Reader’s Choice : Letrozole & Endometriosis

Bottle of Letrozole
Photo courtesy of JLD

One of my local EndoWarriors has started a new medication to help with her Endometriosis pain and symptoms, based upon the recommendation of her new physician.  It’s Letrozole, which I had never heard of.  And she asked me if I had any info on it…so…now I’m inspired to do some research!

What is Letrozole?

Letrozole is the generic name for Femara, a drug classified as an aromatase inhibitor.  What is aromatase?  It’s an enzyme that is crucial in the creation of estrogen. Aromatase inhibitors have been FDA approved for treating breast cancer in post-menopausal patients.  However, it has piqued the interest of the medical community in controlling Endometriosis symptoms.  It is not yet FDA approved for this treatment, but is used as an off-label, accepted treatment among the medical community. As of today’s research, there are no indications that drug manufacturers are going to seek FDA approval for aromatase inhibitors to treat Endometriosis.

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Endometriosis and Infertility

fertility goddess figurine

Many women with Endometriosis also suffer from infertility.  Why? Well, that very question spawned today’s research…

It is believed that Endometriosis is present in 24-78% of infertile women (depending on who you ask).  That’s a huge figure! Infertility associated with Endometriosis may occur at any state of the disease (I to IV; mild to severe).  It’s believed that the Stage of Endo may effect the rate of infertility:  people with “mild” Endo have been known to conceive 2-4.5% per month; people with moderate to severe Endo drop to less than 2%.  Normal, fertile couples conceive at a rate of 15-20% per month.  It’s a big difference all across the board.

The medical and scientific community do not have answers as to why Endo may make women infertile; only theories:

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Reader’s Choice : Can Men Get Endometriosis?

Male symbol

Last night, my boyfriend and I were talking about Endo’s “weirdness” how it can pop up in strange and unheard of places, and he popped the question (no, not THE question…), “Are there any reports of men having Endometriosis?”  I remembered reading somewhere that there were a few rare cases of it, but hadn’t read them deeply enough to understand their situations, diagnoses, and prognoses.  So, we have our topic for today!!

In rare cases, cis-men develop Endometriosis.  Transmen also suffer from the disease. But we will focus on cis-men for this blog: it appears many have been treated with long-term or large doses of estrogen therapy, but some are healthy men who have no history of cancer or estrogen treatment.  Here’s what I could find:

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New Study : Endometriosis and Semen

New unwrapped condom

So there’s an article that was recently published that has a lot of the EndoCommunity in an uproar today on Facebook.  The article was title, “How your sex life may influence endometriosis,” published on May 1, 2015, by MedicalXpress. My initial knee-jerk reaction last night was to be furious.

I interpreted the article as saying that sex can cause and affect Endometriosis growth; to be more precise: seminal fluid can affect Endo growth.  Semen.  Baby-MoJo.  I’ve had my Endo pain since my early years in high school.  And I did not have sex until I was 21.  And my cramps were pretty damn bad back then.  How dare a study suggest that sexual activity had anything to do to heighten my endo symptoms or progression.   And my outrage was further fueled by others’ reactions about the same conclusion.

I’ve decided to take my time, read the study slowly, and try to digest what it is the study is trying to tell us. Wait. Step back. Breathe, breathe.  Relax.  Now go read the study…

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Sugar!!! ALL THE SUGAR!

Evaporated Cane Juice Crystals

Today we’ll be talking more about the “Endo Diet,” particularly why we’ve been told to cut out as much processed sugars as possible.  I’ve read that sugar may cause or aggravate inflammation, but it’s time to dig deeper and find the scientific backing to these claims.

What is Inflammation?

Inflammation, when needed, fights bacteria and infections, repairs damaged tissue, and helps our bodies heal faster from injury or illness.    Cells and proteins whiz to the injury or infection site and begin to surround, protect, and heal.  However, like the old saying goes: all things in moderation.  Too much or excess inflammation can actually damage our bodies.  Chronic inflammation may overwhelm or body rendering it unable to maintain a healthy balance and may lead to clogged arteries, stroke, heart disease, asthma, lupus, or a multitude of chronic illnesses.

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Age Doesn’t Matter!

five-generations4

So I was curious.  I’ve been reading that the usual age women are diagnosed with Endometriosis is in their 20s and 30s, sometimes after years of misdiagnoses and tests.  But, what’s the age of the youngest and oldest person ever recorded to have been diagnosed with Endometriosis?  Aaaaand….Google!

Youngest:

There are conflicting sources for the youngest age:  I’ve seen 8, 10 (diagnosed just after her second period), 11, and 13 years old.  Even though the vast internet has conflicting ages, I’m very shocked at how young these girls were.  I didn’t even start my period until I was about 13 or 14 years old (I should find that date in my old diaries…). I cannot imagine being that young and suffering with this disease.  And imagine the psychological and social effects it must have on those poor girls at that age.

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Birth Control Pills & Endo

a round white pill that reads The Pill

I’ve been advised that once my Lupron Depot treatments are concluded in January, I will be starting a continuous birth control pill.  This is in the hopes to continue to suppress my monthly period, and theoretically my Endometriosis symptoms.  Endometriosis is “fed” by our Estrogen levels.  Doctors may not know what causes Endo, but they mostly agree that it feeds and reacts to our Estrogen levels, as well as the influence of xenoestrogens (environmental estrogens).

But How & Why is it expected to work?  I totally like to know the science behind things…

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EndoInvasion : Stages

A stage with the Bloomin' Uterus logo centered on it in a spotlight
Our Uterus : center stage!

So there are four “Stages” of Endometriosis.  It’s the doctors way of categorizing the depth of the EndoInvasion in our bodies.  It was developed by the American Society of Reproductive Medicine.   Diagrams of the various stages can be in an article published in Fertility & Sterility back in 1997.

I didn’t know my Stage level and had to ask my doctor.  My Endometriosis was Stage 4, the most severe it can get. Probably because it was brewing inside me undetected for nearly 2 decades. Ugly disease. (Update: As of June 6, 2019, I’ve now had a total of four excision surgeries; each one classified my illness as Stage 4).

The interesting things about Stages: the Stage Level doesn’t necessarily dictate our symptom or pain levels.  Someone with Stage 1 can have severe pain, while someone with Stage 4 may not even realize it.  Just one more mystery o’Endo.

So what are these Stages?  Here ya go:

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