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-

Oral Contraceptive Pill

For women who are involved in family planning, some of them must be very familiar with oral contraceptive pill. one of the usage of oral contraceptive pill is it control the pregnancy of women. but how? let us continue reading this article below...

The two hormones in the combined oral contraceptive pill, oestrogen and progestogen work on several levels to prevent pregnancy. Primarily, the Pill works by stopping ovulation (the release of an egg from the ovary). If an egg is not released then of course conception cannot take place. As a back-up, the Pill also makes the mucus released by the cervix thicker so the sperm cannot get through and thins the lining of the uterus so a fertilised egg has difficulty implanting.

The Pill and 'periods'
When a woman takes the Pill her normal menstrual cycle is interrupted. In effect, the Pill tricks the body into believing it is pregnant. When the Pill was being developed, however, it was felt that women would find the lack of a normal menstrual cycle disconcerting. Many women, for example, rely on their regular menstrual period for reassurance of not being pregnant. Consequently, it was decided to have the Pill consist of 21 days of active pills (pills containing the hormones), followed by a pill-free interval of seven days (either no pills or sugar pills). The rapid decline in the artificial hormones which occurs in the pill-free interval results in a 'withdrawal bleed', which somewhat resembles a menstrual period and is often still referred to as a 'period' for simplicity. It is important, however, for women to understand that when they take the Pill the bleeding which occurs during the pill free interval is not a menstrual period.

Similarly, women should be aware the current packaging of the Pill (21 active pills, seven day pill free interval) was developed primarily for acceptability reasons and not because of any physiological reason. Indeed, contraception expert John Guillebaud explains "When you think about it we have here a bizarre contraceptive: one that we providers actually instruct the users not to use - for 25% of the time" (4). As Guillebaud suggests, the pill free interval is the 'Achilles heel' of the Pill's efficacy as it can contribute to pill failure. To stop ovulation from occurring a woman needs to take seven consecutive active pills. In addition, if more than seven days are missed a woman risks ovulation and, if unprotected intercourse occurs, pregnancy. The lengthening of the pill free interval is one of the most common causes of pill failure and is often associated with a woman starting her new Pill packet late. It is very easy to start a pill packet late with women either simply forgetting or not having their new packet with them.

Similarly, if some of the active pills near the end of the previous packet or active pills near the start of the new packet are either missed or not absorbed properly (due to vomiting, diarrhoea, use of antibiotics) this can also mean that there has not been enough pills taken overall to prevent ovulation. Women who miss pills towards the end of their packet often mistakenly believe it does not matter because they are having their 'period' soon. They do not realise that missing pills near the pill free interval may mean they have not taken enough pills to prevent ovulation in the next month. The most dangerous time to miss a pill is at the end or beginning of a packet (because it lengthens the pill free interval beyond seven days).

So why have a pill free interval?
As discussed above, the pill free interval was devised in the early days of the Pill because it was felt that women would find having a 'period' more acceptable. Additionally, all the data on the safety of the Pill was conducted using women who were having a pill free interval (5). If women did not have a pill free interval they would actually be taking more pills a year and, therefore, would be exposed to more of the hormones. For a range of reasons, however, women may choose to tricycle their pill (taking three packets together without a pill free interval), thus reducing the number of withdrawal bleeds a year from 12 to four.

Who could benefit from tricycling?
Women who suffer from headaches or migraines triggered by the sudden drop in hormones during the pill free week and women who experience heavy bleeding may benefit from tricycling. Tricycling is also often recommended for women with endometriosis as it reduces the number of painful withdrawal bleeds and the opportunities for retrograde menstruation (where blood travels in the wrong direction up the fallopian tubes and into the pelvis), thought to be one of the causes of endometriosis. For women who are debilitated by symptoms during the pill free interval, reducing the number of withdrawal bleeds can be extremely beneficial. Tricycling or bicycling (taking two packets together with no pill free interval) can also be useful for women who wish to avoid the withdrawal bleed for special occasions like travel or a honeymoon.

It is important to note that for women taking a fixed dose Pill (all the active pills in the packet are the same) tricycling simply involves taking several packets together without the pill free interval. However, when women are on a phasic Pill (where there are two or three different types of active pills), simply running the packets together can result in break through bleeding (although it will not reduce the efficacy of the contraception). Women taking a phasic pill, therefore, should ask their health care provider about how to tricycle.

if u are interested in learning more about oral contraceptive pill, please visit this website http://www.womhealth.org.au/healthjourney/pill_myths_misconceptions.htm

~ani arina~

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

Menstrual Cramp Relief with Essential Oils

Monthly menstrual cramps can be a real pain, but many women who experience severe menstrual cramps find relief in natural essential oil remedies.

Menstrual cramping is completely unnoticed by some women, while for others it can be a debilitating monthly experience. Fortunately, there are natural aromatherapy remedies that provide relief for many who suffer through severe menstrual cramps.

What are Menstrual Cramps?

Menstrual cramping occurs when a woman's uterus contracts in order to expel its lining. The uterus is a large muscle and its contractions during the monthly period can be felt as anything from a mildly annoying throbbing through to truly painful cramping.

According to the experts at the Mayo Clinic, menstrual cramps or "dysmenorrhea" are perfectly normal for many women. Some women experience menstrual cramping as a result of known health problems (like endometriosis or uterine fibroids) but, in most cases, menstrual pain is linked with a normal, healthy period.

Normal menstrual cramps often include abdominal pain, which may or may not extend into the lower back and legs. Some women also experience loose stools, nausea, sweating, and/or dizziness during their periods.

Natural Menstrual Cramp Remedies

Knowing there's nothing wrong with period cramps doesn't magically cause the pain to disappear, though, so it's fortunate that there are plenty of natural remedies that work wonders in menstrual relief.

Among the most effective natural remedies are calcium-magnesium supplements, vitamin E, gentle exercise, plenty of sleep, and vitamin C. Any or all of these solutions can help in providing relief for severe menstrual cramps. Essential oils are another natural remedy that is often effective against period cramps.

How to Relieve Menstrual Cramps with Essential Oils

Essential oils are natural plant liquids that contain all the medicinal value of the plant in a more potent form. Herbs and essential oils have been used worldwide for millennia to treat all kinds of menstrual and reproductive health issues. They are highly effective when used topically – applied on the abdomen – or internally in capsules or drops on the tongue.

Caution: There are many different qualities or grades of essential oils, but lack of regulation make it difficult to tell which oils are safe (for internal or even topical use) and which ones are toxic. For more information on essential oil safety, see The Real Quality of Essential Oils.

Some of the most effective essential oils for menstrual cramp relief include:

* Clary sage
* Rosemary
* Basil
* Sage
* Marjoram
* Peppermint
* Lavender
* Chamomile
* Cypress
* Tarragon
* Ginger

Essential oils are most effective for relief of menstrual pain when used in combination with a healthy, balanced diet and plenty of rest.

with love and care ~kaled^^

http://aromatherapy.suite101.com/article.cfm/menstrual_cramp_relief_with_essential_oils#ixzz0cHXrRARC

How to Cope With Your Periods??

Not every girl has problems with her monthly periods. Some seem to sail through them as if there was no difference between these and other normal days, while others go through hell. Cramps, sluggishness, mood swings and a general disinclination to do anything are often seen in young girls.

However, here are a few tips that may help to tide over these difficult days without too many problems.

• You have to choose your dress carefully during your periods. Avoid wearing synthetics, especially in summer. Always wear cotton panties that will help your skin breathe especially in the groin area.
• You may go swimming if you are using a tampon but definitely make the session short and try to avoid being in your wet suit for too long.
• You cannot use the pool if you are using sanitary pads.
• It is better to avoid sex during these days as there are more chances of infection and inflammation.
• Wash your genital area at least twice a day and with clean hands. Use a gentle, mild soap only on the external genitals and go front to back to prevent germs entering the vagina from the anus.
• Avoid using a douche in the vagina. This will upset the delicate balance present naturally in that area. Should you use a douche, remember that the resultant unbalanced vaginal microflora will weaken the natural barrier which prevents infection and also irritate and inflame the vagina.
• Never insert, even for fun, unclean things or devices that are a potential threat to the delicate skin in the area.
• Comfortable, hygienic sanitary pads, napkins and tampons are freely available these days. Use these and remember to change them at least 4 or 5 times a day depending on the flow of blood.
• If you use a tampon, remember to wash your hands before inserting it. Never use a tampon for the night.Keep washing your genitals many times during the day and whenever you change.
  

This article is quoted from the http://sitagita.com/health-and-wellness/health-tips-for-women/how-to-cope-with-your-periods.html. For further information please visit the suggested website.

by izzaty

Should Women Fear Chocolate??

This article is quoted from http://free-beauty-tips.glam.com/chocolate.html. For further information please visit the suggested website.

Women on a diet or women who are conscious of their weight and figure always display a certain fear of chocolate. They avoid it like plague, thinking that the sugar and the calories that chocolate contains will make their diet and weight-loss plans go haywire. And yet, when things go wrong and they are feeling down, they go and raid the fridge and gobble on as much chocolate as they can. When these women come to their senses later on, they feel horribly guilty and try to burn the sugar and calories gained from the binge.

Chocolate is a feel-good food; it is always associated with feelings of comfort and love. It is sweet and melts deliciously in the mouth. It induces the production of endorphins in the body, endorphins being hormones that reduce the feelings of pain in the body and makes the body feel pleasure in its stead. Chocolates are often given to children as rewards for good behavior. A lover (or a potential lover) gives a woman a box of chocolates to show his affection.

Given that chocolates do contain sugar and calories that dieting women find highly undesirable, should we women fear chocolate? The answer to this is that they should not. Eating chocolate is not something to be feared or avoided as if one's life depends on not seeing a piece of that brown, melt-in-the-mouth sweet. Chocolate is not known to be physiologically addictive. Whatever cravings chocolate induces in a woman is all in her mind. In fact, chocolate can be beneficial, if eaten in the correct manner.

So, how should we women eat and enjoy chocolate without feeling even an iota of fear or guilt? Simply put, chocolate should be eaten in small amounts, and the experience of eating chocolate should be savored.

Chocolate should be eaten as a treat rather than a snack. If one is feeling hungry, she should eat a proper meal or a snack that is not loaded on calories. Eating chocolate when one is hungry only leads to bingeing. Besides, research has proven that consuming chocolate when one is not hungry lessens the craving for it.

Another thing about eating chocolate is that it should be eaten slowly. Chocolate should be eaten for the pure pleasure of it, so it should be savored. Feeling guilty about eating chocolate will only make the person eat it faster and consume more. One cannot taste chocolate, or anything for that matter, if it is eaten far too quickly, and one will only end up wanting more.

A third thing to remember about eating chocolate is that less is more. One will get more pleasure out of eating a small piece of dark chocolate than from a cookie laden with chocolate chips, simply because there is more chocolate in a small bar than in a cookie. If you are going to take in calories from chocolate, there is no point to adding more to your calorie count by eating something else with the chocolate.

Lastly, chocolates should be kept in a place that is not easily accessible so one would not give in to a sudden binge if the cravings hit her. It should be stored where it is not always in one's line of sight.

Chocolates are not to be feared. They are comfort foods and should be considered as a treat and a reward to one's self. Chocolates are good.

by izzaty

Water For Good Health

The omnipresence of water is truly amazing. Nearly three-quarters of our Earth is covered with it. Our body consists of about 60% water. Most fresh fruits and vegetables store up to 95%, and meats ooze 50%.

A lifeline
The role of water in the human body is supreme. Water is an essential and major component in all living matter as it aids in food digestion and the absorption and transportation of nutrients in the body. It also cleanses our system of its waste products via urine and keeps us cool by regulating our body temperature. It’s also an ideal and natural moisturiser for youthful-looking skin!

We can survive without food for several weeks but will only live a few days without water. In fact, a 20% loss of body water is fatal. Our body loses about 2.5 litres of water daily through urine, faeces, sweat and breath. To stay healthy, we need to maintain this delicate balance of water consumption versus loss.

How much is enough?
Adults are encouraged to consume 6-8 glasses of water daily. However, larger volumes are recommended for expectant and nursing mothers, patients with high fever and those who sweat more, such as athletes and physical workers. Elderly folks whose thirst sensation may be blunted and infants who are unable to express their wants deserve special attention to their water needs. And remember, a warm climate like ours demands more water-intake as we tend to perspire more than in a cold climate.

So even though water is not classified as a nutrient, remember that an adequate flow in your daily diet is necessary for sparkling health and vitality!

with love and care ~kaled^^