Tonight we discuss two conditions that are the result of hormonal imbalance

Tonight we discuss two conditions that are the result of hormonal imbalance - endometriosis and poly cystic ovarian syndrome (PCOS) 

In the Video

• 04:23 - Endometrium
• 05:16 - Why there is monthly flow of cycle?
• 05:52 - Endometriosis
• 06:35 - What Endometriosis causes so much pain
• 09:41 - Why Endometriosis leads to an increased risk of infertility
• 15:29 - Symptoms of PCOS
• 16:17 - How PCOS affects fertility
• 17:53 - How is Endometriosis diagnosed?
• 20:11 - Question and answer session

 

 

04:23 - Endometrium

Our endometrium is the innermost layer of your uterus. Our uterus has three layers that are all important, but we're referring to the inner one, which is made up of highly vascular tissue.  The monthly cycling of our hormones are preparing the vascular layer of our uterine endometrium for the implanting of an embryo.  After implantation, our endometrium has sufficient nutrients to allow the embryo to survive while the placenta develops to take over.  The foetus will then be nourished and fed by the placenta for the remainder of the pregnancy.

05:16 - Why there is monthly flow of cycle?

To secure a pregnancy, we must implant the embryo on a rich vascular surface. This is why our cycle has a monthly ebb and flow of hormones, to ensure a perfect environment to allow implantation.  If fertilisation of the embryo and implantation occur, our hormones change, our our bodies recognise that we are pregnant, so they do not shed the lining, but when you do not get pregnant, those hormones are not triggered, resulting in a monthly shedding of the endometrium, otherwise known as a period or menstruation. In the absence of a pregnancy we shed the endometrium once a month to get rid of the old and replenish with a fresh new vascular environment.  As a result, it will be available for implantation the following month.

05:52 - Endometriosis

Unfortunately in nature, sometimes things can go wrong, and the vascular endometrium can start to develop in places it shouldn't.  It is meant to only be present on the inner lining of your uterus.  Sadly, this tissue can end up in the other layers of your uterus, and it is even possible that it'll end up in your bladder, and even your intestines may be impacted as well.  It is also possible that it will spread to other places of your body as well.  Depending on how severe the endometriosis is, it might end up on your vagina or cervix too.

What happens when this endometrial tissue migrates to other places in your body is that it continues to be affected by the changes in your hormones monthly, resulting in them becoming increasingly vascular towards the end of the cycle, and then shedding blood just like it would in the uterus once the body realises that you are not pregnant.  The trouble here is that it then starts to bleed in these random spots throughout your body causing great pain and discomfort.  

06:35 - What Endometriosis causes so much pain

This blood forming in other tissues in the body leads to blood clots forming in these random places, that may lead to ongoing spot bleeding occurring throughout the entire cycle, as the blood eventually breaks through the other layers of the uterus and makes it's way into the uterus for extraction.   As a result, you may have spot bleeding during your non-period time.  Or on other areas of the body, the shedding of this layer might just inflict excruciating pain since there is no way for the blood to escape.  When the body is working normally the endometrium blood gathers in the uterus and is shed via the vagina, but when the endometrium is in the pelvis on the bladder or bowel for example, it has nowhere to go inside but inside the pelvis, leaving the body to undergo extra work in order to get rid of that blood. Leading to exhaustion and unnecessary pain.

09:41 - Why Endometriosis and PCOS lead to an increased risk of infertility?

Both of these conditions lead to hormonal imbalance.  When the hormones become out of balance the likelihood of the environment being ideal for pregnancy is diminished, resulting in a much narrower window of opportunity for a fertilised embryo implanting into the endometrium.  When the hormones are affected in this way, the body simply doesn't work properly. As a result you may end up with an inability to conceive.  Even if your hormones are capable of maturing and releasing an egg, which is normally unaffected by endometriosis, but is adversely affected by PCOS, the environment for implantation to occur can be jeopardised. So fertilisation may occur, but the embryo may not be able to implant as the environment isn't ideal, or the body may not get the signal to prevent shedding and a cycle may wash away the embryo.   

When you get pregnant, your progesterone levels increase dramatically in order to prevent the loss of your endometrium, to ensure the embryo survives.  Without this signal the progesterone levels drop and the bleeding cycle begins.  In most cases, Endometriosis-related spotting spells are fairly prevalent.  So spot bleeding is one of the telltale symptoms that you have endometriosis, as well as the pain experienced during the bleeding phase of your cycle.  Sadly, it is fairly frequent in teens, as is PCOS.  

15:29 - Symptoms of PCOS

The classic experience with PCOS is an increase in androgens. Androgens can now be produced by your ovaries. They can be produced by both the ovaries, adrenal glands and fat cells. So, in general, a person with PCOS tends to be overweight because their ovary generates too many androgens, as does their fat cells. When we are overweight, our adrenal glands wonder, "What the heck is going on?" It's like our body has another organ producing androgens.  The ovaries are producing excess androgens, as do the fat cells, and then this stimulates more androgens from the adrenal glands too, resulting in a massive excess in our body which can lead to increased hair growth, acne, male pattern baldness, irregular cycles etc.   PCOS results in cysts or follicles on your ovaries, as a result the name polycystic ovarian syndrome makes sense.

16:17 - How PCOS affects fertility

For those of us who are done with kids, it may not be as big of a concern, but for those who aren't PCOS can lead to infertility.  These cysts affect your ability to maintain the correct hormone balance during your cycle, affecting the release of your eggs during ovulation.  Depending on the severity of the PCOS less eggs may mature, or maybe none at all.  As a result, choosing your fertile times to try to conceive becomes difficult. One thing that they do is that say in both Endometriosis and PCOS if you do manage to get pregnant the 9 months of high progesterone levels and changed hormones, helps balance the hormones out enough to really help both of these conditions.

17:53 - How is Endometriosis diagnosed?

They may perform blood tests, but to be certain, they usually perform a laparoscopy in which they inspect what's happening on the inside of your uterus using a camera to see what's going on.  They can usually see the extra endometrial fibres present in unusual places to diagnose this condition.  It also gives them the opportunity to see the extent of the spread of the endometrial tissue.  That's how they'll know how terrible it is, how widespread it is, and where it is. They can also predict what will need to occur next. Treatment often utilises lasers to eliminate the adhesions and burn the endometrium that is present in the wrong places.

20:11 - Question and answer session

Question and answer session with live audience, go through the video link to find the answers.

https://www.facebook.com/drkezchirolab/videos/4033076286705249/