menstrual pain

NSAID Painkillers and Arrhythmia

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A report from Denmark receiving a lot of press lately indicates a connection between the use of NSAID painkillers and an increased risk for a type of arrhythmia called atrial fibrillation. NSAIDs range from the common over-the-counter painkillers like ibuprofen, naproxen, also, caproxen, ketoprofen, dexibuprofen, piroxicam, and tolfenamic acid, and older prescription COX 2 inhibitors such as: diclofenac, etodolac, nabumeton, and meloxicam to the newer prescription COX 2 inhibitors like: celecoxib, rofecoxib, valdecoxib, parecoxib, and etoricoxib.

The researchers identified an increased risk of atrial fibrillation associated with NSAID use. Since atrial fibrillation is mostly a disease of older adults, the press that followed, focused on this relationship. Because of the study’s design, the press reports were completely appropriate, in older adults NSAID use, particularly the newer COX 2 inhibitors, were linked to a higher rate of atrial fibrillation.

The study was one of those large, registry-based, analyses of prescription and hospital records, which by definition include mostly in older adults. The primary endpoints were whether the person had a hospital or physician diagnosed case of atrial fibrillation and whether they also utilized NSAIDs. The study did not tabulate frequency of use or dosage to determine if more frequent use of NSAIDs or higher dosages increased the risk for atrial fibrillation. It simply backed into its findings using the diagnostic codes and prescription fulfillment, as is common in epidemiology and in most of medicine; diagnosis plus prescription equals relative risk. Easy, peasy, but not particularly useful as far as I am concerned.

As a woman, a mom and a women’s health researcher, I know that young women use NSAIDs cyclically, every month, month in and month out for years and years and often at high doses, to manage menstrual and endometriosis pain. What is their risk for NSAID based arrhythmia?  As an athlete, I also know that female and male athletes, are prone to using NSAIDs with stunning regularity. What is their risk for an NSAID based arrhythmia?  As a researcher, I know that women are more frequently prescribed psychotropics for anxiety or panic, for periods of rapid, fluttering heart beats, could these be NSAID based, undiagnosed arrythmias?  And if a young, apparently healthy, woman is diagnosed with atrial fibrillation, or any other arrhythmia, would anyone consider a connection between her arrhythmia to her use of NSAIDs? I doubt it, and therein lay the problem with this type of research, and indeed, the entire disease-medication model of modern medicine. It is woefully incomplete, highly misleading, and it tacitly and often explicitly excludes women’s health issues in research.

Postscript

This research was first published in November 2013. A quick search to see if additional studies had been completed to address the risks of atrial fibrillation in younger adults, women and/or athletes, found nothing. However, one of our favorite heart doctors posted this article on the dangers of NSAID use in athletes. It appears that NSAID use increases inflammation and dehydration – not good. Consider again, the chronic and regular use of women who rely in NSAIDs for menstrual pain relief and the female athlete who utilizes NSAIDs not only to reduce menstrual pain, but also, to reduce training pain. What is her risk?

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Decreasing Dysmenorrhea: High Dose Vitamin D to Reduce Cramps

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Women endure menses for an average of 40 years: once a month for 12 months for four decades—about half of our lives. Menstrual cramps (dysmenorrhea)—to varying degrees of discomfort—are also likely to occur in about 50 percent of reproductive-age women. The cramps are caused by contractions that occur in response to elevated levels of prostaglandin (fatty acids made prior to menses) in the uterine lining. Some over-the-counter and prescription drugs may alleviate these painful cramps, but why must women tolerate menstrual discomfort? Are menstrual cramps an inevitable fact of life?

Can High Dose Vitamin D Reduce Menstrual Cramps?

It is no surprise that a small medical study published in the Archives of Internal Medicinehas garnered a lot of attention around the virtual globe. Italian researchers at the University of Messina investigated the effect of mega-dose vitamin D3 on women who had experienced at least four consecutive painful menstrual periods in the previous six months and had low, circulating vitamin D3 levels. The 60 women enrolled in the study were divided into two groups. Five days prior to the anticipated start of their periods, 30 women were administered a single oral dose of 300,000 IU vitamin D3; the other half received a placebo. On the fifth day of the study, both groups commenced daily supplementation of calcium (1,000 IU) and vitamin D3 (800 IU). After two months, average pain levels decreased by 41 percent for the women treated with mega-dose vitamin D3.  No difference in pain was reported in the placebo group. The researchers concluded that their data support the use of vitamin D3 to reduce menstrual cramps.

The Italian study itself is remarkable because it is reportedly the first research conducted to understand the effectiveness of a single high dose of vitamin D3 on menstrual cramps. Moreover, the outcome is logical.  Vitamin D3’s anti-inflammatory functions combined with the fact that the uterine lining contains vitamin D receptors suggest vitamin D3’s potential use to treat dysmenorrhea. Further, the 41 percent difference in experienced pain between the vitamin D3 and placebo groups is significant.

Questions Regarding Vitamin D and Menstrual Cramps

Some questions remain. The single mega-dose of 300,000 IU vitamin D3 is eyebrow-raising. It far exceeds a prescribed weekly dose of 50,000 IU of vitamin D3. The safety of a single administration of 300,000 IU is unknown. Additional research should be conducted to ascertain the upper limits and safety of such a high dose. We also do not know how vitamin D3 supplementation would improve menstrual cramps in women who maintain adequate levels of circulating vitamin D3 across the menstrual cycle. Is it simply a matter of maintaining adequate vitamin D3 that reduces menstrual cramps or is it the high dose?  Another question regards the length of time pain reductions would continue with the lone sky-high vitamin D3 dose. Even with these questions, however, the Italian study is positive and should encourage additional research on the role of vitamin D3 in treating pain-related conditions in women.

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Editor’s Note: Susan Rex Ryan is the author of the Mom’s Choice Award®-winning book Defend Your Life about the extensive health benefits of vitamin D. For additional information about vitamin D, check out our series of Sue’s articles, and visit her blog at smilinsuepubs.com.

Copyright © 2014 by Susan Rex Ryan. All rights reserved.

This post was published originally on Hormones Matter on July 30, 2014.

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Migraines and Hormones: Behind the Curtain

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Before puberty, migraines are three times more frequent in males than in females but after puberty the tides turn and females are more likely to suffer from migraines than males. An Oxford study found that females are twice as likely to have migraines and that

“brains are deferentially affected by migraine in females compared with males. Furthermore, the results also support the notion that sex differences involve both brain structure as well as functional circuits, in that emotional circuitry compared with sensory processing appears involved to a greater degree in female than male migraineurs.”

The overwhelming belief is that the connection is clear: the hormones kick in for women at puberty and that must be the reason. This begs the questions: 1) Do males have the same hormonal problems before puberty as females do after puberty? If hormones are at root of the problems, then there must be some similarities, right? 2) If female hormones are responsible for migraines, do all females have migraines when they reach puberty? 3) Do migraines cease when hormones stop changing after menopause? 4) What about pregnancy or postpartum, how do hormones impact women then? And finally, 5) Do men stop having migraines after puberty?

Some of the answers to these questions will surprise you and may make you wonder if hormones have anything to do with migraines at all. In this post, I show you that while there are some connections between hormones and migraine they might not be the primary drivers of migraine. The relationship between hormones and migraine is not in the presence of hormonal changes but what those changes require in terms of brain energy, the lack of which causes migraines.

First, I would like to respond in quick the five questions I asked earlier: 1) Do males have the same hormonal problems before puberty as females do after puberty that causes them migraines? The answer to this is no. 2) If female hormones are responsible for migraines, do all females have migraines when they reach puberty? The answer to this also is no. 3) Do migraines stop after menopause? Many women have more migraines and some even start migraines in their menopause, so the answer is no. 4) Do migraine increase or decrease during pregnancy or postpartum? The answer is no during pregnancy, but yes postpartum. 5) Do men stop having migraines after puberty? No they do not.

It is not obvious that the cause of migraines must have anything to do with female monthly cycles and their associated hormones. Given also that many women have migraines after puberty, we are safe to assume that some other factors may play a role. It would be hard to envision a world full of children in which our evolutionary road took women to necessarily experience migraines with their menstrual cycles. So what is the connection to hormones; how do women end up with migraines; and why?

Rather than listing all the hormones that activate throughout the monthly cycle of a woman, let’s take a look at what is happening in the body of that woman backstage, during the hormonal changes. First, in a small review I cover in a few sentences what a migraine is.

Migraine is a collection of symptoms that have an underlying physiological mechanism based on chemical (ionic) imbalance in the brain. Migraine is a neurovascular event that Dr. Charles at UCLA called “spectacular neuro-physiological event” that changes the neurophysiology or chemistry of the brain itself. This can be seen using fMRI technology where oxygenation of brain regions shows where activity occurs during migraine—albeit this does not show why it occurs. The same article also suggests that though medications are available to treat the pain associated with migraines, half the sufferers do not receive any pain relief benefit from the drugs. I find this statement alone interesting because if migraine was truly understood, the pain medication would work for all. This clearly is not the case. To understand what is happening, we must think out of the box and leave behind the hormonal theory of migraines.

Moving Beyond the Hormone Migraine Theory

We now visit the female body all through a month. Let’s start two days after her menstrual cycle has ended. As female, we feel great, no pain, no bleeding, life is awesome. But what we don’t see works hard in the background using up important energy: the brain. Our hormonal changes are happening every moment of the day only we don’t feel it—hormonal changes are directed by the brain. Because we don’t feel the changes, we are ill-prepared for the inevitable day when it reaches a threshold point of not enough brain energy and the migraine starts. This typically happens 2-4 days prior to menses. I do not think migraines are caused by hormones, but rather they are triggered by the lack of energy available to the brain as the hormones cycle. When the brain runs out of energy, a wave of cortical depression begins in some part of the brain. This is what we feel as a migraine.

What actually happens that uses all that energy? After the menstrual cycle is over, the female body immediately prepares for the next menstrual cycle. There is no downtime for rest. The brain turns off one group of hormones and turns on others thereby manipulating how women see the world prior to and during estrus (fertile time). After a menstrual cycle is over, the brain turns on the estrogen to do a few things:

  1.  Prepare the uterus with a new fertile lining to accept the fertilized egg should one arrive and start a new life.
  2. In order to make such fertilized egg happen, the egg must be prepared in the ovaries so hormones initiate the ripening of a new egg.
  3. The woman’s body goes through amazing visible changes at this time of the month. If she had pimples, they magically disappear. If she was bloated, her bloating goes away. Her face becomes the most symmetrical it possibly can; the more symmetrical the more sexually appealing she becomes to the opposite sex.
  4. She becomes extremely attracted to high testosterone males requiring her pheromones to change and to be able to sense a high testosterone pheromone male’s presence. This high testosterone attraction changes after estrus to attraction to low testosterone males for the safety of the child, should mating end in a baby.

With all this activity going on in the female body that she cannot feel, she is in danger of exceeding the threshold of brain energy-shortage without prior notice or preparation. The cost of all of these activities behind the curtains in the female body is very high in terms of brain energy and hydration.  These are sex-hormonal functions that only exist for a certain period of time during the female life. Females are known to be born with all of their eggs they will ever ripen for possible babies. Only these eggs are not “ripe” at birth. Every month one egg ripens in one of two ovaries (sometimes in both and sometimes in none). This egg breaks out of the ovary and starts its journey down the ovarian tube where it either gets fertilized by a sperm or not. If the egg is fertilized, it attaches to the wall of the uterus lining—later to become the placenta of the baby—and a new life cycle begins in the mother-to-be. If however there is no sperm able to penetrate the egg, while it descends in the ovarian tube, the egg will have to be cleared from the uterus together with the nutritious blood vessel rich lining created. This happens with the menstrual bleeding. This we can see and feel.

My Theory: Why Hormone Changes are not the Cause of Migraines

As shown earlier, migraines are not equally present in everyone’s life. Other factors, such as genetic predisposition to sensory organ hyper sensitivities (SOHS) that require more energy, may be the cause. Recent research hints at ionic balance (meaning energy available for use) is crucial in maintaining optimal function and the slightest imbalance can cause major problems (Wei et al.).

When the body is tasked with demanding activities the cells responsible for completing those extra tasks are doing extra chores and need extra energy. The brain regulates the creation of extra hormones for the menstrual cycle. The brain manages the clearing of the uterus after the fertile layer was not used.

By the third day after the cycle, the brain is ordering an egg to ripen—this takes extra energy. This is a once a month event. The brain must have extra energy to complete this task. Ever tried to run a marathon on empty or run your car the extra mile without fuel in your tank? Not possible. Something must break. The brain is the logical one for those who are predisposed to SOHS. If their brain runs out of energy, the neurons cannot generate voltage and stop creating neurotransmitters that instruct the production of hormones in the body. This leads to cortical depression and migraine.

Migraine during Pregnancy

Hands up: how many of you had migraines during pregnancy? Up to 75% of migraineurs do not have migraines during pregnancy. Why you may ask? There is more than one reason for this. The first and most important reason is that while the mom-to-be is pregnant, she has no menstrual cycles so the brain has no monthly cyclical job and it need not use extra energy. Even if the pregnancy comes with a menstrual flow here and there—as it sometimes happens—there is no egg that ripens and there is no uterus layer to remove. It is only a bit of bleeding but no extra energy was needed by the brain for this menstrual flow.

The second important factor is that during pregnancy the mom-to-be seems is more cognizant of what her and her baby-to-be needs. She eat more, tends to eat what she craves and is less likely to be good-looking-body conscious during this time. Pickles with ice cream are famous cravings of women. All the nutrients the brain craves for re-creating energy and feed the brain to prevent migraines: salt, calcium, magnesium, and fat that converts to sugar in the brain.

Migraine during Postpartum

After giving birth nearly, nearly all women immediately revert to eating for a good looking body, lose all the baby fat, and get back into the size zero genes. They stop eating brain-healthy after pregnancy (they never realized they ate brain healthy the first place). Nearly all women return to their migraines postpartum as they return to their old dietary habits.

Post-Menopausal and Menopausal Migraines

We are often told that after we enter menopause or are post-menopausal, our migraines will disappear. Yet, I talk to many women, who have more migraines after their fertile period of life has passed. I am one of those women who experienced more migraines in menopause than in early life. Thus, being no longer fertile, no longer ‘hormonal’ does not mean that we become migraine free; further pointing to the lack of connection of migraines to hormonal fluctuations. In menopause, many women are still very body conscious and watch their dress size more than their health. Others, however, recognize the value of a body supporting diet that may not create a body to fit into such small jeans but may be healthier for an older woman. This second group probably stops experiencing migraines (like I did) whereas the first group remains dehydrated and lacks brain nutrition to work those SOHS brains. They end up continuing their migraines as they had them before.

Of course, we already know from my previous posts that migraines are genetic so not everyone abusing her body will end up as migraineur. To be migraine free, everyone, male or female, must follow the rules of brain fuel.

Fuel for Migraines (Hormonal or Not)

What exactly is the fuel for migraines of any kind? I am leading you back to the first post on migraine that tells you what nutrition the brain needs to return to energy and fuel-filled comfortable homeostasis. The brain works on electricity, which requires specific charge differences inside and outside the cell’s membrane. This voltage is created by salt (sodium and chloride) in ample supply. Sodium also retains water inside the cells for hydrations and opens the sodium-potassium gate to allow nutritional exchange. I am also linking you back to the second post on migraines that explains the anatomy of migraines and what actually happens when the brain in not in homeostasis. How a migraine starts is now visible in fMRI. If you follow the posts I linked to and read the book on how to prevent and fight migraines, chances are, you may never have to face another migraine in your life.

Sources:

  1. Fighting the Migraine Epidemic; A complete Guide. An Insider’s View by Angela A. Stanton, Ph.D. Authorhouse, February 2014. https://www.amazon.com/Fighting-Migraine-Epidemic-Complete-Migraines/dp/154697637X/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=1518636023&sr=8-1 
  2. Why Women Suffer More Migraines Than Men by Patty Neighmond, NOR April 16, 2012 3:17 AM ET http://www.npr.org/blogs/health/2012/04/16/150525391/why-women-suffer-more-migraines-than-men
  3. Her versus his migraine: multiple sex differences in brain function and structure by Maleki et al. BRAIN. 2012: 135; 2546–2559, http://brain.oxfordjournals.org/content/brain/135/8/2546.full.pdf
  4. Hormones & desire Hormones associated with the menstrual cycle appear to drive sexual attraction more than we know. American Psychological Association By Bridget Murray Law. March 2011, Vol 42, No. 3 Print version: page 44 http://www.apa.org/monitor/2011/03/hormones.aspx
  5. Human Oestrus by Steven W Gangestad, Randy Thornhill. The Royal Society, Proceedings B May 2008  http://rspb.royalsocietypublishing.org/content/275/1638/991
  6. Ovulating Women are STRIPPING Men of their Money. Cal Poly Bio 502 class lecture notes article. A blog about human evolution, economics, and sexual physiology. Why do strippers make more money at different times of the month? By Hayley Chilton http://physiologizing.blogspot.com/2013/01/ovulating-women-are-stripping-men-of.html
  7. Migraine and Children. Migraine Research Foundation http://www.migraineresearchfoundation.org/Migraine%20in%20Children.html
  8. Prevalence and Burden of Migraine in the United States: Data From the American Migraine Study II; Richard B. Lipton, MD; Walter F. Stewart, MPH, PhD; Seymour Diamond, MD; Merle L. Diamond, MD; Michael Reed, PhD. Journal Headache; 646:657
  9. Population-based survey in 2,600 women. Karli et al., The Journal of Headache and Pain October 2012, Volume 13, Issue 7, pp 557-565 http://link.springer.com/article/10.1007%2Fs10194-012-0475-0
  10. Multisensory Integration in Migraine Todd J. Schwedt, MD, MSCI. Curr Opin Neurol. Jun 2013; 26(3): 248–253
  11. Unification of Neuronal Spikes, Seizures, and Spreading Depression. Wei et al., The Journal of Neuroscience, August 27, 2014 • 34(35):11733–11743 • 11733
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The Instant Menstrual Cycle

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My uterus decided to end her 6-month vacation yesterday. This is nothing new; I’ve never had regular periods and have tried nearly everything to make my body function on a regular schedule, but it just doesn’t cooperate. Synthetic hormones prescribed by numerous doctors have always made things worse. Acupuncture, when I am working and can afford it, is the only thing that makes them more regular and manageable.

Take a moment to empathize with me – 6 months worth of bloating, fatigue, cramps, blood, etc. in one lousy week. Oh and this would be the second week of a new job – I’m onto you uterus, I’M ONTO YOU!

I’ve tried diet changes, more exercise, less exercise, meditation, medications, channeling my inner moon goddess – everything. I’m finally learning to accept that this is the way my body functions. I don’t like it, but I accept it. What I can’t accept is that we put a man on the moon 45 years ago, but we can’t figure out how to give women some relief. Women have been in science for some time now. Marie Curie won the Nobel prize for Chemistry in 1911. You’d think we could help ourselves, but the most we have advanced in menstrual related relief and technology is OTC pain relievers marketed in pink boxes with a different name and wads of cotton so toxic to our bodies that they can kill us! Don’t you think we need entire labs dedicated solely to easing the pain of menstruation and child bearing. The women scientists can wear brightly colored lab coats and eat an endless supply of chocolate while figuring out new ways to deal with age old biological functions.

Yesterday, I couldn’t leave the couch. I was supposed to go to a barbecue with friends, do all the chores I can’t do during the work-week, and hit up the grocery store, but I was couch-ridden with a heating pad, smelly Chinese herbs, red raspberry leaf tea, and a book. I’m afraid that my friends thought I was lying to get out of the social gathering (I tend to be reclusive), and more than one male employer has given me that “uh-huh, sure” tone when I’ve called in sick over womanly problems. Thankfully, I’m a generally healthy person so that’s the only time I call in sick (and I’m extremely thankful for my health). Take a minute to imagine being in the military and having to tell a male superior that you can’t go out to the field for an exercise because of earth-shattering cramps and excessive bleeding. Then going to a male doctor at sick bay to get a ‘chit’ as proof you weren’t lying.

And I’m supposed to channel my inner moon goddess and be thankful that I’m a woman and can bring life into this world? I’m going to channel my moon goddess alright, channel her and beat her. Don’t get me wrong, I love being a woman and everything that entails, but in the name of science and entrepreneurial spirit – don’t you think it’s about time we figured out a way to ease the pain and suffering that women have to endure monthly?

In an essay originally published in the Boston Phoenix in 1990 and republished posthumously in a collection of essays titled, The Merry Recluse in 2002, Caroline Knapp, wrote, “What Women Really Need from Science.” Here is an excerpt that I think of EVERY time I have an earth-shattering, couch-ridden period, like today:

“So now women can have babies at the age of 90. Big whoop. Roll out the Pampers and Geritol. Open a Cribs ‘n’ Canes shop. And thank you, thank you, thank you, modern medicine.

Something is very wrong here. While a teensy-weensy proportion of women over the age of 75 might welcome the opportunity to procreate in their golden years, and while this development might help ease the pressure some women feel as their biological clocks tick away, most of us shudder at the news. Babies when we’re 90? Postmenopausal midnight feedings?

This news also seems to indicate a slight problem modern science has with focus. What about the here and now? What about the daily realities women face in our younger years?
Any doctor or scientist who truly understood the lives of modern women would be looking in an entirely different direction for ways to ease our burdens and make our lives more manageable. Forget about extending our childbearing years. Forget about finding new and medically thrilling was to complicate our later lives. We need help now! Here, for ambitious doctors everywhere, are a few suggestions.

The Instant Menstrual Cycle

Consider how much simpler life would be if scientists could develop a way to enable women to menstruate in a mere five minutes. No more messy, five- to seven-day bouts of bleeding. No consecutive nights curled on the couch with heating pads to ease the lower back pain. And no more worrying: Will you run out of tampons? Leak? Bleed on his sheets? The five minute menstrual cycle would pack all that discomfort and inconvenience into much more manageable form. One huge cramp. One enormous mood swing. A single flood of tears, and then – whoosh – a single rush of blood into a single, extremely absorbent tampon. If science can come up with an instant coffee, instant breakfast, and instant cameras, instant menstruation couldn’t be that hard.”

Amen sister. She goes on to list other brilliant scientific ideas for some, young scientist to snatch up and make our lives easier including: egg-laying capabilities, clones for working mothers, anti-gravity skin enhancers, and more.

Someone, somewhere, PLEASE hear my plead: We can genetically modify animals to create spider goats and jellyfish pigs, we can travel to space, we can harness the power of nuclear fusion to create electricity and bombs – so why can’t we make advancements in women’s health that would bring relief to half of the world’s population? It’s past time for the Instant Menstrual Cycle – it’s time for a revolution, ladies!

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Hypersensitivity to pain, my ass!

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A multitude of reports have emerged in recent years denoting the over use of pain killers and other medications. With narcotic pain killers, in particular, data suggest a four-fold increase in opioid use since 1999, and over 100,000 deaths by opioid overdose during same time period. The data also indicate a close correspondence between the increase in prescriptions for pain killers and pharma sponsored marketing, ‘research’ and policy changes that have inculcated medical agency guidelines over the last decade.

For women, this is a particularly troubling trend, as other research indicates we are the primary targets of narcotic prescribing; women take 50% more pain killers than men. We also take 36% more medications than men in general. Speculation about why women take more pain killers than men, often involves psychosocial characteristics including a reduced sensitivity to pain, a predisposition to pain causing diseases, and a predilection to report the pain to one’s physician. Women seek out medical treatment at a much higher rate than men.

What often fails to get mentioned is that:

  1. Pain medications don’t work  as well in women because as we’ve reported before few females, rodents or otherwise, are used in the development of these medications.
  2. Even when female animals or women are used in drug development research, cycling hormones are not analyzed as factors in the effectiveness of the medication.
  3. For the myriad of pain related disorders affecting women, many lack evidence-based diagnostic criteria (less than 30% of Ob/Gyn practice guidelines are based on actual evidence) and frequently physicians and the lack of effective diagnostic criteria hastens many to presume an underlying psychosocial or mental health issue.

I personally think the psychosocial arguments that women are more sensitive to pain than men are nonsense. Rather, I think there is a lot more inherent to our physiology that makes pain related conditions not only more likely, but more difficult to treat.

Consider for example, the menstrual cycle and childbirth. These amazingly complex, biochemically radical, pain-inducing, often life-altering experiences are just a ‘normal’ part of female existence. I dare any man to experience the exponential and repeated cyclic change in biochemistry, akin to a repeated drug addiction and withdrawal pattern, that is the female menstrual cycle. The myth of female hypersensitivity to pain, based largely upon the ineffectiveness of pain or medications that were never designed for her changing biochemistry, is just that, a myth. And though I do admit, some humans are more sensitive to pain than others, the contrived experimental methods that designate women as hyper-sensitive do great damage to our understanding of women’s health and the differing pharmacokinetics across the menstrual cycle, pregnancy, postpartum or menopause.

And then of course, there is endometrial sloughing, necessitating a cramping mechanism to propel the tissue outward or the grandmother of all pain experience, childbirth where women deliver 8lb humans through a cavity opening that expands only to 10 centimeters, often times choosing to not utilize pain medications. These ‘normal’ events of a woman’s life are not indicative of a ‘hypersensitivity to pain’.

No, I don’t buy this mumbo jumbo that women are somehow more sensitive to pain than men. If anything, most women have a higher tolerance to everyday pain than most men. But there is a rationale to perpetuating this myth; it limits innovation in women’s health.

Why innovate when a company can make billions prescribing the same old medications at higher and higher dosages, to more and more people? Why address the needs of half the population, when one can blanket the market with drugs for the entire population?  And to that point, why develop more accurate diagnostic criteria or more effective medications for conditions that only effect a small subset of the total population; especially when medications developed over 50 years ago can be used?  If these medications are addictive, have side effects that necessitate other medications and are extremely difficult to withdraw from, well then, those are just added bonuses. It’s a wonderful business model, albeit a little less than ethical.

Despite the obvious marketing excess, we as consumers bear as much responsibility for the increase in narcotic prescriptions as does the pharmaceutical industry. We are letting this happen. Let’s face it, it is much easier to take a pill to make the pain go away (or eat a pint of ice cream to alleviate stress) than go after the root problem. It is difficult to address root causes. It is especially difficult if one is suffering from a medical condition that is chronic, pain-inducing, poorly understood, not easily diagnosed, and for which there are no effective medications. Women disproportionately suffer from these types of conditions – think fibromyalgia, endometriosis or even migraines.  We also make 80% of all family medical decisions. So ladies, we need to stand up and begin educating ourselves and our families about health and disease. We must demand more research and we will probably have to lead it ourselves.

 

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Red Raspberry Leaf Tea to Relieve Menstrual Pain

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My alarm goes off at 0600 every morning. I groggily put on my sports bra and tennis shoes and start one of my many work-out DVDs to start my day. I do push ups, pull ups, lunges and squats all in order to build lean muscle tissue. The science behind this equation is easy – use your muscles to build muscle. But how can you tone muscles in your body that can’t be toned with weights or treadmills? The muscle I’m talking about is the uterus. The uterus or womb is lined with muscles that are primarily designed for childbearing which as we all know gives way to that monthly visitor that brings a suitcase full of cramps, bloating, heavy cycles and more. What if I told you that there is an all natural remedy with no side effects that also helps regulate menstrual cycles, treat cramps, aid in fertility, even lessen the chance of miscarriage, and help labor? Interested?

While there have been very few studies on the effects of red raspberry leaf tea (tea made from the leaves of the raspberry plant), it has been used for thousands of years to tone the uterus for fertility and menstrual problems. Studies have concluded that there are no side effects of this natural remedy. Raspberry leaf tea is full of nutrients including iron, calcium, manganese and magnesium, vitamins B1, B3, C, and E.

In the past, I have tried synthetic hormone treatments to deal with irregular periods, heavy bleeding, and cramps. I suffered through severe side effects including heavy bleeding in between cycles, severe depression and of course, cramps. I decided to try raspberry leaf tea because it had no side effects, could be bought at the grocery store or online, and even if it didn’t work for my specific problems it was still very nutritious. After drinking 1-2 cups a day for about two months I noticed a significant change in the regularity and severity of my cycles.

While I can tone my arms, legs and abdominal muscles through weight and cardio routines, I continue to use red raspberry leaf tea to tone my uterus and reproductive system. Does anyone have other experiences with raspberry leaf tea to share? Any successful fertility stories through this ancient elixir?

Bonus: For an all natural beauty product try applying cold tea or tea bags to your face as an astringent to tone your skin and treat acne.

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Periods from Hell

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Even from the beginning, my periods have been a little off.  My first period was light but it lasted two weeks.  Some years later I had bouts of nausea and vomiting on the first day of my period. I was eighteen then and I thought God was punishing me for losing my virginity, until I realized that perhaps God had better things to worry about.

Period during Pregnancy

My period even made an appearance when I was pregnant. At about nine or ten weeks into the pregnancy, I started to bleed at work.  It was darker like at the end of a period. I panicked, as any woman would. I thought I was having a miscarriage. The emergency room could not tell me any different.  I was put on bed rest until it stopped.  It went on for two weeks and then stopped just as mysteriously as it began.  My son was born about six months later after an emergency cesarean.  Two years later, my daughter was born also by cesarean.  Perhaps those two c-sections and the tubal ligation are what caused a nightmare that lasted more than a decade.

Tubal Ligation and Heavy Periods

Soon after my tubes were tied, I began to have heavy periods.  They would last over a week.  I would seem to have to change tampons every hour and a half.  When I went to my Ob/Gyn, he put me on birth control pills to snap my hormones back in line.  It worked for a while.  I took them for about three or four months and then stopped.  My periods returned to normal length and flow for a short span of time.  Then, it would start again and I would begin the hormone roller-coaster again.  Every time I went on birth control, I had to take it longer for it to work.  I became frustrated with the fact that my tubes were tied but I was still taking (and paying) for birth control pills.  After six or seven years, my body had become immune to the pills. They no longer worked.  Worse than the heavy periods was the increasing pain.

Heavy Periods plus Searing Pain

My lower back pain stayed with me since the birth of my children, but it got worse as the years went on.  I also developed ovarian cysts and other lower pelvic pain.  I had moved and was seeing a new Ob/Gyn.  This one seemed to make it a race to see how quickly she could get me out of her office.  She didn’t listen to my family history when I told her that every woman in my family had a hysterectomy due to fibroid or endometriosis.  She would send me for ultrasounds and other tests that always came back inconclusive.  But she never attempted to find out why I was in so much pain or why I had to use two tampons just to be vertical.  Her answer was Depo-Provera.  It was a shot to stop my ovulation, and therefore, my period.  Perfect answer, she said.  My periods stopped.  My weight shot up forty pounds.  After two shots, I decided I would never take any hormones again.  So a year later my period came back worse than ever.  I lay on the bed for four days straight with back pain that made me want to punch a nun in the face.  The bleeding would be bad to normal, but it was the pain that was the unbearable.

Fighting to Be Taken Seriously

I changed doctors again.  This time, I went in prepared.  I did my research.  I knew that if it was a fibroid tumor, the scan would have picked it up.  I also knew that many of the suspected conditions could go undetected on such scans.  In fact, that was the problem.  Endometriosis and adenomyosis can go with symptoms and no real answers for years.  As I read the lists on the internet, I recognized signs that I did not even think were linked to my period.  Perhaps my back pain had nothing to do with strained muscles.  Perhaps my UTI symptoms that seemed to appear around the time of my period had more to do with my period than ill timing.

With a list of symptoms and searing pain to remind me exactly where my backbone was, I walked into the office.  I was not going to be bullied or pushed out of the office. She sent me for the same tests: ultrasound and transvaginal ultrasound.  The back pain following the exam almost made me pass out.  This was not normal, I said to myself.  One of the nurses called to try to refer me back to my primary physician.  I told her that this pain came with my period and left when it left.  This was not a primary physician issue.  It was a gynecological issue.  She scheduled another appointment and I saw another doctor that was too quick to push me out.  “The tests were normal, so I don’t know why you are here.  I thought they called you.”  She ‘there there’d’ me and handed me a brochure while she encouraged me to think about getting the inside of my uterus singed or taking something to throw me into menopause.  As I walked into the office for my next appointment, I overheard one of the nurses comment, “yeah, her ultrasound was fine. I don’t know what she’s complaining about.”  That was it.  The doctor came in like nothing was wrong so I flipped my bitch switch and let it go.  “I know this is new for you but this is old for me.  I am tired of going on and off hormones.  Every time I go off them, it is worse.  I don’t want to do ablation because 40% of women end up needing hysterectomies anyway.  I don’t want to chemically force myself into menopause.  I do not want to stick a band aid on this.  There is something wrong.  And while I may not know exactly which bleeding problem it is, I know that ablation is not a definitive answer for any of them.  I’ve had my babies.  It’s time to solve the problem and stop throwing a pill at it.”  She gave in and set up the referral for a surgeon.

Flipping the Bitch Switch

Truth is that I am not sure exactly what it is that I have.  On January 24th, I go in for surgery.  It was not a quick decision by any means.  It came after almost fifteen years of increasing pain and problems.  It came when I decided that I was not going to shut up and fill a prescription.  So please, if you are out there and still struggling with pain and periods that seem like they are in competition with Niagara Falls, find your own bitch switch and let it go.  Because despite what the medical community would rather have us believe, a person can make it all the way through med school and still be a moron.  You know your body better than anyone.  Take care of it.

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Endometriosis and Adhesions

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In 2007 when I was finally Diagnosed with Stage IV Endometriosis I wasn’t expecting anything but “a diagnosis”.

When I spoke to the attendee after my surgery she said that there was massive scar tissue from a previous bowel surgery I had when I was seven years old. It had worked its way all the way up to under my ribcage. It took an hour to just cut that all down and that was just part of my Endo surgery.

My entire pelvis was frozen solid with adhesions. Everything was wrapped around my uterus including both of my ovaries (kissing ovaries). To this day I always find it funny that through the 10 or so ultrasounds and transvaginal ultrasounds they kept saying they saw my ovaries with “certainty,” even though each time I watched them struggle to find them.

From 2010-2012, I spent the years protesting adhesions on my bowels and bladder causing painful sex, bowel movements and urination. I went back to my surgeon at least three times. My surgeon told me I was fine and there was no endometriosis. Then on the next visit he said there was fluid in the cul-de-sac and told me to take Lupron. He said, if it goes away its Endo, if not then it’s not Endo. I went back a month later with no change in the pain but he didn’t do another ultrasound to see if the fluid was still there. He just said “It’s not Endo, its Neuropathic Pain Syndrome.” Needless to say I told him off and got an appointment with the Wasser Pain Management Clinic in Toronto. The doctor wanted to try me on different meds. (I was on Visanne which made me suicidal, gave me chest, neck and back acne and severe abdominal pain and Amitriptyline which made me really groggy, crave carbs and gain weight). She wanted to switch me to Gabapentin to see if it would make a difference. None of the medications help. If anything, the meds they gave me made my symptoms worse.

By the time I made it to the pain clinic, I was doing three enemas a week just to have a bowel movement and to not be in pain. I had a another colonoscopy and as usual it showed no signs of anything. They told me my pain was IBS and Endo. I had all the signs of interstitial cysititis (IC) but the cystoscopy showed no signs of inflammation in the bladder. So again the wait continued. I was peeing in my pants because I had no sensation to pee at times, then other times the pain was so intense I would vomit and when I made it to the toilet I couldn’t pee. The pain was out of this world.  It was interfering with my life and job in a big way because I couldn’t go anywhere if I wasn’t near a toilet in seconds. I was peeing 60+ times a day at this point.

December 2012 the Gyne at the Wasser Clinic finally agreed to do the surgery. I was told she would remove my left ovary and both tubes. Since I was no longer looking to have children, if things went wrong she would open me up and remove it all.  I was OK with that. I signed off on that.

When I woke up I wasn’t in a lot of pain like my last surgery and I got very little details from my attendee. I had to wait six weeks to see my surgeon and to get my results.  I was told there was Endo in the cul-de sac, adhesions on my right side on the bowels causing a partial bowel obstruction and my right ovary was embedded in the pelvic wall and she left it there. On the other side the ovary was attached to the uterus by adhesions and the uterus stuck to the sigmoid colon by adhesions. Nothing was removed like I was told, so I was extremely confused.

At my six week appointment she said she ran into difficulties with the density of the adhesions covering the ureter and ovary that was embedded into the pelvic wall and said it was too dangerous to remove unless she opened me up…Umm did I not agree to that before I went in? rrrrr. She said my uterus was nicked with a tool and I was bleeding out but they managed to stop the bleed.

Later, after not being happy with what she told me, I took to Facebook and asked Dr. Redwine some things about my results. He mentioned that the giant cell found on my bladder flap that was biopsied was carbon residue from the laser used in 2007. He said it acts as a splinter so that might explain the painful peeing and all the other issues I had with my bladder.

Right now, after undergoing two endometriosis surgeries, I feel the major battle moving forward will always be the adhesions that seem to grow like wildfire in me. A hysterectomy would not stop the adhesions, so it is something that I still have in the back of my mind but don’t think I will pursue unless 100% necessary.

There are many therapies for adhesions, infertility and endometriosis. One of them is Clear Passage Therapy, however, I don’t live in the US and I can’t afford the treatments but I understand that they have very high success rates.

My only other option right now is Yamuna body rolling. You roll on the ball slowly to break up adhesions. I know many women who have had surgeries and swear by this technique. This is why I have considered it. I am a work in progress and I don’t know what is next. It’s a watch and wait game for now.

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