Hysterectomy Does Not Cure Endometriosis

Posted on October 25, 2018September 8, 2019 by Andrew Orr

One of the things I get asked to comment on often by women, colleagues, media etc, is “Will Hysterectomy Cure Endometriosis?”

Every time I hear the question asked, or hear of women being told that hysterectomy will cure their endometriosis, I almost cringe and have to stop myself from swearing. The fact is this, and I want everyone to know this. Hysterectomy “does not” cure endometriosis. It never has and it never will and I am going to explain why.

Endometriosis is typically not found in the uterus as it is endometrial like tissue that grows outside the uterus. Endometriosis is really normal tissue, growing in abnormal areas. It can grow on the bowels, bladder, pelvic wall, utero-sacral ligaments (USL’s) and it can spread to nearly every part of the body.

Endometriosis is also one of the most misdiagnosed disease states in women and can take up to 10 years to diagnose on average. Some women are never diagnosed and many take up to 20 years, or more, to be diagnosed. This means that a hell of a lot of healthcare people miss it along the way. That is a fact. It also means a hell of a lot of healthcare people do not know much about the disease as well. Another fact as well. Let’s not get started on the surgical side of this either. I have explained this in other posts (Click Here)

The other fact is there is a lot of BS (Bullshit) put out there about endometriosis by uneducated healthcare practitioners, media and general public alike. Again this is a fact.

One of the biggest pieces of misinformation is women being told that hysterectomy will cure endometriosis and is the solution to all the symptoms they are getting. Not only is this not true, but it is downright reckless, misleading and bordering on negligence. It is also causing women to have a healthy uterus removed and many to undergo a procedure that is not even going to cure their disease. There is no cure for endometriosis at this present time.

Why Won’t Hysterectomy Cure Endometriosis

Firstly, there is no cure for endometriosis. That is a fact.

Secondly, endometriosis is outside the uterus. As I have said before it can grow on the pelvic wall, the bowels, the bladder, the ovaries, the fallopian tubes, the USL’s and it can spread to the diaphragm, the lungs, the pericardium, the heart and nearly every part of the body. That is the truth.

Now, if the disease is not in the uterus, how is taking the uterus out going to be a cure for the disease?

Well, it isn’t a cure and this is what we need for people to know. Sure, menstrual related symptoms like period pain, heavy bleeding, clotting etc may be stopped due to a hysterectomy and not getting a period anymore. But, that is it really.

Endometriosis will still be there and so will many of the non-menstrual related symptoms. Worse still many then think, or have been told, that the endometriosis is gone and that the symptoms they are experiencing post hysterectomy are not from endometriosis. The fact is, the endometriosis is still there and those symptoms are still from endometriosis. Many women are then led to believe the symptoms are in their head, or then told to go and see pain specialist and suck it up basically. That is what happens.

The other thing is, many women who have pain with their menses and heavy bleeding may have another condition called Adenomyosis and may not even know they have it. Hysterectomy will help adenomyosis, because this is confined the uterus. So when women say they got relief from having a hysterectomy, they may have just had adenomyosis and not even known they had it.

They may also just be having symptomatic relief from menstrual related symptoms from not having their period. Adenomyosis and endometriosis often go hand in hand too and many do not know they have both disease states. Many now believe they are one in the same disease, but just in different locations. But, regardless, endometriosis will still be there regardless of whether a woman has a hysterectomy, or not.

No matter what anyone tells you, hysterectomy will not cure endometriosis. If endometriosis has been diagnosed, then it will still be there regardless of the uterus being taken. This is what we need all to know. Many women are told hysterectomy will be the cure to their endometriosis only to find the symptoms come back again after the procedure is done. The women I feel sorry for are the ones led to believe that hysterectomy will be the great savior for all their symptoms, only to find out it isn’t.

Let’s not forget that endometriosis symptoms don’t always relate to the menses either. Women with endometriosis can be in constant pain at anytime in their cycle and pain can also be cyclic, regardless whether the period is due or not. “Endo Belly” can strike at anytime. Women can go from having a flat stomach one minute, to looking like they are pregnant the next minute, and then back again.

Then we have all the other physical and emotional symptoms as well. Hysterectomy is not going to fix any of that. Again hysterectomy will only help with the menstrual related physical and functional symptoms and endometriosis will still be there.

There is only one way to deal with endometriosis and that is via a multi-modality approach and manage the disease properly. I have written many articles about this and spoken about it at many seminars and events. If you want to find out more about how to manage endometriosis please click here

I need every woman with this horrible disease to know that Hysterectomy will not cure endometriosis. No matter what anyone says to you, it won’t cure the disease. That is a fact and we need to start getting this information out there and stop those spreading the misinformation to be educated properly. If anyone tells you that hysterectomy will cure endometriosis, tell them they are misinformed. The endometriosis will be there still. If you, or someone else, needs to know the facts about Endometriosis, you can always direct them to my Endometriosis Facts Page or visit Endometriosis Australia’s page as well.

Let’s end the silence and also put an end to the misinformation as well. Lastly, always remember that Period Pain is not normal either.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Expert

-The Endometriosis Experts

Are we really doing enough for women with Endometriosis?

Posted on September 18, 2018September 7, 2019 by Andrew Orr

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

Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

-The Endometriosis Experts

Expectation Versus Reality When It Comes To Hospital Emergency Departments

Posted on August 9, 2018September 7, 2019 by Andrew Orr

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 a 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… don’t 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 the following may assist you also:

Eat a healthy low inflammatory based diet
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
Acupuncture may assist with pain
Herbal medicines and nutritional supplements may assist pain
Chiropractic care, or osteopathy care may assist
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
See a counsellor, or psychologist
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.

If you do need help with a women’s health condition and are not being managed properly, then please give my friendly staff a call and find out how I am may be able to assist you.

Take care

Regards

Andrew Orr

– No Stone Left Unturned

– Women’s and Men’s Health Advocate

-The Endometriosis Experts

-The Women’s Health Experts

The Facts About Endometriosis

Posted on July 27, 2018September 7, 2019 by Andrew Orr

Many things you have heard about period pain and endometriosis are wrong. These are the facts about Endometriosis

Regards

Andrew Orr

-No Stone Left Unturned

-The Endometriosis Experts

Endometriosis Facts

Posted on July 27, 2018September 7, 2019 by Andrew Orr

Many things you have heard about period pain and endometriosis are wrong. These are the facts about Endometriosis

Regards

Andrew Orr

-No Stone Left Unturned

-The Endometriosis Experts

Weeding Out Endometriosis

Posted on April 26, 2018September 23, 2019 by Andrew Orr

Explaining endometriosis to people is not always easy and sometimes you have to use analogies that seem strange at first, but once you get the gist of where I am going with it, it will all make sense. But before I start, I always like to say that please take the personal out of things and just know that what ever analogy I use, it is with good intention and always about helping others.

I just know that when I used the “Endo is like Rust” analogy, which is what it is like, a few people took it to heart as though they had a rusty uterus and this is not what I was saying. Not at all.

Please know that I have loved ones with this horrible disease, so I am here to help, and my main aim now is to help as many people as possible with what I know, and how to treat people properly. I am also about getting the message out there so that women to not have to remain silent about this disease any longer. My motto is, and always will be, “Period Pain is Not Normal”

So, sit back, take out the personal and know that I am writing from a place of caring and sharing and a place of getting the message out there to help you all. Sometimes you just have to tell it how it is, in order for people to sit up and listen, so here we go J

Many of you have read my article of “Rust Never Sleeps and Neither Does Endometriosis” and the reason I wrote this is because endometriosis and how it attacks the body, is very much like how rust attacks metal. If you haven’t read the article, please do so that you can see what I am trying to convey.

I am always doing lots of speaking events and seminars on Women’s Health and also presenting for workshops on Endometriosis. It is so great to get the message out to the world, so that both the public and healthcare professionals can be educated on this subject better.

We need to stop having this disease “Missed” and women being “Dismissed” as I am always saying now. This disease should not be taking 8 years from onset to definitive diagnosis. It used to be 12 years. This is disgusting, to say the least, and there is no excuse for this to be happening, except poor education, sloppy diagnosis, lack of training, negligence and dismissive egos that need an attitude adjustment.

But, in saying that, we also need to teach women to be empowered and not just put up with being told “This is normal”, or “Just go on the pill and it will fix it”. That is bullshit (sorry). But it is true. There needs to be a better way and we need to stand up and say “Enough”. But we also need to not let the disease define you and get caught up in the blame game either.

We also need to get people to stop “Dr Googling” too, as this is also spreading the misinformation. It is great to be educated, but good old “Dr Google” is full of false information and research shows that up to 75% of the health information that the public can access on google, is either wrong, or only partially true.

Now that I have had my little rant about the injustices of many, I would like to share what I have been sharing to others about what endometriosis is really like and how hopefully we can prevent it from returning, hopefully for good.

I do know this is possible with the right care, right follow up treatments and right team of people helping. I see it daily and know what I share to be true. But, again it requires the person to follow the advice given and then to get the information out there. It also requires people to not be defined by their disease and break free from these chains to open their minds to the possibilities of new thought, new treatments and new ways of doing things. We need to not be caught up in what may cause the disease, but what we can do to help those with it now.

Of course prevention is crucial and so important, but once the disease is expressed in the body, what caused it is irrelevant. We can argue about the hypothesis of what may be the initial causal factor until the end of time, but that isn’t helping those with the disease now. The most important factor is how we can help those with it live a normal life and hopefully one day in the future to be free of the disease completely. At least for now, we can look at hopefully giving people a better quality of life than the one they are living each day. From my experience, I do know that this is possible with the right team of people working the help the individual.

To be honest, the most likely cause of this disease is now known to be genetic links, or chromosomal, most likely through the parental mode of inheritance. Gene therapy is probably going to provide the biggest breakthrough in this disease in the years to come. But like any breakthrough, we just have to wait and see what happens there. You heard it here first. I do believe genetics does play a big part, but like any disease, it is not the only contributing factor.

But, all this aside, we need to focus on the here and now to help those who need help now. In order to make change, you need to make those changes required. If you change nothing, nothing will change. I also get how hard it is for those whom have suffered so long to pick themselves up, to make those changes. Believe me, as someone who has been through a major life threatening illness and pain and crawled their way back to good health and do what I do now, I get it. I’ve been to that point of wanting it all to just stop and I get what many women put up with on a daily basis. Pain is pain, no matter where it has stemmed from.

Getting back to the subject at hand, I have now been explaining that Endometriosis is like a weed. Why would I explain it like this?

Like a weed, endometriosis grows and spreads. You can physically remove the weed (surgically), but unless you control the regrowth, seeds have been dropped (endometriosis regrowth) and then the weeds pop up again and start to grow once more. Sound like endometriosis too you?

Like any weed, it needs certain things for its regrowth. We have just talked about the dropping of the seeds ( regrowth) but it needs a food and fuel source to make it grow (estrogens, insulin, inflammatory response from external factors, stress etc). Then once the seeds are fed, the regrowth continues and then the garden is infested with the weed plague once more. Then you need to try and physically removed the weeds again once more and so the cycle begins again. Are you seeing what I am getting at yet?

Just like these weeds, endometriosis is often removed and many people then either believe they are fixed, or they do not do anything post surgery to prevent that regrowth. Before they know it, they again have to go back for more surgery. Often when people do try to control the regrowth (Progestins, Mirena etc), they are only employing one method, for which is either not effective enough, or the weed (Endo) is now resistant too.

This is why we need to employ a multimodality approach post surgery to hopefully complete eradicate the weed regrowth and halt the life cycle of these seeds being spread and to start growing again, thus starting the horrible cycle all over again

Now that we can see how endometriosis is really like a weed that can spread throughout our garden, we need to look at what we can do to hopefully stop it coming back, or spreading into other parts of the body.

Like I said, treatment must be individualised, using a multimodality approach, taking the clinical problem in its entirety into account, including the impact of the disease and the effect of its treatment on quality of life. Pain symptoms may persist despite seemingly adequate medical and/or surgical treatment of the disease.

The real focus needs to be on prevention and treatment strategies post surgery. Even better still, lets prevent it before it starts

There is an ancient Chinese saying – “To try and treat a disease once it is fully expressed into the body is like trying to forge arms once a war has already started, or like trying to dig a well once you are already thirsty – Yellow Emperors Classics of Internal Medicine”

The same goes for endometriosis. Once the disease is there and expressed into the body, it is hard to treat, especially is known methods of treatment are failing and this individualised, multimodality approach is used.

A Multimodality Approach Should Include:

Surgery
Pain Management
Hormone Therapy
Counselling
Lifestyle changes
Exercise
Pilates/Yoga
Changes to Diet
Traditional Chinese Medicine
Acupuncture
Holistic Medicine
Anything people have tried and has worked for them

The Royal College of Obstetricians & Gynaecologist guidelines for the “Investigations and Management of Endometriosis” have the following quote:

“Many women with endometriosis report that nutritional and complementary therapies such as homeopathy, reflexology, traditional Chinese medicine or herbal treatments, do improve pain symptoms. They should not be ruled out if the woman feels they could be beneficial for her overall pain management and/or quality of life, or work in conjunction with more modern medical therapies.”

This is why it is vital to take careful note of the woman’s complaints and to give her time to express her concerns and anxieties, as with other chronic diseases, just as I do for all of my patients. Healthcare providers actually need to listen to the woman and her concerns. Women need to be listened to and be heard and be nurtured

It is also important to involve the woman in all decisions, to be flexible in diagnostic and therapeutic thinking, to maintain a good relationship with the woman and for healthcare providers to seek advice where appropriate from more experienced colleagues. This is something that I try to educate all my patients with and something I also try to educate healthcare providers with when I do my seminars and speaking events about Women’s Health issues and diseases like endometriosis.

But while there are thing that healthcare providers need to do, there also things you must do also. These include

Reducing Stress
Look at Emotions and How They Affect You
Exercise
Get “You Time”
Eat more protein and less High GI Carbs
Eat less process and package foods that we now call “Carbage”
Loss some weight if you have excess fats (which spike estrogens)
Gain some weight if you are underweight.
Do Something You Love (At least once per week)
Laugh Often (Even if some days you feel like crying)
Spend Time With Friends and Loved Ones
Make Love J ( Climax and Oxytocin are your friends)
Do Not Let The Disease Define You
Don’t Buy Into The Label
You are more than this disease
If something is helping, then continue with it, no matter what anyone tells you
Just remember that “You” are uniquely “You”

Please remember these words :

Do Not Let The Disease Define You
Don’t Buy Into The Label
You are more than this disease
If something is helping, then continue with it, no matter what anyone tells you
Don’t buy into everything you read on the internet, social media, or “Dr Google. To be honest, I ban “Dr Google” with my patient (haha)
Make sure you have a good laugh each day, but remember it is also OK to have a good cry too
It is OK to unplug every so often
It is OK to take the “Superwoman” cape off every so often too.
Remember “You” are uniquely “You”

This is why it is so important to not get caught up in what others have done, or tried and may not now be working for you either. We need to look at you as an individual and treat you as such. What works for one person, may not work for another. This is why an individualised multimodality approach is needed to help prevent and treat this horrible disease and we often need a team of people, on the same page, to help treat this properly.

Don’t forget to “Get A Second Opinion”, or a Third, or Fourth, or Tenth one if needed

In many other areas in life we will get multiple quotes, and opinions. Yet, when it comes to our health, we often only get one quote, or maybe two.

Just because someone has your history, or is nice to you, or maybe recommended by a friend etc, does not make them a good practitioner. It does not mean that you cannot get another opinion. If someone isn’t helping you, then you need to look at changing, no matter who they are, or how well they know your history.

Not every specialist you see is a good surgeon either, so please remember this. You need to have someone who specialises in endometriosis and who has done advanced surgical training, not just minimal training. There is good and bad in every profession and the medical profession is not exempt from this either.

The complementary medicine profession, or allied health care profession exempt from this either. Your health is important and so is the value of another opinion. Not every practitioner has all the answers. If someone isn’t helping you, then don’t be scared to change.

Lastly please remember to know that there is always help out there. I am always here to help people as well. I have a special interest in endometriosis and do a lot of education and research into this disease. I also have masters level post graduate training in this disease and other women’s health and reproductive conditions.

You can always come and see me in person, or make an initial online consult (zoom) for those who live at a distance. I have a great team of people I work with to give you the best help possible. I have a team of some of the best health care professionals and I make sure all of the team I work in with, are at the top of their game in their chosen profession.

Let me be the conductor of your health issues and help you get the treatment and advice you so desperately deserve. I am here to listen to you and hear you. I make sure you don’t have things “Missed” and aren’t “Dismissed “ and why my treatment motto is “Leaving No Stone Unturned”. I am out there as a voice for women and being a crusader for women’s health everywhere. I don’t mind stepping on a few toes, and ego’s to get you the best help possible J

Take care and remember that “Period Pain Is Not Normal” and neither are and other “Menstrual Irregularities” that women face on a daily basis. I know what you go through daily and I am out there making sure you all get heard. Let’s end the silence on this horrible disease for you, and the ones close to me whom I love, adore and care about also.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Endometriosis Experts

What is Bladder Endometriosis?

Posted on April 24, 2018September 20, 2019 by Andrew Orr

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

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

Posted on April 10, 2018September 22, 2019 by Andrew Orr

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. [Google Scholar]
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] [Google Scholar]
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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] [Google Scholar]
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] [Google Scholar]

Women Benefit from Acupressure for Menstrual Pain Through Self Help App

Posted on April 7, 2018September 3, 2019 by Andrew Orr

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

Women with Endometriosis More Likely to Suffer Migraines

Posted on March 30, 2018September 19, 2019 by Andrew Orr

Besides endo belly, pelvic pain, period pain etc, one of the other symptoms I see women with endometriosis experience is migraines. While not all migraines are just related to endometriosis, and can be from a variety of factors, having endometriosis could give you more of a chance of having migraines.

Recent research published in the Journal of Fertility and Sterility has shown that adolescents with endometriosis are more likely to experience migraines than adolescents without endometriosis. While the focus was on adolescents, it would be safe to say that any woman with endometriosis may be more likely to suffer migraines as well.

In the research, it was shown that adolescents with endometriosis were more likely to experience migraines (69.3%) than those without endometriosis (30.7%)

Among those with endometriosis, age of when the period started was associated inversely with the odds of migraines. The research also found that women with endometriosis and migraines have more dysmenorrhea than those without migraines.

The research showed a linear relationship exists between migraine pain severity and the odds of endometriosis, suggesting heightened pain sensitivity for adolescents with endometriosis. Due to the strong correlation, patients who present with either condition should be screened for comorbidity to maximize the benefits of care.

While the research showed a relationship between endometriosis and migraines it is also important to rule out other factors that cause migraines too, if you have endometriosis.

For sufferers of the disease, it is important not to just blame every migraine on endometriosis. Diet, additives, stress, anxiety, tight muscles, sublaxations, nerve impingement, sinusitis, TMJ syndrome, jaw tightness and many other factors need to be ruled out as well. This way the actual cause of a migraine is not missed.

For sufferers of Migraines please make sure you read my article on how to banish migraines too.

https://drandreworr.com.au/banishing-headaches-and-migraines/

If you do need help with endometriosis, or migraines, or both, 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 Endometriosis Experts

-The Headache, Migraine and Pain Experts