Showing posts with label Gynecologic Health. Show all posts
Showing posts with label Gynecologic Health. Show all posts
Monday, April 07, 2014
Sunday, April 06, 2014
Lupron Side Effects ~ Tell you Lupron Story on Erin Brockovich Site ~ Read others stories
Lupron Side Effects
For far too long now, I have been contacted by people who tell me that they have been adversely impacted by Lupron. In fact, since 1999, the FDA has received adverse drug reports about Lupron from in excess of 4,000 women and approximately, 3,000 men. According to the FDA, in 325 of those cases, hospitilization was necessary and 25 women died, directly related to Lupron use.
The shared stories on this site reveal lives that have been irreparably damaged. We need to do something about this. Nothing is more powerful in coercing change than the voices of the people. I hope that this site is a place where you can come and share your story and thoughts. This is a place where you can link to other Facebook groups, read blogs and learn about what rights you may have and current news on the Lupron. This is a place where we can become stronger together.
- See more at: http://www.lupronsideeffects.net/#sthash.BMD1RGV9.dpufhttp://www.lupronsideeffects.net/
Monday, March 31, 2014
Eve's Daughters, or, Go With the Flow
In the beginning, there was pain.
My periods began when I was 13-years-old, and I only remember them accompanied with pain. I bled heavily each month for six to eight days. As I got older, I would find myself passed out on my bedroom or bathroom floor from painful cramps. I would pass heavy blood clots, was often lightheaded, and regularly was prescribed iron supplements and over-the-counter medications like ibuprofen. When Alleve came on the market, I was thrilled to try a new pain reliever. They would dull, but never eradicate, the pain. My periods were always preceded with hefty bouts of PMS; I suffered from bloating, fatigue, headaches, skin rashes, and swelling in my knees and fingers.
When I'd report these symptoms to my doctor, he told me that periods can be like that. Some girls have problems, others don't. I just happened to be one of the girls who had a problem period. My mother told me the same thing, adding, "That's what my mother told me. It was like that for me and for other girls I knew growing up, too." As Carol Pearson discusses in her TEDTalk, as Zora Neale Hurston wrote inTheir Eyes Were Watching God ("Black women are the mules of the world"), as Eve was told after she fed into her curiosity and took a bite of that forbidden fruit, I learned -- whether the lesson was intended to be learned this way or not -- that being a girl, becoming a woman, was painful. And I had to live with that pain. I had to learn to handle pain.
And so I did. I went with the flow.
What I didn't know was that I had endometriosis.Endometriosis is a disease that affects 10 percent of women globally. It knows no race, class, or socioeconomic status. Some doctors refer to endometriosis as a benign cancer. Padma Lakshmi, model and co-founder of the Endometriosis Foundation of America, describes the disease as "a web, like a vapor, like weeds in a garden that permeate everything, and stain everything. And metaphorically as well as clinically what you have to go and do, whether it is with laparoscopy or therapy or just understanding and support, is you have to go in there... and get rid of it. Not only getting rid of it in the womb, but getting rid of it in the heart and the mind."
When I'd report these symptoms to my doctor, he told me that periods can be like that. Some girls have problems, others don't. I just happened to be one of the girls who had a problem period. My mother told me the same thing, adding, "That's what my mother told me. It was like that for me and for other girls I knew growing up, too." As Carol Pearson discusses in her TEDTalk, as Zora Neale Hurston wrote inTheir Eyes Were Watching God ("Black women are the mules of the world"), as Eve was told after she fed into her curiosity and took a bite of that forbidden fruit, I learned -- whether the lesson was intended to be learned this way or not -- that being a girl, becoming a woman, was painful. And I had to live with that pain. I had to learn to handle pain.
And so I did. I went with the flow.
What I didn't know was that I had endometriosis.Endometriosis is a disease that affects 10 percent of women globally. It knows no race, class, or socioeconomic status. Some doctors refer to endometriosis as a benign cancer. Padma Lakshmi, model and co-founder of the Endometriosis Foundation of America, describes the disease as "a web, like a vapor, like weeds in a garden that permeate everything, and stain everything. And metaphorically as well as clinically what you have to go and do, whether it is with laparoscopy or therapy or just understanding and support, is you have to go in there... and get rid of it. Not only getting rid of it in the womb, but getting rid of it in the heart and the mind."
Saturday, March 22, 2014
New Guideline: Management of Women With Endometriosis
ESHRE Guideline: Management of Women With Endometriosis
Dunselman GA, Vermeulen N, Becker C, et al
Hum Reprod. 2014;29:400-412
Hum Reprod. 2014;29:400-412
Background
Endometriosis can be diagnosed when endometrial tissue is found in extrauterine locations. It is found in 10%-15% of the general population and in up to one third of the infertile population.[1] There are various theories that attempt to explain its etiology. Some cases can be explained by retrograde menstruation, but metaplasia, hormonal, inflammatory processes, and abnormal cytokine function also seem to play a role.[2]
A wide variety of symptoms may accompany endometriosis. Some women are asymptomatic, whereas others are affected by dysmenorrhea, menorrhagia, dyspareunia, chronic pelvic pain, and urinary and gastrointestinal symptoms. The symptoms typically recur in a cyclic fashion, and an exacerbation can occur around menstruation.
The diagnosis can be suspected on the basis of symptoms but is established when histologic confirmation of endometrial glands and stroma is made from a tissue biopsy sample obtained from an extrauterine location.
Read the rest here: http://www.medscape.com/viewarticle/822100
Saturday, March 15, 2014
How can diagnosis for endometriosis be improved?
Wednesday 12 March 2014 - 8am PST
"Let's start with the gynecologists," begins Linda Griffith.
"Many of them trained in a day when the classic endocrinology and gynecology textbooks described endometriosis as follows: 'The typical endometriosis patient is a nulliparous white woman in her 30s who is well-educated and tends to be highly anxious.' Yup, that is the profile of the patient with the persistence and resources to get diagnosed prior to the 1990s."
Medical News Today is speaking to Massachusetts Institute of Technology (MIT) biological engineer Linda Griffith on the eve of Endometriosis Awareness Day, which will be marked by a huge peaceful demonstration.
An international "Million Women March" will take place on Thursday, March 13th. It begins in Washington, DC, but involves participants in 53 countries across the world."
Saturday, March 08, 2014
New Theory On Cause Of Endometriosis
New Theory On Cause Of Endometriosis
Changes to two previously unstudied genes are the centerpiece of a new theory regarding the cause and development of endometriosis, a chronic and painful disease affecting 1 in 10 women.
The discovery by Northwestern Medicine scientists suggests epigenetic modification, a process that enhances or disrupts how DNA is read, is an integral component of the disease and its progression. Matthew Dyson, research assistant professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine and and Serdar Bulun, MD, chair of obstetrics and gynecology at Feinberg and Northwestern Memorial Hospital, also identified a novel role for a family of key gene regulators in the uterus.
"Until now, the scientific community was looking for a genetic mutation to explain endometriosis," said Bulun, a member of the Center for Genetic Medicine and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. "This is the first conclusive demonstration that the disease develops as a result of alterations in the epigenetic landscape and not from classical genetic mutations."
The findings were recently published in PLoS Genetics.
Women develop endometriosis when cells from the lining of the uterus, usually shed during menstruation, grow in other areas of the body. The persistent survival of these cells results in chronic pelvic pain and infertility. Although the cause of the disease has remained unknown on a cellular level, there have been several different models established to explain its development.
Endometriosis only occurs in menstruating primates, suggesting that the unique evolution behind uterine development and menstruation are linked to the disease. Scientists consider retrograde menstruation – cells moving up the fallopian tubes and into the pelvis – as one probable cause. Previous models, however, have been unable to explain why only 10 percent of women develop the disease when most experience retrograde menstruation at some point. Nor do they explain instances of endometriosis that arise independent of menstruation.
Bulun and Dyson propose that an epigenetic switch permits the expression of the genetic receptor GATA6 rather than GATA2, resulting in progesterone resistance and disease development.
"We believe an overwhelming number of these altered cells reach the lining of the abdominal cavity, survive and grow," Bulun said. "These findings could someday lead to the first noninvasive test for endometriosis."
Clinicians could then prevent the disease by placing teenagers predisposed to this epigenetic change on a birth control pill regimen, preventing the possibility of retrograde menstruation in the first place, Bulun said.
Dyson will also look to use the epigenetic fingerprint resulting from the presence of GATA6 rather than GATA2 as a potential diagnostic tool, since these epigenetic differences are readily detectable.
"These findings have the potential to shift how we view and treat the disease moving forward," Bulun said.
Source: Northwestern University
http://www.science20.com/news_articles/new_theory_cause_endometriosis-131257
Tuesday, February 21, 2012
Santorum pose to questions Obama's world’s view Christian’s faith ~ a world with no birth control pills ?
Santorum pose to questions Obama's world’s view Christian’s faith
http://www.examiner.com/public-policy-in-cincinnati/santorum-pose-to-questions-obama-s-world-s-view-christian-s-faith
Article exerpt
"There is an illness that attacks women that is called endometriosis which can be controlled by birth controlling attention.
Endometriosisis defined as a gynecological medical condition in which cells from the lining of the uterus (endometrium) appear and flourish outside the uterine cavity, most commonly on the ovaries.
The uterine cavity is lined by endometrial cells, which are under the influence of female hormones. These endometrial-like cells in areas outside the uterus (endometriosis) are influenced by hormonal changes and respond in a way that is similar to the cells found inside the uterus. Symptoms often worsen with the menstrual cycle.
Endometriosis is typically seen during the reproductive years; it has been estimated that endometriosis occurs in roughly 5 to 10% of women. Symptoms may depend on the site of active endometriosis. Its main but not universal symptom is pelvic pain in various manifestations. Endometriosis is a common finding in women with infertility. How can these politicians be so insensitive and unconcern?
Nonetheless, Santorum continues to defends himself as he tried to justify his action. In that broadcast interview he said; "I am talking about his world view, and the way he approaches problems in this country. I think they're different than how most people do in America.”
http://www.examiner.com/public-policy-in-cincinnati/santorum-pose-to-questions-obama-s-world-s-view-christian-s-faith
Article exerpt
"There is an illness that attacks women that is called endometriosis which can be controlled by birth controlling attention.
Endometriosisis defined as a gynecological medical condition in which cells from the lining of the uterus (endometrium) appear and flourish outside the uterine cavity, most commonly on the ovaries.
The uterine cavity is lined by endometrial cells, which are under the influence of female hormones. These endometrial-like cells in areas outside the uterus (endometriosis) are influenced by hormonal changes and respond in a way that is similar to the cells found inside the uterus. Symptoms often worsen with the menstrual cycle.
Endometriosis is typically seen during the reproductive years; it has been estimated that endometriosis occurs in roughly 5 to 10% of women. Symptoms may depend on the site of active endometriosis. Its main but not universal symptom is pelvic pain in various manifestations. Endometriosis is a common finding in women with infertility. How can these politicians be so insensitive and unconcern?
Nonetheless, Santorum continues to defends himself as he tried to justify his action. In that broadcast interview he said; "I am talking about his world view, and the way he approaches problems in this country. I think they're different than how most people do in America.”
Thursday, January 12, 2012
Gynaecologist analyses women’s biggest sexual problems
Gynaecologist analyses women’s biggest sexual problems
On January 2, 2012 · In Health | 4:10 pm..
Abuja – Unlike men’s main sexual complaint — erectile dysfunction, women’s biggest sexual problem is caused by a combination of mental and physical factors, a doctor has analysed.
Dr Ekpi Philips, a Consultant Gynaecologist, said that common causes for a loss of sexual desire and drive in women could be interpersonal relationship issues, socio-cultural influences and peer pressure.
Others include partner performance problems, lack of emotional satisfaction with the relationship, the birth of a child and becoming a caregiver for a loved one.
“Medical problems such as mental illnesses, depression, or medical conditions such as endometriosis, fibroids, and thyroid disorders impact on a woman’s sexual drive both mentally and physically.
“Age, medications, certain antidepressants, blood pressure lowering drugs, and oral contraceptives can lower sexual drive.’’
Philips said that testosterone could also affect sexual drive in both men and women.
Testosterone is a hormone made by the body and helps to stimulate and maintain sexual function, maintain bone strength, among others.
“Testosterone levels peak in women’s mid-20s and then steadily decline until menopause, and drop dramatically,’’ he said.
Philips noted that lower sexual drive sets in when a woman experiences a significant decrease in interest in sex and it is having an effect on her.
According to him, sexual desire is more than just an issue of low libido or sex drive.
“Sexual drive is the biological component of desire which is reflected as spontaneous sexual interest including sexual thoughts, erotic fantasies, and daydreams.
“ It’s about your body signaling that it wants to be sexual.
“Whether or not there is any intention to act on it, we all have a certain level of drive.”
He explained that a woman carrying financial burdens of the home could lose interest in sex.
“For a growing number of women, declining hormones, job stress, relationship issues, and other problems are taking their toll in the bedroom.
“When a woman go to work and comes back late, think of bills to pay, prepares the children and think of the attitudes of the husband, such woman can never pick interest in sex’’.
Philips also explained that a woman who is ill and probably on medication, could have low sex drive.
He stated that relationships between the husband must be cordial for both parties to enjoy sex.
He added that loss of sexual desire, known in medical terms as hypoactive sexual desire disorder (HSDD), is the most common form of sexual dysfunction among women of all ages.
“These are not likely to be cured by merely using a pill’’.
He said that since the loss of sexual desire in women was caused by a combination of factors, it required more than an approach to fix the problem.
He advised that putting the desire back in women’s sex lives would require putting her on sex therapy and relationship counseling.
“Changing medications or altering the dose, addressing underlying medical conditions of the woman and the use of vaginal estrogens, testosterone therapy, could help.’’
According to Philips, many gynaecologists recommend off-label uses of testosterone therapy for women with low sexual desire to restore testosterone to normal levels.
“In postmenopausal women, vaginal dryness may be treated with vaginal estrogen creams although no hormone or drug has been approved to treat sexual problems in women,’’ Philips added
http://www.vanguardngr.com/2012/01/gynaecologist-analyses-women%E2%80%99s-biggest-sexual-problems/
On January 2, 2012 · In Health | 4:10 pm..
Abuja – Unlike men’s main sexual complaint — erectile dysfunction, women’s biggest sexual problem is caused by a combination of mental and physical factors, a doctor has analysed.
Dr Ekpi Philips, a Consultant Gynaecologist, said that common causes for a loss of sexual desire and drive in women could be interpersonal relationship issues, socio-cultural influences and peer pressure.
Others include partner performance problems, lack of emotional satisfaction with the relationship, the birth of a child and becoming a caregiver for a loved one.
“Medical problems such as mental illnesses, depression, or medical conditions such as endometriosis, fibroids, and thyroid disorders impact on a woman’s sexual drive both mentally and physically.
“Age, medications, certain antidepressants, blood pressure lowering drugs, and oral contraceptives can lower sexual drive.’’
Philips said that testosterone could also affect sexual drive in both men and women.
Testosterone is a hormone made by the body and helps to stimulate and maintain sexual function, maintain bone strength, among others.
“Testosterone levels peak in women’s mid-20s and then steadily decline until menopause, and drop dramatically,’’ he said.
Philips noted that lower sexual drive sets in when a woman experiences a significant decrease in interest in sex and it is having an effect on her.
According to him, sexual desire is more than just an issue of low libido or sex drive.
“Sexual drive is the biological component of desire which is reflected as spontaneous sexual interest including sexual thoughts, erotic fantasies, and daydreams.
“ It’s about your body signaling that it wants to be sexual.
“Whether or not there is any intention to act on it, we all have a certain level of drive.”
He explained that a woman carrying financial burdens of the home could lose interest in sex.
“For a growing number of women, declining hormones, job stress, relationship issues, and other problems are taking their toll in the bedroom.
“When a woman go to work and comes back late, think of bills to pay, prepares the children and think of the attitudes of the husband, such woman can never pick interest in sex’’.
Philips also explained that a woman who is ill and probably on medication, could have low sex drive.
He stated that relationships between the husband must be cordial for both parties to enjoy sex.
He added that loss of sexual desire, known in medical terms as hypoactive sexual desire disorder (HSDD), is the most common form of sexual dysfunction among women of all ages.
“These are not likely to be cured by merely using a pill’’.
He said that since the loss of sexual desire in women was caused by a combination of factors, it required more than an approach to fix the problem.
He advised that putting the desire back in women’s sex lives would require putting her on sex therapy and relationship counseling.
“Changing medications or altering the dose, addressing underlying medical conditions of the woman and the use of vaginal estrogens, testosterone therapy, could help.’’
According to Philips, many gynaecologists recommend off-label uses of testosterone therapy for women with low sexual desire to restore testosterone to normal levels.
“In postmenopausal women, vaginal dryness may be treated with vaginal estrogen creams although no hormone or drug has been approved to treat sexual problems in women,’’ Philips added
http://www.vanguardngr.com/2012/01/gynaecologist-analyses-women%E2%80%99s-biggest-sexual-problems/
Wednesday, December 14, 2011
Simple remedies for menstrual cramps
Simple remedies for menstrual cramps
GYNOISSUES
By DONNA HUSSEY-WHYTE All Woman writer husseyd@jamaicaobserver.com
Monday, December 12, 2011
SOME women endure cramps so bad each month, that they are forced to stop regular activities for a day or two.
Severe cramping can be caused by a number of things, like disease in the reproductive organs; endometriosis; pelvic inflammatory disease; narrowing of the cervix; or fibroids or growths on the inner wall of the uterus.
But whatever the cause, the recommended remedies are the same.
Gynaecologist and obstetrician at the University Hospital of the West Indies, Professor Horace Fletcher, said young women don't need to suffer horrible pain that keeps them away from work and school.
He suggested:
1. The best way to treat severe menstrual cramps is to take oral contraceptives. This kind of pain responds to contraceptive pills taken in the normal way — once daily for 21 days. The woman should be first evaluated by her doctor to make sure there are no contraindications.
2. Mild cramps respond to normal painkillers like Paracetamol, Panadol, Tylenol, or any of the non- steroidal anti-inflammatory drugs like aspirin or ibuprofen. All of these have some side effects.
3. Antispasmodics like Baralgin or Buscopan can work as well, usually in conjunction with the treatments above.
4. A hot water bottle or heating pad compress against the stomach helps.
Other remedies you could try are:
1. Drink herbal teas like chamomile, mint, raspberry and blackberry, which may help soothe tense muscles and anxious moods.
2. Exercise. Regular workouts decrease the severity of cramps. It is therefore recommended that you start exercising the week leading up to the start of your period.
3. Empty your bladder as soon as you have the urge to urinate.
Read more: http://www.jamaicaobserver.com/magazines/allwoman/Simple-remedies-for-menstrual-cramps_10343747#ixzz1gVWgRTKT
GYNOISSUES
By DONNA HUSSEY-WHYTE All Woman writer husseyd@jamaicaobserver.com
Monday, December 12, 2011
SOME women endure cramps so bad each month, that they are forced to stop regular activities for a day or two.
Severe cramping can be caused by a number of things, like disease in the reproductive organs; endometriosis; pelvic inflammatory disease; narrowing of the cervix; or fibroids or growths on the inner wall of the uterus.
But whatever the cause, the recommended remedies are the same.
Gynaecologist and obstetrician at the University Hospital of the West Indies, Professor Horace Fletcher, said young women don't need to suffer horrible pain that keeps them away from work and school.
He suggested:
1. The best way to treat severe menstrual cramps is to take oral contraceptives. This kind of pain responds to contraceptive pills taken in the normal way — once daily for 21 days. The woman should be first evaluated by her doctor to make sure there are no contraindications.
2. Mild cramps respond to normal painkillers like Paracetamol, Panadol, Tylenol, or any of the non- steroidal anti-inflammatory drugs like aspirin or ibuprofen. All of these have some side effects.
3. Antispasmodics like Baralgin or Buscopan can work as well, usually in conjunction with the treatments above.
4. A hot water bottle or heating pad compress against the stomach helps.
Other remedies you could try are:
1. Drink herbal teas like chamomile, mint, raspberry and blackberry, which may help soothe tense muscles and anxious moods.
2. Exercise. Regular workouts decrease the severity of cramps. It is therefore recommended that you start exercising the week leading up to the start of your period.
3. Empty your bladder as soon as you have the urge to urinate.
Read more: http://www.jamaicaobserver.com/magazines/allwoman/Simple-remedies-for-menstrual-cramps_10343747#ixzz1gVWgRTKT
Saturday, December 03, 2011
Rise in Dangerous Type of Ovarian Cancer
Poon Chian Hui - Straits Times Indonesia | November 18, 2011
More women in Singapore are coming down with an aggressive form of ovarian cancer whose symptoms are vague and survival rate low.
In 1988, 5.2 percent of all ovarian cancers were of the type called clear cell carcinoma. In 2007, the figure went up to 13.4 percent.
Less than 40 percent of women who get it survive, even when the cancer is detected early, said Associate Professor Tay Sun Kuie of the Singapore General Hospital (SGH).
In contrast, other types of ovarian cancer have a survival rate of as high as 70 percent when discovered early.
Prof Tay led a study which looked at the profiles of 256 ovarian cancer patients seen at SGH from 2004 to 2009, and examined national trends based on data from the Singapore Cancer Registry from 1988.
Ovarian cancer is the fifth most common among women in Singapore after breast, colorectal, lung and uterus, and nearly 300 are diagnosed with it every year.
It affects one out of 18 female cancer patients, and some 40 percent of cases occur in those aged 55 and above. The clear cell type usually crops up earlier, in those aged 40 onwards.
The symptoms for clear cell carcinoma are vague, but it has been found to occur in women who have painful and irregular periods and who are mysteriously losing weight or their appetite.
The study also found that women who were never pregnant are 14 percent more likely to get this aggressive cancer, compared with ovarian cancer patients who had at least one child.
There is also a link to endometriosis, a disorder where the womb lining responsible for menstruation is found outside the womb, leading to severe menstrual cramps, chronic pain in the pelvic region and infertility.
Patients who have the clear cell type are nearly five times more likely to have endometriosis than those with other types of ovarian cancer.
Clear cell carcinoma is the most lethal of all ovarian cancers. Even with surgery and chemotherapy, up to 80 percent of sufferers fail to improve, even if they were diagnosed at an early stage.
Prof Tay, a senior consultant in obstetrics and gynaecology, said the cancer cells have special genes that makes them more resistant to chemotherapy drugs. "Giving the cancer cells medicine is like giving them water - it doesn't kill them," he said.
SGH decided to research clear cell carcinoma because the cancerous cysts resemble ordinary ones in ultrasound and computed tomography (CT) scans.
Cysts in the ovaries are common and normally harmless.
"The cyst looks just like an empty fish bowl," said Prof Tay. "It can confuse doctors... because of the seemingly harmless appearance."
This was the case for a patient known only as Madam Lim in the study, which was first presented at the Singapore International Congress of Obstetrics and Gynaecology in August.
The 41-year-old manager, who was married but never pregnant, had a history of endometriosis.
When her pain flared up again, she underwent ultrasound and CT scans which revealed a large cyst measuring 15cm in diameter.
During the operation to remove it, doctors realized she actually had clear cell ovarian cancer.
Her condition is currently stable after treatment.
As doctors "cannot possibly take out every cyst in all women", Prof Tay hoped the study would help doctors in better diagnosing this cancer by pointing out, for example, the link with endometriosis.
He said women who experience an unexplained loss of appetite and worsening symptoms of endometriosis may want to seek medical advice early.
"This doesn't mean that one should be alarmist, but women ought to be more aware of changes in their body," he said.
Reprinted courtesy of Straits Times Indonesia. To subscribe to Straits Times Indonesia and/or the Jakarta Globe call 021 2553 5055.
http://www.thejakartaglobe.com/international/rise-in-dangerous-type-of-ovarian-cancer/479337#Scene_1
More women in Singapore are coming down with an aggressive form of ovarian cancer whose symptoms are vague and survival rate low.
In 1988, 5.2 percent of all ovarian cancers were of the type called clear cell carcinoma. In 2007, the figure went up to 13.4 percent.
Less than 40 percent of women who get it survive, even when the cancer is detected early, said Associate Professor Tay Sun Kuie of the Singapore General Hospital (SGH).
In contrast, other types of ovarian cancer have a survival rate of as high as 70 percent when discovered early.
Prof Tay led a study which looked at the profiles of 256 ovarian cancer patients seen at SGH from 2004 to 2009, and examined national trends based on data from the Singapore Cancer Registry from 1988.
Ovarian cancer is the fifth most common among women in Singapore after breast, colorectal, lung and uterus, and nearly 300 are diagnosed with it every year.
It affects one out of 18 female cancer patients, and some 40 percent of cases occur in those aged 55 and above. The clear cell type usually crops up earlier, in those aged 40 onwards.
The symptoms for clear cell carcinoma are vague, but it has been found to occur in women who have painful and irregular periods and who are mysteriously losing weight or their appetite.
The study also found that women who were never pregnant are 14 percent more likely to get this aggressive cancer, compared with ovarian cancer patients who had at least one child.
There is also a link to endometriosis, a disorder where the womb lining responsible for menstruation is found outside the womb, leading to severe menstrual cramps, chronic pain in the pelvic region and infertility.
Patients who have the clear cell type are nearly five times more likely to have endometriosis than those with other types of ovarian cancer.
Clear cell carcinoma is the most lethal of all ovarian cancers. Even with surgery and chemotherapy, up to 80 percent of sufferers fail to improve, even if they were diagnosed at an early stage.
Prof Tay, a senior consultant in obstetrics and gynaecology, said the cancer cells have special genes that makes them more resistant to chemotherapy drugs. "Giving the cancer cells medicine is like giving them water - it doesn't kill them," he said.
SGH decided to research clear cell carcinoma because the cancerous cysts resemble ordinary ones in ultrasound and computed tomography (CT) scans.
Cysts in the ovaries are common and normally harmless.
"The cyst looks just like an empty fish bowl," said Prof Tay. "It can confuse doctors... because of the seemingly harmless appearance."
This was the case for a patient known only as Madam Lim in the study, which was first presented at the Singapore International Congress of Obstetrics and Gynaecology in August.
The 41-year-old manager, who was married but never pregnant, had a history of endometriosis.
When her pain flared up again, she underwent ultrasound and CT scans which revealed a large cyst measuring 15cm in diameter.
During the operation to remove it, doctors realized she actually had clear cell ovarian cancer.
Her condition is currently stable after treatment.
As doctors "cannot possibly take out every cyst in all women", Prof Tay hoped the study would help doctors in better diagnosing this cancer by pointing out, for example, the link with endometriosis.
He said women who experience an unexplained loss of appetite and worsening symptoms of endometriosis may want to seek medical advice early.
"This doesn't mean that one should be alarmist, but women ought to be more aware of changes in their body," he said.
Reprinted courtesy of Straits Times Indonesia. To subscribe to Straits Times Indonesia and/or the Jakarta Globe call 021 2553 5055.
http://www.thejakartaglobe.com/international/rise-in-dangerous-type-of-ovarian-cancer/479337#Scene_1
Wednesday, October 26, 2011
Endometriosis slowly emerges as a debilitating Disease for Women
Endometriosis slowly emerges as a debilitating Disease for Women
Written by Cleophas Mutinda
Imagine a pain in your abdomen so excruciating that you are unable to get out of bed for several days every month. That is horrible enough, but when it continues 12 times a year for more than 27 years, majority of people would agree it is cruel.
Most women with endometriosis will recognise this shocking scenario as not imaginary, but very real. They know the misery of pelvic pain and have poignant stories of how endometriosis has devastated their lives with terrible suffering. Many women feel angry or despondent about being robbed off a normal life during teenage, adulthood and even sometime a ruined motherhood.
Endometriosis is a gynaecological condition, which occurs when, cells like the ones (endometrial cells) lining inside of the uterus (womb) grow outside, usually on the surfaces of organs in pelvic and abdominal areas. It can be found within the peritoneal cavity, on the ovaries and the bowels or bladder. In extremely rare cases, endometriosis can be found in lungs or other parts of the body. Endometriosis can affect any menstruating woman, from time of her first period to menopause, regardless of race, ethnicity or socio-economic status. Endometriosis rarely persists after menopause. The disorder, for which there is no absolute cure, affects over 70 million women and girls worldwide. Often stigmatized as simply “painful periods,” Endometriosis is a puzzling and widely misunderstood illness.
It is not known exactly what causes endometriosis. But over the years several theories have been advanced to explain the probable cause of the disease although none can fully explain the various clinical manifestations of the disease. A theory proposed by John Sampson in the 1920s, suggests that endometriosis may result from something called “retrograde menstrual flow”, in which some of the tissue that a woman sheds during her period flows back through the tubes and grows in the pelvic cavity. While studies show that retrograde menstrual flow is a universal phenomenon among women of reproductive age, the theory fall short of explaining why the tissues survive in some women, but fail in others. Another theory proposed by Iwanoff in 1898, claims that, the transformation of what we call coelomic epithelium into endometrial-like tissue may be a cause of endometriosis. This theory has been supported by experimental data. The induction theory, proposes that an endogenous factor can induce peritoneal cells to develop into endometrial tissue. This theory has been supported by experiments in rabbits.
Lymphatic or vascular hypothesis suggests that endometrial fragments may be transported through blood vessels or the lymphatic system to other parts of the body. This theory speculates how endometriosis ends up in distant sites, such as the lung, brain, or the skin. A genetic linkage has been adduced which claims that, this disease could be inherited, or result from genetic errors, making some women more prone to develop the condition than others.
Studies show that the risk of endometriosis is seven times greater if the disease has affected a first-degree relative. This theory has been supported by experiments in mouse model but has not been verified either in women. Immunological etiology (cause) has also been conjured since studies report that many women with endometriosis exhibit immunological abnormalities. It is speculated that the immune system may fail to clear the menstrual debris in the pelvic cavity, allowing the endometrial cells to implant and develop into endometriosis.
Also most scientists agree that endometriosis is exacerbated by oestrogen; a hormone involved in the thickening of the endometrium and appears to promote the growth of disease implants. Some studies have pointed out environmental factors like toxins may contribute to the development of endometriosis, though this theory has not been confirmed and remains controversial.
The most common symptoms of endometriosis are abdominal pain and infertility. Some studies have reported that endometriosis may occur in 30%-40% of women with infertility and the incidence of endometriosis in women with pelvic pain may be higher than 50%.
Endometriosis associated pain may include but not limited to extremely painful (disabling) menstrual cramps, chronic pelvic pain (which includes lower back pain and pelvic pain), pain during or after sex, painful bowel movements or painful urination during menstrual periods, heavy menstrual periods and bleeding between periods. The amount of pain a women feels is sometimes not linked to degree of endometriosis. Some women have no pain even though their disease is extensive, while others have severe chronic pelvic pain even though they have only few affected areas.
The relation between endometriosis and pain is still shrouded in the mist of intricate puzzle and ignorance. Many women with endometriosis feel pain during their periods. Normally, a woman’s menstrual cycle involves her endometrial tissue to build up, breaks down into blood and tissue debris, and is shed as her menstrual flow or period. This cycle of growth and shedding happens every month under normal condition. Endometriosis grows outside the uterus and also goes through a similar cycle, build-up, breakdown and bleed every month. The problem is the tissue is in the wrong place and can’t leave the body the way a woman’s period normally does. Studies show that as part of this process, endometriosis may spur the production of substances that may irritate the nearby tissue, as well as provoke the release of chemicals that cause or mediate pain. Over time, endometriosis areas can grow and become nodules or bumps on the surface of pelvic organs, or become cysts (fluid-filled sacs) in the ovaries and may cause the organs in the pelvic area to adhere together.
Endometriosis is more than just simple "killer" cramps. Women and girls around the world continue to suffer in silence with a disease that can be potentially devastating to every aspect of their lives. It can be so painful as to render a woman or teenager unable to care for herself or her family, attend work, school, or social functions, or go about her normal routine. Endometriosis has a negative impact on the individual quality of life, affecting both physical and emotional well-being. A study by the American Endometriosis Association, demonstrated that 81% of the endometriosis patients in USA were unable to work, including household chores, because of pelvic pain. Approximately 27% were incapacitated for 3 or more days and 87% complained of fatigue or low energy. These figures are indicators of enormous suffering, in addition to the healthcare costs incurred. The need to develop intervention strategies is eminent, a published poll reveals women have to wait an average of 11.7 years in US and 8 years in UK to get a correct diagnosis after the initial onset of symptoms and a patient will seek the counsel of five or more physicians before her pain is adequately addressed and diagnosed. Once diagnosed, it is not unusual for a patient to undergo repeat surgeries and embark on many different medical therapies in an attempt to treat her symptoms. Endometriosis is a bit puzzling. We do not know why it causes such extreme symptoms in some women, while less in others. The treatment options can sometimes be unsuccessful. Sadly, endometriosis is associated with menstruation, sex, infertility, and pain (taboos in many societies), thus it is a disease that is not well known, understood, or accepted in the general public. This is frustrating for those who suffer from endometriosis, and for those who care for someone with the disease.
There is no non-invasive test to diagnose endometriosis. In fact, the only gold standard diagnosis of endometriosis is a surgical procedure known as laparoscopy and confirm histologically by taking a biopsy of the suspicious tissue.
However, this is an expensive, minimally invasive procedure. Furthermore, a specialised surgeon is needed for adequate assessment of the pelvis, for recognition of the various types and appearances of the disease. If the patients decline surgery, this makes diagnosis a challenge, and therefore an experienced gynaecologist should be able to recognise symptoms suggestive of endometriosis. The fact that there is no non-invasive diagnostic test for endometriosis is frustrating for clinicians as well as for women with the disease and underscores the need for search of better diagnostic tools.
Since the cause of endometriosis remains unknown, a treatment that fully cures the disease is yet to be developed. Choosing a holistic, treatment option comes down to the individual woman's needs, depending on symptoms, age, and reproductive desires.
Pain is the most common symptom in many women with endometriosis, mainly managed by painkillers, which may vary from simple analgesics to non-steroidal anti-inflammatory drugs. Most researchers agree that endometriosis is exacerbated by oestrogen. Subsequently, hormonal treatments for endometriosis attempt to reverse oestrogen production in a woman's body and thereby alleviate symptoms. However, hormonal therapies have varying degrees of side effects, and unfortunately, whatever pain relief is achieved tends to be only temporary for many women. Most gynaecologists agree that laparoscopic surgery is the only way to diagnose and treat endometriosis. Laparoscopy involves a small cut or incision in the abdomen, inflating the abdomen with harmless gas, and then inserts a viewing instrument with help of light (Laparoscope) into the abdomen. The success of surgery depends largely on the skills of the surgeon and the thoroughness of the surgery. The aim is to remove all endometriosis lesions, cysts, and adhesions. Today, most endometriosis surgery is being done through the laparoscopy, although a full abdominal incision called a laparotomy may still be required in rare cases for extensive disease or bowel resections.
Although the prevalence of endometriosis is well documented in women living in the developed world, studies among African women are still limited. The current myth is that endometriosis rarely affects women of African origin. However, among African-American women in the USA, studies have shown endometriosis is one of the common indications for major gynaecological surgery and hysterectomy, and is associated with a high hospital costs. Although genetically, African-American and African women from the African continent are not necessarily identical given the known genetic admixture among the African-American population. Lack of awareness of endometriosis as a potentially disabling disease and poor access to state-of art diagnostic and therapeutic facilities has contributed to the meagre data on prevalence of the disease in the African population. There is need to initiate awareness campaign of endometriosis to reach all women in Africa. Also to highlight the general lack of information, facilitate endometriosis research efforts and draw attention to the impact and implications of the disease to healthcare systems in our country and the continent in general.
The writer is a Senior Scientist with special interest in endometriosis and ovarian cancer research
http://www.africasciencenews.org/en/index.php/health/63-health/194-endometriosis-slowly-emerges-as-a-life-threatening-disease-for-women
Written by Cleophas Mutinda
Imagine a pain in your abdomen so excruciating that you are unable to get out of bed for several days every month. That is horrible enough, but when it continues 12 times a year for more than 27 years, majority of people would agree it is cruel.
Most women with endometriosis will recognise this shocking scenario as not imaginary, but very real. They know the misery of pelvic pain and have poignant stories of how endometriosis has devastated their lives with terrible suffering. Many women feel angry or despondent about being robbed off a normal life during teenage, adulthood and even sometime a ruined motherhood.
Endometriosis is a gynaecological condition, which occurs when, cells like the ones (endometrial cells) lining inside of the uterus (womb) grow outside, usually on the surfaces of organs in pelvic and abdominal areas. It can be found within the peritoneal cavity, on the ovaries and the bowels or bladder. In extremely rare cases, endometriosis can be found in lungs or other parts of the body. Endometriosis can affect any menstruating woman, from time of her first period to menopause, regardless of race, ethnicity or socio-economic status. Endometriosis rarely persists after menopause. The disorder, for which there is no absolute cure, affects over 70 million women and girls worldwide. Often stigmatized as simply “painful periods,” Endometriosis is a puzzling and widely misunderstood illness.
It is not known exactly what causes endometriosis. But over the years several theories have been advanced to explain the probable cause of the disease although none can fully explain the various clinical manifestations of the disease. A theory proposed by John Sampson in the 1920s, suggests that endometriosis may result from something called “retrograde menstrual flow”, in which some of the tissue that a woman sheds during her period flows back through the tubes and grows in the pelvic cavity. While studies show that retrograde menstrual flow is a universal phenomenon among women of reproductive age, the theory fall short of explaining why the tissues survive in some women, but fail in others. Another theory proposed by Iwanoff in 1898, claims that, the transformation of what we call coelomic epithelium into endometrial-like tissue may be a cause of endometriosis. This theory has been supported by experimental data. The induction theory, proposes that an endogenous factor can induce peritoneal cells to develop into endometrial tissue. This theory has been supported by experiments in rabbits.
Lymphatic or vascular hypothesis suggests that endometrial fragments may be transported through blood vessels or the lymphatic system to other parts of the body. This theory speculates how endometriosis ends up in distant sites, such as the lung, brain, or the skin. A genetic linkage has been adduced which claims that, this disease could be inherited, or result from genetic errors, making some women more prone to develop the condition than others.
Studies show that the risk of endometriosis is seven times greater if the disease has affected a first-degree relative. This theory has been supported by experiments in mouse model but has not been verified either in women. Immunological etiology (cause) has also been conjured since studies report that many women with endometriosis exhibit immunological abnormalities. It is speculated that the immune system may fail to clear the menstrual debris in the pelvic cavity, allowing the endometrial cells to implant and develop into endometriosis.
Also most scientists agree that endometriosis is exacerbated by oestrogen; a hormone involved in the thickening of the endometrium and appears to promote the growth of disease implants. Some studies have pointed out environmental factors like toxins may contribute to the development of endometriosis, though this theory has not been confirmed and remains controversial.
The most common symptoms of endometriosis are abdominal pain and infertility. Some studies have reported that endometriosis may occur in 30%-40% of women with infertility and the incidence of endometriosis in women with pelvic pain may be higher than 50%.
Endometriosis associated pain may include but not limited to extremely painful (disabling) menstrual cramps, chronic pelvic pain (which includes lower back pain and pelvic pain), pain during or after sex, painful bowel movements or painful urination during menstrual periods, heavy menstrual periods and bleeding between periods. The amount of pain a women feels is sometimes not linked to degree of endometriosis. Some women have no pain even though their disease is extensive, while others have severe chronic pelvic pain even though they have only few affected areas.
The relation between endometriosis and pain is still shrouded in the mist of intricate puzzle and ignorance. Many women with endometriosis feel pain during their periods. Normally, a woman’s menstrual cycle involves her endometrial tissue to build up, breaks down into blood and tissue debris, and is shed as her menstrual flow or period. This cycle of growth and shedding happens every month under normal condition. Endometriosis grows outside the uterus and also goes through a similar cycle, build-up, breakdown and bleed every month. The problem is the tissue is in the wrong place and can’t leave the body the way a woman’s period normally does. Studies show that as part of this process, endometriosis may spur the production of substances that may irritate the nearby tissue, as well as provoke the release of chemicals that cause or mediate pain. Over time, endometriosis areas can grow and become nodules or bumps on the surface of pelvic organs, or become cysts (fluid-filled sacs) in the ovaries and may cause the organs in the pelvic area to adhere together.
Endometriosis is more than just simple "killer" cramps. Women and girls around the world continue to suffer in silence with a disease that can be potentially devastating to every aspect of their lives. It can be so painful as to render a woman or teenager unable to care for herself or her family, attend work, school, or social functions, or go about her normal routine. Endometriosis has a negative impact on the individual quality of life, affecting both physical and emotional well-being. A study by the American Endometriosis Association, demonstrated that 81% of the endometriosis patients in USA were unable to work, including household chores, because of pelvic pain. Approximately 27% were incapacitated for 3 or more days and 87% complained of fatigue or low energy. These figures are indicators of enormous suffering, in addition to the healthcare costs incurred. The need to develop intervention strategies is eminent, a published poll reveals women have to wait an average of 11.7 years in US and 8 years in UK to get a correct diagnosis after the initial onset of symptoms and a patient will seek the counsel of five or more physicians before her pain is adequately addressed and diagnosed. Once diagnosed, it is not unusual for a patient to undergo repeat surgeries and embark on many different medical therapies in an attempt to treat her symptoms. Endometriosis is a bit puzzling. We do not know why it causes such extreme symptoms in some women, while less in others. The treatment options can sometimes be unsuccessful. Sadly, endometriosis is associated with menstruation, sex, infertility, and pain (taboos in many societies), thus it is a disease that is not well known, understood, or accepted in the general public. This is frustrating for those who suffer from endometriosis, and for those who care for someone with the disease.
There is no non-invasive test to diagnose endometriosis. In fact, the only gold standard diagnosis of endometriosis is a surgical procedure known as laparoscopy and confirm histologically by taking a biopsy of the suspicious tissue.
However, this is an expensive, minimally invasive procedure. Furthermore, a specialised surgeon is needed for adequate assessment of the pelvis, for recognition of the various types and appearances of the disease. If the patients decline surgery, this makes diagnosis a challenge, and therefore an experienced gynaecologist should be able to recognise symptoms suggestive of endometriosis. The fact that there is no non-invasive diagnostic test for endometriosis is frustrating for clinicians as well as for women with the disease and underscores the need for search of better diagnostic tools.
Since the cause of endometriosis remains unknown, a treatment that fully cures the disease is yet to be developed. Choosing a holistic, treatment option comes down to the individual woman's needs, depending on symptoms, age, and reproductive desires.
Pain is the most common symptom in many women with endometriosis, mainly managed by painkillers, which may vary from simple analgesics to non-steroidal anti-inflammatory drugs. Most researchers agree that endometriosis is exacerbated by oestrogen. Subsequently, hormonal treatments for endometriosis attempt to reverse oestrogen production in a woman's body and thereby alleviate symptoms. However, hormonal therapies have varying degrees of side effects, and unfortunately, whatever pain relief is achieved tends to be only temporary for many women. Most gynaecologists agree that laparoscopic surgery is the only way to diagnose and treat endometriosis. Laparoscopy involves a small cut or incision in the abdomen, inflating the abdomen with harmless gas, and then inserts a viewing instrument with help of light (Laparoscope) into the abdomen. The success of surgery depends largely on the skills of the surgeon and the thoroughness of the surgery. The aim is to remove all endometriosis lesions, cysts, and adhesions. Today, most endometriosis surgery is being done through the laparoscopy, although a full abdominal incision called a laparotomy may still be required in rare cases for extensive disease or bowel resections.
Although the prevalence of endometriosis is well documented in women living in the developed world, studies among African women are still limited. The current myth is that endometriosis rarely affects women of African origin. However, among African-American women in the USA, studies have shown endometriosis is one of the common indications for major gynaecological surgery and hysterectomy, and is associated with a high hospital costs. Although genetically, African-American and African women from the African continent are not necessarily identical given the known genetic admixture among the African-American population. Lack of awareness of endometriosis as a potentially disabling disease and poor access to state-of art diagnostic and therapeutic facilities has contributed to the meagre data on prevalence of the disease in the African population. There is need to initiate awareness campaign of endometriosis to reach all women in Africa. Also to highlight the general lack of information, facilitate endometriosis research efforts and draw attention to the impact and implications of the disease to healthcare systems in our country and the continent in general.
The writer is a Senior Scientist with special interest in endometriosis and ovarian cancer research
http://www.africasciencenews.org/en/index.php/health/63-health/194-endometriosis-slowly-emerges-as-a-life-threatening-disease-for-women
Monday, October 24, 2011
Putting the pieces together: endometriosis blogs, cognitive authority, and collaborative information behavior
J Med Libr Assoc. 2011 April; 99(2): 127–134.
doi: 10.3163/1536-5050.99.2.004 PMCID: PMC3066582
Copyright © 2011, Authors.
Putting the pieces together: endometriosis blogs, cognitive authority, and collaborative information behavior*
Diane M Neal, PhD
Assistant Professor ; Email: dneal2@uwo.caPamela J McKenzie, PhD
Associate Professor and Assistant Dean Research; Faculty of Information and Media Studies, The University of Western Ontario, North Campus Building, Room 240, London, ON, Canada N6A 5B7 ; Email: pmckenzi@uwo.caReceived June 2010; Accepted October 2010.
Readers may use articles without permission of copyright owners, as long as the author and MLA are acknowledged and the use is educational and not for profit. Other Sections▼
AbstractINTRODUCTIONMETHODSRESULTSDISCUSSIONCONCLUSIONSREFERENCESAbstractObjective:
A discourse analysis was conducted of peer-written blogs about the chronic illness endometriosis to understand how bloggers present information sources and make cases for and against the authority of those sources.Methods:
Eleven blogs that were authored by endometriosis patients and focused exclusively or primarily on the authors' experiences with endometriosis were selected. After selecting segments in which the bloggers invoked forms of knowledge and sources of evidence, the text was discursively analyzed to reveal how bloggers establish and dispute the authority of the sources they invoke.Results:
When discussing and refuting authority, the bloggers invoked many sources of evidence, including experiential, peer-provided, biomedical, and intuitive ones. Additionally, they made and disputed claims of cognitive authority via two interpretive repertoires: a concern about the role and interests of the pharmaceutical industry and an understanding of endometriosis as extremely idiosyncratic. Affective authority of information sources was also identified, which presented as social context, situational similarity, or aesthetic or spiritual factors.Conclusions:
Endometriosis patients may find informational value in blogs, especially for affective support and epistemic experience. Traditional notions of authority might need to be revised for the online environment. Guidelines for evaluating the authority of consumer health information, informed by established readers' advisory practices, are suggested. Other Sections▼
AbstractINTRODUCTIONMETHODSRESULTSDISCUSSIONCONCLUSIONSREFERENCES Highlights
•Endometriosis patients who blog about the illness may determine authority of information sources through both cognitive and affective methods.
Implications
•Because patients with chronic illnesses might have different authority criteria than medical librarians do, it could be useful to carefully incorporate electronic patient discussion forums, medical blogs written by laypeople, and other nontraditionally authoritative resources into consumer health information selection policies. Standard biomedical resources are certainly important to recommend to consumers, but they do not convey the complete picture of a chronic illness and its related experience.
•Patients with chronic illnesses and caregivers can benefit from sources such as blogs and online discussion lists that provide social and emotional support as well as accounts of “lived experience.”
•An understanding of the patient's potential epistemological community can make the librarian's recommendations more appropriate for the individual user.
Other Sections▼
AbstractINTRODUCTIONMETHODSRESULTSDISCUSSIONCONCLUSIONSREFERENCESINTRODUCTIONChronic illness is a context in which people may do a great deal of “information work” [1]. Chronic illnesses are often broad in scope and effect, difficult to diagnose, complex, ever changing, and not amenable to conventional treatments. They often have significant physical, emotional, and social repercussions, and their management requires work by the ill person and those around the ill person, much of which may require considerable time and energy, be mentally and emotionally demanding, and occur beyond doctors' offices [1].A major barrier to information access expressed by people with chronic illnesses is the difficulty of finding information relevant to their situations [1, 2]. Chronic illness is an important impetus for collaborative information behavior [3, 4]: As do information seekers in other contexts, people with chronic illnesses tend first to seek help or information from people like themselves [5]. Acquaintances with the same disease can provide socially appropriate opportunities to expose a seeker to disease-relevant information and support [6]. The desire for support underlies the creation of resources, services, and groups in which peers physically or virtually “come together to provide emotional and other support through sharing their personal lived experience as well as exchanging other resources” [7]. Participants in health-oriented support groups [8, 9] and online resources such as discussion forums and peer-authored blogs [10] report receiving both informational and emotional support. Illness blogs have many of the advantages of face-to-face peer sources without the stigma of approaching a peer with a personal question [6].Peer sources may also offer a highly valued and particularly relevant kind of information based on “wisdom and know-how gained through reflection upon personal lived experience” [11] rather than on professional knowledge. Experiential knowledge “consists of the statements, stories or narratives reflecting some aspect of an individual's experience that she or he values and trusts as knowledge. To an uninvolved observer, much experiential knowledge may sound like or appear to be small talk or everyday conversation” [11].The significance of experiential knowledge for people with chronic illnesses poses particular challenges for information professionals, who are schooled in selecting traditionally authoritative resources and employing evidence-based techniques for evaluating health information sources. Selection criteria for a health sciences journal include, among other things, its perceived “scholarly” status, its publisher, the affiliations of the journal's authors and editors, and its impact factor [12]. Health sciences monograph selection tools consist of resources such as core lists, vendors, and book reviews in medical journals [13]. Guidelines for consumer health information collection development focus on patient education literature written by health professionals, as well as by patient advocacy and professional organizations. Consumer-oriented library materials might also include general medical reference books [14]. These and other standard evaluation criteria assume that the most authoritative resources are authored by health care professionals and researchers. However, people with chronic illnesses may use authority criteria that are completely distinct from those that information professionals use [15]. For example, while a blog describing the author's experience with a chronic disease is unlikely to meet librarians' traditional standards for authority, it might be considered very authoritative by someone who is learning to cope emotionally with a new diagnosis [16].Library and information science (LIS) researchers have long been interested in the ways that individuals and communities evaluate the authority of information sources. The concept of cognitive authority has offered a useful framework for explaining an individual's situated judgments about the authority of information sources [17]. Cognitive authority is a particularly important concept for understanding users' evaluations of web resources [18]. It has been defined by Rieh, following Wilson [17], as “the extent to which users think that the information is useful, good, current, and accurate. Cognitive authority is operationalized as to the extent to which users think that they can trust the information” [18]. More recently, LIS researchers have adopted new approaches to the study of authority that consider not the cognitive processes by which an individual makes decisions about an information source, but the social practices whereby a community collaboratively negotiates what counts as an authoritative information source [19–,21]. Depression patients were found to rely on a wide range of resources, while using personal, experiential knowledge as confirmation of treatment effectiveness [20]. A study of the ways that members of a chronic illness community collectively filter, interpret, evaluate, and synthesize as they share can provide insight into the ways that authority is developed and challenged in that community [4]. Studies such as this can provide practitioners with new ways of thinking about the criteria they use when evaluating or recommending peer sources for chronic illness.This article analyzes the ways that peer bloggers with endometriosis present information sources and make cases for and against their authority. Endometriosis is an enigmatic chronic disease that causes uterine tissue implantation in areas other than the uterus. Highly underdiagnosed, it may affect up to 25% of reproductive-age women. Symptoms vary widely, but the most frequent complaint is pelvic pain, and endometriosis is a cause of common infertility. The broad spectrum of presentation and symptoms, as well as the absence of satisfactory treatments, leaves patients largely at a loss for information that they perceive as reliable [22]. For these reasons, Whelan characterizes women with endometriosis who work together to find answers as an “epistemological community” [23]. This analysis will show how bloggers' justification strategies draw on understandings that members of their specific epistemological community commonly hold.Blogs authored by people with chronic illness are of particular interest to LIS researchers, because they provide naturalistic sources of data about the blogger's illness-related information work [2], including selection, justification, evaluation, and interpretation of information identified by the blogger from other sources. Comments and links on blogs provide evidence of what Talja and Hansen call a “community of sharing” [4], a group of people who develop shared understandings and create knowledge structures that may in turn be used by others. Blogs allow both members and nonmembers of epistemic cultures to interact in dialogue and to participate in the culture [24]. They therefore offer the possibility of extending the face-to-face social networks that Veinot [6] has shown to mediate information validation. LIS researchers have begun to study social and community aspects of health- and illness-related information work [6, 25–,27]. Important findings about the readers of illness blogs have been identified [10]. However, there has so far been little consideration of what the blogs themselves can tell librarians and researchers about how people living with chronic illness evaluate information sources.
Read More : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3066582/
doi: 10.3163/1536-5050.99.2.004 PMCID: PMC3066582
Copyright © 2011, Authors.
Putting the pieces together: endometriosis blogs, cognitive authority, and collaborative information behavior*
Diane M Neal, PhD
Assistant Professor ; Email: dneal2@uwo.caPamela J McKenzie, PhD
Associate Professor and Assistant Dean Research; Faculty of Information and Media Studies, The University of Western Ontario, North Campus Building, Room 240, London, ON, Canada N6A 5B7 ; Email: pmckenzi@uwo.caReceived June 2010; Accepted October 2010.
Readers may use articles without permission of copyright owners, as long as the author and MLA are acknowledged and the use is educational and not for profit. Other Sections▼
AbstractINTRODUCTIONMETHODSRESULTSDISCUSSIONCONCLUSIONSREFERENCESAbstractObjective:
A discourse analysis was conducted of peer-written blogs about the chronic illness endometriosis to understand how bloggers present information sources and make cases for and against the authority of those sources.Methods:
Eleven blogs that were authored by endometriosis patients and focused exclusively or primarily on the authors' experiences with endometriosis were selected. After selecting segments in which the bloggers invoked forms of knowledge and sources of evidence, the text was discursively analyzed to reveal how bloggers establish and dispute the authority of the sources they invoke.Results:
When discussing and refuting authority, the bloggers invoked many sources of evidence, including experiential, peer-provided, biomedical, and intuitive ones. Additionally, they made and disputed claims of cognitive authority via two interpretive repertoires: a concern about the role and interests of the pharmaceutical industry and an understanding of endometriosis as extremely idiosyncratic. Affective authority of information sources was also identified, which presented as social context, situational similarity, or aesthetic or spiritual factors.Conclusions:
Endometriosis patients may find informational value in blogs, especially for affective support and epistemic experience. Traditional notions of authority might need to be revised for the online environment. Guidelines for evaluating the authority of consumer health information, informed by established readers' advisory practices, are suggested. Other Sections▼
AbstractINTRODUCTIONMETHODSRESULTSDISCUSSIONCONCLUSIONSREFERENCES Highlights
•Endometriosis patients who blog about the illness may determine authority of information sources through both cognitive and affective methods.
Implications
•Because patients with chronic illnesses might have different authority criteria than medical librarians do, it could be useful to carefully incorporate electronic patient discussion forums, medical blogs written by laypeople, and other nontraditionally authoritative resources into consumer health information selection policies. Standard biomedical resources are certainly important to recommend to consumers, but they do not convey the complete picture of a chronic illness and its related experience.
•Patients with chronic illnesses and caregivers can benefit from sources such as blogs and online discussion lists that provide social and emotional support as well as accounts of “lived experience.”
•An understanding of the patient's potential epistemological community can make the librarian's recommendations more appropriate for the individual user.
Other Sections▼
AbstractINTRODUCTIONMETHODSRESULTSDISCUSSIONCONCLUSIONSREFERENCESINTRODUCTIONChronic illness is a context in which people may do a great deal of “information work” [1]. Chronic illnesses are often broad in scope and effect, difficult to diagnose, complex, ever changing, and not amenable to conventional treatments. They often have significant physical, emotional, and social repercussions, and their management requires work by the ill person and those around the ill person, much of which may require considerable time and energy, be mentally and emotionally demanding, and occur beyond doctors' offices [1].A major barrier to information access expressed by people with chronic illnesses is the difficulty of finding information relevant to their situations [1, 2]. Chronic illness is an important impetus for collaborative information behavior [3, 4]: As do information seekers in other contexts, people with chronic illnesses tend first to seek help or information from people like themselves [5]. Acquaintances with the same disease can provide socially appropriate opportunities to expose a seeker to disease-relevant information and support [6]. The desire for support underlies the creation of resources, services, and groups in which peers physically or virtually “come together to provide emotional and other support through sharing their personal lived experience as well as exchanging other resources” [7]. Participants in health-oriented support groups [8, 9] and online resources such as discussion forums and peer-authored blogs [10] report receiving both informational and emotional support. Illness blogs have many of the advantages of face-to-face peer sources without the stigma of approaching a peer with a personal question [6].Peer sources may also offer a highly valued and particularly relevant kind of information based on “wisdom and know-how gained through reflection upon personal lived experience” [11] rather than on professional knowledge. Experiential knowledge “consists of the statements, stories or narratives reflecting some aspect of an individual's experience that she or he values and trusts as knowledge. To an uninvolved observer, much experiential knowledge may sound like or appear to be small talk or everyday conversation” [11].The significance of experiential knowledge for people with chronic illnesses poses particular challenges for information professionals, who are schooled in selecting traditionally authoritative resources and employing evidence-based techniques for evaluating health information sources. Selection criteria for a health sciences journal include, among other things, its perceived “scholarly” status, its publisher, the affiliations of the journal's authors and editors, and its impact factor [12]. Health sciences monograph selection tools consist of resources such as core lists, vendors, and book reviews in medical journals [13]. Guidelines for consumer health information collection development focus on patient education literature written by health professionals, as well as by patient advocacy and professional organizations. Consumer-oriented library materials might also include general medical reference books [14]. These and other standard evaluation criteria assume that the most authoritative resources are authored by health care professionals and researchers. However, people with chronic illnesses may use authority criteria that are completely distinct from those that information professionals use [15]. For example, while a blog describing the author's experience with a chronic disease is unlikely to meet librarians' traditional standards for authority, it might be considered very authoritative by someone who is learning to cope emotionally with a new diagnosis [16].Library and information science (LIS) researchers have long been interested in the ways that individuals and communities evaluate the authority of information sources. The concept of cognitive authority has offered a useful framework for explaining an individual's situated judgments about the authority of information sources [17]. Cognitive authority is a particularly important concept for understanding users' evaluations of web resources [18]. It has been defined by Rieh, following Wilson [17], as “the extent to which users think that the information is useful, good, current, and accurate. Cognitive authority is operationalized as to the extent to which users think that they can trust the information” [18]. More recently, LIS researchers have adopted new approaches to the study of authority that consider not the cognitive processes by which an individual makes decisions about an information source, but the social practices whereby a community collaboratively negotiates what counts as an authoritative information source [19–,21]. Depression patients were found to rely on a wide range of resources, while using personal, experiential knowledge as confirmation of treatment effectiveness [20]. A study of the ways that members of a chronic illness community collectively filter, interpret, evaluate, and synthesize as they share can provide insight into the ways that authority is developed and challenged in that community [4]. Studies such as this can provide practitioners with new ways of thinking about the criteria they use when evaluating or recommending peer sources for chronic illness.This article analyzes the ways that peer bloggers with endometriosis present information sources and make cases for and against their authority. Endometriosis is an enigmatic chronic disease that causes uterine tissue implantation in areas other than the uterus. Highly underdiagnosed, it may affect up to 25% of reproductive-age women. Symptoms vary widely, but the most frequent complaint is pelvic pain, and endometriosis is a cause of common infertility. The broad spectrum of presentation and symptoms, as well as the absence of satisfactory treatments, leaves patients largely at a loss for information that they perceive as reliable [22]. For these reasons, Whelan characterizes women with endometriosis who work together to find answers as an “epistemological community” [23]. This analysis will show how bloggers' justification strategies draw on understandings that members of their specific epistemological community commonly hold.Blogs authored by people with chronic illness are of particular interest to LIS researchers, because they provide naturalistic sources of data about the blogger's illness-related information work [2], including selection, justification, evaluation, and interpretation of information identified by the blogger from other sources. Comments and links on blogs provide evidence of what Talja and Hansen call a “community of sharing” [4], a group of people who develop shared understandings and create knowledge structures that may in turn be used by others. Blogs allow both members and nonmembers of epistemic cultures to interact in dialogue and to participate in the culture [24]. They therefore offer the possibility of extending the face-to-face social networks that Veinot [6] has shown to mediate information validation. LIS researchers have begun to study social and community aspects of health- and illness-related information work [6, 25–,27]. Important findings about the readers of illness blogs have been identified [10]. However, there has so far been little consideration of what the blogs themselves can tell librarians and researchers about how people living with chronic illness evaluate information sources.
Read More : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3066582/
New Concepts in Diagnosis and Treatment Summarized from ISGE 8th Annual Congress
By Ted L. Anderson, M.D., Ph.D.
October 24, 2011
"What is the hardest of all to do? To see with our eyes what our eyes lay before us. (Paraphrased, with apologies from Goethe) That essentially is the message of the innovative efforts of Ms. Deborah Bush, Chairperson of the New Zealand Endometriosis Foundation. She has developed an interactive Menstrual Health and Endometriosis Education Program that has been presented to over 40,000 young women (ages 15-24), educators and clinicians. There has been an overwhelmingly positive response as this population gained better knowledge of what is "normal" and how to recognize the symptoms of endometriosis. Of note, anecdotal reports show this program has resulted in increased referrals to gynecologists and increased early diagnosis and treatment. Hopefully, such early intervention will mitigate the long-term sequellae of adhesions, pain and infertility. On the other hand, it is too often that we dismiss endometriosis as a source of pelvic and rectal pain, especially in young women and after hysterectomy and salpingo-oophorectomy.
However, infiltrative endometriosis involving the apical vaginal wall, the anterior rectal wall and the soft tissues of the cul-de-sac are not uncommon. This is the advice from Dr. Ray Garry and his colleagues from WEL Foundation, South Cleveland Hospital, Middleborough, UK. Using his techniques of radical laparoscopic excision, he excises the tissue bounded by the uterosacral ligaments laterally, the anterior rectal wall posteriorly and the posterior cervix. Then he removes the tissue en bloc. This technique offers relief from dysmenorrhea, dyspareunia, rectal pain and general pelvic pain in over 80% of his patients as measured by a standardized questionnaire. They have not examined the potential added benefit of hormonal suppressive therapy pre or post-operatively. Despite excellent results in this difficult patient population, this group continues to follow long-term success, as will we, with great interest."
The patient with pelvic pain continues to be one of the greatest therapeutic challenges to gynaecologists. There have been few developments in recent years that will impact treatment success in these patients, as we will likely see with conscious laparoscopy and pain mapping. This was illustrated beautifully in an excellent workshop on pelvic pain, moderated by Dr. Christopher Sutton (The Guilford Nuffield Hospital, Surrey, UK). Our concepts of pain aetiologies were challenged by Dr. FM. Howard (Rochester General Hospital, NY, USA), who provided evidence that endometriosis lesions accounted for only 1/3 of pain described by patients during conscious pain mapping, with adhesions accounting for another 1/3. This group called into question the routine use of postoperative GnRH agonists in this patient population. Dr. John Steege (University of North Carolina, USA), demonstrated the power of pain mapping by showing a procedure without sound in a post-hysterectomy patient with adhesions involving the pelvic sidewall and vaginal cuff, as well as an ovarian remnant. After an audience poll of operative options, he replayed the tape with audio feedback from the patient during the procedure. Much to our surprise, this experience changed the opinion of appropriate operative intervention in a substantial number of participants. Dr. Lawrence Demco (University of Calgary, Canada), illustrated his techniques of pain mapping through multiple video clips. Interestingly, many patients described pain with touching of peritoneal surfaces up to 2.5 cm away from visible endometriotic lesions. Additionally, he demonstrated that the pain perceived by the patient frequently does not correlate with the position of lesions or pain elicited during mapping. For example, touching visible endometriosis on the left pelvic sidewall often correlated with right-sided pelvic pain experienced by the patient. Using these techniques to guide subsequent operative interventions, he has described greater than 80% of patients remain pain free at 6 months follow-up. Dr. Sutton presented his prospective randomized double-blinded study that demonstrated the efficacy of operative treatment for stage I-III endometriosis compared with no treatment. Not surprisingly, there was increasing benefit of surgical treatment with advancing endometriosis stage. Additionally, he presented the results of a study showing no additional benefit of LUNA when endometriosis is ablated surgically. Certainly the message we can learn from this workshop will continue to guide our ability to understand and treat pelvic pain.
http://hcp.obgyn.net/pelvic-pain/content/article/1760982/1975952
October 24, 2011
"What is the hardest of all to do? To see with our eyes what our eyes lay before us. (Paraphrased, with apologies from Goethe) That essentially is the message of the innovative efforts of Ms. Deborah Bush, Chairperson of the New Zealand Endometriosis Foundation. She has developed an interactive Menstrual Health and Endometriosis Education Program that has been presented to over 40,000 young women (ages 15-24), educators and clinicians. There has been an overwhelmingly positive response as this population gained better knowledge of what is "normal" and how to recognize the symptoms of endometriosis. Of note, anecdotal reports show this program has resulted in increased referrals to gynecologists and increased early diagnosis and treatment. Hopefully, such early intervention will mitigate the long-term sequellae of adhesions, pain and infertility. On the other hand, it is too often that we dismiss endometriosis as a source of pelvic and rectal pain, especially in young women and after hysterectomy and salpingo-oophorectomy.
However, infiltrative endometriosis involving the apical vaginal wall, the anterior rectal wall and the soft tissues of the cul-de-sac are not uncommon. This is the advice from Dr. Ray Garry and his colleagues from WEL Foundation, South Cleveland Hospital, Middleborough, UK. Using his techniques of radical laparoscopic excision, he excises the tissue bounded by the uterosacral ligaments laterally, the anterior rectal wall posteriorly and the posterior cervix. Then he removes the tissue en bloc. This technique offers relief from dysmenorrhea, dyspareunia, rectal pain and general pelvic pain in over 80% of his patients as measured by a standardized questionnaire. They have not examined the potential added benefit of hormonal suppressive therapy pre or post-operatively. Despite excellent results in this difficult patient population, this group continues to follow long-term success, as will we, with great interest."
The patient with pelvic pain continues to be one of the greatest therapeutic challenges to gynaecologists. There have been few developments in recent years that will impact treatment success in these patients, as we will likely see with conscious laparoscopy and pain mapping. This was illustrated beautifully in an excellent workshop on pelvic pain, moderated by Dr. Christopher Sutton (The Guilford Nuffield Hospital, Surrey, UK). Our concepts of pain aetiologies were challenged by Dr. FM. Howard (Rochester General Hospital, NY, USA), who provided evidence that endometriosis lesions accounted for only 1/3 of pain described by patients during conscious pain mapping, with adhesions accounting for another 1/3. This group called into question the routine use of postoperative GnRH agonists in this patient population. Dr. John Steege (University of North Carolina, USA), demonstrated the power of pain mapping by showing a procedure without sound in a post-hysterectomy patient with adhesions involving the pelvic sidewall and vaginal cuff, as well as an ovarian remnant. After an audience poll of operative options, he replayed the tape with audio feedback from the patient during the procedure. Much to our surprise, this experience changed the opinion of appropriate operative intervention in a substantial number of participants. Dr. Lawrence Demco (University of Calgary, Canada), illustrated his techniques of pain mapping through multiple video clips. Interestingly, many patients described pain with touching of peritoneal surfaces up to 2.5 cm away from visible endometriotic lesions. Additionally, he demonstrated that the pain perceived by the patient frequently does not correlate with the position of lesions or pain elicited during mapping. For example, touching visible endometriosis on the left pelvic sidewall often correlated with right-sided pelvic pain experienced by the patient. Using these techniques to guide subsequent operative interventions, he has described greater than 80% of patients remain pain free at 6 months follow-up. Dr. Sutton presented his prospective randomized double-blinded study that demonstrated the efficacy of operative treatment for stage I-III endometriosis compared with no treatment. Not surprisingly, there was increasing benefit of surgical treatment with advancing endometriosis stage. Additionally, he presented the results of a study showing no additional benefit of LUNA when endometriosis is ablated surgically. Certainly the message we can learn from this workshop will continue to guide our ability to understand and treat pelvic pain.
http://hcp.obgyn.net/pelvic-pain/content/article/1760982/1975952
Friday, October 14, 2011
Ovarian cyst
An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. Any ovarian follicle that is larger than about two centimeters is termed an ovarian cyst. An ovarian cyst can be as small as a pea, or larger than an orange.
Most ovarian cysts are functional in nature and harmless (benign).[1] In the US, ovarian cysts are found in nearly all premenopausal women, and in up to 14.8% of postmenopausal women.[citation needed]
Ovarian cysts affect women of all ages. They occur most often, however, during a woman's childbearing years.
Some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to remove cysts larger than 5 centimeters in diameter.
Classification[edit] Non-functional cystsThere are several other conditions affecting the ovary that are described as types of cysts, but are not usually grouped with the functional cysts. (Some of these are more commonly or more properly known by other names.) These include:
Dermoid cyst
Chocolate cyst of ovary: An endometrioma, endometrioid cyst, endometrial cyst, or chocolate cyst is caused by endometriosis, and formed when a tiny patch of endometrial tissue (the mucous membrane that makes up the inner layer of the uterine wall) bleeds, sloughs off, becomes transplanted, and grows and enlarges inside the ovaries.
A polycystic-appearing ovary is diagnosed based on its enlarged size — usually twice normal —with small cysts present around the outside of the ovary. It can be found in "normal" women, and in women with endocrine disorders. An ultrasound is used to view the ovary in diagnosing the condition. Polycystic-appearing ovary is different from the polycystic ovarian syndrome, which includes other symptoms in addition to the presence of ovarian cysts.
Ovarian serous cystadenoma
Ovarian mucinous cystadenoma
[edit] Signs and symptomsSome or all of the following symptoms[2] [3] [4] [5] [6] may be present, though it is possible not to experience any symptoms:
Dull aching, or severe, sudden, and sharp pain or discomfort in the lower abdomen (one or both sides), pelvis, vagina, lower back, or thighs; pain may be constant or intermittent—this is the most common symptom
Fullness, heaviness, pressure, swelling, or bloating in the abdomen
Breast tenderness
Pain during or shortly after beginning or end of menstrual period.
Irregular periods, or abnormal uterine bleeding or spotting
Change in frequency or ease of urination (such as inability to fully empty the bladder), or difficulty with bowel movements due to pressure on adjacent pelvic anatomy
Weight gain
Nausea or vomiting
Fatigue
Infertility
Increased level of hair growth
Increased facial hair or body hair
Headaches
Strange pains in ribs, which feel muscular
Bloating
Strange nodules that feel like bruises under the layer of skin
[edit] Diagnosis
A 2cm left ovarian cyst as seen on ultrasound
An Axial CT demonstrating a large hemorrhagic ovarian cyst. The cyst is delineated by the yellow bars with blood seen anteriorly.
A CT scan showing a 8.5 cm cyst in a 29 year old female.Ovarian cysts are usually diagnosed by either ultrasound or CT scan.
[edit] TreatmentAbout 95% of ovarian cysts are benign, meaning they are not cancerous.[7]
Treatment for cysts depends on the size of the cyst and symptoms.
Pain caused by ovarian cysts may be treated with:
pain relievers, including acetaminophen/paracetamol (Tylenol), nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil), or narcotic pain medicine (by prescription) may help reduce pelvic pain.[8] NSAIDs usually work best when taken at the first signs of the pain.
a warm bath, or heating pad, or hot water bottle applied to the lower abdomen near the ovaries can relax tense muscles and relieve cramping, lessen discomfort, and stimulate circulation and healing in the ovaries.[9] Bags of ice covered with towels can be used alternately as cold treatments to increase local circulation.[10]
combined methods of hormonal contraception such as the combined oral contraceptive pill – the hormones in the pills may regulate the menstrual cycle, prevent the formation of follicles that can turn into cysts, and possibly shrink an existing cyst. (American College of Obstetricians and Gynecologists, 1999c; Mayo Clinic, 2002e)[8]
Also, limiting strenuous activity may reduce the risk of cyst rupture or torsion.
Cysts that persist beyond two or three menstrual cycles, or occur in post-menopausal women, may indicate more serious disease and should be investigated through ultrasonography and laparoscopy, especially in cases where family members have had ovarian cancer. Such cysts may require surgical biopsy. Additionally, a blood test may be taken before surgery to check for elevated CA-125, a tumor marker, which is often found in increased levels in ovarian cancer, although it can also be elevated by other conditions resulting in a large number of false positives.[11]
For more serious cases where cysts are large and persisting, doctors may suggest surgery. Some surgeries can be performed to successfully remove the cyst(s) without hurting the ovaries, while others may require removal of one or both ovaries.[12][13]
[edit] References1.^ "Ovarian Cysts Causes, Symptoms, Diagnosis, and Treatment". eMedicineHealth.com. http://www.emedicinehealth.com/ovarian_cysts/article_em.htm .
2.^ "Ovarian cysts: Symptoms". MayoClinic.com. http://www.mayoclinic.com/health/ovarian-cysts/DS00129/DSECTION=2 .
3.^ [1]
4.^ "Ovarian Cysts Causes, Symptoms, Diagnosis, and Treatment". eMedicineHealth.com . http://www.emedicinehealth.com/ovarian_cysts/page3_em.htm .
5.^ "Ovarian Cysts – Symptoms, Treatment and Prevention". HealthScout. http://www.healthscout.com/ency/1/725/main.html#SymptomsofOvarianCysts .
6.^ "Ovarian Cysts". http://www.medicineonline.com/topics/O/2/Ovarian-Cysts.html .
7.^ http://www.nhs.uk/Conditions/Ovarian-cyst/Pages/Symptoms.aspx
8.^ a b "Ovarian Cysts Treatment & Monitoring". Medicine Online. http://www.medicineonline.com/topics/O/2/Ovarian-Cysts/info/Treatment-&-Monitoring.html .
9.^ [2]
10.^ [3]
11.^ MedlinePlus Encyclopedia CA-125
12.^ "HealthHints: Gynecologic Health (January/February, 2003)". Texas AgriLife Extension Service: HealthHints. http://fcs.tamu.edu/health/health_education_rural_outreach/Health_Hints/2003/jan-feb/gynecologic_health.php .
13.^ http://ovariancystinfo.weebly.com/ Cyst on Ovary
[edit] External links"Ovarian cyst Introduction". Health encyclopaedia – NHS Direct. http://www.nhs.uk/conditions/Ovarian-cyst/Pages/Introduction.aspx. Retrieved 3 May 2011.
David B. Redwine, MD. "Endometriosis Persisting after Removal of the Uterus, Ovaries and Fallopian Tubes, Removing Disease, Not Organs, Key to Long-Term Relief". http://www.endometriosistreatment.org/html/reprint7.html . Retrieved 23 February 2009.
"Hemorrhagic Ovarian Cyst". http://www.hemorrhagicovariancyst.com/.
"Corpus Luteum Cyst". http://donorivf.org/articles/corpus-luteum-cyst/.
"Ovarian cyst symptoms". http://www.ovariancystreatment.com/category/ovarian-cyst-symptoms/.
http://en.wikipedia.org/wiki/Ovarian_cyst
Most ovarian cysts are functional in nature and harmless (benign).[1] In the US, ovarian cysts are found in nearly all premenopausal women, and in up to 14.8% of postmenopausal women.[citation needed]
Ovarian cysts affect women of all ages. They occur most often, however, during a woman's childbearing years.
Some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to remove cysts larger than 5 centimeters in diameter.
Classification[edit] Non-functional cystsThere are several other conditions affecting the ovary that are described as types of cysts, but are not usually grouped with the functional cysts. (Some of these are more commonly or more properly known by other names.) These include:
Dermoid cyst
Chocolate cyst of ovary: An endometrioma, endometrioid cyst, endometrial cyst, or chocolate cyst is caused by endometriosis, and formed when a tiny patch of endometrial tissue (the mucous membrane that makes up the inner layer of the uterine wall) bleeds, sloughs off, becomes transplanted, and grows and enlarges inside the ovaries.
A polycystic-appearing ovary is diagnosed based on its enlarged size — usually twice normal —with small cysts present around the outside of the ovary. It can be found in "normal" women, and in women with endocrine disorders. An ultrasound is used to view the ovary in diagnosing the condition. Polycystic-appearing ovary is different from the polycystic ovarian syndrome, which includes other symptoms in addition to the presence of ovarian cysts.
Ovarian serous cystadenoma
Ovarian mucinous cystadenoma
[edit] Signs and symptomsSome or all of the following symptoms[2] [3] [4] [5] [6] may be present, though it is possible not to experience any symptoms:
Dull aching, or severe, sudden, and sharp pain or discomfort in the lower abdomen (one or both sides), pelvis, vagina, lower back, or thighs; pain may be constant or intermittent—this is the most common symptom
Fullness, heaviness, pressure, swelling, or bloating in the abdomen
Breast tenderness
Pain during or shortly after beginning or end of menstrual period.
Irregular periods, or abnormal uterine bleeding or spotting
Change in frequency or ease of urination (such as inability to fully empty the bladder), or difficulty with bowel movements due to pressure on adjacent pelvic anatomy
Weight gain
Nausea or vomiting
Fatigue
Infertility
Increased level of hair growth
Increased facial hair or body hair
Headaches
Strange pains in ribs, which feel muscular
Bloating
Strange nodules that feel like bruises under the layer of skin
[edit] Diagnosis
A 2cm left ovarian cyst as seen on ultrasound
An Axial CT demonstrating a large hemorrhagic ovarian cyst. The cyst is delineated by the yellow bars with blood seen anteriorly.
A CT scan showing a 8.5 cm cyst in a 29 year old female.Ovarian cysts are usually diagnosed by either ultrasound or CT scan.
[edit] TreatmentAbout 95% of ovarian cysts are benign, meaning they are not cancerous.[7]
Treatment for cysts depends on the size of the cyst and symptoms.
Pain caused by ovarian cysts may be treated with:
pain relievers, including acetaminophen/paracetamol (Tylenol), nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil), or narcotic pain medicine (by prescription) may help reduce pelvic pain.[8] NSAIDs usually work best when taken at the first signs of the pain.
a warm bath, or heating pad, or hot water bottle applied to the lower abdomen near the ovaries can relax tense muscles and relieve cramping, lessen discomfort, and stimulate circulation and healing in the ovaries.[9] Bags of ice covered with towels can be used alternately as cold treatments to increase local circulation.[10]
combined methods of hormonal contraception such as the combined oral contraceptive pill – the hormones in the pills may regulate the menstrual cycle, prevent the formation of follicles that can turn into cysts, and possibly shrink an existing cyst. (American College of Obstetricians and Gynecologists, 1999c; Mayo Clinic, 2002e)[8]
Also, limiting strenuous activity may reduce the risk of cyst rupture or torsion.
Cysts that persist beyond two or three menstrual cycles, or occur in post-menopausal women, may indicate more serious disease and should be investigated through ultrasonography and laparoscopy, especially in cases where family members have had ovarian cancer. Such cysts may require surgical biopsy. Additionally, a blood test may be taken before surgery to check for elevated CA-125, a tumor marker, which is often found in increased levels in ovarian cancer, although it can also be elevated by other conditions resulting in a large number of false positives.[11]
For more serious cases where cysts are large and persisting, doctors may suggest surgery. Some surgeries can be performed to successfully remove the cyst(s) without hurting the ovaries, while others may require removal of one or both ovaries.[12][13]
[edit] References1.^ "Ovarian Cysts Causes, Symptoms, Diagnosis, and Treatment". eMedicineHealth.com. http://www.emedicinehealth.com/ovarian_cysts/article_em.htm .
2.^ "Ovarian cysts: Symptoms". MayoClinic.com. http://www.mayoclinic.com/health/ovarian-cysts/DS00129/DSECTION=2 .
3.^ [1]
4.^ "Ovarian Cysts Causes, Symptoms, Diagnosis, and Treatment". eMedicineHealth.com . http://www.emedicinehealth.com/ovarian_cysts/page3_em.htm .
5.^ "Ovarian Cysts – Symptoms, Treatment and Prevention". HealthScout. http://www.healthscout.com/ency/1/725/main.html#SymptomsofOvarianCysts .
6.^ "Ovarian Cysts". http://www.medicineonline.com/topics/O/2/Ovarian-Cysts.html .
7.^ http://www.nhs.uk/Conditions/Ovarian-cyst/Pages/Symptoms.aspx
8.^ a b "Ovarian Cysts Treatment & Monitoring". Medicine Online. http://www.medicineonline.com/topics/O/2/Ovarian-Cysts/info/Treatment-&-Monitoring.html .
9.^ [2]
10.^ [3]
11.^ MedlinePlus Encyclopedia CA-125
12.^ "HealthHints: Gynecologic Health (January/February, 2003)". Texas AgriLife Extension Service: HealthHints. http://fcs.tamu.edu/health/health_education_rural_outreach/Health_Hints/2003/jan-feb/gynecologic_health.php .
13.^ http://ovariancystinfo.weebly.com/ Cyst on Ovary
[edit] External links"Ovarian cyst Introduction". Health encyclopaedia – NHS Direct. http://www.nhs.uk/conditions/Ovarian-cyst/Pages/Introduction.aspx. Retrieved 3 May 2011.
David B. Redwine, MD. "Endometriosis Persisting after Removal of the Uterus, Ovaries and Fallopian Tubes, Removing Disease, Not Organs, Key to Long-Term Relief". http://www.endometriosistreatment.org/html/reprint7.html . Retrieved 23 February 2009.
"Hemorrhagic Ovarian Cyst". http://www.hemorrhagicovariancyst.com/.
"Corpus Luteum Cyst". http://donorivf.org/articles/corpus-luteum-cyst/.
"Ovarian cyst symptoms". http://www.ovariancystreatment.com/category/ovarian-cyst-symptoms/.
http://en.wikipedia.org/wiki/Ovarian_cyst
Wednesday, October 12, 2011
Abdominal pain may be sign of endometriosis
By Christi Myers
HOUSTON (KTRK) -- Women who experience unexplained abdominal pain could be facing endometriosis. The condition can be difficult to diagnose, so here's what women need to look for when it comes to that.
"The nurse and the doctor both looked at me and looked at my stomach and said, 'You look like you're seven months pregnant' and I'm like, 'I know and I'm not pregnant,'" Janet Strickland said.
Strickland was frustrated by her swollen abdomen and the pain she was having. She spent thousands of dollars on tests but got no answers.
"Everyone of those six doctors had told me there's nothing wrong with me," she said.
The doctors were wrong. After four years janet finally got an answer. Fertility Specialists of Houston Dr R.K. Mangal found severe endometriosis, which occurs when the menstrual flow goes back into the body, coating organs like glue.
"It spreads out to the pelvis, into the bowel cavity; we've seen it in lungs, we've seen it in patients with the diaphragm, so anywhere in the abdominal cavity which makes sense," Dr. Mangal said.
Endometriosis can start with painful menstrual cramps, pain during sex, bladder pain, colon pain, and infertility and more. Treatment often starts with the birth control pill to reduces the flow, and laser surgery to remove endometriosis from internal organs.
"I might have been with another doctor and they might have just wanted to do a total hysterectomy because I had it all over," Strickland said.
Instead Dr. Mangal was able to remove it but it took two surgeries to do it, and despite damage that remains, children are still possible.
"I think Janet has a good chance of having a baby," Dr. Mangal said.
But the surgeries, the tests and the pain could have been avoided had one of the first six doctors found it earlier.
Many women only discover they have endometriosis when they have infertility problems. Experts say by catching it early, women can often avoid infertility issues.
HOUSTON (KTRK) -- Women who experience unexplained abdominal pain could be facing endometriosis. The condition can be difficult to diagnose, so here's what women need to look for when it comes to that.
"The nurse and the doctor both looked at me and looked at my stomach and said, 'You look like you're seven months pregnant' and I'm like, 'I know and I'm not pregnant,'" Janet Strickland said.
Strickland was frustrated by her swollen abdomen and the pain she was having. She spent thousands of dollars on tests but got no answers.
"Everyone of those six doctors had told me there's nothing wrong with me," she said.
The doctors were wrong. After four years janet finally got an answer. Fertility Specialists of Houston Dr R.K. Mangal found severe endometriosis, which occurs when the menstrual flow goes back into the body, coating organs like glue.
"It spreads out to the pelvis, into the bowel cavity; we've seen it in lungs, we've seen it in patients with the diaphragm, so anywhere in the abdominal cavity which makes sense," Dr. Mangal said.
Endometriosis can start with painful menstrual cramps, pain during sex, bladder pain, colon pain, and infertility and more. Treatment often starts with the birth control pill to reduces the flow, and laser surgery to remove endometriosis from internal organs.
"I might have been with another doctor and they might have just wanted to do a total hysterectomy because I had it all over," Strickland said.
Instead Dr. Mangal was able to remove it but it took two surgeries to do it, and despite damage that remains, children are still possible.
"I think Janet has a good chance of having a baby," Dr. Mangal said.
But the surgeries, the tests and the pain could have been avoided had one of the first six doctors found it earlier.
Many women only discover they have endometriosis when they have infertility problems. Experts say by catching it early, women can often avoid infertility issues.
Wednesday, October 05, 2011
Endometriosis Therapeutics- Pipeline Assessment and Market Forecasts to 2018
NEW YORK, Sept. 28, 2011 /PRNewswire/ -- Reportlinker.com announces that a new market research report is available in its catalogue:
Endometriosis Therapeutics- Pipeline Assessment and Market Forecasts to 2018
http://www.reportlinker.com/p0648874/Endometriosis-Therapeutics--Pipeline-Assessment-and-Market-Forecasts-to-2018.html#utm_source=prnewswire&utm_medium=pr&utm_campaign=NoCategory
Endometriosis Therapeutics- Pipeline Assessment and Market Forecasts to 2018
Summary
GlobalData, the industry analysis specialist, has released its new report, "Endometriosis Therapeutics- Pipeline Assessment and Market Forecasts to 2018". The report is an essential source of information and analysis on the global endometriosis therapeutics market and identifies the key trends shaping and driving it. The report also provides insights on the prevalent competitive landscape and the emerging players expected to significantly alter the market positioning of the current market leaders. Most importantly, the report provides valuable insights on the pipeline products within the global endometriosis therapeutics sector. This report is built using data and information sourced from proprietary databases, primary and secondary research and in-house analysis by GlobalData's team of industry experts.
GlobalData estimates that the global endometriosis therapeutics market was valued at $785m in 2010 and will grow at a Compound Annual Growth Rate (CAGR) of 5.9% to reach $1,239m by 2018. This steady growth is primarily attributed to the recently launched product, Visanne (dienogest) and the expected launch of the pipeline product, Elagolix (NBI-56418) in 2015 in the US and Europe. Organizations, such as the Endometriosis Special Interest Group (EndoSIG), through their work are creating awareness about the disease among the general public. This increasing awareness and the resultant higher treatment seeking rates for the disease are also expectecd to contribute to the growth of the market. The current market is underserved due to the lack of specific as well as non-invasive diagnostic techniques, alongside low disease awareness and the poor safety and moderate efficacy profiles of the current marketed therapies. There is a high unmet need which is largely driven by the unavailability of products with adequate efficacy and safety profiles.
Scope
The report provides information on the key drivers and challenges of the endometriosis therapeutics market. Its scope includes -
- Annualized seven key markets (US, France, Germany, Italy, Spain, UK and Japan) endometriosis therapeutics market revenues data from 2005 to 2010, forecast for eight years to 2018.
- Pipeline analysis data providing a split across the different phases, mechanisms of action being developed and emerging trends. Pipeline candidates fall under major therapeutic classes of GnRH agonists, GnRH antagonists, Aromatase inhibitors and others.
- Analysis of the current and future competition in the global endometriosis therapeutics market. Key market players covered are Nobelpharma, Novartis AG and Neurocrine Biosciences/Abbott.
- Insightful review of the key industry drivers, restraints and challenges. Each trend is independently researched to provide a qualitative analysis of its implications.
- Key topics covered include strategic competitor assessment, market characterization, unmet needs and the implications for the endometriosis therapeutics market.
- Analysis of key recent licensing and partnership agreements in the endometriosis therapeutics market.
Reasons to buy
The report will enhance your decision making capability. It will allow you to -
- Develop and design your in-licensing and out-licensing strategies through a review of pipeline products and technologies and by identifying the companies with the most robust pipeline.
- Develop business strategies by understanding the trends shaping and driving the global endometriosis therapeutics market.
- Drive revenues by understanding the key trends, innovative products and technologies, market segments and companies likely to impact on the global endometriosis therapeutics market in the future.
- Formulate effective sales and marketing strategies by understanding the competitive landscape and by analyzing the performance of various competitors.
- Identify emerging players with potentially strong product portfolios and create effective counter-strategies to gain a competitive advantage.
- Organize your sales and marketing efforts by identifying the market categories and segments that present maximum opportunities for consolidations, investments and strategic partnerships.
- What's the next big thing in the global endometriosis therapeutics market landscape? – Identify, understand and capitalize.
To order this report:
: Endometriosis Therapeutics- Pipeline Assessment and Market Forecasts to 2018
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http://www.prnewswire.com/news-releases/endometriosis-therapeutics--pipeline-assessment-and-market-forecasts-to-2018-130689453.html
Endometriosis Therapeutics- Pipeline Assessment and Market Forecasts to 2018
http://www.reportlinker.com/p0648874/Endometriosis-Therapeutics--Pipeline-Assessment-and-Market-Forecasts-to-2018.html#utm_source=prnewswire&utm_medium=pr&utm_campaign=NoCategory
Endometriosis Therapeutics- Pipeline Assessment and Market Forecasts to 2018
Summary
GlobalData, the industry analysis specialist, has released its new report, "Endometriosis Therapeutics- Pipeline Assessment and Market Forecasts to 2018". The report is an essential source of information and analysis on the global endometriosis therapeutics market and identifies the key trends shaping and driving it. The report also provides insights on the prevalent competitive landscape and the emerging players expected to significantly alter the market positioning of the current market leaders. Most importantly, the report provides valuable insights on the pipeline products within the global endometriosis therapeutics sector. This report is built using data and information sourced from proprietary databases, primary and secondary research and in-house analysis by GlobalData's team of industry experts.
GlobalData estimates that the global endometriosis therapeutics market was valued at $785m in 2010 and will grow at a Compound Annual Growth Rate (CAGR) of 5.9% to reach $1,239m by 2018. This steady growth is primarily attributed to the recently launched product, Visanne (dienogest) and the expected launch of the pipeline product, Elagolix (NBI-56418) in 2015 in the US and Europe. Organizations, such as the Endometriosis Special Interest Group (EndoSIG), through their work are creating awareness about the disease among the general public. This increasing awareness and the resultant higher treatment seeking rates for the disease are also expectecd to contribute to the growth of the market. The current market is underserved due to the lack of specific as well as non-invasive diagnostic techniques, alongside low disease awareness and the poor safety and moderate efficacy profiles of the current marketed therapies. There is a high unmet need which is largely driven by the unavailability of products with adequate efficacy and safety profiles.
Scope
The report provides information on the key drivers and challenges of the endometriosis therapeutics market. Its scope includes -
- Annualized seven key markets (US, France, Germany, Italy, Spain, UK and Japan) endometriosis therapeutics market revenues data from 2005 to 2010, forecast for eight years to 2018.
- Pipeline analysis data providing a split across the different phases, mechanisms of action being developed and emerging trends. Pipeline candidates fall under major therapeutic classes of GnRH agonists, GnRH antagonists, Aromatase inhibitors and others.
- Analysis of the current and future competition in the global endometriosis therapeutics market. Key market players covered are Nobelpharma, Novartis AG and Neurocrine Biosciences/Abbott.
- Insightful review of the key industry drivers, restraints and challenges. Each trend is independently researched to provide a qualitative analysis of its implications.
- Key topics covered include strategic competitor assessment, market characterization, unmet needs and the implications for the endometriosis therapeutics market.
- Analysis of key recent licensing and partnership agreements in the endometriosis therapeutics market.
Reasons to buy
The report will enhance your decision making capability. It will allow you to -
- Develop and design your in-licensing and out-licensing strategies through a review of pipeline products and technologies and by identifying the companies with the most robust pipeline.
- Develop business strategies by understanding the trends shaping and driving the global endometriosis therapeutics market.
- Drive revenues by understanding the key trends, innovative products and technologies, market segments and companies likely to impact on the global endometriosis therapeutics market in the future.
- Formulate effective sales and marketing strategies by understanding the competitive landscape and by analyzing the performance of various competitors.
- Identify emerging players with potentially strong product portfolios and create effective counter-strategies to gain a competitive advantage.
- Organize your sales and marketing efforts by identifying the market categories and segments that present maximum opportunities for consolidations, investments and strategic partnerships.
- What's the next big thing in the global endometriosis therapeutics market landscape? – Identify, understand and capitalize.
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Tuesday, September 27, 2011
Endometri-what? THE Female Trouble
By Jenn | Published: September 8, 2011
As I flipped through the 2011 Philly Fringe catalogue this summer, Cathy Quigley’s show Female Trouble almost didn’t catch my eye. To me, Female Trouble is a 1974 John Waters movie, a Charm City roller girls team or a reference that is bound to be offensive when it comes out of the mouth of a man (sorry, men). Ironically, this Female Trouble is the Fringe show I am most looking forward to seeing during the Festival this year because, as I found out, it’s the one I can relate to the most.
There are fifteen female performers, ranging in age from 18 to 50, in Cathy’s production, a multimedia performance about endometriosis. Endometri-what? (That, coincidently is the working title of my book about the disease.) This disease affects 10-15% of all women and is one of the top causes of infertility in women in this country. Normally, a women’s uterus will collect and grow tissue to prep itself for a baby and if said woman doesn’t become pregnant, it will release the endometrial lining that has formed. (This is her period.) When a woman has endometriosis, that endometrial tissue not only attaches itself to the uterus walls but also outside the uterus. Most commonly, it will create cysts on the ovaries but in more extreme cases, it can attach to other organs like the bowels, the intestines, even the lungs. The inflammation of the tissue not only affects the way the organ works but also creates a great deal of pain and fatigue in the woman suffering from endometriosis. Forty percent of all women who have endometriosis are infertile.
“This is a show about the patient,” Cathy told me when we spoke. “And while it focuses on endometriosis, it is about women’s health in general. My goal is to teach women to become their own activists when it comes to their health.”
After the jump: The challenges of diagnoses, and the intersection of drama, culture, and fertility.
Cathy doesn’t have to convince me. My endometriosis knowledge is not because of pre-interview research. I was diagnosed at age twenty one and since then, I’ve had two surgeries and even on days where I’m sure, to you, I look fine, I’m probably not. Endometriosis is not fatal but the pain is life altering. While learning how to decrease my own external symptoms of the disease, I saw nine doctors in six weeks. This is not uncommon, as Cathy confirmed.
“When I was in my twenties,” Cathy told me. “I suffered a lot of bizarre medical issues. My period was irregular and painful. I had a lot of stomach pain.” After two years of uncomfortable tests and probing by doctors, a nurse practitioner asked Cathy if she had ever heard of endometriosis.
“Ten to fifteen of women have this disease,” Cathy said. “And yet, it took two years for a medical professional to mention it [to me].”
Cathy became obsessed, something she and I have in common even though she doesn’t suffer from the disease. Laposcopic surgery showed she didn’t have the disease but she did have a ruptured cyst on her ovary. Once a surgeon cleaned that up and Cathy changed her diet, she felt much better. This is an illness that few doctors know about, and that has no cure. While wome speculate on the causes — and I find that those speculations come more from patients than from doctors -– there is no concrete explanation of where it comes from. 176,000,000 women suffer from this disease and yet, it has an average nine-year diagnosis rate: it takes nine years from the time a woman tells her doctor she has the symptoms of it to the time where a medical professional actually diagnoses her as having the disease.
Cathy and I talked about how endometriosis is a “silent” disease. It doesn’t have 5K races or marathons. It doesn’t have a designated ribbon. Mention it and women might have heard of it, or know someone who has it, but few can tell you exactly what it is or how it works.
While I believe that, among other things, that little is known because our society is so uncomfortable with talking about sex (one of the most common symptoms of endometriosis is painful sex for the woman with the disease), Cathy also thinks women’s relationship with fertility has a lot to do with it.
Cathy became interested in fertility while working on Female Troubles, the first version of which was her senior project at Montclair State University.
“In Western Culture,” Cathy says, “Women are obsessed with having a child. From a very young age, females are conditioned to have children. We are given dolls when we are kids and we are told to babysit when we are in high school. It is not always an easy thing to conceive a child and women don’t talk about that. It’s almost a taboo. But women are obsessed with it. You can see a Viagra commercial every time you turn on the television.” But no one is trying to sell you a drug to prevent your female parts from disintegrating during the next commercial break.
Her view on fertility is only one of Cathy’s sentiments that won me over. It is also something I can relate to. As an artist myself, I know that there are ways to create or give birth in today’s world that have nothing to do with giving birth to and raising a child however; as a victim of the disease (endometrial lesions were so heavy that they caused my fallopian tubes to fold over on themselves), infertility will always make me feel biologically broken.
“My hope is to be able to tour this piece to colleges and other spots where I can raise awareness about the disease,” Cathy said. “I’m not an ignorant person. I am educated and knowledgeable but until I dug deep into the research, I hadn’t even heard of the disease. With this piece, I want to raise awareness, explore why doctors know very little about women’s health and create an open dialogue to discuss these ideas.”
Female Trouble runs at 8:00 pm on Saturday, September 10 at 8:00 pm and at 2:00 pm on Sunday, September 11 at the Painted Art Bride Center, 230 Vine Street. $14.
–Jennifer Leah Peck
http://blog.livearts-fringe.org/2011/09/08/endometri-what-the-female-trouble
As I flipped through the 2011 Philly Fringe catalogue this summer, Cathy Quigley’s show Female Trouble almost didn’t catch my eye. To me, Female Trouble is a 1974 John Waters movie, a Charm City roller girls team or a reference that is bound to be offensive when it comes out of the mouth of a man (sorry, men). Ironically, this Female Trouble is the Fringe show I am most looking forward to seeing during the Festival this year because, as I found out, it’s the one I can relate to the most.
There are fifteen female performers, ranging in age from 18 to 50, in Cathy’s production, a multimedia performance about endometriosis. Endometri-what? (That, coincidently is the working title of my book about the disease.) This disease affects 10-15% of all women and is one of the top causes of infertility in women in this country. Normally, a women’s uterus will collect and grow tissue to prep itself for a baby and if said woman doesn’t become pregnant, it will release the endometrial lining that has formed. (This is her period.) When a woman has endometriosis, that endometrial tissue not only attaches itself to the uterus walls but also outside the uterus. Most commonly, it will create cysts on the ovaries but in more extreme cases, it can attach to other organs like the bowels, the intestines, even the lungs. The inflammation of the tissue not only affects the way the organ works but also creates a great deal of pain and fatigue in the woman suffering from endometriosis. Forty percent of all women who have endometriosis are infertile.
“This is a show about the patient,” Cathy told me when we spoke. “And while it focuses on endometriosis, it is about women’s health in general. My goal is to teach women to become their own activists when it comes to their health.”
After the jump: The challenges of diagnoses, and the intersection of drama, culture, and fertility.
Cathy doesn’t have to convince me. My endometriosis knowledge is not because of pre-interview research. I was diagnosed at age twenty one and since then, I’ve had two surgeries and even on days where I’m sure, to you, I look fine, I’m probably not. Endometriosis is not fatal but the pain is life altering. While learning how to decrease my own external symptoms of the disease, I saw nine doctors in six weeks. This is not uncommon, as Cathy confirmed.
“When I was in my twenties,” Cathy told me. “I suffered a lot of bizarre medical issues. My period was irregular and painful. I had a lot of stomach pain.” After two years of uncomfortable tests and probing by doctors, a nurse practitioner asked Cathy if she had ever heard of endometriosis.
“Ten to fifteen of women have this disease,” Cathy said. “And yet, it took two years for a medical professional to mention it [to me].”
Cathy became obsessed, something she and I have in common even though she doesn’t suffer from the disease. Laposcopic surgery showed she didn’t have the disease but she did have a ruptured cyst on her ovary. Once a surgeon cleaned that up and Cathy changed her diet, she felt much better. This is an illness that few doctors know about, and that has no cure. While wome speculate on the causes — and I find that those speculations come more from patients than from doctors -– there is no concrete explanation of where it comes from. 176,000,000 women suffer from this disease and yet, it has an average nine-year diagnosis rate: it takes nine years from the time a woman tells her doctor she has the symptoms of it to the time where a medical professional actually diagnoses her as having the disease.
Cathy and I talked about how endometriosis is a “silent” disease. It doesn’t have 5K races or marathons. It doesn’t have a designated ribbon. Mention it and women might have heard of it, or know someone who has it, but few can tell you exactly what it is or how it works.
While I believe that, among other things, that little is known because our society is so uncomfortable with talking about sex (one of the most common symptoms of endometriosis is painful sex for the woman with the disease), Cathy also thinks women’s relationship with fertility has a lot to do with it.
Cathy became interested in fertility while working on Female Troubles, the first version of which was her senior project at Montclair State University.
“In Western Culture,” Cathy says, “Women are obsessed with having a child. From a very young age, females are conditioned to have children. We are given dolls when we are kids and we are told to babysit when we are in high school. It is not always an easy thing to conceive a child and women don’t talk about that. It’s almost a taboo. But women are obsessed with it. You can see a Viagra commercial every time you turn on the television.” But no one is trying to sell you a drug to prevent your female parts from disintegrating during the next commercial break.
Her view on fertility is only one of Cathy’s sentiments that won me over. It is also something I can relate to. As an artist myself, I know that there are ways to create or give birth in today’s world that have nothing to do with giving birth to and raising a child however; as a victim of the disease (endometrial lesions were so heavy that they caused my fallopian tubes to fold over on themselves), infertility will always make me feel biologically broken.
“My hope is to be able to tour this piece to colleges and other spots where I can raise awareness about the disease,” Cathy said. “I’m not an ignorant person. I am educated and knowledgeable but until I dug deep into the research, I hadn’t even heard of the disease. With this piece, I want to raise awareness, explore why doctors know very little about women’s health and create an open dialogue to discuss these ideas.”
Female Trouble runs at 8:00 pm on Saturday, September 10 at 8:00 pm and at 2:00 pm on Sunday, September 11 at the Painted Art Bride Center, 230 Vine Street. $14.
–Jennifer Leah Peck
http://blog.livearts-fringe.org/2011/09/08/endometri-what-the-female-trouble
Friday, August 19, 2011
Batt Publishes First Scholarly History of Endometriosis
Published August 9, 2011
More than 150 years have elapsed since endometriosis was discovered and described. Yet, until now, no scholarly history has ever been written about the disease, which affects millions of women worldwide.
This summer Springer Publishing released “A History of Endometriosis” by Ronald E. Batt, MD ’58, PhD, professor in the Department of Gynecology-Obstetrics.
The back cover describes Batt’s task as “daunting” and states that the book “provides a stunning chronological and biographical history of endometriosis.”
An Expert Clinician and Practiced Historian
An expert in infertility and reproductive endocrinology, Batt also is a noted historian of medicine in Buffalo and Western New York.
He is writing a historical essay on the life and research of Kornel Ludwig Terplan, MD, professor of pathology at UB from 1933 to 1960.
In addition, he is researching a new book on the history of endometriosis from World War II to the present.
In the book, Batt provides a detailed account of the progress made in identifying and treating the once enigmatic condition from its discovery in 1860 by Austrian physician Carl Rokitansky through World War II.
http://medicine.buffalo.edu/news_and_events/news.host.html/content/shared/smbs/news/2011/08/batt_book_endometriosis_41.detail.html
New hope for endometriosis sufferers
By Cheah Ui-Hoon
Women who suffer from endometriosis now have another drug to turn to in their struggle to manage the condition. A new pill, Visanne, has been designed to tackle the problem differently from conventional hormonal medicine. Whereas the latter prevents the ovaries from producing estrogen - and gives women menopausal side effects as a result - the new drug does not block the production of estrogen.
'This new medicine takes a completely different approach. It blocks ovulation, thus lowering the chances of endometriosis, but it does not block estrogen,' explains Thomas Strowitzki, director of the Department of Gynaecological Endocrinology and Reproductive Medicine at the University of Heidelberg, Germany.
Conventional GnRH (Gonadotropin-Releasing Hormone) analogue drugs put women in a menopausal state for the duration of the treatment. They block the pituitary gland, which stops estrogen production, thus relieving the pain associated with endometriosis. Women are put on this treatment for up to a maximum 12-month course.
Side effects from the resulting low levels of estrogen, however, are common, and most women will experience at least one or two symptoms commonly associated with the menopause. These include insomnia, headaches, mood swings, acne, dizziness, depression, decreased libido and vaginal dryness, although they usually disappear soon after conventional GnRH treatment ends.
Endometriosis is a condition in which the cells of the womb lining (the endometrium) are found outside the womb, usually in the pelvis and around the womb, ovaries and fallopian tubes. Unlike endometrial cells that are normally found in the uterus and which are shed during menstruation, those that grow outside the uterus remain in place and are stimulated during each menstrual cycle. Over the long term, this process gives rise to pain and can also result in scars or lesions on the tubes, ovaries, and surrounding structures in the pelvis.
Left undiagnosed or untreated, endometriosis can be a frustrating condition. Painful periods can cause a woman to miss work or school, strain sexual relationships, and affect the overall quality of her life. Besides irregular bleeding, endometriosis can also be a cause of infertility.
Dr Strowitzki says that doctors don't know why 15 per cent of fertile women develop endometriosis. 'To be honest, we don't know the risk factors and we don't know which group of women is at risk. We also don't know how to avoid the disease as it's not like cancer,' he adds.
Women who suffer from endometriosis now have another drug to turn to in their struggle to manage the condition. A new pill, Visanne, has been designed to tackle the problem differently from conventional hormonal medicine. Whereas the latter prevents the ovaries from producing estrogen - and gives women menopausal side effects as a result - the new drug does not block the production of estrogen.
'This new medicine takes a completely different approach. It blocks ovulation, thus lowering the chances of endometriosis, but it does not block estrogen,' explains Thomas Strowitzki, director of the Department of Gynaecological Endocrinology and Reproductive Medicine at the University of Heidelberg, Germany.
Conventional GnRH (Gonadotropin-Releasing Hormone) analogue drugs put women in a menopausal state for the duration of the treatment. They block the pituitary gland, which stops estrogen production, thus relieving the pain associated with endometriosis. Women are put on this treatment for up to a maximum 12-month course.
Side effects from the resulting low levels of estrogen, however, are common, and most women will experience at least one or two symptoms commonly associated with the menopause. These include insomnia, headaches, mood swings, acne, dizziness, depression, decreased libido and vaginal dryness, although they usually disappear soon after conventional GnRH treatment ends.
Endometriosis is a condition in which the cells of the womb lining (the endometrium) are found outside the womb, usually in the pelvis and around the womb, ovaries and fallopian tubes. Unlike endometrial cells that are normally found in the uterus and which are shed during menstruation, those that grow outside the uterus remain in place and are stimulated during each menstrual cycle. Over the long term, this process gives rise to pain and can also result in scars or lesions on the tubes, ovaries, and surrounding structures in the pelvis.
Left undiagnosed or untreated, endometriosis can be a frustrating condition. Painful periods can cause a woman to miss work or school, strain sexual relationships, and affect the overall quality of her life. Besides irregular bleeding, endometriosis can also be a cause of infertility.
Dr Strowitzki says that doctors don't know why 15 per cent of fertile women develop endometriosis. 'To be honest, we don't know the risk factors and we don't know which group of women is at risk. We also don't know how to avoid the disease as it's not like cancer,' he adds.
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