Common Diseases in Women

PCOD

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PCOD is a problem in which a woman’s hormones are out of balance. It can cause problems with your periods and make it difficult to get pregnant. PCOS also may cause unwanted changes in the way you look. If it isn’t treated, over time it can lead to serious health problems, such as diabetes and heartdisease.

Most women with PCOS grow many small cyst on their ovaries. That is why it is called polycystic ovary syndrome. The cysts are not harmful but lead to hormone imbalances.

Early diagnosis and treatment can help control the symptoms and prevent long-term problems.

Hormones are chemical messengers that trigger many different processes, including growth and energy production. Often, the job of one hormone is to signal the release of another hormone.

For reasons that are not well understood, in PCOS the hormones get out of balance. One hormone change triggers another, which changes another. For example:

  • The sex hormones get out of balance. Normally, the ovaries make a tiny amount of male se hormones (androgens). In PCOS, they start making slightly more androgens. This may cause you to stopovulating, get acne, and grow extra facial and body hair.
  • The body may have a problem using insulin, called insulin resistance When the body doesn’t use insulin well, blood sugar levels go up. lsr leveOver time, this increases your chance of getting diabetes.

The cause of PCOS is not fully understood, but genetics may be a factor. PCOS seems to run in families, so your chance of having it is higher if other women in your family have it or have irrgular periods or  diabetes. PCOS can be passed down from either your mother’s or father’s side.

Symptoms tend to be mild at first. You may have only a few symptoms or a lot of them. The most common symptoms are:

  • acne.
  • weight gain and trouble loosing weight
  • Extra hair on the face and body. Often women get thicker and darker facial hair and more hair on the chest, belly, and back.
  • Thinning hair on the scalp.
  • irregular periods Often women with PCOS have fewer than nine periods a year. Some women have no periods. Others have very heavy bleeding.
  • Fertility problems. Many women who have PCOS have troublegetting pregnant (infetility)
    To diagnose PCOS, the doctor will:

    • Ask questions about your past health, symptoms, and menstrual cycles.
    • Do a physical exam to look for signs of PCOS, such as extra body hair and high blood pressure .The doctor will also check your height and weight to see if you have a healthy body mass index.
    • Do a number of lab tests to check your blood sugar ,insulin, and other hormone levels. Hormone tests can help rule out thyroid or other gland problems that could cause similar symptoms.

    You may also have a pelvic ultrasound to look for cysts on your ovaries. Your doctor may be able to tell you that you have PCOS without an ultrasound, but this test will help him or her rule out other problems.

    Regula excercise, healthy foods, and weight contarerol the key treatments for PCOS. Treatment can reduce unpleasant symptoms and help prevent long-term health problems.

  • .
    • Try to fit in moderate activity and/or vigorous activity often. Walking is a great excercise that most people can do.
    • Eat heart-healthy foods. This includes lots of vegetables, fruits, nuts, beans, and whole grains. It limits foods that are high in saturated fat, such as meats, cheeses, and fried foods.
    • Most women who have PCOS can benefit from losing weight. Even losing 10 lb (4.5 kg) may help get your hormones in balance and regulate your menstrual cycle.
    • If you smoke, consider quitting. Women who smoke have higher androgen levels that may contribute to PCOS symptoms.

    It can be hard to deal with having PCOS. If you are feeling sad or depressed, it may help to talk to a counselor or to other women who have PCOS.

Leukorrhoea

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leucorrhoea  is a thick, whitish or yellowish vaginal discharge. There are many causes of leukorrhea, the usual one being oestrogen imbalance. The amount of discharge may increase due to vaginal infections or STD and also it may disappear and reappear from time to time, this discharge can keep occurring for years in which case it becomes more yellow and foul-smelling; it is usually a non-pathological symptom secondary to inflammatory conditions of vagina or cevix

Leukorrhea can be confirmed by finding >10 WBC under a microscope when examining vaginal fluid.

Vaginal discharge is not abnormal, and causes of change in discharge include infection, malignancy, and hormonal changes. It sometimes occurs before a girl has her first period, and is considered a sign of puberty.

Physiologic leukorrhea

It is not a major issue but is to be resolved as soon as possible. It can be a natural defense mechanism that the vagina uses to maintain its chemical balance, as well as to preserve the flexibility of the vaginal tissue. The term “physiologic leukorrhea” is used to refer to leukorrhea due to estrogen stimulation.[5]

Leukorrhea may occur normally during pregnancy. This is caused by increased bloodflow to the vagina due to increased estrogen. Female infants may have leukorrhea for a short time after birth due to their in-uterine exposure to estrogen.

Inflammatory leukorrhea

It may also result from inflammation or congestion of the vaginal mucosa. In cases where it is yellowish or gives off an odor, a doctor should be consulted since it could be a sign of several disease processes, including an organic bacterial infection (aerobic vaginitis) or STD

After delivery, leukorrhea accompanied by backache and foul-smelling lochia(post partum vaginal discharge, containing blood, mucus, and placental tissue) may suggest the failure of involution (the uterus returning to pre-pregnancy size) due to infection. A number of investigation such as wet smear, Gram Stain, culture, pap smear and biopsy are suggested to diagnose the condition.

Parasitic leukorrhea

Leukorrhea is also caused by trichomonads, a group of parasitic protozoan, specifically Trichomonas vaginalis. Common symptoms of this disease are burning sensation, itching and discharge of frothy substance, thick, white or yellow mucous.

Endometriosis

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Endometriosis (en-doe-me-tree-O-sis) is an often painful disorder in which tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus (endometrial implant). Endometriosis most commonly involves your ovaries, bowel or the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond your pelvic region.

 In endometriosis, displaced endometrial tissue continues to act as it normally would — it thickens, breaks down and bleeds with each menstrual cycle. Because this displaced tissue has no way to exit your body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions — abnormal tissue that binds organs together.

Endometriosis can cause pain — sometimes severe — especially during your period. Fertility problems also may develop. Fortunately, effective treatments are available.

 The primary symptom of endometriosis is pelvic pain, often associated with your menstrual period. Although many women experience cramping during their menstrual period, women with endometriosis typically describe menstrual pain that’s far worse than usual. They also tend to report that the pain has increased over time.
 Common signs and symptoms of endometriosis may include:
      • Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before and extend several days into your period and may include lower back and abdominal pain.
      • Pain with intercourse. Pain during or after sex is common with endometriosis.
      • Pain with bowel movements or urination. You’re most likely to experience these symptoms during your period.
      • Excessive bleeding. You may experience occasional heavy periods (menorrhagia) or bleeding between periods (menometrorrhagia).
      • Infertility. Endometriosis is first diagnosed in some women who are seeking treatment for infertility.
      • Other symptoms. You may also experience fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods.

The severity of your pain isn’t necessarily a reliable indicator of the extent of the condition. Some women with mild endometriosis have extensive pain, while others with advanced endometriosis may have little pain or even no pain at all.

Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID) or ovarian cysts. It may be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation and abdominal cramping. IBS can accompany endometriosis, which can complicate the diagnosis.

When to see a doctor

See your doctor if you have signs and symptoms that may indicate endometriosis. The cause of chronic or severe pelvic pain may be difficult to pinpoint. But discovering the problem early may help you avoid unnecessary complications and pain.

Although the exact cause of endometriosis is not certain, several possible explanations include:

      • Retrograde menstruation. This is the most likely explanation for endometriosis. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These displaced endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle.
      • Embryonic cell growth. The cells lining the abdominal and pelvic cavities come from embryonic cells. When one or more small areas of the abdominal lining turn into endometrial tissue, endometriosis can develop.
      • Surgical scar implantation. After a surgery, such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision.
      • Endometrial cells transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.
      • Immune system disorder. It’s possible that a problem with the immune system may make the body unable to recognize and destroy endometrial tissue that’s growing outside the uterus.
      • Several factors place you at greater risk of developing endometriosis, such as:
        • Never giving birth
        • One or more relatives (mother, aunt or sister) with endometriosis
        • Any medical condition that prevents the normal passage of menstrual flow out of the body
        • History of pelvic infection
        • Uterine abnormalities

        Endometriosis usually develops several years after the onset of menstruation (menarche). Signs and symptoms of endometriosis end temporarily with pregnancy and end permanently with menopause, unless you’re taking estrogen.

        Infertility

        The main complication of endometriosis is impaired fertility. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant.

        For pregnancy to occur, an egg must be released from an ovary, travel through the neighboring fallopian tube, become fertilized by a sperm cell and attach itself to the uterine wall to begin development. Endometriosis may obstruct the tube and keep the egg and sperm from uniting. But the condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg.

        Even so, many women with mild to moderate endometriosis can still conceive and carry a pregnancy to term. Doctors sometimes advise women with endometriosis not to delay having children because the condition may worsen with time.

        Ovarian cancer

        Ovarian cancer does occur at higher than expected rates in women with endometriosis. But the overall lifetime risk of ovarian cancer is low to begin with. Some studies suggest that endometriosis increases that risk, but it’s still relatively low. Although rare, another type of cancer — endometriosis-associated adenocarcinoma — can develop later in life in women who have had endometriosis

Irregular Period

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Menstruation is the time of month when the womb (uterus) sheds its lining and vaginal bleeding occurs. This is known as a menstrual period.

Periods vary widely from woman to woman. Some periods are punctual, some are unpredictable. On average, a woman gets her period every 24 to 38 days. A period usually lasts about two to eight days. Irregular bleeding may require treatment.

What Are Irregular Periods?

You may have irregular menses  if:

  • The time between each period starts to change.
  • You are losing more or less blood during a period than usual.
  • The number of days that your period lasts varies significantly.

There are different terms for different types of irregular periods:

  • Irregular Menstrual Bleeding (IrregMB): Bleeding of more than 20 days in individual cycle lengths over a period of one year.
  • Absent Menstrual Bleeding (amenorrhea): No bleeding in a 90-day period.
  • Heavy Menstrual Bleeding (HMB): Excessive menstrual loss that interferes with the woman’s physical, emotional, social, and material quality of life and can occur alone or in combination with other symptoms.
  • Heavy and Prolonged Menstrual Bleeding (HPMB): Less common than HMB. It is important to make a distinction from HMB given they may have different etiologies and respond to different therapies.
  • Light Menstrual Bleeding: Based on patient complaint, rarely related to pathology.

 

Do Irregular Periods Need Treatment?

Treatment of irregular periods depends on the cause and your desire to have children in the future. Irregular periods can be caused by many different things. Changes in your body’s level of the hormones oestrogen and progestrone can disrupt the normal pattern of your period. That’s why young girls going through puberty and women approaching menopause commonly have irregular periods.

Other common causes of irregular periods include:

  • Having an intra uterinedevice (IUD)
  • Changing birth control pills or using certain medications
  • Excessive exercises
  • Polycystic ovary disease (PCOS)
  • Pregnancy or breastfeeding
  • Stress
  • Oveactive thyroid or hyperthyroidism
  • Thickening of or polyps on the uterine lining
  • Uterine fibroids

A less common cause is severe scarring (adhesions) of the lining of Usually, no treatment is needed for irregular periods caused by puberty and menopause unless they are excessive or bothersome. It is also normal for your period to stop when you are pregnant.

Treatments for irregular periods due to other causes may include:

  • Correcting or treating underlying disease
  • Changing your type of birth pill
  • Lifestyle changes, including weight loss
  • Hormone therapy
  • Surgery

Here are some treatment options:

Treating underlying disease. It is important to treat any underlying diseases that cause irregular periods. If you have irregular periods, your doctor will run blood tests to check hormone levels and thyroid function.

Poly cystic (PCOS) and hypothyroidism are two common causes of irregular periods in women. In general, the goal of treatment is to restore the balance of hormones in the body. Women with PCOS may be given birth control pills or other hormones to trigger a period. If they wish to get pregnant, infertility medications may be prescribed. Hypothyroidism is treated with supplementation of thyroid hormones.

Changing birth control- If you have irregular periods after three months of hormonal birth control, your doctor may recommend another type of birth control.  Read the literature that accompanies your IUD to learn more about side effects.

Lifestyle changes. Some women have changes in their period because they exercise too much. Reducing the frequency and intensity of your workouts may help your period return to normal. Stress leads to many body changes, including irregular periods. Relaxation techniques and counseling may be helpful.

Extreme changes in your weight can affect your periods. Weight gain can interfere with the body’s ability to ovulate, which controls your menstrual cycle. Losing weight may help resolve irregular periods. Extreme sudden weight loss can also lead to infrequent or irregular periods.

Fibroid

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Fibroids are the most frequently seen tumors of the female reproductive system. Fibroids, also known as uterine myomas, leiomyomas, or fibromas, are firm, compact tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus. It is estimated that between 20 to 50 percent of women of reproductive age have fibroids, although not all are diagnosed. Some estimates state that up to 30 to 77 percent of women will develop fibroids sometime during their childbearing years, although only about one-third of these fibroids are large enough to be detected by a health care provider during a physical examination.

In more than 99 percent of fibroid cases, the tumors are benign (non-cancerous). These tumors are not associated with cancer and do not increase a woman’s risk for uterine cancer. They may range in size, from the size of a pea to the size of a softball or small grapefruit.

What causes fibroid tumors?

While it is not clearly known what causes fibroids, it is believed that each tumor develops from an aberrant muscle cell in the uterus, which multiplies rapidly because of the influence of estrogen.

Who is at risk for fibroid tumors?

Women who are approaching menopause are at the greatest risk for fibroids because of their long exposure to high levels of estrogen. Women who are obese and of African-American heritage also seem to be at an increased risk, although the reasons for this are not clearly understood.

Research has also shown that some factors may protect a woman from developing fibroids. Some studies, of small numbers of women, have indicated that women who have had two liveborn children have one-half the risk of developing uterine fibroids compared to women who have had no children. Scientists are not sure whether having children actually protected women from fibroids or whether fibroids were a factor in infertility in women who had no children. The National Institute of Child Health and Human Development is conducting further research on this topic and other factors that may affect the diagnosis and treatment of fibroids.

What are the symptoms of fibroids?

Some women who have fibroids have no symptoms, or have only mild symptoms, while other women have more severe, disruptive symptoms. The following are the most common symptoms for uterine fibroids, however, each individual may experience symptoms differently. Symptoms of uterine fibroids may include:

  • Heavy or prolonged menstrual periods
  • Abnormal bleeding between menstrual periods
  • Pelvic pain (caused as the tumor presses on pelvic organs)
  • Frequent urination
  • Low back pain
  • Pain during intercourse
  • A firm mass, often located near the middle of the pelvis, which can be felt by the physician

In some cases, the heavy or prolonged menstrual periods, or the abnormal bleeding between periods, can lead to iron-deficiency anemia, which also requires treatment.

How are fibroids diagnosed?

Fibroids are most often found during a routine pelvic examination. This, along with an abdominal examination, may indicate a firm, irregular pelvic mass to the physician. In addition to a complete medical history and physical and pelvic and/or abdominal examination, diagnostic procedures for uterine fibroids may include:

  • X-ray. Electromagnetic energy used to produce images of bones and internal organs onto film.
  • Transvaginal ultrasound (also called ultrasonography). An ultrasound test using a small instrument, called a transducer, that is placed in the vagina.
  • Magnetic resonance imaging (MRI). A non-invasive procedure that produces a two-dimensional view of an internal organ or structure.
  • Hysterosalpingography. X-ray examination of the uterus and fallopian tubes that uses dye and is often performed to rule out tubal obstruction.
  • Hysteroscopy. Visual examination of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.
  • Endometrial biopsy. A procedure in which a sample of tissue is obtained through a tube which is inserted into the uterus.
  • Blood test (to check for iron-deficiency anemia if heavy bleeding is caused by the tumor).

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