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Padma Lakshmi Sheds Light on Endometriosis

By Kara Mayer Robinson

padma lakshmi barkha

As the Emmy-nominated host of Bravo TV’s Top Chef, the television series in which amateur chefs compete for the winning title, Padma Lakshmi samples an abundance of gourmet food, from goat cheese ravioli to five-layer wedding cake. Her co-stars and fellow judges, chef Tom Colicchio and culinary expert Gail Simmons, nibble too — but not nearly as much.

“Tom and Gail come in for the main challenge,” says Lakshmi, 48, who’s also a producer of the series, now in its 16th season. “But I eat double what they eat because I’m there every day for the quick-fire challenge.”

While this may seem like a major job perk, for Lakshmi — who’s also an author, entrepreneur, and former model — it’s a challenge. She has endometriosis, a painful gynecological disorder in which the tissue that lines the inside of the uterus grows outside of it, in places like the ovaries, fallopian tubes, and other organs.

“When you have endometriosis, you don’t want to eat heavily because everything is inflamed,” she explains.

About one in 10 American women have endometriosis, a common cause of infertility. During each menstrual cycle, tissue builds up, breaks down, and bleeds, leading to very painful menstrual cramps, chronic lower back and pelvic pain, painful sex, bleeding, diarrhea, constipation, bloating, and nausea.

In the early days of Top Chef, before she had treatment, Lakshmi needed a toolbox of resources to get through the day. “We used to plug in my heating pad under the judges’ table. When I was standing, as the camera would pan away from me, I’d sit down — I had a little wooden box my assistant would drag on set with me. After the first few seasons, I got a dressing room so I could lie down on a couch,” Lakshmi says. “I don’t know if I could’ve continued to do Top Chef for 12 years if I didn’t get the help I needed.”

Unfortunately, help didn’t come quickly or easily.

Pervasive Pain

What started as cramps at age 13 got worse over time. “I was bedridden for several days a month with headaches, cramping, severe dysmenorrhea [painful periods], nausea, numbness, lower back pain, digestive issues, moodiness, swelling, and bloating — and when I say swelling, I mean a full cup size every month,” she says.

Continued

For years, she wondered why she couldn’t handle what other women seemed to take in stride. Maybe I’m exaggerating, she thought. Maybe I’m crazy. Maybe I’m being a sissy.

“I didn’t feel like having sex, so it affected my romantic relationships. I was embarrassed to call in sick, so I wouldn’t take modeling jobs when my period was due,” she says. “It locked me out of my own life.”

Endometriosis is more than just painful periods and potential infertility,” says Ken Sinervo, MD, medical director of the Center for Endometriosis Care in Atlanta. “It can significantly and negatively impact all aspects of an individual’s quality of life — from schooling to career to relationships.”

Lakshmi tried birth control to manage cramps, but it only helped a little. Her gynecologist prescribed painkillers, but they made her feel nauseated and triggered headaches. For 23 years, nobody, including a doctor who removed an ovarian cyst, referred her to a specialist to look for a medical condition that caused her problems.

This is surprisingly common. Even though an estimated 176 million women worldwide have endometriosis, doctors often normalize or dismiss symptoms, creating a long delay in diagnosis, says Sinervo.

On a particularly rough day in 2006, Lakshmi was doubled over in pain and rushed to the hospital. Doctors performed surgery to remove what they thought was scar tissue but was actually endometrial tissue blocking her small intestine. Though they told her she’d likely be fine, her symptoms returned a month later.

Finally, a doctor suggested seeing a specialist, and after decades of pain, Lakshmi learned she had endometriosis. “Dr. [Tamer] Seckin was the first one to really give it a name,” she says. “He didn’t think I was crazy — he listened to me.”

While endometriosis has no cure, treatment can ease symptoms and boost a woman’s chances of getting pregnant. Drug therapy can help with symptoms, but surgery to remove endometriosis patches is often more effective and may improve fertility.

Lakshmi had laparoscopic excision surgery in 2006, and her doctors found more than they expected. “Tissue was all over my fallopian tubes, my ovaries, everything,” she says. “I had stitches on major organs and 19 biopsies — 17 came back positive for endometriosis.”

She had a long recovery. “I was bedridden from Thanksgiving to the first week in February,” she says. Later, in 2007 and 2009, she had two more laparoscopic surgeries. “It wasn’t until a year after that I really healed enough to see what life was like for a normal woman,” she says.

Continued

Call to Action

As Lakshmi thought about how long she’d suffered, her relief morphed into anger. Why wasn’t she diagnosed sooner? Why didn’t her doctors know her pain wasn’t normal? Why wasn’t anyone speaking out about this disease?

She realized endometriosis was largely under the radar — and because of her visibility as a celebrity, she was in a unique position to do something. In 2009, she partnered with Seckin, her surgeon, to create the Endometriosis Foundation of America (EndoFound), which advocates for patients, raises awareness, and funds research.

As co-founder, she talks about endometriosis openly and extensively. She gives lectures at schools, private companies, and universities like the Massachusetts Institute of Technology, where she’s now a visiting scholar and works with research scientists on understanding the interplay between diet, nutrition, and health.

“Padma remains a force of nature to motivate our team of scientists working on endometriosis,” says Linda Griffith, PhD, director of MIT’s Center for Gynepathology Research, adding that Lakshmi’s ongoing visits — she’s been doing them since 2009 — have inspired many MIT students.

She also encourages politicians to include endometriosis awareness in sex education programs at the state level and ensure medical schools teach all doctors, not just gynecologists, about the disease.

Her advocacy extends beyond EndoFound: She’s an ACLU ambassador, focusing on women’s reproductive health and immigration issues, and she believes women’s health issues will get the attention they deserve if we have more women in higher positions in government, universities, hospitals, and pharmaceutical companies.

Life Goes On

In 2009, knowing about one in two women with endometriosis have fertility problems, Lakshmi decided to freeze her eggs. But soon after, she unexpectedly became pregnant. In 2010, she delivered a healthy baby girl, Krishna, who just turned 9. “She’s in third grade and just won the election for student council in her class,” Lakshmi says.

They live in New York City, where they like to cook, roller-skate, and hang out with Krishna’s father, Adam Dell, whom Lakshmi says she’s “dating again but not getting married or anything.” (The couple had been separated.)

Continued

Their days often begin around 6:30 a.m. and end relatively early. “I’m so busy with Krishna that it’s rare that I stay awake past 11 — and I used to have parties that started at 11,” she says with a laugh.

Her endometriosis symptoms still linger. “I get migraines, I have cramps, but it’s nowhere near as bad as it used to be,” she says. She does acupuncture and uses heat for lower back pain. “If you stop me in any airport and look in my bag, there’s an electric heating pad,” she says. When filming Top Chef, she sips tea to soothe cramps and stocks up on heat wraps, which she hides under clothes — inside jeans or under tights.

Lakshmi eats well, which comes naturally. “Obviously if you’ve seen the show ever, you know I have to be quite omnivorous,” she says, “but I grew up lacto-vegetarian.” She eats a lot of legumes and beans and avoids wheat, sugar, alcohol, and fried foods. When she’s home with Krishna, it’s 50% fruits and vegetables, 25% starches, and 25% lean protein.

Exercise depends on symptoms. When she doesn’t feel well, she avoids things like Pilates, which she says worsens her pain. On her worst days, working out is a tall order. “But I do spend a lot of time at the gym,” she says. “I think that has to do with my vanity and my occupational hazard of having to eat so much.”

When you see Lakshmi on Top Chef, critiquing a chef’s technique or a dish’s flavor profile, she may not strike you as someone who’s comfortable sharing personal details about her body. She’s just so cool and composed.

“It was not my wish to get up in front of a room and talk about my vagina,” she says, admitting it was hard at first. “But I had to step up. I just want young women to know they’re not alone. When you have endometriosis, you’re shut out. It’s like a prison. I feel like I’ve finally unlocked and kicked away the chain that’s been invisibly wrapped around my ankle for all these decades.”

Continued

Get the Facts

Like Padma Lakshmi, roughly 6.5 million women in the U.S. have endometriosis.

Some other facts:

Endometriosis is the leading cause of hysterectomies. About 40% of women with infertility have endometriosis. On average, a woman has symptoms for 10 years before getting an accurate diagnosis.

Scientists don’t know what causes endometriosis, but they think it may have something to do with menstrual flow problems, genetics, immune system issues, hormones, or surgery. Endometriosis may be linked to allergies, asthma, chemical sensitivities, autoimmune diseases, chronic fatigue syndrome, fibromyalgia, and certain cancers, like breast cancer and ovarian cancer.

When you have endometriosis as a teen, it’s more likely to get worse over the years. If you have a close relative who has endometriosis, you’re five to seven times more likely to have it.

You’re also more likely to get endometriosis if:

  • You don’t have children.
  • Your periods last more than seven days.
  • Your menstrual cycle is typically less than 28 days.
  • You have a health problem that blocks the normal flow of blood when you have your period.

Many doctors recommend treating endometriosis with laparoscopic surgery, or LAPEX, because it’s effective and minimally invasive.

Find more articles, browse back issues, and read the current issue of WebMD Magazine.

Sources

SOURCES:  

Padma Lakshmi, Endometriosis Foundation of America.

Linda Griffith, Center for Gynepathology Research, Massachusetts Institute of Technology.

Ken Sinervo, MD, Center for Endometriosis Care.

American College of Obstetricians and Gynecologists: “It’s Time We Talk About Endometriosis.”

Endometriosis Foundation of America: “Endometriosis A-Z.”

Mayo Clinic: “Endometriosis.”

Office on Women’s Health: “Endometriosis.”

© 2019 WebMD, LLC. All rights reserved.

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FDA Approves New Drug for Endometriosis Pain

July 24, 2018 — The FDA has approved elagolix (Orilissa), the first drug developed for the treatment of moderate to severe pain from endometriosis.

The FDA approved elagolix under priority review. It is expected to be available in the U.S. next month.

Elagolix represents a “significant advancement for women with endometriosis and physicians who need more options for the medical management of this disease,” Michael Severino, MD, chief scientific officer for AbbVie, the maker of elagolix, says in a news release.

Data from two studies of nearly 1,700 women with moderate to severe endometriosis pain supported the FDA’s approval.

In the studies, elagolix reduced the three most common types of endometriosis pain: daily menstrual pelvic pain, nonmenstrual pelvic pain, and pain with sex, AbbVie says.

The company says that elagolix can reduce bone mineral density. Loss of bone mineral density is greater the longer the drug is used and may not be completely reversible after stopping treatment.

The drug should be taken by mouth at roughly the same time each day, with or without food.

“Endometriosis is often characterized by chronic pelvic pain that can impact women’s daily activities,” Hugh Taylor, MD, study investigator from Yale University School of Medicine in New Haven, CT, says in the release. “Women with endometriosis may undergo multiple medical treatments and surgical procedures seeking pain relief, and this approval gives physicians another option for treatment based on a woman’s specific type and severity of endometriosis pain.”

Medscape Medical News

Sources

Medscape: “FDA Clears Elagolix (Orilissa) for Endometriosis Pain.”

© 2018 WebMD, LLC. All rights reserved.

WebMD Health

Breast-Feeding Linked to Lower Endometriosis Risk

By Mary Elizabeth Dallas

HealthDay Reporter

FRIDAY, Sept. 8, 2017 (HealthDay News) — Women who breast-fed at least one child appear to have a lower risk for developing endometriosis, new research suggests.

Endometriosis is a chronic and often painful condition that occurs when the lining of the uterus grows outside of the reproductive organ on the fallopian tubes, ovaries or another area.

“We found that women who breast-fed for a greater duration were less likely to be diagnosed with endometriosis,” said study author Leslie Farland. She is a research scientist at Brigham and Women’s Hospital in Boston.

“Given the chronic nature of endometriosis and that very few modifiable risk factors are currently known, breast-feeding may be an important modifiable behavior to reduce the risk of endometriosis among women after pregnancy,” Farland said in a hospital news release.

The study involved thousands of women who participated in the Nurses’ Health Study II. That study began in 1989, and the women were tracked for two decades. The researchers found that during this time, nearly 3,300 of the women were diagnosed with endometriosis after giving birth to their first child.

The research team then focused on breast-feeding behavior among the women. Specifically, the researchers considered how long the women nursed their infants, when they introduced solid food or formula, and how much time passed before their first postpartum period.

The women’s risk for endometriosis fell by 8 percent for every three additional months they breast-fed after each pregnancy, the findings showed. Their risk dropped 14 percent for every extra three months of exclusive breast-feeding after each pregnancy.

The researchers also looked at a woman’s lifetime risk. Women who exclusively breast-feed for a cumulative 18 months or more during their reproductive years (which may include multiple pregnancies) have a nearly 30 percent lower risk for endometriosis, the study found.

The temporary pause in periods while women are breast-feeding shortly after birth may partially explain their lower risk for endometriosis, the study authors suggested. The hormonal changes associated with breast-feeding could also play a role.

Continued

However, it’s not entirely clear if women who breast-feed are less likely to develop endometriosis or if they are just less likely to become symptomatic and seek out a surgical evaluation to confirm the diagnosis.

“Our findings lend support to the body of public health and policy literature that advocates for the promotion of breast-feeding,” Farland said.

“Our work has important implications for advising women who are looking to lower their risk of endometriosis. We hope that future research will illuminate whether breast-feeding could help lessen the symptoms of endometriosis among women who have already been diagnosed,” she added.

About 10 percent of women in the United States are affected by endometriosis, the researchers said. Symptoms of the condition include pain in the lower part of the belly, painful periods and pain during sex.

The study was published recently in the BMJ.

WebMD News from HealthDay

Sources

SOURCE: Brigham and Women’s Hospital, news release, Aug. 30, 2017

Copyright © 2013-2017 HealthDay. All rights reserved.

WebMD Health

Breast-Feeding Linked to Lower Endometriosis Risk

FRIDAY, Sept. 8, 2017 — Women who breast-fed at least one child appear to have a lower risk for developing endometriosis, new research suggests.

Endometriosis is a chronic and often painful condition that occurs when the lining of the uterus grows outside of the reproductive organ on the fallopian tubes, ovaries or another area.

“We found that women who breast-fed for a greater duration were less likely to be diagnosed with endometriosis,” said study author Leslie Farland. She is a research scientist at Brigham and Women’s Hospital in Boston.

“Given the chronic nature of endometriosis and that very few modifiable risk factors are currently known, breast-feeding may be an important modifiable behavior to reduce the risk of endometriosis among women after pregnancy,” Farland said in a hospital news release.

The study involved thousands of women who participated in the Nurses’ Health Study II. That study began in 1989, and the women were tracked for two decades. The researchers found that during this time, nearly 3,300 of the women were diagnosed with endometriosis after giving birth to their first child.

The research team then focused on breast-feeding behavior among the women. Specifically, the researchers considered how long the women nursed their infants, when they introduced solid food or formula, and how much time passed before their first postpartum period.

The women’s risk for endometriosis fell by 8 percent for every three additional months they breast-fed after each pregnancy, the findings showed. Their risk dropped 14 percent for every extra three months of exclusive breast-feeding after each pregnancy.

The researchers also looked at a woman’s lifetime risk. Women who exclusively breast-feed for a cumulative 18 months or more during their reproductive years (which may include multiple pregnancies) have a nearly 30 percent lower risk for endometriosis, the study found.

The temporary pause in periods while women are breast-feeding shortly after birth may partially explain their lower risk for endometriosis, the study authors suggested. The hormonal changes associated with breast-feeding could also play a role.

However, it’s not entirely clear if women who breast-feed are less likely to develop endometriosis or if they are just less likely to become symptomatic and seek out a surgical evaluation to confirm the diagnosis.

“Our findings lend support to the body of public health and policy literature that advocates for the promotion of breast-feeding,” Farland said.

“Our work has important implications for advising women who are looking to lower their risk of endometriosis. We hope that future research will illuminate whether breast-feeding could help lessen the symptoms of endometriosis among women who have already been diagnosed,” she added.

About 10 percent of women in the United States are affected by endometriosis, the researchers said. Symptoms of the condition include pain in the lower part of the belly, painful periods and pain during sex.

The study was published recently in the BMJ.

More information

The U.S. National Institutes of Health has more on the benefits of breast-feeding.

Posted: September 2017

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Drugs.com – Daily MedNews

Sunscreen Ingredient Linked to Endometriosis

Study Ties a Common Ingredient in Sunscreens, Nail Polishes, and Lotions to Endometriosis

WebMD Health News

May 11, 2012 — Certain chemicals that are widely used in sunscreens and other products because they protect against UV light are associated with an increased risk of developing the gynecological condition endometriosis, a new study shows.

But the Personal Care Products Council, a group that represents cosmetics manufacturers, called the study “weak” and “unconvincing” and said it shouldn’t scare people away from safe sun practices, including sunscreen use.

Sunscreen Ingredient May Mimic Estrogen

The study, which is published in Environmental Science & Technology, measured concentrations of five kinds of chemicals called benzophenones in the urine of more than 600 women who were evaluated for endometriosis.

Benzophenones are used in a variety of products because they protect against UV light. In small amounts, that helps to stabilize the formulations of products that are stored in clear containers, like nail polish. At higher concentrations, and when they are applied to the skin, they are powerful sunscreens.

Endometriosis is a painful condition that occurs when tissue from the inside of the uterus grows outside of the uterus. When this tissue grows in other parts of the body, typically spilling into the abdomen around the ovaries or fallopian tubes, it behaves as if it were still in the uterus, thickening and shedding each month in sync with a woman’s menstrual cycle. Endometriosis can lead to scarring and infertility.

Studies estimate that about 1 in 10 women have the condition, and some research suggests that it is becoming more common.

Benzophenones are easily absorbed through the skin. Studies by the CDC have found benzophenones in the urine of 97% of people tested.

Scientists are concerned about benzophenones because the body may mistake them for hormones.

“These compounds are estrogenic. They mimic estrogen in the body,” says researcher Kurunthachalam Kannan, PhD, a professor of public health and environmental health sciences with the New York State Department of Health’s Wadsworth Center in Albany.

Kannan says benzophenone-3, which appears on sunscreen labels as oxybenzone, is even more strongly estrogenic than bisphenol-A (BPA), a chemical found in certain plastics that’s recently been the subject of regulatory scrutiny.

The cause of endometriosis is not known, but the condition is fed by the female hormone estrogen. Treatment sometimes involves taking medications that lower estrogen levels.

Study Ties Benzophenones to Endometriosis

Overall, the study found that only one kind of benzophenone, a chemical known as benzophenone-1, was significantly associated with the risk that a woman would have endometriosis.

Women with the highest amounts of benzophenone-1 in their urine had a 65% greater chance of having endometriosis compared to women with the lowest levels.

Benzophenone-1 is a chemical additive that’s mostly used in nail polishes, according to the cosmetics industry web site CosmeticsInfo.org, but it also forms when the body breaks down oxybenzone, the major ingredient in sunscreen.

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