my fair share of non-compliant patients too.

While many have been let down through mismanagement, lack of funding and education, being missed and dismissed etc, there are many women who are self sabotaging as well. I have seen many not take on advice, recommendations and proper management of their disease, that could help them, then these same people scream high and low that the system has let them down. There are some who are just happy to live with the disease, as it is their only way of seeking attention. This is a fact also and we need to talk about it.

This is what has prompted me to do this post so that all concerned get to know what the serious side of mismanaged endometriosis is. Sometimes it is only via the serious harsh side of reality, that all concerned may actually get some help and some serious attention be bought to this disease state.

The common symptoms of endometriosis

We know that many women suffer greatly at the hands of this disease. Women with endometriosis can get the follow common symptoms:

  • Period pain
  • Pain with intercourse
  • IBS like symptoms
  • Gastrointestinal issues
  • Chronic constipation
  • Chronic diarrhoea
  • Pain on bowel movement
  • Bleeding from the bowel
  • Chronic abdominal pain
  • Severe bloating (endo belly)
  • Chronic bloating
  • Aversion to foods (even if they are not the trigger)
  • Ovulation Pain
  • Ovary pain
  • UTI like symptoms (with no infection present)
  • Migraines and headaches
  • Chronic pelvic pain
  • Pelvic and rectal pressure feeling
  • Musculoskeletal pain
  • Chronic nerve pain
  • Fluid retention
  • Iron deficiency
  • Mood swings
  • Anxiety
  • Depression
  • Mood disorders
  • Infertility
  • Other symptoms

Early intervention and management is crucial

Women’s lives are greatly impacted by this disease and it is important that not only healthcare professionals understand this but also sufferers of the disease. Early intervention and proper ongoing management is the key to helping this disease and everyone needs to be aware of this. Being missed and dismissed, or waiting too long to help, can really have some serious consequences if this disease is left to grow and spread and cause serious damage in the body

The serious consequences of mismanaged/unmanaged endometriosis

While we have talked about the common daily symptoms that many can put up with, we also need to bring attention to just how serious this disease can get. Let’s face it, it can and does spread like cancer and it can spread to every organ in the body. It has been found in the joints of bones, fingers, in the liver, around the lungs, around the diaphragm, around the heart, on the bowels, on the bladder, on the ovaries, on the pelvic, in the fallopian tubes, one the retina in the eyes and it has even found in the brain.

There is no doubt that this disease can be very devastating for anyone who has it, but what happens in the worst cause scenario, if it is left unmanaged.

The following can be serious complications of unmanaged endometriosis:

  • Haemorrhage from the ovaries
  • Ruptured ovaries
  • Ovarian torsion
  • Obliterated fallopian tubes
  • Ruptured endometrioma
  • Endometrioma infection
  • Pelvic infection
  • Obliteration of the pelvic cavity
  • Peritonitis
  • Sepsis
  • Compacted bowel
  • Obstructed bowel
  • Perforated bowel
  • Bowel haemorrhage
  • Torsion of the bowel and intestines.
  • Ureteral Obstruction (Blocked ureters)
  • Renal infection
  • Bladder obstruction
  • Painful bladder syndrome
  • Severe adhesions
  • Significant scar tissue build up
  • Significant fluid build up in the pelvic cavity.
  • Multiple organs adhered together
  • Diaphragmic adhesions
  • Liver damage
  • Perihepatic adhesions
  • Pericardial endometriosis
  • Cardiovascular events
  • Stroke
  • Chronic nerve pain
  • Pudendal nerve neuralgia.
  • Chronic musculosketal, or spinal pain
  • Arthritic like pain and associated symptoms
  • Chronic Migraine and neurological events.
  • Malignancies and cancers (rare but more research being done)
  • Hysterectomy
  • Recurrent miscarriage
  • Absolute infertility
  • Opioid dependency and addiction
  • Death from opioids medications
  • Complications from medications and hormonal treatments
  • Psychotic disorders
  • Mania
  • Incapacitation
  • Suicidal tendencies and thoughts
  • Suicide
  • Death (rare from endometriosis directly, but can be from associated factors related to endometriosis and also taking ones own life)
  • Other

Women with endometriosis need to see an “Endometriosis Expert”

This is why endometriosis needs to be managed properly and managed by a healthcare professional that specialises in the management of endometriosis and associated symptoms. You need to see and Endometriosis Expert.

People cannot treat, or manage the symptoms of endometriosis on their own. This is why it is so important to have the right care and also have a multimodality/team approach to endometriosis. No amount of google searching is going to help people treat endometriosis on their own. You need to find an endometriosis expert.

At the same time more education needs to be given to GP’s and other healthcare professionals about endometriosis. Too many women are being missed and dismissed because of lack of practitioner understanding and education at the front line. Women need to see healthcare professionals that specialise in endometriosis and endometriosis experts for this disease, not just a GP. Women also need access to advanced trained laparoscopic surgeons who specialise in excision surgery, not just a regular gynaecologist who is not advanced trained. I have talked about this often.

Endometriosis is not just about period pain

Lastly, we need to educate ‘all’ that endometriosis is not just about period pain. Endometriosis can present with many different signs and symptoms ranging from gastrointestinal symptoms, extreme bloating, bladder issues, bowel issues, IBS symptoms, migraines, fluid retentions, pain with intercourse, pain on bowel movement and so many other symptoms mentioned before. There is also the long-term impact on fertility for up to 50% of women too.

This is why early intervention and management of teenagers presenting with the disease symptoms is crucial. The longer the disease is left, the more damage it can do and all women deserve to be mothers (if they chose) and deserve a normal happy life. We also need to recognise the psychological impact of the disease and how this can present in someone with the disease as well.

Women are dying because of being mismanaged/unmanaged

Let’s face it, there are women dying because of this disease. Maybe not as direct result, but definitely indirectly. No woman should ever be pushed to the point where she cannot handle her pain and symptoms any longer and be only left with the choice of taking ones own life. This is exactly we need to bring more education to all about this disease. This means both healthcare practitioners and people with the disease itself too.

People need to be managed properly and by professionals. We need to start bring education and attention to this, so that people do not try to manage this disease on their own, and practitioners are held more accountable for dismissing women as well. Because if we don’t the complications of this can be very severe and sometime they can be fatal also.

Endometriosis awareness month is next month and I want to see all women with endometriosis being managed properly and seeking the right help. There are endometriosis experts out there who can help you if you have the disease and the associated symptoms. No woman should be doing this on their own.

Let me help you

If you so need help with managing endometriosis and the associated symptoms of endometriosis, please give my staff a call and find out how I can assist you. I have options for in-person consultations and online consultations. I use a multimodality/team approach and I also work in with some of the best medical healthcare professionals and surgeons in the country. I will always make sure you get the best care, best support and best management possible. I will also hold your hand every step of the way and make sure your every concern is listened to as well.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Endometriosis Experts

 

 

 

 

 

The OVA

Let’s Talk About The Health Of The Vagina, The Pelvic Floor & Stone Eggs

As a Women’s Health Expert I hear about all manner of things and what people are trying, or using for their various health issues. Today I am going to talk about the sensitive topic of the health of the vagina and the pelvic floor and how stone eggs (yoni eggs, jade eggs etc) may be of assistance.

Stone eggs have been used by women for thousands of years. The practice of using them is believed to have started in Japan.

Many modern day women are now using these stone eggs (Yoni eggs, Jade eggs, Ba wen balls, Fertility Ball etc) and many are using them under the advice of celebrities, influencers and people who are not healthcare professionals. So I thought it was an important topic to talk about and look at the pros and cons of what these eggs may, or may not be used for.

I also talk about the outlandish claims that some celebrities have made around these stone eggs and I also talks about the things that these eggs many be useful for. I also talks about the importance of quality and hygiene and where to get good quality stone eggs if you are going to try them. As mentioned in the video, before using stone eggs, always consult with your healthcare practitioner, or pelvic floor specialist first.

If you do want to purchase good quality stone eggs, “The Women’s Health Experts” have their own high quality ones called “The O-VA”.  They come in a set of 3 eggs (choice of rose quartz or dark amethyst) and they are also in a discreet box that can be stored away and keep them hygienically clean at the same time, ready for their next use. They also come with instructions on how to use them, clean them, look after them and what they may assist with.

Please be careful of being inferior ones off the internet and from people who are not healthcare professionals. To find out more please contact my staff on 07 38328369, or email info@drandreworr.com.au.

 

mother and daughter 1

Parents, Don’t Let Your Daughters Suffer With The Wait & See Approach For Period Pain

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.

Many parents suffered period pain themselves

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.

The cause of period pain could affect future fertility

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.

Gynaecological conditions cause period pain

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.

Sexually Transmitted Infections

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 parents need to know

The things I am trying to educate all parents on are the following:

  1. No matter what anyone tell you, health professional included, ‘period pain is not normal’
  2. Please do not use the wait and see approach when your daughter is in pain, and has been for months.
  3. Women do not needlessly need to put up with pain each month.
  4. Early intervention is the key to treating and managing any disease or health issue
  5. Teenagers are not too young to have endometriosis, or other gynaecological issues.
  6. Many gynaecological issues are hereditary, so if a parent had period pain, or a diagnosed gynaecological issue, then there is a good chance their daughter will have the same.
  7. Parents should not feel guilty, or blame themselves for passing on hereditary issues. All of us have faulty genes.
  8. Regardless of upbringing, or moral stances, teenagers are having sex earlier these days
  9. Teenagers can have sexually transmitted diseases
  10. The earlier intervention is enacted and proper treatment and health management administered, the better the future fertility and health outcomes are for young woman.
  11. Without early intervention, some parents may never become grandparents.
  12. General practitioners are no gynaecologists, so please make sure you get referred onto a proper specialist. If not, find another GP.
  13. If you don’t get help with the first healthcare practitioner you see, please remember the value or a second, or tenth opinion.

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.

Period pain is not normal

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.

Do not use the wait and see approach for period pain

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.

Final word

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

 

 

 

 

Pelvic Congestion Syndrome 1 1

Let’s Talk About Pelvic Congestion Syndrome

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.

So what is Pelvic Congestion Syndrome (PCS)?

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.

What are the symptoms of Pelvic Congestion Syndrome?

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.

  • Pain starts 7-10 days before your period
  • Pelvic pain is worse when you sit or stand
  • Lying down relieves pelvic pain
  • Varicose veins around the vulva, buttocks, and legs
  • Abnormal vaginal discharge
  • Swelling of the vagina or vulva
  • Tenderness of the abdomen
  • Pain during sex
  • Dysmenorrhea (painful menstruation)
  • Abnormal bleeding during menstruation
  • Backache
  • Depression
  • Fatigue
  • Increased urination
  • Irritable bowel symptoms
  • Hip pain
  • Lower back pain
  • Aches in your legs

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.

How is at Risk?

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.

What Are The Causes of PCS?

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.

How is it diagnosed?

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
  • Laparoscopy (keyhole surgery)
  • CT scan
  • MRI scan
  • Venogram

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.

Treatments for Pelvic Congestion Syndrome 

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:

  • NSAIDs (nonsteroidal anti-inflammatory drugs)
  • chronic pain medications (such as gabapentin plus amitriptyline)

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.

Outlook

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.

Last word

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