Categories
Disease & Condition English Symptoms and cure of the disease

Back pain

Back pain is a common symptom that affects 60–80% of people at some time in their lives.

The prognosis (outcome) is generally good. After 2 days, 30% are better and 90% have recovered by 6 weeks. Recurrences  of  pain  may  occur  and  about  10–15%  of patients  go  on  to  develop  chronic  back  pain  that  may  be difficult  to  treat.  Psychological  elements,  such  as  job  dissatisfaction,  depression  and  anxiety,  are  important  risk factor.

Causes of Back pain

  • Mechanical back pain
  • Prolapsed intervertebral  disc
  • Osteoarthritis
  • Vertebral fracture
  • Spinal stenosis
  • Paget’s disease
  • Spondylolysis
  • Bone metastases etc.

Others causes

Renal colic, Pyelonephritis

Pelvic inflammatory disease

Pancreatitis

Peptic ulcer disease

 

What causes back pain in children?

These injuries are usually caused by activity and overuse. Scheuermann’s disease causes pain that is not severe enough to limit activity. It is the second most common cause of back pain in children and young adults. Your child may have a rounded spine.

Can Stomach pain be caused by back pain?

A back injury or injury to the spine can cause pain to radiate in the abdomen. Also, a pinched nerve can not only cause pain to the entire area served by that nerve, but it can also cause various stomach functioning problems as well. Inflammation of the colon, or colitis, is very often associated with lower back pain.

Why do girls have back pain?

Lower back pain during your period, or primary dysmenorrhea, is caused by contractions in the uterus.

What causes muscle spasms in the lower back?        

Back spasms can be the result of injuries to the muscles, tendons, and ligaments in the back or it can be related to more serious medical conditions. Heavy lifting is a common cause of back spasms. Any activity that puts excessive strain on the muscles and ligaments in the lower back can cause an injury.

 

Symptoms of mechanical low back pain

  • Pain  varies  with  physical  activity  (improved  with  rest)
  • Sudden  onset,  precipitated  by  lifting  or  bending
  • Recurrent  episodes
  • Pain  limited  to  back  or  upper  leg
  • No  clear-cut  nerve  root  distribution
  • No  systemic  features
  • Prognosis  good  (90%  recovery  at  6  wks)

 

Red flags for possible spinal pathology (Danger features)

  • Age:  presentation  <  20  yrs  or  >  55  yrs
  • Character:  constant,  progressive  pain  unrelieved  by rest
  • Location:  thoracic  pain
  • Past  medical  history:  carcinoma,  tuberculosis,  HIV,  systemic corticosteroid  use,  osteoporosis
  • Constitutional:  systemic  upset,  sweats,  weight  loss
  • Major  trauma

Investigations

Investigations are not required in patients with acute mechanical back pain.  Those  with  persistent  pain  (> 6  weeks)  or  red  flags  should  undergo further  investigations such as MRI, X-Ray, Bone scan and some blood tests.

What are the treatment of LBP?

General

  • Self-limiting nature of the condition.
  • Stay active, exercise is helpful rather than damaging
  • Medication if necessary (preferably at fixed time intervals).
    • Paracetamol
    • NSAID like ibuprofen, indomethacin, naproxen.

Regular use, improved mobility, and facilitate exercise

  • Doctor may consider opioids, muscle relaxant medicine
  • Bed rest is not helpful it increase the risk of chronic disability
  • For pain relief doctor may consider spinal manipulation
  • Lumbar supports, back-specific exercises, traction, acupuncture, epidural or facet injections not helpful for mechanical back pain
  • Physiotherapy may be required if not improved within 6 weeks
  • Low dose Tricyclic anti-depressant drugs will help pain, sleep and mood

Specific

Treatment of other causes should be done accordingly with involving other special departments as per doctor advice.

What should we do for back spasms?

Warm water compression helps to promote healing by drawing healthy blood cells to the area of the back spasm. Heat also relaxes the nerves and muscle fibers. Try an ice & heat alternate cycle after the first 72 hours. Some physical therapists suggest using heat applications before stretching and ice after stretching.

What is the cause of muscle spasms?

Spasms may affect many different types of muscles in the body, leading to many different symptoms. Spasms of skeletal muscles are most common and are often due to overuse, dehydration, and electrolyte abnormalities. The spasm occurs abruptly, is painful, and is usually short-lived.

How do you get rid of a muscle spasm?

Natural Treatments for Muscle Spasms.

  • Prevent Electrolyte Imbalances. A potassium and/or magnesium deficiency can contribute to muscle spasms.
  • Stretch and Massage Your Muscles.
  • Stay Hydrated.
  • Use Ice or Heat Packs on Sensitive Muscles
  • Fix Your Posture.
  • Take a Bath with Epsom Salt.

How long does it take to heal from a back spasm?

After the first three days, you can start using heat to loosen muscle tightness and increase blood flow. Waiting at least 72 hours after your spasms start allows the initial swelling and inflammation to go down, and moist heat is generally preferred to dry because it reduces the potential for dehydration.

Dr. Md Elias Bhuiyan

MBBS, FCPS (Medicine)

Registrar

Bangladesh Medical College & Hospital, Dhaka.

Categories
Disease & Condition English Symptoms and cure of the disease

Haemorrhoids (piles)

Haemorrhoids, also known as piles, are swellings containing enlarged blood vessels found inside or around the bottom (the rectum and anus).

When symptoms do occur, they may include:

  • bleeding after passing a stool – the blood is usually bright red
  • itchy bottom
  • a lump hanging down outside of the anus, which may need to be pushed back in after passing a stool
  • a mucus discharge after passing a stool
  • soreness, redness and swelling around your anus

Haemorrhoids aren’t usually painful, unless their blood supply slows down or is interrupted.

When to seek medical advice

See your GP if you have persistent or severe symptoms of haemorrhoids. You should always get any rectal bleeding checked so your doctor can rule out more potentially serious causes.

The symptoms of haemorrhoids often clear up on their own, or by using simple treatments that can be bought from a pharmacy without a prescription.

Speak to your GP if your symptoms don’t get better or you experience pain or bleeding.

Your GP can often diagnose haemorrhoids using a simple internal examination of your back passage, although they may need to refer you to a colorectal specialist for diagnosis and treatment.

Some people with haemorrhoids are reluctant to see their GP. But there’s no need to be embarrassed – GPs are very used to diagnosing and treating haemorrhoids.

What causes haemorrhoids?

The exact cause of haemorrhoids is unclear, but they’re associated with increased pressure in the blood vessels in and around your anus. This pressure can cause theblood vessels in your back passage to become swollen and inflamed.

Many cases are thought to be caused by too much straining on the toilet as a result of prolonged constipation. This is often caused by a lack of fibre in a person’s diet.

Chronic (long-term) diarrhoea can also make you more vulnerable to getting haemorrhoids.

Other factors that might increase your risk of developing haemorrhoids include:

  • being overweight or obese
  • age – as you get older, your body’s supporting tissues get weaker, increasing your risk of haemorrhoids
  • being pregnant – this can place increased pressure on your pelvic blood vessels, causing them to enlarge; read more about piles in pregnancy
  • having a family history of haemorrhoids
  • regularly lifting heavy objects
  • a persistent cough or repeated vomiting
  • sitting down for long periods of time

Preventing and treating haemorrhoids

Haemorrhoid symptoms often settle down after a few days without needing treatment. Haemorrhoids that occur during pregnancy often get better after giving birth.

Making lifestyle changes to reduce the strain on the blood vessels in and around your anus is often recommended.

These can include:

  • gradually increasing the amount of fibre in your diet – good sources of fibre include fruit, vegetables, wholegrain rice, wholewheat pasta and bread, pulses and beans, seeds, nuts and oats
  • drinking plenty of fluid – particularly water, but avoiding or cutting down on caffeine and alcohol
  • not delaying going to the toilet – ignoring the urge to empty your bowels can make your stools harder and drier, which can lead to straining when you do go to the toilet
  • avoiding medication that causes constipation – such as painkillers that contain codeine
  • losing weight if you’re overweight
  • exercising regularly – this can help prevent constipation, reduce your blood pressure, and help you lose weight

 

These measures can also reduce the risk of haemorrhoids returning or even developing in the first place.

Treatment

Medication that you apply directly to your back passage (topical treatments) or tablets bought from a pharmacy or prescribed by your GP may ease your symptoms and make it easier for you to pass stools.

More severe cases need to be treated by a specialist.

One possible treatment is rubber band ligation. Rubber band ligation can be performed in the doctor’s surgery or outpatient clinic and does not require hospital admission.

The procedure involves placing a small rubber band at the base of the haemorrhoid with a special applicator. The rubber band cuts off the blood supply to the haemorrhoid, which eventually falls off after a few days.

Injection of a substance that makes the blood in the haemorrhoid clot is another option (sclerotherapy).

The most serious cases are third-degree haemorrhoids. These protrude through the back passage and can require surgical removal or ‘haemorrhoidectomy’. Such operations are successful in 90 per cent of cases. However, many third-degree haemorrhoids shrink and become symptom-free without surgical treatment.

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Mother & Child Health

Prenatal Care

Prenatal care helps decrease risks during pregnancy and increase the chance of a safe and healthy delivery for the mother and child. Regular prenatal visits can help your doctor monitor your pregnancy and identify any problems or complications before they become serious.

Prenatal care ideally starts at least three months before you begin trying to conceive. Some healthy habits to follow during this period include:

  • quitting smoking and drinking alcohol
  • taking folic acid supplements (400 to 800 micrograms)
  • talking to you doctor about your medical conditions and any dietary supplements and over-the-counter or prescription drugs that you take
  • avoiding all contact with toxic substances and chemicals at home or work that could be harmful

During Pregnancy

Once you become pregnant, your physician, or midwife will schedule regular appointments throughout each stage of your pregnancy.

A schedule of visits may involve seeing your doctor:

  • every month in the first six months you are pregnant
  • every two weeks in the seventh and eighth months you are pregnant
  • every week during your ninth month of pregnancy

During these visits, your doctor will check your health and the health of your baby.

Visits may include:

  • taking routine tests and screenings, such as a blood test to check for anemia, HIV, and your blood type
  • monitoring your blood pressure
  • measuring your weight gain
  • monitoring the baby’s growth and heart rate
  • talking about special diet and exercise

Later visits may also include checking the baby’s position and noting changes in your body as you prepare for birth.

Your doctor may also offer special classes at different stages of your pregnancy.

These classes will:

  • discuss what to expect when you are pregnant
  • prepare you for the birth
  • teach you basic skills for caring for your baby

If your pregnancy is considered high-risk because of your age or health conditions, you may require more frequent visits and special care. You may also need to see a doctor who works with high-risk pregnancies.

 

Categories
Mother & Child Health

Pre Conceptional Care

What is preconceptional care and why is it important?

Having a healthy pregnancy is one of the best ways to promote a healthy birth. Getting early and regular preconceptional care improves the chances of a healthy pregnancy. This care can begin even before pregnancy with a preconception care visit to a health care provider.

Preconception Care

A preconception care visit can help women take steps for a safe and healthy pregnancy before they get pregnant.

Women can help to promote a healthy pregnancy and birth of a healthy infant by taking the following steps before they become pregnant

    • Develop a plan for their reproductive life.
    • Increase their daily intake of folic acid (one of the B vitamins) to at least 400 micrograms.
    • Make sure their immunizations are up to date.
    • Control diabetes and other medical conditions.
    • Avoid smoking, drinking alcohol, and using drugs.
    • Attain a healthy weight.
    • Learn about their family health history and that of their partner.
    • Seek help for depression or anxiety.

 

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Mother & Child Health

Postnatal Care

The postnatal period lasts six to eight weeks, beginning right after the baby is born.

During this period, the mother goes through many physical and emotional changes while learning to care for her newborn. Postnatal care involves getting proper rest, nutrition, and vaginal care.

Getting Enough Rest

Rest is crucial to new mothers who need to rebuild their strength. To avoid getting too tired as a new mother, you may need to:

  • sleep when your baby sleeps
  • keep your bed near your baby’s crib to make night feedings easier
  • allow someone else to feed the baby with a bottle while you sleep

Eating Right Nutrition

Because of the changes your body goes through during pregnancy and labor, getting proper nutrition in the postnatal period is crucial. The weight that you gained during pregnancy helps make sure you have enough nutrition for breastfeeding. However, you need to continue to eat a healthy diet after delivery.

Experts recommend that breastfeeding mothers eat when they feel hungry. Make a special effort to focus on eating when you are actually hungry—not just busy or tired.

Try to:

  • avoid high-fat snacks
  • focus on eating low-fat foods that balance protein, carbohydrates, and fruits and vegetables
  • drink plenty of fluids

Vaginal Care

New mothers should make vaginal care an essential part of their postnatal care. You may experience:

  • vaginal soreness if you had a tear during delivery
  • urination problems, such as pain or a frequent urge to urinate
  • discharge, including small blood clots
  • contractions during the first few days after delivery

Schedule a checkup with your doctor about six weeks after delivery to discuss symptoms and receive proper treatment. You abstain from sexual intercourse for four to six weeks after delivery so that your vagina has proper time to heal.

 

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Mother & Child Health

Ovarian Cancer

Ovarian cancer is a type of cancer that begins in the ovaries. Women have two ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the hormones estrogen and progesterone.

Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is more difficult to treat and is frequently fatal. Early-stage ovarian cancer, in which the disease is confined to the ovary, is more likely to be treated successfully.

Surgery and chemotherapy are generally used to treat ovarian cancer.

Symptoms

Signs and symptoms of ovarian cancer may include:

  • Abdominal bloating or swelling
  • Quickly feeling full when eating
  • Weight loss
  • Discomfort in the pelvis area
  • Changes in bowel habits, such as constipation
  • A frequent need to urinate

Causes

It’s not clear what causes ovarian cancer.

In general, cancer begins when a genetic mutation turns normal cells into abnormal cancer cells. Cancer cells quickly multiply, forming a mass (tumor). They can invade nearby tissues and break off from an initial tumor to spread elsewhere in the body (metastasize).

Types of ovarian cancer

The type of cell where the cancer begins determines the type of ovarian cancer you have. Ovarian cancer types include:

  • Epithelial tumors, which begin in the thin layer of tissue that covers the outside of the ovaries. About 90 percent of ovarian cancers are epithelial tumors.
  • Stromal tumors, which begin in the ovarian tissue that contains hormone-producing cells. These tumors are usually diagnosed at an earlier stage than other ovarian tumors. About 7 percent of ovarian tumors are stromal.
  • Germ cell tumors, which begin in the egg-producing cells. These rare ovarian cancers tend to occur in younger women.

Risk factors

Certain factors may increase your risk of ovarian cancer:

  • Ovarian cancer can occur at any age but is most common in women ages 50 to 60 years.
  • Inherited gene mutation. A small percentage of ovarian cancers are caused by an inherited gene mutation. The genes known to increase the risk of ovarian cancer are called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These genes were originally identified in families with multiple cases of breast cancer, which is how they got their names, but women with these mutations also have a significantly increased risk of ovarian cancer.

The gene mutations that cause Lynch syndrome, which is associated with colon cancer, also increase a woman’s risk of ovarian cancer.

  • Estrogen hormone replacement therapy, especially with long-term use and in large doses.
  • Age when menstruation started and ended. If you began menstruating before age 12 or underwent menopause after age 52, or both, your risk of ovarian cancer may be higher.
  • Never being pregnant.
  • Fertility treatment.
  • Smoking.
  • Use of an intrauterine device.
  • Polycystic ovary syndrome.

If you have a genetic predisposition to ovarian cancer, your doctor may recommend regular pelvic imaging and blood tests to screen for the disease.

Tests and diagnosis

Your doctor is likely to start with a pelvic examination:

  • The outer part of your genitals is carefully inspected.
  • The doctor then inserts two gloved fingers into the vagina and simultaneously presses a hand on your abdomen to feel your uterus and ovaries.
  • A device (speculum) is inserted into the vagina so that the doctor can visually check for abnormalities.

Your doctor also may recommend:

  • Imaging tests, such as ultrasound or CT scans, of your abdomen and pelvis. These tests can help determine the size, shape and structure of your ovaries.
  • Blood test, which can detect a protein (CA 125) found on the surface of ovarian cancer cells.
  • Surgery to remove a tissue sample and abdominal fluid to confirm a diagnosis of ovarian cancer. Minimally invasive or robotic surgery may be an option. If cancer is discovered, the surgeon may immediately begin surgery to remove as much of the cancer as possible.

Staging ovarian cancer

Your cancer’s stage helps determine your prognosis and your treatment options.

Stages of ovarian cancer include:

  • Stage I. Cancer is found in one or both ovaries.
  • Stage II. Cancer has spread to other parts of the pelvis.
  • Stage III. Cancer has spread to the abdomen.
  • Stage IV. Cancer is found outside the abdomen.

Treatments and drugs

Treatment of ovarian cancer usually involves a combination of surgery and chemotherapy.

Surgery

Treatment generally involves removing both ovaries, the fallopian tubes, the uterus as well as nearby lymph nodes and a fold of fatty abdominal tissue (omentum) where ovarian cancer often spreads. Your surgeon also will remove as much cancer as possible from your abdomen.

Less extensive surgery may be possible if your ovarian cancer was diagnosed at a very early stage. For women with stage I ovarian cancer, surgery may involve removing one ovary and its fallopian tube. This procedure may preserve the ability to have children.

Chemotherapy

After surgery, you’ll likely be treated with chemotherapy to kill any remaining cancer cells. Chemotherapy drugs can be injected into a vein or directly into the abdominal cavity or both.

Chemotherapy may be used as the initial treatment in some women with advanced ovarian cancer.

Prevention

There’s no sure way to prevent ovarian cancer. But certain factors are associated with lower risk:

  • Use of oral contraceptives, especially for more than 10 years
  • Previous pregnancy
  • History of breast-feeding
  • Daily use of aspirin

 

Categories
Mother & Child Health

Natural Family Planning

What is natural family planning?

Natural family planning is a method of preventing pregnancy, without using pills or devices. It is based on being able to predict your fertile time. This is the time you are likely to conceive. Pregnancy is avoided if you don’t have sex during this fertile time or use other methods of contraception, such as condoms. It can be a very effective form of contraception. However, it needs a high level of commitment from both you and your partner. It has the advantage that there are no chemicals involved, and therefore no side-effects.

How effective is natural family planning?

If natural family planning is used correctly by 100 women for one year, somewhere between one and nine women would become pregnant. This compares to 80 or 90 women who would become pregnant using no method of contraception. This method will be less effective if not used correctly.

When is the fertile time?

The fertile time lasts for approximately 8-9 days in each cycle. It is from seven days before ovulation until 1-2 days after ovulation. Ovulation is when a woman releases an egg from an ovary – usually once a month. An egg survives for about 24 hours. However, sperm can survive for up to seven days after sex. This is why the fertile time starts from seven days before ovulation. So, if you know exactly when you will ovulate then you can predict when your fertile days are.

How do I know when I will ovulate?

Knowing when you ovulate is the key to this method. Once you are confident that you can predict this then this method of family planning can be very effective. It takes good instruction and 3-6 menstrual cycles to learn how to do natural family planning. This is much more difficult to do if you have irregular periods.

You need to make a record each day of one or more ‘indicators’. These include the following:

  • Body temperature. This typically rises slightly when you ovulate and remains higher until your next period. There are many factors that can upset this, such as illness, and taking medicines (like paracetamol, which can lower your temperature). However, if you take your temperature before getting out of bed each morning, a pattern usually emerges. This will show you when ovulation has occurred. Computerised thermometers are also available which work by combining information about the length of your menstrual cycle and temperature.
  • Secretions from the neck of the womb (cervix). These change throughout the menstrual cycle:
    • Just after a period there is not much secretion and the vagina is dry for a few days.
    • About eight days before ovulation, the secretions become more moist, sticky, and cloudy.
    • Four days before ovulation the secretions become wet, clear, slippery and stretchy (like egg white).
    • A day or so after ovulation the secretions dry up again until after the next period.

So by observing the changes in your secretions you can predict the 7-8 days before ovulation.

  • Cycle length. Ovulation usually occurs 12-16 days before a period. If your cycle is very regular then this may help to predict ovulation.
  • Ovulation prediction kits. These are devices that you can buy from a pharmacy. There are two types of ovulation prediction kits. They both measure hormone levels. One measures them in your urine and the other measures them in your saliva.The urine-based kit detects the increase, or surge, of a hormone called luteinising hormone (LH) that occurs approximately one to two days before ovulation. The main device available in the UK is called Persona®. Although a small amount of LH is always present in your blood and urine, in the days before ovulation, the amount increases by about two to five times.Saliva-based kits test for rising oestrogen levels as you near ovulation. As oestrogen levels rise, the salt content of your saliva increases too and when the salt dries it crystallises into a fern-like pattern. With these kits, you see if ‘salivary ferning’ has occurred as your saliva has dried. The saliva-based kits are less accurate than the urine-based kits. These are not advised for avoiding pregnancy, but may be helpful in planning pregnancy.

Is breast-feeding a natural family planning method?

Yes – this is known as the lactational amenorrhoea method of contraception. Lactational means while you are breast-feeding, and amenorrhoea means not having any periods. Suckling by the baby stimulates hormones that suppress ovulation. Ovulation is unlikely for six months after childbirth if you breast-feed fully (this means the baby has no other food or drink apart from breast milk) and if you have not had a period since childbirth.

Less than one woman in one hundred would become pregnant in these circumstances. However, once you drop feeds, or start having periods this would not be an effective method of contraception.

 

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Mother & Child Health

Miscarriage

A miscarriage is the loss of a baby before the 20th week of pregnancy.

More than 80% of miscarriages occur within the first three months of pregnancy. They are less likely to occur after 20 weeks’ gestation; if they do, they are called late miscarriages.

What Are the Symptoms of Miscarriage?

Symptoms of a miscarriage include:

  • Bleeding that progresses from light to heavy
  • Cramps
  • Abdominal pain
  • Fever
  • Passing of tissue

If you’re pregnant and experience the symptoms listed above, contact your obstetric health care provider.

What Causes Miscarriage?

The causes of miscarriage are not well understood. Most of the miscarriages that occur in the first trimester of pregnancy are caused by chromosomal abnormalities in the baby.

Miscarriages are also caused by a variety of other factors, including:

  • Infection
  • Exposure to environmental and workplace hazards, such as high levels of radiation or toxic agents
  • Hormonal problems
  • Uterine abnormalities
  • Incompetent cervix (the cervix begins to widen and open too early, in the middle of pregnancy, without signs of pain or labor)
  • Lifestyle factors, such as smoking, drinking alcohol, or using illegal drugs
  • Disorders of the immune system, including lupus
  • Severe kidney disease
  • Congenital heart disease
  • Diabetes that is not controlled
  • Thyroid disease
  • Radiation
  • Certain medications, such as the acne drug Accutane
  • Severe malnutrition.

How Is a Miscarriage Treated?

Your doctor will perform a pelvic exam and an ultrasound test to confirm the miscarriage. If the miscarriage is complete and the uterus is clear, then no further treatment is usually required.

If a miscarriage was not confirmed, but you had symptoms of a miscarriage,bed rest is often prescribed for several days, and you may be admitted to the hospital overnight for observation.

Blood tests, genetic tests, or medication may be necessary if a woman has more than two miscarriages in a row (called repeated miscarriage). Some diagnostic procedures used to evaluate the cause of repeated miscarriage include:

  • Endometrial biopsy
  • Hysterosalpingogram
  • Hysteroscopy
  • Laparoscopy

How Do I Know if I Had a Miscarriage?

Spotting and mild discomfort are common symptoms after a miscarriage. If you have heavy bleeding, fever, chills or pain, contact your health care provider . These may be signs of an infection.

Can I Get Pregnant Following a Miscarriage?

Yes. At least 85% of women who have miscarriages have subsequent normal pregnancies and births. Having a miscarriage does not necessarily mean you have a fertility problem. On the other hand, about 1%-2% of women may have repeated miscarriages (three or more). Some researchers believe this is related to an autoimmune response.

If you’ve had two miscarriages in a row, you should stop trying to conceive, use a form of birth control and ask your doctor to perform diagnostic tests to determine the cause of the miscarriages.

When Can I Try to Get Pregnant After a Miscarriage?

Discuss the timing of your next pregnancy with your doctor. Some doctors recommend waiting a certain amount of time (from one menstrual cycle to 3 months) before tying to conceive again. To prevent another miscarriage, your doctor may recommend treatment with progesterone, a hormone needed for implantation in the uterus.

Taking time to heal both physically and emotionally after a miscarriage is important. Above all, don’t blame yourself for the miscarriage. Counseling is available to help you cope with your loss. Pregnancy loss support groups may also be a valuable resource to you and your partner. Ask your doctor for more information about these resources.

Can a Miscarriage Be Prevented?

Usually a miscarriage cannot be prevented and often occurs because the pregnancy is not normal. However, if the problem is related to the woman’s cervix, such as an incompetent cervix, surgical treatments may helpful.

 

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Mother & Child Health

Menstrual Problem

What Are Menstrual Problems?

Menstrual cycles often bring about a wide array of uncomfortable symptoms leading up to your period. Premenstrual syndrome (PMS) encompasses the most common issues, such as mild cramping and fatigue, but the symptoms usually go away when your period begins.

However, other, more serious menstrual problems may also arise. Menstruation that is too heavy or light, or a complete absence of a cycle, all signal issues that can contribute to an abnormal menstrual cycle. It is important to stay in tune with your body and call your doctor right away if you notice any significant changes to your menstrual cycle.

Premenstrual Syndrome

PMS occurs one to two weeks before your period begins. Some women experience a range of physical and emotional symptoms. Others experience few symptoms or none at all. PMS can cause:

  • bloating
  • backaches
  • headaches
  • breast soreness
  • acne
  • food cravings
  • excessive fatigue
  • depression
  • anxiety
  • feelings of stress
  • insomnia
  • constipation
  • diarrhea
  • mild stomach cramps

You may experience different symptoms every month, and the severity of these symptoms can also vary. PMS is uncomfortable, but it is generally not worrisome unless it interferes with your normal activities.

Heavy Periods

Another common menstrual problem is a heavy period. Also called menorrhagia, heavy periods cause you to bleed more than normal. You may also have your period for longer than the average of five to seven days.

Menorrhagia is mostly caused by imbalances in hormone levels, especially progesterone and estrogen. Other causes of heavy or irregular menstrual bleeding include:

  • puberty
  • vaginal infections
  • inflammation of the cervix
  • underactive thyroid gland (hypothyroidism)
  • noncancerous uterus tumors (fibroids)
  • changes in diet or exercise

Absent Periods

In some cases, women may not get their periods. Amenorrhea occurs when you don’t get your period by the time you reach the age of 16. This may be caused by an issue with the pituitary gland, a congenital defect of the female reproductive system, or a delay in puberty.

Another common problem with teens is secondary amenorrhea. This occurs when you start your cycle, but it suddenly stops for three months or more.

Common causes of amenorrhea and secondary amenorrhea include:

  • anorexia
  • overactive thyroid gland (hyperthyroidism)
  • ovarian cysts
  • sudden weight gain or loss
  • stopping birth control
  • pregnancy

The causes of a lack of periods differ in adults. These may include:

  • premature ovarian failure
  • pelvic inflammatory disease (a reproductive infection)
  • pregnancy
  • breastfeeding
  • menopause

A missed period could mean you’re pregnant. If you suspect you could be pregnant, be sure to take a pregnancy test. Drugstore pregnancy tests are the least expensive way to determine whether you are pregnant. To get the most accurate results, wait until you have missed your period by at least one day before taking the test.

Painful Periods

Not only can your period be lighter or heavier than normal, but it can also be painful. Cramps are normal during PMS, and they also occur when your uterus contracts as your period begins. However, some women experience excruciating pain. Also called dysmenorrhea, extremely painful menstruation is likely linked to an underlying medical problem, such as:

  • fibroids
  • pelvic inflammatory disease
  • abnormal tissue growth outside of the uterus (endometriosis)

Diagnosing Menstrual Problems

The first step in diagnosing menstrual problems is to see your doctor for a pelvic exam. Your doctor can tell if your vagina or cervix is inflamed at this time. A Pap smear will also be performed to rule out the possibility of cancer or other underlying conditions.

Blood tests can help determine whether hormonal imbalances are causing your menstrual problems. If you suspect that you may be pregnant, your doctor or nurse practitioner will perform a blood or urine pregnancy test during your visit.

Treating Menstrual Problems

The type of treatment your doctor recommends depends on what’s causing problems with your menstrual cycle. Birth control pills can help relieve symptoms of PMS as well as regulate heavy flows. If a heavier or lighter than normal flow is related to a thyroid or other hormonal disorder, you may experience more regularity once you start hormone replacements.

Dysmenorrhea may be hormone-related, but you may also require further medical treatment to address the problem. For example, antibiotics are used to treat pelvic inflammatory disease.

 

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Mother & Child Health

Menopause

Menopause is defined as occurring 12 months after your last menstrual period and marks the end of menstrual cycles. Menopause can happen in your 40s or 50s.

Menopause is a natural biological process. Although it also ends fertility, you can stay healthy, vital and sexual. Some women feel relieved because they no longer need to worry about pregnancy.

Don’t hesitate to seek treatment for symptoms that bother you. Many effective treatments are available, from lifestyle adjustments to hormone therapy.

Symptoms

In the months or years leading up to menopause (perimenopause), you might experience these signs and symptoms:

  • Irregular periods
  • Vaginal dryness
  • Hot flashes
  • Night sweats
  • Sleep problems
  • Mood changes
  • Weight gain and slowed metabolism
  • Thinning hair and dry skin
  • Loss of breast fullness

When to see a doctor

Starting at perimenopause, schedule regular visits with your doctor for preventive health care and any medical concerns. Continue getting these appointments during and after menopause.

Preventive health care can include recommended screenings at menopause, such as a colonoscopy, mammography, lipid screening, thyroid testing if suggested by your history, and breast and pelvic exams.

Always seek medical advice if you have bleeding from your vagina after menopause.

Causes

  • Natural decline of reproductive hormones
  • Hysterectomy
  • Chemotherapy and radiation therapy
  • Primary ovarian insufficiency

Complications

  • Heart and blood vessel (cardiovascular) disease
  • Osteoporosis
  • Urinary incontinence
  • Sexual function
  • Weight gain

Tests and diagnosis

Tests typically aren’t needed to diagnose menopause. But under certain circumstances, your doctor may recommend blood tests to check your level of:

  • Follicle-stimulating hormone (FSH) and estrogen (estradiol), because your FSH levels increase and estradiol levels decrease as menopause occurs
  • Thyroid-stimulating hormone (TSH), because an underactive thyroid (hypothyroidism) can cause symptoms similar to those of menopause

Treatments and drugs

Menopause requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and preventing or managing chronic conditions that may occur with aging. Treatments may include:

  • Hormone therapy
  • Vaginal estrogen
  • Low-dose antidepressants
  • Gabapentin
  • Medications to prevent or treat osteoporosis