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Tuesday, 10 January 2012

Short menstrual cycles

This would be defined as cycles of less than 26 days. In most cases, there is a deficiency of the female hormone oestrogen. Droopy breasts, depression, irritability in the second half of the cycle will indicate that this is the most likely cause. However if the breasts are painful and swollen in the second half of the cycle then the short cycles are related to a progesterone deficiciency.
A blood test should be done to determine the cause and to make sure that there are no other deficiciencies such as thyroid hormone which will cause the ovaries to malfunction.Treatment would be with bioidentical hormones, the timing and dosage should be adjusted according to the problem.

Sunday, 1 January 2012

Hormonal treatment of endometriosis

In endometriosis, typically the mucous membrane which is present on the womb lining develops in unexpected places such as the ovaries, colon or outer surface of the womb. It is related to a deficiency of the female hormone progesterone which is responsible for keeping the endometrial growth at normal levels. As a result there is excessive growth of the womb lining and allows growth in those areas described.

Thyroid and cortisol deficiencies may also cause progesterone deficiency, and will need to be corrected at the same time. Treatment is with progesterone ( the type of progesterone used depends on the severity of the endometriosis) Magnesium deficiency should also be corrected and this will allow relaxation of the womb muscles. Avoid all milk products, sugar and food allergens which may irritate the colon and allow growth of endometriosis. In many cases, treatment with progesterones may be insufficient and strong drugs such as danazol, lucrin have to be used.

Endometriosis starts at a young age and very often the symptoms of painful periods are passed off as just part of growing up, some will just bear with the pain for many years thinking that it is normal and will disappear after giving birth. Eventually many of my patients present in their late 30s with persistent pain and or infertility and I will find extensive and severe endometriosis with big ovarian cysts and damage to the surrounding organs. They inevitably need surgery followed by medical treatment to prevent a recurrence. The take home message would be to have a gynaecological checkup as early as possible especially if painful periods are present. Regular checkups will ensure that the condition is picked up at an early stage and treated appropriately.