Tag: endometriosis

  • ‘Why we keep talking about endometriosis’

    As a woman, do you experience prolonged abdominal or pelvic pains during your menstrual cycle that is so extreme that it stops you from doing your chores for days? If yes, it is advisable you see a gynaecologist because you may be suffering from endometriosis.

    Described as a medical disorder experienced by women, endometriosis is a condition where patches of the womb’s inner lining are found growing in other parts of the body.

    According to Dr. Abayomi Ajayi, consultant obstetrician and gynaecologist, the disease occurs when tissues similar to the lining of the womb are found where they are not supposed to be, especially in the bladder, ovaries, among others. The tissue bleeds monthly and can cause  chronic pains for sufferers.

    A painful disease that affects women during their reproductive years, endometriosis occurs when uterine-lining tissue is found growing outside of the uterus. This usually results in chronic pain during and between menstrual periods, heavy and long menstrual cycles, gastrointestinal upsets, and fatigue. Because symptoms of endometriosis are varied, many doctors continue to miss its diagnosis, said Dr Ajayi, also the Chief Executive Officer (CEO) of Nordica Fertility Centre, Lagos.

    Endometriosis is associated with menstruation. While the commonest symptom is abdominal or pelvic pains, diagnosis could be like epilepsy and convulsion, said Mrs. Tola Ajayi, clinic manager, Nordica Fertility Centre.

    While the cause remains unknown, scientists said endometriosis may cause infertility. Although it affects about 176 million women worldwide, paucity of data has made it difficult to know the  number of those suffering from endometriosis in the country. Yet, awareness about the ailment has not gained full traction here.

    As part of this year’s global campaign against endometriosis, Dr. Abayomi-led Endometriosis Support Group of Nigeria (ESGN) organised a walk in Lagos. The well-attended march began with a five-kilometre walk from the City Mall in Lagos Island to Muri Okunola Park and climaxed with an ‘Endo carnival,’ awards and other activities.

    Ajayi said the march was intended to create and intensify awareness about endometriosis, besides gathering support and raising funds for research into its cure and management.

    According to ESGN, Nordica Fertility Centre, and other promoters of public awareness about endometriosis, activities geared towards creating awareness about the disease are necessary to help end the silence around endometriosis. Without breaking the silence around endometriosis, it is impossible to put an end to the disease, they said.

    Sadly, there is no cure for endometriosis, despite that one in 10 women suffers from it. Doctors added that its symptoms too can be difficult to manage. Its most common symptom is a debilitating pain. The pains come before, during and after menstruation cycle, mostly accompanied with nausea, fatigue, anxiety and depression.

    Research has also confirmed that endometriosis is the biggest cause of infertility in women because more than half of women that experience it will have difficulty getting pregnant. It is, however, established that endometriosis is a treatable cause of infertility.

    A woman’s first affair with endometriosis usually starts with her first menstrual experience. But most sufferers bear the pain in silence for years. Many sufferers crave to start a family, but endometriosis often decrees otherwise. Endometriosis is so bad that it prevents women from work, while many have lost their means of livelihood because of the complications it brings into their life. Although it is a disorder that affects many women, the average diagnosis can take about 10 years or more, and with long years of suffering, experts, such as Ajayi, have committed to continue to raise awareness about symptoms of endometriosis until the wall of silence around the disease is broken down completely in the country.

    While writhing in excruciating pains and feeling sick, constant visits to doctors and tests hardly help until she meets an experienced gynaecologist who can properly diagnose the disease through a laparoscopy.

    Through diagnostic laparoscopy, endometriosis is revealed in a woman’s uterus, ovaries, bowel or urethra – mostly after having done a huge damage that only a hysterectomy can salvage. Laparoscopy is a minimally invasive procedure that allows a doctor to use a thin telescope to look into the pelvic area and search for visible signs, which helps to confirm diagnosis by examining tissue samples to determine if the disease is present.

    Many studies have shown that it takes an average of 10 years for women to receive a proper diagnosis of endometriosis. This is because there is a lack of adequate knowledge about the disease. But the fact that many sufferers are unaware of  the key symptoms makes matters worse.

    That is why experts have warned that if any woman experiences pain that does not seem ordinary or appears so abnormal that it prevents a sufferer from leaving home for about three days when menstruating, she should seek diagnosis without any further delay.

    An understanding of symptoms also helps. Any woman who bleeds from the navel or rectum during monthly menstrual cycle should cry out, instead of preferring to suffer in silence because doctors insist no woman deserves to writhe in excruciating pains during menstruation.

    Like the pall of ignorance surrounding the disease among the people, Abayomi said many doctors also have difficulty in diagnosing endometriosis, sometimes leading to misdiagnosis. He blamed training in the medical school where endometriosis is not fully covered; so, doctors hardly consider the condition when examining a patient. Another reason for misdiagnosis is that endometriosis symptoms, such as digestive problems, pelvic pain, and leg pain, are shared with other conditions.

    Doctors explain further that one problem that fuels endometriosis is the stigma or the unwillingness to talk about it. Because of cultural taboos, women often find it uneasy to talk openly about it; fearful that they may be judged as weak.

    Doctors insist that continuous conversations about endometriosis are necessary to inform women about the reality of the disease and its impact on their lives to encourage people to speak out.

     

  • How to manage endometriosis, by experts

    Endometriosis Support Group Nigeria (ESGN), in collaboration with the German Endometriosis Scientific Research Foundation (GESRF) and Nordica Fertility Centre, have held a rountable on endometriosis management in Lagos. Two foreign experts Professor Klaus J. Neis and Dr. Klaus Buhle as well as Dr Abayomi Ajayi spoke at the event . OYEYEMI GBENGA-MUSTAPHA reports.

    How to manage endometriosis topped discussions at a rountable in Lagos.

    Experts said the disease can be difficult to diagnose. They said studies had shown that there could be a delay in diagnosis of four to 10 years, resulting in decreased life quality and disease progression.

    The experts Professor Klaus J. Neis, Dr. Klaus Buhle, and Dr Abayomi Ajayi, said endometriosis cannot be ruled out by a normal examination and pelvic ultrasound.

    They spoke at physicians roundtable, which had as theme “Current diagnosis and management of endometriosis.”

    Neis, a specialist in Obstetrics and Gynecology, founder, European Training Centre (For Gynecology, Endoscopy and Surgery) and former Chief Physician, Caritasklinik, St.Theresa in Saabrucken, spoke on “Surgical management of endometriosis’’.

    Buhler, vice-chairman, Scientific Endometriosis Foundation (SEF), former chairman, German Scientific Societies in Reproductive Medicine, former chairman, National IVF-Registry (D-I-R) Certified Clinical and Scientific Endometriosis Centre of the University Hospitals of Saarland spoke on “Medical management of endometriosis,” while Ajayi, obstetrician/gynaecologist, Endo Hero 2016, founder, Endometriosis Support Group Nigeria Convener and Host Annual Physician Roundtable (PRT) and Fertility Treatment Support Foundation trustee, and founder/Medical Director, Nordica Fertility Centre (Nigeria), talked on “Fertility preservation in endometriosis”.

    According to the experts, treatments for endometriosis suppress menstruation and reduce pain. This is because though they are contraceptive, they have no effect on subsequent fertility after discontinuation.

    The physicians advised women who have severe, persistent, or  symptoms and pelvic signs of endometriosis to check if the initial management was effective or not.

    Ajayi said endometriosis could  be long-term, with substantial physical, sexual, psychological, and social impact, adding that the roundtable was aimed at helping participants in the disease’s diagnosis and management.

    Ajayi added that the rountable was aimed at creating awareness on the symptoms of endometriosis, and  advise women with symptoms.

    He added that endometriosis is hormone-mediated and is associated with menstruation. The cause is not known, but it is accepted that its cells in the pelvis can implant and develop. It is a condition caused by pelvic pains, painful periods, and sub-fertility.

    “Endometriosis presents a diagnostic and clinical challenge, with many women left undiagnosed, often for many years. Small observational studies have reported delays of four to 10 years in diagnosis, which can result in decreased quality of life and disease progression. The diagnostic delay is not limited to adults; endometriosis is also often missed in adolescent girls, and this workshop set out to improve care by highlighting this age group in some recommendations,” he explained.

    Ajayi added that younger medical doctors should be urged in laparoscopy training because they have a better grasp of tools and equipment, compared with older doctors.

    Neis advised surgeons to perform surgery for endometriosis laparoscopically, unless there are contraindications.

    “During a laparoscopy to diagnose endometriosis, consider laparoscopic treatment of the following, if peritoneal endometriosis not involving the bowel, bladder or ureter, uncomplicated ovarian endometriomas. As an adjunct to surgery for deep endometriosis involving the bowel, bladder or ureter, consider three months of gonadotrophin-releasing hormone agonists, before surgery. Consider excision rather than ablation to treat endometriomas, taking into account the woman’s desire for fertility and her ovarian reserve,” he added.

    On the management of endometriosis, Buhler said physicians should explain to women with suspected or confirmed endometriosis that hormonal treatment for endometriosis could reduce pain and has no negative effect on subsequent fertility.

    “Offer hormonal treatment, for example, the combined oral contraceptive pill or a progestogen, to women with suspected, confirmed or recurrent endometriosis. If initial hormonal treatment for endometriosis is not effective, not tolerated or is contraindicated, refer the woman to a gynaecology service, specialist endometriosis service/centre, or paediatric and adolescent gynaecology service for investigation and treatment options. It is good to ask women with suspected or confirmed endometriosis about their symptoms, preferences and priorities with respect to pain and fertility, to guide on surgical decision-making,” he added.

  • Endometriosis Awareness Week holds in Lagos

    The Ajayi-led Nordica Fertility Centre  in collaboration with Endometriosis Society (Nigeria) concluded 2017 Endometriosis  Awareness Week with the Physician Roundtable session and a dinner ball-cum- fundraising activities  at the Civic Centre, Lagos with the aim of creating awareness on the ailment as well as the need to raise funds for it at an event tagged “a Touch of Yellow” ball which was attended by prominent people in the society.

    The roundtable session started with a welcome address by the founder and president of Nordica Fertility Centre, Dr. Abayomi Ajayi. In his speech, Ajayi revealed that the major issue is to create proper awareness on the endometriosis and how to reduce the burden it has on the victims and guide all on the signs and how to combat it very early.

    “Our aim is to create awareness .The awareness is still new in Nigeria, though we have been doing this for 12 years.

    “This year, the theme is focusing on Endometriosis in Adults. We are not leaving any stone untouched as we have learnt that it affects young ones too. We were at some secondary schools here in Lagos, and we were surprised that those young girls had it after conducting medical tests on them.

    “We need to work faster and harder. The walks in both Abuja and Lagos were successful. And we were happy that many people are getting informed and involved. Before now, many people cannot call the word ‘endometriosis’, not to talk of knowing about it, but I am happy that people can now pronounce it well”, Ajayi said.

    The 2017 Physician Roundtable session had as the guest speaker, Dr. Robert Zurawin, an Associate Professor in the Division of Gynecology at Baylor College of Medicine, Houston, Texas. He spoke to the practitioners on the theme ‘Endometriosis in adolescents:  The etiologies, diagnosis and treatment options of adolescent endometriosis’. He made audience realized that it is a severe condition that deserves attention.

  • How to tackle endometriosis, by experts

    How to tackle endometriosis, by experts

    Some medical experts have gathered in Lagos to discuss endometriosis, a disease rampant  among women. OYEYEMI GBENGA-MUSTAPHA reports.

    Experts are against surgically removing endometriosis; where the endometrium grows outside the uterus, unless the symptoms do not respond to treatment. But the disease causes severe pains for premenopausal women.

    The experts spoke at an event organised by some specialists in reproductive health in Lagos. They urged reporters to help shed light on the disease which they described as “invisible”, but giving many women headache.

     

    The condition

    What is endometriosis? The Chief Executive Officer (CEO)/Medical Director, Nordica Fertility Centre, Dr Abayomi Ajayi, explained that in preparation for ovulation, the lining of the uterus, or endometrium, thickens. If fertilisation does not occur, the uterus sheds its lining through the vagina. This is known as menstruation. In endometriosis, the endometrium grows outside of the uterus. This leads to endometriosis.

    According to the led convener of the event,  Ajayi,  there is need to get a woman that complains of chronic pains examined because there is a link between endometriosis and ovarian cancer. He said ovarian cancer occurs at higher than expected rates in women with endometriosis, but the lifetime risk is low to begin with. “Nearly half of those affected have chronic pelvic pain, while in 70 percent pain occurs during menstruation. Some studies suggest that endometriosis increases the risk to developing ovarian cancer, but it’s still relatively low. Although rare, another type of cancer, endometriosis-associated adenocarcinoma, could develop later in life in women who have had endometriosis,” Ajayi said.

     

    Common symptoms

    A consultant Obstetrician/Gynaecologist, Dr Bayo Bamisebi said if one or her daughter or any female around is perpetually complaining of any of the following, it is time to check it out with the doctor because they are symptoms of endometriosis: “Painful or heavy periods; pains in the lower abdomen (tummy), pelvis or lower back; pains during and after sex; bleeding between periods or difficulty getting pregnant. Most women with endometriosis get pains in the area between their hips and the tops of their legs. Some women experience this pain all the time.

    “Other symptoms may include persistent exhaustion and tiredness, discomfort when going to the toilet, bleeding from your back passage or rectum) or blood in your poo, or coughing blood which occurs in rare cases when the endometriosis tissue is in the lung.”

    He said: “Another cause is during retrograde menstruation, whereby menstrual fluid flows backward into the fallopian tubes instead of leaving the body through the vagina. Because the fallopian tubes are open-ended, menstrual backflow can spill into the pelvic cavity. Backflow of menstrual fluid may promote the transfer of clumped endometrial cells to other tissues in the pelvis. Or menstrual fluid in the pelvic cavity could transform parts of those tissues into endometrial cells. In either process, clumps of endometrium may start to grow on the tissues lining the pelvic cavity, as well as on the fallopian tubes, ovaries and large intestine. This growth continues to act as it normally would during a menstrual cycle. It thickens, breaks down and bleeds each month.

    “Because there’s nowhere for the blood from this displaced tissue to exit your body, it becomes trapped. Trapped blood may lead to cysts, scar tissue and adhesions, abnormal tissue that binds organs together. Scarring from endometriosis can block your fallopian tubes. Blocked tubes may keep sperm cells from reaching and fertilising the egg, causing fertility problems.The menstrual fluid could alter some types of cells in the pelvic cavity to change their structure, or clumps of endometrial tissue contained in the menstrual fluid could stick to the tissues it lands on and start to grow. In either case, this may be a factor in causing endometriosis,” Bamisebi explained.

     

    Diagnosing endometriosis

    Ajayi said the first step to take is to diagnose the condition. He said the sufferer should see a general medical practitioner if one has symptoms of endometriosis so they could try to identify a cause. “They may refer you to a gynaecologist, or a specialist in problems affecting the female reproductive system. It can be difficult to diagnose endometriosis because the symptoms can vary considerably, and many other conditions can cause similar symptoms. Your gynaecologist will ask about your symptoms, periods and, possibly, sexual activity. They may also carry out an internal pelvic exam or recommend an ultrasound scan to look for cysts in your ovaries that may have been caused by endometriosis,” he added.

     

    Laparoscopy

    Ajayi said: “Endometriosis can only be confirmed with a surgical examination called a laparascopy. This is carried out under general anaesthetic  and you can usually go home the same day. The procedure involves a thin tube with a light on the end (laparoscope), which will be passed into your body through a small cut in your skin at your belly button. It has a tiny camera that transmits images to a video monitor so the specialist can see any endometriosis tissue.

    “During the procedure, a small sample of tissue (biopsy) can be taken for laboratory testing, or other surgical instruments can be inserted to treat the endometriosis. Depending on the severity of the endometriosis, treatment options may include: Hormonal therapies, such as birth control pills, which help control the hormones that cause a buildup of endometrial tissue – and birth control pills are associated with a decrease in ovarian cancer risk.

    “Conservative surgery to remove endometrial growths from pelvic organs without removing your reproductive organs, either with laparoscopic surgery, making only a few small incisions in your abdomen, or traditional abdominal surgery in more extensive cases.

    “Total hysterectomy with salpingo-oophorectomy which removes the uterus and cervix along with both ovaries and fallopian tubes, reserved for women at high risk of ovarian cancer, such as those who have the BRCA1 or BRCA2 genetic mutation.”

    ‘’If you’re worried about how endometriosis might affect your fertility, according to Ajayi that is a different matter.

    “Endometriosis does cause fertility problems for some women. Normal conception, pregnancy and delivery are possible after conservative endometriosis treatment. But if you’re having trouble conceiving, you may need to see a fertility specialist to explore your options for becoming pregnant,” he added.

  • Stakeholders seek awareness on endometriosis

    Stakeholders seek awareness on endometriosis

    Sufferers and key stakeholders have called for more awareness on endometriosis – a medical condition that occurs when the lining of the uterus, called endometrium, grows in other places such as the fallopian tubes, ovaries or along the pelvis.

    They said women with the disease should not be allowed to go through it alone.

    This was their summation during Endomeriosis March in Lagos yesterday organised by Endometriosis Africa and supported by Asbe Shehu Musa Yar’Adua Foundation (ASMYF).

    A sufferer, Miss Mary Okocha said the disease, which comes with severe pain during menstruation before women enter their menopause stage, was still unknown to many doctors let alone ordinary Nigerians.

    She said it took her doctor about three years before he could finally diagnose her correctly.

    “My doctor could not understand why I keep having endless pain every month during menstruation.

    “He was treating me for entirely different ailment. Other doctors too also misdiagnosed my ailment until recently when they found out that I actually have endometriosis,” she said.

    The 28 year-old Delta State indigene said women should not be allow to go through harrowing like she is going through due to endometriosis.

    “My problem started four years ago, I was about 24 years then. I started having blood clot, heavy flow and unending menstrual pain during menstruation.

    “Sometimes, it could go on for as long as seven days. I usually experience pain in my abdomen three days before the start of my menstruation and it will persist for another four days. This affected my work because it usually renders me useless for days.

    “I could change my sanitary pads up to eight times daily due to the heavy flow of blood I experience. This was really disturbing,” she shared.

    Okocha urged people to take the message to all nooks and crannies of the country so that sufferers can fine succour.

    Founder, Endometriosis Africa, Obruche Ongoro, said all Nigerians should take the issue to the front burner.

    She said sufferers should not be left to their fate because they can still be helped if the condition is detected early.

    She urged the government and the private sector to support the fight against endometriosis.

  • Women’s battle against endometriosis

    Some women go through hell during menstruation because of acute pain. Yet the underlying cause,  endometriosis, could be misdiagnosed. OYEYEMI GBENGA-MUSTAPHA writes on when it is advisable to seek medical help and the options.

    About 10  percent of ovulating women have endometriosis, and it takes an average of 10 years to get an accurate diagnosis. Endometriosis is a painful condition, a disorder really, in which the uterine lining grows outside the uterus. Despite the prevalence of endometriosis, there is no cure and medical researchers can’t even explain why the disorder results in such horrible pain for many women.

    Pelvic pain, heavy period, infertility, pain in going to the toilet and painful sex are the five main symptoms of endometriosis.

    The first symptom which is pelvic pain is often accompanied by unusually heavy periods, irregular cycles, and bleeding between periods. Some women with the disorder also have diarrhoea during their periods. A person is considered to be at greater risk for developing endometriosis if they began menstruating at an especially young  age. Some women don’t get diagnosed until they struggle with pregnancy and seek medical guidance.

    According to the Medical Director (MD), Nordica Fertility Centre, Dr Abayomi Ajayi, endometriosis, a condition that occurs when tissue similar to the lining of the womb (uterus) grows in other areas of the body, is considered as one of the three major causes of female infertility as it creates scar tissue around the uterus and ovaries which can impede fertilisation. The disorder can also result in irregular ovulation,another potential roadblock. Thankfully, women who desire to become pregnant can find help through in-vitro fertilisation or hormone therapy. He said during the period, the woman may feel pain or intense discomfort while urinating or having a bowel movement.

    Dr Abayomi Ajayi, who is one of the very few who understands the condition and treats women, said by the design of nature, endometrial tissue grows mainly in the abdominal cavity but sometimes, they are found in some other areas outside the womb and behave as if they are in the womb. “By this I mean, when tissue similar to the lining of the womb is found elsewhere like in the ovaries, recto-vaginal septum, bladder, and even in the bowel. They then behave as if they are in the womb bleeding monthly (as in menstruation) and so cause various degree of pain from moderate to severe and even chronic in the affected woman”, said Dr Ajayi.

    Dr Ajayi a Consultant Gynaecologist who has close to three decades of practice said, “Endometriosis often affects women in their prime of life, however, it is not a lifestyle disease and it is not a disease you get later in life. So endometriosis can attack teens, young women when they should be out there being active, working, having children and having sex; 50 percent of them are struggling with sex because it is too painful. Although, endometriosis could be very painful and could progress with age, sometimes, some may not progress and could just ease off overtime.”

    He appealed to parents and guardians with women that experience any of the above to report to the hospital and request the doctor to examine the woman for endometriosis, as he said: “Breaking the silence has its components and first, we are tired of the 10- year wait to make a diagnosis of Endometriosis. A doctor must always be thinking about it and there must be equipment for him when he is making diagnosis of monthly pains in a female.

    “Secondly, emergency room services must be available to patients with endometriosis so they are no longer told it is a chronic disease and we cannot treat you in the emergency room. Thirdly, painful menses should no longer be taken as part of life. Everybody is to be aware that menses is not supposed to disturb a woman’s normal chores. The moment it is disturbing normal chores, you need to see a doctor and you should not rest until a diagnosis is made as to why your own menstrual pain is more than others. These are all what are being put out to end the silence on Endometriosis, said Ajayi.

    In his little way, Dr Ajayi is demystifying endometriosis as he has joined the international body on the disorder to observe yearly, World Endometriosis Week. And for this year’s a walk,it was held on Thursday February 18 in Abuja and another has been slated for March 5, in Lagos. Take-off point is Onikan Round About.

    As the world marks another Week, Dr Ajayi said the key thing needed to empower Nigerians and the medical world is to raise the level of awareness on the condition.

    “The Endometriosis Support Group Nigeria (ESGN) came into being in 2005 as a Non- Governmental Organisation with the sole aim of assisting women, both young and old who are challenged with the Endometriosis condition. And from inception, we have been at the forefront, actively lobbying for better outcomes, education and awareness and care, treatment options and support for these women affected with the endometriosis condition”, said Ajayi.

    According to Dr Ajayi, “The most important thing in breaking the silence of Endometriosis is to raise the level of awareness and empower the common person. I have begun to see a lot of doctors who are proud to say they have started making diagnosis of Endometriosis and that to me means a lot. It shows doctors are beginning to think a lot about endometriosis and we should never underestimate that achievement.”

    To ensure more medics come on board of accurate diagnosis, he has organised a Physician Round Table to discuss the condition and it holds at the Civic Centre on April 8, and a fund raising on April 9 to help in raising more consciousness among Nigerians on the condition that has compromised the quality of life and caused many women infertility.

    He desired that more medics also undergo training to treat endometriosis. “Honestly, the day a funding agency is set up for endometriosis, people will start treating the condition. But until then, we should hold government accountable for training and providing equipment in our hospitals. One of the problems we are having in Nigeria is paying lip service to Public-Private Partnership (PPP). In the health sector, I don’t think this is working because it is not an easy task to bring both together where the private is for profit and the public is for the masses. The orientations of the two sectors are so different and obviously, healthcare is no longer a social service and it would seemingly be impossible to marry both at the moment”, Ajayi said.

    He shed light on the treatment options, “Diagnosing endometriosis is through using an instrument called Laparoscope. It is a long, thin, rigid tube specially equipped with thin glass fibres along wih light travels to spotlight internal organs. A Laparoscope allows a doctor to visualise the abdomen and pelvis. Some other instruments used with the Laparoscope allow the doctor to make photographic records of the inside of the abdomen, obtain biopsies of tissue for laboratory analysis and removal of abnormal tissue. Laparoscopy is still not widely available in the country because it is still an expensive procedure and so its use is limited to a few clinics and experts. Besides, there is no funding agency for endometriosis yet and therefore, nobody seems to be interested in it.”

  • Many shades of endometriosis

    Many shades of endometriosis

    It has been described as another grim reaper for women. Though it does not kill instantly, but the chronic pain  cuts through the soul for long. And the grim reality is, there is no cure for it yet.  It is a shocking reality that women all over the world, irrespective of birthplace or tribe, have to deal with.

    The Mayo Clinic defines endometriosis as a painful disorder in which the tissue that normally lines inside of the uterus grows outside the uterus. It most commonly involves the ovaries, bowels or the tissue lining the pelvis.

    As a medical condition affecting women, it causes painful symptoms which can interfere with a woman’s quality of life and sometimes compromises fertility.

    According to the Endometriosis Support Group Nigeria, the distressing disease affects tens of thousands of girls and women in the country. Although  symptoms are usually associated with the menstrual period, there is also the challenge of a proper diagnosis, as it can only be done through a process, referred to as laparoscopic (keyhole) surgery.

    Chinasa Chukwu, a 23-year-old Nigerian in the UK, blogs about her battle with endometriosis.

    “My struggle with endometriosis started in England while in school – the First World, as it were. With all the medical facilities, they still couldn’t diagnose it. The fact that there’s no known cause also makes it difficult to diagnose, as there are no step a doctor can follow”.

    Speaking further, she said; “The myth of ‘painful periods’ also hinders detection. Women are told from a very young age that pain is expected when you have periods, and in Nigeria – where I was when I got my first period – I was congratulated. The pain was seen as some sort of rite of passage into womanhood. Obviously, not all women with painful periods have endometriosis, but when it is ‘debilitating,’ you need to speak to someone,” Chioma recently told a health publication online.

    It takes a strong will and determination for women who are suffering from endometriosis to live beyond the gruesome pain and achieve their dreams. This is because of the obligations required in altering lifestyle in order to be able to manage the pain. The change in lifestyle requires making dietary changes, getting more exercise and setting new health goals.

    As a means of relieving the pain, one may be required to eat more home grown food while increasing the intake of vegetables. Regular exercise can also help with muscle strength to deal with pains.

    A fertility expert, Dr.  Abayomi Ajayi, who is also the Medical Director of the Nordica Fertility Centre, in a recent engagement with the media, described endometriosis as  one of the most common gynecological problems affecting women in Nigeria. He added that diagnosis can be delayed or missed, leaving the problem unrecognized and unattended to.

    “That girl or woman who constantly cries or rolls while menstruating or about to menstruate, given some form of treatment, but with no respite could actually be suffering from endometriosis. We have attended to women with the condition, here in Nigeria. None was going to be ‘the Face of Endometriosis’, until Chief Nike Osinowo was treated of the condition. Her submission to share her story, the adequate publicity given to the human interest story has really helped to lay bare that the condition exists in the country. More women have been attended to, and they are getting on better with their lives.”

    Causes

    On likely causes of endometriosis, Dr.  Abayomi said: “The exact cause of endometriosis is unknown. But other possible causes are retrograde menstruation; metaplasia, i.e., cells of the abdomen change to endometrial cells; surgical transplantation can lead to endometriosis; e.g., surgical scar endometriosis, such as cesarean section, episiotomy or even surgeon’s gloves.  Blood streal or lymphatics- brain, lungs or immune failure.’’

    He listed the predisposing factors of endometriosis to include age (25 to 35 years); hereditary, or genetic,  starting menses early, i.e., less than 12 years; frequent periods less than 28 days or longer, lasting menstrual flows of more than seven days; never  having had children; slim women and a closed hymen.

    This brings to the fore the issue of stigmatization and trivialization, which some support group are already trying to address.

    One of such is the endometriosis Support Group, a Nordica Fertility Clinic initiative.

    Another young lady canvassing for support and awareness about endometriosis is Haleemah Ajiga, founder of the Haleemah Ajiga Foundation.

    The graduate of Bio-chemistry from the Crescent University, Abeokuta, Ogun State, told The Nation that she was inspired to start a foundation to fight endometriosis after the discovery that a larger percentage of Nigerian female don’t know about it.

    Ajiga, who is leading the advocacy to close the knowledge gap about endometriosis, said awareness has been encouraging. Her foundation uses tracts and graphics which aids in providing better illustrations, while also recognizing the vital roles men have played in helping to create awareness.

    At the moment, the awareness is geared at secondary schools and ladies in the age of puberty, as well as university and religious community.

    “Our projection into the future is to have a society that is very well-informed about the dangers posed by this disease and also encourage cure for the chronic diseases. We hope to help our sisters in making sure the society give the right attitude about the disease.

    “As of now, we are laying more emphasis on awareness and public enlightenment about the disease. We also interact with endo sisters (that is what we call those suffering from endo) and so, we have been able to build a strong brick of support around them by constantly facilitating their meetings with renowned gynaecologists. We also provide suitable rich diets options. But, most importantly, we form a family circle around them, making them know that they are never alone.”

    While the world awaits medical research and scientific breakthrough aimed at providing a cure for the ailment, there is no overstating the fact that women need to be encouraged with a message of hope.  Already, with its many shades of pain, some women with endometriosis around the world are proving that with a strong will, they can live with it and also achieve their dreams.

  • MBGN winner, Unoaku Anyadike to fight endometriosis

    MBGN winner, Unoaku Anyadike to fight endometriosis

    In line with the demands of her crown, the newly-crowned Most Beautiful Girl in Nigeria 2015, Miss Unoaku Anyadike, has said that she will devote her reign to creating awareness of the dangers of endometriosis in females.

    Anyadike came out tops, beating 36 other contestants to the crown at the event organised by the Siverbird Group at the International Conference Centre, Calabar on Saturday night.

    While Miss Ebonyi, Debbie Collins, was the first runner-up and the Miss Charismatic, Miss Abuja, Chizoba Ejike, was the second runner-up. Miss Bauchi, Chikaodili Nna-Udosen, also emerged third runner-up.

    With her victory, Anyadike will represent Nigeria at the Miss World beauty pageant, while Collins will go for the Miss Universe beauty pageant. The second runner-up, Ejike will contest the Miss Tourism Beauty Pageant while Nna-Udosen, the third runner-up, will carry Nigeria’s flag at the Miss ECOWAS beauty pageant.

    Anyadike, a final year student of psychology at the University of Ibadan, told the News Agency of Nigeria (NAN) that she used to have painful menstrual periods and initially thought she had endometriosis.

    The Ekwuluobia, Anambra-born beauty queen, said the ailment was diagnosed as the lining of the uterus attaching itself to other parts of the body and causing a girl’s monthly flow to be very painful.

    “This platform has given me the opportunity to help create awareness about endometriosis in Nigeria. It’s a disease that so many people don’t know about which affects the female child, so, I intend to go round, starting with secondary schools, to create awareness about endometriosis. I want young girls to know about this disease and try their best to get checked early enough. It is a disease that is fast spreading in Nigeria and it has to be checked; we can easily control it when everybody, especially young girls knows about it,” she said.

    Endometriosis is a disease in which tissue that normally grows inside the uterus grows outside it. The main symptoms are pelvic pain and infertility.

    Among dignitaries present at the event were Cross River State Governor, Ben Ayade, his predecessor, Mr Liyel Imoke, Florence Ita-Giwa as well as Senator Ben Murray-Bruce.

  • Saving women from endometriosis

    Saving women from endometriosis

    Many women who suffer from endometriosis do not like to talk about it. A fertility expert, Dr Abayomi Ajayi, says such women have nothing to be ashamed of, reports OYEYEMI GBENGA-MUSTAPHA. 

    It is a condition suffered by women, yet much is not known about endometriosis.

    Endometriosis is a painful disorder in which the tissue lining a woman’s uterus (the endometrium) grows outside  it (endometrial) implants. It involves the ovaries, bowel or the tissues lining the pelvics. Endometriosis has no cure, for now, and it can lead to infertility in women.  This is why Medical Director of the Nordica Fertility Centre, Lagos, Dr Abayomi Ajayi, is seeking editors’ help on educating the society about endometriosis.

    At a one-day forum with the Guild of Editors at the Eko Hotel and Suites on Victoria Island, Lagos, Ajayi said though endometriosis has no cure  yet, early diagnosis and management are essential. The media can help create awareness on the condition such that all will understand it like other non-communicable diseases, such as malaria.

    He said: “Editors can help spread the message on endometriosis, as one of the most common gynaecological problems. Its diagnosis can be delayed or missed, leaving the problem unrecognised, misdiagnosed. As of today, the prevalence of endometriosis in general population is unknown, and it is mainly found in women of reproductive age and it shrinks at menopause. It is estimated that five to 15 percent of women have some degree of the disease.

    “That girl or woman who constantly cries or rolls while menstruating or about to menstruate, given some form of treatment, but with no respite could actually be suffering from endometriosis. We have attended to quite some women with the condition, here in Nigeria. None was going to be ‘the Face of Endometriosis’, until Chief Nike Osinowo was treated of the condition. Her submission to share her story, the adequate publicity given to the human interest story has really helped to lay bare that the condition exists in the country. It was you, gentlemen of the Press, that took the story to the populace, and now, more women have been attended to, and they are getting on better with their lives.”

    Ajayi said the condition could lead to infertility and deny women of children; “for about eight percent of women in assisted reproductive art (ART) programmes have the primary diagnosis of endometriosis and it constitutes the third commonest findings, 15.7 percent at laparascopy. The data is from Review of laparoscopic procedures at Nordica Fertility Centre done by Strathy et all (1982).”

    According to him, the predisposing factors are age (25 to 35 years); hereditary, or genetic predisposition (if there is a mother or sister with endometriosis in the family); starting menses early, i.e., less than 12 years; frequent periods less than 28 days or longer, lasting menstrual flows of more than seven days; never had children; slim women and a closed hymen.

    But, what is the cause of the deisease? Ajayi said: “The exact cause of endometriosis is unknown. But other possible causes are retrograde menstruation; metaplasia, i.e., cells of the abdomen change to endometrial cells; surgical transplantation can lead to endometriosis; e.g., surgical scar endometriosis, such as cesarean section, episiotomy or even surgeon’s gloves.  Blood streal or lymphatics- brain, lungs or immune failure.’’

    When asked how the symptoms of the disease could be identified, Dr Ajayi said: “Endometriosis is largely asymptomatic; the classic triad pain is the commonest complaint, i.e. painful period, lower abdominal pains outside the periods or pain during sexual intercourse (dyspareunia); pain during defecation (dyschezia) infertility and postmenstrual spotting in about 20 percent.”

    He continued: “The simplest way to understand the mechanism of the condition is that bleeding causes inflammation, leading to scar tissues which may block Fallopian tubes; this can interfere with ovulation and fertilisation. Endometriomas (ovarian cysts) also interfere with ovulation and quality of egg; toxins/chemicals are also released by the endometriotic deposits which are toxic to the eggs and embryos, the toxins also affect the lining of the womb and disturb implantation.”

    He added: “The good news is that diagnosis and treatment are available. Diagnosis is done through taking of history above; pelvic examination and pelvic ultrasound (transvaginal ultrasound). Laparascopy is the gold standard of diagnosis. It can be used to detect, take biopsy sample and treat.

    “Treatment considerations are related to age; severity of symptoms; stage of disease and infertility or fertility desire. No cure yet for the condition but it can be managed; symptoms can be relieved; best chance of cure is removing uterus, tubes and ovaries, a recurrence after this is but possible. Complications are infertility; chronic pelvic pain that interferes with work and social life; endometriomas/largecysts can rupture and intestinal obstruction from adhesions can take place.

    “Our engaging you today on this condition is to ignite hope in women with the condition. That they can get pregnant, some after laparascopic; treatment with intrauterine insemination (IUI) that improves fertility in minimal to mild endometriosis; IVF appropariate especially when tubal function is compromised, if there is male factor infertility and/or other treatments have failed among other treatments available.

    He urged the editors to shed more light on the condition so that women suffering from it could be understood and treatment sought, ‘’just as you did with other diseases, such as HIV/AIDS and Ebola. ‘’We have a support group called Endometriosis Support Group, a Nordica Fertility Clinic initiative. Sufferers must know they are not alone, they can encourage other another and share ideas on how to cope,” said Dr Ajayi.

    Mr Bolaji Tunji, director, Sun Newspapers, who represented the President of Guild of Editors, Mr Femi Adesina, said journalists have always been vibrant in reporting issues, especially that: “which are germane to health and livelihood of citizens. We will continue in that light”.

    The Publisher, City People, Mr Seye Kehinde said he, through the “medium at my disposal have carved a niche to reach the high and mighty, low and lonely and we will continue to ensure the condition-Endometriosis remains in the front burner”.

  • Adefunke Sofowote, Endometriosis, Systemic Lupus

    HOLIDAYS are sweet days. They provide an escape and rest from the daily routine, and, if well spent, may re-invigorate body, soul and spirit. Last April, socially accepted as the right time to observe the Easter anniversary, provided one such opportunity to relax the muscles and nerves, soothe the bones and deepen the mind. For some people, however, the end of May is the peak of the Pentecost season. And looking forward to another escape at the end of this month.

    Back from the April holiday, I found invitations to two health events on my desk. One was from the CANCER TEAM. The other came from the Natural Integrative Medicine Practitioners Association inrespect of a training seminar on hypertension for its members yesterday. The CANCER TEAM last Sunday began exhibition of THE PHOTOGRAPHY OF MRS. ADEFUNKE SOFOWOTE to raise funds for her treatment abroad. There were, also, about endometriosis, systemic lupus erythematosus   (SLE) and brain tumour.

     Adefunke Sofowote

    I met with this ever-smiling, simple, well-mannered and humble woman in Lagos in the late 1970s. Unlike many women who do not concern themselves about the deep life, she was restless in her search for the meaning of Life.

    I had just graduated from National Youth Service in Calabar, where such questions agitated my mind, and returned to Lagos to discover that there was a growing number of people who, dissatisfied with surface life, were sharing experiences and company. Adefunke Sofowote brought her husband along. They were like inseparable twins. They walked everywhere hand-in-hand, and, often, wore clothes made from the same fabric. Theirs was like a marriage made in heaven. It must have been in the 1980s that Mrs. Sofowote mentioned something to me about cancer. I had just gone through the funeral of my maternal grandmother who died of breast cancer, a traumatic event which introduced me to Alternative Medicine. One of the books I bought then, to help understand this disease and obtain healing ideas which may help my grandmother’s condition was Johannah Brandt’s THE GRAPE CURE. Johannah suffered from a cancer which had devastated more than half of her stomach. On a red grape fast, the cancer cleared, and she documented her experiences in that book. Joyfully, I gave this book to Mrs. Sofowote, and I believed it served whatever purpose she needed it for. So, I was surprised a few months ago to learn that she was receiving treatment in a German hospital about 35 years after.

    In the search for funds to finance her treatment, her friends put together THE CANCER TEAM, at the helm of which I believe is her husband, Olusegun. The message of the CANCER TEAM to their friends and well wishers is:

    “You are invited to a fund-raising exhibition of Mrs. Adefunke Sofowote’s photography holding at freedom Park, No 2 Broad Street from 4th – 11th May, 2014. She is undergoing treatment for cancer. Guest of Honour is the First Lady of Lagos State, exhibition opens 4th May. RSVP 08028043785 Let’s give to the Giver. Support Mrs. Adefunke Sofowote’s fight against cancer at her fund-raising exhibition… For more information on how you can also make a donation, please see www.funkesofowotecancerfund.com.

    An exhibition of Mrs. Sofowote’s photographs is a thoughtful way to raise funds for her. For many years before she fell ill, she and her husband were into a special kind of photography. Every Christmas or Easter season, I looked forward to buying that season’s greetings cards which either came plain, for you to couch your own feelings into the message space, or with deep messages that are not to be found in regular cards. The photographs themselves were not “anyhow” photographs, as we describe run-of-the mill things in this part of the world. They expressed the beauty of Mother Nature, and helped you to think deeper. It is most probably because the proceeds of this venture were donated to motherless babies’ homes that the CANCER TEAM has chosen to request that, in her hour of need, we “give” to the “giver”.

    For Adefunke and her husband, their journey together has been a long and interesting one blessed with four children. They met when Mr. Sofowote was editing a photoplay magazine called HONEY DROPS. On that journal, he was a co-director with one of my former bosses, Mr. Olatunde Odesanya. He was the Chief Sub-Editor of the Daily Times when I returned from youth service to rejoin the news paper in 1978 as a senior Sub-editor. Adefunke joined Honey Drops later as the Editor’s Assistant. Segun, who would later become her lover and husband, was the Editor. But they did not discover their liking for each other until Funke had left for a technical college to further her education. He must miss her far, far away in Germany. She, too, must be dreaming of the day she would rejoin him. As for their friends, our hearts should know joy when we see them again holding hands in the street, dressed in clothes sewn from the same fabric, a spectacle which rubs on, and adds value to our romantic lives and marriages. While wishing the CANCER TEAM success, I would like to suggest that the fund raising be expanded beyond one-off donations to networking funding till Adefunke rejoins us, hale and hearty. The proposal is that about 1,000 of astute donors be found who can donate N1,000 every month through bank Standing Order into the fund account. The core of the 1,000 donors can be 10 people. If every-one of these 10 brings 10 each months to add to the persons on board, that makes 100 people. If each of the 100 brings 10 person each, that makes 1,000 people. 1,000 persons donating N1,000 every month unfailingly, will give the fund N1,000,000 (one million naira) every month. This scope can be enlarged or widened.

    The horror of endometriosis

    When I went through the mail on endometriosis this week, I remembered the plight of a mother and her daughter I met a few years ago. The young woman had to quit her lucrative job to take care of her health. Her husband, unable to cope with her, left home. But she was lucky to have a caring mother who had retired from the civil service and, so, had enough time to look after her three grandchildren and fund medical expenses. The woman’s condition was so bad that, if she as little tried to cough, she could discharge a large amount of blood from the vagina. Her mother was always around to tidy the floor, and she was transfused with blood regularly. Also upsetting to her were chronic pain that drugs seemed to have no power over. I do not remember the type of endometriosis she suffered from. But is there any one, any woman would wish to be her lot? Endometriosis reminds me, also, of the Law of Homogeneous Species. By thisnatural law or Law of Nature, only things that are of the same nature or consistency are meant to stay together for beauty and peace to abide among them. To illustrate this law, in the forest, we find that lions live with lions, not with hyenas or elephants. In the deep sea, salmon and whales do not co-habit in the same territory. When soldier ants are on a march in a file, no other ant adulterates their homogeneity. As the sun sets and the birds fly home, one can observe the uniformity of the various groups which fly past. And this should easily remind us of the popular saying… birds of a feather flock together. It is only man who breaks this law in the constitution of the nation-state, which is why, as we shall find in endometriosis, there is always one upheaval or the other in whose countries constituent peoples are not homogeneous.

    Endometriosis is a condition in which cells of the endometrium is growing outside its own territory. The endometriums are the lining of the womb which is meant to support the growth of the foetus after the egg has been fertilised in the fallopian tube. If fertilisation does not occur, this lining is broken down by the body and shed along with the unfertilised egg in the monthly menstrual cycle of menstruation. The cells of the endometrium are among the 100 trillion or so cells in an adult female body. These 100 trillion cells grew out of one cell, the female egg, which was fertilised by one male cell, the spermatozoa. In one of the several wonders of Mother Nature, this fertilised egg soon differentiates into several groups of cells, each group with a specific function and location. Thus skin cells do not grow among brain cells. Similarly, sperm cells are not to be found among eye cells. Lung and liver cells do not intermingle. Each group keeps to its own allotted space.

    In endometriosis, some cells of the endometrium escape from the womb to other regions of the body and begin to grow there as strange bed fellows among the host cells. As their chemistry differs from that of these cells, tension occurs in the region which presents as inflammation, pain and any other discomfort.

    Doctors, like researchers, differ on the causes of endometriosis. Some believe incomplete menstrual discharge, which leads to back up menstrual flow to the fallopian tubes, is the origin. This sounds reasonable. For if the endometrium is detached from the womb but cannot be wholly evacuated with the ensuing menstruation through the vagina, retrograde flow or backward flow may take endometrial cells to the unlucky, fallopian tube.

    Other researchers believe migrant flat worms may drag these cells anywhere they migrate to from the uterus. These worms, faciolopsis in particular, originate from their eggs which are consumed with animal intestinal tissue not well cleaned and cooked. This is one reason I stopped eating animal intestine, a Nigerian culinary delicacy popularly called round about. If the enzymes of the digestive system are weak and do not destroy these eggs, they may survive and grow to adult stage worms. These adult flat worms migrate to comfortable zones of the body. They may reside in the liver, pancreas, prostate or uterus, causing irritation, poisoning and organ dysfunctions. For this reason, it is advisable to periodically clean the body of them with herbal parasite formulas. Among the ones I often suggest are Amazon A-P, Parasite Cleanse, NG4 Parasite Formula, Wormwood, and Pau d’Arco. NG4 Parasite Formula is a combination of some anti-parasite herbs, including wormwood. Mrs. Folake Sanusi-Kuku, an acquaintance, told me of an orthodox doctor acquaintance of hers who was treating a patient with tummy problems with Swedish bitters. The pains persisted. But when he added wormwood to the bitters, the patient, a lawyer, vomited two long worms almost immediately and, surprisingly, the pains subsided almost immediately as well. This doctor also gives Horsetail to his cancer patients.

    Another school of thought suggests genetic inheritance of predisposition to endometriosis. Somehow, while I do not discountenance these postulations, I have more confidence in the retrograde menstruation hypothesis. Only hours ago, I shared my thoughts with, a girl, a virgin, aged 18 who hasn’t menstruated in two months, whose cycle never went beyond three days and, even then, came in blackened clots of blood. This girl suffers from vaginal infection with foul yellow discharge and severe pelvic floor pain. Retrograde menstruation may very well be one of her problems. And her therapy will include herbs that will tone the reproductive organs, oxygenate her blood, bring back her menstruation and support complete menstrual discharge.

    Symptoms

    The signs depend on the location of the problem. When endometrial cells settle among the wrong cells, they begin to grow normally as though they were in the uterus, especially during high tides of hormones, especially estrogen, in the menstrual cycle. The occurrence may be on the ovaries, the intestine, the colon, the lungs, within the muscle walls of the uterus, the pelvis, the tummy, liver or skin. On these organs the endometrial cells grow as patches or adhesions and bleed during menstruation. That is why, in the affected women, it is possible to find blood in the stool or urine. The lesions cause inflammation and pain although they are not cancerous. Research suggests this condition may dispose the sufferers to cancer. About one-third of the women with this condition do not know they are afflicted because they experience no symptoms. Yet for other women the endometriosis nightmare may include pelvic pain during menstruation, vaginal bleeding during sexual intercourse, pain during bowel movement, sensitivity to certain foods, yeast overgrowth, emotional disturbance, paranoia, low blood count, iron deficiency, anaemia and lots more.

    NATURAL THERAPY

    Many sufferers want a magic bullet quick-fix. But this is not possible. All the symptoms have to be addressed. As inflammation causes pain, they are both better treated with anti-inflammatories such as Jobelyn, Curcumin 2000x, Fish oil, Bromelain, plentiful in pineapple peel, Wheatgrass and  chanka Piedra, which is also an anodyne (anti-pain) among many others.

    Bleeding causes loss of electrolytes and iron. This iron deficiency may so drastically reduce the blood count that it may cause the heart to collapse or the patients to faint. Jobelyn should provide iron to rebuild the blood. So should Blackstrap molasses, rich in iron and electrolyte, vitamins and minerals. One teaspoon is said to provide about 40 percent of an adult’s daily iron requirement. Spirulina powder, too, is iron rich. Besides, it supplies lots of easily digested and absorbable protein.

    As hormonal imbalance is a foundation stock which drives endometriosis, especially excess estrogen, it is necessary to balance the hormones NG4. Progesterone cream massaged on the skin may help to bring up progesterone level with estrogen. Dynapharm has a product named Maharani, which supports this effort. Traditionally, Vitex and Dong Quai are used to normalise the female hormones. Upgrading liver capacity to break down excess estrogen and to produce enough bile to move the debris out of the body and in the stool is equally important. This is the province of food supplements such as Liver balance, Carqueja, Licorice DMG, Milk Thistle, NGE Liver Health Formula (Milk Thistle with Artichoke), Maria Trebena Bitters e.t.c  what I may consider the main onslaught of this therapy is how to eliminate endometrial, in foreign tissue. The thought of this backs the suggestion that many women have endometriosis but do not experience the symptoms, perhaps because their bodies are routinely dealing with it, as our bodies routinely destroy cancer cells before they develop anchorages. It would appear women who suffer from endometriosis have partially or wholly lost this capacity. This capacity is built around systemic enzymes. We know the value of enzyme from the digestion of food. Ptyalin  in the saliva breaks polysaccharides ( complex carbonhydrates) into intermediate ones called disaccharides, while another enzymes in the intestine converts disachardes to monosacharides or glucose. Similarly Pepsin converts long chain of proteins to peptones in the stomach while  renin  cuddles fat in the stomach to make it easy to digest to fatty acids in the intestine where an enzyme turns peptones to amino acids. Thus, without enzymes, our bodies cannot convert complex foods to their simplest forms for their use.  Systemic enzymes belong to another class of enzymes. The immune system uses them to fight and destroy foreign and abnormal  bodies such as floaters in the eyes, uterine fibroids, endometrial lesions, and even tumours. There are many brands of them on the shelf. I am familiar with NG4 NS Fibrin and Neprinol  among others. Neprinol is composed of at least four major elements… Curcumin, Serepaptase, Papain and Bromelain. These may be used individually or collectively for greater effects. Curcumin is a powerful anti-inflammartory. Papain can be derived from sap of urine pawpaw or the leaves or trunk. It chemically resembles Papain and digests or dissolves proteins of all bodies foreign to our bodies. Serapaptase comes from the silk worm. When it is mature to breakout of its cocoon, it produces this enzyme to dissolve the cocoon.  Bromelain comes from the pineapple peel. It is anti-inflammatory and anti-pain in addition to its systemic enzymes value. NG4 NS Fibrin breaks down anomalous fibrin growths. Fibrin is a protein.  Too much of it in a tissue can distort that tissue as is evident in uterine fibroids for example. NG4 NS Fibrin can be a good ally in therapies to support the immune system to break them down for excretion through the urine. This suggests that the kidney be fortified to carry out effective filtration and expulsion. Kidney herbs include Kidney Nesue, Kidney Cleanse and Function Tea, Common Club Moss, Horsetait, Yarrow, Dandelian and Nettle, among others.

    Women should not make light of pelvic pain, in or out of menstruation. For the signal could be coming from something other than PID (Pelvic Inflammatory Disease) usually thought to be caused by infections. This PID signal may be endometriosis! It  should be better still if the monthly budget routinely comes along with new dresses, shoes, bags, cosmetics and hair attachments for nutritional supplements which keep their bodies out of harm’s way.