Endometriosis

Common Women Health Problem

Endometriosis affects women in their reproductive years. The exact prevalence of endometriosis is not known, since many women may have the condition and have no symptoms. Endometriosis is estimated to affect over one million women (estimates range from 3% to 18% of women) in the United States. It is one of the leading causes of pelvic pain and reasons for laparoscopic surgery and hysterectomy in this country. Estimates suggest that between 20% to 50% of women being treated for infertility have endometriosis, and up to 80% of women with chronic pelvic pain may be affected.

While most cases of endometriosis are diagnosed in women aged around 25-35 years, endometriosis has been reported in girls as young as 11 years of age. Endometriosis is rare in postmenopausal women. Endometriosis is more commonly found in white women as compared with African American and Asian women. Studies further suggest that endometriosis is most common in taller, thin women with a low body mass index (BMI). Delaying pregnancy until an older age is also believed to increase the risk of developing endometriosis.

What is endometriosis?

Endometriosis is the abnormal growth of cells (endometrial cells) similar to those that form the inside of the uterus, but in a location outside of the uterus. Endometrial cells are cells that are shed each month during menstruation. The cells of endometriosis attach themselves to tissue outside the uterus and are called endometriosis implants. These implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder, although less commonly than other locations in the pelvis. Rarely, endometriosis implants can occur outside the pelvis, on the liver, in old surgery scars, and even in or around the lung or brain. Endometrial implants, while they can cause problems, are benign (not cancerous).

What causes endometriosis?

The cause of endometriosis is unknown. One theory is that the endometrial tissue is deposited in unusual locations by the backing up of menstrual flow into the Fallopian tubes and the pelvic and abdominal cavity during menstruation (termed retrograde menstruation). The cause of retrograde menstruation is not clearly understood. But retrograde menstruation cannot be the sole cause of endometriosis. Many women have retrograde menstruation in varying degrees, yet not all of them develop endometriosis.

Another possibility is that areas lining the pelvic organs possess primitive cells that are able to grow into other forms of tissue, such as endometrial cells. (This process is termed coelomic metaplasia.). It is also likely that direct transfer of endometrial tissues during surgery may be responsible for the endometriosis implants sometimes seen in surgical scars (for example, episiotomy or Cesarean section scars).

Transfer of endometrial cells via the bloodstream or lymphatic system is the most likely explanation for the rare cases of endometriosis that develop in the brain and other organs distant from the pelvis. Finally, some studies have shown alternations in the immune response in women with endometriosis, which may affect the body's natural ability to recognize and destroy any misdirected growth of endometrial tissue.

Common Endometriosis Symptoms

Most women who have endometriosis, in fact, do not have symptoms. Of those who do experience symptoms, the common symptoms are pain (usually pelvic) and infertility. Pelvic pain usually occurs during or just before menstruation and lessens after menstruation. Some women experience painful sexual intercourse (dyspareunia) or cramping during intercourse, and or/pain during bowel movements and/or urination. Even pelvic examination by a doctor can be painful. The pain intensity can change from month to month, and vary greatly among women. Some women experience progressive worsening of symptoms, while others can have resolution of pain without treatment.

Other symptoms related to endometriosis include:

  • lower abdominal pain,
  • diarrhea and/or constipation,
  • low back pain,
  • irregular or heavy menstrual bleeding
  • blood in the urine.
Rare symptoms of endometriosis include chest pain or coughing blood due to endometriosis in the lungs and headache and/or seizures due to endometriosis in the brain.

Endometriosis and cancer risk

Women with endometriosis seem to have a mildly increased risk for development of certain types of cancer of the ovary, known as epithelial ovarian cancer (EOC), according to some research studies. This risk seems to be highest in women with endometriosis and primary infertility (those who have never borne a child), but the use of oral contraceptive pills (OCPs), which are sometimes used in the treatment of endometriosis, appears to significantly reduce this risk.

The reasons for the association between endometriosis and ovarian epithelial cancer are not clearly understood. One theory is that the endometriosis implants themselves undergo transformation to cancer. Another possibility is that the presence of endometriosis may be related to other genetic or environmental factors that also increase a women's risk of developing ovarian cancer.

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Important Books

Endometriosis: Symptoms, Diagnosis and Treatments (Obstetrics and Gynecology Advances)
Endometriosis: Symptoms, Diagnosis and Treatments
Endometriosis: A Holistic Healing Guide
Endometriosis: A Holistic Healing Guide
Endometriosis: Natural & Medical Solutions
Endometriosis: Natural Medical Solutions
51 Tips for Dealing with Endometriosis (Smarter Living Shorts)
51 Tips for Dealing with Endometriosis

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Endo-Ex for Endometriosis
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Fallodox Endometriosis Female Support
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Effects of Coffee on Diabetes

Millions of people rely on their morning cup of coffee to jump-start each day. That caffeine-packed jolt of java is the right elixir to wake the brain and prepare for the mental and physical demands of your daily routine.

Coffee has been maligned for years due to its high caffeine content and tendency to be used as a delivery method for sugar, artificial flavorings and trans-fat laden dairy products, but numerous studies have shown that it also may be protective against type 2 diabetes. Researchers from UCLA have found that coffee demonstrates a molecular protective mechanism that can lower the risk of developing diabetes.

In earlier studies, Dutch researchers discovered that there are compounds in coffee that aid the body's metabolism of sugar. Their study involved 17,000 men and women in the Netherlands. The results were published in November 2002, in the journal Lancet.

According to their study, people who drank 7 cups a day (or more) were 50% less likely to develop type 2 diabetes. Drinking less coffee had less of an impact on diabetes onset. Researchers are still looking at the connection between coffee and diabetes, and caution people that 7 cups of coffee per day is enough to create other health problems.

A new study of coffee and diabetes (Jan 2004) has shown that men who drank 6 cups of coffee a day reduced their chances of developing type-2 diabetes by half, and women who drank the same amount cut their risk by 30 percent. 126,000 people filled out questionnaires over the past 12-18 years with information about their coffee intake and other health questions.

A number of older studies have shown that caffeine may increase your risk of developing diabetes. The theory is that the beneficial chemicals are able to offset the damage done by the caffeine. So drinking decaffeinated coffee would be the best bet if you are thinking of drinking coffee to prevent diabetes.

A special compound in coffee shown to lower diabetes risk. Proper regulation of the sex hormones, testosterone and estrogen has long been known to play a role in the development of diabetes. Details published as a result of this research in the journal Diabetes shows how compounds found in brewed coffee increase the level of a protein known as sex hormone-binding globulin (SHBG). Increased plasma levels of SHBG decrease the risk of developing diabetes.

Researchers from the UCLA School of Public Health have shown that women who drink at least four cups of coffee a day are less than half as likely to develop diabetes as non-coffee drinkers. Studies have consistently shown that there is a correlation between coffee consumption and lower risk of diabetes. This effect was attributed to an improved tolerance to glucose, improved metabolism and lowered insulin resistance.

Why coffee protects againt diabetes? Now, researchers at UCLA have discovered a possible molecular mechanism behind coffee's protective effect. A protein called sex hormone-binding globulin (SHBG) regulates the biological activity of the body's sex hormones, testosterone and estrogen, which have long been thought to play a role in the development of type 2 diabetes. And coffee consumption, it turns out, increases plasma levels of SHBG.

Reporting with colleagues in the current edition of the journal Diabetes, first author Atsushi Goto, a UCLA doctoral student in epidemiology, and Dr. Simin Liu, a professor of epidemiology and medicine with joint appointments at the UCLA School of Public Health and the David Geffen School of Medicine at UCLA, show that women who drink at least four cups of coffee a day are less than half as likely to develop diabetes as non-coffee drinkers.

When the findings were adjusted for levels of SHBG, the researchers said, that protective effect disappeared.
The American Diabetes Association estimates that nearly 24 million children and adults in the U.S. -- nearly 8 percent of the population -- have diabetes. Type 2 diabetes is the most common form of the disease and accounts for about 90 to 95 percent of these cases.

Early studies have consistently shown that an "inverse association" exists between coffee consumption and risk for type 2 diabetes, Liu said. That is, the greater the consumption of coffee, the lesser the risk of diabetes. It was thought that coffee may improve the body's tolerance to glucose by increasing metabolism or improving its tolerance to insulin.

"But exactly how is elusive," said Liu, "although we now know that this protein, SHBG, is critical as an early target for assessing the risk and prevention of the onset of diabetes."

Earlier work by Liu and his colleagues published in the New England Journal of Medicine had identified two mutations in the gene coding for SHBG and their effect on the risk of developing type 2 diabetes; one increases risk while the other decreases it, depending on the levels of SHBG in the blood.

A large body of clinical studies has implicated the important role of sex hormones in the development of type 2 diabetes, and it's known that SHBG not only regulates the sex hormones that are biologically active but may also bind to receptors in a variety of cells, directly mediating the signaling of sex hormones.

"That genetic evidence significantly advanced the field," said Goto, "because it indicated that SHBG may indeed play a causal role in affecting risk for type 2 diabetes."
"It seems that SHBG in the blood does reflect a genetic susceptibility to developing type 2 diabetes," Liu said. "But we now further show that this protein can be influenced by dietary factors such as coffee intake in affecting diabetes risk -- the lower the levels of SHBG, the greater the risk beyond any known diabetes risk factors."

For the study, the researchers identified 359 new diabetes cases matched by age and race with 359 apparently healthy controls selected from among nearly 40,000 women enrolled in the Women's Health Study, a large-scale cardiovascular trial originally designed to evaluate the benefits and risks of low-dose aspirin and vitamin E in the primary prevention of cardiovascular disease and cancer.

They found that women who drank four cups of caffeinated coffee each day had significantly higher levels of SHBG than did non-drinkers and were 56 percent less likely to develop diabetes than were non-drinkers. And those who also carried the protective copy of the SHBG gene appeared to benefit the most from coffee consumption.

When the investigators controlled for blood SHBG levels, the decrease in risk associated with coffee consumption was not significant. This suggests that it is SHBG that mediates the decrease in risk of developing type 2 diabetes, Liu said.

And there's bad news for decaf lovers. "Consumption of decaffeinated coffee was not significantly associated with SHBG levels, nor diabetes risk," Goto said. "So you probably have to go for the octane!"

Other authors of the study included Brian Chen, of UCLA, and Julie Buring, JoAnn Manson and Yiqing Song, of Brigham and Women's Hospital and Harvard Medical School. Funding was provided by the National Institutes of Health. No conflicts of interest were reported by the authors.

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Which Fats Should You Be Eating?


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Recently, fat has gotten a bad rap. Fat has an undeserved reputation as a diet food that is bad for weight loss and health. But the fact is, everyone needs a little fat in their diet. Not just any fat, though—the type of fat is important because it not only affects your overall health, it also influences your cholesterol levels and heart health. Fats helps nutrient absorption, nerve transmission, maintaining cell membrane integrity etc. However, when consumed in excess amount, fats contribute to weight gain, heart disease and certain types of cancer. Fats are not created equal. Some fats promote your health positively while others increase your risks of heart disease. So, which fats should you eat?

The Good Fat


By good fat, it means non-saturated fat - both polyunsaturated and monounsaturated. This type of fat or oil has numerous health benefits.
  • It transports fat-soluble vitamins A, D, E and K throughout the body.
  • It cushions and protects internal organs.
  • Essential fatty acids (EFAs), benefit your heart, metabolism and immune system.
  • Some EFAs are used by the body for structural, hormonal and electrical functions rather than for energy. These EFAs increase metabolic rate and increase fat burn off resulting in loss of weight.
  • Fat is a concentrated source of energy.

Monounsaturated fats

Olives and olive oil
Monounsaturated fats lower total cholesterol and LDL cholesterol (the bad cholesterol) while increasing HDL cholesterol (the good cholesterol). Monounsaturated fats have a great deal of benefit to offer:
  • Olives and olive oil: Great for the heart, as well as the waist and they also have antioxidant and anti-inflammatory benefits because they contain polyphenols and vitamin E.

      Macadamia nu
    • Nuts: Macadamia nuts have the highest content of monounsaturated fats, followed by hazelnuts, pecans, and almonds. Good for the heart, as they are a good source of soluble fiber calories. They also make an ideal snack as they are so filling. Studies also show that the oils they contain stimulate fat loss. 
    Almonds








     
      Avocado
    • Avocados: According to a recent study in Brisbane, Australia, eating avocados daily for three weeks improved blood cholesterol in middle-aged women better than a low-fat diet did. The avocado diet reduced total cholesterol 8 percent compared with 5 percent for the low-fat diet. Most important, avocados improved the good HDL-cholesterol ratio by 15 percent. The daily amount of avocado ranged from 1/2 avocado for small women to 1 1/2 for large women. Expected outcome: By eating avocados, heart patients could cut their risk of heart attack 10-20 percent and death rates 4-8 percent in 3-5 years. 
    Dark chocolate
    • Dark chocolate: Not to be used as an excuse to binge on chocolate, but including some dark chocolate into your cheat meals is a delicious way to get some extra monounsaturated fats into your diet. About a third of the fat found in dark chocolate is monounsaturated. Dark chocolate is also full of flavonoids, which help to protect cells from free radical damage and lower blood pressure. So next time you are staring at the chocolate shelf in your local grocery store be sure to choose the dark option over milk or white chocolate

    Polyunsaturated fats

    Polyunsaturated fats also lower total cholesterol and LDL cholesterol. It contains essential fatty acids (EFAs) such as omega-6s (linoleic acid) and omega-3s (alpha-linoleic acid) that are needed in our diet. So, a certain amount of polyunsaturated fats are needed because essential fatty acids may help in prevent or control of all kinds of ailments and conditions such as:
    • heart disease
    • cancer
    • immune system deficiencies
    • arthritis
    • obesity
    Polyunsaturated fats are also one of few rich sources of vitamin E.
    Polyunsaturated fats are found in foods of plant origin. The best sources are oily fish, walnuts, sesame and pumpkin seeds. Other high sources are vegetable oils such as sunflower and safflower.

    The Bad Fat

    Pork
    Saturated fats have been proven to raise overall cholesterol levels and contribute to heart disease. Saturated fat is found mostly in foods that come from animals. These include:

    A high content of saturated fat can be found in some foods that come from plants such as:
    Palm kernel oil
    Coconut oil

    The Worst Fats


    Cake
    Trans fats were invented when scientists decided to hydrogenate or turn liquid fat into solid fat. This process increases the shelf life of certain products and helps to preserve flavor. However, these fats are particularly dangerous. In fact, the recommended daily amount of trans fats according to the American Food and Drug Administration is zero. Like saturated fats, trans fats have been strongly linked to heart disease.
    Ice-creams
    Where can you find trans fats? You’ll be surprised and shocked! Yes, in chocolates and wafers, in shortening and margarine, in ice-creams, biscuits and cookies, cakes, breakfast cereals, burgers, bakery produce, French fries, pastries, pies and puffs, fried chicken, and pizza.
     

    What Can You Do?

    • Avoid using cooking oils that are high in saturated fats and/or trans fats such as coconut oil, palm oil or vegetable shortening. Instead, use oils that are low in saturated fats and high in monounsaturated and polyunsaturated fats such as canola oil, olive oil and flax seed oil.
    • Minimize using commercially packaged foods which are high in trans fats. Always read labels to look for trans fat free alternatives.
    • As saturated fats are found in animals products, use lower-fat version dairy such as 1% or skim milk instead of whole milk. Trim visible fats and skins from meat products.
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