Hypertension is assumed to be more prevalent in the male population. However, experts suggest that it affects both the genders equally.

A recent study published in the Journal of Hypertension indicates that there is a direct association between social ties and risk of hypertension in women. The longitudinal study including more than 28,000 people between the ages of 45 and 85 years found that women with a small social circle and limited social participation (less than two social activities in a month) are more likely to get hypertension than women who had better or more social interactions. Hypertension risk was also found to be higher in widowed women than married women.

Hypertension (high blood pressure) is assumed to be more prevalent in the male population. However, experts suggest that it affects both the genders equally. In fact, after a certain age, women are more prone to the condition than men and the former have several very unique risk factors for high blood pressure both in the pre and post-menopausal age.

Unique risk factors

According to the American Heart Association, high blood pressure is not directly related to gender. However, pregnancy, menopause and use of birth control pills are some unique factors that put women at a higher risk of hypertension.

Research suggests that women who smoke, have a genetic predisposition to hypertension or are overweight are highly likely to have high blood pressure on regular use of birth control pills.

Similarly, pregnant women often experience high blood pressure. If you have had a history of hypertension, you may have to consult your doctor before trying to conceive since high blood pressure can harm both the baby and the mother.

Gestational hypertension develops after 20 weeks of pregnancy; you may develop this type of hypertension even if you never had the condition before. And then there is pre-eclampsia, a pregnancy complication wherein the woman has high blood pressure and limb swelling and protein in urine. Pre-eclampsia can be life-threatening for the mother and preterm delivery is the only way to resolve it.

Finally, after menopause, when the estrogen levels drop, a woman’s chances of developing hypertension increases significantly. Studies suggest that a combination of various factors including individual genetics, body mass index (BMI) and increased sympathetic nervous system activity are responsible for this spike in risk. The sympathetic nervous system is responsible for the flight and fight response. It increases blood pressure, decreases intestinal motility and accelerates heart rate.

Difference in symptoms

As per the European Society of Cardiology, hypertensive women experience more arterial stiffness, atrial fibrillation and heart failure in older age than hypertensive men. Since they have a smaller diameter of arteries, aneurysms in women rupture at a much smaller size than in men.

Hypertension is said to be a silent killer. Usually, it does not show any symptoms unless there is organ damage. However, in some young and middle-aged women, the condition can also be symptomatic. Such women report some of the following symptoms:

• Headache
• Blurred vision
• A feeling that the bra is too tight
• Chest pain due to stress or continuous pain in chest that often travels up the shoulder and left arm or jaw
• Hot flushes
• Excessive sweating day and night
• Sleep disturbance
• Tiredness

A lot of these symptoms are associated with stress or menopause. Experts suggest that if you notice these symptoms, it is best to consult a doctor, especially if you have a family history of hypertension.

For more information, read our article on High blood pressure.

Health articles on News18 are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.

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Zinc is essential for you health for several functions. When not consumed in optimum levels, you may experience several side effects. Here are some of these you need to know. also know food sources and when to take supplements.

Zinc is an important mineral that your body requires for several body functions. It helps in ensuring the healthy functioning of the immune system and supports metabolic function. It also helps in healing wounds. Zinc is also beneficial for your skin and reduces inflammation. Adding enough zinc to diet also helps reduce the risk of age-related diseases. Zinc deficiency is quite common but many are unable to detect it. Severe deficiency of zinc is not so common. But there are certain signs and symptoms that one may experience when suffering from zinc deficiency. In this article, you will know about the signs and symptoms of zinc deficiency, daily requirement and food sources.

Zinc deficiency: Signs and symptoms

When your body has low levels of zinc you may experience symptoms like-

• Slow healing of wounds
• Unintentional weight loss
• Reduced sense of smell and taste
• Not feeling hungry
• Diarrhea
• Open sores on skin
• Hair fall
• Constant tiredness and fatigue

Also read: 3 Nutrients That Can Prevent Nausea, Headaches And Migraine On Keto Diet

Daily requirement

According to the National Institutes of Health, an adult male requires 11 mg of zinc in a day whereas a female requires 8-9 mg per day. During pregnancy, women should consume 11 mg. Mothers during lactation period must add 12 mg to their daily diet.

Also read: Inflammation Prevention, Wound Healing And Building Immunity- Reasons Why You Need Zinc

Zinc food sources

Zinc is present in several foods. Some of the best sources are- meat, legumes, shellfish, seeds (hemp seed, flaxseeds and pumpkin seeds), nuts (cashew), eggs, whole grains, dairy products, dark chocolate and vegetables like potato.

Also read: Zinc: Why You Need It And Foods That Contain Zinc

You may consult an expert if you are experiencing symptoms of zinc deficiency. Do not add supplements to your diet without your doctor’s recommendation.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

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The leading cause of snoring in infants is a stuffy nose, but there are other reasons that could cause your child to snore. Here they are.

Parenthood, especially for first-time parents, can be tough with a lot of endless things to worry about. There’s already a ton of things that you find yourself anxious over, from the right diapers to buy, to whether your baby is well-fed, to how to fix sleepless nights and constant crying, to whether your little one is achieving their milestones or whether you’re doing enough as a parent while still meeting your own personal goals. Another thing that you may find yourself worrying about is baby snoring. On the surface, these noises may sound unanticipated or even troublesome. So, you’ll often wonder, are these noises normal? Should you rush your baby to the hospital? Continue reading to find out more about baby snoring.

You may be surprised by how something so small can produce such loud, unexpected sounds. However, these snores won’t sound like those of a grown-up. It won’t be that low, grumbly, rough kind of snore. It will sound more like a soft sound. So, it may sound musical, like whistling, bubbling, snorting, or snuffing. These sounds may increase if your baby has nasal allergies or a cold-just like it does for you.

Is Baby Snoring Normal?

For newborns, snoring is completely normal. Newborns have small nasal passages and excessive mucus build-up, which can make them snore. The good thing is that they eventually grow out of it. Usually, babies will breathe noisily, but mainly so when asleep. This breathing usually sounds like a snore and may actually be a snore. No need to worry as these noises are just an indication of a typical benchmark for growth. Snoring in babies is the sound produced when the soft tissues of your little one’s airways vibrate, and it is normally nothing that you need to stress over. There are, however, other factors that may lead to baby snoring.

A Stuffy Nose

The leading cause of snoring is a stuffy nose. Saline drops can quickly clear up nasal blockage. However, this should subside with time, as their nostrils get bigger. Still, there are other reasons why your baby’s nose may be stuffed.

RELATED: A White Noise Machine Could Solve Your Baby’s Sleeping Problems

Other Reasons For Your Baby’s Snoring

Loud baby snoring can be caused by a couple of other factors, including:

• Allergies or upper-respiratory infections. Occasional snoring occurs when your baby has the flu, cold, or seasonal allergies. This is because the little one’s nose gets stuffy, forcing him or her to breathe through their mouth, increasing snoring chances.
• A deviated septum. This may be a significantly prevalent occurrence during the first days after the baby is born, occurring in up to 20% of newborns, according to this study. Most newborns will show no symptoms from a deviated septum, and it should go away with time.
• Sleep Apnea. Sleep apnea, otherwise known as Obstructive Sleep Apnea Syndrome (OSAS), is a more serious condition. It is caused by your infant’s airways being narrower than usual, or they get partly closed, mostly because of swollen tonsils or adenoids causing your baby to literally stop breathing for a couple of seconds or longer. An alarm is sounded in the brain, telling her body to begin breathing again. So, she will gag or snort, wake up for a while and begin to breathe again. Such cycles of disruptions in sleep can prevent your baby from getting adequate sleep.
• Inflated adenoids or tonsils. These structures are intended to protect your baby from infection. They do this by trapping inhaled bacteria and viruses. However, in the process of doing so, they could get infected and swell, blocking airflow as the baby sleeps.

What Are The Remedies For Baby Snoring?

1. Nasal Aspirator – You can use an aspirator to suction the excess mucus out. While it may seem gross, it will easily clear your baby’s breathing.
2. Nasal Spray – Once your pediatrician gives the go-ahead, you can get a nasal spray to open up your little one’s nasal passages, helping her breathe easier. Alternatively, you can purchase an over-the-counter spray approved for infants in most pharmacies.
3. A Humidifier – Humidifying the air in your baby’s room using a humidifier or warm mist vaporizer will help reduce the snoring. Identically, you can loosen the secretions by giving your baby a warm shower or bath, allowing your little one to sleep better.
4. Sleeping Position – The position in which your baby sleeps may cause snoring. Sleeping on the back or stomach will most likely cause snoring. However, sleeping on the side can be dangerous for babies. Not unless they can sleep on the side naturally. So, you can elevate her head using a pillow, depending on their age. Alternatively, you can wait it out! Just let your toddler sleep on her back even though it causes a little snoring.

When Should I Visit A Doctor?

There’s no need to visit a doctor if your baby snores for a couple of days when sick and experiencing a stuffy nose or congestion. However, if your baby snores excessively, to the point where they cannot sleep, it’s advisable that you visit their pediatrician. However, most cases of baby snoring just go away on their own.

The post Baby Snoring: Causes, Symptoms, And Treatment appeared first on MyMedicPlus.

SUPPLEMENTS could be used to lower your risk, or even prevent some high blood pressure symptoms. This is useful and natural remedy to avoid the deadly signs and symptoms of hypertension. Should you consider adding vitamin C supplements to your diet, to prevent high blood pressure?

High blood pressure is a common condition that affects more than 25 percent of all adults in the UK. But you could lower your risk of developing hypertension by simply taking daily vitamin C supplements, it’s been claimed.

Hypertension puts extra stress on blood vessels and vital organs.

Eating an unhealthy diet or not doing enough regular exercise could be raising your chances of high blood pressure.

But you could lower your chances of developing the condition by taking supplements, scientists have claimed.

One of the most effective remedies for hypertension is vitamin C supplements, it’s believed.

Vitamin C helps to maintain blood vessels’ elasticity, which has a subsequent effect on blood pressure, according to nutritionist Dr Sarah Brewer.

Arteries that aren’t very elastic increase the risk of hypertension.

Regularly taking vitamin C supplements could lower your blood pressure by as much as 3.8/1.5mmHg, if you already have hypertension.

The European Union recommends taking no more than 80mg of vitamin C every day.

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“Vitamin C is a useful natural remedy for high blood pressure,” she wrote on her website, MyLowerBloodPressure.com.

“It is needed for collagen formation which allows blood vessels to function normally and retain their strength and elasticity.

“As vitamin C is a water-soluble vitamin, it cannot be stored in the body and a regular intake is essential.

“Dietary sources include most fruit and vegetables including citrus, berries, blackcurrants, capsicum peppers, kiwi fruit and green leafy vegetables.”

Vitamin C helps the body to keep its cells healthy, while also maintaining the health of skin and bones.

Without enough vitamin C in your diet, you may be at risk of scurvy.

The most common vitamin C deficiency symptoms include having rough or bumpy skin, easily bruising, and even having corkscrew-shaped body hair.

Speak to a doctor if you’re worried that you may have a vitamin C deficiency.

Meanwhile, it’s not always easy to know if you have high blood pressure, which is why it’s often known as ‘the silent killer’.

But some of the earliest symptoms of hypertension include severe headaches and unexplained dizziness.

Everyone over 40 years old should check their blood pressure at least once every five years.

Speak to a doctor or pharmacist to have your blood pressure checked.

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Kidney stones are mineral deposits that form in the kidneys. They can vary in size, with some being as small as a grain of sand, and others being as large as a pebble. The size of the kidney stone does not always correspond to the severity of the symptoms a person might experience.

Small kidney stones may pass through the urinary tract without causing any symptoms. However, larger stones may become stuck in the urinary tract. This is usually the point at which a person will experience the first signs and symptoms of a kidney stone.

This article outlines the early signs and symptoms of kidney stones. We also discuss the causes of kidney stones, as well as their potential complications.Early signs and symptoms

The post What symptoms do kidney stones cause? appeared first on MyMedicPlus.

HIGH BLOOD pressure is medically known as hypertension and having the condition puts a person at risk of having a heart attack or stroke. There is a lesser known condition known as secondary hypertension, which can also result in some life-threatening complications. What is it and what are the symptoms?

Blood pressure is the pressure of blood in the arteries which are the vessels that carry blood from the heart to the brain and the rest of the body. A person needs a certain amount of pressure to get the blood moving around the body. Blood pressure naturally goes up and down throughout the day and night and it is normal for it to go up while one is moving about. However, it’s when the overall blood pressure is consistently high, even when resting, that it becomes concerning.

Secondary hypertension is high blood pressure that’s caused by another medical condition.

Secondary hypertension can be caused by conditions that affect the kidneys, arteries, heart or endocrine system.

The condition can also happen during pregnancy.

Secondary hypertension differs from the usual type of high blood pressure which is often referred to simply as high blood pressure.

Primary hypertension has no clear cause and is thought to be linked to genetics, poor diet, lack of exercise and obesity.

Similar to primary hypertension, secondary hypertension usually has no specific signs or symptoms, even if the blood pressure has reached dangerously high levels.

If a person has been diagnosed with high blood pressure, having any of these signs may mean the condition is secondary.

hese include high blood pressure that doesn’t respond to blood pressure medications, very high blood pressure, high blood pressure that no longer responds to medication that previously controlled the blood pressure, sudden-onset high blood pressure before age 30 or after age 55, no family history of high blood pressure and no obesity.

In a study with Singapore Medical Journal, secondary hypertension in adults was investigated.

The study noted: “Secondary hypertension occurs in a significant proportion of adult patients.

“Recognition, diagnosis and treatment of secondary causes of hypertension lead to good clinical outcomes and the possible reversal of end-organ damage, in addition to blood pressure control.

“Left undiagnosed, secondary hypertension can lead to resistant hypertension, cardiovascular and renal complications.

What are the causes of secondary hypertension?

Mayo clinic said: “A number of conditions can cause secondary hypertension.

“Several kidney diseases may cause secondary hypertension and these include diabetes complications, polycystic kidney disease, glomerular disease or renovascular hypertension.

“Renovascular hypertension is often caused by the same type of fatty plaques that can damage the coronary arteries or a separate condition in which the muscle and fibrous tissues of the renal artery wall thicken and harden into rings.

“This condition can cause irreversible kidney damage.”

The greatest risk factor with secondary hypertension is having a medical condition that can cause high blood pressure, such as kidney, artery, heart or endocrine system problems.

Secondary hypertension can worsen an underlying medical condition a person may have that’s causing their high blood pressure.

If a person doesn’t receive treatment, secondary hypertension can also be associated with other medical conditions.

These include damage to arteries, aneurysm, heart failure, weakened and narrowed blood vessels in the kidney, thickened or torn blood vessels and trouble with memory or understanding.

If you suspect you may have secondary hypertension, speak with your GP about the best next steps to take to help better manage the condition.

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High blood pressure is one of the conditions that could literally affect your daily routines. The symptoms of high blood pressure can be debilitating; you might end up staying at home all day. Some patients immediately notice the various symptoms, which is why they’re also able to find the proper treatment right away.

However, there are instances when you might already be experiencing the symptoms, and yet you are not even aware that it signals high blood pressure. One of these symptoms is swelling of your ankles.

How It Affects the Ankles

According to an explanation in Express, your ankles could warn you of high blood pressure. This condition makes the heart work harder every single day. Over the course of time, the heart could no longer pump enough blood to reach the different parts of the body. The heart muscle has now thickened and has become less effective at pumping the blood all over the body.

Because of this, fluids would start to build up in different areas of the body. The lower legs would start to suffer from it, the same with the ankles. These parts would start to swell up. The failure of the heart to pump blood more effectively is a long-term result.

There are cases when the swelling could be caused by taking in blood pressure medicines like the calcium channel blockers. These medicines make your blood vessels open wider so as to allow a better flow of blood and decrease the pressure. However, there are patients that would experience having more fluid to leak out of the blood vessels and into the tissues.

The fluid would start collecting around your ankles, causing them to swell. Aside from high blood pressure, swelling of the ankles could also be a result of kidney failure, heart disease, and also liver disease.

Should You Worry?

During the early stages, having swollen ankles can cause some discomfort, but the problem can’t be touted as a serious one. However, if the condition is not treated and is left as it is overtime, you might face serious health issues. This would start to put unwanted pressure on the tissues and the blood vessels. Some of the problems caused by swollen ankles include varicose veins, cellulitis, and venous ulcers.

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It is possible to improve symptoms in autistic children with a cheap generic drug, our latest study shows. The drug, bumetanide, is widely used to treat high blood pressure and swelling, and it costs no more than £10 (US$13) for a month’s supply of pills.

Autism is a neurodevelopmental disorder which is more common in boys than girls. According to the World Health Organization, 1-2 percent of people have the condition.

Autism can be diagnosed as early as two years old or even at 18 months. Children with moderate or severe autism can find social situations difficult. They may not make eye contact with their parents or take part in cooperative play and conversation.

They may also show repetitive behaviour and have an intense interest in objects. This behaviour not only affects engagement in family activities but can also make it harder for them to make friends at school.

International study

We were motivated to test bumetanide as a result of background findings which suggested that the drug changed important brain chemicals in mouse models of autism; and also by some studies, including in autistic teenagers, showing that bumetanide may have beneficial effects.

Our research group, an international collaboration between researchers at several institutions in China and the University of Cambridge, wanted to focus on young children with moderate and severe autism and to test whether bumetanide could improve their symptoms.

We also wanted to understand the mechanism by which the drug achieved this. Understanding how bumetanide worked could lead to future drug development to treat moderate and severe autism.

There were 81 children with moderate to severe autism in our study – 42 in the bumetanide group, who received 0.5mg of bumetanide twice a day for three months; and 39 children in the control group, who received no treatment. The children were three to six years of age.

Some of the children had their brains scanned using magnetic resonance spectroscopy (MRS) – 38 in the bumetanide group and 17 in the control group.

MRS is a non-invasive way of measuring chemicals in the brain. For our study, we measured brain chemicals called GABA and glutamate, which are important for learning and brain plasticity (the brain’s ability to change and adapt as a result of experience).

In the bumetanide group, autism symptoms improved as measured by the childhood autism rating scale (CARS) and also by a doctor’s overall impression. The doctors who were assessing symptom change were “blind” to treatment – that is, they were unaware of who was receiving bumetanide.

Improvements in symptoms were associated with changes in the brain chemicals GABA/glutamate ratios and, in particular, with decreases in GABA.

Looking specifically at what improved on the rating scale, we found decreases in repetitive behaviour and decreased interest in objects. These reductions in unsociable behaviour allow more time for increases in social behaviour.

One of the mothers of a four-year-old boy, living in a rural area outside Shanghai, said that her child, who was in the bumetanide group, became better at making eye contact with family members and relatives and was able to take part in more family activities.

We also found that the drug is safe for young autistic children and has no significant side-effects. Bumetanide could improve the quality of life and wellbeing of autistic children.

Existing treatments are predominantly behavioural, including Applied Behaviour Analysis or ABA. Most families, particularly those in rural areas, will have limited or no access to these treatments, which are generally only available in specialised centres. The use of bumetanide would mean that there would even be a treatment for autistic children living in rural areas.

This study is important and exciting because bumetanide can improve social learning and reduce autism symptoms when the brains of these children are still developing. We now know that human brains are still in development until late adolescence and early adulthood.

Further research is now needed to confirm the effectiveness of bumetanide in treating autism. 

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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.

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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.”

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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.

Endometriosis, a gynecological condition affecting the lower abdomen or pelvic area, has a reputation for being super painful. You might assume that if you had it, you’d know it.

Or would you? Maybe not. This common condition doesn’t always make itself known with red flags and flashing lights.

We talked to reproductive endocrinologist Marjan Attaran, MD, to find out what women should know about the signs and symptoms of endometriosis.

1. Period pain is the biggest clue

Endometriosis occurs when fragments of the tissue that lines the uterus go rogue, growing in places they don’t belong. Those cells can glom onto the ovaries, fallopian tubes or intestine. During your period, those tissues bleed, which may trigger pain and swelling.

“The classic symptom of endometriosis is terrible period pain that doesn’t go away with birth control pills or anti-inflammatory medications like ibuprofen,” Dr. Attaran says. But not all women with endometriosis have horrible cramps. And not all women with horrible cramps have endometriosis. Intense period pain is a tip-off, not a smoking gun. 

2. Endometriosis pain can be fickle

Most often, endometriosis pain crops up low in the pelvis, Dr. Attaran says. But women can have very different experiences. Some describe the pain as sharp. Others experience a dull ache. Cramps might squeeze just one side of the pelvis, or both, or they might move from side to side. (See what we mean about fickle?)

3. Sex might hurt

Many women with endometriosis experience a “deep” pain during or after sex.

4. Stomach problems are common

If cramping wasn’t enough,women with endometriosis sometimes have digestive problems, too. These can include nausea, diarrhea, constipation or bloating, especially during that (least favorite) time of the month.

4. Some women have no symptoms

Just because you don’t have excruciating cramps during your period doesn’t mean you can rule out endo. Some women with the condition have mild symptoms, or even no symptoms at all, Dr. Attaran says.

The symptoms you experience often get worse over time. You might not see any signs until your late 20s, 30s or even 40s. “People don’t wake up one day with all of these symptoms,” she says. “They usually develop slowly as time goes by.”

5. Trouble getting pregnant

If you’ve tried unsuccessfully to get pregnant, mild endometriosis might be involved.

Diagnosing endometriosis would be a lot easier if there were red flags. But for many women, it’s more of a gray area. “It’s a frustrating disease,” Dr. Attaran says. “But if you have symptoms, it’s worth following through to get the diagnosis so you can be active about managing the disease.” 

The post Endometriosis Symptoms: Red Flags or Gray Areas? 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.

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