Hey Guys! There’s Another Kind of Headache

"Not tonight dear". We all know what that message means. But there’s a type of pain that isn’t at all questionable and 99.9 percent of males haven’t a clue about it. But can you blame them when so many people have no idea of their own anatomy?

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A recent report in the British journal BMC Family Practice is hard to believe. King’s College researchers asked 722 patients where certain anatomical organs were located. Only 46 percent knew the location of the heart, 31 percent the lungs, 42 percent kidneys, and 38 percent had no idea where the stomach was located. Both sexes scored the same! No one apparently asked where the vagina was located. But in view of this report, it’s small wonder that males and many females have no idea about endometriosis. The diagnosis of endometriosis means bleeding is occurring internally at the same time as the menstrual period. It happens because cells located inside the abdomen have the same structure as cells lining the uterine cavity. How these intrauterine cells get displaced into other locations is debatable. One theory is that blood carries them back through the fallopian tubes during menstruation. Or that uterine cells are transported by blood vessels or the lymphatic system. But when uterine cells bleed so these inside the abdomen. This creates a serious problem. Endometriosis results in blood being trapped inside the abdominal cavity that often causes severe menstrual pain. Internal bleeding can also result in extensive scarring of ligaments at the end of the vagina. And husbands, unaware of the disease or the anatomy, cannot understand why their wives are complaining about so much pain during sexual intercourse. But if Engelbert Humperdink is unable to sing with a sore throat, similarly women can’t enjoy sex with a painful vagina. The diagnosis can be as easy as rolling off a log when pelvic examination shows hard, tender nodules at the end of the vagina. But there can be extensive scarring in this location and it’s not possible to detect this by ultrasound. In order to make a definite diagnosis a laparoscopy exam must be done where a lighted instrument is inserted through the abdominal muscles to see these lesions. Mild cases of endometriosis do not need treatment other than medication to control pain. For others, symptoms can be eased for years by the use of oral contraceptives and other hormones. Today, if surgery is needed, what is done depends on the extent of the disease and whether the patient desires to have children. In extreme situations a hysterectomy is needed. Unfortunately, there now appears to be more to endometriosis than the phrase, "Not tonight dear." Dr. Pamela Stratton, a researcher at the National Institute of Health in Bethesda, Maryland, reported to the American Society of Reproductive Medicine, that endometriosis increases the risk of a number of infections. A survey of 4,000 women who suffered from this disease showed they had seven times the number of upper respiratory infections than those without endometriosis. Dr Stratton reported that even vaginal infections were markedly increased in patients with endometriosis. There was also a slight increase in the risk of developing ovarian cancer. Another surprising finding was an increase in the number of melanomas. Why this happens is not known. But we know that endometriosis is an estrogen-sensitive disease and melanoma is also an estrogen sensitive malignancy. So women who have endometriosis should make sure their doctor does a full body examination to detect any suspicious moles. Dr. Stratton is unable to answer why the presence of endometriosis triggers such a variety of problems. She suggests that endometriosis may be due to genetics or a immune disorder. Her studies show that these patients may also be more prone to chronic fatigue, allergies and other symptoms. And she says that vaginal infections and upper respiratory infections are more common when patients feel run down. I’m sure that not many of today’s men nor women are going to fail a test on where the vagina is located. But I hope that after reading this column males will have a better understanding of why, "Not tonight dear", may be due to more than a headache.