Affecting up to 100,000 women in Ireland, endometriosis is a gynaecological condition which causes pelvic pain and in some cases infertility. It can be difficult to diagnose and many women suffer for years before receiving treatment.

Caitríona McCormack has experience of this, she went through many years of crippling pain before finally being diagnosed.

“I had my first symptoms when I was 22 years old – I suffered with excruciating pain and ended up in A&E more times than I can remember,” says the Kildare woman. “They couldn’t tell me what was wrong as nothing showed up in my bloods or x-rays. I didn’t like taking painkillers because I believed they were bad for the body but seven years later I was still in an out of my GP every other week and eventually a friend saw me curled up on the sofa with a hot water bottle and said I needed help.

“I think I had become so used to the pain that it became my norm. But it was affecting everything, my hormones were up and down, and I was having mood swings. It affected my relationships with my family, boyfriend and my work was suffering. Until that point, I just kept going and didn’t see anyone when I was in a bad way, so I don’t think people really knew how bad things were.”

McCormack took her friend’s advice and sought medical help. After a laparoscopy and hysteroscopy, she was diagnosed with endometriosis and pelvic congestion syndrome. And while the initial treatment alleviated some of the pain she was going through, it didn’t last long.

“The doctor removed some endometrial tissue during the procedure, and I had some relief for about a year, then the symptoms worsened again,” says the 47-year-old. “I was prescribed the pill to help with the symptoms as well as different painkillers and anti-inflammatories. I was told that they would work, but they didn’t, and I ended up many more times in A&E over the years in dire pain. I put on morphine which finally took the pain away but the side effects (debilitating migraines and nausea) were dreadful – so I couldn’t take it.”

Things began to get worse for McCormack who developed a cyst on her uterus which was removed. But a week later, while visiting a friend in the UK, she haemorrhaged and was rushed to hospital. She lost so much blood that she was bedridden for a fortnight and the whole experience sent her body into shock and triggered depression.

360 degree turn of events

This episode preceded several more years of living with constant pain while trying a string of alternative treatments to try and bring an end to her suffering.

“For years I had continuous acupuncture and physiotherapy, tried Chinese herbs, pain management and healings from various types of healers all over the country but none of it really helped or worked,” she says. “Also, no one really talks about the financial aspect of being sick and self-employed in this country – most are too embarrassed I suppose – but the pressure was immense.

“I had two more laparoscopies and then five years ago it was time for a hysterectomy. This was the last option which I was trying to avoid at all costs. I still wanted children and I had met a few women at endo (endometriosis) conferences who had hysterectomies but are still in daily pain.

“My dream of having a family, even one child, was over. My relationship had finished, and I was too sick to be in another or take care of anyone else, much less a baby even if I was able to conceive. The grief of never having a baby was intense. I had to stop working, I just couldn’t do it anymore and was totally exhausted so I had to find a road to healing. I felt like my life was passing me by and I had no compass, no control over what was happening, it seemed like there was no light at the end of the tunnel and no end to this nightmare.”

McCormack says depression, anxiety and panic attacks became part and parcel of her life. “My first panic attack happened when I couldn’t drive after getting into the car – me, the one who travelled fearlessly around Europe on her own,” she recalls. “The constant pain kept me awake at night, so that combined with the cocktail of medication was taking its toll on me and mentally I was really struggling. I had always been a go getter and as a young girl loved to dance, run and play tennis – and I was a brown belt in Karate. Now I spent most of my time in bed, a 360 degree turn of events – it was pretty soul destroying.”

Before endometriosis, McCormack had loved yoga and now at an incredibly low ebb, she decided to give it another go. “One day I dragged myself to a restorative yoga class with others who were ill with cancer, arthritis, fibromyalgia and other illnesses,” she says. “After the class my pelvic pain had eased, I had forgotten how powerful yoga is. I continued going to the class and got back on to my mat at home, doing various breathing practices to help relax my body and support and strengthen my mind.

“I continued my daily practice in tandem with counselling, a healthy diet which supported my liver, daily herbal supplements and doing reiki on myself as I’m a reiki master – and I gradually started to improve.”

She now runs Yoga Ireland and Authentic Reiki Tera Mai (in Dublin and Kildare). “I still have my bad days, but they are vastly reduced, and the pain is much less. My hormone balance, mental health and mood are all much improved and if I feel unwell, I do some breathing and mindfulness which helps me cope and I always feel better and more energised for it.”

Lucille Cassidy from Dunfanaghy, Co Donegal is a chartered physiotherapist as well as both a Pilates and yoga teacher. She runs Sandhill House, a retreat centre for health and wellness. “I now see my yoga practice as an opportunity to breathe deeply, move consciously in a way which feels good and to use the movement as medicine to nurture all parts of myself; body, mind, heart and soul,” she says.

“Aches and pains are eased, muscles and joints are lengthened and after a yoga practice, I always feel more grounded, calm and relaxed. It soothes my nervous system, balances my energy and helps to relieve stress and tension.”

What is endometriosis?

– Endometriosis is a gynaecological condition which causes painful periods, pelvic pain and sometimes infertility.

– It affects up to 100,000 women in Ireland and is commonly found on the ovaries, behind the womb and close to the bowel.

– Like the lining of the uterus, it bleeds during a woman’s period and this can cause pain.

– Endometriosis on the ovaries can lead to ovarian cysts and severe endometriosis can cause pelvic scarring and adhesions – this makes the pelvic organs “sticky” so an ovary can get stuck to the back of the womb or the bowel can become attached to the ovary or womb.

– Treatment includes surgery and medication.

The post Living with endometriosis: ‘My dream of having a family was over’ appeared first on MyMedicPlus.

An estimated 11 percent of women between the ages of 15 and 44 are affected by endometriosis, a painful disorder in which tissue that normally lines the uterus grows outside the uterus. “The tissue often travels backwards from inside the uterus, through the fallopian tubes, into the pelvis and becomes trapped in the pelvic cavity,” Dr. Edward Tangchitnob, an OB-GYN with Emanate Health in Southern California, tells SheKnows. “[This can] lead to scarring, inflammation, and cysts.”

Although the illness is different for everyone, some of the most common symptoms are painful periods and bleeding between periods. There are four stages of endometriosis, with stage one being “minimal” and stage four being “severe.”

To help understand the differences between the four stages of endometriosis, we spoke with women’s health experts about how the symptoms vary and how the different stages affect the women diagnosed.

Stage One

Based on surgical findings as set forth by the ASRM (American Society for Reproductive Medicine), Dr. Rebecca Brightman, a private practice OB-GYN in New York and educational partner for SpeakENDO, explains that stage one is considered “minimal disease.” Women with stage one endometriosis have small implants and lesions, and minimal scarring or adhesions.

“It’s important to note that women may feel severe pain and discomfort in this stage, along with stage two,” says Dr. Tangchitnob.

Dr. Brightman also emphasized that just because stage one is considered “minimal,” it certainly doesn’t mean it’s painless. “The stage of disease or extent of disease does not always correlate with the degree of symptoms,” she tells SheKnows, adding that women with stages one and two can be severely impacted by the symptoms of disease.

Stage Two

Dr. Brightman says stage two is also considered minimal “with implants collectively measuring less than 5 cm and confined to pelvic organs.” In women with stage two endometriosis, adhesions are minimal if present.

Doctors may find more implants deeper in your body compared to stage one, according to Dr. Tangchitnob.

Stage Three

Stage three is considered “moderate.”

Dr. Tangchitnob says doctors will likely find deep implants in this moderate stage, in addition to an endometrial cyst or two on at least one ovary. “These are called ‘chocolate cysts’ since they are filled with endometriosis fluid and blood,” he explains. “These cysts are caused by endometrial tissue that attaches to the ovary, shedding blood and tissue.”

In women with stage three endometriosis, doctors may also find filmy adhesions, or bands of tissues, binding your organs together when they shouldn’t be connected. “Many think that this binding could cause the stabbing pain and nausea that many women cope with,” Dr. Tangchitnob tells SheKnows.

Stage Four

Stage four endometriosis is considered severe. “Women [with stage four endometriosis] may have at least one large ovarian cyst, along with a large number of dense adhesions that we typically find throughout the pelvic region,” says Dr. Tangchitnob. He notes that doctors also continue to find deep endometriosis implants in this stage and the pelvis often appears so scarred that the gynecologic organs are no longer mobile, possibly leading to issues with fertility and pain.

The Bottom Line

As Both Dr. Brightman and Dr. Tangchitnob emphasized, the stage of the illness doesn’t directly correlate with the severity of the symptoms. Women with stage one endometriosis may experience extremely painful symptoms, so they should never be dismissed simply because their diagnosis is classified as “minimal.”

While endometriosis causes excruciating and sometimes debilitating pain for certain patients, Dr. Brightman adds that many women with the illness are asymptomatic. “The diagnosis of endometriosis is sometimes made as an incidental finding at the time of surgery or evaluation for other medical problems,” she notes.

Although there isn’t a direct correlation between stage and symptoms, Dr. Brightman explains that women with advanced stages of endometriosis may be more likely to experience severe pelvic pain, as well as urinary and gastrointestinal symptoms, during menstruation.

“They may have irregular menstrual bleeding as well,” she says. “While the extent of disease doesn’t always correlate with infertility, those women with advanced disease may be more likely to encounter problems with fertility.”

If you’re experiencing symptoms associated with endometriosis, Dr. Brightman emphasizes the importance of being open with your doctor so you can work together on an individualized treatment plan that includes treatment options, goals, symptom management, and how to integrate treatment into your day-to-day life.

“Women often experience endometriosis symptoms differently and everybody’s needs are different. It may feel uncomfortable discussing these topics with your doctor, but it’s important that you feel empowered to do so, especially since endometriosis can easily go undiagnosed,” Dr. Brightman tells SheKnows, noting that it can take up to ten years to receive a proper diagnosis.

The post The Four Different Stages of Endometriosis, Explained appeared first on MyMedicPlus.

Endometriosis is known as a painful disorder in which the tissue that usually lines the inside of your uterus grows outside your uterus. Endometriosis involves your Fallopian tubes, the ovaries and the tissues that are lining your pelvis. It rarely happens that the endometrial tissue may spread beyond your pelvic organs.

With endometriosis, the endometrial tissue would break down, thicken and bleed with every menstrual cycle. But since the tissue has no way to exit your body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may develop. The surrounding tissue in your ovaries may become irritated, and they may eventually develop scar tissues and adhesions. Adhesions are abnormal bands of fibrous tissue that can cause the organs and the pelvic tissues to stick together.

Endometriosis can cause pain, especially during your menstrual period. Fertility problems may also develop. Good thing there are effective treatments available.

What causes endometriosis?

There is still no known cause of endometriosis. There is one theory that suggests that the endometrial tissue is placed in unusual locations because of the retrograde flow of menstrual tissues through the Fallopian tubes into the abdominal and pelvic cavities. The cause of this retrograde menstruation is not understood. However, retrograde menstruation is not the only cause of this painful disorder, as a lot of women who have retrograde menstruation do not have the condition.

Another possibility of endometriosis is that areas lining the pelvic organs have primitive cells that can form into other forms of tissue, like endometrium.

Symptoms

The main symptom of endometriosis is pelvic pain, usually linked with menstrual periods. Even though many experiences cramping during their menstrual cycle, those with endometriosis usually describe menstrual pain that is far worse than usual. The pain may also increase over time.

Common signs and symptoms of endometriosis include:

Painful periods or dysmenorrhea. Cramping and pelvic pain may begin before and it may extend several days into a menstrual period. You may also have abdominal pain and lower back pain.
Feeling pain during intercourse. It is a common sign of endometriosis if you feel pain during or after sex. You may also feel pain with urination or bowel movements. You are most likely to experience these symptoms while you are on your period.
Excessive bleeding. You may experience heavy menstrual periods occasionally or you may bleed between periods.
Infertility is also a sign of this disorder, endometriosis is first diagnosed in those who are seeking treatment for infertility.
The other signs and symptoms include diarrhea, fatigue, bloating, constipation, nausea, especially during menstrual periods. The severity of your pain is not necessarily a reliable indicator of the extent of the condition. You could be diagnosed with mild endometriosis with severe pain, or you could have advance endometriosis with no pain or you may experience a bit of pain.
Endometriosis is usually mistaken for other conditions that can cause pelvic pain like PID or pelvic inflammatory disease or ovarian cysts. It may be mistaken for IBS or irritable bowel syndrome, a condition that causes constipation, diarrhea, and abdominal cramping. IBS can accompany endometriosis, and this can complicate the diagnosis.
When to see a doctor

If you have the signs and symptoms of endometriosis, it is best to see your doctor immediately. Endometriosis can be a difficult condition to manage. An early diagnosis, an understanding of your diagnosis and a multidisciplinary medical team may result in better management of your disorder.

The post What is Endometriosis and How Would You Know If You Are Suffering From It? appeared first on MyMedicPlus.

These are all symptoms more commonly associated with endometriosis – which is when tissue that lines the uterus grows on other pelvic organs.

But it might actually be the lesser-known “ugly sister” to the agonising condition – adenomyosis.

Both conditions share similar symptoms and women can have both at the same time, they’re caused by different issues.

Affects 1 in 10

Adenomyosis happens when the bits of tissue that line the uterus – known as the endometrium – grows into the muscle layer of the womb.

Like endometriosis and PCOS, it is thought to affect 1 in 10 women.

It can cause feelings of fullness or bloating which means women with the condition are often misdiagnosed as having irritable bowel syndrome (IBS).

As it can lead to excess bleeding, women are also at risk of becoming anaemic.

Consider diet

Gynaecologist Dr Anita Mitra says although there have been no studies looking into the link between diet and adeno, what you eat is still important in managing the symptoms.

If you’re bleeding loads, you need to make sure that you’re really stocking up on fibre and leafy green veg.

She told Stylist: “Why is that? So that you can do a good poo to help your body excrete the old oestrogen that it doesn’t need, as well as preventing constipation which could be worsening the pain of adenomyosis by putting extra pressure on your already inflamed uterus.

“My advice would be to keep a symptom diary if you think there’s a particular food that is affecting your symptoms, but seek advice from a nutrition professional before you seek to cut out entire food groups to make sure that you aren’t running into nutrient deficiencies. “

Keep a symptom diary if you think there’s a particular food that is affecting your symptoms

She also stresses that despite the fact that hysterectomies are often promoted as a cure for the condition, they definitely shouldn’t be your first thought.

Painkillers, oral contraceptive pills and the Mirena coil are all primary options.

Because the cause of the condition is still unknown, there’s not a lot out there other than hormonal treatments and very invasive surgeries.

Dr Mitra stresses that the initial options can be “quite life-changing for many women”.

They work by reducing the monthly thickening and shedding of the uterus – which is the main source of pain experienced by adenomyosis sufferers.

Unlike endometriosis, which can only be definitively diagnosed through a key-hole surgery, a diagnosis of adenomyosis can be done through both invasive and non-invasive methods.

The most common invasive method is a uterine biopsy (tissue sampling).

A biopsy of the uterus can also be performed to make the diagnosis by an abdominal key-hole surgical procedure (laparoscopy) but this remains limited to clinical trials.

Damaging

Biopsies going through the vagina up to the uterus may have a role in the diagnosis of adenomyosis, but can potentially damage the uterus and therefore are avoided in women wishing to fall pregnant.

Ultrasound is also commonly available and can be done either using the probe on the abdomen or, preferably, placing the probe in the vagina.

However, ultrasound isn’t always the best choice as it only detects adenomyosis about 50-87 per cent of the time.

Magnetic resonance imaging (MRI) is a better choice as there are a number of typical features seen during MRI.

These vary throughout the cycle and in response to hormonal therapy but can reliably predict adenomyosis.

There is some evidence adenomyosis can reduce fertility, but this is still controversial.

Clinical studies are limited by difficulties and differences in diagnosis and their study designs have problems.

Some MRI studies show changes consistent with infertility, but because patients presenting with infertility in their 30s and 40s are more likely to be diagnosed with adenomyosis, it’s difficult to say if adenomyosis is the cause of their fertility issues.

When couples are undergoing assisted reproduction (such as IVF) there is limited evidence to support a negative impact on oocyte and embryo quality, implantation and pregnancy rates.

Overall, there appears to be limited negative impact of adenomyosis on allowing the embryos to implant or overall pregnancy rates.

The post SYMPTOM CHECKER Heavy periods and painful sex could be caused by adenomyosis – the common condition is mistaken for endometriosis appeared first on MyMedicPlus.

Leila says she battled with her school for months before they finally agreed to help her. Now, she is encouraging other women with endometriosis to make their voices heard.

Around 120,000 women in New Zealand have endometriosis. The condition causes tissue similar to the lining of the uterus to grow outside the womb. It can cause extreme pain, vomiting, heavy bleeding and lead to infertility. Endometriosis affects roughly one in 10 women.

Leila, who didn’t want her last name used, was diagnosed with the disease at just 14 years old after suffering from painful periods for more than a year.

At first, her illness was manageable. She was getting good grades and attending school regularly. However, in 2019, she was very sick, so her doctors put her on a medication that mimics menopause. While this has helped with pelvic pain, it came with extreme fatigue and bone pain as a side effect. As a result, Leila has missed significant amounts of school. 

In an effort to keep up with her studies, Leila met with her school leaders multiple times asking for help, however, until November, she said they never offered her any. 

At one point the school agreed to speak with her teachers and come up with a plan for her, but never followed through, she said. 

“They would also make promises saying, ‘Oh we will get all the teachers together and get me some assistance’, but then we would ask them about it because it hadn’t happened, they would say, ‘They aren’t obligated to do that’.”

“They just started to give me the cold shoulder and I became a bit of a burden to them.”

Leila felt like they were “setting her up for failure” and ignoring how much she was struggling. “I would have loved their support.” 

She said the disease isn’t easy to live with and more awareness is needed over how incapacitating it can be. 

“It’s something that is kind of brushed under the rug because it’s not recognised as a debilitating disease.”

“Even when you’re off school they [her school] expect you to be mentally okay and able to do work at home, but I feel really nauseous and dizzy and I don’t really feel up for anything. That’s why I am off school, because I can’t perform how I normally would.”

People with endometriosis are eligible for special assessment conditions, according to the New Zealand Qualifications Authority (NZQA). For someone with endometriosis, special conditions may include taking assessments in a separate room or more frequent bathroom breaks. 

An NZQA spokesperson told Newshub students with endometriosis are also eligible for derived grades, which is where the school gives a student who has missed significant amounts of school a grade based on pre-existing tests, exams and work. 

Leila said her school never made her aware of the support that was available and only offered help after her mother got “upset” and confronted them. 

While things aren’t perfect, the school is now helping her in certain classes and making more allowances for her.

Leila is urging other students with endometriosis not to give up and to make sure they get the support they need. Although, she admitted it’s frustrating fighting to receive the help you are already entitled to. 

“Reach out to as many people as possible for help. Make sure you’re heard by your school, so they know how important education is to you, but [let them know] you may need some allowances made for you due to the symptoms of endometriosis.”

When Leila first started asking her school for help, it felt like her illness wasn’t being taken seriously and it seemed like they were trying to brush her off to avoid extra work.  

This was especially upsetting for the 16-year-old because her school regularly had endometriosis awareness talks. But she kept fighting and is encouraging anyone else going through something similar to do the same.

Ministry of Education deputy secretary sector enablement and support Katrina Casey told Newshub Leila’s situation “appears to be unusual”. 

Casey said schools take the health and safety of their students very seriously and the Ministry expects students with health conditions to be helped. 

“We expect schools to support children and young people with health conditions to have the same opportunities to participate in education as their peers. We recognise this can be challenging for schools and have prepared guidelines to help them do that.”

“The guidelines include information about drafting health care plans, handling medications and where to go for more information on specific conditions.”

Endometriosis New Zealand 

However, Endometriosis New Zealand CEO Deborah Bush said Leila’s struggle isn’t unique and is something girls all over the country are dealing with. 

Bush told Newshub endometriosis isn’t taken seriously across the board, with family members, schools and workplaces often failing to appreciate the severity of the disease.

“The general response to endometriosis might be to roll your eyes and say, ‘Suck it up and get on with it, many women before you have dealt with period pain’ but it’s actually so much more.”

“The impact on quality of life…one very common effect in young people is extreme fatigue and tiredness, so they don’t have to have advanced-stage disease to struggle with the challenges.” 

It is very common for women with endometriosis to miss school because of their illness, which can have serious impacts on their studies and careers. 

Bush said it is crucial that schools are aware and supportive of young girls who have endometriosis.

The post Kiwi student urging schools to take endometriosis seriously appeared first on MyMedicPlus.

A group of women in the Scottish Borders have joined together to raise awareness about an incurable condition that affects one in every 10 women in the UK.

Tao McCready set up the Endometriosis Awareness in the Scottish Borderssupport group to get people talking about the disease which can cause pain and even infertility.

She said: “I realised there was no support for girls who suffer with endometriosis. So I set it up, and it’s purely to support the women out there and let them know that there is a place that they can come and they can talk.”

The post Endometriosis support group set up in the Borders appeared first on MyMedicPlus.

Endometriosis is a disorder in which the tissues normally present inside the uterus, start growing in other parts of the body. Endometriosis most commonly occurs in other organs of the pelvic and reproductive organs — the ovaries, the exterior parts of the uterus, fallopian tubes. During the menstrual cycle, the hormonal changes in your body break down the tissues, which can cause you immense pain. It can also cause long-term painful adhesions or scar tissue during your periods. However, there are some effective methods by which one can minimise menstrual pain owing to endometriosis.

How to ease endometriosis pain?

Physical therapy

Physical therapies are very effective in reducing endometriosis pain. It is observed that endometriosis can affect the way your abdomen and pelvis work, and that can cause more pain. However, a physical therapist can get those areas to work right again.

Regular exercise

It is common to feel pain even if you are just lying down on the couch when suffering from endometriosis. But it is recommended by doctors to still practice regular exercise as it can make you feel better. You should not do extreme exercises, but can opt for walking, stretching, and breathing exercises that can ease your endometriosis pain.

Prefer a gluten-free diet

You might feel less endometrial pain if you follow a gluten-free diet. It is possible that it may not work on everyone, but the majority of women switch to it. You can try cutting wheat-based food and regular pasta from your diet. Instead, try eating corn pasta, rice, buckwheat, and lentils. It is advisable to talk to your doctor before you make any changes to your diet.

Take a nap

Women get tired very soon during endometriosis. Hence, to keep yourself fresh and alert, keep your sleep schedule consistent and listen to your body. It is good if you take short naps throughout the day, whenever you need one. It is observed by medical experts that a short mid-afternoon nap can keep your mood good during periods and make you more alert.

The post Endometriosis: Here Are Some Easy Ways That Can Ease Your Pain appeared first on MyMedicPlus.

More than 13,500 women have taken part in research revealing the devastating effect of endometriosis.

Half said they had had suicidal thoughts, and many said they rely on highly addictive painkillers.

Most also said endometriosis – involving painful periods – had badly affected their education, career and relationships.

MPs are to launch an inquiry into women‘s experiences of endometriosis following the research.

Women with the condition answered questions on how the condition has affected them. The charity Endometriosis UK helped gather the responses.

The condition affects one in 10 women and, as well as extremely heavy periods, can cause debilitating pain and sometimes infertility.

Bethany Willis, who lives in Essex, was one of those who took part in the research. She began having endometriosis symptoms aged just nine.

She knew what it was because her mum and grandmother also have the condition.

Now 19, Bethany says: “The pain is like barbed wire wrapped around your insides and someone‘s pulling it while at the same time an animal is trying to eat its way through you.”

At one point she was in so much pain that she took an overdose.

“I texted my boyfriend and said goodbye. I was ready to end my life there and then because of the pain.”

She was finally diagnosed this summer following surgery and – though still in daily pain – she is managing to cope.

“My mind is clearer and I have more energy, but the years of not being treated mean I‘ve had to drop out of veterinary school and my dream career,” she said.

Anna Turley MP, a member of the All-Party Parliamentary Group for Endometriosis which will carry out the inquiry, said: “It wasn‘t until I was hospitalised and had the diagnosis that I realised how little attention endometriosis receives, how limited research funding is, and how many women are misdiagnosed.”

She said the data gave “millions of affected women a voice” and the APPG would be calling on the government to act.

Tayla Marshall, 24, from Northamptonshire, is one of those who relies on pain relief to cope with her symptoms.

She has been through multiple operations and two chemically-induced menopauses and she is now addicted to strong opioid medication.

“I worry every day about my opioid intake. I take 50ml of morphine sulfate, Fentanyl patches, Naproxen and 30mg of amitriptyline and although I‘m not addicted in my mind, my body is physically dependant on this now.

“If I went a day without it, I would start to experience nasty withdrawal symptoms.”

Because her condition is so severe, Tayla is considering having a hysterectomy when she‘s 30.

“I have six years to try for a family,” she said.

“But my last relationship ended due to the impact of endometriosis. I wasn‘t able to be intimate with my partner very often, unless I was dosed up on medication.

“I am also in a position where I have reduced chances of falling pregnant naturally and carrying a baby.

“I have sort of managed to get my head around the idea of not having children but it breaks my heart every day.”

What is endometriosis?

Emma Cox, CEO of the charity Endometriosis UK, which helped gather the women‘s testimonies, said: “It cannot be overstated the devastating impact this condition is clearly having on people‘s physical and mental health.

“Without investment in research, a reduction in diagnosis time – which averages at a shocking 7.5 years – and better access to pain management, women will continue to face huge barriers in accessing the right treatment at the right time.”

Some women choose to undergo a hysterectomy and early menopause in a bid to stop their symptoms.

Michelle Middleton, 42, from West Yorkshire, recently underwent the operation to remove her ovaries, womb, fallopian tubes and cervix.

She says it is her last hope: “I just want rid of everything,” she said.

But she added: “The risk is that I‘m no better and that there‘s damage and it gets worse but you have to have hope.”

Minister for women‘s health, Caroline Dinenage said: “I urge clinicians to play their part in breaking down the ongoing stigma around endometriosis by ensuring they follow NICE guidelines and encourage employers to rise to the challenge by creating supportive and flexible ways to help those living with these conditions.”

The post Endometriosis: Thousands share devastating impact of condition appeared first on MyMedicPlus.

No woman looks forward to those days of the month . Most struggle with mood swings, swelling and cramping. But women with endometriosis often find that having the period is particularly unbearable. For them, an average period is anything but average, with debilitating cramps.

During a typical menstrual cycle, the inner lining of the uterus, the endometrium, accumulates and then breaks off with bleeding that occurs during menstruation. In women with endometriosis, that lining grows outside the uterus, usually around the ovaries or under the uterus in an area called posterior cul-de-sac . As it accumulates and breaks off, it causes small amounts of bleeding inside the pelvis. This leads to pain, inflammation, swelling and scarring.

If you think you might have endometriosis, you should know that you are not alone. The condition affects hundreds of thousands of women every year.

Five symptoms

At least there are five common signs of endometriosis. This is what you should keep in mind:

1. Painful periods. Most women have cramps during their periods, but women with endometriosis often have acute pain.

2. Chronic pelvic pain. Sometimes, women have chronic and severe pelvic pain, even when they don’t have their periods, says Christianson. This may be due to prolonged illness and scars.

3. Painful sex. This common symptom, also known as dyspareunia, is due to endometriosis under the uterus. During penetration, women may have severe and localized pain.

4. Cysts in the ovaries. These cysts, known as endometriomas, are another hallmark of endometriosis. They can become large and painful, and often need to be removed.

5. Infertility. Infertility is defined as not conceiving within a year, despite regular sexual intercourse without contraceptives. About 10 percent of women living with infertility have endometriosis. “This is the main cause of infertility because it can cause scar tissue, as well as damage and inflammation in the fallopian tubes, which are necessary to conceive naturally,” explains Christianson. “Research also shows that endometriosis can affect the quality of the ovules and reduce the amount of them in the body.”

The above symptoms are not exclusive to endometriosis. Painful periods do not always point to endometriosis; Sometimes they are a separate condition known as dysmenorrhea. Pelvic pain can also be caused by scar tissue, previous infections or a history of appendicitis. Irritable or inflammatory bowel syndromes can also cause pelvic pain.

Diagnosis and treatment

If you have any of the above symptoms, consult your gynecologist. Women with infertility may need to see a reproductive endocrinologist or a fertility specialist. Some doctors also specialize in pelvic pain and endometriosis.

To confirm a diagnosis, your doctor is likely to perform a minimally invasive laparoscopy. During this procedure, a thin, lighted tube will be placed in a small abdominal incision. This allows your doctor to see your pelvic organs and take a small amount of tissue for biopsy and make a diagnosis.

Often, symptoms can be controlled with medications such as birth control pills or leuprolide acetate. Both prevent the pituitary gland from releasing hormones that make endometriosis grow.

The post Period pains? It could be endometriosis appeared first on MyMedicPlus.

Orilissa (elagolix), an FDA-approved medication for managing endometriosis pain, lowers ovulation rates in a dose-dependent manner but does not seem to affect the amount of developing eggs in the ovaries — which is important for maintaining a woman’s fertility — a Phase 1 trial reports.

The study, “Elagolix suppresses ovulation in a dose-dependent manner: Results from a 3-month, randomized study in ovulatory women,” was published in The Journal of Clinical Endocrinology & Metabolism.

An oral medication, Orilissa was approved in the U.S. in July 2018 for the management of moderate-to-severe endometriosis pain, including painful periods (dysmenorrhea), painful intercourse (dyspareunia), and nonmenstrual chronic pelvic pain. It is sold by AbbVie and is available as 150 mg and 200 mg tablets.

The therapy works by dialing down the signals of gonadotropin-releasing hormone (GnRH), a hormone that stimulates the production of follicle stimulating hormone (FSH) and luteinising hormone (LH). In turn, these hormones stimulate the maturation and release of an egg during ovulation, and the production of estrogen in the ovaries.

Orilissa inhibits GnRH receptors in the brain’s pituitary gland — an organ that produces many of the body’s hormones — preventing FSH and LH production and lowering estrogen. This helps reduce inflammation and relieve pain.

Because estrogen makes endometrial lesions grow, lowering its levels is a common way to manage the symptoms of endometriosis.

Orilissa also is under development for the management of heavy menstrual bleeding associated with uterine fibroids.

In healthy, premenopausal women, a prior trial showed that Orilissa was well-tolerated and quickly brought down estrogen levels. This effect could be rapidly reversed after the women stopped taking the medication.

In a subsequent study, Orilissa doses higher than 100 mg twice daily led to such low levels of progesterone — an ovarian hormone that rises after ovulation to prepare the body for pregnancy — that it suggested ovulation was stopped. However, the study was too short to fully determine whether this really was the case.

To specifically address this question, AbbVie scientists — joined by researchers at the Eastern Virginia Medical School in Norfolk, Va. — conducted a trial in healthy women to characterize the effects on ovulation and sex hormones of different doses and dosing regimens of Orilissa.

The trial was a Phase 1, randomized, open-label study (NCT01403038) that enrolled 205 healthy, premenopausal women, ages 18 to 40 years, in the U.S.and Puerto Rico.

Orilissa pills were given during three 28-day dosing intervals (84 consecutive days) at 100 to 200 mg once daily, 100 to 300 mg twice daily, and 300 mg twice daily plus estradiol/norethindrone acetate (E2/NETA; brand names Activella and others) once daily. E2/NETA therapy consists of lab versions of estrogen and progesterone, and is used to treat menopause symptoms.

Throughout the study, ovulation rates — specifically, how many times each woman ovulated — were measured by transvaginal ultrasound, which uses an ultrasound probe placed inside the vagina, as well as blood levels of several hormones, including estradiol and progesterone. Estradiol is the main estrogen found in women.

The study confirmed that Orilissa suppressed ovulation in a dose-dependent fashion. The percentage of women who ovulated was highest at 100 mg daily (78%), followed by 150 and 200 mg daily, and 100 mg twice a day (47%-57%). It was lowest at 200 mg twice daily (32%) and 300 mg twice daily (27%).

Taking E2/NETA in addition to Orilissa further reduced the ovulation rate by 10%, but did not lower estradiol levels any further. Blood levels of progesterone also confirmed these results.

The treatment also lowered overall levels of LH and FSH, resulting in suppression of estradiol and progesterone in a dose-dependent manner. This supported the prior observations. It also made the uterus wall, called the endometrium, stay thinner throughout the menstrual cycle.

However, Orilissa did not seem to harm the ovaries’ pool of developing eggs than can be fertilized — known as the ovarian reserve. This was indicated by the levels of anti-Müllerian hormone (AMH), a hormone secreted by cells in developing egg sacs, which remained relatively stable throughout the study.

This finding is important for women’s fertility.

It suggests “that there was the continued growth of small follicles [ovarian structures where eggs develop] during the treatment period. Given that endometriosis and uterine fibroids are common in women of reproductive age, the rapid return of ovulatory function may be desirable in this population,” the researchers said.

After stopping treatment with Orilissa, normal menses took a maximum of 42 days to resume.

As for safety, 79% (162 of 205) of women experienced a treatment-related side effect. The most common were headache (25%), hot flush (23%), and nausea (19%).

Overall, the study shows that women with Orilissa have lower ovulation rates but may still ovulate. Thus, women using the medication “should use effective methods of contraception,” the researchers said.

The post Orilissa Lowers Ovulation Rates But Does Not Seem to Affect Ovaries’ Egg Supply, Phase 1 Trial Shows appeared first on MyMedicPlus.

Too many patients with endometriosis are being prescribed opioids and not enough people are aware. Not even physicians.

It first dawned on doctor Georgine Lamvu at a national conference for gynaecologic surgeons. As a specialist in chronic pelvic pain, she and her colleagues were conversing about the pros and cons of doing multiple repeated surgeries for those with endometriosis. 

‘Endo’, as it’s sometimes shortened, is a little-known, often painful disorder that occurs when endometrial-like cells grow outside the womb. Sometimes referred to as ‘the most common disease you’ve never heard of’, it impacts no less than 1 in 10 women and is one of the top three causes of female infertility worldwide.

Today, there is still no cure or long-term treatment for endometriosis; in many cases, surgeries are repeated with little to no relief. A potential drawback, Lamvu remembers saying at the conference, is that a lot of patients end up taking opioids.

“A surgeon blatantly said to me, ‘oh that’s not true, we don’t use opioids to treat patients with endometriosis’,” Lamvu told ScienceAlert.

“And I said, oh, well, that’s interesting. Why don’t I try and find out.”

It wasn’t so much a hunch, she says. Lamvu knew for a fact that opioids were commonly used to treat chronic pain patients outside her own practice, even though regulations are now stricter.

Over the years, opioids have become one of the most common treatments for chronic pain in the US. And while they might be useful for short and acute cases, their efficacy in the long run is currently under intense scrutiny.

Today, despite scientific evidence suggesting opioids are ineffective at treating chronic pain, 92 percent of physicians and patients believe these drugs help reduce pain, and 57 percent report a better quality of life.

When as many as 19 percent of those who are prescribed long-term opiates abuse the drug or become addicted, it’s no surprise that many chronic pain patients are wrapped up in the opioid crisis.

“It almost seemed inconceivable to me that endometriosis patients with chronic pelvic pain would somehow be spared the opioid epidemic,” Lamvu told ScienceAlert.

“It just didn’t really make sense, even though it’s what this colleague of mine was saying.”

Her deep dive into the issue, published in Obstetrics & Gynecology in June this year, confirmed her worst suspicions: too many people with endometriosis have been taking prolonged opioids for their chronic pain. To her knowledge, it’s the largest sample size to date, drawing on publicly available insurance data from 53,847 endometriosis patients and 107,694 others without the disease.

From 2006 to 2016, Lamvu and colleagues found women with endometriosis were nearly three times as likely to fill an opioid prescription, compared to the control group. And while Lamvu admits she has no evidence any of these patients are addicted or dying from narcotics, she sees the pattern as a big problem.

In the findings, patients with endometriosis were nearly four times as likely to fill a larger dose of opioids, equivalent to some 100 milligrams of morphine or more. According to the US Federal Drug Administration (FDA), that’s a large enough amount to cause an overdose if taken by someone who isn’t regularly taking opioids.

What’s more, the data reveal that these patients, aged anywhere between 18 and 49 years, were also more likely to use opioids for over a month, and at the same time as benzodiazepenes – a combination that is 10 times more likely to lead to a fatal overdose.

Similar results were found even after excluding prescriptions specifically for surgery.

“I was surprised by the magnitude of the numbers, I can’t lie about that,” Lamvu admits. “I thought we would see a difference but I just didn’t think it would be this.”

The problem appears to start straight away. Within seven days of being diagnosed with endometriosis, her team found more than a quarter of endo patients filled an opioid prescription.

The results are consistent with a 2018 survey from the American College of Obstetricians and Gynecologists (ACOG), which found almost a quarter of ob-gyns nationwide were prescribing opioids to patients with endometriosis.

But while there’s some other research out there looking at chronic pelvic pain and opioid rates, Lamvu and her team’s research is one of the first to look at endo specifically.

“Although these well-insured study participants may not represent the entire US female population, their prolonged opioid use despite evidence of little or no therapeutic benefit is astonishing,” writes reproductive endocrinologist Robert Rebar from Michigan State University in a review of the team’s study.

People with endometriosis might very well be hidden figures in the opioid epidemic; we just don’t have the data to say for sure. And much of what we do know is anecdotal.

In his decades of experience treating gynaecologic diseases, Serdar Bulun from Northwestern University told ScienceAlert he has seen at least two or three high-school age teenagers who were addicted to opioids when they came to him, and who had been using these narcotics for a year or more.

He himself does not prescribe opioids for chronic pelvic pain, and he suspects these patients were first given the drugs in an emergency room. A good number, he says, go to the local hospital when they experience intense pelvic pain, usually because they can’t get in to see their gynaecologist right away.

In these urgent situations, doctors might see a narcotic as the only option. Encouraged by the pain relief, patients might later go to their regular doctor and ask for more, he suggests.

“I presume it must be an issue,” Bulun told ScienceAlert. “I don’t know what the magnitude is.”

One young patient, he recalls, was on such strong pain killers, she was finding it hard to concentrate in her high-school class. And yet, in the end, nothing else was helping her cope.

That’s the saddest part for Lamvu: the sheer lack of alternatives for desperate patients and for physicians who desperately want to help. As an expert on pelvic pain, she laments the fact we’ve spent two or three decades on one class of pain medication, at the expense of further research on such a common pain disorder.

Today, for the average patient, arriving at a diagnosis of endometriosis takes more than four years; by that time, all a person wants is some sort of relief.

“We’ve done a disservice to our patients, because we’ve basically said, well, you need a surgery. And then if that doesn’t work, pain management, and if that doesn’t work, then opioids.”

Sawsan As-Sanie, a chronic pelvic pain specialist at the University of Michigan, is now building on Lamvu’s findings. Her research has not yet been published, but she told ScienceAlert that her preliminary results suggest a very high prevalence of opioid prescriptions are being given to patients with endometriosis.

A large portion of these are not related to surgery, and a small but worrying subset of patients are taking prolonged high doses.

“I’m not necessarily surprised because it’s frankly not different to what we see in other chronic pain populations,” As-Sanie told ScienceAlert, “but I think it does bring light to the fact that even amongst patients where we have an identifiable cause for their pain, they are still being prescribed opioids that we know can be very dangerous.”

Few healthcare providers are adequately trained to diagnose or manage endometriosis, she says, and far fewer take the time to properly educate their patients about pain management or set their expectations – even though a recent study by her team has actually shown that such information can decrease opioid use after hysterectomies.

In 2017, ACOG reported that up to “63 percent of general practitioners feel uncomfortable diagnosing and treating patients with endometriosis, and as many as half are unfamiliar with the three main symptoms of the disease.” In another study, published that same year, some clinicians were found to be so ill informed, they thought endometriosis was caused by poor mental health.

As such, As-Sanie urges those with endometriosis to work with their primary care physicians and find a gynaecologist who listens to their concerns and fully understands all the available options, whether medical, surgical or pharmacological.

There’s not just one treatment that fits all, she says. And patients deserve safe, effective, non-addictive strategies to manage their chronic pain.

The post The ‘Most Common Disease You’ve Never Heard Of’ Is Being Handled With Dangerous Drugs appeared first on MyMedicPlus.

Women with endometriosis in Australia using cannabis on their own to manage their disease report its use helps to ease pain and other symptoms like nausea, with very few side effects, a study based on an online survey reports.

The study, “Cannabis Use, a Self-Management Strategy Among Australian Women With Endometriosis: Results From a National Online Survey,” was published in the Journal of Obstetrics and Gynecology Canada.

Severe chronic pelvic pain that significantly affects quality of life is well-reported in endometriosis.

Non-surgical treatments for this disease include combined oral contraceptives or progestins alone and non-steroidal anti-inflammatory drugs, among other options. However, these therapies are limited in their effectiveness, and discontinuation rates range between 25% and 50% due to side effects.

Opioids are commonly prescribed for pain, but carry a high risk of dependency and a potential for overdose.

Due to these limitations on existing medical treatments, women with endometriosis are increasingly turning to self-care or lifestyle interventions for symptom relief. More research is needed, the study said, into the effectiveness of these self-management strategies.

But preliminary studies suggest that cannabis, which acts via the endocannabinoid system (ECS), can help manage pain in women with this disease.

“Cannabis has a long history of use in the ancient and scientific literature for various conditions such as period pain, however until now nothing has been investigated for cannabis being used for endometriosis,” Justin Sinclair, the study’s lead author, an NICM Health Research Institute Research Fellow and coordinator of the Australian Medicinal Cannabis Research and Education Collaboration, said in a press release.

Researchers designed an online survey targeting Australian women with surgically confirmed endometriosis to determine the prevalence of cannabis use, its cost, tolerability, their opinions of its effectiveness, and possible changes they have made in pharmaceutical treatment use.

“Past research has demonstrated that certain compounds within cannabis known as cannabinoids exert analgesic and anti-inflammatory activity. Our research sought to determine the prevalence, tolerability, and self-reported effectiveness of cannabis in women with endometriosis,” Sinclair said.

A total of 484 responses were analyzed, among which 76% of women reported practicing general self-management strategies in the previous six months.

Among these people, 13% (48 women) reported using cannabis for symptom control, and most likely it was not approved medical cannabis, the study noted.

“Medicinal cannabis regulations in Australia were introduced in December 2016, but few prescriptions of standardized, quality-assured medicinal cannabis in this pathway have been dispensed,” the researchers wrote. “[I]t is likely that most, if not all, of the women in this survey were using illicit cannabis,” and this raises serious concerns as to “quality control and potency.”
Survey responders rated cannabis’ effectiveness on pelvic pain at 7.6, on a zero to 10 numeric rating scale with 10 being most effective. Twenty-seven of these women, 56%, reported its effectiveness allowed them to cut by at least half their pharmaceutical medication use.

Women reported the greatest improvements were in sleep, nausea, and vomiting. Side effects were found to be infrequent (10%) and minor, particularly when compared to adverse event reporting for non-steroidal anti-inflammatory drugs (11%−14%) and opioid-based medications (78%).

“Women report good efficacy of cannabis in reducing pain and other symptoms, with few adverse effects reported,” the researchers wrote.

As studies have found a high number of cannabinoid receptors (which cannabis binds to) in the female reproductive system, it is plausible that cannabis can help biologically alleviate endometriosis symptoms.

But Sinclair cautions that cannabis use is not without risk.

“One in ten women in the study who used cannabis reported an undesirable effect such as drowsiness, rapid heartbeat, or increased anxiety,” he said.

And, again, while Australian women with endometriosis report using cannabis quite commonly, it likely was not via prescription.

“Due to the timing of when the survey was administered, most if not all of the women in the survey would have been using illicit cannabis as access to medicinal cannabis was still in its infancy,” said Mike Amour, MD, with the NICM Health Research Institute and the study’s chief investigator.

“This means we don’t have any information about the different varieties of cannabis that women were using, or what might have been in the cannabis that was being used as it was derived from illicit sources which are not quality assured,” he said. “Also, this was a self-reported survey, which can lead to over or under estimation of the positive or the negative effects.”

The scientists add that further clinical research is warranted to determine the effectiveness of cannabis in managing endometriosis’ symptoms.

The post Cannabis Use Eases Pain and Other Symptoms of Endometriosis, Survey of Women in Australia Reports appeared first on MyMedicPlus.

Andrea Long Chu is a writer who has thrown the world of homosexual and transgender activism into disarray with her 2018 essays in n+1 and The New York Times, and now in her new book, “Females,” in which she argues that gender is not who one is but what one wants. Chu is a biological male who identifies as female and has undergone sex reassignment surgery. Chu has outraged feminists (this goes double for lesbian feminists) by embracing so many of the “traditional” (which is to say “stereotypical”) notions of femininity that feminists of all stripes have decried for decades as artificial constructs imposed by the desires of men. In particular, Chu has invited the ire of TERFs (“trans-exclusionary radical feminists”) for suggesting (as a New Republic interview with her is titled), “We are all female now.”

To read Chu’s essays — as well as those of her critics — is to find oneself immersed in a maelstrom of philosophical and political debates about women, women, women. But what’s left unspoken is what all of this obsession with sexual identity and transition says about our society’s view of men.

I am tempted to make a sweeping denunciation of our society’s pathological need to eradicate men and masculinity. Oh, there is definitely a movement afoot to do just that. But in fact, it isn’t “society” as a whole pushing this agenda. It is a small, brittle crust of malcontents who cast themselves as the cultural elite, and who develop theories and spearhead movements as a way of making themselves feel important — or at least validated.

If this were the extent of their impact, they would only warrant our pity. But they have hundreds and thousands of enablers and water carriers throughout academia and the media who refuse to challenge their patent absurdities, who promote and praise the nonsense in order to themselves be thought intellectual and avant-garde.

In academia and literary circles especially, bizarre, counterintuitive, unproven and completely unscientific “theories” like those espoused by Chu and many others enjoy broad acclaim. And it is a much larger problem than just sexual identity politics, as scholars and authors Peter Boghossian, James Lindsay and Helen Pluckrose revealed in the expose they published in Areo magazine last year.

The three authors submitted for publication in peer-reviewed journals a series of deliberately absurd, counterfactual, wholly unresearched articles worded in gobbledygook academe-speak. A shocking number of them were accepted for publication.

Why does this matter?

“(T)here is a problem in our universities, and … it’s spreading rapidly into culture,” say Boghossian, Lindsay and Pluckrose. “Radical constructivism is … a dangerous idea that … we must, on moral grounds, largely reject the belief that access to objective truth exists.”

The post There IS a War on Men. Fight Back appeared first on MyMedicPlus.

Lorena Beatriz was 23 when an ultrasound to check for endometriosis revealed her ovaries were abnormally small.

After her doctor advised her to stop taking the contraceptive pill, her menstrual cycles ceased.

What followed was an onslaught of perimenopausal symptoms; hot flushes involving a burst of intense heat that would start in her face and spread through her body, fatigue, mood swings and vaginal dryness.

The post ‘My first reaction was to cry’: Lorena showed signs of menopause at 25 appeared first on MyMedicPlus.

The post What is endometriosis and how can the Government help? appeared first on MyMedicPlus.