¿Qué es la fibromialgia?
La fibromialgia es una condición que causa dolor en los músculos, articulaciones, ligamentos y tendones. El dolor ocurre en áreas llamadas lugares agudos. Los lugares sensibles más comunes son en frente de las rodillas, los codos, las articulaciones de las caderas y alrededor del cuello.
Fibrositis afecta al 5% de la población, incluyendo niños. Este desorden es hereditario, así que puede tener miembros de familia con síntomas similares.
Volver
¿Cuáles son los síntomas de la fibromialgia?
El aumento de la sensibilidad del dolor es el síntoma mayor. Las personas que padecen este trastorno también presentan muchos otros síntomas. Los síntomas pueden irse y regresar.
Uno puede sufrir un dolor constante, pero la severidad del dolor puede aumentar en respuesta a la actividad, tensión, cambios de clima y otros factores. Puede tener un dolor profundo o un dolor que quema. Puede que tenga espasmos o endurecimientos musculares. Muchos personas tienen dolor migratorio (dolor que se mueve por el cuerpo).
La mayoría de personas que tienen Fibromialgia se sienten cansados o fatigados (sin energías). Esta fatiga puede ser leve o severa. Puede que tenga problemas al dormir, y esto puede añadir al nivel de fatiga que sufre.
Puede que sienta entumecimiento u hormigueo en partes de su cuerpo, o una sensación de que la sangre no llega bien a ciertas partes del cuerpo. Muchas personas sienten molestias con ciertos olores, luces brillantes, bullas fuertes y hasta medicinas. Es común tener dolor de cabeza y dolor en la mandíbula.
Además, uno puede tener los ojos secos o tener dificultad al enfocarse en los objetos. Pueden ocurrir problemas con el balance o mareos. Algunas personas sienten dolor de pecho, latidos de corazón rápidos o irregulares, o falta de respiración.
Los síntomas digestivos son comunes en la fibromialgia e incluyen dificultad al pasar comida, acidez, gas, dolor abdominal como calambres, y cambiando constantemente de la diarrea a la constipación.
Algunas personas se quejan de problemas con la orina, que incluyen el orinar con frecuencia, un fuerte deseo de orinar y dolor en el área de la vejiga. Las mujeres con fibromialgia muchas veces tienen síntomas pélvicos, como dolor, menstruaciones dolorosas, y dolor al tener relaciones sexuales.
Volver
¿Por qué me siento deprimido?
La depresión o ansiedad puede ocurrir como resultado del dolor crónico y fatiga, o por la frustración que puede causar su condición. Es también posible que la falta de balance en los químicos del cerebro, causantes de la fibromialgia, pueden también causar la depresión y ansiedad.
Volver
¿Y la fibromialgia causa daños permanentes?
No. Aunque la fibromialgia causa síntomas que pueden ser muy incómodos, sus músculos y órganos no son afectados permanentemente. Esta condición no amenaza la vida, pero es crónica. Aunque no exista una cura, puede hacer muchas cosas para sentirse mejor.
Volver
¿Hay alguna medicina que puedo tomar para sentirme mejor?
Existen muchos medicamentos que ayudan a aliviar los síntomas de la fibromialgia. Muchas de estas medicinas (tal como la amitriptilina (nombre de marca: Elavil) o ciclobenzaprine (nombre de marca: Flexeril)) se toman antes de acostarse y mejoran su sueño. También ayudan a aliviar el dolor y los otros síntomas.
Probablemente empezará a notar los beneficios de los medicamentos en 6 u 8 meses. Cuando empiece a tomar la medicina, es común sentirse muy débil la mañana siguiente. Otros efectos secundarios posibles incluyen secedad de los ojos y la boca, pesadillas, constipación y aumento de apetito. Estos efectos secundarios son peores cuando recién empieza a tomar las medicinas pero mejoran con el tiempo.
Volver
¿Qué más puedo hacer para aliviar mis síntomas?
Una de las mejores cosas que puede hacer es ejercicios aeróbicos de bajo impacto. Ejemplos de esta clase de ejercicios son natación, o ejercicios en agua, bicicleta estacionaria, y ejercicios en máquinas de ski. Puede que sea necesario empezar sus ejercicios en niveles bajos. Una buena cantidad al comienzo puede ser 5 minutos cada 2 días. Continúe incrementando la duración y frecuencia de los ejercicios hasta que esté ejercitando por lo menos de 30 a 60 minutos en un mínimo de 4 veces por semana. Una vez que ha llegado a este punto, puede considerar empezar a hacer ejercicios aeróbicos de alto impacto como caminar, correr o jugar tenis.
Por lo que sus síntomas de la fibromialgia se empeoran con la tensión y el mal sueño, es importante cortar toda la tensión posible de su vida y dormir todo el tiempo que su cuerpo sienta necesario. Poco antes de acostarse, evite las sustancias que causan problemas al dormir, como el alcohol y el café.
Existen otros cambios pequeños y simples que pueden ser útiles. Por ejemplo, trate de mantener un nivel de actividad constante todos los días. Muchas personas con fibromialgia tratan de hacer demasiado en días que se sienten mejor, lo que causa tener varios días de cansancio después. Si mantiene su nivel de actividad constante, puede no tener tantos días de cansancio.
Volver
¿Cómo puedo aprender más?
En muchas ciudades, existen grupos de apoyo de personas con fibromialgia que pueden proveer información y ayuda. El Arthritis Foundation (La Fundación de la Artritis) también tiene alguna información que le puede interesar (teléfono: 800-283-7800; la dirección en el Internet: www.arthritis.org). Además, usted puede inscribirse para recibir un periódico sobre la fibromialgia através del Fibromyalgia Network (La Red en Fibromialgia) P.O. Box 31750, Tucson, AZ 85751-1750, (teléfono: 800-853-2929; la dirección en el Internet: www.fmnetnews.com).
Volver
http://familydoctor.org/e070.xml
Friday, April 14, 2006
Characteristic images of deeply infiltrating rectosigmoid endometriosis on transvaginal and transrectal ultrasonography
Kaori Koga1, Yutaka Osuga1,3, Tetsu Yano1, Mikio Momoeda1, Osamu Yoshino1, Yasushi Hirota1, Koji Kugu1, Osamu Nishii1, Osamu Tsutsumi1,2 and Yuji Taketani1
1 Department of Obstetrics and Gynecology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 and 2 CREST Japan Science and Technology, 4-1-8 Honmachi, Kawaguchi 332-0012, Japan
Abstract
BACKGROUND: To evaluate the usefulness of transvaginal and transrectal ultrasonography for diagnosis and management of deeply infiltrating rectosigmoid endometriosis.
METHODS: A series of six patients (aged 32–39 years) with rectosigmoid endometriosis underwent transvaginal and transrectal ultrasonography. In three patients undergoing surgical resection of the intestine, the ultrasonographic findings were compared with macroscopic and microscopic findings. In one patient, sequential observations of the lesion using ultrasonography were conducted before and after medical treatment and following childbirth.
RESULTS: In all cases, the lesion was detected as a hypoechoic irregular-shaped area surrounded by a hyperechoic rim located posterior to the uterus, with size ranging from 18 x 17 to 29 x 28 mm in diameter. The comparison of the ultrasonographical findings with histology revealed that the hypoechoic irregular-shaped area corresponded to a layer of hypertrophic muscularis propria of the lesion, while the hyperechoic rim represented the layer including the mucosa, submucosa and serosa. In one patient, the lesion decreased in size and lost its central hypoechoic area after childbirth in association with pain relief.
CONCLUSIONS: Transvaginal and transrectal ultrasonography provides characteristic appearances for rectosigmoid endometriosis that correlate well with its histological findings.
The procedures would be useful in the management of rectosigmoid endometriosis.
Key words: endometriosis/rectum/ultrasound
V. Anaf, I. El Nakadi, Ph. Simon, J. Van de Stadt, I. Fayt, Th. Simonart, and J.-C. NoelPreferential infiltration of large bowel endometriosis along the nerves of the colonHum. Reprod., April 1, 2004; 19(4): 996 - 1002.
[Abstract] [Full Text] [PDF]
http://humrep.oxfordjournals.org/cgi/content/full/18/6/1328
1 Department of Obstetrics and Gynecology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 and 2 CREST Japan Science and Technology, 4-1-8 Honmachi, Kawaguchi 332-0012, Japan
Abstract
BACKGROUND: To evaluate the usefulness of transvaginal and transrectal ultrasonography for diagnosis and management of deeply infiltrating rectosigmoid endometriosis.
METHODS: A series of six patients (aged 32–39 years) with rectosigmoid endometriosis underwent transvaginal and transrectal ultrasonography. In three patients undergoing surgical resection of the intestine, the ultrasonographic findings were compared with macroscopic and microscopic findings. In one patient, sequential observations of the lesion using ultrasonography were conducted before and after medical treatment and following childbirth.
RESULTS: In all cases, the lesion was detected as a hypoechoic irregular-shaped area surrounded by a hyperechoic rim located posterior to the uterus, with size ranging from 18 x 17 to 29 x 28 mm in diameter. The comparison of the ultrasonographical findings with histology revealed that the hypoechoic irregular-shaped area corresponded to a layer of hypertrophic muscularis propria of the lesion, while the hyperechoic rim represented the layer including the mucosa, submucosa and serosa. In one patient, the lesion decreased in size and lost its central hypoechoic area after childbirth in association with pain relief.
CONCLUSIONS: Transvaginal and transrectal ultrasonography provides characteristic appearances for rectosigmoid endometriosis that correlate well with its histological findings.
The procedures would be useful in the management of rectosigmoid endometriosis.
Key words: endometriosis/rectum/ultrasound
V. Anaf, I. El Nakadi, Ph. Simon, J. Van de Stadt, I. Fayt, Th. Simonart, and J.-C. NoelPreferential infiltration of large bowel endometriosis along the nerves of the colonHum. Reprod., April 1, 2004; 19(4): 996 - 1002.
[Abstract] [Full Text] [PDF]
http://humrep.oxfordjournals.org/cgi/content/full/18/6/1328
Thursday, April 13, 2006
Deep Endometriotic Lesions Impair Sexual Functioning
By Megan Rauscher
NEW YORK aPR 06, 2005 (Reuters Health) - Deep infiltrating endometriotic lesions of the uterosacral ligament often severely impair sexual health and functioning, according to a study conducted in Italy.
Dr. Simone Ferrero and colleagues from San Martino Hospital, University of Genoa, evaluated the sexual function of 299 women undergoing surgery for infertility, pelvic pain or adnexal masses. One hundred seventy had endometriosis and 129 did not (the controls).
As expected, the prevalence of deep dyspareunia was significantly higher among women with endometriosis (60.6%) relative to controls (34.9%), the authors report in the March issue of Fertility and Sterility.
"Interestingly," primary deep dyspareunia was much more common in women with endometriosis (57.3%) than in controls (37.8%) and "more than 50% of women with endometriosis have had deep dyspareunia during their entire sex lives."
It's also "interesting that communication about sex with the partner was significantly compromised in women with endometriosis," Dr. Ferrero noted in comments to Reuters Health.
The final study population with deep dyspareunia included 96 women with endometriosis -- 76 with and 20 without deep infiltrating endometriosis of the uterosacral ligament -- and 40 controls.
According to the study findings, women with deep infiltrating endometriosis of the uterosacral ligament had intercourse less often and had less satisfying orgasms, more frequent interruption of intercourse due to pain and felt less relaxed and fulfilled after intercourse, compared with the other two groups.
"Surprisingly," Dr. Ferrero said, "the presence of mono- or bilateral endometriotic lesions on the uterosacral ligaments did not affect the intensity of pain and the severity of sexual life impairment."
This is the first study to describe the abnormalities in sexual function of women with deep endometriotic lesions on the uterosacral ligament, according to Dr. Ferrero.
Several studies have shown that radical excision of endometriotic lesions can lessen the intensity of deep dyspareunia and improve the quality of sexual activity in these women, the investigators note in their report.
SOURCE:
Fertility and Sterility 2005;83:573-579.
NEW YORK aPR 06, 2005 (Reuters Health) - Deep infiltrating endometriotic lesions of the uterosacral ligament often severely impair sexual health and functioning, according to a study conducted in Italy.
Dr. Simone Ferrero and colleagues from San Martino Hospital, University of Genoa, evaluated the sexual function of 299 women undergoing surgery for infertility, pelvic pain or adnexal masses. One hundred seventy had endometriosis and 129 did not (the controls).
As expected, the prevalence of deep dyspareunia was significantly higher among women with endometriosis (60.6%) relative to controls (34.9%), the authors report in the March issue of Fertility and Sterility.
"Interestingly," primary deep dyspareunia was much more common in women with endometriosis (57.3%) than in controls (37.8%) and "more than 50% of women with endometriosis have had deep dyspareunia during their entire sex lives."
It's also "interesting that communication about sex with the partner was significantly compromised in women with endometriosis," Dr. Ferrero noted in comments to Reuters Health.
The final study population with deep dyspareunia included 96 women with endometriosis -- 76 with and 20 without deep infiltrating endometriosis of the uterosacral ligament -- and 40 controls.
According to the study findings, women with deep infiltrating endometriosis of the uterosacral ligament had intercourse less often and had less satisfying orgasms, more frequent interruption of intercourse due to pain and felt less relaxed and fulfilled after intercourse, compared with the other two groups.
"Surprisingly," Dr. Ferrero said, "the presence of mono- or bilateral endometriotic lesions on the uterosacral ligaments did not affect the intensity of pain and the severity of sexual life impairment."
This is the first study to describe the abnormalities in sexual function of women with deep endometriotic lesions on the uterosacral ligament, according to Dr. Ferrero.
Several studies have shown that radical excision of endometriotic lesions can lessen the intensity of deep dyspareunia and improve the quality of sexual activity in these women, the investigators note in their report.
SOURCE:
Fertility and Sterility 2005;83:573-579.
Wednesday, April 12, 2006
Healthcare worker "conscience clause" expanding
In the latest case reflecting the healthcare worker "conscience clause" movement, a California appeals court has ruled in favor of doctors who refused to artificially inseminate a lesbian patient. Guadalupe Benitez filed a sexual orientation discrimination suit against the physicians at a women's clinic in San Diego for refusing to artificially inseminate her in 2000.
The details of the case are complex. The plaintiff says that when she first went to the clinic, the doctor she saw told her she could not inseminate her because her religious beliefs did not permit her to perform such a procedure on a gay person. According to Benitez, the doctor told her there was another doctor in the clinic who could perform the procedure. Benitez then underwent almost a year of tests, exams, and surgeries, only to be told she could not be inseminated at the clinic because of the religious beliefs of all of the staff members.
One of the pending legal questions is whether Benitez was denied the procedure because she was a lesbian or because she was unmarried. California law protects citizens from discrimination by businesses on the basis of sexual orientation, but not on the basis of marital status. The doctors' attorney is claiming that the decision was based on Benitez's marital status, but the plaintiff's attorney confirms that Benitez was told that the procedure could not be done because of her homosexuality.
The appeals court ruled in favor of the doctors on the grounds of protecting religious liberty.
Meanwhile, throughout the country, pharmacists continue to refuse to sell certain products to women because of the pharmacists' religious beliefs. Arkansas, Georgia, Mississippi, and South Dakota have passed laws allowing pharmacists to refuse to dispense emergency contraceptive drugs. Arizona, Arkansas, California, Georgia, Indiana, North Carolina, Rhode Island, South Dakota, Tennessee, Texas, Vermont, West Virginia, and Wisconsin have introduced legislation that would allow pharmacists to refuse to provide services. Only three states--Missouri, New Jersey, and West Virginia--have introduced legislation that would require pharmacists to fill prescriptions.
Emergency contrapceptive pills contain high doses of of the hormones that are found in regular contraceptive pills. Emergency contraceptives can delay ovulation and prevent fertilization, and--in some cases--prevent implantation. Wal-Mart led the way by refusing to sell emergency contraceptive pills, and then other retail outlets followed by giving their pharmacists the option to use a conscience clause to opt out of filling ecp prescriptions.
It isn't just emergency contraception that is being denied women, however. Pharmacists who are opposed to any artificial means of birth control are using the conscience clause to refuse to fill regular birth control prescriptions. Aside from the obvious fact that birth control pills, patches, and devices are legal in the United States, birth control pills are also prescribed to treat certain disorders, such as irregular menstrual periods, acne, endometriosis, and severe premenstrual syndrome. Women whose mothers or grandmothers had ovarian cancer may be given birth control pills to protect them from the disease.
And finally, though condoms are frequently sold at the pharmacy counter, we do not hear about American pharmacists' refusing to sell them, nor do we hear about an expansion of the conscience clause that would permit checkout staff to refuse to ring up condom purchases.
Source: MoJoBlog
http://www.motherjones.com/mojoblog/archives/2005/12/11-week/
The details of the case are complex. The plaintiff says that when she first went to the clinic, the doctor she saw told her she could not inseminate her because her religious beliefs did not permit her to perform such a procedure on a gay person. According to Benitez, the doctor told her there was another doctor in the clinic who could perform the procedure. Benitez then underwent almost a year of tests, exams, and surgeries, only to be told she could not be inseminated at the clinic because of the religious beliefs of all of the staff members.
One of the pending legal questions is whether Benitez was denied the procedure because she was a lesbian or because she was unmarried. California law protects citizens from discrimination by businesses on the basis of sexual orientation, but not on the basis of marital status. The doctors' attorney is claiming that the decision was based on Benitez's marital status, but the plaintiff's attorney confirms that Benitez was told that the procedure could not be done because of her homosexuality.
The appeals court ruled in favor of the doctors on the grounds of protecting religious liberty.
Meanwhile, throughout the country, pharmacists continue to refuse to sell certain products to women because of the pharmacists' religious beliefs. Arkansas, Georgia, Mississippi, and South Dakota have passed laws allowing pharmacists to refuse to dispense emergency contraceptive drugs. Arizona, Arkansas, California, Georgia, Indiana, North Carolina, Rhode Island, South Dakota, Tennessee, Texas, Vermont, West Virginia, and Wisconsin have introduced legislation that would allow pharmacists to refuse to provide services. Only three states--Missouri, New Jersey, and West Virginia--have introduced legislation that would require pharmacists to fill prescriptions.
Emergency contrapceptive pills contain high doses of of the hormones that are found in regular contraceptive pills. Emergency contraceptives can delay ovulation and prevent fertilization, and--in some cases--prevent implantation. Wal-Mart led the way by refusing to sell emergency contraceptive pills, and then other retail outlets followed by giving their pharmacists the option to use a conscience clause to opt out of filling ecp prescriptions.
It isn't just emergency contraception that is being denied women, however. Pharmacists who are opposed to any artificial means of birth control are using the conscience clause to refuse to fill regular birth control prescriptions. Aside from the obvious fact that birth control pills, patches, and devices are legal in the United States, birth control pills are also prescribed to treat certain disorders, such as irregular menstrual periods, acne, endometriosis, and severe premenstrual syndrome. Women whose mothers or grandmothers had ovarian cancer may be given birth control pills to protect them from the disease.
And finally, though condoms are frequently sold at the pharmacy counter, we do not hear about American pharmacists' refusing to sell them, nor do we hear about an expansion of the conscience clause that would permit checkout staff to refuse to ring up condom purchases.
Source: MoJoBlog
http://www.motherjones.com/mojoblog/archives/2005/12/11-week/
Tuesday, April 11, 2006
Endorectal Ultrasonography in Predicting Rectal Wall Infiltration in Patients With Deep Pelvic Endometriosis
Dis Colon Rectum. 2006 Apr 5; [Epub ahead of print]
Related Articles,
Links
Endorectal Ultrasonography in Predicting Rectal Wall Infiltration in Patients With Deep Pelvic Endometriosis: A Modern Tool for an Ancient Disease.Bahr A, de Parades V, Gadonneix P, Etienney I, Salet-Lizee D, Villet R, Atienza P.Proctologie Medico-Interventionnelle, Groupe Hospitalier Diaconesses - Croix Saint Simon, Paris, France.
PURPOSE: This study evaluated the validity of endorectal ultrasonography in predicting rectal infiltration in patients with deep pelvic endometriosis.
METHODS: Patients were recruited consecutively in the Department of Surgical Gynecology of Diaconesses Hospital from April 1996 to July 2003. Inclusion criteria were the suspicion of deep pelvic endometriosis on the basis of outpatient history and/or clinical symptoms with a mass palpable on bimanual examination that might infiltrate the rectal wall. There were no exclusion criteria. Endorectal ultrasonography wasperformed by the same investigator with a 7.5-MHz to 10-MHz rigid probe, producing a 360 degrees view of the rectal wall and adjacent areas. We used surgical and histopathologic findings as the "gold standard" to evaluate the validity of endorectal ultrasonography.
RESULTS: This study was based on 37 patients (mean age, 35.8 (range, 26-46) years) who underwent surgery. The time between endorectal ultrasonography and surgery ranged from 4 to 529 (mean, 88.7) days. Eight patients had endometriosis nodules penetrating the rectal wall. Endorectal ultrasonography showed sensitivity, specificity, a positive predictive value, and a negative predictive value of 87.5, 97, 87.5, and 97 percent, respectively, in the diagnosis of infiltration of the rectal wall by endometriosis.
CONCLUSIONS: Endorectal ultrasonography is a reliable technique for visualizing rectal infiltration in patients with deep pelvic endometriosis. It should be more widely used by gynecologists because knowing about rectal infiltration before surgery is fundamental to defining the best possible surgical approach.
PMID: 16583293 [PubMed - as supplied by publisher]
Related Articles,
Links
Endorectal Ultrasonography in Predicting Rectal Wall Infiltration in Patients With Deep Pelvic Endometriosis: A Modern Tool for an Ancient Disease.Bahr A, de Parades V, Gadonneix P, Etienney I, Salet-Lizee D, Villet R, Atienza P.Proctologie Medico-Interventionnelle, Groupe Hospitalier Diaconesses - Croix Saint Simon, Paris, France.
PURPOSE: This study evaluated the validity of endorectal ultrasonography in predicting rectal infiltration in patients with deep pelvic endometriosis.
METHODS: Patients were recruited consecutively in the Department of Surgical Gynecology of Diaconesses Hospital from April 1996 to July 2003. Inclusion criteria were the suspicion of deep pelvic endometriosis on the basis of outpatient history and/or clinical symptoms with a mass palpable on bimanual examination that might infiltrate the rectal wall. There were no exclusion criteria. Endorectal ultrasonography wasperformed by the same investigator with a 7.5-MHz to 10-MHz rigid probe, producing a 360 degrees view of the rectal wall and adjacent areas. We used surgical and histopathologic findings as the "gold standard" to evaluate the validity of endorectal ultrasonography.
RESULTS: This study was based on 37 patients (mean age, 35.8 (range, 26-46) years) who underwent surgery. The time between endorectal ultrasonography and surgery ranged from 4 to 529 (mean, 88.7) days. Eight patients had endometriosis nodules penetrating the rectal wall. Endorectal ultrasonography showed sensitivity, specificity, a positive predictive value, and a negative predictive value of 87.5, 97, 87.5, and 97 percent, respectively, in the diagnosis of infiltration of the rectal wall by endometriosis.
CONCLUSIONS: Endorectal ultrasonography is a reliable technique for visualizing rectal infiltration in patients with deep pelvic endometriosis. It should be more widely used by gynecologists because knowing about rectal infiltration before surgery is fundamental to defining the best possible surgical approach.
PMID: 16583293 [PubMed - as supplied by publisher]
Dr Kruschinski will not deal with your endo even if he claims he did
Dr Kruschinski (Chameleon) and his "Word"
I am a former patient and you can take my word for it that there is big time scamming going on in Selegenstadt, Germany, Emma Klinik.
I don't expect anyone to take my word for anything.
We are on the internet after all.
We can be anything we want to be in cyberspace.
I offer more than just words, my operative reports.
My surgery in Boston where I have chronic stage 4 endometriosis and adhesions.
My two surgeries with Daniel Kruschinski ,
I'm cured, I am adhesion free, I NEVER had endo.
Two month post surg from Germany I am desparate again.
A few months later I am angel flighted to surgeons here in the US and post surgical diagnosis of that surgery reveals chronic endometriosis and dense even calcified adhesions.
Dawn Rose Operative Reports - You decide
Click link to read more: Dr Kruschinski (Chameleon) and his "Word"
If it sounds too good to be true, it probably is
Beware this one endo sisters
I am a former patient and you can take my word for it that there is big time scamming going on in Selegenstadt, Germany, Emma Klinik.
I don't expect anyone to take my word for anything.
We are on the internet after all.
We can be anything we want to be in cyberspace.
I offer more than just words, my operative reports.
My surgery in Boston where I have chronic stage 4 endometriosis and adhesions.
My two surgeries with Daniel Kruschinski ,
I'm cured, I am adhesion free, I NEVER had endo.
Two month post surg from Germany I am desparate again.
A few months later I am angel flighted to surgeons here in the US and post surgical diagnosis of that surgery reveals chronic endometriosis and dense even calcified adhesions.
Dawn Rose Operative Reports - You decide
Click link to read more: Dr Kruschinski (Chameleon) and his "Word"
If it sounds too good to be true, it probably is
Beware this one endo sisters
Endometriosis in the News
Susan Sarandon's secret? Seeing past the ingenue
Charleston Post Courier (subscription), SC - 3 hours ago... lesbian romp "The Hunger.". In 1984, she was 38, the veteran of a few good movies and a battle with endometriosis. The year after ...
Ovary Removal May Up Dementia Risk FOX News - Apr 6, 2006... He suggests that women who have the kinds of problems that result in hysterectomy -- such as uterine fibroids or endometriosis -- have some underlying defect ...
'Killer Cramps' Not Necessarily Serious Hollister Free Lance, CA - Mar 7, 2006By the Faculty of Harvard Medical School. Q: I heard that women with endometriosis are more likely to have other medical problems, including ovarian cancer. ...
New Moms Thank Complementary Therapies for a Special Mother's Day International News Service, Australia - Apr 3, 2006... of honor. Sue Carlton, diagnosed infertile due to endometriosis and adhesions, is expecting her first baby this Mother's Day. She ...
Seeds sown for a new Pill Independent Online, South Africa - Apr 1, 2006... The new Pill could also bring an end to premenstrual syndrome and other painful gynaecological conditions such as endometriosis. ...
Pain Drug for Endometriosis
"Pfizer Inc. said on Tuesday it has received U.S. regulatory approval to sell a drug to treat the pain associated with endometriosis, a condition in which tissue from the uterus migrates and implants in other areas of the body."
Charleston Post Courier (subscription), SC - 3 hours ago... lesbian romp "The Hunger.". In 1984, she was 38, the veteran of a few good movies and a battle with endometriosis. The year after ...
Ovary Removal May Up Dementia Risk FOX News - Apr 6, 2006... He suggests that women who have the kinds of problems that result in hysterectomy -- such as uterine fibroids or endometriosis -- have some underlying defect ...
'Killer Cramps' Not Necessarily Serious Hollister Free Lance, CA - Mar 7, 2006By the Faculty of Harvard Medical School. Q: I heard that women with endometriosis are more likely to have other medical problems, including ovarian cancer. ...
New Moms Thank Complementary Therapies for a Special Mother's Day International News Service, Australia - Apr 3, 2006... of honor. Sue Carlton, diagnosed infertile due to endometriosis and adhesions, is expecting her first baby this Mother's Day. She ...
Seeds sown for a new Pill Independent Online, South Africa - Apr 1, 2006... The new Pill could also bring an end to premenstrual syndrome and other painful gynaecological conditions such as endometriosis. ...
Pain Drug for Endometriosis
"Pfizer Inc. said on Tuesday it has received U.S. regulatory approval to sell a drug to treat the pain associated with endometriosis, a condition in which tissue from the uterus migrates and implants in other areas of the body."
The "Big" NIH Endometriosis Study association with other diseases
National Institute of ChildHealth and Human Development
EMBARGOED BY JOURNAL
Thursday, September 26, 20027:01 p.m. ET
Contact:Marianne Glass Duffyor Robert Bock(301) 496-5133
Women with Endometriosis Have Higher Rates of Some Diseases
Women who have endometriosis are more likely than other women to have disorders in which the immune system attacks the body's own tissues, according to researchers at the National Institute of Child Health and Human Development (NICHD), the George Washington University, and the Endometriosis Association.
The researchers also found that women with endometriosis are more likely to have chronic fatigue syndrome and to suffer from fibromyalgia syndrome — a disease involving pain in the muscles, tendons, and ligaments. Women with endometriosis are more likely to have asthma, allergies, and the skin condition eczema. The researchers surveyed 3,680 women who said they had been surgically diagnosed with endometriosis.
“This study indicates that women with endometriosis may be more likely to have a variety of diseases involving the immune system,” said Duane Alexander, M.D., Director of the NICHD. “Further study of the immune system in endometriosis may yield important clues to identifying the causes and treatment of the disease.”
In women who have endometriosis, tissue like the lining of the uterus — the endometrium — grows in other parts of the abdominal cavity. The endometrial tissue may attach itself to the ovaries, the outside of the uterus, the intestines, or other abdominal organs. Endometriosis affects an estimated eight to ten percent of reproductive age women. It may cause infertility or pelvic pain, although researchers believe that some women with the disease may not experience symptoms. In addition, the researchers found that family members of women with endometriosis more commonly had the disease, as reported by others.
The researchers published their findings in the October 2002 issue of Human Reproduction.
Roughly 99 percent of the women in the study said they had experienced pelvic pain for about 10 years before they were diagnosed with endometriosis. The women in the study reported that their pain began shortly after their first periods. The researchers do not know whether endometriosis actually occurs at the first period or if it develops over time. It is also unclear whether treating pain early could prevent chronic pelvic pain from developing in these women. For this reason, the study authors suggested that physicians treating patients with pelvic pain — particularly adolescents — consider whether endometriosis might be causing the problem.
Ninet Sinaii, MPH, of NICHD’s Pediatric and Reproductive Endocrinology Branch, and her colleagues analyzed information from a 1998 survey of members of the Endometriosis Association. The researchers focused on the 3,680 women who said they had been surgically diagnosed with the disease. The study authors compared the likelihood of women with endometriosis having a variety of disorders to the likelihood of women in the general population having these same conditions. These included:
Autoimmune diseases — disorders in which the immune system attacks the body's own tissues.
Chronic fatigue syndrome — a strong feeling of fatigue that lasts for at least six months without letting up.
Fibromyalgia — a recurrent pain in the muscles, tendons, and ligaments.
Endocrine diseases — disorders of the glandular tissue
Atopic diseases — such as allergies or asthma
The researchers found that women with endometriosis were at greater risk than were other women for such autoimmune diseases as systemic lupus erythematosus, Sjögren’s Syndrome, rheumatoid arthritis, and multiple sclerosis.
The women in the study were over a hundred times more likely to experience chronic fatigue syndrome than the general population of U.S. women. The women with endometriosis were more than twice as likely as other women to experience fibromyalgia. In addition, 20 percent had more than one other disease, and up to 31 percent of those with more than one disease had also been diagnosed with either fibromyalgia or chronic fatigue syndrome.
Hypothyroidism — an underactive thyroid gland — was seven times more common in the endometriosis patients. In many cases, hypothyroidism may also be an autoimmune disorder, resulting from an immune system attack on the thyroid gland.
The researchers also found that the rates of allergies and asthma were higher among women with endometriosis than among women in the U.S. population, and higher still if they had other diseases. The researchers found that 61 percent of the women with endometriosis reported allergies (as compared to 18 percent of the general female population) and 12 percent had asthma (as compared to 5 percent). If a woman had endometriosis and an endocrine disease, the percent with allergies rose to 72 percent, and if a woman had endometriosis plus fibromyalgia or chronic fatigue syndrome, the rate for allergies rose to 88 percent.
Two-thirds of the women reported that relatives also had diagnosed or suspected endometriosis, suggesting a familial basis for the condition.
The study authors cautioned, however, that the study may not be representative of all patients with endometriosis. First, the women may have joined the Endometriosis Association because they were experiencing pain from their condition and so may not be typical of all patients with endometriosis. Also, such self-reported surveys may be more open to error than are surveys taken by a trained interviewer. For example, some of the women who answered the survey may have misinterpreted questions, may not have recognized the names of specific diseases, or may not have accurately reported conditions experienced by their family members.
The women who responded to the Endometriosis Association survey were predominantly white (nearly 95 percent) and educated (90 percent had at least some college education), and ninety-one percent were of reproductive age (15-45 years old). To compensate for such possible sources of bias, the researchers conducted a type of statistical test known as a sensitivity analysis. This analysis helps to confirm that even if a disease is underestimated in the general population and overestimated in the study sample, the rates of the various conditions reported in women with endometriosis are probably still significantly higher than in the general population.
“These findings suggest a strong association between endometriosis and autoimmune disorders, chronic fatigue syndrome and fibromyalgia" said Ms. Sinaii. “Health care professionals may need to consider endometriosis when evaluating their patients for these disorders.”
More information about endometriosis is available from the NICHD publication,
Endometriosis, at http://www.nichd.nih.gov/publications/pubs/endometriosis.pdf.
Information about endometriosis is also available from the Endometriosis Association, 8585 North 76th Place, Milwaukee, WI 53223; phone, 414-355-2200; http://www.EndometriosisAssn.org/
The NICHD is part of the National Institutes of Health, the biomedical research arm of the federal government. The Institute sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. NICHD publications, as well as information about the Institute, are available from the NICHD Web site, http://www.nichd.nih.gov, or from the NICHD Clearinghouse, 1-800-370-2943; e-mail NICHDClearinghouse@mail.nih.gov.
http://www.nih.gov/news/pr/sep2002/nichd-26.htm
EMBARGOED BY JOURNAL
Thursday, September 26, 20027:01 p.m. ET
Contact:Marianne Glass Duffyor Robert Bock(301) 496-5133
Women with Endometriosis Have Higher Rates of Some Diseases
Women who have endometriosis are more likely than other women to have disorders in which the immune system attacks the body's own tissues, according to researchers at the National Institute of Child Health and Human Development (NICHD), the George Washington University, and the Endometriosis Association.
The researchers also found that women with endometriosis are more likely to have chronic fatigue syndrome and to suffer from fibromyalgia syndrome — a disease involving pain in the muscles, tendons, and ligaments. Women with endometriosis are more likely to have asthma, allergies, and the skin condition eczema. The researchers surveyed 3,680 women who said they had been surgically diagnosed with endometriosis.
“This study indicates that women with endometriosis may be more likely to have a variety of diseases involving the immune system,” said Duane Alexander, M.D., Director of the NICHD. “Further study of the immune system in endometriosis may yield important clues to identifying the causes and treatment of the disease.”
In women who have endometriosis, tissue like the lining of the uterus — the endometrium — grows in other parts of the abdominal cavity. The endometrial tissue may attach itself to the ovaries, the outside of the uterus, the intestines, or other abdominal organs. Endometriosis affects an estimated eight to ten percent of reproductive age women. It may cause infertility or pelvic pain, although researchers believe that some women with the disease may not experience symptoms. In addition, the researchers found that family members of women with endometriosis more commonly had the disease, as reported by others.
The researchers published their findings in the October 2002 issue of Human Reproduction.
Roughly 99 percent of the women in the study said they had experienced pelvic pain for about 10 years before they were diagnosed with endometriosis. The women in the study reported that their pain began shortly after their first periods. The researchers do not know whether endometriosis actually occurs at the first period or if it develops over time. It is also unclear whether treating pain early could prevent chronic pelvic pain from developing in these women. For this reason, the study authors suggested that physicians treating patients with pelvic pain — particularly adolescents — consider whether endometriosis might be causing the problem.
Ninet Sinaii, MPH, of NICHD’s Pediatric and Reproductive Endocrinology Branch, and her colleagues analyzed information from a 1998 survey of members of the Endometriosis Association. The researchers focused on the 3,680 women who said they had been surgically diagnosed with the disease. The study authors compared the likelihood of women with endometriosis having a variety of disorders to the likelihood of women in the general population having these same conditions. These included:
Autoimmune diseases — disorders in which the immune system attacks the body's own tissues.
Chronic fatigue syndrome — a strong feeling of fatigue that lasts for at least six months without letting up.
Fibromyalgia — a recurrent pain in the muscles, tendons, and ligaments.
Endocrine diseases — disorders of the glandular tissue
Atopic diseases — such as allergies or asthma
The researchers found that women with endometriosis were at greater risk than were other women for such autoimmune diseases as systemic lupus erythematosus, Sjögren’s Syndrome, rheumatoid arthritis, and multiple sclerosis.
The women in the study were over a hundred times more likely to experience chronic fatigue syndrome than the general population of U.S. women. The women with endometriosis were more than twice as likely as other women to experience fibromyalgia. In addition, 20 percent had more than one other disease, and up to 31 percent of those with more than one disease had also been diagnosed with either fibromyalgia or chronic fatigue syndrome.
Hypothyroidism — an underactive thyroid gland — was seven times more common in the endometriosis patients. In many cases, hypothyroidism may also be an autoimmune disorder, resulting from an immune system attack on the thyroid gland.
The researchers also found that the rates of allergies and asthma were higher among women with endometriosis than among women in the U.S. population, and higher still if they had other diseases. The researchers found that 61 percent of the women with endometriosis reported allergies (as compared to 18 percent of the general female population) and 12 percent had asthma (as compared to 5 percent). If a woman had endometriosis and an endocrine disease, the percent with allergies rose to 72 percent, and if a woman had endometriosis plus fibromyalgia or chronic fatigue syndrome, the rate for allergies rose to 88 percent.
Two-thirds of the women reported that relatives also had diagnosed or suspected endometriosis, suggesting a familial basis for the condition.
The study authors cautioned, however, that the study may not be representative of all patients with endometriosis. First, the women may have joined the Endometriosis Association because they were experiencing pain from their condition and so may not be typical of all patients with endometriosis. Also, such self-reported surveys may be more open to error than are surveys taken by a trained interviewer. For example, some of the women who answered the survey may have misinterpreted questions, may not have recognized the names of specific diseases, or may not have accurately reported conditions experienced by their family members.
The women who responded to the Endometriosis Association survey were predominantly white (nearly 95 percent) and educated (90 percent had at least some college education), and ninety-one percent were of reproductive age (15-45 years old). To compensate for such possible sources of bias, the researchers conducted a type of statistical test known as a sensitivity analysis. This analysis helps to confirm that even if a disease is underestimated in the general population and overestimated in the study sample, the rates of the various conditions reported in women with endometriosis are probably still significantly higher than in the general population.
“These findings suggest a strong association between endometriosis and autoimmune disorders, chronic fatigue syndrome and fibromyalgia" said Ms. Sinaii. “Health care professionals may need to consider endometriosis when evaluating their patients for these disorders.”
More information about endometriosis is available from the NICHD publication,
Endometriosis, at http://www.nichd.nih.gov/publications/pubs/endometriosis.pdf.
Information about endometriosis is also available from the Endometriosis Association, 8585 North 76th Place, Milwaukee, WI 53223; phone, 414-355-2200; http://www.EndometriosisAssn.org/
The NICHD is part of the National Institutes of Health, the biomedical research arm of the federal government. The Institute sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. NICHD publications, as well as information about the Institute, are available from the NICHD Web site, http://www.nichd.nih.gov, or from the NICHD Clearinghouse, 1-800-370-2943; e-mail NICHDClearinghouse@mail.nih.gov.
http://www.nih.gov/news/pr/sep2002/nichd-26.htm
Infertility Questions and Answers
Infertility Questions and Answers
What is infertility?
Primary infertility describes a couple that after having regular intercourse without contraception are not able to get pregnant by one year.
Those with secondary infertility are couples who have previously been able to achieve pregnancy at least once, but later attempts are unsuccessful.
What causes infertility?
Causes of infertility can include a wide range of factors. Approximately 30-40% of all infertility is due to a “male” factor.
These include – retrograde ejaculation (the entry of semen into the bladder instead of going out through the urethra during ejaculation), impotence, hormone deficiency, environmental pollutants, scarring from sexually transmitted disease (STDs), and/or decreased sperm count.
A “female” factor (such as, scarring from STDs or endometriosis, ovulation dysfunction, poor nutrition, hormone imbalance, ovarian cysts, pelvic infection, and/or tumors), is responsible for 40-50% of infertility. The remaining 10% to 30% of causes are often times unexplained.
What are the risks that contribute to infertility?
In addition to age-related factors, increased risk for infertility can include:
Multiple sexual partners (increases the risk for STDs)
Sexually transmitted disease (STD)
History of pelvic inflammatory disease (PID)
Mumps (men)
A varicocele (varicose veins within the scrotum)
Past medical history of DES exposure (men and women)
Eating disorders (women)
Anovulatory menstrual cycles (menstrual cycles where no egg was produced)
Endometriosis
Abnormalities of the uterus of cervical obstruction
Chronic diseases, such as diabetes
What can be done to prevent infertility?
Because STDs frequently cause infertility, practicing safer sex may reduce the risk of future infertility. Gonorrhea and Chlamydia are the most frequent causes of STD- related infertility. These diseases can cause scarring of the fallopian tubes and subsequent decreased fertility, absolute infertility, or an increased incidence of ectopic pregnancy. Mumps immunization to prevent mumps in males is important in preventing mumps-related sterility. Some forms of birth control carry a higher risk for future infertility (such as the IUD). Women who choose the IUD as a form of birth control must be willing to accept the very slight risk of infertility associated with its use.
What are the symptoms of infertility?
Basically, the inability to become pregnant is the first sign of potential infertility. However, emotional issues can also be a contributing factor. Couples should keep an open and candid line of communication with their physician.
What is the treatment for infertility?
Treatment will depend upon the cause of the infertility for any given couple. Options range from education and counseling, to the use of medications that treat infections or promote ovulation. Sometimes artificial reproductive technologies, such as in-vitro fertilization (IVF) or Intra-Cytoplasmic Sperm Injections (ICSI), are the appropriate form of treatment.
What tests are used to diagnose infertility?
A comprehensive medical examination of both partners is the first step to an accurate diagnosis. Tests that may be performed include:
Semen Analysis
Measuring basal body temperature to determine the woman’s time of ovulation
Monitoring cervical mucus changes throughout the menstrual cycle
Postcoital test to measure the serum hormone levels for either or both partners
Endometrial biopsy
Progestin challenge is sometimes performed with sporadic or absent ovulation
Hysterosalpingography (HSG) is an X-ray procedure done with contrast dye that enables evaluation of potential transport from the cervix through the uterus and fallopian tubes.
Laproscopy is sometimes used for direct visualization of the pelvic cavity.
Pelvic exam (women) to determine if there are cysts.
What is Artificial Reproductive Technology?
The types of Artificial Reproductive Technology (ART) include:
In Vitro Fertilization (IVF) – This is the original “test tube” technique
Intra-Cytoplasmic Sperm Injection (ICSI) – With this technique, a single human sperm is injected into the cytoplasm of the egg.
Gamete Intra-Fallopian Transfer (GIFT) – Gametes are transferred to the fimbrial end of the fallopian tube immediately after ova aspiration.
Zygote Intra-Fallopian Transfer (ZIFT) – The transfer of the early-fertilized egg into the fallopian tube.
Micro-Epididymal Sperm Aspiration (MESA) / Testicular Sperm Aspiration (TESA) – Sperm harvested by these techniques is specific to male infertility.
Important Facts to Know
Natural fertility is 20% per menstrual cycle, increasing to 50% by three months and 85% by one year.
Approximately 15-20% of all couples experiences infertility.
Females, while still in the womb, have the most number of eggs at 16-20 million. By birth that number has already decreased to around 8 million. As they age, females lose many eggs each day until menopause. Since the eggs they carry at age 35 are the same ones they carried even before birth, the chance for chromosomal abnormalities increases. Males are able to produce sperm throughout their entire life. However, a decrease in sperm production due to health complications can occur. There are numerous conditions that can contribute to infertility.
A woman’s peak fertility is in her early 20s. As a woman ages beyond 30 (and particularly after 35), the likelihood of conceiving is less than 10% per month.
http://www.westtexasreproductive.com/infertility_questions_answers.htm
What is infertility?
Primary infertility describes a couple that after having regular intercourse without contraception are not able to get pregnant by one year.
Those with secondary infertility are couples who have previously been able to achieve pregnancy at least once, but later attempts are unsuccessful.
What causes infertility?
Causes of infertility can include a wide range of factors. Approximately 30-40% of all infertility is due to a “male” factor.
These include – retrograde ejaculation (the entry of semen into the bladder instead of going out through the urethra during ejaculation), impotence, hormone deficiency, environmental pollutants, scarring from sexually transmitted disease (STDs), and/or decreased sperm count.
A “female” factor (such as, scarring from STDs or endometriosis, ovulation dysfunction, poor nutrition, hormone imbalance, ovarian cysts, pelvic infection, and/or tumors), is responsible for 40-50% of infertility. The remaining 10% to 30% of causes are often times unexplained.
What are the risks that contribute to infertility?
In addition to age-related factors, increased risk for infertility can include:
Multiple sexual partners (increases the risk for STDs)
Sexually transmitted disease (STD)
History of pelvic inflammatory disease (PID)
Mumps (men)
A varicocele (varicose veins within the scrotum)
Past medical history of DES exposure (men and women)
Eating disorders (women)
Anovulatory menstrual cycles (menstrual cycles where no egg was produced)
Endometriosis
Abnormalities of the uterus of cervical obstruction
Chronic diseases, such as diabetes
What can be done to prevent infertility?
Because STDs frequently cause infertility, practicing safer sex may reduce the risk of future infertility. Gonorrhea and Chlamydia are the most frequent causes of STD- related infertility. These diseases can cause scarring of the fallopian tubes and subsequent decreased fertility, absolute infertility, or an increased incidence of ectopic pregnancy. Mumps immunization to prevent mumps in males is important in preventing mumps-related sterility. Some forms of birth control carry a higher risk for future infertility (such as the IUD). Women who choose the IUD as a form of birth control must be willing to accept the very slight risk of infertility associated with its use.
What are the symptoms of infertility?
Basically, the inability to become pregnant is the first sign of potential infertility. However, emotional issues can also be a contributing factor. Couples should keep an open and candid line of communication with their physician.
What is the treatment for infertility?
Treatment will depend upon the cause of the infertility for any given couple. Options range from education and counseling, to the use of medications that treat infections or promote ovulation. Sometimes artificial reproductive technologies, such as in-vitro fertilization (IVF) or Intra-Cytoplasmic Sperm Injections (ICSI), are the appropriate form of treatment.
What tests are used to diagnose infertility?
A comprehensive medical examination of both partners is the first step to an accurate diagnosis. Tests that may be performed include:
Semen Analysis
Measuring basal body temperature to determine the woman’s time of ovulation
Monitoring cervical mucus changes throughout the menstrual cycle
Postcoital test to measure the serum hormone levels for either or both partners
Endometrial biopsy
Progestin challenge is sometimes performed with sporadic or absent ovulation
Hysterosalpingography (HSG) is an X-ray procedure done with contrast dye that enables evaluation of potential transport from the cervix through the uterus and fallopian tubes.
Laproscopy is sometimes used for direct visualization of the pelvic cavity.
Pelvic exam (women) to determine if there are cysts.
What is Artificial Reproductive Technology?
The types of Artificial Reproductive Technology (ART) include:
In Vitro Fertilization (IVF) – This is the original “test tube” technique
Intra-Cytoplasmic Sperm Injection (ICSI) – With this technique, a single human sperm is injected into the cytoplasm of the egg.
Gamete Intra-Fallopian Transfer (GIFT) – Gametes are transferred to the fimbrial end of the fallopian tube immediately after ova aspiration.
Zygote Intra-Fallopian Transfer (ZIFT) – The transfer of the early-fertilized egg into the fallopian tube.
Micro-Epididymal Sperm Aspiration (MESA) / Testicular Sperm Aspiration (TESA) – Sperm harvested by these techniques is specific to male infertility.
Important Facts to Know
Natural fertility is 20% per menstrual cycle, increasing to 50% by three months and 85% by one year.
Approximately 15-20% of all couples experiences infertility.
Females, while still in the womb, have the most number of eggs at 16-20 million. By birth that number has already decreased to around 8 million. As they age, females lose many eggs each day until menopause. Since the eggs they carry at age 35 are the same ones they carried even before birth, the chance for chromosomal abnormalities increases. Males are able to produce sperm throughout their entire life. However, a decrease in sperm production due to health complications can occur. There are numerous conditions that can contribute to infertility.
A woman’s peak fertility is in her early 20s. As a woman ages beyond 30 (and particularly after 35), the likelihood of conceiving is less than 10% per month.
http://www.westtexasreproductive.com/infertility_questions_answers.htm
“Endometriosis: the Challenge of our time”
“Endometriosis: the Challenge of our time”
The topic was chosen by the scientific committee of the International Society for Gynaecologic Endoscopy to be the theme of their 8th Regional Meeting because many issues pertaining to this disease still beg to be resolved. To this day despite a plethora of scientific information and clinical observations its aetiology remains unresolved, its pathology disputed, and its treatment inadequate. This article will try to highlight some observations and trends that have developed over the recent past.EpidemiologyAlthough endometriosis is one of the most prevalent diseases in Gynaecology affecting about 15% of women of childbearing age, very little is known about its epidemiology. This is primarily because of the complex nature of the disease comprising both environmental and genetic influences affecting expression. In addition there is also a lack of consensus on a precise definition and pathophysiology. This statement is remarkable considering that a Medline search lists more then 10,000 articles. Read More
The topic was chosen by the scientific committee of the International Society for Gynaecologic Endoscopy to be the theme of their 8th Regional Meeting because many issues pertaining to this disease still beg to be resolved. To this day despite a plethora of scientific information and clinical observations its aetiology remains unresolved, its pathology disputed, and its treatment inadequate. This article will try to highlight some observations and trends that have developed over the recent past.EpidemiologyAlthough endometriosis is one of the most prevalent diseases in Gynaecology affecting about 15% of women of childbearing age, very little is known about its epidemiology. This is primarily because of the complex nature of the disease comprising both environmental and genetic influences affecting expression. In addition there is also a lack of consensus on a precise definition and pathophysiology. This statement is remarkable considering that a Medline search lists more then 10,000 articles. Read More
Managing Chronic Pain ~ Rights, Quality of Life Scale, More
Your Basic Rights
People with chronic pain are often “people pleasers.” We find it hard to express our needs and require that others respect them. And when our needs are not met, tension is increased and our pain seems worse.
But you do have the same basic rights that you grant to others. You have the right to:
Act in a way that promotes dignity and self-respect.
Be treated with respect.
Make mistakes.
Do less than you are humanly capable of doing.
Change your mind.
Ask for what you want.
Take time to slow down and think before you act.
Ask for information.
Ask for help or assistance.
Feel good about yourself.
Disagree.
Not have to explain everything you do and think.
Say "no" and not feel guilty.
Ask why.
Be listened to and taken seriously when expressing your feelings.
Read and reread these rights so that you not only know them by heart, but so that they become part of your daily life.
ACPA Quality of Life Scale Chronic pain has an impact on your life as well as your body. The ACPA Quality of Life Scale can help you and your health care team to more accurately evaluate your condition and track your progress over time.
Many pain scales now in use focus on pain---on how much and where you hurt. But we know that the experience of pain is a highly personal and relative thing. The ACPA feels that it's important to look at not just your level of pain but also on how much that pain limits your ability to live a full life.
The Quality of Life Scale considers your ability to participate in work, family, and social activities. We hope it will be useful to you both as a way to track your own progress and as a communication tool with family, care givers, and others.
Please feel free to download and print it to share with your doctor and other members of your medical team.
Click here to open the ACPA Quality of Life Scale in PDF format.
Source: American Chronic Pain Association http://www.theacpa.org/pf_main.asp
Why Do People Suffer With Pain?
Many people suffer with chronic pain because they are unaware of treatment options that can help them live more normal lives. Others have fears that prevent them from talking about their pain, which in turn creates barriers to seeking adequate relief. (Not all treatment options are applicable to your type of pain.)
Read the following to see if you fall into one of these categories. If you can relate to these fears, remember that help and relief are possible, but only if you discuss your symptoms with your doctor.
Fear of being labeled a "bad patient." You won't find relief if you don't talk with your doctor about your pain.
Fear that increased pain may mean that your disease has worsened. Regardless of the state of your disease, the right treatment for pain may improve daily life for you and your family.
Fear of addiction to drugs. Research shows that the chance of people with chronic pain becoming addicted to pain-relieving drugs is extremely small. When taken properly for pain, drugs can relieve pain without addiction. Needing to take medication to control your pain is not addiction.
Lack of awareness about pain therapy options. Be honest about how your pain feels and how it affects your life. Ask your doctor about the pain therapy options available to you. Often, if one therapy isn't effectively controlling your pain, another therapy can.
Fear of being perceived as "weak." Some people believe that living stoically with pain is a sign of strength, while seeking help often is considered negative or weak. This perception prevents them seeking the best treatment with available therapies.
Source: Medtronic
People with chronic pain are often “people pleasers.” We find it hard to express our needs and require that others respect them. And when our needs are not met, tension is increased and our pain seems worse.
But you do have the same basic rights that you grant to others. You have the right to:
Act in a way that promotes dignity and self-respect.
Be treated with respect.
Make mistakes.
Do less than you are humanly capable of doing.
Change your mind.
Ask for what you want.
Take time to slow down and think before you act.
Ask for information.
Ask for help or assistance.
Feel good about yourself.
Disagree.
Not have to explain everything you do and think.
Say "no" and not feel guilty.
Ask why.
Be listened to and taken seriously when expressing your feelings.
Read and reread these rights so that you not only know them by heart, but so that they become part of your daily life.
ACPA Quality of Life Scale Chronic pain has an impact on your life as well as your body. The ACPA Quality of Life Scale can help you and your health care team to more accurately evaluate your condition and track your progress over time.
Many pain scales now in use focus on pain---on how much and where you hurt. But we know that the experience of pain is a highly personal and relative thing. The ACPA feels that it's important to look at not just your level of pain but also on how much that pain limits your ability to live a full life.
The Quality of Life Scale considers your ability to participate in work, family, and social activities. We hope it will be useful to you both as a way to track your own progress and as a communication tool with family, care givers, and others.
Please feel free to download and print it to share with your doctor and other members of your medical team.
Click here to open the ACPA Quality of Life Scale in PDF format.
Source: American Chronic Pain Association http://www.theacpa.org/pf_main.asp
Why Do People Suffer With Pain?
Many people suffer with chronic pain because they are unaware of treatment options that can help them live more normal lives. Others have fears that prevent them from talking about their pain, which in turn creates barriers to seeking adequate relief. (Not all treatment options are applicable to your type of pain.)
Read the following to see if you fall into one of these categories. If you can relate to these fears, remember that help and relief are possible, but only if you discuss your symptoms with your doctor.
Fear of being labeled a "bad patient." You won't find relief if you don't talk with your doctor about your pain.
Fear that increased pain may mean that your disease has worsened. Regardless of the state of your disease, the right treatment for pain may improve daily life for you and your family.
Fear of addiction to drugs. Research shows that the chance of people with chronic pain becoming addicted to pain-relieving drugs is extremely small. When taken properly for pain, drugs can relieve pain without addiction. Needing to take medication to control your pain is not addiction.
Lack of awareness about pain therapy options. Be honest about how your pain feels and how it affects your life. Ask your doctor about the pain therapy options available to you. Often, if one therapy isn't effectively controlling your pain, another therapy can.
Fear of being perceived as "weak." Some people believe that living stoically with pain is a sign of strength, while seeking help often is considered negative or weak. This perception prevents them seeking the best treatment with available therapies.
Source: Medtronic
Making the Most of a Brief Office Visit
By GINA KOLATA
Your doctor seems rude or arrogant, rushed or inattentive. But the doctor is supposed to be the best in the field, and you need a technician, not a counselor, right?
Not necessarily, say doctors who are teaching other doctors how to be compassionate and attentive.
"It's a fallacy that you have to choose between a nice doctor and a smart doctor," says Dr. Rita Charon, a professor of clinical medicine at the Columbia University College of Physicians and Surgeons.
But what if you are stuck with a difficult doctor?
Prepare before going in for a visit, says Dr. Richard Frankel, a professor of medicine and geriatrics at Indiana University. Dr. Frankel has found that patients, on average, have 18 seconds to talk to a doctor before they are interrupted and that women doctors interrupt at the same rate as men. The trick for patients is to decide ahead of time what they want to convey and to deflect interruptions to say it.
Patients should also take a list of their complaints and ask the doctor to staple it to their chart. That way, Dr. Frankel says, the doctor almost always addresses them.
After you leave the office, tell the difficult doctor about your experience, as soon as possible and in as neutral a way as possible, writing a letter or sending an e-mail message. You may also want to send a copy to the medical director of the doctor's practice, which increases the chances that your complaint will bring results.
The message to convey, Dr. Frankel says, is, "I had a bad experience today, and I'd like to tell you why." Most doctors have no idea they are difficult, he says, and "if you don't give feedback - this is unacceptable, this is inappropriate, this hurts my feelings - you reinforce the behavior."
http://www.nytimes.com/2005/11/30/health/30visit.html
Your doctor seems rude or arrogant, rushed or inattentive. But the doctor is supposed to be the best in the field, and you need a technician, not a counselor, right?
Not necessarily, say doctors who are teaching other doctors how to be compassionate and attentive.
"It's a fallacy that you have to choose between a nice doctor and a smart doctor," says Dr. Rita Charon, a professor of clinical medicine at the Columbia University College of Physicians and Surgeons.
But what if you are stuck with a difficult doctor?
Prepare before going in for a visit, says Dr. Richard Frankel, a professor of medicine and geriatrics at Indiana University. Dr. Frankel has found that patients, on average, have 18 seconds to talk to a doctor before they are interrupted and that women doctors interrupt at the same rate as men. The trick for patients is to decide ahead of time what they want to convey and to deflect interruptions to say it.
Patients should also take a list of their complaints and ask the doctor to staple it to their chart. That way, Dr. Frankel says, the doctor almost always addresses them.
After you leave the office, tell the difficult doctor about your experience, as soon as possible and in as neutral a way as possible, writing a letter or sending an e-mail message. You may also want to send a copy to the medical director of the doctor's practice, which increases the chances that your complaint will bring results.
The message to convey, Dr. Frankel says, is, "I had a bad experience today, and I'd like to tell you why." Most doctors have no idea they are difficult, he says, and "if you don't give feedback - this is unacceptable, this is inappropriate, this hurts my feelings - you reinforce the behavior."
http://www.nytimes.com/2005/11/30/health/30visit.html
Check out Teen Endo Website
Check out Teen Endo Website
Great resource and fellow Bravenet website.Wishing you all the best in helping others.
Teenage Endometriosis Network
Great resource and fellow Bravenet website.Wishing you all the best in helping others.
Teenage Endometriosis Network
¿Qué es la Endometriosis?
La endometriosis es una enfermedad crónica y dolorosa que afecta a 5.5 millones de mujeres y niñas en los Estados Unidos y el Canadá y millones más alrededor del mundo. Ocurre cuando tejido como el que se acomoda en el útero (tejido llamado el endometrio) es encontrado afuera del útero, usualmente en el abdomen sobre los ovarios, las trompas de falopio y los ligamentos que sostienen el útero; el área entre la vagina y el recto; la superficie exterior del útero; y el revestimiento de la cavidad pélvica. Otros lugares para estos crecimientos endometriales pueden incluir la vesícula, el intestino, la vagina, la cerviz, la vulva y en cicatrices quirurgicas del abdomen. Se encuentran en forma menos común en pulmones, brazos, muslos y otros lugares.Este tejido mal ubicado, se desarrolla en tumores o lesiones las cuales responden al ciclo menstrual de la misma manera en que lo hace el revestimiento del útero: cada més el tejido se desarrolla, se descompone y se desprende. La sangre menstrual fluye del útero y sale del cuerpo por la vagina, pero la sangre y el tejido que se desprende de los tumores endometriales no tiene forma de abandonar el cuerpo. Esto trae como resultado, hemorragias internas, descomposición de la sangre y el tejido de las lesiones, e inflamación y puede causar dolor, infertilidad, formación de tejido con cicatriz, adherencias y problemas de la vesícula.¿Cuáles son los síntomas de la endometriosis?
Dolor antes y durante los períodos
Dolor al tener relaciones sexuales
Infertilidad
Fatiga
Orina con dolor durante los períodos
Movimientos dolorosos del intestino durante los períodos
Otros malestares gastro intestinales tales como diarrea, estreñimiento y nausea.
Adicionalmente otras mujeres con endometriosis sufren de:
Alergias
Sensibilidades químicas
Infecciones vaginales frecuentes
El diagnóstico se considera incierto hasta que sea comprobado por una laparoscopia, un proceso quirúrgico menor realizado bajo anestesia. Normalmente una laparoscopia muestra la ubicación, tamaño y la extensión de los tumores. Esto ayuda al doctor y a la paciente a tomar mejores decisiones ne cuanto a tratamientos.
¿Qué causa la endometriosis?
La causa de la endometriosis es desconocida. La decadente teoría de la menstruación (Teoría de migración transtubal) sugiere que durante la menstruación parte del tejido menstrual, retrocede a través de las trompas de falopio, se implanta en el abdomen y crece. Algunos expertos creen que todas las mujeres sufren de alguna clase de retroceso de tejido menstrual y que un problema en el sistema inmunológico o un problema hormonal permite que este tejido crezca en las mujeres que desarrollan endometriosis.Otra teoría sugiere que el tejido endometrial es distribuido desde el útero hacia otras partes del cuerpo a través del sistema linfático o a través de la corriente sanguínea. Una teoría genética sugiere que puede ser llevada en los genes en ciertas familias o que algunas familias pueden tener factores que predisponen a la endometriosis.El transplante quirúrgico tambien ha sido mencionado en varios casos donde la endometriosis es encontrada en cicatrices abdominales, aunque esto también se ha encontrado en tales cicatrices donde el implante accidental no parece posible.Otra teoría sugiere que los restos del tejido de cuando la mujer era un embrión más tarde puede desarrollarse en endometriosis, o que algunos tejidos adultos retienen la habilidad que tenían en la etapa embrionaria de transformar tejiido reproductivo en algunas circunstancias.En investigaciones llevadas a cabo por la Endometriosis Association se descubrió un eslabón inicial entre la exposición de dioxina (TCCD) y el desarrollo de la endometriosis. La dioxina es un químico tóxico derivado de la fabricación de pesticidas, pulpa blanqueada y productos de papel, y de la incineración de desechos médicos y municipales. La EA descubrió una colonia de monos Rhesus que había desarrollado endometriosis después de ser expuestos a la dioxina. 79% de los monos expuestos a la dioxina desarrollaron endometriosis y, adicionalmente, mientras la exposición a la dioxina era mayor, la endometriosis era más severa.
Dolor antes y durante los períodos
Dolor al tener relaciones sexuales
Infertilidad
Fatiga
Orina con dolor durante los períodos
Movimientos dolorosos del intestino durante los períodos
Otros malestares gastro intestinales tales como diarrea, estreñimiento y nausea.
Adicionalmente otras mujeres con endometriosis sufren de:
Alergias
Sensibilidades químicas
Infecciones vaginales frecuentes
El diagnóstico se considera incierto hasta que sea comprobado por una laparoscopia, un proceso quirúrgico menor realizado bajo anestesia. Normalmente una laparoscopia muestra la ubicación, tamaño y la extensión de los tumores. Esto ayuda al doctor y a la paciente a tomar mejores decisiones ne cuanto a tratamientos.
¿Qué causa la endometriosis?
La causa de la endometriosis es desconocida. La decadente teoría de la menstruación (Teoría de migración transtubal) sugiere que durante la menstruación parte del tejido menstrual, retrocede a través de las trompas de falopio, se implanta en el abdomen y crece. Algunos expertos creen que todas las mujeres sufren de alguna clase de retroceso de tejido menstrual y que un problema en el sistema inmunológico o un problema hormonal permite que este tejido crezca en las mujeres que desarrollan endometriosis.Otra teoría sugiere que el tejido endometrial es distribuido desde el útero hacia otras partes del cuerpo a través del sistema linfático o a través de la corriente sanguínea. Una teoría genética sugiere que puede ser llevada en los genes en ciertas familias o que algunas familias pueden tener factores que predisponen a la endometriosis.El transplante quirúrgico tambien ha sido mencionado en varios casos donde la endometriosis es encontrada en cicatrices abdominales, aunque esto también se ha encontrado en tales cicatrices donde el implante accidental no parece posible.Otra teoría sugiere que los restos del tejido de cuando la mujer era un embrión más tarde puede desarrollarse en endometriosis, o que algunos tejidos adultos retienen la habilidad que tenían en la etapa embrionaria de transformar tejiido reproductivo en algunas circunstancias.En investigaciones llevadas a cabo por la Endometriosis Association se descubrió un eslabón inicial entre la exposición de dioxina (TCCD) y el desarrollo de la endometriosis. La dioxina es un químico tóxico derivado de la fabricación de pesticidas, pulpa blanqueada y productos de papel, y de la incineración de desechos médicos y municipales. La EA descubrió una colonia de monos Rhesus que había desarrollado endometriosis después de ser expuestos a la dioxina. 79% de los monos expuestos a la dioxina desarrollaron endometriosis y, adicionalmente, mientras la exposición a la dioxina era mayor, la endometriosis era más severa.
Massachusetts House of Representatives Urging Increased Awareness of Endometriosis
Massachusetts House of Representatives
Urging Increased Awareness of Endometriosis
Whereas, Endometriosis is a painful, reproductive and immunological disease which is a leading cause of female infertility, chronic pelvic pain, and gynecological surgery, and accounts for nearly half the 600,000 hysterectomies performed annually, and endometriosis is more prevalent than Alzheimer's disease, Parkinson's disease and even Breast Cancer, that places significant costs for the individual, and the Commonwealth in medical bills and lost productivity; and
Whereas, Endometriosis can negatively affect a woman or teen's ability to work, attend school, social functions or care for herself and her family, and can frequently be misdiagnosed due to lack of awareness and understanding of the symptoms ; and
Whereas, Endometriosis symptoms include pelvic pain with or without menstruation, infertility, miscarriage, ectopic pregnancy, pain associated with sexual intercourse, gastrointestinal difficulties, fatigue, chronic pain, allergies and other immune system-related dysfunction and associations to diseases including multiple sclerosis, lupus, and fibromyalgia, and endometriosis can lead to painful internal scar tissue know as adhesions, resulting in a complex set of symptoms called Adhesion Related Disorder; and
Whereas, studies have also shown an elevated risk of certain cancers and autoimmune disorders in women with endometriosis and rarely, even malignant changes within the disease itself, thus researchers remain unsure as to the specific cause of endometriosis and there is no definitive cure, and current treatments are often accompanied by significantly negative side effects; and
Whereas, in recognition of the disabling effects endometriosis as a significant disabling disease in women, it is incumbent upon the citizens of the Commonwealth of Massachusetts to support the courageous individuals living and coping with this painful condition; therefore be it
Resolved, That the Massachusetts House of Representatives moves to promote Endometriosis Awareness Month every March and to encourage awareness of the Endometriosis Research Center, The Endometriosis Association, and The International Adhesion Society; and be it
Resolved, That a copy of these resolutions be forwarded by the clerk of the House of Representatives to the Endometriosis Association.
House of Representatives, adopted October 31, 2005
Our deepest gratitude to Representative Elizabeth A. Poirier for her continuing dedication to women's issues in the Commonwealth.
Urging Increased Awareness of Endometriosis
Whereas, Endometriosis is a painful, reproductive and immunological disease which is a leading cause of female infertility, chronic pelvic pain, and gynecological surgery, and accounts for nearly half the 600,000 hysterectomies performed annually, and endometriosis is more prevalent than Alzheimer's disease, Parkinson's disease and even Breast Cancer, that places significant costs for the individual, and the Commonwealth in medical bills and lost productivity; and
Whereas, Endometriosis can negatively affect a woman or teen's ability to work, attend school, social functions or care for herself and her family, and can frequently be misdiagnosed due to lack of awareness and understanding of the symptoms ; and
Whereas, Endometriosis symptoms include pelvic pain with or without menstruation, infertility, miscarriage, ectopic pregnancy, pain associated with sexual intercourse, gastrointestinal difficulties, fatigue, chronic pain, allergies and other immune system-related dysfunction and associations to diseases including multiple sclerosis, lupus, and fibromyalgia, and endometriosis can lead to painful internal scar tissue know as adhesions, resulting in a complex set of symptoms called Adhesion Related Disorder; and
Whereas, studies have also shown an elevated risk of certain cancers and autoimmune disorders in women with endometriosis and rarely, even malignant changes within the disease itself, thus researchers remain unsure as to the specific cause of endometriosis and there is no definitive cure, and current treatments are often accompanied by significantly negative side effects; and
Whereas, in recognition of the disabling effects endometriosis as a significant disabling disease in women, it is incumbent upon the citizens of the Commonwealth of Massachusetts to support the courageous individuals living and coping with this painful condition; therefore be it
Resolved, That the Massachusetts House of Representatives moves to promote Endometriosis Awareness Month every March and to encourage awareness of the Endometriosis Research Center, The Endometriosis Association, and The International Adhesion Society; and be it
Resolved, That a copy of these resolutions be forwarded by the clerk of the House of Representatives to the Endometriosis Association.
House of Representatives, adopted October 31, 2005
Our deepest gratitude to Representative Elizabeth A. Poirier for her continuing dedication to women's issues in the Commonwealth.
Saturday, April 08, 2006
The "Big" NIH Endometriosis Study association with other diseases
NATIONAL INSTITUTES OF HEALTH
National Institute of ChildHealth and Human Development
EMBARGOED BY JOURNAL
Thursday, September 26, 20027:01 p.m. ET
Contact:Marianne Glass Duffyor Robert Bock(301) 496-5133
Women with Endometriosis Have Higher Rates of Some Diseases
Women who have endometriosis are more likely than other women to have disorders in which the immune system attacks the body's own tissues, according to researchers at the National Institute of Child Health and Human Development (NICHD), the George Washington University, and the Endometriosis Association.
The researchers also found that women with endometriosis are more likely to have chronic fatigue syndrome and to suffer from fibromyalgia syndrome — a disease involving pain in the muscles, tendons, and ligaments. Women with endometriosis are more likely to have asthma, allergies, and the skin condition eczema. The researchers surveyed 3,680 women who said they had been surgically diagnosed with endometriosis.
“This study indicates that women with endometriosis may be more likely to have a variety of diseases involving the immune system,” said Duane Alexander, M.D., Director of the NICHD. “Further study of the immune system in endometriosis may yield important clues to identifying the causes and treatment of the disease.”
In women who have endometriosis, tissue like the lining of the uterus — the endometrium — grows in other parts of the abdominal cavity. The endometrial tissue may attach itself to the ovaries, the outside of the uterus, the intestines, or other abdominal organs. Endometriosis affects an estimated eight to ten percent of reproductive age women. It may cause infertility or pelvic pain, although researchers believe that some women with the disease may not experience symptoms. In addition, the researchers found that family members of women with endometriosis more commonly had the disease, as reported by others.
The researchers published their findings in the October 2002 issue of Human Reproduction.
Roughly 99 percent of the women in the study said they had experienced pelvic pain for about 10 years before they were diagnosed with endometriosis. The women in the study reported that their pain began shortly after their first periods. The researchers do not know whether endometriosis actually occurs at the first period or if it develops over time. It is also unclear whether treating pain early could prevent chronic pelvic pain from developing in these women. For this reason, the study authors suggested that physicians treating patients with pelvic pain — particularly adolescents — consider whether endometriosis might be causing the problem.
Ninet Sinaii, MPH, of NICHD’s Pediatric and Reproductive Endocrinology Branch, and her colleagues analyzed information from a 1998 survey of members of the Endometriosis Association. The researchers focused on the 3,680 women who said they had been surgically diagnosed with the disease. The study authors compared the likelihood of women with endometriosis having a variety of disorders to the likelihood of women in the general population having these same conditions. These included:
Autoimmune diseases — disorders in which the immune system attacks the body's own tissues.
Chronic fatigue syndrome — a strong feeling of fatigue that lasts for at least six months without letting up.
Fibromyalgia — a recurrent pain in the muscles, tendons, and ligaments.
Endocrine diseases — disorders of the glandular tissue
Atopic diseases — such as allergies or asthma
The researchers found that women with endometriosis were at greater risk than were other women for such autoimmune diseases as systemic lupus erythematosus, Sjögren’s Syndrome, rheumatoid arthritis, and multiple sclerosis.
The women in the study were over a hundred times more likely to experience chronic fatigue syndrome than the general population of U.S. women. The women with endometriosis were more than twice as likely as other women to experience fibromyalgia. In addition, 20 percent had more than one other disease, and up to 31 percent of those with more than one disease had also been diagnosed with either fibromyalgia or chronic fatigue syndrome.
Hypothyroidism — an underactive thyroid gland — was seven times more common in the endometriosis patients. In many cases, hypothyroidism may also be an autoimmune disorder, resulting from an immune system attack on the thyroid gland.
The researchers also found that the rates of allergies and asthma were higher among women with endometriosis than among women in the U.S. population, and higher still if they had other diseases. The researchers found that 61 percent of the women with endometriosis reported allergies (as compared to 18 percent of the general female population) and 12 percent had asthma (as compared to 5 percent). If a woman had endometriosis and an endocrine disease, the percent with allergies rose to 72 percent, and if a woman had endometriosis plus fibromyalgia or chronic fatigue syndrome, the rate for allergies rose to 88 percent.
Two-thirds of the women reported that relatives also had diagnosed or suspected endometriosis, suggesting a familial basis for the condition.
The study authors cautioned, however, that the study may not be representative of all patients with endometriosis. First, the women may have joined the Endometriosis Association because they were experiencing pain from their condition and so may not be typical of all patients with endometriosis. Also, such self-reported surveys may be more open to error than are surveys taken by a trained interviewer. For example, some of the women who answered the survey may have misinterpreted questions, may not have recognized the names of specific diseases, or may not have accurately reported conditions experienced by their family members.
The women who responded to the Endometriosis Association survey were predominantly white (nearly 95 percent) and educated (90 percent had at least some college education), and ninety-one percent were of reproductive age (15-45 years old). To compensate for such possible sources of bias, the researchers conducted a type of statistical test known as a sensitivity analysis. This analysis helps to confirm that even if a disease is underestimated in the general population and overestimated in the study sample, the rates of the various conditions reported in women with endometriosis are probably still significantly higher than in the general population.
“These findings suggest a strong association between endometriosis and autoimmune disorders, chronic fatigue syndrome and fibromyalgia" said Ms. Sinaii. “Health care professionals may need to consider endometriosis when evaluating their patients for these disorders.”
More information about endometriosis is available from the NICHD publication, Endometriosis, at http://www.nichd.nih.gov/publications/pubs/endometriosis.pdf.
Information about endometriosis is also available from the Endometriosis Association, 8585 North 76th Place, Milwaukee, WI 53223; phone, 414-355-2200; http://www.EndometriosisAssn.org/
The NICHD is part of the National Institutes of Health, the biomedical research arm of the federal government. The Institute sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. NICHD publications, as well as information about the Institute, are available from the NICHD Web site,
http://www.nichd.nih.gov, or from the
NICHD Clearinghouse, 1-800-370-2943;
e-mail NICHDClearinghouse@mail.nih.gov.
http://www.nih.gov/news/pr/sep2002/nichd-26.htm
National Institute of ChildHealth and Human Development
EMBARGOED BY JOURNAL
Thursday, September 26, 20027:01 p.m. ET
Contact:Marianne Glass Duffyor Robert Bock(301) 496-5133
Women with Endometriosis Have Higher Rates of Some Diseases
Women who have endometriosis are more likely than other women to have disorders in which the immune system attacks the body's own tissues, according to researchers at the National Institute of Child Health and Human Development (NICHD), the George Washington University, and the Endometriosis Association.
The researchers also found that women with endometriosis are more likely to have chronic fatigue syndrome and to suffer from fibromyalgia syndrome — a disease involving pain in the muscles, tendons, and ligaments. Women with endometriosis are more likely to have asthma, allergies, and the skin condition eczema. The researchers surveyed 3,680 women who said they had been surgically diagnosed with endometriosis.
“This study indicates that women with endometriosis may be more likely to have a variety of diseases involving the immune system,” said Duane Alexander, M.D., Director of the NICHD. “Further study of the immune system in endometriosis may yield important clues to identifying the causes and treatment of the disease.”
In women who have endometriosis, tissue like the lining of the uterus — the endometrium — grows in other parts of the abdominal cavity. The endometrial tissue may attach itself to the ovaries, the outside of the uterus, the intestines, or other abdominal organs. Endometriosis affects an estimated eight to ten percent of reproductive age women. It may cause infertility or pelvic pain, although researchers believe that some women with the disease may not experience symptoms. In addition, the researchers found that family members of women with endometriosis more commonly had the disease, as reported by others.
The researchers published their findings in the October 2002 issue of Human Reproduction.
Roughly 99 percent of the women in the study said they had experienced pelvic pain for about 10 years before they were diagnosed with endometriosis. The women in the study reported that their pain began shortly after their first periods. The researchers do not know whether endometriosis actually occurs at the first period or if it develops over time. It is also unclear whether treating pain early could prevent chronic pelvic pain from developing in these women. For this reason, the study authors suggested that physicians treating patients with pelvic pain — particularly adolescents — consider whether endometriosis might be causing the problem.
Ninet Sinaii, MPH, of NICHD’s Pediatric and Reproductive Endocrinology Branch, and her colleagues analyzed information from a 1998 survey of members of the Endometriosis Association. The researchers focused on the 3,680 women who said they had been surgically diagnosed with the disease. The study authors compared the likelihood of women with endometriosis having a variety of disorders to the likelihood of women in the general population having these same conditions. These included:
Autoimmune diseases — disorders in which the immune system attacks the body's own tissues.
Chronic fatigue syndrome — a strong feeling of fatigue that lasts for at least six months without letting up.
Fibromyalgia — a recurrent pain in the muscles, tendons, and ligaments.
Endocrine diseases — disorders of the glandular tissue
Atopic diseases — such as allergies or asthma
The researchers found that women with endometriosis were at greater risk than were other women for such autoimmune diseases as systemic lupus erythematosus, Sjögren’s Syndrome, rheumatoid arthritis, and multiple sclerosis.
The women in the study were over a hundred times more likely to experience chronic fatigue syndrome than the general population of U.S. women. The women with endometriosis were more than twice as likely as other women to experience fibromyalgia. In addition, 20 percent had more than one other disease, and up to 31 percent of those with more than one disease had also been diagnosed with either fibromyalgia or chronic fatigue syndrome.
Hypothyroidism — an underactive thyroid gland — was seven times more common in the endometriosis patients. In many cases, hypothyroidism may also be an autoimmune disorder, resulting from an immune system attack on the thyroid gland.
The researchers also found that the rates of allergies and asthma were higher among women with endometriosis than among women in the U.S. population, and higher still if they had other diseases. The researchers found that 61 percent of the women with endometriosis reported allergies (as compared to 18 percent of the general female population) and 12 percent had asthma (as compared to 5 percent). If a woman had endometriosis and an endocrine disease, the percent with allergies rose to 72 percent, and if a woman had endometriosis plus fibromyalgia or chronic fatigue syndrome, the rate for allergies rose to 88 percent.
Two-thirds of the women reported that relatives also had diagnosed or suspected endometriosis, suggesting a familial basis for the condition.
The study authors cautioned, however, that the study may not be representative of all patients with endometriosis. First, the women may have joined the Endometriosis Association because they were experiencing pain from their condition and so may not be typical of all patients with endometriosis. Also, such self-reported surveys may be more open to error than are surveys taken by a trained interviewer. For example, some of the women who answered the survey may have misinterpreted questions, may not have recognized the names of specific diseases, or may not have accurately reported conditions experienced by their family members.
The women who responded to the Endometriosis Association survey were predominantly white (nearly 95 percent) and educated (90 percent had at least some college education), and ninety-one percent were of reproductive age (15-45 years old). To compensate for such possible sources of bias, the researchers conducted a type of statistical test known as a sensitivity analysis. This analysis helps to confirm that even if a disease is underestimated in the general population and overestimated in the study sample, the rates of the various conditions reported in women with endometriosis are probably still significantly higher than in the general population.
“These findings suggest a strong association between endometriosis and autoimmune disorders, chronic fatigue syndrome and fibromyalgia" said Ms. Sinaii. “Health care professionals may need to consider endometriosis when evaluating their patients for these disorders.”
More information about endometriosis is available from the NICHD publication, Endometriosis, at http://www.nichd.nih.gov/publications/pubs/endometriosis.pdf.
Information about endometriosis is also available from the Endometriosis Association, 8585 North 76th Place, Milwaukee, WI 53223; phone, 414-355-2200; http://www.EndometriosisAssn.org/
The NICHD is part of the National Institutes of Health, the biomedical research arm of the federal government. The Institute sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. NICHD publications, as well as information about the Institute, are available from the NICHD Web site,
http://www.nichd.nih.gov, or from the
NICHD Clearinghouse, 1-800-370-2943;
e-mail NICHDClearinghouse@mail.nih.gov.
http://www.nih.gov/news/pr/sep2002/nichd-26.htm
Friday, April 07, 2006
Endometriosis News EndoTimes
Techniques Push Stem Cells to Repair Damaged Nerves
Potential breakthroughs from marrow transplants and seaweed
Severe shortage of child psychiatrists takes toll
Read full story for latest details.
Market Entry Of Generic Versions Of Medications Can Reduce Prices Compared With Brand-Name Versions, FDA Says
New Test Developed For Early Detection Of Ovarian Cancer, Researchers Say
Kaiser Daily Women's Health Policy Report Summarizes Recent Magazine Coverage Of Women's Health
HPV Testing To Screen For Cervical Cancer: More Sensitive Than Current Screening Methods
Massachusetts Legislature Approves Bill That Requires Individuals To Have Health Insurance, Levy Assessment On Employers That Do Not Provide Coverage
IFPMA Welcomes World Health Day Call To Build Strong Healthcare Workforces, Especially In Developing Countries
Novo Nordisk Withdraw Their Application To Extend The Marketing Authorisation For NovoSeven
FemmePharma Global Healthcare, Inc. Opens Investigational New Drug...
'Killer Cramps' Not Necessarily Serious
Infertility and Endometriosis
Potential breakthroughs from marrow transplants and seaweed
Severe shortage of child psychiatrists takes toll
Read full story for latest details.
Market Entry Of Generic Versions Of Medications Can Reduce Prices Compared With Brand-Name Versions, FDA Says
New Test Developed For Early Detection Of Ovarian Cancer, Researchers Say
Kaiser Daily Women's Health Policy Report Summarizes Recent Magazine Coverage Of Women's Health
HPV Testing To Screen For Cervical Cancer: More Sensitive Than Current Screening Methods
Massachusetts Legislature Approves Bill That Requires Individuals To Have Health Insurance, Levy Assessment On Employers That Do Not Provide Coverage
IFPMA Welcomes World Health Day Call To Build Strong Healthcare Workforces, Especially In Developing Countries
Novo Nordisk Withdraw Their Application To Extend The Marketing Authorisation For NovoSeven
FemmePharma Global Healthcare, Inc. Opens Investigational New Drug...
'Killer Cramps' Not Necessarily Serious
Infertility and Endometriosis
"The Big" NIH Endometriosis Study showing links to other diseases
NATIONAL INSTITUTES OF HEALTH
National Institute of ChildHealth and Human Development
EMBARGOED BY JOURNALThursday, September 26, 20027:01 p.m. ET
Contact:Marianne Glass Duffyor Robert Bock(301) 496-5133
Women with Endometriosis Have Higher Rates of Some Diseases
Women who have endometriosis are more likely than other women to have disorders in which the immune system attacks the body's own tissues, according to researchers at the National Institute of Child Health and Human Development (NICHD), the George Washington University, and the Endometriosis Association.
The researchers also found that women with endometriosis are more likely to have chronic fatigue syndrome and to suffer from fibromyalgia syndrome — a disease involving pain in the muscles, tendons, and ligaments. Women with endometriosis are more likely to have asthma, allergies, and the skin condition eczema. The researchers surveyed 3,680 women who said they had been surgically diagnosed with endometriosis.
“This study indicates that women with endometriosis may be more likely to have a variety of diseases involving the immune system,” said Duane Alexander, M.D., Director of the NICHD. “Further study of the immune system in endometriosis may yield important clues to identifying the causes and treatment of the disease.”
In women who have endometriosis, tissue like the lining of the uterus — the endometrium — grows in other parts of the abdominal cavity. The endometrial tissue may attach itself to the ovaries, the outside of the uterus, the intestines, or other abdominal organs. Endometriosis affects an estimated eight to ten percent of reproductive age women. It may cause infertility or pelvic pain, although researchers believe that some women with the disease may not experience symptoms. In addition, the researchers found that family members of women with endometriosis more commonly had the disease, as reported by others.
The researchers published their findings in the October 2002 issue of Human Reproduction.
Roughly 99 percent of the women in the study said they had experienced pelvic pain for about 10 years before they were diagnosed with endometriosis. The women in the study reported that their pain began shortly after their first periods. The researchers do not know whether endometriosis actually occurs at the first period or if it develops over time. It is also unclear whether treating pain early could prevent chronic pelvic pain from developing in these women. For this reason, the study authors suggested that physicians treating patients with pelvic pain — particularly adolescents — consider whether endometriosis might be causing the problem.
Ninet Sinaii, MPH, of NICHD’s Pediatric and Reproductive Endocrinology Branch, and her colleagues analyzed information from a 1998 survey of members of the Endometriosis Association. The researchers focused on the 3,680 women who said they had been surgically diagnosed with the disease. The study authors compared the likelihood of women with endometriosis having a variety of disorders to the likelihood of women in the general population having these same conditions.
These included:
Autoimmune diseases — disorders in which the immune system attacks the body's own tissues.
Chronic fatigue syndrome — a strong feeling of fatigue that lasts for at least six months without letting up.
Fibromyalgia — a recurrent pain in the muscles, tendons, and ligaments.
Endocrine diseases — disorders of the glandular tissue
Atopic diseases — such as allergies or asthma
The researchers found that women with endometriosis were at greater risk than were other women for such autoimmune diseases as systemic lupus erythematosus, Sjögren’s Syndrome, rheumatoid arthritis, and multiple sclerosis.
The women in the study were over a hundred times more likely to experience chronic fatigue syndrome than the general population of U.S. women. The women with endometriosis were more than twice as likely as other women to experience fibromyalgia. In addition, 20 percent had more than one other disease, and up to 31 percent of those with more than one disease had also been diagnosed with either fibromyalgia or chronic fatigue syndrome.
Hypothyroidism — an underactive thyroid gland — was seven times more common in the endometriosis patients. In many cases, hypothyroidism may also be an autoimmune disorder, resulting from an immune system attack on the thyroid gland.
The researchers also found that the rates of allergies and asthma were higher among women with endometriosis than among women in the U.S. population, and higher still if they had other diseases. The researchers found that 61 percent of the women with endometriosis reported allergies (as compared to 18 percent of the general female population) and 12 percent had asthma (as compared to 5 percent). If a woman had endometriosis and an endocrine disease, the percent with allergies rose to 72 percent, and if a woman had endometriosis plus fibromyalgia or chronic fatigue syndrome, the rate for allergies rose to 88 percent.
Two-thirds of the women reported that relatives also had diagnosed or suspected endometriosis, suggesting a familial basis for the condition.
The study authors cautioned, however, that the study may not be representative of all patients with endometriosis. First, the women may have joined the Endometriosis Association because they were experiencing pain from their condition and so may not be typical of all patients with endometriosis. Also, such self-reported surveys may be more open to error than are surveys taken by a trained interviewer. For example, some of the women who answered the survey may have misinterpreted questions, may not have recognized the names of specific diseases, or may not have accurately reported conditions experienced by their family members.
The women who responded to the Endometriosis Association survey were predominantly white (nearly 95 percent) and educated (90 percent had at least some college education), and ninety-one percent were of reproductive age (15-45 years old). To compensate for such possible sources of bias, the researchers conducted a type of statistical test known as a sensitivity analysis. This analysis helps to confirm that even if a disease is underestimated in the general population and overestimated in the study sample, the rates of the various conditions reported in women with endometriosis are probably still significantly higher than in the general population.
“These findings suggest a strong association between endometriosis and autoimmune disorders, chronic fatigue syndrome and fibromyalgia" said Ms. Sinaii. “Health care professionals may need to consider endometriosis when evaluating their patients for these disorders.”
More information about endometriosis is available from the NICHD publication, Endometriosis, at
http://www.nichd.nih.gov/publications/pubs/endometriosis.pdf.
Information about endometriosis is also available from the Endometriosis Association, 8585 North 76th Place, Milwaukee, WI 53223; phone, 414-355-2200; http://www.EndometriosisAssn.org/
The NICHD is part of the National Institutes of Health, the biomedical research arm of the federal government. The Institute sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. NICHD publications, as well as information about the Institute, are available from the NICHD Web site,
http://www.nichd.nih.gov,
or from the NICHD Clearinghouse, 1-800-370-2943; e-mail NICHDClearinghouse@mail.nih.gov.
National Institute of ChildHealth and Human Development
EMBARGOED BY JOURNALThursday, September 26, 20027:01 p.m. ET
Contact:Marianne Glass Duffyor Robert Bock(301) 496-5133
Women with Endometriosis Have Higher Rates of Some Diseases
Women who have endometriosis are more likely than other women to have disorders in which the immune system attacks the body's own tissues, according to researchers at the National Institute of Child Health and Human Development (NICHD), the George Washington University, and the Endometriosis Association.
The researchers also found that women with endometriosis are more likely to have chronic fatigue syndrome and to suffer from fibromyalgia syndrome — a disease involving pain in the muscles, tendons, and ligaments. Women with endometriosis are more likely to have asthma, allergies, and the skin condition eczema. The researchers surveyed 3,680 women who said they had been surgically diagnosed with endometriosis.
“This study indicates that women with endometriosis may be more likely to have a variety of diseases involving the immune system,” said Duane Alexander, M.D., Director of the NICHD. “Further study of the immune system in endometriosis may yield important clues to identifying the causes and treatment of the disease.”
In women who have endometriosis, tissue like the lining of the uterus — the endometrium — grows in other parts of the abdominal cavity. The endometrial tissue may attach itself to the ovaries, the outside of the uterus, the intestines, or other abdominal organs. Endometriosis affects an estimated eight to ten percent of reproductive age women. It may cause infertility or pelvic pain, although researchers believe that some women with the disease may not experience symptoms. In addition, the researchers found that family members of women with endometriosis more commonly had the disease, as reported by others.
The researchers published their findings in the October 2002 issue of Human Reproduction.
Roughly 99 percent of the women in the study said they had experienced pelvic pain for about 10 years before they were diagnosed with endometriosis. The women in the study reported that their pain began shortly after their first periods. The researchers do not know whether endometriosis actually occurs at the first period or if it develops over time. It is also unclear whether treating pain early could prevent chronic pelvic pain from developing in these women. For this reason, the study authors suggested that physicians treating patients with pelvic pain — particularly adolescents — consider whether endometriosis might be causing the problem.
Ninet Sinaii, MPH, of NICHD’s Pediatric and Reproductive Endocrinology Branch, and her colleagues analyzed information from a 1998 survey of members of the Endometriosis Association. The researchers focused on the 3,680 women who said they had been surgically diagnosed with the disease. The study authors compared the likelihood of women with endometriosis having a variety of disorders to the likelihood of women in the general population having these same conditions.
These included:
Autoimmune diseases — disorders in which the immune system attacks the body's own tissues.
Chronic fatigue syndrome — a strong feeling of fatigue that lasts for at least six months without letting up.
Fibromyalgia — a recurrent pain in the muscles, tendons, and ligaments.
Endocrine diseases — disorders of the glandular tissue
Atopic diseases — such as allergies or asthma
The researchers found that women with endometriosis were at greater risk than were other women for such autoimmune diseases as systemic lupus erythematosus, Sjögren’s Syndrome, rheumatoid arthritis, and multiple sclerosis.
The women in the study were over a hundred times more likely to experience chronic fatigue syndrome than the general population of U.S. women. The women with endometriosis were more than twice as likely as other women to experience fibromyalgia. In addition, 20 percent had more than one other disease, and up to 31 percent of those with more than one disease had also been diagnosed with either fibromyalgia or chronic fatigue syndrome.
Hypothyroidism — an underactive thyroid gland — was seven times more common in the endometriosis patients. In many cases, hypothyroidism may also be an autoimmune disorder, resulting from an immune system attack on the thyroid gland.
The researchers also found that the rates of allergies and asthma were higher among women with endometriosis than among women in the U.S. population, and higher still if they had other diseases. The researchers found that 61 percent of the women with endometriosis reported allergies (as compared to 18 percent of the general female population) and 12 percent had asthma (as compared to 5 percent). If a woman had endometriosis and an endocrine disease, the percent with allergies rose to 72 percent, and if a woman had endometriosis plus fibromyalgia or chronic fatigue syndrome, the rate for allergies rose to 88 percent.
Two-thirds of the women reported that relatives also had diagnosed or suspected endometriosis, suggesting a familial basis for the condition.
The study authors cautioned, however, that the study may not be representative of all patients with endometriosis. First, the women may have joined the Endometriosis Association because they were experiencing pain from their condition and so may not be typical of all patients with endometriosis. Also, such self-reported surveys may be more open to error than are surveys taken by a trained interviewer. For example, some of the women who answered the survey may have misinterpreted questions, may not have recognized the names of specific diseases, or may not have accurately reported conditions experienced by their family members.
The women who responded to the Endometriosis Association survey were predominantly white (nearly 95 percent) and educated (90 percent had at least some college education), and ninety-one percent were of reproductive age (15-45 years old). To compensate for such possible sources of bias, the researchers conducted a type of statistical test known as a sensitivity analysis. This analysis helps to confirm that even if a disease is underestimated in the general population and overestimated in the study sample, the rates of the various conditions reported in women with endometriosis are probably still significantly higher than in the general population.
“These findings suggest a strong association between endometriosis and autoimmune disorders, chronic fatigue syndrome and fibromyalgia" said Ms. Sinaii. “Health care professionals may need to consider endometriosis when evaluating their patients for these disorders.”
More information about endometriosis is available from the NICHD publication, Endometriosis, at
http://www.nichd.nih.gov/publications/pubs/endometriosis.pdf.
Information about endometriosis is also available from the Endometriosis Association, 8585 North 76th Place, Milwaukee, WI 53223; phone, 414-355-2200; http://www.EndometriosisAssn.org/
The NICHD is part of the National Institutes of Health, the biomedical research arm of the federal government. The Institute sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. NICHD publications, as well as information about the Institute, are available from the NICHD Web site,
http://www.nichd.nih.gov,
or from the NICHD Clearinghouse, 1-800-370-2943; e-mail NICHDClearinghouse@mail.nih.gov.
Thursday, April 06, 2006
RISKS AND SIDE EFFECTS WITH DRUG TREATMENTS AND SURGERY ASSOCIATED WITH ASSITED REPRODUCTIVE TECHNOLOGY (ART)
There are risks associated with everyday living and all of us unconsciously calculate these in undertaking daily activities (eg. car accident, falling down stairs). We also suffer side effects as a result of daily exposure to most things we come into contact with (eg. hay fever, sunburn).
You must now understand the risks and side effects that may occur with drugs we might suggest you take, and the surgical treatment possibly required for ART ie. IVF, GIFT etc. You must decide whether these risks are worth taking and whether the side effects are worth tolerating.
A) SURGERY
Oocyte (eggs) collection is undertaken using either:
Laparoscopy
Transvaginal Ultrasound
The following complications of surgery have been described:
General
Bleeding ie. From the ovary or from adjacent pelvic structures. Bleeding usually settles by itself but very rarely the "bleeding point" must be tied off requiring surgery.
Pelvic Infection: Some Concept patients take antibiotics before and during treatment to help prevent this occurring but the possibility still exists.
Anaesthesia: Risks include allergic rashes, temporary paralysis, vomiting and even, in more extreme cases, death. With young, fit, healthy women these risks are lower than for general surgery patients.
Laparoscopy requires deeper anaesthesia than for Transvaginal Aspiration which may be carried out under sedation with local anaesthesia.
Laparoscopy.
"Accidental" bowel injury. Patients who have had previous surgery (and this applies to many requiring ART) may have bowel adhesions. This increases the risk of injury to the bowel. Any injury must be repaired immediately to avoid peritonitis (infection of the abdomen).
"Superficial" haemorrhage. Some bruising around the puncture marks or abdominal wall is common.
Retained "gas". The carbon dioxide gas which is placed into the abdomen during laparoscopy may not all be expelled at the end of the operation; again this is more usual in patients with adhesions. This may provide some discomfort under the ribs or in the shoulder. It does not usually last longer than twenty four hours.
Transvaginal Ultrasound Aspiration
Unrecognised bleeding. Symptoms should be noted within four hours and this is the basis of our requirement that nursing observation be carried out for this period of time.
In general, the risks of surgery are higher where the patient is obese, smoke excessively or is in a state of poor nutrition.
B) MEDICATIONS
It is neither possible nor useful to list all the possible reactions to medication. All drugs produce some side effects. These can be one or more of the following;
Allergic reactions: These are bizarre responses peculiar to some individuals and not to others (eg. Penicillin can produce lumpy rashes or sudden fluid retention and, if this occurs within the larynx, some obstruction to breathing is possible).
Exaggerated side effects: These are the effects of medication which in some degree are common to many patients taking drugs but some people have an exaggerated reaction (eg. Pethidine produces relief of pain but commonly "queasiness" or light headed feelings).
The specific medications which are used in ART are as follows:
1) LUCRIN/SYNAREL
This medication is used to suppress the natural menstrual cycle to allow greater control over the response by the ovaries to gonadotrophins eg. Humegon/Puregon and Gonal F.
It will produce similar effects to the menopause. It does not produce an early menopause. The main side effects are hot flushes and mood swings.
Stopping the drug will allow the pituitary to recover (similar to the effect of oral contraceptives). Hence the normal menstrual cycle may be delayed.
2) GONADOTROPHIN (PUREGON/GONAL F/HUMEGON)
These are the injectable drugs which directly stimulate the ovaries to produce more oocytes (eggs). The side effects are very similar to the menopause since these medications are exactly the same hormones as menopausal women have in their own bodies. Patients may notice weariness, mood changes, hot flushes, nausea and headaches These are temporary and cease as soon as the medications are stopped.
As the ovaries will swell to accommodate the follicles, some patients may notice an increased pelvic pressure. If the ovaries are bound down by adhesions the pressure may be felt as pain. This pressure may continue into the second half of the cycle (luteal phase) and if pregnant, for up to three (3) months.
Very rarely, the ovary may rotate and twist or may bleed. These may produce severe pelvic pain and lead to a requirement for further surgery.
3) HUMAN CHORIONIC GONADOTROPHIN (HCG/PROFASI/PREGNYL)
This medication causes the final maturing of the oocyte before aspiration.
It may be a slightly more uncomfortable injection than the others.
4) CLOMIPHENE (CLOMID/SEROPHENE)
This oral drug is used to stimulate the pituitary to stimulate the production of extra oocytes.
Occasionally side effects like headache, weariness, occasional visual disturbance and hot flushes may be noticed after a few days on this drug. These cease as soon as patients stop taking it..
Some patients who have used Clomid have suffered breast and ovarian cancers in later life but there is no proven association between the use of Clomid and cancer. (*NOTE: women who delay child bearing until later in life or those who do not have children also have a higher incidence of breast and ovarian cancer in later life and Clomid users are in these groups).
5) FOLIC ACID
A deficiency of this vitamin may be responsible for neural tube defects (eg. spina bifida). All Concept patients are advised to supplement their diet with folic acid before ART treatment.
6) DOXYCYCLINE
Concept believes that the use of the tetracycline drug, doxycycline will be of benefit in the following situations:
a)
In reducing the chance of pelvic infection during oocyte aspiration.
b)
Protecting the embryo from cervical or vaginal bacteria after embryo transfer.
c)
Protecting the embryo from bacteria in the semen sample during fertilisation.
The side effects of doxycycline may occasionally be:
a)
nausea, vomiting or diarrhoea
b)
skin rashes, including photo sensitivity to sunlight, ie. making some areas of skin more sensitive to sunlight.
c)
Increased chances of vaginal thrush
Women who are susceptible to thrush should use anti-thrush medication at the same time. Patients with side effects should stop the drug and contact the Co-ordinator and their doctor.
OVARIAN HYPERSTIMULATION SYNDROME (OHSS)
What is it?
This is a specific problem which occurs in about 1% - 2% of patients who undergo super-ovulation induction. It is impossible to predict which patients may suffer from it before Assisted Reproductive Technology treatments commence.
During the treatment it is more likely to occur in those producing large numbers of follicles and high hormone levels. It does NOT occur if the final HCG injection is not given.
Essentially, fluid from the blood stream leaks into the abdominal cavity causing it to swell noticeably and leaving the blood more concentrated and more viscous. Mild cases of OHSS may pass unnoticed.
The consequences of severe OHSS can be breathing difficulties, temporary kidney "shut-down", and some arterial and venous thrombosis. Rarely extensive thrombosis could cause interference with blood supply to parts of the brain or to other organs. Death due to OHSS whilst very rare, is possible.
Patients who suffer severe OHSS must be hospitalised and treated. This treatment would involve the infusion of intravenous fluids and the fluid in the abdomen may need draining off.
OHSS always disappears in a few days unless a pregnancy occurs. In early pregnancy the problem may last weeks and require prolonged hospitalisation.
PREVENTION OF OHSS
All patients using HMG or Puregon will require close monitoring using blood tests and ultrasound scanning of the ovaries to ensure the ovaries do not over- respond to the drugs.
Patients are generally monitored daily and those who have oestradiol (E2) levels approaching 12,000pm/L are considered to be getting close to the risk level. If this occurs, the options are as follows:
1)
To cancel the cycle
2)
To collect and fertilise the oocytes and then freeze the embryos (ie. avoiding pregnancy in that cycle).
These will be discussed with you should this situation arise.
C) MISCELLANEOUS
1. DISAPPOINTMENT
Infertility itself creates a feeling of intense hurt and disappointment. The opportunity of an ART treatment and thus the possibility of a pregnancy offers hope. However, the intensity of effort put in undergoing ART procedures is more than likely to be unrewarded in each cycle (otherwise the pregnancy rate would be more than 50%). Success is achievable for most couples, as long as a number of attempts are tried.
It is also likely that your parents, relations or friends will not appreciate what you have been through. They cannot really know. You may feel lonely yet become irritated by sympathy; angry, but not sure who or what with or why. Do not be afraid or ashamed to ask for help. The Concept Counsellor is available for everyone to talk to.
2. MULTIPLE PREGNANCY
There is an increased pregnancy rate with an increase in the number of oocytes or embryos replaced but there is also an increased risk of multiple pregnancies.
One or two oocytes or embryos are currently replaced but, depending upon age, cause of infertility and previous outcomes three may be replaced.
This will be discussed with you before the oocytes or embryos are replaced.
With two embryos or two oocytes replaced the chances of twins are about one in five.
There are some possible disadvantages in multiple pregnancies.
Medical (Maternal)Obstetrically, carrying two babies places greater pressures on the pregnant women. There is an increased risk of miscarriage, obstetrical complications, premature deliveries and birth complications. Please discuss these with your gynaecologist.
Medical (Babies)Babies born as one of multiple birth have a greater risk of prematurity which may or may not then require neonatal intensive care. These babies are also at greater risk of cerebral palsy although delivery methods may contribute to this. Please discuss this further with your obstetrician.
Social (Babies)Babies born as one of a multiple need to compete for the attention and care provided by the parents. This may cause greater social problems in due course. Please discuss this with your gynaecologist.
3. ECTOPIC PREGNANCY
(i.e. implanting, and growing in the Fallopian tube and not in the uterus.)
It is easy to understand that this can happen in GIFT procedures but it may not be realised that placing embryos into the uterine cavity can also result in this situation. The embryo may frequently transfer to the Fallopian tubes: in the great majority returning normally to the uterus. Some embryos, however, may stay and implant "ectopically".
A tubal pregnancy can grow, rupture and lead to a surgical emergency. If recognised early measures can be taken to avoid such emergency situations. It is important that Concept's screening procedures be followed to ensure that no patient suffer from an unrecognised ectopic pregnancy.
A patient diagnosed as pregnant following IVF or GIFT should have an ultrasound carried out at such time that an intra-uterine pregnancy can be identified. This is possible from three weeks after ovulation or when the QHCG level reaches 3000 units or more.
That patients assumed "not pregnant" have this confirmed by a negative QHCG at two weeks (14 days) after ovulation. A "period" can occur with an ectopic pregnancy and is not sufficient reasurrance.
These precautions are most important for "country" patients, i.e. outside metropolitan Perth, as an ectopic pregnancy far from medical help could be disastrous.
1 SPERM TREATMENTS
In some cases where reduced sperm motility or numbers indicate that normal fertilisation rates might not be attainable, the use of a stimulant on the sperm will be recommended.
This stimulant will be Pentoxyfilline. Both these agents act by removing some of the excess oxygen compounds from the sperm and eliminating some of the damaging effects of these compounds. The result is that sperm are more capable of swimming faster and have an increased fertilizing potential. Some other chemical agents are used to improve the sperm recruitment procedures. These include Percoll, Nycodens and Isolate.
These agents have been in use routinely, to improve the fertilizing capacity of sperm, for a number of years.
While there has been no evidence, to date, that these agents have any damaging effect on the developing embryo or baby, there is no proof that this cannot occur. None of these agents were developed or registered for these specific uses but have been used in these ART treatments since the early 1980's.
If you have any concerns over the use of any of these agents please discuss these with Dr.Bellinge or your doctor.
2. CULTURE MEDIUM
The Earles and T6 culture fluids for A.R.T. procedures utilise inert salt solutions.
A number of other materials including but not limited to such products as Propylene Glycol, Hepes and D.M.S.O. are also used in the culture and in the freezing of sperm and embryos. None of these agents were developed or registered for the specific uses but have been used in ART culture treatments since the early 1980's.
Penicillin and Streptomycin are also included in the culture medium but in such minute quantities that even women who have penicillin allergies have not noticed any effects at Concept in the past seventeen years. Some other human blood products may be used and although they are made from plasma which has been screened or tested for known transmissible agents such as HIV (AIDS), hepatitis B and hepatitis C, there may be possible contamination with these or other unknown agents. Chemical processing and virus inactivation stages included in the manufacture of these products are believed to render them safe from the risk of infection. Nevertheless the possibility of transmitting these agents must always be considered.
If you have any concerns over the use of any of these agents please discuss these with Dr.Bellinge or your doctor.
http://www.conceptfert.com.au/facts/risks_and_side_effects.htm
You must now understand the risks and side effects that may occur with drugs we might suggest you take, and the surgical treatment possibly required for ART ie. IVF, GIFT etc. You must decide whether these risks are worth taking and whether the side effects are worth tolerating.
A) SURGERY
Oocyte (eggs) collection is undertaken using either:
Laparoscopy
Transvaginal Ultrasound
The following complications of surgery have been described:
General
Bleeding ie. From the ovary or from adjacent pelvic structures. Bleeding usually settles by itself but very rarely the "bleeding point" must be tied off requiring surgery.
Pelvic Infection: Some Concept patients take antibiotics before and during treatment to help prevent this occurring but the possibility still exists.
Anaesthesia: Risks include allergic rashes, temporary paralysis, vomiting and even, in more extreme cases, death. With young, fit, healthy women these risks are lower than for general surgery patients.
Laparoscopy requires deeper anaesthesia than for Transvaginal Aspiration which may be carried out under sedation with local anaesthesia.
Laparoscopy.
"Accidental" bowel injury. Patients who have had previous surgery (and this applies to many requiring ART) may have bowel adhesions. This increases the risk of injury to the bowel. Any injury must be repaired immediately to avoid peritonitis (infection of the abdomen).
"Superficial" haemorrhage. Some bruising around the puncture marks or abdominal wall is common.
Retained "gas". The carbon dioxide gas which is placed into the abdomen during laparoscopy may not all be expelled at the end of the operation; again this is more usual in patients with adhesions. This may provide some discomfort under the ribs or in the shoulder. It does not usually last longer than twenty four hours.
Transvaginal Ultrasound Aspiration
Unrecognised bleeding. Symptoms should be noted within four hours and this is the basis of our requirement that nursing observation be carried out for this period of time.
In general, the risks of surgery are higher where the patient is obese, smoke excessively or is in a state of poor nutrition.
B) MEDICATIONS
It is neither possible nor useful to list all the possible reactions to medication. All drugs produce some side effects. These can be one or more of the following;
Allergic reactions: These are bizarre responses peculiar to some individuals and not to others (eg. Penicillin can produce lumpy rashes or sudden fluid retention and, if this occurs within the larynx, some obstruction to breathing is possible).
Exaggerated side effects: These are the effects of medication which in some degree are common to many patients taking drugs but some people have an exaggerated reaction (eg. Pethidine produces relief of pain but commonly "queasiness" or light headed feelings).
The specific medications which are used in ART are as follows:
1) LUCRIN/SYNAREL
This medication is used to suppress the natural menstrual cycle to allow greater control over the response by the ovaries to gonadotrophins eg. Humegon/Puregon and Gonal F.
It will produce similar effects to the menopause. It does not produce an early menopause. The main side effects are hot flushes and mood swings.
Stopping the drug will allow the pituitary to recover (similar to the effect of oral contraceptives). Hence the normal menstrual cycle may be delayed.
2) GONADOTROPHIN (PUREGON/GONAL F/HUMEGON)
These are the injectable drugs which directly stimulate the ovaries to produce more oocytes (eggs). The side effects are very similar to the menopause since these medications are exactly the same hormones as menopausal women have in their own bodies. Patients may notice weariness, mood changes, hot flushes, nausea and headaches These are temporary and cease as soon as the medications are stopped.
As the ovaries will swell to accommodate the follicles, some patients may notice an increased pelvic pressure. If the ovaries are bound down by adhesions the pressure may be felt as pain. This pressure may continue into the second half of the cycle (luteal phase) and if pregnant, for up to three (3) months.
Very rarely, the ovary may rotate and twist or may bleed. These may produce severe pelvic pain and lead to a requirement for further surgery.
3) HUMAN CHORIONIC GONADOTROPHIN (HCG/PROFASI/PREGNYL)
This medication causes the final maturing of the oocyte before aspiration.
It may be a slightly more uncomfortable injection than the others.
4) CLOMIPHENE (CLOMID/SEROPHENE)
This oral drug is used to stimulate the pituitary to stimulate the production of extra oocytes.
Occasionally side effects like headache, weariness, occasional visual disturbance and hot flushes may be noticed after a few days on this drug. These cease as soon as patients stop taking it..
Some patients who have used Clomid have suffered breast and ovarian cancers in later life but there is no proven association between the use of Clomid and cancer. (*NOTE: women who delay child bearing until later in life or those who do not have children also have a higher incidence of breast and ovarian cancer in later life and Clomid users are in these groups).
5) FOLIC ACID
A deficiency of this vitamin may be responsible for neural tube defects (eg. spina bifida). All Concept patients are advised to supplement their diet with folic acid before ART treatment.
6) DOXYCYCLINE
Concept believes that the use of the tetracycline drug, doxycycline will be of benefit in the following situations:
a)
In reducing the chance of pelvic infection during oocyte aspiration.
b)
Protecting the embryo from cervical or vaginal bacteria after embryo transfer.
c)
Protecting the embryo from bacteria in the semen sample during fertilisation.
The side effects of doxycycline may occasionally be:
a)
nausea, vomiting or diarrhoea
b)
skin rashes, including photo sensitivity to sunlight, ie. making some areas of skin more sensitive to sunlight.
c)
Increased chances of vaginal thrush
Women who are susceptible to thrush should use anti-thrush medication at the same time. Patients with side effects should stop the drug and contact the Co-ordinator and their doctor.
OVARIAN HYPERSTIMULATION SYNDROME (OHSS)
What is it?
This is a specific problem which occurs in about 1% - 2% of patients who undergo super-ovulation induction. It is impossible to predict which patients may suffer from it before Assisted Reproductive Technology treatments commence.
During the treatment it is more likely to occur in those producing large numbers of follicles and high hormone levels. It does NOT occur if the final HCG injection is not given.
Essentially, fluid from the blood stream leaks into the abdominal cavity causing it to swell noticeably and leaving the blood more concentrated and more viscous. Mild cases of OHSS may pass unnoticed.
The consequences of severe OHSS can be breathing difficulties, temporary kidney "shut-down", and some arterial and venous thrombosis. Rarely extensive thrombosis could cause interference with blood supply to parts of the brain or to other organs. Death due to OHSS whilst very rare, is possible.
Patients who suffer severe OHSS must be hospitalised and treated. This treatment would involve the infusion of intravenous fluids and the fluid in the abdomen may need draining off.
OHSS always disappears in a few days unless a pregnancy occurs. In early pregnancy the problem may last weeks and require prolonged hospitalisation.
PREVENTION OF OHSS
All patients using HMG or Puregon will require close monitoring using blood tests and ultrasound scanning of the ovaries to ensure the ovaries do not over- respond to the drugs.
Patients are generally monitored daily and those who have oestradiol (E2) levels approaching 12,000pm/L are considered to be getting close to the risk level. If this occurs, the options are as follows:
1)
To cancel the cycle
2)
To collect and fertilise the oocytes and then freeze the embryos (ie. avoiding pregnancy in that cycle).
These will be discussed with you should this situation arise.
C) MISCELLANEOUS
1. DISAPPOINTMENT
Infertility itself creates a feeling of intense hurt and disappointment. The opportunity of an ART treatment and thus the possibility of a pregnancy offers hope. However, the intensity of effort put in undergoing ART procedures is more than likely to be unrewarded in each cycle (otherwise the pregnancy rate would be more than 50%). Success is achievable for most couples, as long as a number of attempts are tried.
It is also likely that your parents, relations or friends will not appreciate what you have been through. They cannot really know. You may feel lonely yet become irritated by sympathy; angry, but not sure who or what with or why. Do not be afraid or ashamed to ask for help. The Concept Counsellor is available for everyone to talk to.
2. MULTIPLE PREGNANCY
There is an increased pregnancy rate with an increase in the number of oocytes or embryos replaced but there is also an increased risk of multiple pregnancies.
One or two oocytes or embryos are currently replaced but, depending upon age, cause of infertility and previous outcomes three may be replaced.
This will be discussed with you before the oocytes or embryos are replaced.
With two embryos or two oocytes replaced the chances of twins are about one in five.
There are some possible disadvantages in multiple pregnancies.
Medical (Maternal)Obstetrically, carrying two babies places greater pressures on the pregnant women. There is an increased risk of miscarriage, obstetrical complications, premature deliveries and birth complications. Please discuss these with your gynaecologist.
Medical (Babies)Babies born as one of multiple birth have a greater risk of prematurity which may or may not then require neonatal intensive care. These babies are also at greater risk of cerebral palsy although delivery methods may contribute to this. Please discuss this further with your obstetrician.
Social (Babies)Babies born as one of a multiple need to compete for the attention and care provided by the parents. This may cause greater social problems in due course. Please discuss this with your gynaecologist.
3. ECTOPIC PREGNANCY
(i.e. implanting, and growing in the Fallopian tube and not in the uterus.)
It is easy to understand that this can happen in GIFT procedures but it may not be realised that placing embryos into the uterine cavity can also result in this situation. The embryo may frequently transfer to the Fallopian tubes: in the great majority returning normally to the uterus. Some embryos, however, may stay and implant "ectopically".
A tubal pregnancy can grow, rupture and lead to a surgical emergency. If recognised early measures can be taken to avoid such emergency situations. It is important that Concept's screening procedures be followed to ensure that no patient suffer from an unrecognised ectopic pregnancy.
A patient diagnosed as pregnant following IVF or GIFT should have an ultrasound carried out at such time that an intra-uterine pregnancy can be identified. This is possible from three weeks after ovulation or when the QHCG level reaches 3000 units or more.
That patients assumed "not pregnant" have this confirmed by a negative QHCG at two weeks (14 days) after ovulation. A "period" can occur with an ectopic pregnancy and is not sufficient reasurrance.
These precautions are most important for "country" patients, i.e. outside metropolitan Perth, as an ectopic pregnancy far from medical help could be disastrous.
1 SPERM TREATMENTS
In some cases where reduced sperm motility or numbers indicate that normal fertilisation rates might not be attainable, the use of a stimulant on the sperm will be recommended.
This stimulant will be Pentoxyfilline. Both these agents act by removing some of the excess oxygen compounds from the sperm and eliminating some of the damaging effects of these compounds. The result is that sperm are more capable of swimming faster and have an increased fertilizing potential. Some other chemical agents are used to improve the sperm recruitment procedures. These include Percoll, Nycodens and Isolate.
These agents have been in use routinely, to improve the fertilizing capacity of sperm, for a number of years.
While there has been no evidence, to date, that these agents have any damaging effect on the developing embryo or baby, there is no proof that this cannot occur. None of these agents were developed or registered for these specific uses but have been used in these ART treatments since the early 1980's.
If you have any concerns over the use of any of these agents please discuss these with Dr.Bellinge or your doctor.
2. CULTURE MEDIUM
The Earles and T6 culture fluids for A.R.T. procedures utilise inert salt solutions.
A number of other materials including but not limited to such products as Propylene Glycol, Hepes and D.M.S.O. are also used in the culture and in the freezing of sperm and embryos. None of these agents were developed or registered for the specific uses but have been used in ART culture treatments since the early 1980's.
Penicillin and Streptomycin are also included in the culture medium but in such minute quantities that even women who have penicillin allergies have not noticed any effects at Concept in the past seventeen years. Some other human blood products may be used and although they are made from plasma which has been screened or tested for known transmissible agents such as HIV (AIDS), hepatitis B and hepatitis C, there may be possible contamination with these or other unknown agents. Chemical processing and virus inactivation stages included in the manufacture of these products are believed to render them safe from the risk of infection. Nevertheless the possibility of transmitting these agents must always be considered.
If you have any concerns over the use of any of these agents please discuss these with Dr.Bellinge or your doctor.
http://www.conceptfert.com.au/facts/risks_and_side_effects.htm
Subscribe to:
Posts (Atom)