Endometriosis ~ Abdominal Pain ~ Endo ~ Scar Tissue ~ Adhesions ~ Infertility ~ Hysterectomy

Tuesday, April 24, 2007

10 ways a woman can boost her fertility

IN reality, a woman’s reproductive system is extremely sensitive, and any stressor — psychological, nutritional, or physical — can affect the delicate balance.
Whether or not she’s trying to conceive, these simple health moves can help maximize and protect her fertility.

Watch your weight
Excess body fat can lead to an overproduction of certain hormones, which could short-circuit the whole ovulation process. Your cycles may be less regular, you may ovulate less often, and you lower your chances of getting pregnant. Exercise can help maintain a healthy weight. Just don’t overdo it!
Eat well
Staying well nourished boosts odds of conceiving. Make sure to include enough protein, iron, zinc, and vitamin C, because deficiencies in these nutrients have been linked to lengthened menstrual cycles (and therefore less frequent ovulation) and a higher risk of early miscarriage.
Avoid tobacco smoking
Cigarette toxins not only damage a woman’s eggs, interfering with the fertilization and implantation process, but also cause the ovaries to “age.”
Get to know your cycle
When you’re ready to conceive, find your “fertile window,” during which you should have intercourse regularly. A woman’s fertile days are usually the day of ovulation and the four or five days before, not after. But don’t assume that you automatically ovulate on day 14 of your cycle.
Avoid stress and depression
Women are less likely to conceive during months of psychological distress. Stress, like heavy exercise, may throw off the body’s hormone production, making the menstrual cycle less reliable. But learning to manage stress through relaxation techniques can get your hormones back on track,
Think before you drink
Alcohol consumption has been linked with a decreased ability to get pregnant (not to mention the harm it can cause to a developing foetus). Alcohol alters oestrogen levels, which may interfere with egg implantation. If you’re thinking about getting pregnant, limit alcohol intake.
Get busy in the bedroom
Women who engage in regular (at least weekly) intercourse are more likely to have predictable menstrual cycles and normal ovulation patterns than women who have sporadic sex. Having sex every 36 to 48 hours in the few days before ovulation will make the most of your fertile window.
Don’t douche
This cleansing routine can wipe out normal, protective bacteria in the vagina, shifting the balance and increasing risk for common but often overlooked vaginal infection linked to preterm labour and associated with higher risk of miscarriage and infertility.
Stay on the Pill
Birth-control pill may actually enhance fertility. For some women, the Pill can be critical in preserving fertility because it keeps endometriosis and uterine fibroids under control by slowing uterine-tissue growth.
Check his health
The same things that harm your fertility can also wreck your husband’s reproductive health. Cigarettes, alcohol, a poor diet — any of these can contribute to lower sperm production or quality. Getting enough nutrients — particularly vitamins E and C and selenium — helps him produce healthy sperm. Taking a daily multivitamin is a good step.
Source

Monday, April 23, 2007

Facts about Menstrual Pains

Facts about Menstrual Pains
Dysmenorrhoe is the medical term for severe period pain or menstrual cramps and it affects up to 50% of menstruating women, making normal everyday activities very difficult. Every month, the womb prepares itself to receive and hold a baby. This preparation involves the thickening of the inner lining of the womb, which also becomes well supplied with blood vessels. If no conception or pregnancy occurs for that month, this thickened womb-lining breaks down along with the blood and blood vessels in it and passes out through the vagina as the period or menses. The womb then starts the whole process all over again. The first menstruation in a girl's life is termed menarche while menopause refers to when menstruation ceases. This elaborate mechanism of menstruation is controlled by several hormones that are released into the blood at varied quantities at different times of the month.
To help expel the menstrual products, the body, under the influence of these hormones, produces substances known as prostaglandins. These substances enable the womb to contract to expel its contents. During a normal period, the contraction of the womb causes little pain that is not disturbing. The pain of dysmenorrhoea is however disabling. These are primary dysmenorrhoea and secondary dysmenorrhoea. In primary dysmenorrhoea, there is no organic or psychological abnormality in the woman. It is primarily due to the over production of a particular type of prostaglandin which causes excessive contraction of the womb. When the womb contracts excessively blood supply to the ceIls of the waIl of the womb is cut off for a longer period. This injures the cells, which respond with pain to indicate that something is wrong. Primary dysmenorrhoea normally affects adolescent women; that is after menarche when the ovulatory cycle becomes established. The pain of primary dysmenorrhoea can be intermittent, or continuous, lasting for 1-3 days. It usually starts at the onset of bleeding and then subsiding over the next one or two days. The cramps and pain can be accompanied by headaches, dizziness, nausea and vomiting. The release of prostaglandins can also cause constipation and/or diarrhoea because of their effect on the smooth muscles of the intestines. Apart from severe stomach cramps, the pain can also extend into the lower back or into the thighs and legs. In secondary dysmenorrhoea, there is an abnormality or pathology in the pelvis of the woman.The pain of secondary dysmenorrhoea is similar to that of primary dysmenorrhoea, but it tends to affect older women. The pathologies whose presence cause secondary dysmenorrhoea include endometriosis; a disease in which some of the tissue lining the womb happens to be found else where in the body cavity.Pelvic inflammatory disease (PID), ovarian cysts, fibroids and sexual frustration are also well known causes. Dysmenorrhoea must be reported to the hospital or gynaecology unit for investigations, diagnosis and appropriate management. It is important that women monitor their menstrual cycle and symptoms in a diary for a couple of months so that you can give a detailed description of their menstrual pain. For example the woman should be able to tell the doctor how long her periods usually last, how regular her periods are and when pain occurs, how long she has suffered from painful periods and what type of pain it is, whether the blood loss has become heavier recently, whether blood loss includes clotting in the flow and whether the pain prevents her from carrying out her day-to-day activities. At the hospital, the doctor examines the patient with emphasis on the organs in the pelvis and lower abdomen. Tests done include blood and urine analysis as well as ultrasound scan of the abdomen and pelvis for abnormalities. Further tests may also be done. Treatment of dysmenorrhoea depends on the type. For secondary dysmenorrhoea, the underlying cause is identified and treated. Primary dysmenorrhoea is treated mostly by preventing the woman form ovulating in the first place by manipulating the hormone levels or by blocking the synthesis of prostaglandins in the body. The use of oral contraceptive pills is very effective at preventing primary dysmenorrhoea but it also prevents pregnancy. It is therefore not good for women who want a baby. There are several drugs that block the manufacture of prostaglandins in the body. They do this by inhibiting an enzyme called prostaglandin synthetase, which converts rapidly certain substances into prostaglandins. These drugs include the fenamates and some non-steroidal anti-inflammatory agents, which doctors will not hesitate to prescribe if a diagnosis is made. Primary dysmenorrhoea usually occurs during adolescence mainly between the ages of 17 and 25 years and the pain tends to lessen with age. With secondary dysmenorrhoea, if the underlying cause is identified and successfully treated, the symptoms should disappear. It is easier said than done but reducing stress levels can really be of help as it relaxes our muscles. Gentle exercise such as jogging and brisk walks can also be beneficial in reducing the pain of dysmenorrhoea. Old favourites include hot water bottles on the tummy. Some women prefer pain relief the natural way using magnetic treatment. Others have also tried herbal medicines, acupuncture or chiropractic. Source: The Chronicle
http://www.myjoyonline.com/archives/health/200704/3722.asp

Wednesday, April 18, 2007

News from the Front ~ EndoTimes Blog

Rigel to Present New Research Programs at AACR MeetingPR-Inside.com (Pressemitteilung), Austria - Apr 16, 2007Cancer is the second leading cause of death in America and endometriosis is estimated to affect 5.5 million females in the US and Canada. ...

Baby dreams finally come trueLaconia Citizen, NH - Apr 16, 2007"It could be fallopian tubes, endometriosis, pelvic scar tissue." Glatstein said that age can also be a factor, with many women waiting until they get ...

Adolescent Endometriosis

(CBS) Leading doctors are spreading the word that many young girls are suffering from a gynecological condition commonly associated with infertility. Most don't even know they have it. High school senior Valerie Berrin splits her time between softball and homework. But, life wasn't always so typical for the teen. When she was 8-years-old, she started suffering terrible pain. "It was almost like a rock was sitting on my stomach,” Berrin said. “Sometimes it was sharp, very sharp."
The pain was so chronic, Berrin and her mom Fran traveled to dozens of specialists across the country. No one could figure out the problem. "I had colonoscopies and endoscopies," Berrin said. "As a mom, I felt it was very frustrated," Fran Berrin said.

Fran says there was a series of misdiagnoses. Then, finally, an answer. Valerie had a gynecological condition called endometriosis--years before she even got her first period. "I was overwhelmed at the fact that this very young girl was now a gynecological endometriosis patient," Fran Berrin said. The condition occurs when tissue that lines the uterine walls grows outside the uterus. It can cause serious pain and infertility. An estimated five and a half million women have it. But, leading specialists warn symptoms can start as young as 12-years-old or sooner. "It can occur in adolescence very, very early with the onset of puberty, before menstruation when estrogen levels are rising," reproductive endocrinologist Dr. John Rock said. Research shows 47 percent of adolescent females suffering with pelvic pain have endometriosis. But the American College of Obstetricians and Gynecologists say many of those cases go undiagnosed."Adolescents may be cared for by their pediatrician, adolescent health care provider, family practitioner,” pediatric gynecologist Dr. Marc Laufer said. “Not all of them are familiar with endometriosis." It's also tough to detect in any patient--it can't be seen through an x-ray or MRI. "The best way to make a diagnosis is through a laparoscopy, where you actually look in through the pelvis and see the implants and the disease," Rock said. There are warning signs, like pelvic discomfort. Some teens may also have frequent urination, diarrhea or constipation. "If it's interfering with her life, then I think it's important to further evaluate," Laufer said. Valerie Berrin had surgery to remove her disease. She's speaking out in the hopes that other young girls in pain will get help. The American College of Obstetricians and Gynecologists recommends teenage girls first visit an ObGyn between 13-years-old and 15-years-old.
Source

Many causes for painful intercourse

Q: Sexual intercourse has become very painful since stopping HRT (Hormone Replacement Therapy). I've tried progesterone and Vagifem, but nothing helps. I think this is a concern for many women. Do you have any other suggestions?-- E.K., Ocala, Florida

A: Indeed, many women have this problem, especially older ones who experience vaginal dryness while going through menopause. Some women also take certain medications that lead to vaginal dryness, including antihistamines used for allergies, tricyclic antidepressants and, believe it or not, birth control pills.Younger women who still have a menstrual cycle may experience painful intercourse because of endometriosis, a condition that usually includes severe cramping and back pain during menstruation, painful bowel movements, fatigue, spotting and difficulty conceiving.The quick fix for vaginal dryness is a lubricant, easily found at any major retailer, health food store, or pharmacy. Brand names include AstroGlide, K-Y, LifeStyles, Replens, Zestra and others.Some of these inexpensive products are "warming," while others are "cooling." These effects are intended to heighten sensation and reduce friction. Personal lubricants only work temporarily and won't help every couple because painful sex may have nothing to do with vaginal dryness. That's why doctors may need to get involved for a proper diagnosis. I always suggest taking oral vitamin E, about 400-800 IU daily, which also nourishes hair and skin. In addition, omega 3 fish oils (1,000 mg once daily) are important for the same lubricating reasons.Another consideration is your hormones. Ask your OB/GYN if you have lower levels of thyroid, estrogen or testosterone -- three hormonal issues that could also lead to vaginal dryness. You can buy your own hormone test kit at zrtlab.com.Getting your hormones balanced is really important, and I can't stress this enough. Speaking of stress, if your life is riddled with hassles and obligations, dominated by a never-ending "to-do" list (welcome to Earth), consider Panax ginseng. This oriental herb supports adrenal function so you can cope, but it also helps men and women boost sex drive and reduce painful sex (because it thickens vaginal mucosa). Panax ginseng is a terrific option and is considered very safe, but it doesn't work overnight. Be compliant --dosages vary, but 400 mg every morning is a common dose. It's fine to take with vitamin E and fish oils, too.Readers alert: A batch of griseofulvin oral suspension used to treat fungal infections has been recalled because of glass fragments in the bottle. Consumers can call (800) 510-0383 to check lots.This information is not intended to treat, cure or diagnose your condition. Suzy Cohen is a registered pharmacist. Her column is published Tuesdays in the TimesDaily.-To contact her, visit dearpharmacist.com.
Source

Thursday, April 12, 2007

Endometriosis Clinical Trials from clinical trials.gov

19 studies were found.
1.
Not yet recruiting
The Immune Base of EndometriosisCondition: Endometriosis
2.
Recruiting
Effects of Endometriosis on Bone Mineral DensityCondition: Endometriosis
3.
Recruiting
Pelvic Pain in Women With EndometriosisConditions: Endometriosis; Pelvic Pain; Healthy; Tubal Ligation
4.
Recruiting
Medical Treatment of Endometriosis-Associated Pelvic PainConditions: Endometriosis; Pelvic Pain
5.
Recruiting
Effect of Rosiglitazone on Peritoneal Cytokines in Women With EndometriosisCondition: Endometriosis
6.
Recruiting
Use of Rosiglitazone in the Treatment of EndometriosisCondition: Endometriosis
7.
Not yet recruiting
The Effectiveness of Lng IUD for Treatment of the Patient Undergone Conservative Surgery for Pelvic EndometriosisConditions: Endometriosis; Pelvic Pain; Dysmenorrhea
8.
Recruiting
A Multinational, Randomized, Double-Blind, Placebo‑Controlled, Parallel Group Study to Investigate the Efficacy, Safety and Duration of Effect of a Single Administration of Various Doses of Cetrorelix SR in Subjects With Histologically Confirmed EndometriosisCondition: Endometriosis
9.
Recruiting
Evaluation of DR-2001 for the Management of Endometriosis-Related Pelvic PainCondition: Endometriosis
10.
Recruiting
Treatment of Endometriosis With Norethindrone Acetate ( NA) VS. Gonadotropin- Releasing Hormone (GnRH) Agonist (Lupron Depot 11.25 mg)Conditions: Endometriosis; Dysmenorrhea; Dyspareunia
11.
Recruiting
Safety and Efficacy Study of NBI-56418 in EndometriosisCondition: Endometriosis
12.
Recruiting
Use of Arimidex and Zoladex as Pretreatment to IVF in Women With Ovarian EndometriosisCondition: Endometriosis
13.
Recruiting
Evaluation of Endometrial Stromal Cell Apoptosis in AdenomyosisCondition: Endometriosis
14.
Recruiting
Progestin Treatment for Endometrial Stromal Cells in AdenomyosisCondition: Endometriosis
15.
Recruiting
'SPRING'-Study: "Subfertility Guidelines: Patient Related Implementation in the Netherlands Among Gynaecologists"Conditions: Male Infertility; Female Infertility; Ovarian Hyperstimulation Syndrome; Premature Ovarian Failure; Endometriosis
16.
Recruiting
Health-Related QoL Among Women Receiving Hysterectomy in NTUHConditions: Leiomyoma; Adenomyosis
17.
Recruiting
Uterine Artery Embolization for Symptomatic FibroidsConditions: Uterine Fibroids; Menorrhagia; Adenomyosis
18.
Recruiting
Treatment of Uterine Fibroids With the Selective Progesterone Receptor Modulator CDB-2914Conditions: Leiomyomata; Uterine Leiomyomata; Fibroids
19.
Not yet recruiting
PTEN and IGFBP-3 Correlation in Ovarian Carcinoma InvasionCondition: Ovarian Cancer

http://clinicaltrials.gov/ct/search?term=endometriosis

Wednesday, April 11, 2007

Live Laugh Love Blog

Endometriosis
It's just hit me. I have endometriosis. I was told this last Monday but the words didn't really mean much until today. I was out of it for all of last week from my pain killers and then there was Easter so I guess today is the first day I've had to actually sit down and think about it. I'm feeling very emotional and confused. I don't understand much about what is going to happen to me from now on and it's so frustrating!! I have so many questions and no one to answer them, well not until the 31st of May when I go back to my surgeon. I can't believe I have to wait that long. I'm going to drive myself crazy with 'what if's' by then. All they could tell me when I was in hospital was that they found "a bit of endometriosis". I don't know where. I don't know how bad this 'bit' is. I don't know if they got rid of it while they were in there. And today I'm starting to feel the pain again... on top of the pain I'm still feeling from my operation, so I guess it's also the first time I've had to think that maybe they couldn't do anything and I have to live with this pain forever. I think up until today, I thought that everything was going to be ok. I think I'm just tired and overwhelmed by it all at the moment. I know it's not the end of the world, and I know I shouldn't whinge when there are so many people in the world who are so much worse off than I am but I just can't help but feel sorry for myself at the moment. I know it will pass, but for now I think I need a hug and a cry.
Check it out

Health Challenges Blog

About Me: Introduction
I decided to start this blog to create an outlet where I can discuss my own health challenges, and hopefully, to hear from others who have or are experiencing similar issues. My biggest health problem is my struggle with endometriosis, adhesions, and pelvic pain.I have suffered from painful periods for most of my life, starting at adolescence. In the past few years, my pain has significantly increased and has become severe, daily pain. Despite many treatments, medication, and surgeries, the pain is not under control. Between the pain, fatigue, and side effects of my medication, I struggle to manage daily life. I have been disabled by my symptoms for several years now and have been unable to work.This blog is where I'd like to chronicle the medical, financial, spiritual, interactional, emotional, and other consequences of my condition, and seek and give support around the issues of chronic pain; chronic illness; endometriosis and pelvic pain; and disability in general.If you are reading this and have a health challenge that severely impacts your life long-term, or know someone who does, please leave a comment, or send an email (I should have one up on the sidebar shortly if it isn't already there), to introduce yourself. I'd love to hear from you.
Check it out

Tuesday, April 10, 2007

Hope For Ending The Pain, Infertility Of Endometriosis?

Main Category: Women's Health / OBGYN News
Article Date: 10 Apr 2007 - 0:00 PDT
Jan Ruma's pain was getting worse, but she wrote it off as just a part of growing older and a normal side-effect of "that time of the month.""I was increasingly having painful menstrual periods, cramping, painful abdomen and lower back pain," says Ruma, 43.After running some tests, her doctor discovered that Ruma had endometriosis, a painful condition that affects one in 10 women, usually of childbearing age. In addition to painful menstrual periods, it can cause fertility problems, heavy bleeding, painful intercourse and appears to be associated with autoimmune disorders such as rheumatoid arthritis, lupus and thyroid disorders.

"Endometriosis, simply put, is when the lining of the uterus, or the womb, is located where it should not be: outside of the uterus," says Dan Lebovic, M.D., M.A., assistant professor of obstetrics and gynecology at the University of Michigan Medical School, who is exploring new treatment options for women with endometriosis.

"The quality of life in patients with endometriosis is severely compromised. We see a lot of patients whose jobs have been jeopardized because they have to stay home on account of pain, sometimes up to two weeks at a time," he notes.

Treatments for the condition include medications and surgery, says Lebovic, also the co-director of the U-M Health System Endometriosis Center. Physicians sometimes prescribe pain killers or oral contraceptives to diminish the woman's period and therefore reduce her pain, and hormones that suppress ovarian function and therefore suppress the estrogen that "seems to feed these lesions," he says.

Surgical options include a simple laparoscopy, a procedure with only small incisions that can be used to excise small lesions in cases of mild endometriosis. More severe cases may require a laparotomy, a surgery with a larger incision in the abdomen that may require many weeks to months of recovery time. Women who do not wish to maintain their fertility occasionally resort to a hysterectomy, the full removal of the uterus and ovaries.

None of these options is perfect, Lebovic notes. In many cases, the treatment of the pain and heavy periods can lead to the end of a woman's fertility. That's why Lebovic and other U-M Health System researchers are exploring the possible use of the diabetes medication called rosiglitazone as a treatment for endometriosis.

The trial is in progress of recruiting participants with Stage I or II (minimal or mild) endometriosis, and there is no conclusive result yet, but Lebovic says the medication may help to decrease endometriosis patients' pain and lesion size without making them infertile. "We are certainly hopeful this medicine will make a great impact on women with endometriosis," Lebovic says.

Ruma is one of the participants in the trial. While it is too early to say definitively how the treatment will affect her, she says it has improved her health and reduced her symptoms in the six months she has been on the medication.

7 things to know about endometriosis

1.What it is:Endometriosis is a condition in which the lining of the uterus is located outside of the uterus.

2. Symptoms:Painful periods, heavy bleeding, painful intercourse and sometimes fertility problems. Some women also have chronic pain in the lower back and pelvis, as well as intestinal pain.

3. Diagnosis:A doctor will begin with a physical exam, including a pelvic exam, followed by ultrasound and/or magnetic resonance imaging (MRI). The only way to be certain that a person has endometriosis is through a surgery called laparoscopy, in which a small, lighted tube is used to see the uterus region.

4.Prevention:Endometriosis cannot be prevented.

5. Who is at risk:One in 10 women has endometriosis. Typically it occurs when a women is of childbearing age. Women have a five- or six-times greater chance of developing endometriosis if a family member has had it, and women who started their periods early may have a higher risk.

6. Treatment:Treatments can assist with the pain and fertility issues that arise with endometriosis. Pain medication, birth control pills or oral contraceptives, hormone therapy to suppress ovarian function, and surgery are some options. Several types of surgery can be performed, including laparoscopy (surgery with small incisions used to remove small lesions), laparotomy (a major abdominal surgery with a larger incision) or hysterectomy (removal of the uterus). There is no cure for endometriosis.

7. Possible treatment in the future:University of Michigan Health System researchers are conducting a clinical trial involving a medication called rosiglitazone, currently used to treat people with diabetes.

To learn more about this study, visit http://www.umengage.org.
University of Michigan Health System2901 Hubbard St., Ste. 2400Ann Arbor, MI 48109-2435United Stateshttp://www.med.umich.edu/
Source

Many Young Girls Suffering from Endometriosis

Symptoms Can Start as Young as 12
By Denise Dador
Apr. 9, 2007 (KABC-TV) - High school senior Valerie Berrin splits her time between softball and homework, but life wasn't always so typical for the teen. When she was just eight, she started suffering terrible pain.
"It was almost kind of like a rock was kind of sitting on my stomach. Sometimes it was sharp, very sharp," Valerie said.
The pain was so chronic, Valerie and her mom Fran traveled to dozens of specialists across the country. No one could figure out the problem.
"I did colonoscopies and endoscopies," Valerie said.
"I felt it was very frustrating as a mom," Fran said.
Fran says there was a series of misdiagnoses. Then, finally, an answer. Valerie had a gynecological condition called endometriosis, years before she even got her first period.
"I was overwhelmed at the fact that this very young girl was now a gynecological endometriosis patient," Fran said.
The condition occurs when tissue that lines the uterine walls grows outside the uterus. It can cause serious pain and infertility. An estimated 5.5 million women have it. But, leading specialists now warn symptoms can start as young as 12, or even sooner.
Read More

Monday, April 09, 2007

University of Michiganre searchers explore possible use of diabetes medication to treat endometriosis in women.

Jan Ruma's pain was getting worse, but she wrote it off as just a part of growing older and a normal side-effect of "that time of the month."
"I was increasingly having painful menstrual periods, cramping, painful abdomen and lower back pain," says Ruma, 43.
After running some tests, her doctor discovered that Ruma had endometriosis, a painful condition that affects one in 10 women, usually of childbearing age. In addition to painful menstrual periods, it can cause fertility problems, heavy bleeding, painful intercourse and appears to be associated with autoimmune disorders such as rheumatoid arthritis, lupus and thyroid disorders.
"Endometriosis, simply put, is when the lining of the uterus, or the womb, is located where it should not be: outside of the uterus," says Dan Lebovic, M.D., M.A., assistant professor of obstetrics and gynecology at the University of Michigan Medical School, who is exploring new treatment options for women with endometriosis.
"The quality of life in patients with endometriosis is severely compromised. We see a lot of patients whose jobs have been jeopardized because they have to stay home on account of pain, sometimes up to two weeks at a time," he notes.
Read More

Growth-associated protein 43-positive sensory nerve fibers accompanied by immature vessels are located in or near peritoneal endometriotic lesions.

Mechsner S,
Schwarz J,
Thode J,
Loddenkemper C,
Salomon DS,
Ebert AD.
Endometriosis Research Center Berlin, Department of Gynecology.
OBJECTIVE: To investigate the topographical relationship between nerve fibers and peritoneal endometriotic lesions and to determine the origin of endometriosis-associated nerve fibers. DESIGN: Retrospective nonrandomized study. SETTING: University hospital endometriosis research center. PATIENT(S): Premenopausal women with histologically confirmed endometriosis were selected (n = 73). Peritoneal endometriotic lesions (n = 106) and unaffected peritoneal biopsies from patients without endometriosis (n = 9) were obtained. INTERVENTION(S): Immunohistochemistry was used to study the expression of neurofilament, substance P, smooth muscle actin, von Willebrand factor, growth-associated protein 43, nerve growth factor, and neutrophin-3 in peritoneal endometriotic lesion samples from women with symptomatic endometriosis and in peritoneal samples from women without endometriosis. RESULT(S): Pain-conducting substance-P-positive nerve fibers were found to be directly colocalized with human peritoneal endometriotic lesions in 74.5% of all cases. The endometriosis-associated nerve fibers are accompanied by immature blood vessels within the stroma. Nerve growth factor and neutrophin-3 are expressed by endometriotic cells. Growth-associated protein 43, a marker of neural outgrowth and regeneration, is expressed in endometriosis-associated nerve fibers but not in existing peritoneal nerves. CONCLUSION(S): The data provide the first evidence of direct contact between sensory nerve fibers and peritoneal endometriotic lesions. This implies that the fibers play an important role in the etiology of endometriosis-associated pelvic pain. Moreover, emerging evidence suggests that peritoneal endometriotic cells exhibit neurotrophic properties.
PMID: 17412328 [PubMed - as supplied by publisher]
Source

Wednesday, April 04, 2007

'Lung Endometriosis is Life Threatening and can be Fatal,' Says Glynis Wallace, DMD, Author, Living with Lung and Colon Endometriosis

Download this press release as an Adobe PDF document.
The truth about Lung Endometriosis is incontrovertible -- malice may attack it, ignorance may deride it, but in the end, you are forced to face it. This non-cancerous disease, lung endometriosis, can be fatal. You can die from lung endometriosis. Does this sound alarming? It should. In the misinformation aftermath of last month's National Endometriosis Awareness month observation, it is now supremely evident that the message about the perils of endometriosis is vastly understated, according to Glynis Wallace, DMD, author of the globally acclaimed book Living With Lung and Colon Endometriosis: Catamenial Pneumothorax, and the founder of the new website www.catamenialpneumothorax.org.
Torrance, CA (PRWeb) April 4, 2007 -- You can die from lung endometriosis. Does this sound alarming? It should.
In the misinformation aftermath of last month's National Endometriosis Awareness month observation, it is now supremely evident that the message about the perils of endometriosis is vastly understated, according to Glynis Wallace, DMD, author of the globally acclaimed book Living With Lung and Colon Endometriosis: Catamenial Pneumothorax, and the founder of the new website www.catamenialpneumothorax.org. This life threatening and devastating disease is finally receiving worldwide recognition among physicians and its victims.
Explains Dr. Wallace, "Morbidity and mortality is a little known result of endometriosis that causes the lung(s) to collapse (also known as Catamenial Hemopneumothorax and Catamenial Pneumothorax). There is misinformation or a misnomer in the world of endometriosis that you cannot die from endometriosis. This information is incorrect."
How can this be fatal?
Lung endometriosis resulting in Catamenial Hemopneumothorax and Catamenial Pneumothorax causes the inability to breathe. Says Dr. Wallace, "We need oxygen to keep us alive, when breathing stops, the heart soon stops beating, brain damage occurs leading to irreversible consequences."
Her personal quest to manage her own battle with lung endometriosis underscores the severity of the symptoms.
Recounts Dr. Wallace, "My last catamenial pneumothorax started with 'shortness of breath' leading to the seventh chest tube placement, a tension pneumothorax and decompression of my chest.
Dr. Wallace, a former USAF Major and a graduate of Tufts University School of Dental Medicine, explains that diagnosing endometriosis early is an important first step in helping "prevent" endometriosis sufferers from experiencing a life of monthly pain, discomfort and even some life threatening symptoms.
"Living with Lung and Colon Endometriosis: Catamenial Pneumothorax," outlines Dr. Wallace's 13-year experience with pulmonary endometriosis through narrative summaries from the physicians who attempted to control this disease. As an active duty military officer, she underwent extensive and extremely thorough diagnostic tests to determine fitness for duty. This led to excellent medical treatment, which allowed her to continue serving on active duty.
Endometriosis is an abnormal growth of tissue in the pelvic area and can travel through the body attaching to organs in its path. It has many undefined symptomatic presentations. The symptoms may include back pain, chest pain, shortness of breath, pressure, bloating, constipation, seizures, fatigue and consistently painful menstrual cramps.
View Endometriosis Migration Organ Documentation blog at http://blog.catamenialpneumothorax.org. Dr. Wallace recently launched the website www.catamenialpneumothorax.org to spearhead quicker, easier and more widespread global diagnosis, and subsequent treatment regimes.
For media inquiries, please contact Peggy C. Frank, MBA, Frank Public Relations Worldwide, 818-735-3591, pfrank @ frankpr.com, www.frankpr.com.
http://www.emediawire.com/releases/2007/4/emw516304.htm

Tuesday, April 03, 2007

Hope for Ending the Pain, Infertility of Endometriosis?

Description An ongoing U-M Health System study is looking at the use of a common diabetes medication, rosiglitzaone, to treat endometriosis.
Use of the drug would allow women with endometriosis to be treated without compromising their future fertility.
Video is available by contacting the source.
Newswise — Jan Ruma’s pain was getting worse, but she wrote it off as just a part of growing older and a normal side-effect of “that time of the month.”
“I was increasingly having painful menstrual periods, cramping, painful abdomen and lower back pain,” says Ruma, 43.
After running some tests, her doctor discovered that Ruma had endometriosis, a painful condition that affects one in 10 women, usually of childbearing age. In addition to painful menstrual periods, it can cause fertility problems, heavy bleeding, painful intercourse and appears to be associated with autoimmune disorders such as rheumatoid arthritis, lupus and thyroid disorders.
“Endometriosis, simply put, is when the lining of the uterus, or the womb, is located where it should not be: outside of the uterus,” says Dan Lebovic, M.D., M.A., assistant professor of obstetrics and gynecology at the University of Michigan Medical School, who is exploring new treatment options for women with endometriosis.
“The quality of life in patients with endometriosis is severely compromised. We see a lot of patients whose jobs have been jeopardized because they have to stay home on account of pain, sometimes up to two weeks at a time,” he notes.
Treatments for the condition include medications and surgery, says Lebovic, also the co-director of the U-M Health System Endometriosis Center. Physicians sometimes prescribe pain killers or oral contraceptives to diminish the woman’s period and therefore reduce her pain, and hormones that suppress ovarian function and therefore suppress the estrogen that “seems to feed these lesions,” he says.
Surgical options include a simple laparoscopy, a procedure with only small incisions that can be used to excise small lesions in cases of mild endometriosis. More severe cases may require a laparotomy, a surgery with a larger incision in the abdomen that may require many weeks to months of recovery time. Women who do not wish to maintain their fertility occasionally resort to a hysterectomy, the full removal of the uterus and ovaries.
None of these options is perfect, Lebovic notes. In many cases, the treatment of the pain and heavy periods can lead to the end of a woman’s fertility. That’s why Lebovic and other U-M Health System researchers are exploring the possible use of the diabetes medication called rosiglitazone as a treatment for endometriosis.
The trial is in progress of recruiting participants with Stage I or II (minimal or mild) endometriosis, and there is no conclusive result yet, but Lebovic says the medication may help to decrease endometriosis patients’ pain and lesion size without making them infertile. “We are certainly hopeful this medicine will make a great impact on women with endometriosis,” Lebovic says.
Ruma is one of the participants in the trial. While it is too early to say definitively how the treatment will affect her, she says it has improved her health and reduced her symptoms in the six months she has been on the medication.
7 things to know about endometriosis
1.What it is: Endometriosis is a condition in which the lining of the uterus is located outside of the uterus.
2. Symptoms: Painful periods, heavy bleeding, painful intercourse and sometimes fertility problems. Some women also have chronic pain in the lower back and pelvis, as well as intestinal pain.
3. Diagnosis: A doctor will begin with a physical exam, including a pelvic exam, followed by ultrasound and/or magnetic resonance imaging (MRI). The only way to be certain that a person has endometriosis is through a surgery called laparoscopy, in which a small, lighted tube is used to see the uterus region.
4.Prevention: Endometriosis cannot be prevented.
5. Who is at risk: One in 10 women has endometriosis. Typically it occurs when a women is of childbearing age. Women have a five- or six-times greater chance of developing endometriosis if a family member has had it, and women who started their periods early may have a higher risk.
6. Treatment: Treatments can assist with the pain and fertility issues that arise with endometriosis. Pain medication, birth control pills or oral contraceptives, hormone therapy to suppress ovarian function, and surgery are some options. Several types of surgery can be performed, including laparoscopy (surgery with small incisions used to remove small lesions), laparotomy (a major abdominal surgery with a larger incision) or hysterectomy (removal of the uterus). There is no cure for endometriosis.
7. Possible treatment in the future: University of Michigan Health System researchers are conducting a clinical trial involving a medication called rosiglitazone, currently used to treat people with diabetes. To learn more about this study, visit http://www.umengage.org.
For more information, visit these Web sites:
University of Michigan Endometriosis Center http://www2.med.umich.edu/departments/obgyn/index.cfm?fuseaction=Obgyn.UMEC
U-M Adult Health Advisor: What is Endometriosis? http://www.med.umich.edu/1libr/aha/aha_endometr_crs.htm
Womenshealth.gov: Endometriosishttp://www.4woman.gov/faq/endomet.htm
American College of Obstetricians and Gynecologistshttp://www.acog.org/publications/patient_education/bp013.cfm
Source

Community Health Network Lands Embryo Adoption Program

InsideIndianaBusiness.com Report

3/30/2007 12:13:02 PM
Indianapolis-based Community Health Network has become the first national satellite location for an embryo adoption program. The program offers a new option for infertile couples and is in affiliation with the National Embryo Donation Center. Under the program, embryos left over from consenting families that have tried invitro fertilization are placed for adoption and implanted in an infertile woman. In the past, these embryos have been thrown out or donated to research.
Press ReleaseIndianapolis, IN---Community Health Network has been chosen as a national site for an embryo adoption program in affiliation with the National Embryo Donation Center (NEDC) in Knoxville, Tennessee. This unique program offers a new option for infertile couples. Community is a national leader in the cryopreservation of eggs.In the embryo adoption process, an infertile couple receives donated embryos (fertilized eggs) from a couple who have completed their families using invitro fertilization (IVF). When couples undergo IVF, there are often leftover embryos that are frozen and stored for later use. In the past, frozen embryos have been discarded or donated to research. Women who choose embryo adoption as an answer to infertility will experience pregnancy, labor and delivery if the embryo transfer is successful. “We are honored to be chosen as a partner with the NEDC,” said Dr. Donald Cline, reproductive endocrinologist/fertility specialist with Reproductive Endocrinology Associates. “This is an exciting new option for women who wish to conceive. When the genetic parents decide their family is complete and embryos are still frozen, they usually face a moral or ethical dilemma about what to do with the leftover embryos. The embryo adoption program offers an acceptable answer to many of these couples.”“We are happy to be able to add embryo adoption to the list of advanced reproductive technologies offered in our program,” said Dr. Jeffrey Boldt, scientific and program director for Assisted Fertility Services at Community Hospital North and a longtime partner of Dr. Cline. “Our goal is to provide patients with a range of options to build their families.”The adoption process is similar to that of the traditional adoption of children. The NEDC undertakes an extensive screening of potential couples wanting to donate their embryos, including the medical, legal and social requirements of embryo donation. Recipient couples also undergo extensive screening. Surveys estimate that only 9,000 of the 400,000 embryos currently in cryopreservation (freezing) in the U.S. are available for adoption to another couple. Since most of those embryos will likely not be transferred to the genetic mother, they are either stored for an indefinite period of time, or thawed and discarded. The pregnancy rate is approximately 40-percent per embryo transfer.For more information on embryo adoption, visit www.reproductivehope.com or www.eCommunity.com. The Web site for the National Embryo Donation Center is www.embryodonation.org. The NEDC is a non-profit organization endorsed by the Christian Medical Association.

Monday, April 02, 2007

UK Fertility Watchdog Considers Reducing Multiple Embryo Implants

Written by Catharine Paddock
The UK's fertility watchdog, the Human Fertilisation and Embryology Authority (HFEA), is to consider reducing the number of embryos that can be implanted in women having IVF treatment in order to bring down the rate of multiple births...[read article]

European Parliament host seminar to highlight suffering of women with endometriosis

This week Diana Wallis MEP, Vice-President of the European Parliament, will host a seminar in Brussels to highlight the campaign to raise awareness of endometriosis. Diana Wallis MEP said: "Raising awareness of this disease is essential as endometriosis affects at least 14 million women and girls in the EU. "Although it is difficult to predict precisely how much endometriosis costs, it is thought that in the region of €30 billion a year is lost just in days taken off work due to illness. Yet due to a lack of awareness, both in the medical professions and amongst the general public, sufferers face an average wait of eight years from presenting with symptoms to being diagnosed." As part of this awareness-raising exercise Diana Wallis MEP, herself an endometriosis sufferer, will host a lunch seminar on 28 March at 12.30 in the European Parliament.
She will be joined by Senator Laura Bianconi, who will explain the Italian five-year plan to improve treatments for those with endometriosis. Italy is the first member state to recognise endometriosis as a social disease and Senator Bianconi will call on her colleagues across Europe to do the same. Diana Wallis MEP further added: "Recent studies show that endometriosis costs society more than migraine and Crohn's disease. However researchers suffer from a lack of funding. I am hoping we really raise awareness and turn this around with the event this week." In 2005 a Written Declaration on Endometriosis, organised by Diana Wallis in the European Parliament, attracted more signatures than on any other human health issue. Lone Hummelshoj, Secretary General of the World Endometriosis Society, concluded: “Despite the success of the 2005 Written Declaration, endometriosis is still being left behind. At a time where gender equality appears to be a priority, women’s health and endometriosis in particular – in contrast with diseases such as osteoarthritis – is being neglected despite its prevalence and impact on society. It is time we start seeing investment into female specific benign, chronic diseases on the same scale as for male specific benign and chronic disease.”
Please visit the World Endometriosis Society website
http://wes.endometriosis.org/

ESHRE guideline for the diagnosis and treatment of endometriosis

The aim of this guideline is to provide clinicians with up-to-date information about the diagnosis and treatment of endometriosis, based upon the best available evidence. This guideline, which is reviewed annually, was last updated on 17 June 2006.
ObjectiveThe objective was to develop recommendations for the diagnosis and treatment of endometriosis and its associated symptoms.
DesignA working group was convened comprised of practising gynaecologists and experts in evidence-based medicine from Europe, as well as an endometriosis self-help group representative.
After reviewing exisiting evidence-based guidelines and systematic reviews, the expert panel met on three occasions for a day during which the guideline was developed and refined. Recommendations based soley on the clinical experience of the panel were avoided as much as possible. The entire ESHRE Special Interest Group for endometriosis and endometrium was given the opportunity to comment on the draft guideline, after which it was available for comment on the ESHRE website for 3 months. The working group then ratified the guideline by unanimous or near-unanimous voting; finally, it was approved by the ESHRE Executive Committee.
The guideline will be updated annually, and has been made available on this website with hyperlinks to the supporting evidence, and the relevant references and abstracts.
Main conclusionsFor women presenting with symptoms suggestive of endometriosis, a definitive diagnosis of most forms of endometriosis requires visual inspection of the pelvis at laparoscopy as the 'gold standard' investigation. However, pain symptoms suggestive of the disease can be treated without a definitive diagnosis using a therapeutic trial of a hormonal drug to reduce menstrual flow.
In women with laparoscopically confirmed disease, suppression of ovarian function for 6-months reduces endometriosis-associated pain; all hormonal drugs studied are equally effective although their side-effects and cost profiles differ. Ablation of endometriotic lesions reduces endometriosis-associated pain and the smallest effect is seen in patients with minimal disease; there is no evidence that also performing laparoscopic uterine nerve ablation (LUNA) is necessary.
In minimal-mild endometriosis, suppression of ovarian function to improve fertility is not effective, but ablation of endometriotic lesions plus adhesiolysis is effective compared to diagnostic laparoscopy alone. There is insufficient evidence available to determine whether surgical excision of moderate-severe endometriosis enhances pregnancy rates. IVF is appropriate treatment especially if there are coexisting causes of infertility and/or other treatments have failed, but IVF pregnancy rates are lower in women with endometriosis than in those with tubal infertility.
The management of severe/deeply infiltrating endometriosis is complex and referral to a centre with the necessary expertise is strongly recommended. Patient self-help groups can provide invaluable counselling, support and advice.
The guideline has been produced by the ESHRE Special Interest Group for Endometriosis and Endometriosis Guideline Development Group, and the original, concise, version was published in Human Reproduction 2005;20(10):2698-2704
This website provides access to the concise version of this guideline and to further supporting documentation. To access the concise version of this guideline please click on the 'Concise' link under each chapter heading. To access the supporting documentation for this guideline please click on the 'Supporting Documentation' link under each chapter heading.