Menorrhagia: excessive menstrual bleeding

Menorrhagia is defined as menstruation at regular cycle intervals but with excessive flow and duration and is one of the most common gynecologic complaints in contemporary gynecology. Clinically, menorrhagia is defined as total blood loss exceeding 80 mL per cycle or menses lasting longer than 7 days. The World Health Organization reports that 18 million women aged 30-55 years perceive their menstrual bleeding to be excessive. Menorrhagia must be distinguished clinically from other common gynecologic diagnoses. These include metrorrhagia (flow at irregular intervals), menometrorrhagia (frequent, excessive flow), dysfuntional uterine bleeding and polymenorrhea (bleeding at intervals <21days).

Signs and symptoms
§ Useful historical features include: bleeding substantially heavier than the patient’s usual flow, bleeding lasting more than 7 days, flow associated with passage of significant clots Anemia
§ The following symptoms tend to suggest that cycles are ovulatory: regular menstrual interval, mid-cycle pain (mittelschmerz), Dysmenorrhea, premenstrual symptoms - breast soreness, mood changes, etc.
§ Abdominal pain or cramps at other times of the cycle may be associated with structural causes: Myomas, Polyps, Ovarian tumors
§ Hirsutism or acne: may accompany polycystic ovarian syndrome

Mortality/Morbidity
Patients who lose more than 80 mL of blood, especially repetitively, are at risk for serious medical sequelae.
· Menorrhagia is the most common cause of anemia. Women are likely to develop iron-deficiency anemia as a result of their blood loss. This usually can be remedied by simple ingestion of ferrous sulfate to replace iron stores.
- If the bleeding is severe enough to cause volume depletion, patients may experience shortness of breath, fatigue, palpitations, and other related symptoms. This level of anemia necessitates hospitalization for intravenous fluids and possible transfusion and/or intravenous estrogen therapy, or surgical intervention if required to control the menorrhagia.
· Other sequelae associated with menorrhagia usually are related to the etiology. For example, with hypothyroidism, patients may experience symptoms associated with a low-functioning thyroid (eg, cold intolerance, hair loss, dry skin, weight gain) in addition to the effects of significant blood loss.

Causes:
Menorrhagia can be caused by a variety of causes include: Imbalance of hormones (estrogen and progesterone), Fibroids (benign uterine tumors), Pelvic infection, Endometrial disorder, Intrauterine device, Hypothyroidism, Pregnancy, Ovarian cyst or tumor and other hormonal causes.
§ Hypothyroidism
§ Endometrial proliferation/excess/hyperplasia: Anovulation, oligo-ovulation, Polycystic ovarian disease (PCOD), Ovarian tumor, Obesity, Hormone (estrogen) therapy
§ Endometrial atrophy: Postmenopause, Prolonged progestin or oral contraceptive administration
§ Local factors: Endometrial polyps, Endometrial neoplasia, Adenomyosis/endometriosis, Uterine myomata (fibroids), Intrauterine device (IUD), Uterine sarcoma
§ Coagulation disorders: Thrombocytopenia, platelet disorders, von Willebrand disease, Leukemia, Ingestion of aspirin or anticoagulants, Renal failure/dialysis

Medications:

Drugs of choice:

§ For acute control of severe bleeding: Estrogen, conjugated (Premarin)
§ For less severe bleeding or after control of acute bleeding: Medroxyprogesterone acetate (Provera), any combination oral contraceptive, (usually one of the “high dose” oral contraceptives)
§ To prevent heavy bleeding in subsequent cycles: Medroxyprogesterone acetate, usual cyclic dose of a combination oral contraceptive
§ For endometrial atrophy in postmenopausal woman: Estrogen plus progesterone replacement therapy
*Please refer and consult with the physicians or pharmacists for contraindications and precautions of the medicines suggested.

Alternative Drugs
§ Non-steroidal prostaglandin-synthetase inhibitors (naproxen, mefenamic acid, ibuprofen, and others) can reduce blood loss with ovulatory cycles and reduce dysmenorrheal, Norethindrone acetate (Aygestin) during the assumed latter half of menstrual cycle, Danazol and GnRH, Megestrol acetate (Megace) to prevent progression to endometrial carcinoma and to treat atypical hyperplasia

http://emedicine.medscape.com/article/255540-overview

http://www.health.am/gyneco/more/menorrhagia/

by: -eLiNA-

Sexually Transmitted Diseases (STDs) in Woman

What is STDs?

STDs is a disease that can be transmitted from individual to another through any type of sexual contact. It is also referred to as sexually transmitted infections (STIs) as they involve the transmission of a disease-causing organism from one person to another during sexual activity. Sexual contact includes more than just sexual intercourse (vaginal and anal), but it is also includes kissing, oral-genital contact, and the use of sexual "toys," such as vibrators. Most of STDs are treatable, but successful cures are lacking for others, such as HIV, and hepatitis B and C.

Microorganism that can cause STDs

1.Gonorrhea

Gonorrhea is a bacterial infection that caused by the organism Neisseria gonorrheae that is spread by sexual contact. It is one of the oldest known sexually transmitted diseases and it is expected that over one million women are currently infected with gonorrhea. It survives on moist surfaces within the body , for example in the vagina and cervix, and also can be found in the tube through which urine drains from the bladder and even exist in the back of the throat and also in the rectum.

2.Chlamydia

Chlamydia (Chlamydia trachomatis) is a bacterium that causes an infection that is likely to gonorrhea in the way that it is spread and the symptoms it created. It is common and affects around 4 million women annually. Chlamydia bacterium is found in the cervix and urethra and can live in the throat or rectum. Chlamydia is very destructive to the Fallopian tubes. It can also cause severe pelvic infection. If untreated, less than 50% of women with chlamydia will develop pelvic inflammatory disease.

3.Syphilis

Syphilis is an STD that has been around for centuries. It is caused by a microscopic bacterial organism called a spirochete ( Treponema pallidum). The spirochete is a wormlike, spiral-shaped organism that wiggles strongly when viewed under a microscope. It transmits a disease to the person by burrowing into the moist, mucous-covered lining of the mouth or genitals.

STDs can be present in, and spread by people who do not have any symptoms of the condition and have not yet been diagnosed with an STD. Thus, community awareness and education about this disease and the methods of preventing them are important.

This article is summarizing from the article by the medical doctor which is Merissa Conrad Stoppler. So, for further information about this disease, especially about symptoms, diagnosis and treatment, you can visit the website below.

http://www.medicinenet.com/sexually_transmitted_diseases_stds_in_women/article.htm

By Amaal Farhana Mohamed

Abnormal Perspiration: Hyperhidrosis

About Hyperhidrosis
Hyperhidrosis is the condition characterized by abnormally increased perspiration in excess of that required for regulation of body temperature and causing embarrassment and interfering with daily activities.
Alternatively, hyperhydrosis may be classified according to the amount of skin that is affected. Excessive sweating in an area that is greater than 100 cm2 (up to generalized sweating of the entire body) is differentiated from sweating that affects only a small area.
Hyperhidrosis can either be generalized or localized to specific parts of the body. There are two types of hyperhidrosis:

Primary hyperhidrosis: emotional stimuli are believed to trigger excessive sweating.
• Palmar/plantar hyperhidrosis affects the hands/feet. Sweaty palms are the most troublesome symptom.
• Palmar/axillary hyperhidrosis affects palms/armpits.
• Isolated axillary hyperhidrosis affects only the armpits.
• Craniofacial hyperhidrosis affects the face and head. It's the least common form.

Secondary hyperhidrosis: associated with an underlying medical condition, such as infection, malignancy, neurologic or endocrine disorders, spinal cord injury, and other conditions.

Treatment
Treatment options for hyperhidrosis range from over-the-counter and prescription antiperspirants to surgery to interrupt the nerve causing excessive sweating.

Topical medications
For light-to-moderate hyperhidrosis, doctors will likely recommend applying a nonprescription, over-the-counter, clinical strength antiperspirant on problem areas as an initial treatment.
Prescription antiperspirants with aluminum chloride are the next step. Typically, prescription antiperspirants (Drysol, Xerac) are applied to dry skin before bedtime. Six to eight hours later, the antiperspirant should be washed off. Prescription antiperspirants may cause red, swollen and itchy skin.

Iontophoresis
A battery-powered device is used to deliver a low current of electricity to the hands or feet, and sometimes the armpits, through water-saturated wool pads. This treatment alters the outer layers of skin to prevent sweat from coming to the surface. This intense treatment can decrease sweating for several weeks. However, it is not suitable for pregnant women or people who have a pacemaker.

Oral Medications
• Anticholinergics (such as glycopyrrolate) block nerve impulses to sweat glands.
• Carbonic anhydrase inhibitors (such as topiramate) inhibit sweating.
• Clonidine reduces nerve stimuli, thereby reducing sweat output.
Older types of antidepressants, such as amitriptyline, can reduce sweating and also can help patients cope with hyperhidrosis.

Surgery
If you have severe hyperhidrosis and other treatments haven't worked, surgery may be an option. Two approaches involve interrupting the nerve signal triggering excessive sweating. The other approach is to remove some sweat glands.

Read more about hyperhidrosis at
http://www.mayoclinic.org/hyperhidrosis/treatment.html


By: -eLiNA-

Migraines Linked to Lower Breast Cancer Risk

Migraines & Breast cancer, link to one another

Have you ever heard that migraines can reduce the breast cancer risk ? It is the first time for me. How about you ??
According to the recent study which is a follow-up to research published in 2008, Women who suffer from migraine headaches have a significantly lower risk of getting breast cancer than those who don't suffer the headaches.Yes, The lead author of both studies and a breast cancer epidemiologist and associate member of the Fred Hutchinson Cancer Research Center's Public Health Sciences Division in Seattle , Christopher Li, MD, PhD said that "It does appear that migraines may protect women from breast cancer, and that it's equally protective for both younger and older women". After surveys and research had done, it shown about 26% reduction of breast cancer risk when the women experience migraines.

It's not known why having migraine headaches appears to lower breast cancer risk but it might due to the hormone level and other factors as well. Scott Maul, MD, a medical oncologist in Milwaukee who also reviewed the study for WebMD says the potential link between migraines and reduced breast cancer risk does make sense. Higher lifetime exposure to estrogen is a known risk factor for breast cancer, he notes, and some migraines seem to be associated with a drop in estrogen. "But not all migraines are due to hormone fluctuations" -WebMD

For more info, you can visit this webisite :- http://www.webmd.com/migraines-headaches/news/20090709/migraines-linked-lower-breast-cancer-risk

-JihanDiyana-

Psoriatic Arthritis: A Chronic Disease

First of all, what is psoriatic arthritis? Actually, psoriatic arthritis is a chronic disease characterized by inflammation of the skin (psoriasis) and joints (arthritis). Psoriatic arthritis affects one in ten people about who have psoriasis.The inflamed joints become painful, swollen, hot, and red. The cause of this condition is currently unknown. A combination of genetic and immune as well as environmental factors are likely involved. Briefly, there are five types of psoriatic arthritis which are symmetric (affects joints on both sides of the body simultaneously and most similar to Rheumatoid arthritis), asymmetric (does not occur in the same joints on both sides of the body and usually only involves less than 3 joints), arthritis mutilans (deforming and destructive arthritis and can progress over months or years causing severe joint damage), spondylitis (stiffness of the spine or neck, and also affect the hands and feet) and distal interphalangeal predominant (inflammation and stiffness in the joints nearest to the ends of the fingers and toes). Psoriatic arthritis can develop at any age. For the majority of people this is between the ages of 20 and 50. Both males and females are affected equally. In addition, some patients have had arthritis for over 20 years before psoriasis eventually appears!

Treatments

First line medication used are NSAIDs such as diclofenac and naproxen. While, joint injections with corticosteroids is the other treatment practical if a few joints are affected. However, if the first line medication is not effective, second line treatments with immunosuppressants such as methotrexate or leflunomide are added to the treatment regimen. Recently, a new class of therapeutics developed using recombinant DNA technology called Tumor necrosis factor-alpha inhibitors have come available. For example, infliximab, etanercept, Golimumab and adalimumab. These are becoming increasingly commonly used but are usually reserved for the most severe cases. As more is learned regarding the long-term safety of these biologic agents, there is a trend toward earlier use to prevent irreversible joint destruction.

Change your life style:

• Exercise : Exercise maintains mobility of your joints and strengthens muscles to protect the joints. However, if an exercise becomes painful, reduce it a little.
• Rest : Avoid carrying heavy objects which drag down your shoulders or strain your fingers. You should have sufficient rest.
• Diet : balanced diet is important in promoting overall good health. If you are overweight, you need to diet because of the strain this puts on the leg joints.

http://www.medicinenet.com/psoriatic_arthritis/article.htm

http://www.afm.org.my/info/psoriatic_arthritis.php

http://emedicine.medscape.com/article/331037-overview

by: -Elina-

Suffering From Menstrual Pain? Want To Know More About It?

Well.. first of all, i would like to welcome all of u who are willing to drop by to our blog and since this is the first post for this blog, i would like to begin with a topic that many of us women out there suffer especially during your menstrual cycle.. some of us have experienced extreme pain in the stomach, mood swing, and even nausea and vomiting.. all of this symptoms are called premenstrual syndromes or PMS..

however, you don't have to worry anymore.. nowadays, there are many pills that you can take to relief the pain such as aspirin and acetaminophen.. these are among the drugs that are categorized under non-steroidal anti-inflammatory drugs (NSAIDS).. nevertheless, you have to follow the right doses and insructions when taking these drugs..

besides, if you don't want to take any medication, changing your lifestyles might also help in reducing the pain.. reduce salts and refine sugar intake and also caffeine since it can cause irritability.. and most importantly, don't forget to exercise..

so, i guess this is all for now.. if you want to know more about PMS and the treatment, you can visit this website..

http://www.medicinenet.com/menstrual_cramps_and_pms_medication_guide/article.htm

written by: anie

Endometriosis