Health Niche

Wanting a child is a basic need for many women. After months or years of trying to conceive without success, the unhappy couple seeks medical advice. In about 1/3 of the cases the problem is caused by the woman’s infertility. In 1/3 of the cases the male partner is the one with fertility issues.

The remaining 1/3 is a mixed bag of women’s, men’s and unknown factors. Checking for the reasons of infertility can be a long tedious process. Usually tests of fertility are first conducted using blood work and in the man, semen testing. The doctors will look at overall health, hormonal levels in both woman and man, and any evidence of infection. From there, the woman will undergo a complete physical.

Looking at the issues of irregular periods or none at all, very painful periods, pelvic inflammatory disease and having more than one miscarriage are all necessary in the detective work to find the reason for a woman’s infertility.

In most cases of the woman’s infertility, the major cause is lack of ovulation. The fallopian tubes have not released an egg to be fertilized. This can be caused by a fallopian tube blocked by infection or inflammation. The cause could also be a fallopian tube blocked by scar tissue from an ectopic pregnancy (a pregnancy that occurs inside the fallopian tube which requires surgical intervention).

The fallopian tube could become blocked if the woman suffers from endometriosis (a condition where tissue from the lining of the womb migrates outside the uterus). There is a home ovulation kit available at most drug stores that can provide the answer to whether ovulation is taking place. 

Other common reasons for a women’s infertility are age (about 20% of the women in the US wait until after age 35 to attempt to conceive), being over or underweight, stress, alcohol, sexually transmitted diseases and tobacco smoking. For every year over age 30, a woman’s chances of becoming pregnant, and carrying a child to term decrease rapidly.

While looking at all the possible causes, a complete diet history is collected to be sure the woman is eating correctly. Research has found that eating just 4 grams of trans fats a day can increase chances of becoming infertile by 70 to 100 percent. This is the amount of trans fats in a single donut. The trans fats prevent ovulation. Instead of the label reading trans fats, it may say ‘hydrogenated or partially hydrogenated’ oils. That is the same thing. 

Other reasons for infertility can be fibroid tumors in the uterus. While benign, they can create a block to the progress of the egg to sperm. Also, the uterus may be tipped toward the back, like a limp balloon, closing off entry to the sperm. The sperm may not be strong enough to enter the egg itself. The number of sperm may be reduced due to various health problems. The mucus quality in the vagina may impede the sperm.

There are many reasons for lack of conception however a large number can be successfully treated through various medicines. Sometimes it is necessary to undergo surgery before conception is possible, as in the case of a blocked fallopian tube. 

Heart Disease is the narrowing or blocking of the coronary arteries, the blood vessels that supply blood to the heart. This is Coronary artery disease and it happens very slowly over time. Men are more likely to get Coronary artery disease and other heart related diseases. While it is true that women are still not as badly affected as men, heart disease is certainly not a strictly male province. Today, heart disease is the leading cause of death of American Women. More than 366,000 women in America die every year of heart disease. In UK, almost one in six women dies of heart disease.

Many doctors, who as late as in the 1980s did not even really believe that women developed heart disease, still over look uniquely women heart disease risks, sometimes even to the point of misdiagnosing or dismissing women’s heart attacks while they are happening.

Two widely believed myths persist that only men have heart disease and that women are at risk only in old age. The truth is that at least 1.2 million women live with heart disease and this figure is rising. One may even be surprised to learn that more than 20,000 women under the age of 65 have heart attacks each year. And while heart attack rates for men are falling, rates for women are on the rise. Death rates from heart attack are generally declining but they are declining at a slower rate for women than for men.

Women play down their own risk. Menopause is a defining moment for women and Heart Disease. Before menopause, a woman’s naturally high oestrogen levels protect her heart. After the menopause, women have higher cholesterol levels, which may increase their risk of heart disease, especially if their level of triglycerides which is another type of fat particle in the blood is raised too. In general, women who have high levels of triglycerides (over 3.0mmol/l) and low HDL ‘Good Cholesterol’ (under 1.2mmol/l) have greater risks for heart disease than do men with similar levels. 

The causes of heart disease are different for women. For example, Type 2 Diabetes increases heart disease risk more in women than in men. Women who smoke are twice as likely to have heart attacks as male smokers. Depression is also a stronger heart risk factor for women than it is for men. 

Women have risk factors that men don’t face. Taking contraceptive pills is one example. High blood pressure is two or three times more common in women who take oral contraceptives – especially in those who are overweight. Also, women whose blood pressure rise during pregnancy and returns to normal after delivery are more likely to have high blood pressure and heart disease later in life. 

The simplest truth to get rid of heart disease in women is to gain more understanding of one’s own heart risk. Then in easy terms, eat wisely, take exercise, climb stairs instead of lifts and elevators, reduce stress, be aware of fluctuations in body weight, waist measurements, cholesterol levels and blood pressure. This is a good advice for women with heart disease.

Menstrual problems are common among women. Among the different problems they face are PMS or premenstrual syndrome, irregular or missed periods, menstrual cramps and heavy bleeding or overbleeding. Though menstrual issues are a common occurrence, however severe or prolonged issues like these can signify a menstrual disorder. At an early age, these problems are just a sign of the woman’s body getting used to the natural rhythm of a menstrual cycle. However, it is best to consult so that any disorder is diagnosed and treated early.

The most common types of menstrual disorders are PMS or pre-menstrual syndrome, dysmenorrheal or menstrual cramps, amenorrhea or missed periods, and overbleeding or menorrhagia. These disorders are outlined below.

Premenstrual Syndrome

Premenstrual syndrome may occur from seven to fourteen days before a period starts; and sometimes continues for some time after the period has begun. However, the symptoms are not the same for all women. Some women feel severe pain or experience mood swings during this stage of the menstruation cycle. PMS is caused by the hormonal changes in a woman’s body that start at the point of ovulation and continue till menstruation starts. Around 85% of the female population experiences premenstrual symptoms during their reproductive years. If more than three mild to moderate symptoms are detected in a woman, then treatment for PMS is suggested since it is possible that these symptoms may disrupt her normal life. 

Missed Periods

Missed or absent periods is also known as amenorrhea. Amenorrhea can be of two types - primary amenorrhea and secondary amenorrhea. In the case of a woman who has never menstruated, the condition is known as primary amenorrhea. In case of a pregnancy, a woman misses her periods as well. This condition of missed periods is known as secondary amenorrhea.

Menstrual Pain

Menstrual cramps are a common issue for women of reproductive age. This disorder is also known as dysmenorrhea. Dysmenorrhea is also of two types like amenorrhea - primary dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea has no underlying cause. It is the name given to the cramping of the lower abdomen just before and after the period begins. Secondary dysmenorrheal pain occurs due to disorders in the reproductive system. Pain from secondary dysmenorrhea usually begins earlier in the menstrual cycle and lasts longer than common menstrual cramps.

Overbleeding

Overbleeding, also known as menorrhagia is excessive or prolonged menstrual bleeding. Menorrhagia is also called hypermenorrhea. Menorrhagia does not include the normal heavy bleeding that is sometimes experienced during a period. Only severely heavy bleeding or bleeding that lasts longer than seven days can be termed as menorrhagia. It is often accompanied by discharge of large blood clots. The most probable causes for such bleeding are uterine fibroids or misbalanced hormones. 

The above discussed disorders are the most common menstrual issues faced by women. These disorders can also be warning signs of other serious problems like endometrial cancer, uterine fibroids etc.

It is advisable for women to get a regular check-up and keep track of their menstrual cycles, so as to detect any changes. Keeping a diary of symptoms and their severity through at least two to three cycles helps to evaluate any condition and is invaluable for physicians if medical assistance is required.

Endometriosis affects about 5 million women in the United States. That fact makes it one of the common health problems affecting women. The name, Endometriosis comes from the word endometrium that indicates the tissue lining the uterus. Each month, this tissue grows and then when menstruation occurs, is sloughed off to be grown again the next month. 

When endometriosis occurs, this tissue grows outside the womb. Small patches grow behind the uterus, on or under the ovaries, and on the bowels or bladder. It is rare, but not unheard of, for this tissue to grow in other places in the body. Each month, as the cycle progresses, the patch grows and bleeds, but because it is not in the uterus, it has no place to go. Inflammation then results. No one knows for sure what causes Endometriosis. 

Among the theories are that it is genetic, or there is a faulty immune response when endometrial tissue begins to grow outside the uterus. Pain is the most common symptom of Endometriosis. Usually the pain is in the lower abdomen, lower back or in the pelvis. 

Some women will have large areas of Endometriosis with little or no pain, others with small patches will be in major pain. No reason has been uncovered yet to determine why this may be. Women with Endometriosis may have very heavy periods, painful bowel movements, diarrhea, constipation, bloating, severe menstrual cramps that worsens over time, and spotting or bleeding between periods because the endometrium may migrate to the ovaries, being unable to get pregnant frequently occurs. 

A woman has a greater chance of having Endometriosis, if she started her periods at an early age, has heavy and lengthy periods, and has a close relative, who also has Endometriosis. It is important to seek medical attention, if you suspect that you may be developing Endometriosis. Many times, a woman will have symptoms for 2 to 5 years before diagnosis, due to the fact that the Endometriosis worsens over time, eventually causing enough distress to warrant attention. 

The doctor will conduct the examination by doing a pelvic exam, after taking the health history. If no obvious growths show this way, the next step would be to look for large growths using ultrasound. This is a painless exam using sound waves to see inside the body. 

The next choice is the do a MRI (magnetic resonance imaging) exam. It is also painless. The MRI uses magnets and radio waves to make a ‘picture’ of the body. To be 100 percent sure that Endometriosis is the problem, the doctor may decide to perform a surgical procedure called a Laparoscopy. 

In this procedure, a tiny incision is made in the abdomen and a small scope is inserted to look for patches of tissue. If any are found, it is often possible to remove the patches, or destroy them with intense heat without harming the tissues around them. Women recover from this surgery much faster than more invasive types.

In some cases, it is advised and necessary to perform a major abdominal surgery, but it is considered to be the last resort. Only when no other option is possible, will a hysterectomy be chosen and then for women, who no longer wish to bear a child. There are some medications available, which will reduce the pain and other symptoms, but as of now, there is no cure. 

Breast is a collection of glands and fatty tissues that lies between the skin and the chest wall. Milk is produced by the glands inside the breast when the woman has a baby. The milk gets to the nipple by way of glands through a tube called ducts. 

At times, the cells in the breast grow out of control and attack the nearby tissues. Without any check, this growth spreads throughout the body and becomes breast cancer. These out of control tissues are called tumors. Some of the tumors are harmless, as they cannot spread and threaten one’s life. So they are called benign tumors. The other harmful tumors are called malignant tumors. 

Any type of tissue in the breast can form a cancer but it either comes from the ducts or the glands. It takes months or years for a tumor to get large enough to feel in the breast. Screening of the breast to check for tumors is called mammograms.

Women in North America and Europe are prone to get affected by breast cancer. In fact, every woman is at risk for breast cancer. Statistics prove the breast cancer in American women are the second largest and the first largest is the lung cancer.

Some of the factors, which influence the breast cancer are being a women growing older, having a family history of breast cancer, or previous history of cancer and radiation therapy to the chest region, initiation of periods when still young, i.e., below 12 years of age, and starting menopause quite late after 50’s, never having children, or having children late after 30’s.  Hormone Replacement Therapy in some cases, can also lead to breast cancer. Overweight or alcoholic women are prone to get cancer.

Proper screening and early detection are the best methods in which most of the cancer can be treated. Regular check ups with the physicians, and learn to perform breast self exam is also a natural way to check for breast cancer. X ray of the breast is called a mammogram. The breast is placed between two plates for some seconds and the x ray is taken. If something appears abnormal, then a better angled film can be taken with the magnified view. 

Every woman after the age of 40 should take mammogram every year.  Every month, one should check your breast on your own. About 15% of the tumors can be felt but cannot be seen in the regular mammography screen. Women above 20 and below 39 should go for check up at least once in three years. A diagnostic mammogram or ultra sound can be done and then biopsy can be sent for checking. 

Breast cancer has four stages. In stage one the tumor is less than 2cms. In the second stage, it is more than 2 cms but less than 5cms. In stage three, it is more than 5 cms and spread up to the lymph nodes.  In stage four, it spreads outside the breast and inside the other parts of the body. 

Depending upon the stages, doctors will decide if the treatment would be surgery, or chemotherapy, radiotherapy, hormonal therapy and biologic therapy.  Once the patient has undergone this treatment, the follow up testing is very important.