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Endometriosis Glossary, Benign, Endometrium

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Hormones (estrogen or estrogen/progesterone) which are given during a course of GnRH agonist drug treatment for endometriosis to help prevent bone loss and help alleviate other side effects of the GnRH agonists

Adenomyosis

A disease in which the lining of the uterus, the endometrium, grows into the muscular part of the uterus; sometimes known as the 'sister' disease of Endometriosis.

Adhesion

A web-like growths of scar tissue, which is a common cause of pain associated with endometriosis. Adhesions can bind any of the pelvic organs to one another; Adhesions may be caused by surgery and injury as well as endometriosis and commonly causes pelvic pain

Analgesic

A drug that relieves pain. With an effective analgesic, there is an inability to feel pain while still conscious. From the Greek an-, without + algesis, sense of pain.

Anesthetic

A drug used to prevent pain during surgery or other procedures. A general anesthetic makes the person unconscious. A local anesthetic numbs the area where the surgery is to be performed. Local anesthetics may be combined with sedatives to make a person relax and sleepy but not unconscious.

Anastomosis

Surgical connection of tubular bodily structures (bowel, blood vessels), restoring or preserving its function.

Anemia

A low red blood cell count, or a low amount of hemoglobin, caused by heavy menstrual bleeding or other blood loss; the most obvious symptom is fatigue. It can be a common problem with the heavy menstrual blood loss of Endometriosis

Anovulation

Failure to ovulate

Anterior

The front part of an organ - as in anterior of the womb

Antibiotics + Antifungals

Drugs used to kill bacterial or fungal infections

Anticonvulsants

Drugs originally developed to treat epilepsy, but have been found to have other effects on the nervous system and the body's ability to perceive pain

Androgens

Hormones produced in smaller amounts by women - responsible for facial hair and other secondary masculine characteristics. The same effects are caused by specific hormone drug treatment for endometriosis

Benign

An abnormal growth that is not malignant cancer and will not spread to other areas of the body

Biopsy

Removal of tissue for diagnosis. This procedure should be performed during a laparoscopic surgery to obtain a definite diagnosis of endometriosis

Bowel Prep

This is a cleansing of the bowels prior to going into hospital for treatment, so that any treatment can be carried out in safety. It involves changing your diet for a day or two before treatment, and you are given various concoctions to purge your system completely. It is not a pleasant procedure, but does ensure the best outcome for your surgery to be done in safety and minimize any risk of infection

Bowel Resection

A surgical procedure performed when a blockage of the intestines occurs. The procedure removes the portion of the bowel where the obstruction is located. This procedure may be used if endometriosis has affected the bowel.

Breakthrough Bleeding

Irregular vaginal bleeding, like a light period, that can occur when taking hormone drug treatment for endometriosis. This is probably caused by the body trying to overcome the suppressive effects of the hormone drug treatment. Also, a delayed dose of hormone treatment can cause breakthrough bleeding.

CA-125

A marker for ovarian cancer which has been found to be elevated in women with endometriosis even if they do not have cancer


Clomid-Clomidiphene Cirtrate

Estrogen drug used in IVF to induce ovulation

Coagulation

When used to refer to a surgical procedure, coagulation means the destruction of tissue with an electrical current, which is one procedure which may be used during a laparoscopy to destroy the growths of endometrial implants

Colonoscopy

Visualization of the large intestine through a scope, which may be used to check for endometriosis in this region

Coloposcopy

Visualization of the vagina and cervix through a device which greatly magnifies the scope of view

Colostomy

Temporary or permanent connection of the colon to the abdominal wall, allowing stool to be collected in a plastic bag attached to the opening of the abdominal wall

Congenital

Existing at birth - as in the theory that Endometriosis may be inherited

CT scan

Also known as a CAT scan, which stands for stands for 'computerized axial tomography'. Basically, CT scans consist of a highly sensitive x-ray beam that is focused on a specific plane of the body. As this beam passes through the body, it is picked up by a detector, which feeds the information it receives into a computer. The computer then analyzes the information on the basis of tissue density. A picture is then produced on a screen showing a cross-section of the body. Bone appears as white, gases and liquids as black, and tissue as varying shades of grey, depending on ite density. A CAT scan is sometimes used to look for evidence of endometriosis.

Cul-de-sac

A pouch formed by the space between the uterus and the rectum - also known as the Pouch of Douglas which is a prime site for endometriosis

Cyst

A sac or cavity containing liquid, which is the major physical evidence of endometriosis.

Cytoscope

Examination of the wall of the bladder with a thin, lighted probe inserted through the urinary opening

Danazol

A hormone drug treatment for endometriosis. It is a derivative of testosterone. This drug suppresses endometriosis by two separate mechanisms. First it will decrease estrogen production in the ovaries, by suppressing FSH production and LH ovulatory surge. The second mechanism is a direct effect on the implants of endometriosis causing them to shrink. Danazol has side effects including weight gain, hot flashes, increased hair growth and decrease in breast size.

Danazol vaginal suppositories

Vaginal Danazol suppresses endometriosis by absorption directly into the pelvic tissues through the wall of the vagina

Diaphragm

The abdominal diaphragm separates the chest from the abdominal cavity, and endometriosis can be found in this site on occasions

D & C

Dilation and curettage, a scraping of the uterine lining while the cervix is dilated

Dioxin

A toxic chemical found in some paper products, pesticide-treated food, any many other chemical by-products. It is now wide-spread throughout the world and may be linked to endometriosis because of the Xenoestrogenic effect on the body. See Xenoestrogens below.

Dysmenorrhea

Painful periods - the most common symptom of endometriosis

Dyspareunia

Painful or difficult sexual intercourse experienced by a woman. Can be caused in endometriosis if adhesions stick organs together or with large ovarian cysts or internal inflammation.

Dysuria

Painful urination–sometimes a symptom of endometriosis

Ectopic pregnancy

When an ovum is fertilised and begins to develop inside the fallopian tubes; a dangerous condition that can be fatal to a woman if left untreated. Ectopic pregnancy is more of a risk for women with endometriosis

Electrocauthery

A method of sealing vessels and cutting tissue by use of a high-energy electric current

Endo

Short term for endometriosis

Endocrine system

The body's control system that involves interactions between hormones. The word endocrine means internal secretions which act as messengers. Endocrine organs include the hypothalamus, hypocampus, thyroid, parathyroid, thymus, adrenals, ovaries and testes.

Endocrinology

The study of the endocrine glands and the substances they secrete (hormones)

Endometrial ablation

The removal of the endometrium using a variety of procedures including laser, microwave, electric current, or heated fluid and freezing. This is a treatment for heavy menstrual bleeding that permanently stops menstruation and prevents future childbearing.

Endometrioma

A collection of endometriosis in the ovary. This is usually a cystic structure containing fluid resembling chocolate syrup or old motor oil. Also known as a "chocolate cyst".

Endometrium

The inner lining of the uterus. Menstrual flow is derived from the endometrium. After each menstrual period, the endometrium grows to replace the part of the surface that has been lost.

Endorphins

Small molecules secreted by the brain that act as a natural analgesics. e.g. as morphine does in controlling pain. A product of the pituitary gland, they are thought to be concerned with controlling the activity of the endocrine glands. Thiamine is known to be used by endorphins. The increase of endorphins through exercise can help reduce the pain of endometriosis.

Estrogen

Ahormone that regulates the female menstrual cycle. Estrogen is the hormone that 'feeds' the continuing growth of endometriosis.

Excision

To surgically cut out and remove tissue using any surgical tool including a laser

Fallopian tubes

Tubes through which the egg passes from the ovary to the uterus

Follicle Stimulating Hormone (FSH)

The hormone that is released by the anterior pituitary gland that stimulates the ovary to produce follicles and mature eggs. Released in the first 14 days of the cycle. In anovulation FSH levels are deficient.

Gastrointestinal disorders

Disorders that affect the intestines and stomach, causing cramping, diarrhea and/or constipation. Often diagnosed as Irritable Bowel Syndrome (IBS). Endometriosis commonly causes gastrointestinal disorders, and especially IBS.

Gonadotrophins

The hormones (LH and FSH) released from the pituitary gland which stimulate the ovaries to produce follicles and undergo the process of ovulation

Gonadotrophin Releasing Hormone (GnRH)

A hormone produced in the hypothalamus that stimulates the pituitary to produce and secrete gonadotrophins. Its production is dependent on absorption of zinc and vitamin B6.

GnRH

Stands for Gonadotropin-releasing hormone; one of the hormones that regulates the female menstrual cycle

GnRH agonists (gonadotropin-releasing hormone agonists)

A group of drugs which reduce a woman's estrogen levels; these drugs are used to treat endometriosis and reduce the size of fibroids. These drugs prevent ovulation and cause an artificial menopause. They may cause symptoms similar to the menopause, and can also cause bone mineral loss eventually leading to osteoporosis. For these reasons, GnRH agonists are most often a temporary treatment, relieving symptoms until other approaches can take effect.

Harmonic Scalpel

A laparoscopic instrument that uses energy created by sound waves to cut tissues and seal blood vessels. May be used during surgery to treat endometriosis.

Heavy Bleeding

A common symptom of endometriosis. Also known as menorrhagia. Heavy bleeding can be caused by: hormone imbalance, certain prostaglandins, cartain birth control pills, certain anti-inflammatory drugs as well as other gynecological disorders like fibroids.

Hormone receptors

Special proteins on, or in cells to which hormones attach. Attachment (binding) of the hormone to the receptor will cause the endocrine effect of the hormone. Can be disrupted by Xenoestrogen hormones from pesticides and other chemicals. See Xenoestrogens.

HRT

Hormone replacement therapy - used after a total hysterectomy with the aim to restore some hormonal balance in the body and prevent osteoporosis.

Hypermenorrhea

Increased menstrual flow which is common with endometriosis

Hypothalamus

Part of the brain that directs the nervous system and endocrine system through the pituitary gland

Hysterectomy

Surgery for removal of the uterus. During a simple hysterectomy only the uterus and cervix are removed, during a total hysterectomy the uterus and cervix are removed along with the ovaries and fallopian tubes. The more extensive procedure is usually used in cancer treatment and to treat fibroids. Total hysterectomy is too commonly used for the treatment of endometriosis. It is usually misguided information given to women with endometriosis that a hysterectomy will eliminate the disease for good.

Hysterosalpingograph

X-ray with dye injected into the uterus to see if the tubes are obstructed

Hysteroscopic resection

The removal of fibroids from the inner wall of the uterus with a fiberoptic device called a hysteroscope.

Implants

Small, flat patches of endometrial-like cells growing outside the uterus. The main evidence of endometriosis

Infertility

The inability to have children; not being able to achieve pregnancy after one year of regular, unprotected sex, or the inability to carry a pregnancy to a live birth.

Inflammatory reaction

A reaction of the body to trauma, infection, or foreign substances. The purpose of the reaction is to isolate, neutralize or remove it from the body. There is an inflammatory reaction caused by endometriosis implants or growths.

Intravenous

Injection of a substance directly into a vein

Intrauterine

In the uterus (the womb). As opposed to extrauterine: outside the uterus.

Irritable Bowel Syndrome (IBS)

IBS a bowel disorder which can cause abdominal cramps, diarrhea or constipation, and urgency. Irritable bowel syndrome does not cause physical changes in the gut. IBS is very common with endometriosis.

Laparoscopy

This procedure uses a fiber-optic device called a laparoscope to examine the inside of the pelvic cavity. The laparoscope is inserted through a small incision in the abdomen. This is the most common procedure used to diagnose and treat endometriosis.

Laparotomy

Traditional abdominal surgery - the incision is made in the abdominal wall vertically or horizontally. The surgery is performed through these incisions. Recovery takes longer and is more painful. This type of surgery is used if endometriosis is more advanced and the surgeon needs better access to the abdominal cavity

Laser

A laser is an instrument that uses a beam of light (energy) to cut, vaporize and coagulate tissues and seal blood vessels. There are 3 major types of laser used in gynecology - Argon laser - using Argon gas. CO2 laser - the most common, which mixes CO2 to create a laser. YAG laser - produces a beam of energy that can be transported via a flexible fiber.

Laser ablation

One method of destroying endometriosis by utilizing a concentrated beam of light

Luteinising hormone (LH)

A hormone produced by the pituitary which stimulates the corpus luteum to produce progesterone. Released from day fourteen to day twenty eight in the normal hormonal cycle.

Lupron Depot

A GnRH agonist drug used in the treatment of Endometriosis that causes pseudomenopause by suppressing production of FSH and LH hormones. Causes the body to go into a menopausal state with the aim of causing the endometriosis implants to shrink, due to the lack of estrogen. There are many side effects associated with Lupron Depot including the possibility of bone density loss. Women are then given Add-back therapy (see above) of estrogen, in the hope of counter-balancing this problem.

Lupus erythematosus

An autoimmune disease where the body's own immune system attacks its tissue; may cause a skin rash, arthritis and/or damage to the kidneys and cardiovascular system

Luteal phase

The portion of a woman's menstrual cycle between ovulation and menstruation

Macrophage

A wandering immune cell that is found in tissue and blood that can 'eat' bacteria and other 'alien' matter that makes its way into the body

Mirena Coil

The Mirena Coil has started to be used for the treatment of Endometriosis, because the hormone which is released by the coil greatly reduces menstrual blood flow.

The Mirena Coil is an Inter Uterine Device (IUD). IUD's are normally small plastic or metal devices placed inside the uterus. Standard types create a mild inflammation that prevents sperm from fertilizing eggs or fertilized eggs from implanting themselves on the uterine wall.

The Mirena works, instead, by delivering a small quantity of progesterone hormone (20 mcg levonorgestrel) directly on the inner wall of the uterus continuously for five years. The dosage is the equivalent to taking two to three mini-pills a week.

Recently doctors have been treating heavy periods by inserting the Mirena Coil. which can reducing blood flow by 85% within three months. Eventually periods may stop completely.

Myofascial Release Massage

An internal physical therapy technique that can stretch and massage the pelvic muscles to decrease pelvic spasms.

Myomectomy

The surgical removal of a fibroid

Neurectomy

Removal of a specific nerve, usually to treat pain associated with endometriosis

Neurons

Long, branched cells that carry nerve impulses including pain signals

Neuropathic pain

A pain experience different than normal because the ability of the nervous system to perceive pain has been damaged by chronic pain.

Nodule

A small lump or cluster of tissue

Oophorectomy

Surgical removal of the ovaries, which will be performed during a hysterectomy as treatment for severe endometriosis

Opioids

A group of drugs which include morphine and opium that relieve pain and cause sedation, constipation, and slower breathing

Oral contraceptive

Orally administered drugs that are derived from ovarian steroids which interfere with the reproductive process and induce temporary infertility. They disrupt blood chemistry causing vitamin A and copper levels to be raised whilst lowering levels of B vitamins and zinc. Often used to treat endometriosis.

Osteoporosis

A disease in which the bones become thin, porous and break easily. Osteoporosis is a side effect of using specific hormone drug treatment (GnRH agonists) for endometriosis

Ovaries

Female glands that produce eggs and the hormones estrogen and progesterone. A common site for the cysts of endometriosis

Ovarian Cystectomy

This is the removal of an ovarian cyst (fluid-filled collection) from the ovary and then conserving the ovary.

Ovarian Follicle

The normal 'cyst like' structure that forms on the ovary during the menstrual cycle, which contains the developing egg

Ovary

Almond shaped organs lying in the pelvis that produce hormones (estrogen and progesterone) and eggs

Ovarian cysts

A fluid filled sac, one or more of which can develop in the ovary. Most are non-malignant but can reach a very large size and cause gross swelling and pain. In endometriosis, chocolate cysts filled with stale brown blood are common. With polycystic ovaries many cysts develop. High copper levels are related to cyst formation. The birth control pill increases blood copper levels.

Ovulation

The process of expulsion of the egg from the ovarian follicle to the fallopian tube. Occurs around the 14-15th day of a normal cycle.

Oxytocin

A protein derived hormone secreted by the posterior pituitary that stimulates uterine contractions during the birthing process and the release of milk from the breast.

Pap smear/test

Staining test used to detect abnormal cells

PCBs

Polychlorinated biphenyls; chemicals that are now banned in many countries, but are still present in the environment. They were once used in inks, paint, and as additives when making plastics. These chemicals are Xenoestrogens which 'feed' endometriosis.

Pelvic congestion

Dilation (swelling) of the veins in the pelvis causing pressure and pain

Pelvic Inflammatory disease (PID)

A general infection in the peritoneal cavity that can be caused by a variety of bacteria that gain entrance into the peritoneal cavity through the female reproductive tract from poor hygiene or infected male sperm. The disease is associated with flu like symptoms and adhesions leading to infertility. Often given as a mis-diagnosis to the symptoms of endometriosis.

Peritoneal Cavity

The lower abdomen (belly) which contains the reproductive tract, bladder,kidneys and adrenals, small and large intestine, liver, pancreas and stomach. Endometriosis can be scattered all over the peritoneal cavity

Peritoneal Fluid

The fluid found in the peritoneal cavity

Peritoneum

The thin membrane that covers the pelvis and abdomen walls, as well as the pelvic organs

Peyers Patches

Clusters of cells found on the small intestine that are involved in the immune system. They act as testing stations for 'alien' food particles, bacteria, parasites, chemicals etc. It is the peyers patch that is thought to react favorably to Castor Oil pack treatments to help alleviate the pain of endometriosis.

Phytoestrogens

Plant based compounds that act like estrogen in the body and are found in many foods we eat. Many different plants produce compounds that may mimic or interact with estrogen hormones. At least 20 compounds have been identified in at least 300 plants from more than 16 different plant families. Referred to as phytoestrogens, these compounds are weaker than natural estrogens and are found in herbs and seasonings (garlic, parsley), grains (soybeans, wheat, rice), vegetables (beans, carrots, potatoes), fruits (dates, pomegranates, cherries, apples) and drink (coffee). Phytoestrogens differ a great deal from synthetic environmental estrogens (Xenoestrogens) in that they are easily broken down, are not stored in tissue and spend very little time in the body.

Pituitary

Endocrine gland at the base of the brain that secretes a variety of hormones many of which affect other endocrine glands. The major hormones of the pituitary that affect the reproductive system are Follicle Stimulating Hormone (FSH), Luteinising Hormone (LH) and prolactin. The pituitary is divided into the anterior (front) and posterior (back) pituitary. Known as the conductor of the endocrine orchestra. Known to use vitamin B6 and zinc.

Polycystic Ovarian Syndrome(PCOS)

Simultaneous formation of many cysts on both ovaries. Can be present along with endometriosis.

POPs - Persistent Organic Pollutants

This is a generic title for chemicals found in the environment which do not break down by natural processes. The word ‘organic’ is used because they are carbon based.

There are many of these substances in use, which then enter the environment. The best known are PCBs and Dioxin. See Xenoestrogens.

Pouch of Douglas

The blind pouch that makes the bottom of the peritoneal cavity. It lies between the vagina and the colon and below the left ovary. Also called the 'cul-de-sac' area of the peritoneal cavity. It is a prime site for endometriotic implants.

Premarin

Conjugated estrogens obtained from the urine of pregnant mares used for HRT. The method of collecting the mares urine forces the mare to be tied up continuously in her stable with a bag tied to her rear end to collect the urine.

Presacral neurectomy

A surgical procedure in which nerves at the back of the uterus are severed in an attempt to eliminate or reduce pain associated with endometriosis

Proctosigmoidoscopy

Insertion of a lighted tube to search for tumors, polyps or endometrial tissue in the lower bowel

Progesterone

A female steroid sex hormone which prepares the endometrium of the uterus for pregnancy and is required for the maintenance of pregnancy. Secreted by the corpus luteum in the ovary once conception has taken place to prepare the womb lining and placenta. Maintains the pregnancy and prevents release of further eggs from the ovary.

Progesterone Cream

A laboratory produced compound that acts like human progesterone and helps to alleviate the symptoms of Endometriosis, PMT and menopause.

Progestogens

Synthetic chemicals, mostly made from plant sources, which are used to shrink endometrial tissue. They are used as an endometriosis treatment but can have severe side effects.

Prostaglandins

Naturally-occurring substances that cause the uterus to contract and are responsible for period cramps and possibly the pain of endometriosis.

Pseudomenopause

A hormonal drug induced state of menopause. Used as a drug treatment for endometriosis to stop the menstrual cycle and shrink endometrial implants.

Rectovaginal septum

The wall separating the rectum and the vagina

Resection

The surgical removal of an organ or other structure

Retroflexed

Tilted backward, usually in reference to the uterus

Retrograde bleeding

The backward flow of menstrual discharge through the fallopian tubes into the pelvis, which occasionally occurs during a woman's period. Has been thought to be the cause of endometriosis

Retroverted

Tilted forward, usually in reference to the uterus

Salpingectomy

Surgical removal of a fallopian tube

Scar tissue

Tissue formed in the body's attempt to repair damaged tissue. Scar tissue will develop with adhesions of endometriosis.

Sigmoidoscopy

A procedure that enables the physician to examine the lining of the rectum and a portion of the colon by inserting a flexible tube that is about the thickness of 1 cm into the anus and advancing slowly into the rectum and lower part of the colon.


Spinal cord

The bundle of nerves inside the spinal column that carry nerve impulses to and from the brain

Staging

The various classifications of endometriosis based on the severity of the disease

Suction evacuation

Removal with a suction device of the ovarian cysts of endometriosis

T Cells

A type of cell that helps the immune system; also known as helper T-cells, which switch the immune system on and suppressor T-cells which switch the immune system off

Thoracic Endometriosis

Endometriosis in the thorax or chest cavity. The two most common areas are either deep in the lung tissue or on the pleura, the tissue surrounding the lungs

Thoracentesis

A search for endometrial blood in the lungs through a small puncture in the wall of the chest

Thyroid Stimulating Hormone (TSH)

The hormone secreted by the pituitary that stimulates the thyroid gland to produce thyroxine

Thymus

A ductless gland that is found under the breast bone. It doubles in size by puberty and shrinks thereafter. Functional tissue becomes replaced by fatty tissue. Involved with the early development of the immune system and the main production site for T-lymphocytes which migrate from bone marrow to mature in the thymus (white blood cells associated with anti-body production). Zinc dependent organ.

Thyroxine

The major hormone secreted by the thyroid. Thyroxine regulates general metabolism. Requires iodine, riboflavin, vitamin B2, selenium, and vitamin E for its formation. Is an antagonist with estrogen. If estrogen is too high thyroxine will be low and visa versa.

Tilted (tipped) uterus

A tilted uterus is a general term that refers to a uterus that's tipped backward (retroverted) instead of normally forward on the cervix. Doctors may also call this a tipped uterus.

In most cases, this is a normal anatomical variation. It causes no signs or symptoms and needs no treatment. In the past, it was thought that a tilted uterus may contribute to infertility. But this isn't true. Rarely, a sharply tilted uterus may be due to disease such as endometriosis. In this case, endometriosis — not the position of the uterus — may cause infertility.


Transvaginal surgery

Surgery where the incision is inside the vagina; transvaginal surgery may be used for surgery that affects the bladder such as stress incontinence

Trigger points

Painful areas on the body caused by referred pain.

Tumor

A mass of cells that may be benign or cancerous. The mass of cells or cysts of endometriosis are not cancerous.

Ultrasound

An ultrasound is used to visualise soft body tissues by directing high frequency sound waves. The 'echoes' produce an on-screen image. Thicker tissue appears lighter on the ultrasound screen. This procedure is sometimes used to try and diagnose endometriosis, but is not very reliable as endometriosis may be present as microscopic implants that cannot be picked up by the ultrasound.

Urethral syndrome

Pain and inflammation of the urethra, the tube which carries urine out from the bladder

Urinary tract disorders

Disorders of the urinary tract causing painful urination, frequent urination, and/or urine leakage, such as cystitis. Sometimes confused with the symptoms of endometriosis on the bladder.

Uterosacral ligaments

Ligaments that attach the uterus and cervix to the base of the spine. Can often be the location of endometriosis cysts or growths

Uterus

The female organ that holds and sustains the fetus

Vaporization

One way to surgically treat endometriosis by destroying endometrial tissue with a laser or electrosurgical knife

Visceral

Pertaining to the internal organs

Xenoestrogens

Chemically based compounds that enter the body and can act like or interfere with the body's own estrogen hormones. Most xenoestrogens enter the body via the food chain with the use of herbicides, pesticides, industrial pollution washing onto pasture land which is then consumed by live-stock. The most widespread toxin on the planet, Dioxin, also mimics the action of estrogen. These xenoestrogens are also produced by chemicals found in toiletries. Xenoestrogens will have an adverse affect on endometriosis as they will feed the growths of endometriosis by acting like estrogen in the body.

Yam Cream

A plant based cream containing extracts of wild yam. Has been advertised and promoted to assist with estrogen dominance and endometriosis. However, research has found that the compounds in this cream are unable to convert into any useful properties in the body for serious health problems. Yam cream may be beneficial for the skin. Many women have though yam cream and progesterone cream are the same thing, but they are not.

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