A BREAKTHROUGH IN A DISEASE THAT NO ONE LIKES TO TALK ABOUT

POSTED BY AMANDA SCHAFFER

http://www.newyorker.com/online/blogs/elements/2014/02/a-breakthrough-in-a-disease-that-no-one-likes-to-talk-about.html

"The work also hints at potential new treatments. No new drugs for endometriosis have been approved in decades, and most of the current ones target hormones that can fuel the growth of uterine tissue. “The first line is always a birth-control pill,” said Taylor. This approach seems to work for some women, reducing pain and perhaps stopping the growth of lesions, but not for everyone, and sometimes its effectiveness wanes. Patients also commonly use drugs like ibuprofen, which target inflammation but are not specifically designed to treat endometriosis. The M.I.T. group’s work suggests that it might be possible to reduce inflammation in a more targeted way in some patients with the disease."

Endometriosis Has Major Effect on Lives of Women

Notice of Decision for Pr VISANNE® Canada

Notice of Decision for PrVISANNE®Help on accessing alternative formats, such as Portable Document Format (PDF), Microsoft Word and PowerPoint (PPT) files, can be obtained in the alternate format help section.

(PDF Version - 23 K)
Contact: Bureau of Metabolism, Oncology and Reproductive Sciences

Date issued: November 7, 2011

On October 12, 2011, Health Canada issued a Notice of Compliance to Bayer Inc. for the drug product, Visanne.

Visanne contains the medicinal ingredient dienogest which is a progestin.

Visanne is indicated for the management of pelvic pain associated with endometriosis. The efficacy of Visanne has not been tested beyond 15 months.

Endometriosis is a gynaecological disease where endometrial tissue is found outside the uterine cavity, most commonly on the ovaries and the peritoneal surface. This tissue can cause inflammation and adhesions which result in chronic pelvic pain and often infertility. The cause of endometriosis remains unknown. Visanne reduces the endogenous production of estradiol and thereby suppresses the trophic effects of estradiol on both the eutopic and ectopic endometrium. When given continously, Visanne leads to a hyperprogestogenic and moderately hypoestrogenic endocrine environment causing initial decidualization of endometrial tissue. In addition to the estradiol-mediated effects Visanne also has direct antiproliferative, immunologic and antiangiogenic effects that contribute to the reduction of pelvic pain associated with endometriosis.

The market authorization was based on quality, non-clinical, and clinical information submitted. The efficacy and safety of Visanne were demonstrated primarily in three multicentre Phase III studies. All three studies enrolled patients with a confirmed diagnosis of endometriosis with various stages of disease severity. Assessment of pelvic pain associated with endometriosis was determined by using a visual analog scale (0-100 mm, where 0 mm represents no pain and 100 mm represents severe pain). The first study was a double-blind placebo-controlled study where 102 patients were treated orally (PO) with a Visanne 2 mg tablet once daily (OD) compared to 96 patients who were treated with a placebo, over a 12 week period. The second study was an open-label extension to the placebo-controlled study. The extension study included 168 women; 87 previously treated with Visanne (2 mg, PO, OD) and 81 previously treated with placebo. All 168 women received Visanne (2 mg, PO, OD) for an additional 52 weeks to assess the long-term efficacy of Visanne treatment. The third study compared Visanne (2 mg, PO, OD) to 3.75 mg leuprolide acetate administered intramuscularly every four weeks, where 120 patients received Visanne treatment and 128 patients received leuprolide acetate, for a 24-week treatment period. Results from all three studies demonstrated that treatment with Visanne produced clinically significant reductions in pelvic pain compared to baseline values. In the placebo-controlled study, following 12 weeks of treatment with Visanne, the mean reduction of pelvic pain compared to baseline was 27.4 ± 22.9 mm. The open-label extension study showed continued improvement in pelvic pain for up to 15 months. In the third active comparator study, Visanne demonstrated efficacy similar to leuprolide acetate in reducing pelvic pain associated with endometriosis. In all clinical studies, Visanne was generally well-tolerated.

Visanne (2 mg, dienogest) is provided in tablet form. The recommended dose of Visanne is one oral tablet per day, preferably taken at the same time each day, with some liquid as needed. Visanne tablets are intended for continuous administration regardless of any vaginal bleeding. Dosing guidelines are available in the Product Monograph.

Visanne is contraindicated in women with any of the conditions listed below, which are partially derived from information on other progestin-only preparations. Should any of the conditions appear during the use of Visanne, treatment must be discontinued immediately.

•Known or suspected pregnancy;
•Lactation;
•Active venous thromboembolic disorder;
•Arterial and cardiovascular disease, past or present [for example (e.g.) myocardial infarction, cerebrovascular accident, ischaemic heart disease];
•Diabetes mellitus with vascular involvement;
•Presence or history of severe hepatic disease as long as liver function values have not returned to normal;
•Presence or history of liver tumours (benign or malignant);
•Known or suspected sex hormone-dependent malignancies;
•Undiagnosed abnormal vaginal bleeding;
•Any ocular lesion arising from ophthalmic vascular disease, such as partial or complete loss of vision or defect in visual fields;
•Current or history of migraine with focal aura;
•Hypersensitivity to dienogest or to any ingredient in the formulation or component of the container.
Visanne should be administered under the conditions stated in the Product Monograph taking into consideration the potential risks associated with the administration of this drug product. Detailed conditions for the use of Visanne are described in the Product Monograph.

Based on the Health Canada review of data on quality, safety, and efficacy, Health Canada considers that the benefit/risk profile of Visanne is favourable for the indication stated above.

© 2011, Bayer Inc.
®VISANNE is a trademark used under license by Bayer Inc.

Notices of Decision (NDs) are produced in accordance with the Summary Basis of Decision (SBD) initiative. All NDs will be reproduced within the corresponding SBD, normally available within 5 months of product authorization.

http://www.hc-sc.gc.ca/dhp-mps/prodpharma/sbd-smd/drug-med/nd_ad_2011_visanne_132174-eng.php

Visanne® is the first oral treatment approved in more than 10 years for Canadian women with endometriosis

MORE FINANCIALS November 29, 2011 7:00 AM - General
Save Visanne® is the first oral treatment approved in more than 10 years for Canadian women with endometriosis~ Provides women with the first approved long-term, oral treatment option to relieve debilitating pelvic pain from endometriosis ~

TORONTO, Nov. 29, 2011 /CNW/ - There is now relief for Canadian women living with the pelvic pain associated with endometriosis. The symptoms of endometriosis, including severe menstrual cramps, painful intercourse, painful urination or bowel movements, and lower back or abdominal pain, take a toll on a woman's emotional health and overall quality of life. Bayer HealthCare announced that Visanne® (2 mg dienogest tablets) was approved by Health Canada for the management of pelvic pain associated with endometriosis. It is the first long-term, oral, progestin-only regimen specifically developed for women with endometriosis in more than 10 years.1

"Once diagnosed, endometriosis patients must use a treatment on a daily basis to cope with the immense pain of the disease," said Dr. Sony Singh, Director of Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, University of Ottawa. "Visanne is an important management option for patients with the disease, as it is proven to relieve the chronic, debilitating pelvic pain caused by endometriosis including menstrual pain and pain during sexual intercourse. This is the first new treatment in more than a decade to help these women, which is encouraging."

Visanne® has been shown to provide effective pain relief in women with endometriosis, as clinical studies of up to 15 months duration, have proven that Visanne® is effective at relieving pelvic pain.2 Visanne® contains a novel progestin called dienogest, which suppresses the effects of estradiol on endometrial tissue and effectively reduces pelvic pain.3

The Impact of Endometriosis
Endometriosis is the growth of tissue, similar to the kind that lines the uterus every month, elsewhere in the abdomen. This excess tissue responds to the monthly menstrual cycle and when the tissue breaks down, it can lead to inflammation, causing pain. Common sites for endometrial growth are the ovaries, on the uterus and behind the uterus.4 The condition affects approximately 5 - 10 per cent of women of reproductive age.5 Pain associated with endometriosis can be excruciating and debilitating and is often the most difficult symptom for women with the disease.6

The disease can greatly impact a woman's social, professional and personal life, and women with endometriosis often experience a higher incidence of depression and emotional distress due to the uncertainty of diagnosis, unpredictability of symptoms and living a normal life.7

Recognize the Symptoms
Despite the high prevalence of endometriosis, there is a lack of general disease awareness and few women recognize the symptoms - thus causing a significant delay in diagnosis. Studies show it takes an average of three years from the time a woman has her first symptom to the time she discusses it with her doctor.8 It frequently takes up to 12 years for a woman to get a confirmed diagnosis from the first time she seeks help for her symptoms.9

"It is very common for women to live for several years with the severe pelvic pain of endometriosis before receiving an official diagnosis. This often means a delay in disease management consequently, negatively impacting their professional, social and psychological life," said Jan Silverman, The Endometriosis Network of Toronto (TENT). "It's important for women to learn about the symptoms of endometriosis, rather than just thinking pelvic pain is 'normal.' Women need to know that endometriosis is real and the pain can be treated, so it's important for them to speak with their doctors. The availability of a new treatment is good news and a step in the right direction."

The Facts on Visanne®
Visanne® (2 mg dienogest tablets) is indicated for the management of pelvic pain associated with endometriosis. Clinical trials regarding the efficacy of Visanne® have lasted up to 15 months.10

In clinical trials, Visanne® was generally well tolerated. The most frequent side effects reported were headache, breast discomfort including breast engorgement and breast pain. Undesirable effects, such as irregular bleeding, are more common during the first months of treatment with Visanne® and subside with continued treatment.2 Patients are encouraged to talk to their healthcare provider to see if Visanne® is right for them.

To learn more about endometriosis, visit www.endometriosisinfo.ca. For more information on endometriosis support groups from TENT, visit the group's Facebook page: http://www.facebook.com/group.php?v=info&ref=mf&gid=301016744454
.

About Bayer Inc.
Bayer Inc. (Bayer) is a Canadian subsidiary of Bayer AG, an international research-based group with core businesses in health care, crop science and innovative materials. Headquartered in Toronto, Ontario, Bayer Inc. operates the Bayer Group's HealthCare and MaterialScience businesses in Canada. Bayer CropScience Inc., headquartered in Calgary, Alberta operates as a separate legal entity in Canada. Together, the companies play a vital role in improving the quality of life for Canadians - producing products that fight diseases, protecting crops and animals, and developing high-performance materials for applications in numerous areas of daily life. Canadian Bayer facilities include the Toronto headquarters and offices in Montréal and Calgary.

Bayer Inc. has approximately 800 employees across Canada and had sales of $827 million CDN in 2010. Globally, the Bayer Group had sales of over 35 billion Euro in 2010. Bayer Inc. invested approximately $36 million CDN in research and development in 2010. Worldwide, the Bayer Group spent the equivalent of over 3.1 billion Euro in 2010 in R&D. For more information, go to www.bayer.ca.

Forward-Looking Statements
This news release may contain forward-looking statements based on current assumptions and forecasts made by Bayer Group or subgroup management. Various known and unknown risks, uncertainties and other factors could lead to material differences between the actual future results, financial situation, development or performance of the company and the estimates given here. These factors include those discussed in Bayer's public reports which are available on the Bayer website at http://www.bayer.com/
. The company assumes no liability whatsoever to update these forward-looking statements or to conform them to future events or developments.

References:
--------------------------------------------------------------------------------

1 Lupron Depot Canadian Product Monograph. http://www.abbott.ca/static/content/document/LUPRON-DEPOT-ENDO-PM-23MAR10.pdf.
 May 20, 2011.

2 Visanne Product Monograph. 2011. Page 21.

3 Visanne Product Monograph. 2011. Page 14.

4 SOGC.ca. What is Endometriosis? Available at http://www.sogc.org/health/health-endometriosis_e.asp
. Accessed November 1, 2011.

5 Endometriosis. Infertility Awareness Association of Canada. Available at: http://www.iaac.ca/content/endometriosis-1
. Accessed October 31, 2011.

6 Hummelshoj L. Medical needs in endometriosis. Gynaecology Forum 2010;15(2):5-7.

7 Kennedy S, Bergqvist A, Chapron C, D'Hooghe T, Dunselman G, Greb R, Hummelshoj L, Prentice A, Saridogan. ESHRE guideline on the diagnosis and management of endometriosis. Human Reproduction 2005;20(10):2698-2704. Also available online at: http://guidelines.endometriosis.org/.


8 Diagnosis: http://www.womenshealthmatters.com/centres/pelvic_health/endometriosis/diagnosis/index.html . Accessed November 1, 2011.

9 SOGC Diagnosis and Management Guidelines. Available at: http://www.sogc.org/guidelines/documents/gui244CPG1007E.pdf.  Accessed November 1, 2011.

10 Visanne Product Monograph. 2011. Page 3.



For further information:
For more information or to arrange an interview, please contact:

Laine Jaremey Tiana DiMichele
GCI Group (Canada) Bayer Inc.
416-486-7224 416-240-5466
laine.jaremey@gcicanada.com

http://www.newswire.ca/en/story/886139/visanne-is-the-first-oral-treatment-approved-in-more-than-10-years-for-canadian-women-with-endometriosis

'Top Chef' Host Padma Lakshmi On Dealing With Her Chronic Pain From Endometriosis

Padma Lakshmi, an author, model and Emmy-nominated host of Bravo's "Top Chef," suffered chronic pain every month for 23 years before she was finally diagnosed with endometriosis at age 36.

"I even had regular exams, and I had an ovarian cyst removed. They said everything would be better, but it didn't, and that was the tip of the iceberg," Lakshmi, now 41, said in an interview with HuffPost. "If I had been diagnosed at 20, or 25, the quality of my life would have been drastically different."

Endometriosis is actually quite common, affecting 8.5 million women in North America, though many are not diagnosed until their mid-20s, according to the Endometriosis Foundation of America, a non-profit organization Lakshmi co-founded with her doctor, Dr. Tamer Seckin, MD, to educate girls and young women about the condition. Just last month, the foundation held a conference to teach nurses about endometriosis, as they are often the first to see potential signs of the condition.

Undiagnosed and untreated, endometriosis causes abnormally painful cramping, bloating and nausea, and can even lead to infertility, according to the Mayo Clinic. It's often confused for ovarian cysts, pelvic inflammatory disease and irritable bowel syndrome. There is no cure for the condition, which occurs when the endometrium (the tissue that lines the inner part of the uterus) grows outside of the uterus, most commonly on the ovaries, bowel or the tissue that lines the pelvis, according to the Mayo Clinic. Depending on the pain, painkillers, hormone therapy, surgery and even hysterectomy are options for treating the condition.

Risk factors for the condition include having a shorter-than-normal menstrual cycle, having never given birth and having a family history (a mom, aunt or sisters) of the disease, the Mayo Clinic reported.

Lakshmi's in the family history camp. Her mother had undiagnosed endometriosis, and so when Lakshmi grew up experiencing the severe pain every month, she thought "it was just my lot in life."

Click here to read the rest: http://www.huffingtonpost.com/2011/11/15/padma-lakshmi-endometriosis-chronic-pain_n_1094003.htm l

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

Endometriosis.

Niger J Med. 2011 Apr-Jun;20(2):191-9.
Endometriosis.
Okeke TC, Ikeako LC, Ezenyeaku CC.
SourceDepartment of Obstetrics & Gynaecology University of Nigeria Teaching Hospital, Enugu, Nigeria. Ubabikctochukwu@iyahoo.comendometriosis

Abstract
BACKGROUND: Endometriosis is a common mysterious and fascinating gynaecological condition with diverse clinical manifestations, highly variable and unpredictable clinical course with decreased quality of life. Despite extensive research, endometriosis is fraught with controversies.

METHODS: Review of pertinent literature on endometriosis, selected references, internet services through gynaecological search which have been critical in the understanding of this puzzling gynaecologic condition were included in the review.

RESULTS: Endometriosis most commonly afflict women in there late 20s and 30s. The classic symptom complex include dysmenorrhoea, dyspareunia, menorrhagia and infertility. About 30% of the patients are asymptomatic. The incidence of infertility amongst women suffering from endometriosis ranges from 30%-40%. The factors implicated in causing endometriosis-associated infertility are multiple and its management is shrouded in controversy, complex and imperfectly understood.

CONCLUSION: Inspite of diverse clinical manifestations, variable and unpredictable clinical course, there is a chance to improve pregnancy rates with improvement in assisted reproductive technology.

PMID:21970227[PubMed - in process]
http://www.ncbi.nlm.nih.gov/pubmed/21970227

Endometriosis can Reach Your Bowel and Bladder

Endometriosis can Reach Your Bowel and Bladder
By Deborah Ross
Having endometriosis is tricky business. For many women, it’s something you have to “look forward to” every month. Sometimes friends and family don’t understand the pain you are enduring with your cycle. And sometimes endometriosis is causing abnormalities in your reproductive area, pelvis and gut that you can’t even feel.

As defined by the American Congress of Obstetricians and Gynecologists, endometriosis occurs when the tissue that normally lines the uterus and gets shed during menstrual cycles for some reason is found growing outside the uterus, usually on the ovaries, fallopian tubes or other pelvic structures. In many cases that endometrium -- the lining -- can cause problems such as chronic abdominal pain, pressure or fullness in the pelvis, debilitating menstrual cramps, pain with intercourse and, sadly, infertility, according to ACOG.

Endometriosis can be an issue not only in a woman’s reproductive area, but also in the bowel and bladder. That’s because the displaced tissue responds to changes in hormones and can break down and bleed each month just as if it were in the uterus. Scar tissue, or adhesions, can form, sometimes binding organs together with painful results.

So, for many women having endometriosis, it’s not just the discomfort of a menstrual cycle but also pain that extends outward toward the digestive system. During a menstrual period, there can be diarrhea, constipation, bloating, nausea, aches in the lower back, and pain during bowel movements and urination.

More than 5 million American women have endometriosis, with it most often hitting women in their 30s and 40s, according to a fact sheet from womenshealth.gov.

The fact sheet also noted that sometimes women can have endometrial growths in a number of areas outside the uterus yet feel no pain. On the other hand, some women with endometriosis have only a few abnormal growths and still feel severe pain.

Researchers are looking at associations between endometriosis and a number of conditions, including allergies, autoimmune diseases, chronic fatigue syndrome, certain cancers and yeast infections.

Read More:

http://www.empowher.com/endometriosis/content/endometriosis-can-reach-your-bowel-and-bladder

Combating endometriosis

A new surgical procedure offers hope and promise

Vasudha Rai

Ashwini K. Trehan, consultant gynaecological surgeon at Spire Elland Hospital and Dewsbury and District Hospital, UK, is giving many with endometriosis a reason to smile.

While pelvic peritoneal excision surgery (basic laparoscopy where parts affected with endometriosis are removed) is effective, it has a 50% recurrence rate and may result in the removal of ovaries. Dr Trehan’s technique is called total pelvic peritoneal excision, where the entire pelvic lining is removed to prevent recurrence.

In a study conducted by Dr Trehan and F. Sanaullah, post-CCT clinical fellow in minimal access surgery, and C. Rooke, clinical audit facilitator, at Dewsbury and District Hospital in 2008, it was found that the new surgery improved the symptoms of endometriosis in 89.6% of women.

The circumstances in which removing the entire pelvic lining may not work is when the disease has spread into the uterus or in spots where endometriosis has reached very deep into the organs.

Dr Trehan says ovarian removal is the main reason for early death in women because it increases the risk of cancer, heart disease and acute menopause.


For more information, visit www.endometriosis-consultant.co.uk

Write to us at businessoflife@livemint.com

http://www.livemint.com/2011/08/08220011/Combating-endometriosis.html?h=B

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

Team eyes infrared route to diagnose endometriosis

24 May 2011 | By Andrew Czyzewski

Infrared (IR) spectroscopy could greatly improve the diagnosis of endometriosis, bypassing the need for invasive surgical biopsy, according to a team from from Lancaster University




The team found that tissue from women with the condition carried a distinct IR signature — thus paving the way for routine assessment such as that done for cervical smears.


‘We use spectroscopy as a method of deriving what we call a biochemical cell fingerprint of a tissue sample — and from that we can get an absorption spectrum associated with the functionality of the tissue we’ve looked at,’ project lead Dr Francis Martin of Lancaster told The Engineer.



Read more: http://www.theengineer.co.uk/sectors/medical-and-healthcare/news/team-eyes-infrared-route-to-diagnose-endometriosis/1008781.article#ixzz1OEE8qLKt

Symptoms in teen years may foretell severe endometriosis

I have a 16 year old daughter.
 I suffer with deep infiltrating endo and I believe my mother and my grandmother may have suffered also. They both had hysterectomies at a young age. I had one at age 32.
 I am terrified for my daughter as I am sure all parents with Endo are. ~ Chef

Symptoms in teen years may foretell severe endometriosis
By Amy Norton

NEW YORK
Fri Nov 19, 2010 5:31pm EST




NEW YORK (Reuters Health) - In some teenage girls, very painful menstrual periods that interfere with daily life may signal an increased risk of developing the most extensive form of endometriosis, a preliminary study suggests.


In a study of 229 women undergoing surgery for endometriosis, French researchers found that those with the most extensive form -- known as deep infiltrating endometriosis (DIE) -- were more likely to have had particularly painful periods as teenagers.


As a group, they were four times as likely as women with non-DIE endometriosis to have used birth control pills to treat severe menstrual pain before the age of 18. And they were 70 percent more likely to say they'd missed school days because of menstrual symptoms.


The findings, published in the journal Fertility and Sterility, suggest that such problems in adolescence can sometimes predict a later diagnosis of DIE.

In endometriosis, pieces of the tissue that lines the uterus (the endometrium) also grow outside the organ -- often on the ovaries, the fallopian tubes or elsewhere in the pelvis. Like the endometrium, this misplaced tissue changes with each menstrual cycle, thickening and then breaking down and bleeding.




This leads to a buildup of adhesions, or scar tissue, outside the uterus, with symptoms including pelvic pain and heavy, painful menstrual periods. Some women also have difficulty becoming pregnant.



There are three forms of endometriosis: superficial endometriosis, ovarian endometriomas and DIE, with the latter being the most extensive. Women with DIE usually have adhesions in multiple areas of the pelvis, including the vagina, bladder, bowel and the ligaments attaching the uterus to the pelvis.



Endometriosis can be tricky to diagnose, and many girls and women go years before a diagnosis.



The condition may, for instance, be mistaken for other causes of pelvic pain, like ovarian cysts, pelvic inflammatory disease or, depending on the symptoms, irritable bowel syndrome. In addition, while a pelvic exam or ultrasound test are often used to help diagnose endometriosis, the only way to definitively diagnose it is through minimally invasive laparoscopic surgery to take a tissue sample.



Compared with the other forms of endometriosis, DIE appears to have a longer delay to diagnosis.



So for the new study, Dr. Charles Chapron and colleagues at Universite Paris Descartes tried to find out whether women undergoing surgery for endometriosis had any early symptom history that was associated with a greater likelihood of having DIE.



The study included 229 women who had surgery at a single medical center between 2004 and 2009; 43 percent had DIE, while the rest had the less-extensive forms of endometriosis. All of the women were interviewed about their symptom history; their average age at the time of surgery was 32.



Overall, 58 percent of women with DIE had ever been prescribed birth control pills to treat severe menstrual pain, versus 26 percent of women with non-DIE forms. Similarly, 21 percent of women with DIE had their first prescription before the age of 18, compared with 6 percent of those in the non-DIE group.



When it came to missed school days, 38 percent of DIE patients said they'd had absences due to menstrual symptoms, versus one-quarter of women in the non-DIE group.



Women with DIE were also more likely to report a family history of endometriosis; 13 percent did, compared with just under 5 percent of women with non-DIE endometriosis.



The study has a number of limitations, including the fact that it surveyed women at one time point and asked them to recall symptoms from adolescence. A study that followed young women over time to see whether symptoms predicted a later diagnosis of DIE would be more informative.



These findings now set the groundwork for such a long-term study, Chapron told Reuters Health in an email.



But the "crux of the issue," he noted, is whether diagnosing endometriosis earlier will eventually lead to fewer cases of DIE and less need for surgery.



"Today, there is no effective way to prevent the progression of endometriosis to its most severe stage, DIE," Chapron said.



And the current results, he noted, suggest that treating severe menstrual pain with birth control pills does not prevent progression to DIE, as a history of such treatment was linked to the condition. Chapron also pointed out, however, that this does not mean that birth control pills contributed to the development of DIE either.



Still, even though it is not clear whether progression to DIE can be prevented, an earlier diagnosis of endometriosis would at least allow girls and women to know the cause of their symptoms.



According to Chapron and his colleagues, girls and women with severe menstrual pain that does not respond to pain relievers like ibuprofen should see their doctors, and, if appropriate, be evaluated for endometriosis.



Besides painkillers and birth control pills, non-surgical treatments for endometriosis include several types of hormonal medications that inhibit the growth of the endometrial tissue.



SOURCE: link.reuters.com/xam46q Fertility and Sterility, online November 11, 2010

ENDURING Endometriosis

Painful disorder may increase risk of infertility

EILEEN CIPRIANI Times Leader Correspondent


It is among the top three causes of infertility and pelvic pain in women. There is a research center and a foundation in the United States, as well as an international society and yellow ribbon devoted to the disorder. According to the U.S. Department of Health and Human Services more than 5 million women in America alone have been diagnosed. Oscar Award-winning actress Susan Sarandon and “Top Chef” host Padma Lakshmi are among them. In March at the 3rd annual Blossom Ball fundraiser for research in New York, Sarandon and Lakshmi shared their first-hand experiences with the malady -- endometriosis.

Endometriosis is when endometrial cells that normally line the interior of the uterus relocate in other areas of the body. The cells usually become displaced in the pelvic area, but in extremely rare cases they can be found in other parts of the body, says Dr. Jennifer Sue Gell of Geisinger Health System’s Women’s Health Center. Gell is obstetrics-gynecology certified with a practicing specialty in reproductive endocrinology and fertility.


In endometriosis the displaced tissues acts as it normally would during the menstrual cycle. It thickens and bleeds, but because it is unable to exit the body it irritates surrounding tissue causing pain and eventually develops scar tissue and adhesions.

Click link to read the rest
http://www.timesleader.com/features/ENDURING_Endometriosis_05-02-2011.html

Understanding Endometriosis

Endometriosis News

There is no cure for endometriosis but there are endometriosis treatment options to keep the pain and other difficulties under control. Non-steroidal anti-inflammatory drugs (NSAIDS) are used to relieve pain during periods. Endometriosis surgery can be used also, as a primary or secondary line of treatment, or sometimes along with medication.

Dutch researchers have recently made a breakthrough that will inhibit the growth of new endometriosis lesions and hope to control the growth of existing lesions. Although the preliminary tests have been successful, the new breakthrough has yet to take shape.

Researchers and doctors from the U.K. have also found a new breakthrough for endometriosis. They claim that endometriosis symptoms could be triggered by an out of control enzyme known as Telomerase which is usually released by the inner lining of the womb during menstruation. For those who are already affected by endometriosis, this enzyme is released at a later stage when it destroys the chances for a woman to become pregnant.

Researchers feel that these breakthroughs could be the stepping stone to the treatment of endometriosis.


Click to see full artlicle

No health insurance? Get help here

From Cnn
Click below for full story
http://www.cnn.com/2009/HEALTH/02/12/ep.health.insurance.help/index.html
Negotiating with doctors and hospitals is just one thing you have to learn how to do when your insurance disappears, says Steve Luptak, executive director of an assistance group called Healthcare Advocacy. "I've had so many people who've just been laid off coming to me for help because they've lost their insurance. They're so stressed, they're so depressed, they feel like it's the end of the world," he says. "But there are things you can do. It's not a futile situation," he says. Watch for more tips for the uninsured »
If you want to try to get new, affordable insurance, or find programs that offer you financial help for doctor's visits, prescription drugs and more, follow these steps:
Step 1: Get good advice
When you get laid off and lose your health insurance, you may need someone in your corner. Several places specialize in helping people find new, affordable insurance and free care:
Healthcare Advocacy
Patient Advocate Foundation
Patient Services Incorporated
Step 2: Search for affordable insurance
With advice from experts at the groups above, begin your search for affordable insurance. Start with COBRA, which means you continue with your employer's insurance, except now you're paying the entire premium on your own. You can learn about COBRA at the Department of Labor's Web site.
If you can't afford to go on COBRA, you're in good company; a recent study by the Commonwealth Fund found that only nine percent of people who are offered COBRA actually use it. Sometimes it's less expensive to buy your own insurance policy rather than going on COBRA. You can compare prices at ehealthinsurance.com.
Step 3: Get your child on SCHIP
Even if you have too much money to qualify for Medicaid, your children may qualify for SCHIP, the State Children's Health Insurance Program. Here's a state-by-state directory of SCHIP programs.
There are other government programs, too. Your entire family may qualify for insurance from a state high-risk pool if you live in a state that has one.
If you think you might quality for Medicaid, see this state-by-state Medicaid directory.
Step 4: Get help with prescription drugs
If you can't afford health insurance -- or if your insurance doesn't include good prescription drug benefits -- look for $4 generic drugs at many major supermarkets and drug stores. Also, your state may offer a discount drug program (after you click, scroll down to see Table 2). You can also check these private groups that offer prescription assistance.
HealthWell Foundation
FamilyWize discount drug card
Needy Meds
Rx Assist
Rx Hope
Chronic Disease Fund
Partnership for Prescription Assistance
The Access Project
Step 5: Find financial assistance for your particular disease
Many diseases have specific foundations that offer financial assistance.
Heart Disease: Heart Support of America
Kidney Disease: American Kidney Fund
HIV/AIDS: The Access Project
Hepatitis: The Access Project
Cancer: see this Empowered Patient for a list of services
Alpha-1 Antitrypsin Deficiency, Chronic Granulomatous Disorder, Huntington's Disease, Idiopathic Pulmonary Fibrosis, and Pulmonary Arterial Hypertension: Caring Voice Coalition
Other rare diseases: National Organization for Rare Diseases
Vision Care: EyeCare America and Vision USA
Step 6: Find free clinics
Federally funded health centers offer free care in both urban and rural areas. Put in your address here and find one near you.

Out-of-control enzyme may trigger endometriosis

A news flash from Stephanie St. James
http://www.myspace.com/stjamesendoawareness

Out-of-control enzyme may trigger endometriosis
Scientists may be one step closer to solving the mystery behind endometriosis — what doctors say is a common health problem for women. In their latest study, scientists at the University of Liverpool in the UK have discovered what may be triggering this condition. Their findings were recently published in the journal Human Reproduction.

The telomeres enable egg cells to continue dividing
© Shutterstock


'Endometriosis occurs when cells of the inner lining of the womb are found growing outside of the uterus,' explained Dr Dharani Hapangama from the Department of Reproductive and Developmental Medicine, University of Liverpool. 'At the time of a woman's menstruation cycle these cells, called endometrial cells, are shed and can be expelled into the abdominal cavity,' he said. 'If these cells continue to live and are implanted in the pelvis and abdomen it can cause severe pain and in serious cases can lead to infertility.'

The telomerase enzyme, found in cells and the inner lining of the womb, patrols the end parts of chromosomes, called telomeres. These telomeres hold the two ends of the chromosomes together and ensure that they stay intact during cell division. The researchers found that telomerase is released by cells in the inner lining of the womb at the beginning and towards the end of the menstrual cycle in women suffering from this condition. Cancer cells also contain this enzyme, which seemingly replicates DNA sequences during cell division in chromosomes, experts say.

The lead researcher went on to say that the team found the telomere to be unusually long in women with endometriosis. 'During menstruation, telomeres normally shorten in length with each cycle of cell division until they reach a certain length at which they can no longer divide,' Dr Hapangama commented. 'The enzyme can extend the length of the telomeres so that they can continue to divide and this can happen in some special cells, such as sperm and egg cells, but not normally in cells that make up the organs of the body.'

'Women who have endometriosis express this enzyme in both the early and late stages of the menstrual cycle which means that the cells will continue to divide and lose their "focus" in supporting the establishment of a pregnancy,' he said. Due to this, the womb's lining 'may be more hostile to an early pregnancy', Dr Hapangama explained. 'The cells that are shed at this late stage in the menstrual cycle may be more "aggressive" and more able to survive and implant outside the uterus, causing pain in the pelvic or abdomen area.'

In general, endometriosis emerges in the lower region of the female pelvis causing extreme pain and discomfort. Around 50% of the cases involve the ovary, and the condition is also responsible for half of the infertility cases.

More than 88 million women worldwide are affected by endometriosis. While the condition affects around 15% of women of reproductive age, up to 4% of the cases are diagnosed in the postmenopausal period.
http://ec.europa.eu/research/headlines/news/article_08_09_18_en.html

Stephanie'>http://vids.myspace.com/index.cfm?fuseaction=vids.individual&videoid=6466478">Stephanie St. James talking about Endometriosis

Find Out about ARD, before you have any surgery!

September is Adhesion Related Disorder Awareness Month.

What are Adhesions?
An ADHESION is a type of scar that forms an abnormal connection between two parts of the body. Adhesions can cause severe clinical problems. For example, adhesions involving the female reproductive organs (ovaries, Fallopian tubes) can and do cause infertility, dyspareunia (painful intercourse) and debilitating pelvic pain. Adhesions involving the bowel can cause bowel obstruction or blockage. Adhesions may form elsewhere such as around the heart, spine and in the hand where they lead to other problems.
Adhesions occur in response to injury of various kinds. For example, non-surgical insults such as endometriosis, infection, chemotherapy, radiation and cancer may damage tissue and initiate ADHESIONS. By far the most common kind of ADHESION is the one that forms after surgery. ADHESIONS typically occur at the site of a surgical procedure although they may also occur elsewhere.

Dr. David Wiseman - International Adhesions Society

Please visit these site for advocacy news and general education.
International Adhesion Society

United Kingdom Adhesion Society

Adhesion Related Disorder
GynSurgery website
ARDchat.com

ARDvark Blog

EndoTimes

Education helps prevent Adhesions!

Headlines: Possible Cause Of Endometriosis Identified

Possible Cause Of Endometriosis Identified
Science Daily (press release) - Aug 5, 20085, 2008) — Scientists at the University of Liverpool have identified an enzyme that could be responsible for a condition called endometriosis – the most ...

Secret to damage caused by endometriosis unlocked Telegraph.co.uk

Breakthrough for endometriosis sufferers as discovery offers hope ... Daily Mail
Clue to cause of womb condition
BBC News
all 24 news articles »

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