Health related information and news from around the world.

You may have something in common with Charlotte other than the physical symptoms of the disease. You may be striving, working woman in your twenties or thirties who has put off childbearing to pursue a career. A surprising third portrait reveals you as a teenage girl, highly sensitive, but with a strong sense of competition that may or may not be fully expressed.

What do personal issues of fulfillment through work, or work as a matter of sheer economic survival, have to do with endometriosis? Don’t unambitious, nonstriving women—even altruistic, spiritual women—develop the disease? Certainly they do! But they are not the most vulnerable. In these transitional times, working women are most likely to succumb to endometriosis.

In the 1980s it is nearly impossible for a gynecologist and obstetrician to care sensibly for a patient without identifying, describing, and fully examining some crucial details of her personal life. As part of treating the person, not just the symptoms, we must examine the external influences—physiological and psychological—that create changes in her health.

These are exciting times for women with professional aspirations, with greater chances than ever for taking on new responsibilities. In 1985, one-third of American earning power was a result of women’s work on every level. In 1970, 26 percent of women between eighteen and twenty-four years of age were unmarried. In 1986, 56 percent of the same age group were single—most of them in the work force. More relevant to our story, in 1950, 80 percent of women had borne at least one child by the age of thirty, whereas today, the figure has dropped to 60 percent.

Beyond job stress, women are juggling the minute-to-minute priorities of work and intimacy, confronting any ambivalence about achievement along with conflicts over dependency on men, figuring out how to achieve a balance on a day-to-day basis—and they are postponing childbirth.

Endometriosis isn’t fair. It isn’t interested in bow hard a woman works and it doesn’t care why a woman has not had children early in life, when there are fewer chances of organic complications. It thrives on stress-related immune system weakness, which, along with other factors that I will discuss in great detail later on, can control a woman’s body and her life. But it needn’t happen this way. With my plan, you eon learn to control endometriosis and not feel that you must choose between your work and your health.

Describing endometriosis as the “career woman’s” or working woman’s disease may be the switch that turns on a highly charged debate among doctors, scientists, and even victims of the disease. But whatever else may be so, the change in life-style is here to stay, and it is every women’s right to pursue the optimal health she desires in order to live a fully productive life.

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These are also sometimes called sensitivity groups, and are not to be confused with more orthodox group therapy. Encounter groups are larger, up to say 18 members, and sometimes have no official leader, whilst there is always a qualified therapist running the more orthodox groups. Encounter groups focus on ‘personal difficulties’, and often specialize in specific problem areas, such as stress in a corporate situation or in a bad marriage.

These groups commenced in the United States in the 1960s, and have been described as treatment for people who are not sick but simply seeking fulfilment. Nevertheless, their aims are decidedly therapeutic. They seek to make the individual feel human again, at ease with his own emotions and those of the people around him; they seek to counter the depersonalizing effects of the industrial society in which many of us live. They consituto a kind of mass folk therapy, and it is estimated that some two million Americans have so far been moved to join them.

Within these groups, the veneer of politeness has to be lifted, masks must disappear. It is the opposite of the usual cocktail party situation. Physical routines may be used to get things started, such activities as closing one’s eyes and groping, letting oneself fall backwards into another’s arms, and hand wrestling. When doing psychodrama the group members are told to act out experiences that have given them distress in the past— perhaps, a family quarrel. Then the group rotates roles, and so each member may move from acting out his problems to getting to see himself from other angles. There are limits to what encounter groups can accomplish and, very occasionally, there are dangers involved. Psychotic breakdowns under group pressure, though rare, have happened. The grouper who returns alone into the everyday world can carry with him certain misconceptions of reality. He has changed, but the world has not. It is possible that Alcoholics Anonymous bears out what Dr Pratt discovered in Boston: that the greatest benefit from groups is gained by those people caught in the same specific stress problem, be it alcohol, skin disorders, or alienation.

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Biological factors which influence body fat levels are generally not amenable to modification. The main biological factors known to influence obesity are genetic (including sex and race), age, hormone status, illness and disability.

Heredity accounts for about 25-40 per cent of the variance of body mass index suggesting that obesity has a strong genetic base, and according to evidence to date, is polygenic (influenced by many genes rather than a few). Sex differences are also known to affect fat/energy balance. In general, adipose stores are more hormonally controlled in females, particularly during the reproductive years. Fat loss and maintenance of lower equilibrium fat stores also becomes more difficult with age. Differences occur between the sexes early in life, become greatest with the onset of menses, then tend to decrease with the changes in female hormone status in post-menopausal women. Finally, there is increasing evidence of racial influences on body composition. The implications of these biological influences are in accepting factors beyond the wilful control of the obese person. Obesity should no longer be thought of as being due solely to either sloth and/or gluttony.

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Transcutaneous electrical nerve stimulation, commonly known as TENS, is a treatment developed when it was observed that pain symptoms eased when electricity was applied to the skin at the site of pain.

A TENS unit is a small battery-operated machine (about 10 centimetres by 8 centimetres) that is usually clipped to a belt or placed in a pocket. Two small electrodes that are stuck on to the skin with paste at the site of the pain run from this battery. The small electrical impulses emitted from the battery are transmitted through the electrodes and stimulate the nerves which, in turn, control the pain symptoms. The intensity and rate of the impulses can be regulated by a dial located on the machine.

It is thought that TENS may work in two ways. Firstly, the electrical currents may stimulate the nerves to prevent the pain messages from the area reaching the brain. Secondly, it may increase the production of endorphins — pain-killing chemicals produced by the body.

During the treatment women have said that they experience a tingling or pulsating sensation under the electrodes.

There is no evidence that TENS is addictive and during the day it can be used continuously or intermittently.

It appears that the effect of the TENS may be such that after a time you will be able to decrease the amount of time that you need to use it.

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Once the fragments of endometrium have implanted they begin to respond to the fluctuating levels of the menstrual cycle hormones in the same way as the endometrium lining the uterus. Thus, the implants thicken and swell with blood and then break down and bleed each month. This blood then cannot escape from the body so it bleeds directly onto the surface of the surrounding organs, causing irritation which leads to inflammation, scarring and, sometimes, the development of adhesions.

As the disease progresses the implants gradually enlarge in size and may form small cysts.

As a cyst enlarges, the pressure within the cyst may cause it to rupture during menstruation, spilling the contents onto the adjacent tissues. This may in turn lead to the development of new implants.

What does endometriosis look like

Classical implants-Until recently, endometrial implants were thought to be fairly uniform in appearance. However, in the last few years there has been a growing appreciation that they have a range of characteristic appearances.

It is now understood that what were traditionally recognized as being classical implants are, in fact, probably only one end of the spectrum of appearances and that they are probably only typical of older implants.

Classical implants usually appear as tiny dots, or clusters of dots, on the surface of the organ or ligament on which they have implanted. They are usually only pinhead in size but they may be up to a centimetre or more in diameter. They range in colour from brown to black depending on how much old blood they contain. When magnified they may look like clusters of black grapes.

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