About Health & Medicine

Endometriosis affected regularly menstruating women before Homo sapiens discovered how to control tire or chip a block of stone into a working wheel. Though we have no way of knowing how earliest woman coped with menstrually related distress. We might guess that she believed the cause was cosmologies and out of her control. The early Egyptians, who created one of the most advanced cultures four and five thousand years ago, were diligent recorders of history, astronomy, and science. It was they who for the first time made reference to a “painful disorder of her menstruation,” duly noted on the Papyrus Ebers from the year 1600 B.C.

We are without further medical identification of the disorder until 1696, when the French surgeon Saviard noted the presence of endometrial tissue outside the uterus. Then in 1835 another French doctor, Jean Cruveilhier, described uterine cysts. Twenty-five years later. Dr. K. von Rokitansky, a German doctor, published the first paper on the disease, referring to it as an “adenomyoma,” now called adenomyosis, or endometriosis confined entirely to the muscle wall of the uterus. At the turn of the century, two American doctors further described degrees of the disease, but it was not until 1921 that Dr. Sampson, as noted earlier, recorded his theory of how endometrial tissue implants on internal organs.

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Comments (0) May 08 2009

Luteinised unruptured follicle syndrome, usually known as LUF syndrome, occurs when the ovarian follicle matures and prepares itself for ovulation but at the time of ovulation the follicle fails to rupture and release the ovum.

LUF syndrome is very hard to detect because the usual methods of determining whether or not ovulation has taken place, such as basal body temperature charts and measuring progesterone levels in the second half of the cycle, all indicate that ovulation has occurred. It can only be reliably detected by inspecting the follicle during a laparoscopy or by measuring the size of the follicle during repeated ultrasound scans. In the past many researchers thought that the LUF syndrome was a major cause of infertility in women with endometriosis. However, now many researchers believe that it does not play a significant role and some believe that the LUF syndrome is probably just a random event which occurs in most women from time to time.

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Comments (0) May 08 2009

In the past it was often claimed that endometriosis could be prevented if women had frequent pregnancies early in their reproductive life. But it is now well documented that early and frequent childbearing does not necessarily protect a woman from developing endometriosis as many women have been diagnosed after they have had their children.

So far, gynaecologists and researchers have not been able to find a way of preventing endometriosis because no one knows precisely the causes or what factors influence its development or who it affects.

There is a considerable amount of research being carried out which is attempting to identify the possible factors that may increase or decrease a woman’s risk of developing endometriosis. To-date, none of the results have been sufficiently consistent for any conclusions to be made. In the future it may be possible to identify those women and girls who are most likely to develop endometriosis and to offer them advice regarding the things that they could do to reduce their risk of developing the condition.

Eventually, when more is known about what determines how — and why — the misplaced endometrium implants in some women and not others, it may also be possible to find ways to prevent endometriosis from occurring altogether or at least to prevent recurrences of the condition. For example, it may be possible to develop a vaccine against the condition or to develop drugs which cure the condition permanently.

Lyn’s story

It came as something of a shock when I was told in December 1986 that I had endometriosis — a shock because I had never heard of ‘endometriosis’.

Coming from a family of eight children I suppose I just assumed fertility would never be a problem.

Thinking back now, I am sure I developed endometriosis when I was about 16 — about two years after I started menstruating. I would get severe cramps on the first two days of my period, usually requiring me to stay home from school tucked up in bed with my faithful hot waterbottle.

I remember waking one night in such severe pain I could hardly walk. I staggered to the bathroom, thinking I had a severe bout of diarrhoea. For two hours I suffered hot flushes and pain which, although I have never experienced childbirth, came with the irregularity of labour pains. I remember staggering out of the bathroom and fainting much to the horror of my father.

You see, he was a jockey and his small five foot frame was no match for my larger, heavier and limp body. Much to his credit, he was able to carry me to bed!

The next morning my mother took me to our local doctor. After describing the symptoms, he told us I had probably experienced a twisted bowel which had ‘corrected itself. His solution for my painful periods was to put me on the pill.

For the next 10 years I went on and off the pill. I didn’t think it was too healthy to stay on the pill for such a long stretch but each time I took a break, the cramping periods would be back as bad as ever. It was easier to stay on the pill and enjoy a relatively painless cycle.

In 1985 my husband and I decided it was time to start a family. I just presumed that the first month off the pill would result in the expected pregnancy.

When this didn’t eventuate, I was given the usual advice: ‘Try not to think about it dear’, ‘Your job is too stressful’, ‘Just relax!’.

Six months later I had another attack of what I thought was a twisted bowel. Again I went to a doctor and again he confirmed that it was a twisted bowel which had corrected itself. I mentioned to him that I was having difficulty becoming pregnant. His answer was that as I was only 25,1 shouldn’t worry. He said he would not recommend seeing a specialist for another two years.

Neither my husband nor I were happy with that suggestion and we decided to see another doctor. As luck would have it, a girl I went to school with was working as a GP near our home. I went to her, told her my symptoms and had an appointment with a gynaecologist two weeks later. That’s when the fun really started. On my first visit, he did an internal examination and told me I was very tender on my right side. Who wouldn’t be tender when someone is tugging at your ovaries!

He suspected an ectopic pregnancy and sent me to have blood tests and an ultra-sound, both of which confirmed I was not pregnant. I was then booked in to have a laparoscopy and this revealed I had severe endometriosis.

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Comments (0) May 08 2009

We need fibre to keep our bowels healthy and prevent constipation but fibre is also vital for our fertility.

The fibre contained in whole grains, fruit and vegetables reduces excess oestrogen levels, clearing out old hormone residues. It does this by preventing oestrogens that have been excreted in the bile from being reabsorbed back into the blood.

Studies have shown that women who eat a vegetarian diet excrete three times more ‘old’, detoxified oestrogens than women who also eat meat. The meat-eaters also reabsorb more oestrogen. So, for both men and women aiming to keep their reproductive systems in optimum balance, it makes sense to ensure that you are getting enough fibre in your diet.

Contrary to popular belief, the best way to do this is not to add bran to your food. Whatever you may have read or heard about its benefits, bran can actually block the absorption of vital nutrients such as iron, zinc, calcium and magnesium. It is much better to eat it in its natural form (as whole grains) instead.

To increase your fibre intake, you need to eat plenty of fresh fruit and vegetables (cooked and raw), whole grains (brown rice, whole meal bread, oats, wholegrain crackers and whole meal pasta), beans, nuts and seeds.

You should also avoid refined carbohydrates (such as cakes, white bread and biscuits, and anything containing white flour and sugar). Don’t be tempted to eat bran on its own or when added or made into breakfast cereal.

It is important for your bowels to work efficiently so that ‘old’ hormones can be quickly excreted and also so that food does not end up putrefying (which it may do if it stays in your bowel too long). Proper bowel function also helps you get rid of chemicals, pesticides, heavy toxic metals and other toxins that can affect your fertility.

I have found that even patients diagnosed with high lead levels, caused by daily commuting to work through London, soon start to get rid of the excess lead once they are on a healthy, high-fibre diet.

Help for constipation

What can you use instead of bran? First try increasing your intake of fresh fruit and vegetables. If you need extra help then either sprinkle 1 tablespoon of linseeds onto your breakfast cereal in the mornings or soak 1 tablespoon of linseeds in a small amount of “water and swallow. Vitamin Ñ can also be used to help soften stools. Try taking l,000 mg per day, and increase by 500mg at a time until your stools are manageable, soft and comfortable.

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Comments (0) Apr 23 2009

Life is a continuous process: a roller coaster ride with ups and downs and changes of direction. Some parts are tranquil; some are exhilarating; some are frightening. Many people fear old age.

Middle age and old age have no definite boundaries. Middle age is generally taken to be from 45 to 65 years, though you may wake on your 65 th birthday feeling no different or even better than you did on your 50th. If you’re over 65, you’ll be counted in the statistical category of ‘elderly’ because you’re over retirement age, but you may feel just as good at 75 as you did at 65 years of age.

We’re always hearing that people are living longer these days. Since the start of this century, the mean human life span in developed countries has been prolonged by 27 years. However, there has been no change in the maximum duration of life. All living things have a finite life span, and biologists have estimated that human cell lines are unlikely to last much longer than around 90 years. In a population free of accidents, suicides, nutritional shortages and infectious diseases, the majority of people would live into their eighties before cancer, heart disease or stroke eventually carried them off.

The physical changes that progress during any life are inevitable. Our human bodies go through many changes over the years, though their rate and sequence car be different from one person to the next.

Some physical changes that are programmed into our genes (particularly those associated with reproduction such as puberty and the menopause) have profound physiological consequences that develop over a relatively short time span and around the same age for all people.

Other normal changes of ageing happen very slowly and gradually so that we barely notice them. Most of the change: of ageing don’t spoil our enjoyment of life because we can adjust and live comfortably with them, or because they are, to a certain extent, correctable.

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Comments (0) Mar 12 2009

If you think you could have caught an STD, go to your doctor or an STD clinic immediately. The sooner STDs are diagnosed and treated, the better for everybody.

The checkup should include the doctor taking a thorough history of your sexual activities and your use of drugs (if any) as well as an examination and tests. HIV infection may be the most unlikely STD you could have caught. Make sure that tests are taken for chlamydia, gonorrhoea, syphilis and hepatitis B. If you’re due for a Pap smear this might be a good time to have one. If you’re still changing partners you should ask your doctor about having a hepatitis В vaccination.

You may feel angry at a partner whom you think has given you an infection. Your feelings may be justified if it turns out that he knew he was at risk. But wait to hear his side of the story. He may not know that he’s infected. There’s not much to be gained from resentment after the event. It’s often impossible to tell who infected whom. The important thing is for you both to be treated (as well as anyone else with whom either of you has had sex).

Contact tracing

If you’ve had only one partner ever, you can be pretty sure where your infection came from. If you’ve had more than one you won’t know, and you must speak to each one. How far back you go will depend on advice from your doctor. It can be very hard to front up to a partner and admit that you have an STD, especially if you think you may have caught it from someone else. But you must be honest.

Otherwise the infection will continue to spread, perhaps back to you.

STD clinics have counsellors to advise you how best to break the news and who will help to contact anyone else who may be at risk. If you can’t face the idea or don’t want to reveal your condition to a previous partner, the counsellor can do the job for you at your request.

Comments (0) Mar 12 2009

Endometriosis is a distressing condition. Dealing with your emotional reactions can be as difficult as coping with the symptoms. Even before the diagnosis is made, women become anxious and frustrated. What is causing the symptoms? Is your doctor taking them seriously? Are you neurotic? Could it all be in your head? (No! It’s all in your pelvis!) Are your family and friends getting fed up with you because you’re so often unwell and out of action? Also, many women feel more restrained about telling people that they’re not well because of menstrual problems than because of, say, earache.

There’s often a sense of relief when diagnosis gives the symptoms a name, though further frustration soon follows when you discover that there’s no certain cure for the disease. You may feel anger (why me?) and guilt (have I done something to deserve this?), or depressed because the future seems bleak.

If pain makes you avoid sex you’ll be missing out on one of the good things of life, and you’ll also have to cope with your partner’s reaction: some men are wonderfully supportive but others feel rejected and the relationship can fall apart. And if infertility is a problem, there are all the complex emotional reactions to that disappointment.

Some of the side-effects of treatment don’t do much for your self-esteem: most women are unhappy if they develop acne, gain weight, the voice deepens or they have menopausal symptoms (though of course not everyone does).

One development in the past decade that can really help sufferers of endometriosis is the establishment of support groups. These groups can be found in the capital cities of every State and in some large country centers. They offer emotional support and counselling for women with endometriosis and their families, plus full information about services, treatments and research in endometriosis. Contact the Endometriosis Association (Victoria), 37 Andrew Crescent, Croydon, Vic. 3136 for information about groups in your district.

Understanding of endometriosis is growing, new hormonal treatments are on the horizon and surgical techniques are constantly improving. The prospects for relief of symptoms and improved fertility are very much better now than they were 30 years ago, and let’s hope that the future brings a cure.

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Comments (0) Mar 12 2009

Treatment

When I was a medical student, all we had was gentian violet for painting the vaginal walls; something you can’t do yourself. This treatment worked, but slowly: several visits for repainting were needed to be sure of a cure.

Treatment is easier today. Some very effective antifungal medications have been developed over the past 30 years. Most of these are not absorbed from the bowel, so must be used locally as pessaries or cream. Many different creams, pessaries and tablets are available. If you prefer to use pessaries or tablets in your vagina, get some cream as well to apply to your genital skin and give some to your partner for use on his penis.

Treatment for a week is prescribed most commonly, but more concentrated pessaries for one or three days can be effective in some cases. It’s very important to complete the full course of treatment, even if your symptoms disappear in а day or two.

Some of the newest antifungals are absorbed into the blood from the bow are effective against fungal infection anywhere in the body. The oral antifungals are more likely to have side-effect they can’t be used during pregnancy or breast-feeding) so they are generally used only in cases that haven’t responded to local treatment.

Why do some women gel repeated attacks?

Some women seem to be particularly prone to vaginal thrush, and will attack every time they become run down, stressed, or take antibiotics, and sometimes for no apparent reason, these women have lower resistance to the fungus and can only keep it at bay in the very best circumstances.

Recurrent thrush, like anything makes sex painful, can really disturb sexual relationships. No matter how standing and patient your partner must frequently say ‘No’ to sex your genitals are sore, tensions are bound to develop.

If you get repeated attacks your doctor should check to rule out all of all sources of reinfection (your nails, bow skin; your partner) and also to make sure that you have no other illnesses often associated with recurrent thrush, such as diabetes.

If antibiotics usually bring on an attack, it may be wise to use vaginal antifungals while you’re taking them.

Women who’ve had frequent recurrences are often advised to take a course of the new oral treatment and at the same time to begin local treatment with pessaries or cream, which is continued for three or four weeks. This should get rid of any hidden sources of vaginal reinfection.

Comments (0) Mar 12 2009

This can be achieved by taking steps to maintain strong, healthy bones. The most important influences on bone health are exercise, diet and hormones. If any one of these factors is inadequate either when bones are growing to their peak mass during puberty or during any stage of adult life, bone strength suffers.

Exercise

Women tend to take less exercise as they
get older. The physical demands of child-raising and housekeeping are less than we think, and jobs are often sedentary. Also, until recently our society has rather discouraged physical activity in women of middle age and beyond. Rest was considered to be more beneficial than exercise and strenuous activities were thought to be ‘unladylike’. Many women over the age of 70 are now suffering the consequences of this attitude.

To maintain healthy bones you must continue regular weight-bearing exercise from puberty throughout adult life. This means moving around on your feet, sun as in walking, running, tennis and golf. (Swimming is not a weight-bearing exercise, though it is beneficial in many other ways.) A brisk walk of 2 kilometers more at least every second day would good for your bones, as well as reducing: your risk of heart disease. Unlike Eliza Doolittle, resolve never to ride if you car possibly walk (this includes lifts). But though it is important in slowing the rate of bone loss after middle age, exercise alone won’t prevent osteoporosis.

Diet

Exercise maintains bone density only m dietary calcium is adequate. Women past menopause need 1000-1500 mg of calcium per day. You’ll get this amount from a liter of milk or its equivalent in milk products. Dairy produce is the best source of calcium, but many people avoid milk products in an attempt to reduce the content of their diets. All low-fat dairy ducts (except cottage cheese) are excellent sources of calcium.

Dairy-marketing authorities have produced excellent information leaflets, which you can find in your local doctor’s or hospital’s waiting room, in any health centre and even in the supermarket. These leaflets list the calcium content of other foods as well as milk products, so that if you
don’t like or can’t tolerate milk and cheese you can get your daily requirements from such calcium-rich foods as small fish (for example, canned salmon and sardines where you eat the bones), shellfish, broccoli, spinach, sesame seeds and many others.

I’m sure that most people would prefer to get their nutritional requirements from food rather than from tablets, but if you fee1 that you can’t get enough calcium from your diet, ask your doctor about
supplements. It’s possible to overdose on calcium supplements, so follow your doctor’s or the manufacturer’s dosage instructions carefully. It’s unlikely that you could get too much calcium from food, except that high-calcium diets can be harmful in the rare problem of calcium-containing urinary stones.

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Comments (0) Mar 12 2009

During your first pregnancy you’ll get heaps of information about what to expect in labour, so I won’t add another description to your collection. As well as your antenatal classes you’ll learn about labour from books, films, your doctor, family and friends. Information and advice often comes from surprising sources: your hairdresser; people in the queue at the post office; strangers at the bus stop; everyone wants to tell you about their own experience, and you’ll hear many different stories.

Not long to go

During the final couple of weeks of pregnancy, you’ll notice some changes that warn you that the big day is near.

• The top (fundus) of your uterus moves down in your abdomen as the baby’s head usually moves further down in the pelvis and stays there (engaging of the head), and because the amount of amniotic fluid decreases (‘lightening’). People will remark ‘You’ve dropped. Not long now’. Engaging of the head brings changes to how you feel: some good and some not so good. The ‘drop’ takes the pressure off your ribs and makes breathing easier, but it can throw your centre of gravity further forward and put more strain on your back.

The head in the pelvis leaves little’ for the bladder to fill, so you’ll need to pass urine more frequently. Other changes will develop.

• Foetal movements lessen because there’s less room for your baby to move

• Braxton-Hicks contractions become stronger and more frequent.

• There’s often mild diarrhoea during the last few days.

• Many women mention a burst of energy when the head engages. They busily check that everything’s in readiness for going to hospital and for bringing home the new baby.

• You may feel excited, restless and impatient, especially if you’ve passed your EDD.

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Comments (0) Mar 11 2009