Tag Archives: Gynaecology

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Could You Be Suffering With Interstitial Cystitis?

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Interstitial cystitis (IC) is a chronic inflammatory bladder condition in which there is persisting chronic pelvic pain, urinary frequency and urgency, bladder pain or pressure, and it can also resemble the symptoms of a urinary tract infection, but there will be no infection present. The pain can range from being mild to severe.

Worldwide Interstitial Cystitis affects up to 100 million people and it can affect both men and women, regardless of age. IC is also known as painful bladder syndrome (PBS), bladder pain syndrome (BPS) and chronic pelvic pain (CPP)

Women with interstitial cystitis may experience many of the same symptoms as those with endometriosis. Women can have both Interstitial Cystitis and endometriosis at the same time. Some people with IC may also have irritable bowel syndrome (IBS), Fibromyalgia and other pain syndromes

People with IC have chronic symptoms in the urinary tract that last more than 6 weeks in duration. Infection has not been identified as a cause of IC. Physical and emotional stress can worsen the symptoms of IC.

Interstitial Cystitis can cause the following symptoms:

  • Chronic pelvic pain that lasts 6 months or more
  • Symptoms affected by the menstrual cycle
  • Pain, pressure, discomfort or unpleasant sensation that may worsen as the bladder fills
  • Urinating often alleviates the pain and may give a temporary sense of relief;
  • Suprapubic pain or discomfort
  • Pelvic pain (lower abdominal pain), sometimes extending to the lower part of the back, the groin and thighs
  • In women there may be pain in the vagina and vulva
  • In men, pain in the penis, testicles, scrotum and perineum
  • Both men and women may have pain in the urethra and rectum
  • Pain with sexual intercourse in both men and women (dyspareunia)
  • Pain on ejaculation in men
  • Pain may worsen with specific foods or drinks
  • A frequent need to urinate (frequency), including at night (night-time frequency or nocturia)
  • An often urgent or compelling need to urinate (urgency)

The pain may be experienced as discomfort or tenderness or irritation or burning sensation in the bladder, in the form of spasms in or around the bladder, or stabbing or burning vaginal pain or simply a feeling of pressure on or in the bladder or a feeling of fullness even when there is only a little urine in the bladder.

In many people, the pain is relieved temporarily by urination, while other people may also feel strong pain following urination.

The pain or discomfort may be constant or intermittent. It may also be felt throughout the pelvic floor, including the lower bowel system and rectum. In some patients the pain may be very severe and debilitating.

Other people, particularly in the early stages, may have milder frequency with/without urgency and without a true sensation of pain. What they may experience, however, is a feeling of heaviness, fullness, discomfort or pressure.

Diagnosis

During the evaluation of potential IC, several tests may be completed to make a diagnosis. These tests may include taking a full medical history, completing a bladder diary, pelvic examination, including a neurological exam and urinalysis to rule out or diagnose an infection

Other diagnostic tests that can be carried out include:

Cystoscopy: This is performed inserting a tube, with a camera attached, into the bladder to evaluate the lining and to look for inflammation and signs of disease. A specialist may also evaluate the bladder capacity with a cystoscopy.

Urodynamics: The bladder is filled to test its capacity by measuring the pressure during filling and voiding. These tests evaluate the function of the bladder, urethra, and sphincter muscles.

Biopsy: During a cystoscopy, a biopsy may or may not be taken to rules out cancer or other inflammatory bladder conditions that can cause pain similar to IC.

Potassium sensitivity test: This is a test in which potassium and water are instilled into the bladder. In healthy bladders, pain is not felt with either solution. In cases of IC, however, pain is typically experienced when the potassium is instilled.

Diet

People with IC may be sensitive to certain foods and beverages. There is a range of items a person may need to excluded from their diet after receiving an IC diagnosis. This will be different for each individual but there are certain foods and drinks that an individual with IC should be aware of potentially needing to avoid. There are food and drinks such as:

  • tea and coffee
  • Soft drinks and soda (including diet drinks)
  • alcohol
  • citrus, citrus drinks and cranberry
  • artificial sweeteners
  • spicy food

Some people with IC may need to a food elimination diet over several weeks to see which specific foods and drinks may be exacerbating their symptoms. There are many foods that do not have an irritating effect on the bladder and contain vital nutrients to help fight disease. This is why elimination diets and specific dietary requirements need to be done under the guidance of a healthcare professional.

People with IC should also give up smoking if they are a smoker, as the chemicals can affect this condition too.

Treatment

The treatment of interstitial cystitis is complex and needs a multimodality approach to treat it effectively. It may require treatments such as:

  • Urodynamic Therapies
  • Physiotherapy with a specialised pelvic floor physiotherapist
  • Pelvic Floor Therapy (Kegels, Yoni eggs, Ba Wen Balls, internal TENS)
  • Surgery, including laser surgery
  • Neuromodulators, such as electrical nerve stimulators
  • Injections, such as Nerves blocks, Antispasmodics and Botox therapy
  • Pain medications- including narcotics, NSAIDS, Anti-inflammatories,
  • Hormone therapy, both oral and intravaginal
  • Antidepressants
  • Acupuncture
  • Pilates and Yoga
  • Exercise
  • Herbal Medicines, including Chinese Herbal Medicines
  • Amino acids, vitamins and antioxidants
  • Sex Therapy and counselling
  • Mindfulness
  • Adopting health sleeping habits

Your specialist or healthcare provider will discuss the best forms of treatment for your individual case. People with IC should also be referred to a Urodynamic and Pelvic Floor Specialist who specialises in this area.

Complications

Complications from IC can vary between individuals and why there is no one treatment fix all approach to this conditions. IC can affect a person life on so many levels. It can affect their bladder volume, their quality of life, their sex life, their libido and have an affect on sexual intimacy and it can also cause them emotional distress. It is a complex condition that can affect every aspect of a person’s life both physically and mentally and why a multimodality treatment approach is needed.

Causes

The exact cause of IC is not known, but there are several theories as to what triggers the condition. Some possible causes include:

  • Damage due to previous surgery
  • Defects in the lining of the urinary bladder that cause irritation
  • Overstretching of the bladder due to trauma
  • Pelvic floor muscle dysfunction
  • Autoimmune disorders
  • Spinal cord trauma
  • Genetics
  • Allergy

IC is a chronic inflammatory condition that affects many people world wide. It cannot be fully cured and requires close clinical management and care. A multimodality treatment approach needs to be adopted that is suited to the individual. When this is done properly, people with IC can still have a good quality of life.

Recommended treatment usually involves diet and lifestyle changes, stopping smoking, drinking less before bedtime, and scheduling planned toilet breaks to ensure the bladder does not get too full.

If you do need assistance with Interstitial Cystitis, please call my friendly staff and find out how I may be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Women’s Health Experts

Bladder Endometriosis

What is Bladder Endometriosis?

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Endometriosis is a condition where tissue resembling the uterus lining grows outside the uterus, such as on the ovaries or fallopian tubes. Endometriosis can spread to every organ in the body and can grow inside, or on the outer surface of the bladder.This is what is known as Bladder Endometriosis.

To learn more about endometriosis and to learn about the symptoms of this disease, you can click on this link to find out more (Click Here)

If endometriosis forms in, or on the bladder, it that can cause severe discomfort and pain. It can also make a woman want to urinate more and also with urgency, pain, burning and frequency.

There are other bladder conditions with the same, or similar symptoms, but endometriosis can also aggravate these conditions, or be present at the same time as well. I will discuss the other forms of bladder pain and interstitial cystitis, which can have similar symptoms to endometriosis affecting the bladder, or bladder endometriosis.

Prevalence

Bladder endometriosis is not common. Reports state that around 2 percent of women with endometriosis may have endometrial growths in their urinary system, with endometriosis growing in, or on the bladder. But even if endometriosis isn’t on, or in the bladder, it can still cause issues with the bladder and cause associated symptoms.

What are the Symptoms of Endometriosis in, or on the bladder?

One of the main symptoms bladder endometriosis is pain when the bladder is full and a woman needing to urinate more frequently. It can also cause symptoms resembling a urinary tract infection, but no infection will be found to be present.  Women do need to be aware that a significant portion of women with endometriosis are asymptomatic (meaning no symptoms) and may not be aware that they have endometriosis until they have investigations for another reason, such as not being able to fall pregnant.

Some women are more likely to notice symptoms of endometriosis around the time they are due to have their menstrual cycle.

Other symptoms of bladder endometriosis may include the following:
• More frequent need to urinate
• Needing to urinate urgently
• Feeling pain when the bladder is full
• Stinging and burning or painful sensations when passing urine
• Seeing blood in the urine
• Experiencing pelvic pain
• Having lower back pain, more on one side of the body

Diagnosis

The definitive diagnosis for endometriosis is via a laparoscopy as this is the gold standard investigation for investigating disease states inside the pelvic cavity. A biopsy is usually taken at the same time to check the microscopic implants of endometriosis, which cannot be seen visually. Normal ultrasound, transvaginal or abdominal, cannot diagnose endometriosis. Blood tests cannot diagnose endometriosis either.

If Endometriosis has spread inside the bladder a cystoscopy would be needed also. A cystoscopy is where a small scope is inserted into the bladder and the specialist can then see if there is endometriosis, or other inflammatory disease in the bladder lining.

The specialist will then see what stage the endometriosis is at. This is a staging system from 1-4, but this is only to let the surgeon know how much of the disease is present. The staging system does not have anything to do with pain levels, as pain levels “are not” related to the extent of the disease. A woman with stage 1 endometriosis could have more pain than someone who is stage 4, and someone who is stage 4, may not have any pain, or associated symptoms at all.

Treatment

There is no current cure for endometriosis. However, the condition can be managed through a multimodality approach that involves surgery, hormones, pain medication, physiotherapy, herbal medicines, acupuncture, yoga, pilates, diet, lifestyle changes, counselling and an individualised approach. Women with endometriosis need a team approach.

Surgery, via a laparoscopy, is the most common treatment, and definitive diagnosis, for those with endometriosis. If endometriosis had been found in the bladder transurethral surgery will be done at the same time. This involves a scope inside the bladder to cut away any endometriosis in the bladder lining. Sometimes a partial cystectomy is needed to remove an affected part of the bladder.

While surgery is a much-needed part of the treatment and diagnosis of endometriosis, it is not a cure. Endometriosis can, and often does, grow back again, even with the best medical forms of treatments and interventions.

Fertility

Bladder endometriosis does not have any effect on a woman’s fertility. However, endometriosis does grow in other parts of a woman’s body and reproductive system such as the ovaries, which may affect a woman’s likelihood of conception. But, endometriosis does not always affect fertility.

The Difference Between Bladder endometriosis interstitial cystitis
When endometriosis gets in the bladder it can cause very similar symptoms to another bladder condition called interstitial cystitis. This can often make it very hard to differentiate on symptoms alone.

It is also very possible to have both interstitial cystitis and endometriosis present at the same. This is why further investigations are needed to definitively diagnose both these conditions.

I do have a separate post on interstitial cystitis so that people know more about this inflammatory condition that affects the bladder.

Outlook for Women With Bladder Endometriosis

At present there is no real known cause of endometriosis and only speculation as to what the true cause is. We know that endometriosis is estrogen driven (not from estrogen dominance), but the most likely cause is probably due to genetic reasons and being a hereditary condition passed on through the parental mode of inheritance and then expressed into the body. The how, when and why will hopefully be answered in the not too distant future hopefully.

Women with endometriosis in the bladder do need to be careful and managed properly as it can cause kidney damage. There is also some research to show that endometriosis in the bladder can lead to cancer in the bladder, but this is thought to be very rare.

For now, anyone with endometriosis needs to be clinically managed properly through a multimodality team approach mentioned before. Let’s get more education out there so that women with this horrible disease have a voice and we end the silence for these women as well. Hopefully through education, funding and further research, this leads to the cure that women with endometriosis so desperately deserve.

If you do need help with endometriosis, please call my clinic staff and find out how I may be able to assist you. I do have a special interest in endometriosis and am very passionate about women receiving the right care and health management moving forward.

Regards

Andrew Orr

-No Stone Left Unturned

-Period Pain IS NOT Normal

-The Endometriosis Experts

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Genetics & Gene Sequencing May Be The Path To a Cure for Endometriosis

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I have always said that the biggest inroads to the management and treatment of endometriosis will come from the area of genetics. I’ve also said that if there is going to be a cure, this will be the pathway that is comes from.

We know that there are hereditary components to endometriosis and that if a parent, or someone in the family tree has the disease, it is likely to be passed onto the offspring in the gene pool of that family tree.

Research published in the New England Journal of Medicine has revealed that Gene sequencing has found a set of genetic mutations which may help to develop molecular tests to distinguish between mild and aggressive types of endometriosis.

This is a big step forward into finding out more about endometriosis and developing better medical treatments and management strategies. Hopefully one day it will also lead to a cure for women with this horrible disease.

Endometriosis is a painful disorder in women which ‘endometrial like’ tissue grows outside of the womb, most commonly into the abdomen, and will affect at least 1 in 10 women. It can spread to every part of the body.

Many women with endometriosis will experience symptoms of abdominal pain, migraines, pain with sex, ovulation pain, IBS like symptoms, UTI like symptoms (without infection present), menstrual cramps, abdominal distension and possible issues with infertility.

Endometriosis can affect both physical and mental health in sufferers. While a portion of women with endometriosis get pain and associated symptoms, it needs to be noted that a significant portion of women with endometriosis are asymptomatic (no symptoms) and would not even know that had it, until they are investigated for fertility purposes.

This discovery helps moves towards developing genetic based systems for classifying endometriosis to sort out which forms of the disorder needs more aggressive treatment. Presence of the unusual set of mutations suggest that while origins are rooted in normal endometrial cells mutations change their fate, the mutations identified have links to genetic mutations found in some forms of cancer. Abnormal endometriosis tissue growth will often spread throughout the abdominal cavity but rarely becomes cancerous with exception to a few cases when the ovaries are involved.

The close links to cancer have always baffled scientists, as endometriosis does behave like a cancer the way it spreads, and now they have found some of the same mutations found in cancers, in some of the endometriosis lesions. But again, endometriosis rarely turns cancerous, except if it does spread to the ovaries, but there have been some studies to suggest links that women with endometriosis may be at more risk of endometrial cancer.

In this research, the research scientists analysed the samples looking for mutations or abnormal changes in DNA and filtered out normal variations in genes which commonly occur. At least one or more mutations in endometriosis tissue that were not present in their normal tissue, in which the number and type of mutations varied per endometriosis lesion and each woman.The types of mutations found were among the most common mutated genes found, which are all known for DNA repair, controlling cell growth, and cell invasion.

The researchers are working on additional studies to investigate whether patient outcomes correlate with the mutations. Testing which can sort lesions into less or more aggressive has potential to help decide how to monitor progression as well as control and treat the endometriosis. It may also be possible to develop new treatments which use agents that block gene related pathways specific to an individual’s disease.

Women are normally prescribed anti-hormonal treatments, which block estrogen to shrink lesions. Endometriosis is estrogen driven and is not from estrogen dominance, as some people would have women believe.

Even small amounts of estrogen can drive the disease and cause the expression of the lesions. When endometriosis occurs on the ovaries and forms a large cyst, or endometrioma, it is typically removed as it increases the risk of developing ovarian cancer in some women.

I honestly believe (in my opinion only) that Endometriosis is a genetic condition passed down through the parental mode of inheritance and is much the same as other hereditary genetics issues such as haemachromatosis etc.

I also believe that the closest disease we can compare endometriosis to is cancer, as endometriosis spreads very much the same and can cause inflammation and pain in many part of the body. I do think we need to start talking about endometriosis being more like a benign form of cancer, in the way that it behaves and spreads through the body and the havoc it causes on the body too.

While this new development is not a cure for endometriosis, it is providing new insights into the disease, which will hopefully one day see a cure in the not so distant future. Lets help end the silence for women with this horrible disease by getting more awareness out there and let us hope that the cure will eventually come one day soon.

Regards

Andrew Orr
-No Stone Left Unturned
-Period Pain IS NOT Normal
-The Endometriosis Experts

References:

    1. https://www.nejm.org/doi/10.1056/NEJMoa1614814 –  (Cancer-Associated Mutations in Endometriosis without Cancer)
    2.  https://www.ncbi.nlm.nih.gov › pmc › articles › PMC6447774 – the genetic profile of endometriosis
    3. https://imb.uq.edu.au/article/2017/03/spotlight-endometriosis-research-long-game-help-our-daughters
    4. Stefansson H, Geirsson RT, Steinthorsdottir V, Jonsson H, Manolescu A, Kong A, Ingadottir G, Gulcher J, Stefansson K. Genetic factors contribute to the risk of developing endometriosis. Hum Reprod. 2002;17:555–559. doi: 10.1093/humrep/17.3.555. [PubMed]
    5. Matalliotakis M, Goulielmos G, Zervou M, Matalliotaki C, Koumantakis G, Matalliotakis I. The familial risk of endometriosis among the female relatives of patients with endometriosis in Greece. JEPPD. 2017;9:184–187. []
    6. Treloar SA, O’Connor DT, O’Connor VM, Martin NG. Genetic influences on endometriosis in an Australian twin sample. sueT@qimr.edu.au. Fertil Steril. 1999;71:701–710. doi: 10.1016/S0015-0282(98)00540-8. [PubMed] [CrossRef] []
    7. Krishnamoorthy K, Decherney AH. Genetics of endometriosis. Clin Obstet Gynecol. 2017;60:531–538. doi: 10.1097/GRF.0000000000000293. [PubMed] [CrossRef] []
    8. Wang M, Hao C, Huang X, Bao H, Qu Q, Liu Z, Dai H, He S, Yan W. Aberrant Expression of lncRNA (HOXA11-AS1) and Homeobox A (HOXA9, HOXA10, HOXA11, and HOXA13) Genes in Infertile Women With Endometriosis. Reprod Sci. 2018;25:654–661. doi: 10.1177/1933719117734320. [PubMed] [CrossRef] []
    9. Christofolini DM, Mafra FA, Catto MC, Bianco B, Barbosa CP. New candidate genes associated to endometriosis. Gynecol Endocrinol. 2019;35:62–65. doi: 10.1080/09513590.2018.1499090. [PubMed] [CrossRef] []
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Women Benefit from Acupressure for Menstrual Pain Through Self Help App

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A new study published in the American Journal of Obstetrics and Gynaecology has shown that acupressure may help to alleviate menstrual pain.

There have been numerous studies on the effectiveness of acupuncture assisting period pain, but now researchers from Charité — Universitätsmedizin Berlin, have found that acupressure could help to alleviate menstrual pain as well.

Acupressure is a technique derived from traditional Chinese medicine (TCM). Rather than using needles, this technique involves massage or pressure being applied to specific points on the body. The good thing is that this can be taught to women and they can use these methods at home.

Approximately 50 to 90 percent of young women experience pain during their periods. Before we go any further, it is important for all women to know that period pain “IS NOT” Normal and could be a sign of a major gynaecological condition such as endometriosis.

Any woman who gets period pain, should be evaluated by a a healthcare practitioner who specialises in endometriosis and uses a multimodality treatment and management approach.One of my mottos is that Period Pain IS NOT Normal and no woman should have to endure pain each cycle.

While this pain primarily manifests itself as lower abdominal cramping, other symptoms include headache, backache, nausea, bloating, fluid retention and diarrhoea.

The researchers wanted to evaluate whether self acupressure would be more effective at achieving a sustained reduction in menstrual pain than usual care alone (e.g. pain medication and hormonal contraceptives). A total of 221 participants, aged between 18 and 34 years, were randomly assigned to one of two treatment groups, both of which received a study app and short introduction. Only one of the groups had acupressure points on their app.

After three months, (37 percent) of participants in the acupressure group reported a (50 percent) reduction in pain intensity. After six months, this proportion had increased to more than half of the women in this group (58 percent). The acupressure group also used less pain medication than women in the control group and reported lower levels of pain overall.

The researchers also noted the they were surprised to see that, after six months, two thirds of participants continued to use self-acupressure and continued to gain the benefits of this age old technique.

Acupuncture and acupressure is something I do recommend to assist any woman with period pain, or conditions such as endometriosis, with other associated symptoms and pain.

If you do need help with period pain, please call my friendly staff and find out how I may assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Women’s Health Experts

-The Endometriosis Experts

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Women With PCOS May Be At More Risk of Uterine Cancer

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Researchers in the United Arab Emirates (UEA) have found that women who have Polycystic Ovaries Syndrome have an increased risk of uterine cancer, reducing their chances of fertility.

The researchers have also found that women, who are overweight, or obese, are also at increased risk of uterine cancer. Being overweight and obese also increases a woman’s chances of PCOS too, but not all women with PCOS are overweight.

A study published in the Journal of the National Cancer Institute last year has shown that endometrial cancer diagnoses have increased in 26 of 43 countries, mainly due to increasing obesity cases which themselves have tripled in the last 40 years, according to World Health Organisation.

The experts believe that obese women are 10 times more likely to suffer from uterine cancer. Being overweight, or obese also puts women at risk of other diseases such as heart disease and diabetes. Obesity and being overweight also puts women at risk of other cancers too.

There are other factors involves such as an imbalance in the hormones with over-exposure to estrogens can lead to endometrial cancer. This could be due to endogenous causes such as Polycystic Ovaries Syndrome, or exogenous causes such as unopposed estrogens in menopausal hormone therapy if progesterone is not prescribed.

Some women may have genetic family syndromes that is predispose to uterine cancer along with breast, ovarian and other cancers. The causes of uterine cancer may be multifactorial, but this new research does help with screening of women who are suffering from PCOS, or who maybe overweight, or obese.

The researchers did find that regular exercise and healthy lifestyle choices can serve as a protection against uterine cancer, but can also help with PCOS and obesity.

The researchers did warn that women in reproductive years should not take symptoms of endometrial cancer lightly, since early diagnosis and treatment is an essential key to fertility preservation.

Once a condition that only affected women of advanced years, increasing clinical evidence now suggests that even women below 40 years of age can be diagnosed with uterine cancer.

The cancer cases are on the rise due to higher incidence of known co-morbidities such as obesity, diabetes mellitus and hypertension.

Symptoms of the endometrial cancer include:

  • vaginal bleeding between periods
  • bleeding after menopause
  • an abnormal, watery or blood-tinged discharge from vagina
  • constant back and pelvic pain
  • unintended weight loss
  • fatigue and nausea

Early screening is essential and women can safely consider fertility preservation provided that the cancer is diagnosed in early stages.

Fact around uterine cancer

  • Early diagnosis of uterine cancer can save women from fertility loss
  • World over, an increasing number of women in reproductive years falling prey to the disease
  • Obese women are 10 times more likely to suffer from endometrial/uterine cancer, other causes include hypertension and diabetes
  • PCOS may now be a risk factor for uterine cancer

Women who have PCOS, or who are overweight, should be seeking help with dietary and lifestyle management to help prevent them from other risk factors such as certain cancers. According to the world health organisation, the number one treatment for PCOS is changing to a low GI diet and doing regular exercise.

One of the major causes of PCOS is insulin resistance and this is a big factor in many who are overweight, or obese, or have type 2 diabetes. All of these issues can be controlled with the right management. I do need to state that women of all body types do have PCOS and insulin resistance can be seen in all body types too.

If you do need help with PCOS, I do have a special interest in this disease state and may be able to assist you. To find out more, please call my friendly clinic staff. They will be able to explain everything to you and book you in for a consultation.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The PCOS Experts

Womens Health Consultations

Women’s Health Consultations with Dr Andrew Orr

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Are you sick of Painful Periods?

Are you tired of the flares from Endometriosis?

Is your period irregular and messing with your life?

Are you getting bad acne?

Are you sick of having to put up with mood swings and hormone imbalance?

Sick of being “Missed” and “Dismissed” by healthcare professionals and friends telling you that your symptoms are normal?

Are you just not getting the answers to your health issues?

Do you just want to get your quality of life back and be able to do everything you want to do in life?

Getting Help

Many of the health and reproductive issues women face are not normal, but more importantly many of issues can be managed and assisted with right treatments and management protocols. The problem for most women, is knowing who to see, and where to start, for Women’s Health Consultations on the journey to a better life and better health.

Let Dr Andrew Orr Guide You Through Your Health Journey

Dr Andrew Orr’s multi-modality treatment approach (using medical science and complementary medicines) has helped and assisted thousands women with women’s health conditions locally, interstate and overseas.

Dr Orr has a special interest in conditions such as period pain, endometriosis, PCOS and menstrual irregularities and other women’s health conditions.. You can find out more on some of his social media articles.

If you need someone who cares, someone who listens and can be your caring guide every step of the way through the challenges you are facing, then you need to book in a consultation with Dr Andrew Orr.

Dr Andrew Orr’s mottos are the “Period Pain IS NOT Normal” and he has a “No Stone Left Unturned” approach to every person he guides, manages and assists through their journey to a better quality life and better health.

Dr Andrew Orr has seen women from all over Australia and all over the world and can see you for a consultation in person, or through online services. Through easy to use online services, Dr Orr can now see anyone from all over Australia, or anywhere in the world. *(conditions may apply)

If you are suffering from a particular women’s health condition, or unknown health issue, Dr Andrew Orr is here to care for you and guide you through his step by step multimodality health management protocols and get you the help and care that you are so desperately needing.

* To find more please call Dr Andrew Orr’s clinic, or submit an online enquiry through the website.

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The Silent Face of Endometriosis

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She closes the door and enters the day, with the face that she wants the world to see. She is beautiful, she is vibrant, she is smiling, and she is ready to face what ever the day may bring.

She is immaculately dressed, her hair brushed so neatly and even though she doesn’t need it, she has her make up on, her lipstick applied so neatly and she is every bit the goddess that the world will see today and every other day as well. All this makes her feel good and helps her to go about her day. She is a daughter too some, a sister to others and a partner to her beloved. She is grace and elegance and she is every bit a woman and she it about to embrace her day.

But, while she is every bit the goddess, and a warrior, and her beauty knows no bounds, underneath her catwalk like composure, is another story that the world around her may never really know, or ever come to understand. It is something that they just cannot even see.

Today is like any other day for her, but today is the day that her hidden disease has decided to raise its ugly head. Unlike the beauty that we see before us, this inner demon has taken hold of her and nobody will know the torment that goes on beneath her skin and deep into every organ in her precious body. Today would buckle many and have many lose their way, but not her, she is a warrior and she will not give in.

While the constant anxiety and pain and mixed emotions scatters every cell in her brain, she remains composed and ever focussed and this is all that she will let the outer world see. Very few will know that today is not a good day, but even then those that know, will know that this will not stop her from going about her day.

There are days though, that none shall see her and these are the days that no matter how hard she tries to embrace the day, the disease within has its tight grasp around her and she just need to hide away and deal with the pain. On these days it is just all too much to bear and though she will not give in, todays battle is best not fought, and she just wisely knows today is the day to rest, heal and repair. She knows that sometimes to win a battle, it is best to not fight at all.

Today the flare of the disease within has sent aches to her muscles, sensitivity to her skin, aches to her head, cloudiness to her brain, deep pain to her bones and spine and pulsating pain to her womb. Her belly is swollen, like she is about to give birth and the intestines feel like that are being twisted and ripped apart. She feels nauseas, her head pounds like the worst every hangover and she feels like she is about to pass out. Even the most important bodily functions are just too hard and just too sore today. The disease tries to contort her, to stop her, but she remains upright and continues her day. She does not let the disease win and she will never buy into the label and let it confine her.

Some days are even more stressful, because her monthly cycle has appeared and has come with full vengeance and feels like flood waters through the place that a woman gives birth. On those days, she may even feel like she has given birth and what is bought forth, only few will ever hear about. Not even her partner may see what these flood waters bring and what she just felt like she birthed. That is secret women’s business and only talked about in private, or to the healthcare provider that may assist her from time to time.

She is loving, she is vulnerable, she is caring, she is giving, she is strong, she is fierce when needed and she is every bit the woman that the world knows a woman to be. Even at times of intimacy, she will still give her all and love with such passion and tenderness, but all the while her partner will never know that the pain that may be within. Some days are good, some days are bad, but that doesn’t stop her expressing her passion, her love and her womanly desires and love for her partner. Her heart is pure love and a good man will know how to love her and support her and care for her on the days where she needs gentle, loving, tender care.

Today may not be a good day, but she will brave the day just like any other and hide the disease crippling her within. She will not cry out in the open, she will not even make a fuss. Not many will know today is a bad day, because her courage and strength will get her through the day, just as it has every other day. You will only see what she wants you to see and that is a smiling, strong, vibrant woman about to go and conquer her day.

This is what I see through my eyes, of the strong, vibrant goddess that we all shall see. Because I know the war she is fighting, I see what many do not see. I see what she goes through and why she sometimes has to hide away. I see her wipe away the tears she sheds in silence. I see how restless she is when she tries to sleep. I see the mixed day of pain and emotions and how she tries to regain composure to overcome her day.

Through my eyes I don’t see weakness and someone who is fragile, or someone who gives in. I see a goddess, a mighty warrior, someone who can overcome and conquer all before her. Not by brute force, but by love, by compassion, by listening, by understanding and by knowing how to do what is needed and when it is needed. That is true strength, she is a true warrior and she shows what is it is to be a strong capable super woman. She will not let her kryptonite conquer her and she will overcome it and conquer it instead.

Through my eyes I will never really be able to know, or understand what she really goes through. I can never know what she endures each day. I can only but imagine what it is like to be in her shoes and walk the path that she walks most days. But I know that on days that she isn’t feeling her best, she will let the world see the best that she can be. She won’t fuss, she won’t cry, she won’t show any pain. She is a true warrior and she just puts on her makeup, puts on her lipstick, brushes her hair nicely, dresses eloquently and gets on with her day. Those are the days that we can support her and love her and help her get through her day.

This is the face of endometriosis and only those that suffer from this horrible disease will know what it is like to live in silence while the rest of the world is completely unaware.

Let’s end the silence for the strong warrior endo sisters and the next time someone tells you that they have endometriosis, remember that just because they look fine, they look vibrant, they look strong, they look like a beautiful goddess etc……Just remember that they may be fighting the fight within and today may not be a good day.

This is for my loved ones with the disease and every one of the “endo sisters”

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Period Pain IS NOT Normal

-The Endometriosis Experts

Endometriosis Awareness Month-March 2018

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The month of March is Endometriosis awareness month and I wanted to bring awareness about this disease where many women are missed and dismissed by multiple healthcare practitioners in the process.

Endometriosis is an inflammatory disease, by which endometrial like tissue grows outside the endometrium and affects 1 in 10 women. But while the current research says that 1 in 10 women are affected by endometriosis, as someone who special interest in endometriosis management, I believe that these figures may be grossly under exaggerated.

So many women suffer this horrible disease and many more do not even realise they have it. A significant portion of women with endometriosis are asymptomatic (meaning no symptoms). Women with this disease may take up to 10 years, or more, to be diagnosed after seeing multiple healthcare practitioners and specialists on the way. This amount of time to diagnosis is disgusting and just highlights how many women are missed and dismissed along the way. Many women are misdiagnosed as having Irritable Bowel Syndrome and other inflammatory disease states, when in fact the actually have endometriosis. I know that if this disease affected some of these so called healthcare practitioners, or if men had to endure this kind of pain, or their testicles were paining them all day, something would have been done about this disease long ago.

Meanwhile women with period pain caused by endometriosis have to live a life of pain, trauma and physical and emotional torment. Many of these women are barely getting through a day, let alone a whole month of exhausting symptoms related to this disease. Some are even at the point of suicide.

Endometriosis is mostly found outside the endometrium and can spread to the pelvis, bowel, bladder and intestines. It has even been known to get into the brain, joints, chest cavity, and around the heart. It has been found in nearly every part of the body.

According to the Royal College of Obstetricians and Gynaecologist Guidelines for the Management of Endometriosis, it can cause the following symptoms:

  • Heavy Menstrual Bleeding
  • Irregular bleeding
  • Period Pain
  • Pain with sex
  • Ovulation Pain
  • Irritable bowel like symptoms
  • Bladder issues (UTI like symptoms etc)
  • Chronic fatigue
  • Swollen painful pregnant looking belly (known as endo belly)
  • Pain with bowel movement

I am a healthcare practitioner with over 20 years experience in assisting women with the management of endometriosis. I have helped women all over the world with this horrible disease. I know all too well the trials and tribulations women have to go through before someone actually listens and gives these poor women a proper diagnosis and get them the help they so desperately need.

“Period pain IS NOT normal” and all too often women are told that period pain and other associated symptoms is normal and nothing could be further from the truth. We need to educate women and young girls that period pain is not normal.

I would like to see better education and awareness for the general public, but I would also like better education and awareness for all healthcare professionals. I want all healthcare professionals to know what the signs and symptoms of endometriosis are so that women can be referred for appropriate treatment and management. Early intervention and treatment is the key to treating this disease and managing it properly

No woman should ever be missed, or dismissed with this horrible disease every again. Let’s end the silence on endometriosis and bring awareness to every woman and healthcare practitioner on this planet that period pain IS NOT normal.

Regards

Dr Andrew Orr

-No Stone Left Unturned

 

 

 

Atrophic Vaginitis

What causes a burning sensation in the vagina and around the vulva?

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A burning sensation in and around the vaginal, vulva area is a relatively common complaint that many women experience and something that is seen by healthcare practitioners very often.

There are so many different causes of vaginal and vulva burning, including irritants, sexually transmitted diseases, atrophic vaginitis, thrush, lichen sclerosis, climates changes and is very common in peri-menopause and the menopause period. Each of the causes has its own set of symptoms and the treatments can all vary, depending what the cause it.

In this article we will look at the common causes of having a burning sensation in the vagina and around the vulva area. We will also look at treatments and management of these as well.

Before we start, it is important that women know that often people use the wrong term for the vagina and the surrounding area and often refer to a woman’s genitals as just being the vagina. It is important that we use the correct terms for a woman’s anatomy so that we can correctly identify were problems are.

The vagina is more the internal part of the female genitals and the vulva is the external part. Th Vulva is an umbrella term for the various parts of the external female genitals. These parts include:

  • Mons pubis – the fatty ‘pad’ that’s covered in pubic hair
  • Labia majora – outer lips
  • Labia minora – inner lips
  • Clitoris – small organ that’s packed with nerve endings
  • Urethral opening – which allows the passage of urine
  • Vestibule – area around the opening of the vagina
  • Perineum – area between the vagina and anus

Now that we understand the proper terms for the anatomy, lets have a look at what some of the common causes of burning sensation are.

Common causes of vaginal and vulva burning sensation

1.Skin Irritation

There are many things that can irritate the skin of the vulva and vagina when they come into direct contact with it. This is known as contact dermatitis.

Irritants that can cause contact dermatitis, inflammation and burning symptoms include non pH neutral soaps, certain fabrics, perfumes, vaginal hygiene sprays, some lubricants and allergens. As well as burning sensations, women may experience the following:

  • severe itching
  • redness and rawness and sometimes bleeding
  • stinging feelings and sensations of heat
  • pain and sometimes

The main way to treat irritation is to avoid whatever has caused the irritation in the first place. Avoiding the irritant and allowing the inflamed area and the skin to heal is one of the best things to do. Sometimes, a woman may require medications to settle the inflammation, or dermatitis down.

2. Candidiasis (Thrush, Yeast infections)

An overgrowth of bad bacteria in the vagina can lead to a burning, stinging sensation and one of the common causes of issues for women. Candidiasis, or thrush is very common in women and is causes through changes in the gut and vaginal flora and this then leads to overgrowth of bacteria, which causes many of the following symptoms

  • itching
  • soreness
  • pain during sex
  • pain or discomfort when urinating
  • discharge from the vagina (either white, or coloured)

Women are more likely to be prone to getting thrush if they are taking antibiotics, using certain form of hormones and contraceptives, have a weakened immune system, live in humid climates, have diabetes, are pregnant, or not cleaning themselves properly. High stress can also lead to changes in the gut and vagina flora and this can also lead to thrush.

Thrush is usually an antifungal medicine called azoles. Azoles can either be used internally into the vagina, or taken orally as a capsule, or both at the same time. Pre and Probiotics should be taken to help build up the good bacteria and women should take care with personal hygiene. Partners may also need to be treated to prevent further reintroduction of thrush via sexual intercourse.

3. UTI- Urinary tract infection

When a woman has a urinary tract infection (UTI), she will be likely to feel burning in and around the vagina when urinating. There may be other presenting symptoms such as:

  • needing to urinate more frequently, or have urgency to urinate
  • pain with urination
  • smelly, or cloudy urine
  • blood in urine
  • pain in lower stomach and radiating pain into the back and kidney area
  • feeling tired or unwell

When a woman has a urinary tract infection antibiotics will be needed and the antibiotics needed will depend on what the cause of the infection is. Usually an infection will clear up in around 5 days after starting a course of antibiotics.Repeat medication may be required if an infection returns.

4. Bacterial Vaginosis (BV)

Bacterial Vaginosis (BV) is the most common vaginal infection in women aged 15 to 44. Bacterial Vaginosis (BV) is a condition that occurs when there is too much of certain kinds of bad bacteria in the vagina, affecting the balance of good bacteria and flora. One of the main symptoms of BV is a burning sensation in the vagina, which can also occur when urinating.

BV does not always cause symptoms but when it does cause symptoms, besides a burning sensation, it can cause the following:

  • white or gray vaginal discharge
  • pain and irritation
  • itching and redness
  • strong fish-like odor, especially after sex (one of the key symptoms)

Having BV can increase a woman’s risk of STI’s and it can also increase her risk of miscarriage, once she is pregnant. If you think that you may have the symptoms of BV, you need to have it check by your doctor as soon as possible. BV is usually treated with antibiotics and you can use complementary medicines to assist in the treatment as well. It is a good idea to restore the good bacteria into the gut and vagina as well. This can be done through the use of prebiotic and probiotic bacteria combined.

5. Trichomoniasis

Trichomoniasis is a common STI and is caused by a parasite that is passed from one person to another during sexual intercourse. Many people may not know that have Trichomoniasis, but symptoms can present with a burning sensation and may  also present with  the following:

  • itching, redness, or soreness
  • discomfort when urinating
  • women can have vaginal discharge that can be clear, white, yellow, or green and with a fishy smell

Trichomoniasis can increase a woman’s risk of miscarriage, so it need to be treated asap. Trichomoniasis is treated by using certain forms of medicines called azoles.

6. Gonorrhea

Gonorrhea is an sexually transmitted infection where bacteria called Neisseria gonorrheae infect mucous membranes, such as the cervix, uterus, and fallopian tubes. If a woman is infected with gonorrhoea she can experience vaginal burning when urinating, as well as the following symptoms:

  • pain when urinating
  • vaginal discharge
  • vaginal bleeding between periods

Gonorrhea can be cured with the right medical treatment and it needs to be treated with specific medications. Often dual forms of medication are used for effective treatment.

7. Chlamydia

Chlamydia is a common STI caused by the bacteria Chlamydia trachomatis and is  transmitted through sexual intercourse with someone who has the infection.

If a woman comes in contact with chlamydia through intercourse, many times she may be asymptomatic (meaning no symptoms) and this is why it is often known as a silent infection. When symptoms do occur it can cause a burning sensation in the vagina and surrounding area. There can be other symptoms which include:

  • increased vaginal discharge
  • pain with urination and pain during sex
  • bleeding during sex and between periods

Chlamydia can cause damage to a woman’s reproductive organs and can affect her fertility, so it is important to have this treated as soon as possible.  Chlamydia is treated using specific high dose antibiotics. Treatment may also require IV antibiotics and for someone to be admitted to hospital while these are being administered.

8. Genital herpes

Genital herpes is a common sexually transmitted disease caused by skin-to-skin contact with a person with the herpes virus. Once a person has the virus, it stays with them for life. Sometimes the virus can remain dormant and then at certain stages of life (during stress, illness etc), it can become active and start producing symptoms.

If the virus becomes active, they might experience a burning sensation in the vagina, along with some of the following symptoms:

  • an itching or tingling sensation
  • flu-like symptoms
  • swollen glands
  • pain in the vaginal area, particularly when urinating
  • change in vaginal discharge

Painful sores, blisters, or ulcers may also develop after a few days. The symptoms of genital herpes can be treated with antiviral medication but once you have herpes, it cannot be cured. You just need to manage it and its symptoms.

9. Lichen sclerosus

Lichen sclerosus is a skin condition that affects the vulva area in women. Lichen sclerosus can cause burning sensation around the vulva area. It can also cause the following symptoms:

  • itching and tenderness.
  • Pain
  • Scarring
  • Wrinkling and white patches

Postmenopausal women are most susceptible to have lichen sclerosus. The cause is thought to be an autoimmune response of some kind, since the condition is associated with autoimmune disorders such as Graves’ disease and vitiligo. Treatment includes topical steroid creams, other medications, silica cream, zinc cream and regular medical monitoring. Lichen sclerosus is linked to an increased risk of vulvar cancer.

10. Menopause

Vaginal and vulva burning can be as a result of the perimenopause, or menopause stages of life. The shifting levels of hormones in a woman’s body before she enters menopause can affect the vagina and surrounding area. Burning sensations, in the vagina and around the vulva area is one possible result of these changes, especially during sex.

Some of the common symptoms of the perimenopause/menopause period are:

  • hot flushes & night sweats
  • difficulty sleeping
  • reduced sex drive
  • vaginal dryness
  • headaches
  • mood changes
  • Pain with sex
  • Atrophic vaginitis.

Not all women entering menopause have treatment to relieve symptoms, but there are often options available that a doctor, or healthcare practitioner, can outline, including hormone therapy. There are also many natural therapies that can help during peri-menopause and menopause stages of life.

What you can do to help yourself

Many causes of vaginal burning require medical treatment. If you are concerned, the best you can do is to see your healthcare practitioner. There are things you can do before seeing your doctor. Sometimes a ice pack or cold compress to the affected area can help reduce the burning sensation. You can also try some over the counter soothing creams, or antifungals.

Make sure you are practicing proper hygiene and cleaning the outer area of the vulva properly. Women should avoid using douches, which can affect the good bacteria and internal flora of the vagina.  Wearing cotton underwear and avoiding tight-fitting clothes can help reduce irritation in the vaginal area. It is also important to avoid products that could irritate the area further, such as perfumed soap, scented toilet paper, and sanitary products with deodorant, or a plastic coating.

Possible complications

Some causes of vaginal burning, such as urinary tract infections, BV, STI’s, lichen sclerosis can have some serious complications if left untreated. Cancer also needs to be ruled out so this is why it is important to have any symptoms of burning checked out by your doctor.

STI’s can affect future fertility and are also harmful to women who are pregnant, as they can affect their baby, or pregnancy. Many STI’s can cause preterm delivery and also increase the risk of miscarriage.

While some causes of vaginal and vulva burning may go away on their own over time, it is still important to go and get your doctor’s advice just to be safe. If your symptoms aren’t going away, are becoming worse, or are of a concern, then the woman should go and see a doctor as soon as possible. The longer you leave something, the worse it can get and the more issues it can cause, if left untreated. Many of the cases of burning sensation in the vagina and around the vulva will be relieved once the underlying cause is treated properly and with the appropriate medicines.

While medical options will be needed for some conditions, there are complementary medicines and complementary medicine modalities that may be able to assist your particular issue, or alongside medical treatments. Please always see a qualified healthcare practitioner and not use Dr Google, or take advice from friends or family for any medical advice.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Women’s Health Experts

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Soft Drinks/Sweetened Drinks Reduce a Couple’s Chances of Conceiving by 30 Percent

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Consuming just one sweetened soft drink a day reduces a couples’ chances of conceiving by more than 30 per cent, according to new research published in the journal of epidemiology in February 2018.

Men who drink at least one sugary softdrink/soda a day reduce their chances of fathering a child by 33 per cent, research has found.

Women who drink just one sugar-sweetened softdrink/soda beverage a day are 25 per cent less likely to become pregnant in any given month, the research adds.

Before you think about switching to diet soft drinks, or diet soda, you may want to think again. Studies have shown that diet drinks of any kind are actually worse than the ones containing real sugar. These diet drinks contain aspartame, which then gets converted to phenylalanine in the body. Phenylalanine is toxic and what we use to preserve dead bodies with. It can have a detrimental effect on fertility.

Previous research has also shown that eggs and embryos may fail to thrive in high blood glucose environments. Sugar and highly refined foods has also been linked to erectile dysfunction in men.

The researchers analysed 3,828 women and 1,045 of their male partners, who enrolled in the study between June 2013 and May 2017, and were followed until pregnancy or for up to 12 menstrual cycles. The couples were not using fertility treatments and had only been trying to conceive for six months or less.

The researchers from Boston University found positive associations between intake of sugar-sweetened beverages and lower fertility, which were consistent after controlling for many other factors, including obesity, caffeine intake, alcohol, smoking and overall diet quality.

Couples planning a pregnancy should be looking and lifestyle and diet before trying to conceive and consider limiting their consumption of these beverages, especially because they are also related to other adverse health effects.

In my comprehensive fertility program, diet and lifestyle choices are all covered along with everything a couple needs to conceive. No stone is left unturned with my multi-modality approach to assist couples with fertility and trying to have a baby.  If you would like to find out more about my fertility program, please call my friendly staff and they will be able to assist you further

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The International Fertility Experts