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Why Iron Deficiency and Anaemia Should Be Take More Seriously

One of the common things I am seeing in women of all ages is iron deficiency and anaemia. Many women have very low levels of iron and are unaware of the dangers this may pose to their short term, and long term health. We are also seeing women being hospitalised and seek emergency help due to iron deficiency and anaemia and this highlights that there is inadequate management and detection of a very preventable condition. It also means that many women are not taking this matter seriously enough and often put off seeking screening and then aren’t having their iron levels managed properly.

I need to let all women know that having low iron can be very dangerous. It is something that should not be glossed over, or taken lightly. Iron deficiency can and does cause short term and long term health complications.

Iron deficiency can raise the risk of the following health conditions

  • Coronary heart disease
  • Stroke
  • Osteoporosis
  • Compromised immune system
  • Increased risk of infections
  • Tachycardia
  • Heart failure
  • Enlarged heart
  • Lung problems
  • Muscle aches and cramps
  • Restless leg syndrome
  • Delayed growth and development (mainly in children)

These are just some of the health issues that being low in iron can cause and it very important that we start educating all women and healthcare providers about the importance of iron.

What are the symptoms of Iron Deficiency and Anaemia?

  • Fatigue
  • Weakness
  • Dizziness
  • Fainting, or feeling of feeling faint
  • Pale skin
  • Breathless
  • Frequent headaches
  • Palpitations or racing heart
  • Easily irritated
  • Difficulty in concentrating
  • Cracked, or reddened tongue, sore tongue
  • Loss of appetite
  • Strange food cravings such as wanting to eat dirt, or clay
  • Cold hands and feet
  • Brittle nails
  • Hair loss
  • Tingling, or crawling feeling in the legs

Iron deficiency is a very common cause of fatigue and other health issues in women and men, but is more commonly seen in women. Iron deficiency is also the most common cause of anaemia.

What are the causes of Iron Deficiency and Anaemia?

  • Heavy menstrual bleeds
  • Endometriosis
  • Adenomyosis
  • Fibroids
  • Polyps
  • Coeliac disease
  • Inflammatory Bowel Disease
  • Stomach or intestinal ulcers
  • Pregnant and Breast Feeding Women
  • Certain Cancers
  • Vegetarians and Vegans
  • Eating disorders and food restriction
  • Girls going through puberty
  • Certain illnesses

Heavy menstrual bleeds and gynaecological condition’s such as Endometriosis, Adenomyosis, Fibroids and Polyps are some of the main causes of iron deficiency and anaemia in women. This is closely followed by dietary inadequacies and food and nutritional restriction.

Many women have undiagnosed gynaecological conditions which are the cause of their iron deficiency and anaemia. Some of these gynaecological conditions will require surgical interventions to be diagnosed properly.

How are Iron Deficiency and Anaemia Diagnosed?

Your healthcare provider can organise routine blood tests to test for iron deficiency and anaemia. These will include the following

  1. Full Blood Count (FBC)
  2. Iron Studies

These tests will provide the following information on :

  • The Total Iron level in your blood
  • Ferritin levels
  • Total iron-binding capacity (TIBC)
  • Iron saturations levels
  • The red blood cells size and colour (RBCs)
  • The white bloods cells (WBCs)
  • Haemoglobin
  • Hematocrit ( the percentage of blood volume that is made up of RBCs
  • Blood platelets

Other tests

There are other tests to check for the cause of iron deficiency and anaemia and these could include stool analysis (check for blood in stool), endoscopy and colonoscopy ( surgical intervention gastrointestinal bleeding) and laparoscopy (key hole surgery for gynaecological conditions)

Treatments for Iron Deficiency and Anaemia

Diet– A healthy diet that is rich in proteins, vegetable and iron rich foods is the best way to ensure your iron levels stay at optimum levels. A proper diet should include leans meats, seafood, nuts, seeds, healthy oils, green leafy vegetables and other coloured vegetables, and moderate fruit intake.

Supplements– Supplements will help to keep iron levels and vitamin B12 levels in optimum ranges. Iron supplements are very much needed if you are vegetarian, or vegan. There is now research to show that women who experience fatigue will benefit from supplemental iron, even if their iron levels and ferritin are within normal range. Those with heavy menstrual cycles, or those whom have inflammatory bowel issue should also be supplementing

NB- All iron supplements should be taken with vitamin C to help with absorption. Many iron supplements also cause constipation and therefore you should get a good one that does not interfere with your bowel habits and is more easily absorbed. Many of the mineral based iron products are not absorbed well and do cause gastrointestinal upset.

I always recommend a specific practitioner only brand to my patients because it is better absorbed, and it does not interfere with the bowel habits.

Iron Infusion– Sometimes when iron gets too low, supplements just will not be enough to get iron levels up to where they should be quick enough. This is where iron infusions can be very effective. Please see my post on when you need to use and iron infusion. (Click here)

Treating the underlying cause of bleeding

Supplements will not help if the cause of the iron deficiency and anaemia is from excessive bleeding. It may help a little, but it will not be enough. Even iron infusions will only be short lasting if you don’t treat the underlying cause of the bleeding issue. Extreme cases may even need a transfusion to get iron levels and blood levels back up to optimum.  This is why it is important to screen for underlying gynaecological conditions that can cause heavy and excessive bleeding.

If you are getting low in iron if means there is something wrong and there is a deficiency that needs to be addressed. Please do not take iron deficiency lightly and always be prompt to find the causes and restore optimum levels of iron in the body.

Prevention is a must

Prevention is always the best way to treat any health condition and this goes for iron deficiency as well. Ensuring you eat a healthy diet with iron rich diet is a great start. As said before, vegetarians and vegans are going to have to supplement and work really hard with their diet to ensure they get adequate iron. Even then it can still be hard as plant based foods just do not have the iron levels that meats, eggs and seafood’s have.

Make sure you also have lots of vitamin C in your diet to help with iron absorption and it is a good idea to supplement with vitamin C to ensure you get the right daily intake.

Final Word

If you do think you might be low in iron or have anaemia, please make sure you talk to your doctor, or your healthcare practitioner. Please do not supplement with iron without checking your levels first. Having too much iron can be dangerous and you also need to make sure you do not have hereditary high iron (hemochromatosis), which can present with the same symptoms as low iron.

If you are found to be low in iron, then please make sure you take prompt action to restore your iron levels and also make sure you are screened as to why you are low in iron in the first place.

Iron deficiency and Anaemia can be very serious and should never be taken lightly. Please always consult with your doctor, specialist, or healthcare practitioner for the most effective ways to keep your iron levels in healthy ranges.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

01 Dr Andrew Orr 1

 

 

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Insights into Endometriosis

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.

Take care

Regards

Dr Andrew Orr

– No Stone Left Unturned

– Endometriosis Expert

– Women’s and Men’s Health Advocate

Dr Andrew Orr Logo Retina 20 07 2016

Dr Andrew Orr Logo Retina 20 07 2016

 

 

 

 

 

 

 

 

 

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The Importance of Electrolytes

The reason for this post is to talk about Electrolytes and how important they are for the body. I also need to let people know what proper electrolytes are.

Electrolytes are so important for the body and we actually need to replenish them on a regular basis. Water alone is not enough to hydrate you properly and therefore we need electrolytes for proper hydration and to carry fluids around our body. They also have so many other important actions.

Every single one of us needs electrolytes to be able to survive. Many of our bodily functions require an electric current to function, and electrolytes provide this charge. Electrolytes are substances that help to conduct electricity when it is dissolved in water. These Electrolytes also interact with each other and the cells in the tissues, nerves, and muscles. A balance of different electrolytes, in the right ratios, is so important for everyone to function daily and to support optimum health.

What are Electrolytes and what do they do for us?

As mentioned before, electrolytes are chemicals that help to conduct electricity current in the body and they also regulate our nerves and help our muscles to function. They also help with the rebuilding of damaged tissue. Muscles and tissue rely on electrolytes to hydrate the cells and the fluid inside them. The heart, muscles and nerves cells also use electrolytes to carry electrical impulses to the cells and other parts of the body.

Their most important function of Electrolytes is hydrating the body, but they also help to balance blood acidity and blood pressure as well. Without proper electrolyte balance people can die. This is why they are so important and people need to know about them. As mentioned before, while water is important for hydration, electrolytes are just as important.

Common electrolytes include are sodium, potassium, calcium , bicarbonate, magnesium, chloride and phosphate. When these substances become imbalanced, it can lead to either muscle weakness or excessive contraction. All our muscles needs calcium, sodium, and potassium to contract. The heart, muscle, and nerve cells use electrolytes to carry electrical impulses to other cells.

These electrolytes also need sugar to help transport them and I will talk about this later. To maintain hydration, there needs to be a balance of electrolytes and sugar, in very specific ratios.

Symptoms of Electrolyte Imbalance

Symptoms will depend on which electrolyte is out of balance. The symptoms of electrolyte imbalances can show as the following:

  • Muscles Spasms and cramping
  • Muscles Twitching
  • Weakness and fatigue
  • Excessive tiredness
  • Dry mouth and throat
  • Not able to quench ones thirst
  • Irregular heartbeat and palpitations
  • Changes in blood pressure
  • Bone disorders and aching bones
  • Confusion and lack of mental clarity
  • Headaches and Migraines
  • Seizures
  • Numbness
  • Nervous system disorders
  • Convulsions
  • Loss of appetite
  • Nausea
  • Feeling faint
  • Dizziness
  • Moodiness and Irritability

Causes of Electrolyte Imbalances

There are many reasons for an electrolyte imbalance and especially those suffering from dehydration symptoms. These include:

  • Prolonged periods of illness, such as vomiting and diarrhea
  • Severe Dehydration
  • Not staying hydrated before and after exercise
  • Prolonged periods in Air-conditioning (due to drying affect)
  • Bladder issues (excessive urination, frequent urination, incontinence)
  • Pregnancy (due to frequent urination)
  • Kidney disease
  • Poor diet and nutrition
  • Incorrect acid and alkaline balance in the body
  • Congestive Heart failure
  • Cancer treatments
  • Some drugs, such as diuretics steroids
  • Eating disorders
  • Menopause
  • Age, as the kidneys become less efficient as we get older

Monitoring and Testing for Imbalances

If you are feeling any of the symptoms above, or have any of the known causes of electrolyte imbalance, taking a proper electrolyte solution is a good idea. If you are feeling symptoms of dehydration, you should take an electrolyte solution anyway.

There are ways to tests for electrolyte imbalances and these are more fined tuned for which electrolyte may be out of balance. This test is called a Electrolyte panel and this is used to screen for imbalances of electrolytes in the blood and measure acid-base balance and kidney function. Your doctor may order this test to also monitor the progress of treatment relating to a known imbalance. Many drugs and hormone treatments can affect our electrolyte imbalance and it is important to monitor these effects.

Oral Hydration Therapy

Most people will know of oral hydration solutions for dehydration, or after long periods of illness. This treatment is used mainly for people experiencing an electrolyte shortage alongside dehydration, normally following severe vomiting or diarrhea.

It is important to know what proper electrolyte solution is because some of the so called sports drinks (Powerade, Gatorade) are not electrolytes and should not be used as such. These are really just highly colored cordials with a bit of extra salt in them.

Those so called sports drinks are not electrolytes and are really over commercialized cordials. They are not even allowed to call themselves an electrolyte solution and nowhere on the bottle will you find the word ‘electrolyte’. They may be able to call themselves re-hydration fluids, but they cannot call themselves and electrolyte, because that would be false advertising. Any drinkable fluid can call itself a re-hydration fluid.

People taking these so called sports drinks thinking they are an electrolyte, could be seriously putting themselves in danger using them thinking they have a therapeutic value.

The World Health Organization (WHO) has approved a solution to be used in oral re-hydration therapy that contains:

  • 6 grams (g) of sodium
  • 5 g of potassium chloride
  • 9 g of sodium citrate

These are dissolved in 1 liter (l) of water and given orally.

There are now proper electrolyte solutions available through chemists and drugs store.

The ratios of Electrolyte solutions are important

When using a proper electrolyte solution, it is important that the ratios of electrolytes are in the right proportion. It isn’t just about taking an isolated electrolyte, especially when it comes to dehydration. The world health organisation has standards that these electrolyte ratios should be at, especially for proper hydration after illness.

Electrolyte levels can change in relation to water levels in the body as well as other factors. Important electrolytes are lost in sweat during exercise, if someone is urinating too much, through air-conditioning, illness, certain medications, taking hormones and so much more.

The most common electrolytes imbalances are usually sodium and potassium. The concentration can also be affected by rapid loss of fluids, such as after a bout of diarrhea or vomiting. Water alone will not hydrate someone after an illness and if someone is dehydrated. This is why it is important to get proper ratios of electrolytes into a person after an illness otherwise they could become severely ill, or even die.

Sugars Role in Re-hydration

These days people are worried about any solution that contains sugar. I often get people telling me they don’t want to have proper electrolyte solutions because they contain sugar. But, all electrolyte solutions need to have a certain amount of sugar in them. This is the one of the only times I will look at sugar in a positive light. Sugar plays an important role in replenishing and transporting electrolytes around the body and into cells. What many people do not understand is that rapid and effective hydration depends on the active co-transport of glucose and sodium molecules through the small intestine. In other words, this means that the sugar is needed to help you absorb the electrolyte. If there’s no sugar in your electrolyte solution, it will not activate the co-transport of glucose and sodium for your body to rapidly replace fluid and electrolytes you’ve lost through sweating, illness, or other factors. It is all about the ratios of what is in the electrolyte solution and these need to be very specific to have a therapeutic value.

When there is too much sugar, such as in these so called sports drinks, you can be left feeling bloated and uncomfortable. Too many of them can also put your diabetes risk up too.  Because there are not proper ratios of electrolytes in these drinks, you are not getting a therapeutic value out if it either. Research has shown that drinks with high sugar concentrations can lead to unpleasant feelings of fullness, and delayed emptying of the stomach. These sugar drinks can also lead to other health issues as well. Many of them are full of additives and colourings as well. This is why it is important to know what a proper electrolyte solution is, and know the difference between sports drinks and a proper therapeutic electrolyte drink

Coconut Water

While coconut water does contain some electrolytes, we cannot regard it as a therapeutic electrolyte. Too much coconut water can also cause stomach upset as well. Coconut water can be used as part of your daily hydration and is another way of maintaining some crucial electrolytes in the body.

Foods and Electrolytes

There are many foods that we eat daily that contain sodium, calcium, potassium, chloride and magnesium. It is still vital to have these foods to maintain electrolyte balance in the body. Just remember that when you are sick, or are severely dehydrated these electrolytes get depleted and this is why you need an electrolyte solution for rapid hydration.

Fertility, Gynaecology, Pregnancy and Electrolytes

Many of the hormones used in IVF and gynaecology can interfere with our electrolyte balance and why I recommend the use of electrolytes to my patients.

Long term pain, use of steroids, pain medications, hormones etc, can all interfere with certain electrolytes and their absorption into the body. Some medications and hormones actual cause depletion of crucial electrolytes too.

Electrolytes can help with pain management and muscle spasms etc, that many gynaecological conditions, such as endometriosis can cause.

Electrolytes are also needed for a dangerous condition called Ovarian Hyper-stimulation Syndrome (OHSS). This dangerous condition is caused by hormones hyper-stimulating the ovaries, which can lead to the painful and sometimes fatal condition. Yes, OHSS can kill you if it isn’t monitored and managed properly. One of the things that helps with the prevention, and the treatment of this syndrome, is proper therapeutic electrolyte solutions.

Pregnancy is also a time where electrolytes can be out of balance. This can be due to excessive urination and also because the baby stripping you of nutrients and electrolytes also.

If you are Pregnant, or undertaking IVF, or fertility treatments, have a gynaecological condition etc, electrolytes should be a part of your treatment and management.

Final Word on Electrolytes

Electrolytes are a very important and vital part of a person’s chemical makeup, and an imbalance can affect the body’s ability to function properly. Regular monitoring and consuming electrolytes after intense exercise, profuse sweating, illness and even certain medications can help to preserve your body’s levels.

So next time you are drinking lots of water and not quenching your thirst, it may be time to get some electrolytes into you. If you feel faint, or dizzy, or have muscles cramps etc, this could be one of the reasons also. We all need them on a regular basis. Just make sure they are a proper electrolyte and not the lolly water rip offs that line the supermarket shelves. Please remember to stay hydrated at all times and while water is needed for this to happen, electrolytes are a very important part of this also.

Take care and stay hydrated and healthy

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

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Is it Endometriosis, or Adenomyosis, or both?

Endometriosis and Adenomyosis can often present with the same symptoms and many now believe they may be one in the same disease, just in different locations. Despite both of them sharing similar symptoms, there are pointers for properly trained professional to which disease may be presenting. Both diseases are often missed and dismissed as well. To learn more about Endometriosis, or Adenomyosis please click on the hyperlinks.

I have 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
  • Infertility

What is the difference between Endometriosis and Adenomyosis?

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

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

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

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

As I have mentioned earlier, hysterectomy does not cure endometriosis, but it can help adenomyosis. Many women have been led to believe that hysterectomy will cure their endometriosis and associated symptoms, but this is not true. Some women who have had a hysterectomy and then think they are getting relief from symptoms of endometriosis, but are actually getting relief from adenomyosis not being there anymore. It is just that they did not know it was there, they have never been diagnosed, and then believe their endometriosis is cured. Once the uterus is removed, the adenomyosis is removed too. Then all the adenomyosis abnormal bleeding, period pain and period related symptoms are usually gone as well.

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

Proper investigation is important

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

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

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s Health Expert

Dr Andrew Orr Logo Retina 20 07 2016

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Why Early Puberty Is More Common Than Ever

In today’s modern world we are seeing more and more young girls going through puberty much younger than they used to. We do know that girls as young as 7 years old are getting their menstrual cycle and going through all the changes of puberty, yet these poor children aren’t able to fully comprehend the emotional changes that go with it, or what this means for them on a reproductive level. Researchers Blame Childhood Obesity, Endocrine Disruptors and I will discuss this at length for you all.

It wasn’t that long ago the average girl would begin menstruating around the age of 16 or 17. On average, the general consensus would have been that girls could be starting to begin menstruation around the age of 14 years old. By early 2000’s, that age had fallen to less than 13 years old and now it has fallen again to being as young as 7 years old.

What we forget is that even before a girl gets her first period, there are signs of maturation that signal impending changes, and these come even earlier. So actually, some of these girls are beginning their puberty phase when they are 5 years, or 6 years old. A generation ago, less than 5 percent of girls would see these changes in their bodies— being breast growth, body hair, acne, pubic hair and all the other things that go with puberty. But now many of these young girls are seeing this around 7 years old, with an average age being 8 years old, for all of these changes to start to happen. This is definitely becoming the increasing norm and some experts think this age is still falling. Some doctors see fit to begin assessing girls for puberty-related changes at age 6.

Early Puberty

Classically, precocious puberty has defined puberty that begins before age 8 in girls and 9 in boys, but this is no longer universally accepted. In general experts are now saying that 7 years old is now probably a normal age to have some signs of puberty. While they are some that may not agree, we do need to start asking the big questions as to why this is happening?

So far, researchers haven’t proven any physical risks that come with early maturity. Although this could pose a significant risk to their ongoing fertility, bone health and also be putting women into menopause earlier too.

Many researchers have suggested that the main risks that come along with precocious puberty are not biological. Recent studies have found that girls who began the process early had an increased risk of depression during their adolescent years. There are also social risks that can disrupt a girl’s healthy development.

Puberty can be very confusing and emotionally damaging for girls, as they may face “sexual innuendo or teasing” long before they’re ready for it, according to researchers and experts. Early puberty may change the way a girl behaves, along with the way others behave towards her. This could pose other significant risk factors such as early pregnancy, but also exposure to STI’s and many other things these young girls are too young and too naive to know. This could even lead to earlier use of alcohol and drugs as well.

Why Is It Happening?

One of the biggest issues for young girls, and women in general, is changes in diet and higher use of highly processed foods and high intake of grains. This leads to higher levels of insulin and then the body storing more fats and stops the burning of fats and this then also creates inflammatory disease in the body. High insulin levels also lead to higher levels of estrogen in the body too. This is leading to more children being overweight and problem with changes to hormones, their cycles and gynaecological conditions. Childhood obesity rates have increase exponentially in the past 30 years, with more than one-third of children and adolescents weighing in as overweight, or obese. What people fail to realize is these Fat cells produce estrogen ( now known as Obestrogens), which plays a central role in stimulating breast growth in girls, causing problems with hormones, causing gynaecological conditions and playing a major factor in them getting their cycles much younger.

Researchers and experts are saying that obesity is leading to earlier puberty and this theory is well supported by the fact that these girls’ breasts are developing at a much younger age, and the age at which they start to menstruate has declined. The ovaries control menstruation, signaling that earlier breast development may be occurring because of different variables such as diet and environmental factors

There may be are other factors at play, other than diet, lifestyle and obesity though. Girls at a normal weight have been starting puberty earlier as well, though at a lower rate than these girls whom are overweight, or obese. Chemicals known as endocrine disruptors, such as the phthalates used in the production of plastics, as another potential contributor to early puberty have been cited as the most likely cause. They mimic estrogen and also cause disruption to the reproductive function and could therefore cause precocious breast growth and issues with the menstrual cycle. We know that there are over 87,000 chemical found in our foods, plastics, and preservatives and even in our water ways from detergents and even small traces of the contraceptive pill making its way into our water we drink as well. Others have said stress during childhood can play a role in prompting puberty as well.

Many children now face far more stresses that did in generations gone by, with many children growing up in families with a lot of domestic violence, arguing at home, or violence in their neighborhood are more likely to develop earlier. There have been studies and research that has suggested that girls who grew up without their biological father were twice as likely to get their period before age 12.

Scientists are even researching prenatal variables. Researchers now know that the parental mode of inheritance, through genes, is one way parents health, diet and lifestyle is being passed onto children. One study found that overweight mothers who developed gestational diabetes while pregnant gave birth to daughters who would start puberty earlier in life, regardless of what the girls themselves weighed. But, we also now know that the sins of the fathers can play a part in a child’s development. If the father isn’t healthy at the time of conceptions, or has genetic abnormalities, or genetic issues, these can be passed through the sperm and then onto a child, who then is affected with this issues that get expressed later, or now early, in life.

Regardless of whether its cause is environmental, genetic, biological, or some combination, precocious puberty may be reaching a biological breaking point.

This is why we need to be more aware of our children’s health early on, but we also need to be aware of our own health, before conceiving too, as we can pass our genetic disposition onto our children.

Teenagers and younger women are not too young to have gynaecological issues

Early intervention and prevention is the centre of managing any issue such as this and this is why we need to teach our children better eating habit, having a healthy active body and also being in touch with their bodily functions and emotions at a young age

Period pain and menstrual irregularities are not normal and we need to teach young girls this. We know that teenagers and younger women are not too young to have gynaecological issues such as Endometriosis and PCOS. Please see our article of what a proper menstrual cycle should be like to familiarize you and your daughter with this. The earlier you get onto menstrual issues and gynaecological issues, the better long term prognosis they have for their health and future fertility overall.

If you or your daughter need help with menstrual issues and know more about better menstrual health, please book in and see me sooner than later. As I have said before, the earlier we start educating young women on what is right, then better is for them later on in life and for their future health and fertility

Take care

Regards

Dr Andrew Orr

“The Brisbane Baby Maker” & “Women’s and Men’s Health Crusader”

-Leaving No Stone Left Unturned

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Excess Body Fat Can Cause Gynaecological Conditions, Lead to Menstrual Irregularities and Also Lead to Infertility

When women come to see me for help with gynaecological conditions, or couples who come to see me for help with having a baby, one of the first things I ask all of them to address is excess body fats and look at diet and lifestyle modifications.

Women, men, and couples who are underweight, need to look at this also, because being underweight can be just as bad as being overweight, but for the purposes of this post, we are going to look at how excess fats can not only interfere with fertility, but they can be a major driving factor in gynaecological and men’s health conditions that many face on a daily basis. Worse still, excess body fat can also lead to many cancers that both men and women get also.

One of my biggest challenges with men, women and couples is getting them to look at how excess body fat is playing a big part in their current health. It can also be challenging to show how excess body fats, or having too little body fat, can affect the gynaecological condition they have, or how it is affecting their fertility.

I always get all sorts of excuses from “My friend was overweight and he/she does not have my condition”, or “The next door neighbour is overweight and she has had 3 children” and all many of excuses that seem to be a big block in actually taking responsibility for one’s health. I get that it can be hard to get started and hard to make the steps for a better life, but at the end of the day, all these things I hear are just excuses really.

Yes, the next door neighbour may not have your health issue, but they may also have some other health issue, or be at risk of another health issue. Yes, your friend might be overweight and has had a couple of children easily, but they may also be younger than you and many of the health issues they face because of their weight may not have caught up with them yet, but it will. I always have to get people to stop focusing on others and get back to looking at themselves, because other people are different. Other people are not you. We are all different individuals with different weaknesses in the body and what may affect one person, may not affect another, but this does not mean we can sit back and just do nothing about our health, or keep comparing our life to another.

Looking at a person’s body fat is paramount for any health condition that the body faces and we need to look at the individual, not at the masses. Research shows us that excess body fat can lead to diabetes, heart disease, cardiovascular events, cancers, gynaecological issues, infertility, men’s health issues and many other complaints in the body. It can also lead to an early death too. This is a fact and no matter how many excuses people want to make, nothing is going to change the fact that excess body fat is not good for us and it causes problems with our health and now costing the health systems dearly too.

Excess body fat produces excess estrogens in the body and we are now calling these “Obestrogens”. These excess estrogens can not only have an effect on testicular and ovarian function, but they also interfere with other hormones, increase inflammation in the body and then add as drivers for other health issues in the body. These “Obestrogens’ can also interfere with your DNA and can also be passed on to your future offspring through the DNA of the sperm and eggs and also pass genetic conditions onto them as well.

Eating too many grains, sugars, alcohol and refined foods are a big cause of excess fats in the body. These foods lead to increased blood sugar levels, which in turn lead to excess insulin in the body. This then leads to the body storing fat and also stopping the burning of fat. This then leads to high levels of inflammation in the body and a big driver behind many of the major health complaints in the body and even our leading causes of death, in both men and women. When people ask me how refined foods and grains lead to excess fats I also ask them “How do we fatten up cattle and livestock?” The answer is we give them high amounts of grains which increase hormone levels, which then lead to excess growth and also lead to higher amounts of fats in their bodies.

How Excess Body Fats Affect Our Health

Excess body fats are a big contributing factor in PCOS, Endometriosis, Fibroids, Cysts, Polyps, Sperm quality issues, Prostate issues, Diabetes, Infertility, Cardiovascular disease, Heart disease and Cancers in both men and women

For women excess body fat can lead to menstrual irregularities and heavy periods too, without necessarily having a known gynaecological condition. These excess fats produce estrogens, which are needed to thicken the uterine lining. But when there are too much circulating estrogens, the lining becomes too thick and unstable, eventually leading to bleeding. This can be unpredictable, and often very heavy, lasting a long period of time. These excess estrogens can then lead to, or be a driver of gynaecological conditions such as PCOS, Endometriosis, Fibroids etc. They can also be a big contributing driver of cancers in women.

These excess fats can also lead to men growing breasts, feminisation, having prostate cancers, prostate issues, sperm issues, diabetes, heart disease, infertility, erectile dysfunction, and many cancers that men face.

With many of the developed western countries have a population with over 70% of its people being overweight, or obese, now more than ever we need to look at ways of educating people about eating better, exercising more and looking after their health. While we need governments to intervene, we also need people to take personal responsibility too. Here in Australia we do have healthy eating guidelines that is set by the government and while they are not perfect, they do tell us about the dangers of excess body fat.

With so much health information about the dangers of refined foods, processed foods, sugars, grains and alcohol, we really do have lots of resources that we never used to have available to us. There really is no excuse any longer. If you really do not know what a good diet is supposed to be, there are qualified health professionals, such as nutritionists etc, who can help you.

If you truly are eating a proper healthy diet and exercising, then you shouldn’t be overweight. If you are doing all the right things, then there could be other underlying issues that need to be addressed by an appropriate healthcare professional. But many times I find that what people think is a healthy diet, or appropriate exercise, is very far from what a healthy diet and appropriate exercise is. It is all about what people have been taught by their family and what their perception of a healthy lifestyle is.

If you do have a gynaecological condition, have a men’s health issue, are having problem with fertility, or just need to get healthier, now is the time to act. We can no longer deny that excess fats are a major concern for the population and are causing so many health issues across the board.

Just so people know, it isn’t necessarily about weight and measuring yourself with scales. Scales do not show the amount of body fat we have and muscle weighs more than fat per cubic cm. We need people to get out the tape measure to truly see how much fat they have and start to look at waist measurement, rather than weight measurement.

A health male needs to have a waist measurement of 94cms or below and a woman needs to have a healthy waist measurement of 80cms or below. If a male has a waist measurement about 94cm or more, or a woman has a waist measurement of 80cms or more, both he and she are at increased risk of health issues. A measurement of above 102 cm (for men) or 88 cm (for women) is one of the components of Metabolic Syndrome, which puts you at increased risk of diabetes, cardiovascular disease and cancers.

Maintaining a healthy lifestyle is vital protection against many of the health issues we face. Regular exercise, limiting alcohol, non-smoking, a nutritious diet, reducing grains and refined foods and stress reduction are all important.

The lower GI diets (Primal, Paleo, Ketogenic, Zone etc) have been shown to be much better than others for people who are overweight, obese and have excess body fats. Part of any of my treatment plans involve a healthy diet. A healthy diet, along with other nutritional support,  has been researched and shown to benefit health and longevity. It has also been shown to increase fertility and assist with many health issues we all face.  Diet and lifestyle changes are a big part of my overall treatment and health management for everybody that comes to see me for help.

When I help people with weight issues I always say that I am there to help you, not judge you. It is about helping people help themselves have a better life and have better health and that is the main priority.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Expert

Dr Andrew Orr Logo Retina 20 07 2016

Dr Andrew Orr Logo Retina 20 07 2016

PCOS

Why it is important to manage PCOS properly via a multimodality approach

The one thing I see daily in practice is that many women with PCOS are not being managed properly with regards to their symptoms and future health implications.

Many women, who actually do have PCOS, have been misdiagnosed, undiagnosed, dismissed, or are not being managed properly at all. This is quite concerning as PCOS can have long and short-term term health implications and can also have an effect on fertility.

Every day I see women, who have irregular cycles and symptoms of PCOS (Acne, Hirsutism, weight issues, emotional issues etc), being told that they do not have PCO, or PCOS. Just today a colleague and myself had to call a radiology centre and get their head radiologist to go back and look over a scan of a woman who had been told she did not have Polycystic ovaries, and from the scan that we were viewing actually showed that she did have Polycystic Ovaries. There was a big rush around and a major apology and an updated scan report sent with the notation saying the patient has multiple cysts on the ovaries consistent with PCOS. This is exactly why so many women with PCO and PCOS are misdiagnosed, or not even diagnosed at all.

Just so everyone knows, scans and blood tests are not always accurate in the diagnosis of PCOS and new guidelines, published recently, for the diagnosis of PCOS now highlight this. https://www.mja.com.au/journal/2018/209/7/new-evidence-based-guideline-assessment-and-management-polycystic-ovary-syndrome

The point I am trying to make is that many women are not aware they have PCO, or PCOS and the ones that do have the diagnosis, just are not being managed properly.

The main symptoms of PCOS

  1. Irregular or absent menses
  2. Acne
  3. Hirsutism (excess hair growth)
  4. Weight issues
  5. Emotional Issues (depression, anxiety etc)

Women with PCOS may only have 1-2 of the symptoms, or may have all of the symptoms combined. Up to 90% of women with acne will have PCOS, especially when combined with menstrual irregularities.

Many women with PCO and PCOS are completely unaware of the serious future, and sometimes present, health implications as a result of their disease state.

Women with PCO and PCOS are at very real danger of the following

  1. Type 2 diabetes
  2. Gestational diabetes
  3. Cardiovascular disease
  4. Infertility
  5. Recurrent Miscarriage
  6. Mood disorders (Depression and Anxiety)
  7. Weight issues (Obesity, Eating disorders etc)

All of the above are well known health risk factors for women with PCO and PCOS and this is not often explained to the patient.

Women with PCO and PCOS need to be educated that a multimodality approach is needed to treat and manage their disease state properly. The number one treatment for PCO and PCOS should always be diet and lifestyle modifications and interventions. The main focus should be on treating the main driver, being insulin resistance. Once this is achieved, many of the symptoms of PCO and PCOS will settle down as well. If remaining symptoms do not settle, then other treatments and health care management should be used.

The Pill

While the oral contraceptive pill can offer symptomatic relief of the symptoms of PCOS, it is not going to treat the underlying cause of the disease, nor is it going to be a cure. The other issue is that many women are having their underlying symptoms being masked by the contraceptive pill and completely unaware of the future health and fertility issues that can still be present. Women need to be made aware of this and often aren’t.

Metformin

While metformin is routinely used for women with PCO and PCOS, it does have a high side effect profile. Gastrointestinal and digestive upset are one of the major reasons many women stop taking it. It is also a category C drug and should not be used in pregnancy, as it is could affect the unborn baby. Metformin also has risk factors for depleting Vitamin B 12 and can lead to anaemia if used long term. Long-term use of metformin can also damage the liver and kidneys.

There are some very effective alternatives to Metformin, without the high side effect profile, and these can be discussed with you healthcare practitioner.

Modalities that assist PCOS

As mentioned before, PCO and PCOS can be effectively managed and assisted using a multimodality approach, which could include the following:

  1. Medical treatments and interventions
  2. Hormonal Therapies
  3. Surgical Intervention (Ovarian Drilling)
  4. Diet and Nutritional advice and modification
  5. Exercise
  6. Complementary Therapies and Complementary Medicines
  7. Vitamins and nutritional supplements
  8. Acupuncture
  9. Psychology and counselling
  10. Lifestyle changes
  11. Mindfulness
  12. Relaxation and meditation

Women with PCO and PCOS may need a few of the modalities combined and some may need all of them combined together. It would all depend on the individual and how bad their presenting symptoms are. A healthcare practitioner who specialises in this area will be able to tell you which modalities and therapies will be best for your individual needs.

PCO and PCOS can have long-term and short-term health consequences and some of these can be very serious. We need for practitioners and patients to know this. Education is key for any disease state and the facts also need to be presented as part of this education as well.

New guidelines have just been published by an Australian led international collaboration, to help improve the care, health outcomes and quality of life of women with PCO and PCOS. Key changes in the new guidelines include refinement of individual diagnostic criteria focusing on improving accuracy of diagnosis; reducing unnecessary testing; increased focus on education, lifestyle modification, emotional wellbeing and quality of life; and emphasising evidence-based medical therapy and appropriate fertility management.

A multimodality approach is something that I always talk about and has always been a part of my clinical approach to assisting women with PCO and PCOS. It is also something that I educate my fellow colleagues and practitioners on as well. Women who suffer from PCOS also need to be educated about this as well and why I will always continue to write these posts.

If you do have PCOS, or suspect that you may have PCOS, please make sure you get the help and care you should be getting and do not leave it too long to get that care and assistance as well. Make sure the person that you see also specialises in PCOS as well. If not, then find somebody who does. You can always book in to see me, in person, or via online consult, as well. I help people from all over the world.

 

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Reproductive Medicine and Women’s Health Medicine Expert

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Are we really doing enough for women with Endometriosis?

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

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

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

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

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

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

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

Women are then offered radicle treatments and removal of body parts and that is not the answer to their often horrible daily journey either. Hysterectomy does not cure endometriosis, not at all. But it is still being offered as such by the ignorant, ego driven and uneducated out there still. Sure, it can stop you having a menstrual cycle. Sure it can help with symptoms associated with the menses. The trouble is that many women that get relief from hysterectomy actually have adenomyosis as well, or in isolation (usually missed diagnosed or missed completely), which a hysterectomy will help, and these symptoms are then controlled permanently by this procedure. But, the problem then is that these women think that their endometriosis is gone and cured. Not so. If endometriosis has been diagnosed, it will still be there and it can still cause inflammation, and flares, and gastrointestinal symptoms, destabilise moods, causes endo belly, still spread throughout the body, still wreak havoc on bodily functions and most likely still need interventions of some sort.

Many women with the disease are at the point on suicide some days; let alone asking them to undergo reproductive suicide. I am sorry to put it so bluntly, but that is what it is. I have seen young women who have being told that the only way to cure their endometriosis is to undergo reproductive suicide and permanently halt their chance at having a family, all due to ignorance and being told BS, heartless, unethical statements like that. Just go and chop out your uterus and you will feel better they say. No woman should ever be faced with that option because there are ways to manage this disease that many have not even been told about, or even begun to explore. I want every woman to know that hysterectomy does not cure endometriosis and that is a fact. I also want women to know there are options for a normal life, outside the current medical model, or to be used in conjunction with the medical model.

The other issue is that like the fashion industry and their assault of women through marketing, we also have pharmaceutical companies trying to mislead women to believe they have the latest and greatest “fix all” pill for their endometriosis. Again, much of that is just over marketed hype and remarketing of medications and hormones that we already have and are just being sold under another patent and another name. Many women work out very quickly that the benefits being marketed are not forthcoming and are again left with the feeling of despair. I would love to see a new medication to help women. I would love to see the cure all pill appear on the market, but unfortunately there is no such thing, it does not exist and probably will not exist in the near future either.

We also now have women basically addicted to pain medication, because without them, they cannot function in a day to day life. This then leads to judgment by many and we are now seeing women being viewed as ‘druggies’ so to speak. Many women are also being questioned at pharmacies, even when they have a doctor’s script. We also have medical centre GP’s refusing women pain medication because they just have not listened to the women and her symptoms and that she in fact has endometriosis. All they hear is “Here is another addict trying to get pain meds”. No, this woman is in pain and you are not listening to her, or even able to understand the level of distress and pain she is in daily. Sure, pain meds are addictive and they have side effects, but what other options do we have for these poor women? Until someone comes up with a better solution, on a medical level, then this is what women with endometriosis have to do in order to survive their day.

So, yes, while we have come far in awareness and recognition etc, which we desperately need, but we are still stuck in the dark ages as far as medical diagnosis, disease classification, interventions and true clinical and overall health management of the disease. What women with endometriosis need is an individualised, case by case, individualised, multidisciplinary approach to fully treat and manage the disease but this is not happening.  Much of this is due to ego, certain marketing, suppression of research by pharmaceutical interests, lack of funding, lack of education, lack of awareness and people not willing to research or explore new ideas around this disease that don’t fit the model they want to explore, or believe.

There are ways to treat this disease effectively and it requires a multi-modality approach to do so. It requires the team approach that I always talk about. There is good research and evidence out there to suggest that there are some great treatments and management options outside the medical model, which can also be used alongside medical options to enhance treatments and overall health for those with endometriosis. We just need more education, more research, more funding, more open mindedness, less suppression of research and education by those with monetary interests in certain areas of medicine, more subsidisation for affordable treatment options and certain people letting go of old belief systems and ego so that new thought processes and education can occur.

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

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

Regards

Dr Andrew Orr

-Reproductive Medicine and Women’s Health Expert

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

Dr Andrew Orr Logo Retina 20 07 2016

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Expectation Versus Reality When It Comes To Hospital Emergency Departments

Before I start on this latest post, I do just want to say how amazing the people are who work in Accident and Emergency departments around the world. As someone who has a disease state that can be fatal, I know all to well how the amazing efforts at accident and emergency departments can save lives. I should know, because they have saved my life a few times I can tell you.

The reason for this post is that everyday I get messages from people in chronic disease state, such as endometriosis, and many of these messages often complain that they went to their local hospital emergency centre and they did nothing for them. Many of the messages are saying “I waited for hours in pain”, or “the emergency staff did nothing and then sent them home”, or messages such as “The didn’t fix me”

One of the things I always tell my patients is that if they are in pain, and it is after hours, or they cannot get a handle on their pain, then they should go to their nearest A&E (Accident & Emergency) and seek help. But I am also very clear with my patient’s expectation around what emergency centres are there for, or will do for them.

Accident and Emergency Centres at hospitals are there for exactly that; Accidents and Emergencies. They are there to help with people who have been in accidents, the critically ill, the dying, and those that require emergency assistance. Emergency departments are trained to assess who needs help now and who doesn’t.

There is scale of who requires immediate help and who doesn’t. People who have been in near fatal accidents, people with open wounds, close to death, people having heart attacks, asthma attacks and anyone who could possible die from their suffering, will always be attended to first and if need be with be admitted and monitored accordingly. For the rest of the people it is simply this.

  • How bad is your pain?
  • How long have you had it for?
  • and Could it possibly kill you if we leave it too long for you to receive care?

If the answer is that it isn’t going to kill you, but you are definitely in a lot of pain, you will receive treatment. When and how long that takes, compared to critical patients, all depends on how busy the emergency department is that night, or day.

What I do need to reiterate is that emergency departments jobs are to basically assess if your condition could kill you, then administer appropriate treatment, get you out of pain and then either send you home, or admit you if it is absolutely necessary. That is it really. They are not there to fix your chronic condition. They are there to ease your pain, administer appropriate treatment, save your life if necessary, and then work out if they send you home, or send you to intensive care for critical monitoring, or admit you to the general wards.

If you are assessed properly and your pain etc, has been controlled and then sent home, what should happen then is that you should be given medications to control your condition when you get home, given an action plan and also a referral to your local GP, or healthcare professional to help you in managing your disease state, or pain state, properly. This is to ensure you get proper care. Sometimes you may even be referred back to the hospital you have just been to but to an appropriate department for your condition, or disease state.

But does this always happen like this?

Well, not always and it just depends how busy the emergency centre was and how far down their emergency scale you were. If you weren’t dying, it may seem like they are saying to you “we fixed you up, we helped your pain and then sent you on your way with no help”.

But in reality they have got you out of pain and then have administered appropriate care and treatment, but it may not just be in way your expectation was. Please just remember that A&E’s are there to help you get out of pain and then basically send you home, or admit you if needed. That is it really.

If your pain levels have escalated, or become acute, more often than not it is because your condition isn’t being managed properly, or as well as it could be.

  • Maybe the healthcare practitioner managing you just isn’t as educated on your disease state as you thought.
  • Maybe your medications are wrong.
  • Maybe you haven’t been taking your medications properly.
  • Maybe you have been self-prescribing too long and need to see someone for better care.

There could be many factors to why your disease state has flared

  • Could you flare up be due to stress, or emotional factors?
  • Are you sleeping properly?
  • Are you eating a proper balanced nutritional diet?
  • Have you been drinking too much alcohol?
  • Are you drinking enough water?
  • Are you exercising enough and moving the body enough?
  • Are you taking your medications properly?
  • Could you need surgical intervention?

There are so many reasons why disease states can flare, or pain cycles can start. Sometimes there is no answer to your pain, or disease state flaring.

As I have stated before, places such as the A&E (Accident and Emergency) are there to help people in chronic, or acute pain states and assess you properly to make sure everything is ruled out and then control your pain and have you managed accordingly. Most of the time, if things are not critical they will send you home, but usually after making sure you are managed properly first. If this doesn’t happen, then you need to ask the questions as to why, and then ask questions of the powers that would be, if necessary. If you are truly in pain, then you should not go home and you need to voice your concerns as to why you need to be looked at further. Sometimes it really is “He/She who cries out loudest, gets heard”

If you do have a diagnosed condition such as endometriosis, it may be best not to let some A&E’s know you have this condition, due to them probably not going to fully understand your condition, and put you in the period pain basket, and probably not take you seriously. I am not saying this happens all the time, but it does happen and I hear this often. But, just remember that A&E departments are specialised in some disease states such as endometriosis either, so you need to take that into consideration. But they need to take into consideration that you are in pain and that it isnt just simple period pain, or you are being dramatic. If you weren’t in real pain, you wouldn’t be there. So, just a precautionary word… dont tell them you have endometriosis, if that is what your are there for. Let them do a proper assessment and control your pain first and if they work that out, then they have done their job anyway. If they don’t work that out, they will at least manage your pain and then try and work on why you are in pain. If necessary, they will admit you until they can work it out,  so win win situation.

But, even after all this, if your pain, or disease state has reached its peak point, it means that you aren’t being managed properly, you need proper management, or you may in fact need surgical intervention, along with appropriate treatments and clinical management moving forward. Once this is addressed then you need to do the following also

  • You need to eat a healthy low inflammatory based diet
  • You need to make sure you address the emotional aspect of your health
  • Address stress levels
  • Make lifestyle changes
  • Address weight and body fat (lose or gain weight/body fat)
  • Drink adequate water and electrolytes to stay properly hydrated
  • Exercise and move your body to promote blood flow and circulation
  • Get some acupuncture
  • Get some herbal medicines and nutritional supplements
  • See a chiropractor, or osteopath
  • Do a mindfulness course, or learn some meditation
  • Get at least an hour of “You Time” daily
  • Take your medications as prescribed
  • Book in with your healthcare practitioner and get a proper pain management, or disease state management protocol going
  • Improved your gut health and microbiome
  • Be positive and look at positive words and affirmations
  • Stay away from negativity and negative people
  • See a pain management specialist if need be
  • If something isn’t working, then change it. This may also mean changing the person you are seeing. It may also mean changing self, or self-beliefs.

Lastly, never self prescribe, or try to manage your own disease state. Nobody can manage their own disease state properly, no matter how much they know, or how hard they try. Always seek proper help and clinical management from a properly trained healthcare professional who specialises in your disease state

I hope this has helped everyone understand a little more about what emergency departments do, or are supposed to do, when it comes to pain and critical care. We really do need to be aware of expectation, versus reality for this type of care and what emergency centres actually do. I also want people to know what they can do also need to be proactive in their disease states and helping manage their disease state and symptoms properly. With proper care and proper management, you truly can reduce symptoms, reduce pain, reduce flare ups and also live a fairly normal life as well.

Lastly, when pain does get too bad, or your are unable to control your disease sate properly, it means you need to get proper help and this also means seeing an appropriately trained healthcare professional to assist you in every aspect of your disease. Please do not try to do it yourself, or google it, or ask friends for advice. Always see a healthcare professional who is trained to deal with your disease properly and administer appropriate care, treatment and management moving forward. If your current healthcare professional isn’t assisting your properly, I am the first person to tell people the value of a second, or tenth opinion.

Take care

Regards

Dr Andrew Orr

– No Stone Left Unturned

– Women’s and Men’s Health Advocate

Dr Andrew Orr Logo Retina 20 07 2016

 

 

PCOS Awareness The Facts About PCOS

The Facts About PCOS

These are some of the main Facts about PCOS

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Copy of PCOS Awareness Hirsutism and PCOS           PCOS Awareness Acne and PCOS

 

PCOS Awareness Contraceptive Pills do not cure PCOS           PCOS Awareness Depression and anxiety can be a symptom of PCOS 1

 

PCOS Awareness PCOS does not always cause infertility           PCOS Awareness

 

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Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women and Men’s Health Advocate

Dr Andrew Orr Logo Retina 20 07 2016