Anti phospholipid antibodies and infertility

Infertility is the inability to conceive and have offspring. More specific, infertility is also defined as the failure to conceive after a year of regular intercourse without contraception. Evidence is emerging that inability to conceive or recurrent miscarriage in a healthy patient can provide an early clue of an adverse health condition.

anti phospholipid antibodies and infertility

Investigation to disclose the causes of reproductive failure can therefore assist with an earlier management strategies, so it can provide a long term benefit for women and restore their natural fertility. There are many causes of infertility, one of them is thrombophilia. How thrombophilia causes infertility remains unknown and poorly understood. After excluding other physical or anatomical causes such as fibroids, uterine scar tissue, congenital abnormalities, and polyps, assessment of medical history of the patient is an important next step.

Thrombophilias are disorders of blood coagulation that increase the likelihood of inappropriate clotting. It can be a concern during pregnancy because in pregnancy, blood tends to clot easily. Thrombophilia can be both congenital or acquired. The most common form of acquired thrombophilia is antiphospholipid syndrome (APS). In APS, there are antibodies against phospholipids in association with either vascular thrombosis or recurrent misscariage.

Laboratory test
For women with medical history of recurrent miscarriages, they are recommended to be screened for antiphospholipid antibodies. The most significant antibodies (immunoglobulin) involved in APS are lupus anticoagulant, anticardiolipin (ACA), and anti beta 2 glycoprotein 1 & 2.

Treatment
There are two options. First is oral antiplatelet (aspirin) and the second is UFH (unfractionated heparin). Combination of both therapies may reduce pregnancy loss in APS-positive cases by as much a 54% compared to aspirin alone.

Thrombophilia and contraception
Estrogen-containing medications can increase the risk of venous thromboembolism including deep vein thrombosis (DVT). So don't hesitate to contact your doctor to choose the best contraception for you.

How to avoid blood clot?
Control your weight, do not be overweight. Keep a healthy diet, avoid saturated fats. Keep your cholesterol level low. Stop smoking. Lower your blood pressure. Controll your glucose level (if you are diabetician). No more than 14 units of alcohol per week.

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How to conceive quickly

how to conceive quickly

Many people see to be very easy to get pregnant, as easy as dreaming it. But for other couples, it feels so long, because what we are waiting for is uncertainty. As we know, ages plays a big role. A research said that approximately one third of women ages 35-39 and half of women more than 40 have trouble getting pregnant (infertility = inability to conceive for 12 months). For men, age starts to be a fertility factor in the late 30s. One study found that in men ages 35-40, the percentage who don't conceive is about 18-28%.

There are many factors: controllable and uncontrollable. What parts of fertility we can control? What do many studies say about how your environment and lifestyle habbits play a role in the complex process of baby making?

DIET

One of the biggest research to examine the role of diet in fertility was done by the researchers of Harvard University in 2007. After observing 18,000 women and their dietary, the researchers found a pattern of eating that seemed to boost baby-making potential. Women with few risk of infertility ate fewer sugars and trans fat, more fiber and iron, more proteins from veggies instead of animals, and more high-fat dairy products than low-fat ones. These patterns are independent of age.

SMOKING

Smoking lowers a woman's chance of getting pregnant both naturally and when using fertility treatments like invitro fertilization (IVF). How about passive smokers? Studies said that women who were exposed to second-hand smoke as children have been shown to have a harder time getting and staying pregnant (with 68% higher chance of miscarriage or difficulty to conceive). So for you who are smoking, quitting smoking before trying isn’t just a good idea for your own healthy pregnancy, it helps ensure that, down the line, your baby will have a healthy pregnancy too. And for men, do not smoke since smoking has been shown to lower healthy sperm counts.

BODY WEIGHT

Body weight influences the reproductive cycle. An excess or deficit of fat cells seems to upset the delicate cascade of chemical events that are needed to make a baby. Being obese can exacerbate polycystic ovary syndrome (PCOS). But even for women who ovulate, weight has been shown to play into fertility. There’s a strong association between having a BMI over 30 or under 20 and delayed conception. One research found that for every BMI interval over 29, chances of pregnancy went down by five percent. Roughly one in four U.S. women of childbearing age is obese.

ENVIRONMENTAL CHEMICALS

A handful of chemicals are suspect when it comes to getting pregnant – for example, phthalates (used in plastics, food packaging, toys, and more), pesticides, bisphenol A (BPA), air pollutants, as well as polychlorinated biphenyls (PCBs). Last year, for example, a study of Chinese factory workers found that those with higher levels of BPA exposure had lower semen quality. PCBs, which were banned decades ago but still linger in the environment, seem to clearly affect sperm motility and damage sperm DNA.

It’s not a bad idea to find ways to limit exposure to the dubious chemicals (buy organic “dirty dozen” fruits and veggies, use BPA-free products when possible, consider not living near a highway, eat less processed and packaged food, check your cosmetics with the Environmental Working Group’s database, and so forth).

But there are a few reasons not to head for full-blown panic over chemicals in the environment. For one, it’s very hard for scientists to accurately pinpoint how and in what quantity one particular chemical affects something like sperm health because controlled studies are near impossible. Consider also that we bump into hundreds of environmental chemicals every day through no choice of our own – to a large extent it’s all out of our control.

LAST BUT NOT LEAST: KNOW YOURS, BUT NO OVERTHINK

It’s tempting with information like this to go overboard, especially when something as precious as your fertility is seemingly at stake. That said, just as with age and fertility statistics, lifestyle and fertility stats are just that – averages and trends across large samples of women. Plenty of moms get pregnant without a hitch on a steady diet of hamburgers, just as plenty who have impeccable diet and exercise habits struggle with infertility. Your best plan for getting pregnant? Stay informed, but don’t make yourself crazy with the details.

Source: BabyHopes

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Candida Yeast Infection Treatment

candida yeast infection treatment

What is candida yeast infection?

Candidiasis is a fungal infection that can affect areas such as the:

• Skin
• Genitals
• Throat
• Mouth
• Blood

It is caused by the overgrowth of a type of yeast called Candida, usually Candida albicans. This yeast is normally found in small amounts in the human body. But certain medicines and health problems can cause more yeast to grow, particularly in warm, moist body areas. This can cause uncomfortable and sometimes dangerous symptoms.

Candida yeast infection symptoms
Symptoms and treatment depend on which part of the body is infected. 

• If it is in the mouth or throat, it is called oral candidiasis, oropharyngeal candidiasis, or thrush.
• If it affects the genital area, it is called a yeast infection. In women, it may be called a vulvovaginal yeast infection.
• If yeast infects the skin on a baby's bottom area, it causes a diaper rash.
• If the infection enters your bloodstream, it is called invasive candidiasis or candidemia.

Candida yeast infection treatment

Candidiasis is commonly treated with antimycotics; such as:

• topical clotrimazole
• topical nystatin
• fluconazole, and 
• topical ketoconazole.

Source:

http://www.webmd.com

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Blocked fallopian tubes

blocked fallopian tubes

While there are many causes of infertility, a blocked fallopian tube is often the reason why many women are unable to conceive. Each month, when ovulation happens, an egg is released from ovary, and goes through the tubes and reaches the uterus. The sperm also need to swim from cervix through the uterus and to the fallopian tubes to meet the egg. Fertilization usually takes place here while an egg is traveling through the tube. If one or both fallopian tubes are blocked, the egg can't reach the uterus, and that's why the sperm can't meet the egg. This will prevent any fertilization and pregnancy.

Get to know about fallopian tubes, what are fallopian tubes?

The fallopian tubes are the pathways in which the ova travel from the ovaries down into the uterus. They consist of two thin tubes. Their function is to lead the mature egg from the ovaries to the uterus. Blocked fallopian tubes typically prevent successful passage of the egg to the sperm, and/or the fertilized egg to the uterus. In some cases, blocked fallopian tube is not total, but partial. This can increase the risk of a tubal pregnancy or ectopic pregnancy.

What causes blocked fallopian tubes?

Blocked fallopian tube is the major cause of infertility in women at about 20% of the infertility cases. Here are common causes of blocked fallopian tubes.

• Endometriosis
• Uterine fibroids
• PID (pelvic inflammatory disease)
• Ectopic pregnancy
• Tubal ligation removal
• Genital tuberculosis (rare cases)
• Complications from lower abdominal surgery, such as Caesarian section.

How to diagnose blocked fallopian tubes?

There are no specific symptoms and signs that make us know if we are suffering from blocked fallopian tubes. But if you have PID, it is important to think of blocked fallopian tubes, because based on epidemiologic studies, 75% of women with sexually transmitted disease do suffer from blocked fallopian tubes.

The only sign that there is a blocked fallopian tube is an inability to conceive, or we call it primary infertility. To detect this abnormality, there are some diagnostic modalities. Here are the details.

1. HSG (hysterosalpingogram). It is an X-ray test using a contrast dye to view any blockage or obstruction in the fallopian tubes.
2. Laparoscopy surgery / chromotubation. This procedure is similar to HSG because chromotubation includes dye being passed into the fallopian tubes and uterus. This test is performed on a laparoscopic surgery so the doctors can see the dye spelling from the fallopian tube.
3. Sonography (almost similar to USG). It is a non invasive test using ultrasound imaging to determine any abnormalities in reproductive organs.
4. Blood test to detect Chlamydia antibodies because tubal disease is often related to Chlamydia infection.

How to open blocked fallopian tubes?

1. Selective tubal cannulation. This procedure is performed for proximal tubal blockage with 60% pregnancy success rate.
2. Tubal ligation removal (tubal reanastomosis). In this procedure, the doctor will remove the portion of the fallopian tube that was tied or cauterized in the original surgery and reattaches the two ends to make a complete tube. Tubal reanastomosis has a 75% pregnancy success rate.
3. While IVF therapy has largely replaced tubal surgery in the treatment of infertility, the presence of hydrosalphinx is a detriment to IVF success. It has been recommended that prior to IVF, laparoscopic surgery should be done to either block or remove hydrosalpinges.

What are the risks of blocked fallopian tubes surgery?

• Pelvic infection
• Ectopic pregnancy
• Regrowth of scar tissue
• Tissue adhesion

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Heavy menstrual bleeding

heavy menstrual bleeding

Heavy menstrual bleeding (menorrhagia) is one od the most common gynecologic abnormality that can take a heavy toll on the women it affects. Many women with heavy menstrual bleeding problem do not discuss their condition with their clinicians because they mistakenly believe that it is something they actually have to live with or some women also complain about their fear of hormonal and surgical therapy.

Definition

The definition of heavy menstrual bleeding refers to blood loss > 80 mL during menstruation. NICE (National Institute for Health and Clinical Excellence) of the UK proposed that heavy menstrual bleeding can be defined as excessive menstrual blood loss that interferes with patient's physical, emotional, socialm and material quality of life, and which can occur alone or in combination with other symptoms.

Epidemiology

About 30% of women experience heavy menstrual bleeding at some point of their lives. This condition affects more than 10 million women in USA each year, which is about one in five women; however only about 5% of women of reproductive age seek treatment for it annually.

Risk factors

There is a little facts about demographic risk factor of heavy menstrual bleeding. A study has reported that heavy menstrual bleeding has correlation with age, and others show no correlation of heavy menstrual bleeding with ethnicity, genetics, or parity. Lifestyle factors such as alcoholism and smoking are still unknown.

What causes heavy menstrual bleeding?

Here are the causes of heavy menstrual bleeding, according to FIGO classification system:

• Structural causes
• Endometrial or cervical polyps
• Adenomyosis
• Leiomyoma
• Malignancy and hyperplasia
• Non structural causes
• Coagulation disorders
• Ovulatory dysfunction
• Endometrial
• Iatrogenic

Treatment of heavy menstrual bleeding

Treatment of heavy menstrual bleeding should be based on many factors such as:

• Your medical history
• Causes and severity of heavy menstrual bleeding
• Tolerance for specific drugs or procedures
• Your future childbearing plans

Medication/drug therapies for heavy menstrual bleeding may include:

• Iron supplements, if heavy menstrual bleeding is accompanied by anemia
• Analgetics or nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen, ibuprofen, mefenamic acid, they help reduce menstrual blood loss and also relieve menstrual cramps (dysmenorrhea)
• Oral contraceptives, it can help regulate and normalize the menstrual cycles and also reduce prolonged menstrual bleeding
• Oral hormones (progesterone), it will correct hormonal imbalance and reduce menstrual bleeding
• Hormonal IUD (Mirena). It is an intrauterine device that contains progestin (levonorgestrel) which makes the uterine lining thin and reduce menstrual blood flow, relieve cramps.

• 
  

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Endometrial Cancer Symptoms And Signs

endometrial cancer symptoms and signs

Endometrial cancer is a cancer that is originated from endometrium, the lining of the womb (uterus). The exact cause of endometrial cancer is still unclear, but it is proven that there is a genetic mutation in endometrial cells. Endometrial cancer is different from cervical cancer, that is mostly detected in advanced stages, in endometrial cancer, early stages are more often detected because the cancer produces abnormal vaginal bleeding. When detected, total removal of the uterus will completely eliminate cancer cells. 

Endometrial cancer symptoms and signs

• Pelvic pain or cramping, sometimes abdominal pain
• Pain during intercourse
• Abnormal menstrual period, with abnormal menstrual bleeding
• For menopause women: bleeding between usual periods, spotting, vaginal bleeding, heavy and frequent vaginal bleeding
• Abnormal vaginal discharge after menopause (watery, blood-tinged discharge)
• Signs/diagnostics:
• Endometrial biopsy, then examine it microscopically by a pathologist.
• D and C (dilation and curettage)

Treatment

Generally, there are 4 treatment options for endometrial cancer:

1. Surgery
2. Radiation
3. Chemotherapy
4. Hormonal therapy

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Hyperthyroid Symptoms In Women

hyperthyroid symptoms in women 

As we have discussed before (here), hyperthyroid briefly means overactive thyroid gland. 

Hyperthyroid symptoms in women are:

• Feel weak, tired easily
• Mental instability, moody, nervous, anxiety, irritability, depression, nervousness
• Bulging eyes
• Tremor, shaky hands
• Breathing problems, breathlessness
• Fast heartbeat, sometimes irregular beat, chest pain
• Warm and itchy skin, moisy
• Hair loss
• Increased sweating, always feel hot
• Increased appetite, more eating, hungry easily
• Weight loss although you eat more than usual
• Less frequent menstruation, lighter menstrual blood flow
• Diarrhea

When you experience the symptoms above, it is very important to consult with an internist. If hyperthyroid is not properly treated, it will cause more problems for women such as: bone problems, fertility and pregnancy problems, heart problems, and thyroid storm.

Diagnostic Tests

Diagnosis of hyperthyroid is made by physical examination, signs and symptoms, and also some diagnostic tests as listed below:

• Ultrasonography (USG) of the thyroid. It is a non invasive procedure.
• Blood test:
• Free T3 and  T4 (usually high)
• TSH sensitive (usually low)

 Hyperthyroid treatment

• Anti-thyroid drugs. These drugs will reduce hyperthyroid symptoms by preventing thyroid gland from making too many hormones.  
• Propylthiouracil
• Methimazole
• Beta blockers, such as Propanolol. This drug treats heart palpitation and slower heart beat.
• Radioactive iodine. It is given orally and will absorbed by the gland. The hyperthyroid symptoms will reduce gradually in 3-6 months. 
• Surgery. If drugs and radioactive iodine do not show an improvement, in some cases, the thyroid gland should be removed. After thyroid surgery, you will need a lifetime medication to supply the thyroid hormone such as levothyroxine.

Sources:

• WebMD
• American Academy of Family Physician
• Mayo Clinic

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Thyroid Problem Symptoms In Women

thyroid problem symptoms in women

Thyroid is a gland located at the base of the neck. It produces the most important hormones in metabolism called T3 and T4. These hormones regulate many mechanism in the body, such as the rate of heart beat, calories metabolism, and so on. These hormones should at their right amounts to provide their proper functions.

Thyroid problems mostly affect women at about three times more than men. This fact is due to a hormonal connection. There are several types of thyroid problems in women, such as:

1. Hyperthyroidism. It is a condition where thyroid function is overactive, produce more hormones than usual. The symptoms are:
• Less frequent menstruation with lighter flow
• More eating than usual
• Fast heartbeat, sometimes irregular
• Insomnia
• Anxietas
• Irritability
• Increased sweating
• Tremor in hands and fingers
• Diarrhea; more rapid bowel movement
2. Hypothyroidism: when thyroid gland does not produce enough hormones. The symptoms are:
• More bleeding while menstruation
• Increased sensitivity to cold
• Frequent constipation
• Fatigue and muscle weakness
• Dry skin and puffy face
3. Thyroiditis. It is inflammation or infection on the thyroid gland. They are mostly auto immune disease and hereditary. Types of thyroiditis are:
• Hashimoto's thyroiditis
• Postpartum thyroiditis
4. Thyroid cancer. Most patients with thyroid cancer have also thyroid nodules but they are asymptomatic. It can be diagnosed by thyroid scan/ultrasonography. People who often exposured with radiation, older than 40 years old and have familial history of thyroid cancer are at a high risk of having thyroid cancer.
5. Thyroid nodules. It is a swelling in unilateral (one section) of the thyroid gland. Most of thyroid nodules cases are asymptomatic. Symptoms will appear when there are so many nodules that produce more thyroid hormones causes hyperthyroidism. The thyroid nodules sometimes can be palpated in the neck.
6. Goiter. It is an abnormal enlargement of the thyroid gland. The most common cause is iodine deficiency. The symptom is swelling in the neck. Very large gland will cause problems of swallowing and breathing.

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Vaginal Infection Causes

vaginal infection causes 

Vaginal infection, or vaginitis, is a medical terminology that means infection and/or inflammation of the vagina. There are many causes of vaginal infection, such as bacteria, yeast, viral, and also local irritations caused by clothing, creams, and so on. 

The most common vaginal infection causes are bacterial, yeast, and trichomoniasis. The origin of them are different but the symptoms are generally similar as described below.

1. Bacterial vaginosis. It is the most common cause of vaginal infection. Gardnerella vaginalis is the name of organism causes bacterial vaginosis. It happens when there is an imbalance in the types of the bacteria normally found in the vulva and vagina. Here are some risk factors that cause them:
• Multiple sexual partner
• Frequent douching habit
• Pregnancy
• Intrauterine device (IUD) use 
• Swimming pools and toilet seats CAN'T spread the bacteria.
2. Vaginal yeast infection. It is mainly caused by fungus named Candida albicans, so it is called candidiasis. The overgrowth of yeast in vagina is possibly caused by any of these events:
• Use of steroid
• Immunocompromized condition (HIV/AIDS)
• Use of antibiotics. Vaginal yeast infection may happen after taking antibiotics therapy for another condition in the body such as strep throat. Antibiotics kill protective bacteria and make the fungus overgrow.
• Pregnancy and diabetes mellitus. In these two conditions, there is a low glycogen store in certain vaginal cells. This causes increasing in vaginal pH that is suitable for fungal growth.
• Menopause.
• Use of birth control pills. Estrogen in birth control pills can change the normal vaginal environment.
• Wearing tight underwear can cause irritation that tends to candidal overgrowth.
3. Trichomonas vaginalis. It is a kind of sexually transmitted disease (STDs) that mostly affects the urinary tract.
4. Viral vaginal infection. It is caused by non specific viruses.

Vaginal infection symptoms

General symptoms of vaginal infection are:

• Itching around the vagina
• Abnormal vaginal discharge with bad odor
• Burning in urinating
• Pain on sexual intercourse.

Vaginal infection treatment

Before taking treatment, we have to confirm the diagnosis. Diagnosis can be based on symptoms and also other diagnostic tests such as: urine tests and vaginal cultures/sensitivity test. The proper treatment is actually based on the cause. If bacterial, take antibiotics as recommended in the sensitivity test. Vaginal yeast infection may be treated by vaginal suppositories and/or antifungal pills.

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Urinary Tract Infection Treatment

urinary tract infection treatment

Urinary tract infection is infection that occurs in the urinary system. Urinary system consists of kidneys, ureters, bladders, and urethra. Urinary tract infection can occur in every part but the most common part is th lower urinary tracts especially bladder and urethra. Because of the anatomy of urinary system (short distance between urethra opening and bladder), women have a greater risk to develop urinary tract infection. Urinary tract infection can be mild and severe if it spreads to the kidneys.  

Urinary tract infection: Causes

The infection starts when bacteria enter the urinary tracts through urethra, stay in the bladder, grow and spread around. The most common forms and causes of urinary tract infection are:

1. Cystitis. It is bladder infection usually caused by E. coli (bacteria commonly found in gastrointestinal tract. It may be caused by sexual intercourse, but people who are sexually inactive also have chance to get cystitis.
2. Urethritis. It is urethra infection, typically caused by bacterial spreading from anus to urethra. The causes of urethritis are mostly sexually transmitted diseases such as gonorrhea, chlamydia, and herpes virus infection.

Urinary tract infection: Symptoms

Most of urinary tract infection is asymptomatic. But here are symptoms that easy to be recognized:

• Pelvic pain (women), rectal pain (men)
• Burning sensation while urinating
• Frequent urinating with small amounts each
• Persistent urge of urinating
• Cloudy urine
• Bad smell urine
• Hematuria or presence of blood in the urine.

Urinary tract infection treatment

Antibiotics are the main treatment. The choice of drug is principally based on urine culture and sensitivity test of antibiotic. Antibiotics that are proven potent to treat urinary tract infection are:

• Trimethoprim-sulfamethoxazole (Bactrim)
• Nitrofurantoin (Macrodantin)
• Penicillin derivate: Amoxicillin (Larotid), Ampicillin 
• Quinolones: Ciprofloxacin, Levofloxacin (Lovequin)

Doctor sometimes also give you analgetics to relieve the symptoms. Be sure to take water at least 2 liters per day. Severe, recurrent infection, infection on the kidneys, and other complicated urinary tract infection need hospitalization. Drugs should be given intravenously.

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Vaginal Yeast Infection Treatment

vaginal yeast infection treatment

Vaginal yeast infection is the most common problem in women. The symptoms are itching, burning, irritation, redness, and white or yellowish vaginal discharge with strong odor. Predominantly, vaginal yeast infection occurs in childbearing age women. There are some conditions that provide a chance for vaginal yeast infection, such as broad spectrum antibiotics, poor nutritional status, over consumption of sugar, contraceptive pills, hormonal shifta and immunocompromised problems.

Vaginal Yeast Infection Treatment

There are some treatment choices that can be used in first aid vaginal yeast infection treatment :

• Boric acid. This remedy has antiseptic and antifungal properties. It is used as vaginal suppositoria. The side effects are vaginal burning and skin allergy/irritation.
• Essential tea tree oil. This is a natural remedy, used by diluting and applying topically to the vulvovaginal area.
• Antifungal drugs
• Antifungal tablet. Mostly used is fluconazole (Canesten, Diflucan). Antifungal tablet can be very effective, usually one tablet as single dose is enough to cure vaginal yeast infection. Side effects include nausea, vomiting, diarrhea, bloating, and constipation. Pregnancy and breastfeeding are contraindications for this treatment.
• Pessaries. Intravaginal pessaries do not have systemic effects, can cause local irritation. Examples for intravaginal pessaries are clotrimazole (Canesten), econazole (Ecostatin), and miconazole (Gyno-Dactarin). Pregnancy is also contraindication because it will cause cervical injury.
• Creams. Creams are additional therapy to tablet and pessaries to cure redness and soreness around vagina, vulva, or perineum.

Vaginal Yeast Infection Treatment Failure

The failure of vaginal yeast infection treatment can occur due to: patient's poor compliance, longer use of oral and topical drugs, double infection with bacteria, or there are underlying diseases that worsen the infection.

Vaginal Yeast Infection Treatment at Pregnancy

Drugs of choice are: tropical clotrimazole, miconazole, and econazole. Avoid to use nystatin because it is less effective.

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Vaginal Yeast Infection Symptoms

vaginal yeast infection symptoms

Vaginal Yeast Infection is usually caused by a yeast or fungus called Candida albicans. This yeast is normally found vulva and vaginal area as flora normal. Statistically, it is estimated that three of four women (75%) will have vaginal yeast infection at least once in their lifetime.

There are risk factors that contribute to vaginal yeast infection such as: diabetes mellitus, pregnancy, oral contraceptive using, prolonged broad spectrum antibiotics using, and chronic use of corticosteroid. Vaginal yeast infection is commonly found in after menopausal women, because of decreasing estrogen levels within the vaginal wall.

Vaginal Yeast Infection Symptoms

• White vaginal discharge (it is the most common symptom). The texture is similar with cottage cheese.
• Dyspareunia (pain on sexual intercourse)
• Pain on urinating
• Red and swollen area around vagina and vulva

Vagina yeast infection is basically not a emergency condition. But in people who have low immunity status (HIV, prolonged corticosteroid user, pregnancy), it will be possible fot the infection to spread into the blood stream and cause systemic yeast infection, a potentially life-threatening problem. The vaginal yeast infection symptoms that may be life-threatening are:

• High fever (more than 38 celcius degree)
• Severe pelvic pain or abdominal pain
• Bleeding while pregnant
• Chest pain
• Respiratory problems: shortness of breath (dyspnea), wheezing, etc
• Nausea and vomitus

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Ovarian Cyst Malignant Treatment

Ovarian Cyst Malignant Treatment

Ovarian Cyst Malignant, is USG enough?

The malignancy level of any ovarian cysts cannot be diagnosed with certainty by using ultrasonography (USG). The best way to determine the malignancy is to identify characteristics that make it more likely to become benign or malignant cyst. But sometimes it can be confusing since many benign conditions can appear on USG as a worrisome condition for malignancy. These include: endometriosis, dermoid cysts, hydrosalpinges, pelvic abscess, etc. 

Ovarian Cyst Malignant: How About CA-125 Level?

CA-125 is an ovarian cancer antigen test but it is NOT specific. It can also become positive in many cases of benign pelvic and abdominal disease, especially premenopausal. Endometriosis, liver diseases, benign ovarian tumors, and other non-malignant conditions can cause an elevation of CA-125. The normal limit is less than 35 u/ml and only when more than 100 u/ml, it will be a great concern for a malignancy.  

Ovarian Cyst Malignant: Age Distribution

Statistically, benign cysts and other ovarian masses can happen in all age ranges. But ovarian malignancy is definitely higher in older women and lower in younger ages.  Benign cyst can occur with almost equal frequency before and after menopause.

Ovarian Cyst Malignant Treatment

Every woman with an enlarge ovary is possible to have an ovarian cancer and considered to be operated, except those women who are proven to have a small cyst less than 1 cm in diameter, or women with early pregnancy. For women with pregnancy, ovulatory phase, and small cyst, the therapy is conservative, but they should be monitored and reexaminated in 4 weeks. After 4 weeks, if the cyst becomes smaller, then it can be still conservatively followed until it is gone. So it is called: functional cyst.

Every ovulating woman has a cyst for every cycle. The size is usually just 2 cm when it later breaks and releases an egg. But in some cases, the follicle cyst do not break and becomes larger. It will eventually break on its own, but if detected during this time, then an ovarian cancer should be considered. Sometimes, a follicle cyst ruptures and becomes a corpus luteum cyst. This will go away by its own. Ovarian cyst that persists for long period will have to be operated to ensure a diagnosis of cancer. A gynecologist will perform an USG test to differ between simple cysts and complex cysts. A simple cyst is a fluid-filled cyst, only fluid; but a complex cyst has an internal structure or solid matters within it. A complex cyst should be operated to exclude the diagnosis of cancer.

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Diabetes Type 2 Symptoms In Women

Diabetes Type 2 Symptoms in Women

Diabates type 2 can be classified in Non Insulin Dependent Diabetes Mellitus (NIDDM) is a metabolic disorder characterized by high blood glucose. This type of diabetes can be controlled (but not treated!) with diet and/or taking certain medications. There are various diabetes type 2 symptoms in in women, all of them are not specific, mostly are just the same with general diabetic symptoms, as listed below.

Diabetes type 2 symptoms in women :

1. Losing weight gradually.
2. Increased thirst and desire to urinate frequently arise. 
3. Itchy vulva, caused by vaginal yeast infection.
4. Easy to be hungry and weak
5. Decreased levels of vision .
6. In the event of injury, takes longer to heal or dry.
7. In some spots there are folds of skin color or black and is called acanthosis nigricans is insulin resistance.

This diabetes type 2 symptoms in women can be controlled if patient immediately visit the doctor and follow doctor's advice, regularly control blood glucose, diet modification, and eat some drugs as needed.

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Ovarian Cyst Symptoms After Menopause

Ovarian Cyst Symptoms After Menopause

Ovarian Cyst  is a fluid collection that occurs in the ovary. The fluid is wrapped by a membrane that is formed by the outermost layer of the ovary.

Ovarian Cyst in after menopausal women are quite common.

After menopause, ovarian cysts are contracted . No optimal management for cysts exists. Many cysts will be naturally absorbed  without any problems. Ovarian cysts and malignancy do not appear to have a close correlation, but we are already know that ovarian cancer is showing a disturbing rise in older women. Most of ovarian cysts are not dangerous; not cancerous. The diagnosis is made by ultrasonography (USG), although sometimes the cysts are palpable (can be touched) enough. It was highly recommended to remove the cysts seriously, but now, as rapid advance in imaging technology, clinicians have developed a criteria for how to manage an ovarian cyst especially for post menopausal women. In general, not all cysts should be removed; cysts that do not grow may just be observed.

Ovarian Cyst Causes

Ovarian cysts are formed by a variety of reasons. The cause will determine the type of cyst. Among all types of ovarian cysts, follicular type is the most common one. This follicular cysts are formed because the growth not controlled.

The follicle is a fluid cavity that normally found in the ovary. In normal circumstances, follicle containing eggs will open during the menstrual cycle to release an egg. However, in some cases, these follicles do not open, and this fluid retention will later become cysts.

Fluid inside the cysts mostly are blood which comes as a result of the injury of the small blood vessels around the ovary. But in rare cases, cysts may also contain abnormal body tissues such as: hair and teeth. This is called dermoid cysts.

Ovarian Cyst Symptoms

Most women do not realize that she is suffering from a ovarian cyst. The most ovarian cyst symptom is pain felt in the hips and lower abdomen. This pain is caused by ruptured cyst wall, cyst enlargement that rapidly grow, or bleeding inside the cyst, and torsion cyst. The pain will be severe when the cysts twist. 

When you experience the symptoms like above, better you come to an expert in pelvic sonography and also a gynecologyst. They will perform a blood test called CA-125. If there is an elevated CA-125, the cysts are potentially malignant/cancerous.If the CA-125 is within normal limits, it may be sign of simple cyst, which only contain liquid and should be followed by serial USG until a period of time. But elevated CA-125 with pain are suspected to be dangerous; so removal is considered. Gynecologyst will also perform a new blood test called OVA1 if your CA-125 is high. The result  of high OVA1 will confirm that the cyst is malignant.

Ovarian Cysts Treatments

If the cysts are confirmed malignant, they should be removed. Removal process is not always an open procedure (called laparotomy), now clinicians perform a laparoscopy technique (make a belly button or keyhole surgery). Better for you to do the procedure under the supervision of a gynecologic oncologyst.

Summary

• Most ovarian cysts in after menopausal women are benign.
• When the cyst is small (by USG), the CA-125 is normal, and painless, she should have a serial USG and CA-125 testing.
• If USG shows a growing significantly cyst, it means the cyst has potentially malignant characteristic. It usually followed by elevated CA-125 and pelvic pain.
• The approach of managing ovarian cyst in post menopausal women is now minimally invasive surgery, because older women tend to have underlying disease.

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Polycystic Ovary Syndrome Treatment

Polycystic Ovary Syndrome Treatment

Polycystic Ovary Syndrome
Synonim : Stein-Leventhal Syndrome, polycystic ovarian syndrome (PCOS)

Polycystic ovary syndrome is one of the most common hormonal disorder in women, at about 5-10% women of reproductive age and so far it is thought to be one cause of female infertility. Polycystic ovary syndrome defined as a collection of these symptoms, that caused by hyperandrogenism (increasing in androgen hormones) and the presence of ovulation without congenital  adrenal hyperplasia, increasing prolactin hormone (hyperprolactinemia) or  caused by tumor/neoplasm that produces androgen hormone.

The term "polycystic" means "many cysts", but it is often misunderstood. Some people still think that any cyst should require surgery, and this understanding can worry patients and families. So what is actually polycystic ovary syndrome? There are some folicles (size 4-8 mm) that aren't well developed so they seem as very little cysts at the ovary. So, it is NOT a big cyst that indicates tumor/cancer.

Symptoms of Polycystic Ovary Syndrome 
The symptoms can vary from asymptomatic until symptomatic such as infertility, chronic anovulation that is characterized by amenorrhea (no menstruation), olygomenorrhea (few menstruation), menstrual disorder, dysfunctional uterin bleeding (DUB), masculinization, obesity, and acne. Symptoms and severity of polycystic ovary syndrome vary widely among women.

According to the Rotterdam's criteria (2003), the diagnosis of polycystic ovary syndrome is established if we meet two of three following symptoms:

1. The existance of menstrual disorder due to little (oligo) or no ovulation
2. The presence of biochemical or clinical signs of hyperandrogenism
3. The presence of polycystic ovary at USG examination.

Polycystic Ovary Syndrome & Infertility
One study found that 7 of 10 women who experience infertilility due to ovulation disorder and experience menstrual disorder was suffering from polycystic ovary syndrome. Patients with increasing luteinizing hormone (LH) cause hormonal imbalance that is likely to lead to polycystic ovary syndrome. If they become pregnant, the frequency of miscarriage is high.

Treatment of Polycystic Ovary Syndrome
Women with polycystic ovary syndrome don't mean they won't get pregnant. They just need some help to make them ovulate normally. They are several things to do:

1. How to lower insulin resistance. This can be obtained by reducing body weight. Exerciee regularly, low carbohydrate diet, and take some medications such as metformin and thiazolidinedione (proglitazone). Regular consumption of metformin will normalize ovary's function. Menstruation will be normal after + 2 months of therapy.
2. How to lower androgen hormones and regulate menstruation. High androgen hormones can be lowered by medications of cyproteron acetate (birth control pills). Birth control pills can also help normalizing the abnormal composition of polycystic ovary. After several treatments, the next therapy is to stimulate ovum growth.

Polycystic ovary syndrome treatment is important, not only for reproductive health but also long term health because women with polycystic ovary syndrome tend to have diabetes mellitus, hypertension, cardiac problems, and high risk of uterus cancer in the future.

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