at age 11 or 12. Occasionally even children aged four to five years begin precocious puberty.
Research reported in the Journal of Pediatrics in 1999 noted that girls with the highest prenatal polychlorinated biphenyl (PCB) – oestrogenic pesticide – exposure tended to hit the first stages of puberty a bit earlier than others. In one study, 15 per cent of white girls were showing outward signs of puberty (breast buds and pubic hair growth) by the age of eight. Other research shows that overweight girls tend to mature earlier while very underweight girls mature later.
Early development may be caused by a protein hormone called leptin, produced by fat cells and known to be necessary for the progression of puberty. It functions in a lipostatic pathway and mediates energy production. The presence of leptin reduces appetite and increases energy production. It is possible that leptin and insulin work in a way to balance one another. Those girls who are overweight also have more insulin circulating in their blood, and high levels of insulin stimulates the production of sex hormones from the ovary and adrenal glands. No one has looked at the effects of growth hormones fed to beef and dairy cattle and their breakdown in the human body, so their effects in this area are unknown. But some research suggests that the chemicals used in plastics, like phthalates and bisphenol A – ‘chemical cousins’ to oestrogen – can affect the reproductive systems in animal experiments.1
Of course, such early development can bring endometriosis into the realm of adolescents. Already, one girl of 17 has reported to the author that she has undergone seven laser laparoscopies, and has been on the oral contraceptive pill once, and gonadotrophin-releasing hormone (GnRH) antagonists twice, to put her into a state of menopause, and had a Marina coil inserted – to no avail. A nine-year-old when operated on had her womb and ovaries stuck together with adhesions and active endometriotic implants, having begun her periods at the age of eight. We all have to find a less harsh approach than this for young girls.
There are four kinds of people in the world:
People who watch things happen,
People to whom things happen,
People who don’t know what is happening,
And people who make things happen.
Anon
For some women and young girls, the normal hormone balance becomes disrupted, and ovarian tissue responds by developing abnormally; cysts and tumours may form. This may also be due to chemicals that pollute our world. Cysts appear and disappear all the time. Normal physiological cysts, such as follicular cysts and luteal cysts, are the only ones that are meant to be present and are discussed in chapter 2. The follicular cyst appears from day 1 to day 14 to ripen the ova and release it into the Fallopian tube. The luteal cyst (corpus luteum) appears from day 15 to day 28 and produces progesterone to maintain any possible pregnancy. They are usually 1cm in diameter, appear and are reabsorbed monthly.
When the follicular cyst bursts and releases the ova, it may spew out a small amount of blood, which gives rise to some short sharp pains and inflammation for a few minutes in some women midcycle (known as Mittleschmertz); this is normal. But if the pain is extreme, then something is wrong, and anti-inflammatory agents are needed to reduce the pain and immune support to clear away the debris. If a luteal cyst grows abnormally, it may cause hormonal problems. The excess progesterone may cause an irregularity of the menstrual cycle and stimulate the endometrium, thus altering blood loss.
ABNORMAL CYSTS
Endometrial cysts begin when the follicle does not burst and release an ova, or maybe a corpus luteum fills with blood and continues to grow and fill as the monthly bleed continues, trapping endometrium tissue inside. Endometriomas lie within the ovary or may grow from their surface. They have a wall around them not unlike moss on a stone. The term ‘chocolate cyst’ comes from the stale brown blood that they contain. They may be removed by laser or by aspiration (rupturing with a long needle), but they have been known to return within a few days unless their core has been removed by ovarian resection. Large ones up to 45cm diameter have been known, though most are 4–9cm in size. Strangely, gynaecologists always liken their sizes to fruits such as grapefruit, tangerine, orange or plum. These cysts produce oestrogen and, as such, can ‘feed’ the development of endometriosis. Ovulation can still occur with smaller cysts, though it may be erratic in the presence of excess oestrogen. It has been suggested that the presence of endometriomas alters the ova and may disrupt fertility.
Polycystic ovary cysts, on the other hand, produce more androgen hormones, such as testosterone, and do disrupt ovulation (see pp).
Mucoid cysts are filled with clear mucus not unlike that of the nose, and can come and go within the ovary or be joined to it by a stalk. They are most often benign, but some can become malignant. They show up on scans as being full of dense matter and can grow alongside endometriomas.
Dermatoid cysts are bizarre, as they contain hair, nails and teeth. They can cause pain and need to be removed surgically. They are more unusual and develop if the cells that produce the ovum behave abnormally.2
When any of these cysts goes into torsion – where it twists on its stalk and cuts off the blood supply – great pain may be caused. Large cysts may also rupture, spewing out hot sticky blood or mucus all over the intestines. As bowel tissue is very sensitive and moves away if lightly touched during an operation, this shock of hot inflammatory blood causes the intestinal muscles to go into spasms.
The pain is so intense and terrifying that one wonders how the body can live through such pain. People who have not experienced this can have no idea of the severity of this pain. If we consider that most health professionals may have only ever experienced a severe toothache, it becomes understandable why they may have no idea of what we are talking about. Kidneystone pain may be the nearest agony the pelvic cavity can undergo. Often the body goes into shock and shakes violently, and there may be vomiting and cold sweats rather like standing under a waterfall. The immune system then has to work hard to clear up all the inflammatory debris that has been flung around the peritoneal cavity. Extra macrophages and polymorphs may be found in the fluid as they attempt to clear up the mess.
Some ovarian cysts are symptom-free and may only be found by chance on pelvic examination. Indeed, many women with endometriosis are asymptomatic and their cysts have only been discovered during an operation for sterilization. Sometimes women feel pain during intercourse, and the abdomen may become enlarged and uncomfortable if the cyst is large. The bladder may also be affected by the extra pressure, and urination may become more frequent. The vast majority of cysts are benign and the body is able to reabsorb those that are below 4–5cm in diameter (normal-sized). Larger cysts may require surgery to remove them, though they can recur within a few days in some cases.
New research suggests that cysts may be triggered by a variety of factors. Excess dairy foods, yoghurt and eggs are thought to be involved in cyst formation in some studies using Mormon women as controls. Another study found high copper levels when ovarian cysts are present. The latest research suggests an association with a high intake of refined carbohydrates and sugars. Research shows that B-complex vitamins aid the body in control of excess oestrogen, but excess sugars reduce their ability to work. Reduction of sugars and dairy foods, and an improved intake of B vitamin-rich foods, may help.
SYNDROME X OR INSULIN RESISTANCE
Syndrome X or insulin resistance is hidden and may be life-threatening. It affects body metabolism, and the evidence grows daily that many of us are inflicting it upon ourselves through chronic food intoxification. In the early stages it often goes unnoticed, the symptoms are silent and remain hidden – high blood pressure, raised levels of triglyceride fats in the blood, and insulin resistance (as the body struggles and acquires resistance to the insulin hormone, which normally enables the body to control glucose levels). Insulin is a hormone produced in the pancreas, an endocrine gland, and acts as a messenger between cells. It can affect the follicle of the ovary because it balances the effects of other hormones, including oestrogen, testosterone and glucose tolerance factor.
Insulin