***Disclaimer: this blog post is not intended to be used as a diagnostic tool or as a source of medical advice, this blog post is solely intended to provide information in order to help you make decisions regarding your health care. Please see your general doctor and/or specialist for medical advice if you are concerned about your health.***
 
Many women face the possibility of having a reproductive disease/problems at some point in their lifetime. For some they’ve had issues their whole lives, for others problems develop suddenly with little or no warning. Some of the reproductive diseases that women can face are well known while others are not very well known and often get missed or misdiagnosed until it is either too late for treatment or the woman is physically and mentally/emotionally crippled by the pain.
This blog post series is inspired by my own recent experience of facing a potential diagnosis of either Endometriosis, which is what I was officially diagnosed with after a minor laparoscopic surgery and I already had a rudimentary knowledge of endometriosis as my mother has it as well, or Ovarian Cancer, which I knew pretty much nothing about let alone what the most common symptoms were until I faced the possibility of having it and began researching everything I could about ovarian cancer, so we are going to have a look at some of the most common reproductive diseases and problems that we as women can potentially face including endometriosis and ovarian cancer. I must stress right now that not everyone will develop one of these diseases/problems and this is not intended as a diagnostic or medical tool, this post is meant to provide awareness as it is always a good idea to know the signs and symptoms that can point to there being a problem so that you can find the best care provider possible for your particular circumstances.
The diseases we will be looking at in this blog post series are as follows:

• Endometriosis
• Adenomyosis
• Ovarian Cancer
• Cervical Cancer
• Uterine Cancer
• Pelvic Inflammatory Disease (PID)

Part 6:
Pelvic Inflammatory Disease (PID)
Pelvic inflammatory disease is a common condition that affects approximately 1 in 8 women during the lifetimes and is most common in young women who are sexually active between the ages 20-24.
10,000 or so women in Australia are hospitalised for pelvic Inflammatory disease each year, and approximately 59,000-60,000 are treated for it by their family doctor.
 
So What Is Pelvic Inflammatory Disease (PID)?
Pelvic inflammatory disease is an infection and/or inflammation of one or more pelvic organs in a woman – the cervix, uterus, fallopian tubes and/or ovaries. The infection is commonly a sexually transmitted one like Chlamydia or Gonorrhoea, which can be transferred via unprotected sex with an affected person, but it can also develop after a surgery, childbirth, miscarriage, insertion of an intrauterine birth control device, D&C or termination of pregnancy.
If left untreated PID can damage your reproductive organs causing the development of scar tissue, chronic pelvic pain, abscesses on the ovaries and/or fallopian tubes, ectopic pregnancy and infertility, so early treatment is important although it is made difficult as clinical presentation differs greatly and many doctors don’t have much experience in recognising the symptoms or just simply don’t realise that the symptoms being displayed by a patient have been caused by pelvic inflammatory disease*.
*If you’ve ever been fobbed off by a doctor for really bad period pain or abnormal mid-cycle pelvic pain you’ll know how difficult it can sometimes be to get a correct diagnosis for a genuine pelvic and/or gynaecological issue, many women all around the world, every single day, are told that their pelvic pain is “all in your head” and are recommended by their doctor to see a psychologist or counsellor.
 
Signs and Symptoms of Pelvic Inflammatory Disease (PID)

• Pelvic and/or lower abdominal pain and/or tenderness
• Lower back pain
• Abnormal menstrual periods
• Changes in the amount, colour of and/or smell of vaginal discharge
• Fever
• Deep pain during sexual intercourse
• Bleeding after sex
• Increased period pain
• Painful urination
• Chills
• Nausea/Vomiting

 
Diagnosis and Treatment of Pelvic Inflammatory Disease (PID)
Diagnosis:
Diagnosis can be difficult as symptoms can often be mild, absent or applicable to many other conditions that aren’t PID. Vaginal and cervical swabs are normally taken for testing in order to test for the presence of bacteria however if the bacteria is only in the pelvic cavity and is not present in the vagina or cervix this can result in a false negative result on tests. Urine is often tested for the presence of the Chlamydia and Gonorrhoea bacteria. A pelvic exam and other tests may also be required, especially if there are no physical symptoms (asymptomatic).
A pelvic ultrasound can used to assess the size of the fallopian tubes and may show if there is any scar tissue present in the pelvic area.
Sometimes a laparoscopy (keyhole surgery where small camera’s are inserted into the abdomen to see what is going on inside) may be necessary to get a definitive diagnosis, a small sample of fluid and/or tissue of suspect areas can then be obtained and sent to pathology to see if there is any type of infection present.
Treatment:
Treatment consists of a course of antibiotics. The longer that a woman remains untreated increases her chances of having a future ectopic pregnancy and/or infertility because of damage to the fallopian tubes.
Completing the entire course of antibiotics is important as stopping before the end of the prescribed course can result in the infection not being completely eradicated and coming back (even if symptoms have ceased please do continue to take the antibiotics). Temporary abstinence until the treatment period has been completed is also advised.
If your PID was caused by a sexually transmitted disease (eg Chlamydia or Gonorrhoea) it is recommended that you contact past sexual partners so that they can be tested and also treated if necessary as men often show little or no symptoms when they are infected.
Some women may need to be hospitalised for IV antibiotic treatment, especially pregnant women, as IV antibiotics are generally considered to be safer to use during pregnancy.
Unfortunately any damage that has already occurred cannot be reversed or healed, however surgery can be done to remove scar tissue (this has the risk of more scar tissue forming post surgery) from the fallopian tubes and may be able help correct some of the damage done to the fallopian tubes.
 
When do I seek Help?
Please see your doctor or go to your local emergency department ASAP if you experience any of the following:

• Severe pain low in your abdomen/in your pelvis
• Nausea/vomiting and unable to keep anything down
• A high fever (temperature higher than 38.3 C)
• Foul vaginal discharge

 
 
 
References:
https://www.betterhealth.vic.gov.au/health/healthyliving/pelvic-inflammatory-disease-pid
https://womhealth.org.au/conditions-and-treatments/pelvic-inflammatory-disease
https://www.healthdirect.gov.au/pelvic-inflammatory-disease
https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594
http://www.sti.guidelines.org.au/syndromes/pid-pelvic-inflammatory-disease

***Disclaimer: this blog post is not intended to be used as a diagnostic tool or as a source of medical advice, this blog post is solely intended to provide information in order to help you make decisions regarding your health care. Please see your general doctor and/or specialist for medical advice if you are concerned about your health.***
 
Many women face the possibility of having a reproductive disease/problems at some point in their lifetime. For some they’ve had issues their whole lives, for others problems develop suddenly with little or no warning. Some of the reproductive diseases that women can face are well known while others are not very well known and often get missed or misdiagnosed until it is either too late for treatment or the woman is physically and mentally/emotionally crippled by the pain.
This blog post series is inspired by my own recent experience of facing a potential diagnosis of either Endometriosis, which is what I was officially diagnosed with after a minor laparoscopic surgery and I already had a rudimentary knowledge of endometriosis as my mother has it as well, or Ovarian Cancer, which I knew pretty much nothing about let alone what the most common symptoms were until I faced the possibility of having it and began researching everything I could about ovarian cancer, so we are going to have a look at some of the most common reproductive diseases and problems that we as women can potentially face including endometriosis and ovarian cancer. I must stress right now that not everyone will develop one of these diseases/problems and this is not intended as a diagnostic or medical tool, this post is meant to provide awareness as it is always a good idea to know the signs and symptoms that can point to there being a problem so that you can find the best care provider possible for your particular circumstances.
The diseases we will be looking at in this blog post series are as follows:

• Endometriosis
• Adenomyosis
• Ovarian Cancer
• Cervical Cancer
• Uterine Cancer
• Pelvic Inflammatory Disease (PID)

Part 5:
Uterine Cancer
Uterine cancer is a cancer of the uterus. There are two types of uterine cancer, each one forming from different areas of the uterus.
It is also called Cancer of the Uterus, is more common in women over 50 and is the most diagnosed gynaecological cancer in Australia with over 2,500 women being diagnosed in 2013 alone. In 2014 there were almost 500 reported deaths from Uterine Cancers.
 
So What Is Uterine Cancer?
Uterine cancer is made up of two types of cancers – the most common with approximately 75% of all uterine cancer diagnoses is endometrial cancer which forms in the endometrium, or lining, of the uterus (the endometrium is, amongst other things, what is shed each cycle during a menstrual period), and uterine sarcomas which develop in the muscle tissues that form the rest of the uterus (the muscle tissue of the uterus is known as the myometrium).
 
Signs and Symptoms of Uterine Cancer

• Unusual vaginal bleeding not related to your normal period (this is the most common symptom of uterine cancer) or unusual bleeding occurring after you have been through menopause
• Some women have reported experiencing unusual or watery discharge, different to their normal cyclic discharge, which may have an offensive smell
• Difficulty urinating and/or painful urination
• Pain during sex
• Abnormal pain in the pelvic area or abdomen
• Abnormal pap smear results
• Unexplained weight loss

All of these symptoms can be a sign of something else so it is important to see your doctor if you notice one or more of the above symptoms or anything else that is worrying you.
 
Diagnosis and Treatment of Uterine Cancer
Diagnosis:

• Diagnosis of uterine cancer is not as simple as having a pap smear. If uterine cancer is suspected you will likely be given a physical examination to check your abdomen for swelling or abnormal lumps, which will include an internal examination much like when you have a pap smear only instead of just having your cervix “scraped ” your doctor may feel your uterus by placing two fingers inside your vagina and pressing down on your lower abdomen from the outside at the same time, your doctor may also use a speculum. You will likely also have a blood test, or a series of them, and will be asked questions about your health, your immediate families health and your family medical history as well.
• Part of the testing you undergo will highly likely include a transvaginal (internal) ultrasound to have a look at your bladder, ovaries, fallopian tubes uterus and the thickness of the endometrium. An ultrasound may pick up abnormalities that cannot be felt during a physical examination and will assist your doctor by providing more information about your internal organs during the diagnostic process. An MRI, CAT scan or PET scan may be offered to give clearer images of your internal organs as well, these scans can assist with finding and diagnosing illnesses but MRI and CAT scans do not always show the early stages of cancer (a PET scan can show where areas of inflammation/activity are located, if cancer is suspected a PET scan can show the general location of where it might be which can help with both diagnosis and treatment, and can also monitor progression of the disease and/or the effectiveness of treatment).
• Depending on the location of your uterine cancer a D&C (dilation and curette) and/or a biopsy will be needed to conclusively diagnose uterine cancer. These can be done awake with local anaesthesia or while you are unconscious under general anaesthesia. A D&C is used to collect endometrial tissue for testing and a biopsy is used to collect both endometrial and myometrial tissue for testing. There are two types of biopsy – fine needle aspiration which is where some tissue/cells are collected by a needle, and excisional biopsy where larger tissue samples are surgically collected. Excisional biopsy has a lower failure rate than fine needle biopsies (sometimes not enough tissue is gained in the fine needle sample resulting in you having to go back and have another one done) and excision also has a lower false negative rate (related to not enough tissue being gained from fine needle biopsy, this can also happen by not getting a tissue sample from the exact place where the affected tissue is located as well, excision takes a larger section of tissue which allows for more of the suspect area to be tested).

 
Treatment:
Treatment will depend on the stage and type of cancer that you have, the location of your cancer within your body, the size of the cancer, where it started, your family history and your own health.
For many women surgery will be the only treatment that they need, however if it has spread beyond the uterus you will need further treatment like radiotherapy, chemotherapy and/or hormone treatment (some uterine cancers can be treated with hormone therapy).
Alternative or complimentary therapies, when combined with any of the above listed treatment options, can be useful for many and may contribute to making cancer treatment easier to get through.
If treatment does not work or the cancer is too far advanced at the time of diagnosis for treatment to have much effect then you may be offered Palliative Care.
It is best to speak with your doctor and ask lots of questions to help you understand what your treatment options are and what you can do, using the BRAIN acronym – benefits (what are they?), risks (what are they?), alternatives (are there any other options/alternatives to what is on offer?), intuition (what does your intuition/gut tell you?) & nothing (what would happen if you do nothing at all?)  - can help you with making your decision about what you wish to do.
​
When do I seek Help?
Seek help when:
When you experience any of these symptoms continuously and/or regularly for more 4 weeks (in the case of post menopausal women) or 4 or more menstrual cycles (if you still have your menstrual cycle). If symptoms worsen suddenly, or change further please see your doctor and/or specialist ASAP.
 
 
References:
http://www.cancer.org.au/about-cancer/types-of-cancer/uterine-cancer.html
https://www.medicinenet.com/uterine_cancer/article.htm
https://www.cancer.net/cancer-types/uterine-cancer/symptoms-and-signs
http://www.cancervic.org.au/about-cancer/cancer_types/uterine_cancer
https://www.thewomens.org.au/health-information/womens-cancers-pre-cancers/endometrial-cancer/
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/uterine-cancer
https://cancerqld.org.au/cancer-information/types-of-cancer/cancer-of-the-uterus/

Everyone has heard a horror story about pregnancy and birth – vomiting the whole 9 months of pregnancy, hemorroids, diarrhea, severe constipation, emergency cesarean where mum needed to go under general anaesthetic, mum and/or baby nearly died or mum/baby did die, bright red bleeding, uterine rupture, haemorrhage... you’ve probably heard at least one horror story about most of these things and you’re probably scared and worried that it will happen to you as well, it’s normal to feel scared of the unknown and it's also normal to become scared of the horror stories (though I do wholeheartedly wish that they could be more tempered with the "positive" stories), I’ve been there too, in fact most mums have been there, and for the most part, in a healthy, normal pregnancy, you have no need to worry about any of these things until something actually happens (which isn't guaranteed and likely won't even happen!)

Let’s be honest though, yes bad things do happen in pregnancy and birth, just like bad things happen during everyday life as well. You may have a car accident if you drive, you may fall off a bike while riding, you may be injured playing sport, your plane might crash or disappear completely when you are on your way to a holiday destination, your drink may be spiked while you’re at the pub or club, all of these things scare us and may happen to any of us but for the majority of people we don’t allow the fear of them to overwhelm us and take over our decision making processes.

And then there’s childbirth.

Apparently childbirth is different just because we have a baby growing inside us, we are expected to do what our care providers tell us to do, we are expected to shy away from what our care providers, family, friends and random strangers on the street tell us are the risks involved in bringing a baby into the world and we are made to fear those risks as if they WILL happen to us if we don’t do what we are told to do.

The reality though is that majority of the risks of childbirth are small, most of them are less likely to happen than being peripherally involved in a car accident or getting a sports injury, but to us they are for more important because everyone tells us that they are, everyone shares the horror stories and the worst case scenarios and avoids the much more common positive stories. More importantly people ignore the things that led to the horror stories happening and they either forget just simply do not know that many of them could have been prevented or reduced in severity with different care providers.

The most common horror story out there is the “my baby nearly died” birth story, I know this one very well because it happened to me too. It’s very scary when your baby goes into distress and everyone starts rushing around to get baby out quickly, either via forceps or ventouse (vacuum extraction) or via emergency caesarean. For the woman sharing this particular type of horror story it has likely been an extremely traumatic experience, they may only be 4cm dilated, or they may have just started pushing or they may have been pushing for hours and all of a sudden it’s panic stations and she is being told that “baby needs to come out now or he/she will die!” It’s a horrible experience for a mum and it doesn’t matter if she is a first time mother or has 4 other children at home, the trauma and fear is very real and affects you in some way for the rest of your life, and now she has shared that fear with you even though you most likely didn’t even want to know and you are scared that it or something like it is going to happen to you as well. Now that you have heard this story you have a choice – you can either give in to the fear and expect that it WILL happen to you and you can book an elective cesarean instead so that it doesn’t happen at all (the announcement of which leads to more horror stories about cesareans from other well-meaning mothers, grandmothers, sisters, cousins etc who don’t realise that they are making you even more scared), or you can face that fear, look at it and accept that yes it is a valid fear and there is a chance that it could occur, and then move past it and put it aside and accept it as a risk that you are willing to take and do everything that you can to prevent it from happening, that way if it does happen you’ve done everything possible to prevent it and are prepared for it as well.

Tough choices aren't they?  Fear can make us do many things that we wouldn't otherwise do; will you  avoid your fear and opt for the seemingly "easier" or less fearful way out? Or will you face your fear and push yourself through it in order to have the kind of birth that will leave you happy, empowered and ready to take on the world?

The choice is yours and yours alone.
 
References
http://www.midwiferytoday.com/articles/theroleoffear.asp
http://joyinbirthing.com/articles/fear-and-its-effects-on-labor/
Birth Without Fear – Michael Odent

***Disclaimer: this blog post is not intended to be used as a diagnostic tool or as a source of medical advice, this blog post is solely intended to provide information in order to help you make decisions regarding your health care. Please see your general doctor and/or specialist for medical advice if you are concerned about your health.***
 
Many women face the possibility of having a reproductive disease/problems at some point in their lifetime. For some they’ve had issues their whole lives, for others problems develop suddenly with little or no warning. Some of the reproductive diseases that women can face are well known while others are not very well known and often get missed or misdiagnosed until it is either too late for treatment or the woman is physically and mentally/emotionally crippled by the pain.
This blog post series is inspired by my own recent experience of facing a potential diagnosis of either Endometriosis, which is what I was officially diagnosed with after a minor laparoscopic surgery and I already had a rudimentary knowledge of endometriosis as my mother has it as well, or Ovarian Cancer, which I knew pretty much nothing about let alone what the most common symptoms were until I faced the possibility of having it and began researching everything I could about ovarian cancer, so we are going to have a look at some of the most common reproductive diseases and problems that we as women can potentially face including endometriosis and ovarian cancer. I must stress right now that not everyone will develop one of these diseases/problems and this is not intended as a diagnostic or medical tool, this post is meant to provide awareness as it is always a good idea to know the signs and symptoms that can point to there being a problem so that you can find the best care provider possible for your particular circumstances.
The diseases we will be looking at in this blog post series are as follows:

• Endometriosis
• Adenomyosis
• Ovarian Cancer
• Cervical Cancer
• Uterine Cancer
• Pelvic Inflammatory Disease (PID)

Part 4:

Cervical Cancer
Cervical cancer develops from the tissues of the cervix. It is the third most commonly diagnosed reporductive cancer in Australian women and, with regular screening via pap smear, is one of the easiest reproductive cancers to diagnose.
 
So What Is Cervical Cancer?
Cervical cancer is a cancer that forms on the cervix in the area where the two different types of cells (the Squamous cells that are found on the outside of the cervix and the Glandular cells which are found inside the cervical canal) meet (called the squamocolumnar junction). Cervical cancer forms when there are changes in the cells, beginning in their DNA, which alter the way that the cell works and grows, causing abnormal growth and activity. According to cancer.org.au the most common type of cervical cancer is squamous cell carcinoma which accounts for approximately 80% of diagnosed cases, the other type of cervical cancer, Adenocarcinoma, is less common and much more difficult to diagnose as it develops higher up in the cervix/cervical canal.
 
Signs and Symptoms of Cervical Cancer
When the cells of the cervix first begin to change from their normal state there aren’t usually any symptoms at all and these changes are normally only picked up during a routine pap smear.
However, if these changes in the cervical cells to develop into cervical cancer, the following symptoms may become apparent:
 

• Vaginal bleeding in between normal periods/during the middle of your menstrual cycle when you wouldn’t normally bleed
• Your periods may become longer or heavier than is normal for you
• You may start bleeding after having sex
• You may experience pain during intercourse that you did not experience before
• You may notice unusual vaginal discharge that you did not experience before
• If you have already been through menopause you may notice abnormal vaginal bleeding
• You may experience excessive fatigue/tiredness
• You may notice leg pain or swelling that is abnormal for you
• You may begin to experience lower back pain which may worsen or stay the same
  
  

 
Diagnosis and Treatment of Cervical Cancer

Diagnosis:
Up until 2017 the only way to screen for cervical cancer was to have a pap smear, diagnosis was determined by studying the cervical cells and, if they appeared to be abnormal, having a biopsy, colposcopy and/or LLETZ proceedure to gain a large enough sample of the abnormal cells for testing that could be sent to pathology to determine if they were pre-cancerous or cancerous. Pap smears were recommended to be done from age 18 or every 2 years from first beginning sexual activity and have contributed greatly to a 50% reduction in cervical cancer deaths in Australia since 1991.
In Australia, as of December 1st 2017, the old pap smears that we know (and in many cases dread) will no longer be recommended and instead HPV testing screening will be recommended for all women every 5 years between the ages of 25 to 74 to test for the human papillomavirus (HPV) and to test cervical cells at the same time since several strains of HPV are known to contribute to the development of cervical cancer. The idea behind this is to improve early detection rates* for HPV related cervical cancers (many cervical cancers have a higher likelihood of being caused by one of several different strains of HPV which can contribute to the development of cervical cancer from the changes that it makes in the cervical cells during an active infection, however it should be noted that not all cervical cancers are caused by HPV infection and many people diagnosed with cervical cancer have not been exposed to any of the cancer causing strains of HPV at all, HPV just increases the chances of it developing at a later date. Having had the HPV vaccine also does not, unfortunately, preclude anyone from needing the HPV screening either as the vaccine only covers a few of the most common cancer-contributing strains and not all of them).

*As a side note, how this new HPV screening would be able to reduce cervical cancer deaths and provide earlier cervical cancer detection for the majority with a longer time frame between screenings is, to me, questionable since cervical cancer, and non-HPV related precancerous cells themselves, can in many cases develop quite quickly between the current screening times of 2 years between pap smears - 5 years is a long time to wait between screenings and, based on observations of our countries past history prior to 2-yearly pap smears and other countries (eg the USA for example) history with low numbers of regular pap smears being done, may end up resulting in an increase in later stage cervical cancer diagnoses as opposed to early stage and precancerous diagnoses, although how effective or ineffective it may end up being we will not likely know for another decade or so before we can make any accurate conclusions of effectiveness or ineffectiveness. I also wonder about the HPV screening for people who have not and, in the case of people who practice abstinence and monogamous couples who do not stray from each other and have previously been tested negative to HPV, would it not be a waste of resources screening people for something that they have not been exposed to and are unlikely to be exposed in future? These are questions for which I eagerly await unbiased evidence based answers and I will be going through any and all research that I can find about this new screening before I make my own personal conclusions.

Treatment:
If diagnosed with cervical cancer you will be given a stage (stages vary from 0 to IV, with 0 being abnormal cells on the surface layer and IV being that the cancer has spread to other organs), staging helps your doctor (in the case of cervical cancer it is usually an oncologist specialising in gynaecological cancers) determine the best options for treatment to suit your individual needs.
If the tumour/cancerous area of tissue is only small then a cone biopsy may be all that is needed to excise the cancerous cells.
For advanced disease confined to a small area a combination of radiotherapy and chemotherapy will likely be offered and, depending on how you respond, may be all that needed.
For metastatic disease (where it has spread elsewhere in the body creating new tumours/cancerous areas) treatment is a combination of chemotherapy, usually to try and reduce the size of the tumours/cancerous areas to give you more time with your loved one/s, and/or palliative care.
Surgery (excision) of the affected area may be a possible option for some people in combination with other treatments, it is best to speak with your doctor and ask lots of questions to help you understand what your treatment options are and what you can do, using the BRAIN acronym – benefits (what are they?), risks (what are they?), alternatives (are there any other options/alternatives to what is on offer?), intuition (what does your intuition/gut tell you?) & nothing (what would happen if you do nothing at all?)  - can help you with making your decision about what you wish to do.
 
When do I seek Help?
Seek help when:
Please seek help from your medical care provider if you experience any combination of the above listed symptoms for more than 4 weeks or for more than 4 menstrual cycles in a row.
If your symptoms worsen and do not get better, if you start to lose or gain weight without trying and without doing anything different, if your pelvis and lower abdomen starts to enlarge without any discernible reason, if you start vomiting regularly without any discernible reason (eg you aren’t pregnant but are vomiting daily), if you start struggling to breathe on a daily basis without any discernible reason and/or anything else occurs that has you worried please see your medical care provider (and in the case of struggling to breathe, if its severe please go straight to your nearest emergency room or call an ambulance).
 
 
References:
https://cervical-cancer.canceraustralia.gov.au/
http://www.cancer.org.au/about-cancer/types-of-cancer/cervical-cancer.html
http://www.cancervic.org.au/about-cancer/cancer_types/cervical_cancer
http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/content/future-changes-cervical
https://www.cancer.net/es/node/18679

​***Disclaimer: this blog post is not intended to be used as a diagnostic tool or as a source of medical advice, this blog post is solely intended to provide information in order to help you make decisions regarding your health care. Please see your general doctor and/or specialist for medical advice if you are concerned about your health.***

Many women face the possibility of having a reproductive disease and/or problems at some point in their lifetime. For some they’ve had issues their whole lives, for others problems develop suddenly with little or no warning. Some of the reproductive diseases that women can face are well known while others are not very well known and often get missed or misdiagnosed until it is either too late for treatment or the woman is physically and mentally/emotionally crippled by the pain.
​
This blog post series is inspired by my own recent experiences of facing a potential diagnosis of either Endometriosis, which is what I was officially diagnosed with after a minor laparoscopic surgery and of which I already had a rudimentary knowledge of endometriosis as my mother has it as well, or Ovarian Cancer, which I knew pretty much nothing about let alone what the most common symptoms were until I faced the possibility of having it and began researching everything I could about ovarian cancer, so we are going to have a look at some of the most common reproductive diseases and problems that we as women can potentially face including endometriosis and ovarian cancer. I must stress right now that not everyone will develop one of these diseases/problems and this is not intended as a diagnostic or medical tool, this post is meant to provide awareness as it is always a good idea to know the signs and symptoms that can point to there being a problem so that you can find the best care provider possible for your particular circumstances.

The diseases we will be looking at in this blog post series are as follows:

• Endometriosis
• Adenomyosis
• Ovarian Cancer
• Cervical Cancer
• Uterine Cancer
• Pelvic Inflammatory Disease (PID)

Part 3:

Ovarian Cancer
Ovarian Cancer is labelled as the "silent killer" of women because usually by the time a woman starts to have symptoms the cancer has advanced past the easiest to treat stages.
Awareness of the earliest symptoms is the key to increasing the survival rates of this horrible disease and of catching it early.
The symptoms are generally vague and similar to the symptoms of other more minor illnesses and conditions (Irritable Bowel Syndrome for example).
Ovarian cancer is a cancer that affects the ovaries. In Australia alone it is the 9th most common cancer diagnosis and the 6th most common cause of death affecting women.
 
So What Is Ovarian Cancer?
There are 3 types of ovarian cancer – the common epithelial type (making up approximately 90% of ovarian cancer cases) that is formed in the cells on the outside of the ovary; the germ cell type that is formed from the cells that produce eggs; and the rare stromal type that forms from the supporting tissues within the ovary itself (where the female hormones are normally produced).
Ovarian cancer can develop on one or both ovaries and cancerous or pre-cancerous cells can still be presentwithin the pelvic cavity even after a full hysterectomy.
 
Signs and Symptoms of Ovarian Cancer
Ovarian cancer can be very difficult to diagnose in the early stages as there aren’t usually any symptoms, or only very vague symptoms, in the beginning, but the most common symptoms are:

• Abdominal or Pelvic Pain that is abnormal for you.
• Increased abdominal size or persistent bloating that lasts longer than 4 weeks and doesn't generally come and go but stays constant.
• The need to urinate more often or urgently (a similar type of need to go as many women get when they are pregnant or have a UTI, if you aren't pregnant and don't have a UTI it can be a concern).
• Feeling full after eating only a small amount or a very noticeable reduction in how much you would normally eat with no other explanation for it).

 
Other symptoms that have been reported are:
·         Fatigue that doesn't go away even with adequate rest.
·         Menstrual irregularities (eg abnormal spotting in between periods, periods that last longer than normal and are heavier than normal, the development of sudden irregular menstrual cycles that are abnormal to you and aren't related to menopause or being perimenopausal, the sudden development of random bleeds/spotting if you are post menopausal etc).
·         Abnormal back pain that can't be explained or isn't related to a pre-existing condition.
Constipation or diarrhea or other sudden changes in your bowel habits that isn't normal for you and can't be explained by something else.
·         Pain during sexual intercourse.
 
Diagnosis and Treatment of Ovarian Cancer
If you are experiencing possible symptoms of ovarian cancer and are seeing a medical professional about it your doctor may suggest several tests or scans to look for cysts, tumours or other changes.
This may include the following:

• Physical examination in which the doctor will check your abdomen for any lumps and do an internal vaginal examination
• Blood tests
• Imaging scans
• Ultrasound
• CT scan
• PET scan
• Colonoscopy
  
  

These can show if there are any abnormalities but a biopsy (taking a tissue sample) is the only way to fully confirm a cancer diagnosis. 

Types of Treatment
Treatment depends on the extent of the cancer. Surgery is used to determine the extent of disease and, if localised to one area, is the main treatment. If the cancer has spread, an attempt is made to remove as much as possible before beginning further treatments.
Chemotherapy, is commonly used after surgery to try to eliminate all disease identified by scan and CA125 blood test. Chemotherapy can be injected into the bloodstream through the vein or instilled into the abdominal cavity or both.
With widespread disease, chemotherapy may be used first. Surgery after chemotherapy can assess response. Germ cell tumours can be cured with chemotherapy.
​
Treatment teamDepending on your treatment you will be seen by several specialists, for example:

• Gynaecological oncologist who specialises in treating women with cancers of the reproductive system
• Medical oncologist  who prescribes the course of chemotherapy
• Radiation oncologist who prescribes the course of radiotherapy
• Radiologist who is trained to interpret diagnostic scans
• Cancer nurses
• Other health professionals such as dietitian, physiotherapist, social worker and counsellor.

When do I seek Help?
Ovarian Cancer Australia says not to worry too much initially if you have 1 or more of these symptoms but to just be aware of any changes and to see your GP if they last longer than 4 weeks or for 4 or more menstrual cycles to first rule out more common and minor causes which are much more likely.
If you are unhappy with your GPs diagnosis or don't feel that it is the right diagnosis don't hesitate to get a second opinion and a referral to a gynecologist (Ovarian Cancer Australia has an easy to use symptom diary on their website that you can download for free to record any worrying or concerning symptoms for a record to show your GP or just for your own peace of mind).
If the symptoms start to impact on your relationships, life in general, your sexual activities, your health, if you have suddenly lost a large amount of weight in a short amount of time or have suddenly worsened with no warning please go to your doctor ASAP to arrange for an assessment with an appropriate specialist.
 
 
References:
http://www.cancer.org.au/about-cancer/types-of-cancer/ovarian-cancer.html
https://ovariancancer.net.au/awareness/symptoms/
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/ovarian-cancer
http://www.cancervic.org.au/about-cancer/cancer_types/ovarian_cancer