Health Issues Specific to Womens Health – Girls Period

Health Issues Specific to Women’s Health

Health Issues Specific to Womens Health: Whereas each women and men contract numerous situations, some well being points have an effect on girls otherwise and extra generally. Moreover, many ladies’s well being situations go diagnosed and most drug trials don’t embrace feminine test topics. Even so, girls bear unique well being considerations, corresponding to breast cancer, cervical most cancers, menopause, and being pregnant.

 

Top 8 Health Issues Specific to Womens Health

 

  • Heart Disease – Health Issues Specific to Womens Health

Heart disease in women is a very important topic historically women have been thought not to get heart disease it’s really been a disease of men but in fact, the incidence of heart disease in women is increasing every day also women tend top resent with heart disease further along in their disease process because again it’s not thought of when we see women in the office or in the hospital but also women tend to have more silent symptoms.

 

If you will women who are experiencing heart attack or chest pain generally don’t have that classic pain they might have just a symptom of fatigue or a little bit of short of breath or just not feeling well so generally it goes unrecognized so we don’t discover that they have heart disease until much later in their course which also leads to poor prognosis so it’s been our focus more recently.

 

The American Heart Association has had a strong campaign to bring awareness to heart disease in women and that needs to continue to be delivered that message needs to continue to be delivered in order to slow the progression of heart disease in women I think here at Memorial Regional Hospital.

 

We have first-class team assembled that can provide cardiac surgery services to the general public what makes us special I think is really the quality of our team, not just the heart surgeons, particularly but you know medical personnel such as two trained board-certified cardiac anesthesiologist who are really expert at what they do nursing therapists physical therapists nutritionists we really have a first-rate team in place that I think allows us to deliver the very highest quality of cardiac surgery.

 

We also I feel we’re at the cutting edge of cardiac surgery we offer all aspects of treatment from standard coronary artery bypass surgery to valve surgery to minimally invasive valve surgery we also provide services such as treatment of arrhythmias particularly atrial fibrillation and then recently we’ve added a real expertise in aortic surgery in patients who have a or to gander isms or the emergency aortic dissections we feel that that really improves the overall outcomes of patients after they’ve had something like heart surgery.

 

Heart Disease Symptoms In Women?

The signs and symptoms of heart disease are very different in women than in men or female patients the symptoms can sometimes be more complex they tend not to have the classic elephant sitting on their chest occasionally we’ll see that but a lot of times patients will come in or female patients particularly will complain of shortness of breath and fatigue those are probably the two that I see the most sometimes they’ll present with dizziness or palpitations that can be a sign of heart disease.

 

Occasionally we’ll get some very unusual chest pain syndromes could be pain between the shoulder-blades I see that much more in my older population occasionally it’s sort of a heartburn type symptom that’s also common in women and unfortunately even today with all the literature that’s out there about how significant heart diseases and women I think unfortunately a lot of those symptoms get downplayed and patients don’t get in until they have pretty severe diseases or if already had damage to their heart.

Heart disease treatment in women?

Heart disease is the number 1 killer and women and it is surpasses all forms of cancer combines most heart disease is preventable so if we could reach these women in their 20s and 30s and 40s and educate them on what to watch for and get treatment started early when it’s necessary and find early detection studies for heart disease in the same way we do early detection studies for Breast Cancer we’re going to save a lot more lives.

 

Heart Disease In Women, Heart Disease, cardiovascular disease, prevention, causes and symptoms, Heart disease valve, treatment, Symptoms

Stress reduction is very important to maintaining a heart-healthy lifestyle and it is something that I counseled many of my patients on particularly the women. What’s important about having a woman’s heart center is that we have physicians who are passionate about taking care of women, we have physicians that are educated in the differences between cardiovascular disease and men and women and we also have the benefit of being able to do research in an underserved field so we’ll be able to further our knowledge of women’s heart disease in the future and what we can do to prevent heart disease in women and how we can manage women with heart disease.

 

  • Emory: Woman’s heart center is really to promote awareness among women that heart disease is the number one killer so the primary way we do this is through our screening program to help educate individual women on their individual risk and what they can do to modify that risk and then possibly if needed get further treatment.
  • Community Events: So we go out and speak to corporations women’s group’s church groups really anyone who wants to know more about heart disease and women and we do that all year long with a lot of focus in February being Heart Month.
  • Increase Education among physicians: Who care for women and so one thing we do is we put on an annual education program to primary care physicians OBGYNs family practice internal medicine and mid-levels who take care of these patients as well as cardiologists to really promote the research and information on how to best care for women and the differences in women with heart disease.
  • Promote research among women: If women don’t enroll in the research studies then we’re never going to know exactly what’s best for them, Unfortunately, many research studies over the past 30 years have only had about 20% enrollment and females and some studies have had none at all so until we actually do the research on women we’re not going to know the best way to treat women in the future.

 

Heart disease valve in women?

Each year as many as 5 million Americans are diagnosed with heart valve disease is a cardiovascular condition that affects men and women of all ages but that becomes increasingly more common with age overall it is estimated that 1 in 50 women have valve disease but by the age of 75 and older, that number grows to 1 in 10 women.

 

Valve diseases involve damage to one of the hearts for valves the thin leaflets of tissue that separate the 4 chambers of the heart. A person may be born with a heart defector valve damage that may develop later in life from an infection of cardiovascular problems like a heart attack or simply aging.

 

Heart Disease In Women, Heart Disease, cardiovascular disease, prevention, causes and symptoms, Heart disease valve, treatment, Symptoms

Most heart valve disorders involve either regurgitation or stenosis though some may involve both types of damage with regurgitation the valve doesn’t close completely allowing leaks stenosis occurs when the opening becomes stiff or narrowed and limits blood flow all 4 valves can be damaged but diseases of the tricuspid and pulmonary valves are rare.

 

Aortic Stenosis is one of the most common types of valve disease affecting one in four women over the age of 65 and is often caused by thickening of the valve from a natural build-up of calcium. Aortic Regurgitation or insufficiency occurs in around 8% of women where leakage causes the heart to stretch and enlarge.

 

Mitral Valve Prolapse is a type of regurgitation where an enlarged or floppy mitral valve fails to close properly it only occurs in about 6% of women mostly younger and declines with age with mitral valve stenosis the narrowing of the mitral valve opening women account for 70% of cases and are 3 times more likely than men to have the condition while many types of valve disease are not serious others cause the heart to work harder enlarged and lead to complications that can cause major health problems disability loss of Independence and death.

 

Fortunately, People of all ages who have valve disease can usually be successfully treated with valve repair or replacement even though both men and women get heart valve disease for the experience can be very different women tend to be smaller than men in both body weight and stature and have smaller hearts these differences are important when it comes to recognizing symptoms getting diagnosed and making proper treatment decisions.

 

Some people with valve disease may not show symptoms but severe cases usually cause symptoms like chest pain or pressure, joint pain, muscle aches, sudden weight loss, irregular heartbeat, headaches, severe fatigue, dizziness, shortness of breath, nausea, and swelling in the ankles feet or belly sometimes these symptoms are inaccurately dismissed as a normal consequence of aging.

 

Women may also experience different symptoms than men with the same disease additionally compared with men women with symptoms tend to see a healthcare professional later and are less likely to be seen by a heart specialist women are also treated later and too often have their symptoms misdiagnosed as anxiety early detection of valve disease is critical and can save lives so women experiencing symptoms should see a healthcare professional right away.

 

A health care professional may suspect heart valve disease if abnormal heartbeats or murmurs are heard through a stethoscope or if their patient complains of symptoms further testing may be necessary to confirm valve disease.

 

Some valve diseases do not need treatment but should be monitored regularly other valve diseases may require valve repair or replacement in most cases this is the only way to effectively treat the disease in some cases remodeling valve tissue or repairing scarred valve leaflets may help them open more easily, in cases where valves are severely damaged heart valve replacement surgery may be recommended for most patients.

 

The risk of complications from replacement are low no matter what their age however for patients with other diseases and conditions that make them poor candidates for surgery less invasive procedures are now available more than 60% of heart valve replacements are performed in women can have different surgical outcomes than men so it’s important to discuss risks with a healthcare professional.

 

The selection of a new valve the Mechanical or Tissue may depend on the woman’s age and body size recognizing the symptoms of heart valve disease is critical to effective treatment if you have a heart murmur or other symptoms of valve disease talk to your healthcare professional discuss your family and medical history medications and any symptoms you may be experiencing if you have been diagnosed with heart valve disease be sure to discuss the best treatment options.

 

Heart disease causes and symptoms?

Doctor’s noticed a disturbing trend in a particular segment of our population we are seeing a little bit of you sometimes younger women in their 40s they have the what we call is the syndrome X they have obesity, hypertension, insulin resistance, hyperlipidemia so we are seeing a significant segment of that population show up in the clinic with heart disease I do feel a lot of it is related to obesity that we are seeing particularly in certain segments in women there is some ethnic prevalence seeing more in Hispanic women we are seeing women who are what we would call obese.

 

Symptoms of heart disease for men and women can vary but most commonly involved:

  1. Shortness of breath
  2. Heart palpitations
  3. Faster heartbeat
  4. Weakness or Dizziness
  5. Nausea or Sweating

 

Women may experience more subtle signs that can sometimes be overlooked or mistaken for other issues. Some of the more ones are just feeling of extreme fatigue shortness of breath lack of energy and just feeling and in some acute case it’s just a sense of gloom and doom which is when they’re actually having in a heart attack that if a woman is having these symptoms on a consistent basis she certainly should be concerned that it could represent significant heart disease and she needs to be evaluated for the same.

 

Heart disease prevention?

Heart disease prevention Nearly 2,500 people will die every day due to heart disease but it is our lifestyle that is killing us. One reason heart disease is so common is because of this issue of Abdominal fat. Abdominal fat is different than fat else where in our body these fat cells produce molecules or hormones that can go into our genes and turn on bad genes, turn on a gene for high blood pressure, turn on a gene for diabetes, turn on a gene that can disrupt cholesterol in the tab listen, and when these genes are turned on is like a light switch.

 

We have heart disease the next thing you know you’re in an ambulance with crushing chest pain being rushed to the hospital now in the hospital there are many life-saving medications procedures to open those blocked heart arteries but once the person recovers and returns home if they do not change their lifestyle those procedures were merely aband-aid.

 

We spend 2 trillion dollars every year on health care yet 75% of all those expenditures are spent on there results of our poor nutrition and lack of regular exercise we can do better as individuals and we can do better as a society enough talk let’s go exercise. So the latest statistics show that many people have taken this message to heart they’re exercising more regularly yes a third are not exercising but a third are at least occasionally and one-third has really gotten the message they’re exercising regularly you’ll never guess what group has really taken this message to heart it’s our elderly population yes our senior citizens they’re exercising more than any time in history so challenge yourself and make it fun see what your body can do.

 

Heart disease prevention Not only does our body crave exercise it craves good healthy food but there’s the rub we say we don’t have enough time to eat healthily so we resort to process food, fast foods we actually do have the time is just a matter of priority setting it does not have to be complicated sauteing vegetables just takes literally a few minutes put a fish fillet in the oven broil it you can have a wonderfully delicious dinner ready in just 30 minutes celebrate food to enjoy it don’t be at odds with it.

 

I cannot talk about heart health without talking about the power of love joy appreciation you see these are very important concepts the brain communicates with the heart it can send healthy messages or concern healthy messages the power of love laughter has actually been shown to favorably express healthy genes so enjoy celebrate have fun appreciate something or someone.

 

what is cardiovascular disease?

Cardiovascular disease involves abnormalities of the heart and blood vessels. Coronary heart disease is the most common condition and is the leading cause of death in the United States for both men and women.

 

The lifetime risk for developing significant cardiovascular disease is greater than the likelihood of developing cancer. Your heart is a muscular pump that requires heart arteries to supply oxygen-rich blood to keep it going.

 

Coronary heart disease occurs when these blood vessels become narrowed due to a buildup of plaque. The plaque is made up of cholesterol and other substances. This process is called atherosclerosis. Atherosclerosis occurs over a lifetime and is influenced by risk factors.

 

Some risk factors can’t be changed, however, others can be altered through healthy lifestyle choices and medications if needed. Symptoms of coronary heart disease occur when the heart muscle does not get enough oxygen.

 

Some describe this as chest pressure or chest pain that starts over the left chest and can radiate or travel to the left arm, left jaw, back, or sometimes to the right chest. Some patients do not have any chest pain or pressure symptoms, but instead, have intense shortness of breath or epigastric discomfort that can feel like bad heartburn. Breathlessness, nausea, vomiting, or sweats can also sometimes be associated. These symptoms are called angina.

 

There are many treatments for angina, including medications, angioplasty and stents, and bypass surgery. Aggressive risk factor modification is part of every treatment plan. Coronary heart disease can have serious complications, including heart attacks and even sudden death. Fortunately, developing significant coronary heart disease is largely preventable.

 

Early prevention is best, but you can still improve how you’ll do no matter how old you are by reducing your risk factors. One study found that 50-year-old people who had not already developed significant cardiovascular disease and didn’t have major risk factors reduced their lifetime risk for developing significant cardiovascular disease, and they lived longer.

 

  • Breast Cancer – Health Issues Specific to Womens Health

Cancer can be anywhere in our body and any cell of our body can develop in the cancer cell. Any change in our body can be in the cancer cell. If this change comes in breast tissue and breast cells. If there is abreast of the breast that develops in cancer cells and changes and cancer is there, then we call it breast cancer Causes.

 

Breast Cancer Causes, Treatments, Breast Cancer, Causes,

Breast cancer Causes is the most spreading cancer in women and millions of palaces are victims of this cancer every year, so women are conscious and keep checking their breasts from time to time in their own homes. If there is a slight doubt, then contact the doctor immediately.

 

Breast cancer Causes are widely seen in women around the world today. It is important for women to know and identify the symptoms of cancer, although women themselves can also identify cancer at home. It is very easy to identify.

 

How can breast cancer be?

If you have breast cancer in your family then you also get the chance of getting cancer.

 

Breast Cancer Causes, Treatments, Breast Cancer, Causes,

  • Do not breastfeed
  • Growing up at an early age,
  • Much delay in becoming a mother
  • Smoking
  • Drinking alcohol
  • Do not take sleep
  • To become a mother at a higher age
  • Wear a tight bra

 

All of these can be caused by breast cancer. Many times poor lifestyle may also cause cancer in women. Therefore supervision is very important.

 

What are the initial symptoms of breast cancer?

Breast cancer is common among women, but nowadays this disease is also seen in men. Cancer is mostly done in older women, low incidence of cancer in women is very low.

 

  • Lump in the breast
  • Breaking in the breast
  • Breathing in the breast without pain
  • Exposure of any fluid or blood from the breast nipple
  • Pain or swelling between the breast and arm
  • Changes in the shape of breasts
  • Breast swelling
  • Skin scissors on breasts
  • Turn on the nipple or inward side
  • Itchy in the breasts without itching

 

Having any of these signs does not mean that you have cancer. If any symptoms are found, contact the doctor immediately. Because you can tell the doctor only after examining it correctly.

 

Most women do not like to talk about breasts. Sometimes even if breast cancer symptoms are found, it is either to tell the doctor or to be ashamed. All those women are requested to bring forth the problem without any hesitation so that you can save yourself from this cancer.

 

How to check breast cancer?

Women can also check cancer at home. When you stand in front of the glass, now press your entire breasts slowly with the fingers of your hands. Or bring hands down on the breasts slowly.

 

And see, there is no lump if there is any lump, you will surely feel, if any lump is felt, then by pressing the lump, it is painful. If you do not have any pain on pressing the lump, then chances of cancer are increased.

 

So in this way you can check the lump in your breasts and keep checking the breasts regularly. If there is any symptom, do not ignore immediately contact the doctor. Women’s beauty comes from her breasts. So they are in your care.

 

Breast Cancer Treatment

Breast Cancer Causes, Treatments, Breast Cancer, Causes,Breast Cancer Treatment is now possible but it depends on what stage of cancer is there. How much cancer is spread, how large is the size of the food? The most common method is cancer surgery in which the breast is removed by the operation.
One more thing is that some women keep a mobile phone in their bra. Do not do this, radiation is generated from mobile phones which can cause these symptoms.

Treatment options for Breast Cancer include

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

 

There are several surgical options depending on the severity of cancer.

  • Lumpectomy: Removes the tumor and a small amount of neighboring tissue.
  • Mastectomies: Involves removing the entire breast and its tissues.
  • Sentinel lymph node removal: This is typically performed in addition to lumpectomies and mastectomies here your surgeon will remove the lymph node closest to the tumor and check it for the presence of cancer cells. If this node is clean it may not be necessary to remove more lymph nodes.
  • Prophylactic mastectomy: Is a preventative surgery for high-risk women that removes the entire breast to lower the risk of breast cancer.
  • Radiation therapy: Uses high-energy x-rays or other types of radiation to kill the cancer cells or to keep them from growing.
  • Internal radiation therapy: Can be used to treat cancer from the inside of the body with needles wires or catheters.
  • Chemo Therapy: Is a treatment that uses drugs to stop the growth of cancer cells by either killing them or inhibiting their cell division once the drugs enter the bloodstream they can travel and reach cancer cells throughout the body some types of breast cancers need hormones in order to grow and spread.
  • Hormone Therapy: Works by blocking the cancer cells from receiving the natural hormones that they need tests can show if your breast tumor has these receptors and if it is a good treatment option.

 

  • Ovarian and Cervical Cancer – Health Issues Specific to Women’s Health

What Is Ovarian Cancer?

Ovarian Cancer is a subtle disease it can sneak up on us like a beast in the night disguised as common problems such as Prolonged Bloating the constant need to pee and fatigue while the warnings are the same the most common type of ovarian cancer begins in Aphelion Cells.

 

Ovarian and Cervical Cancer

A type of cell that makes up the Tissue covering the Ovary surface to best Treat Ovarian Cancer doctors at Roswell Park first confirm the diagnosis and learn the stage or extent of the cancer this requires a procedure called surgical staging during which a surgeon carefully examines your Pelvic and Abdominal areas.

 

Ovarian Cancer Stages

The stage of Ovarian Cancer is determined by where cancer cells are found in the body in Stage 1 Ovarian Cancer is found in or on the surface of one or both Ovaries or Fallopian Tubes or in fluid collected from the abdomen in stage 2.

 

Ovarian Cancer Stage 3

The cancer is spread from its initial site to other areas of the Pelvis such as the Ovaries Fallopian Tubes and the Uterus Finding Cancer only in the lining of the abdomen is also considered Stage 2, Stage 3 means that the cancer has spread outside the Pelvis and is found in other parts of the Abdomen.

 

Ovarian and Cervical Cancer, uterus

 

Nearby lymph nodes or on the surface of the liver or spleen the cancer has reached Stage 4 when it’s spread beyond the abdomen into other parts of the body such as the liver Lungs bones or in the lymph nodes in the groin at Roswell Park we have a highly experienced team of board-certified gynecologic oncologists who focus specifically on Gynecological Cancers know your body ovarian Cancer Whispers.

Ovarian Cancer Risk Factors / Risk Factors for Ovarian Cancer?

I had none of the risk factors for Ovarian Cancer as far as I’m aware we’ve had no cancer on either side in the family I was on the pill for a while when I was younger I Breastfed my baby I’ve always eaten my green vegetables.

 

I had absolutely I was the person least likely to get cancer that was a complete bolt out of the blue and a shock I’m one of approximately two percent of ovarian cancer patients who didn’t have any Abdominal Symptoms prior to Diagnosis my first symptoms was were chest pain and breathlessness due to secondary tumors in the pleura.

 

My lungs first of all I went to my GP because of the breathlessness and she initially prescribed me Antibiotics on the assumption it was some sort of respiratory infection and a week later I was on holiday in another part of the country and it was no better and I went to the local GP there who immediately spotted that something desperately wrong and the next thing I knew I was in hospital within half an hour under going tests.

Ovarian Cancer Survival Rates /Survival Rates Ovarian Cancer

The survival rates vary tremendously for Ovarian Cancer because it depends on the cell type and the sixth stage of the Ovarian Cancer obviously the earlier the stage the better chance for cure and longer term Survival Rates but it’s somewhat dependent on how early it’s diagnosed and what type of Ovarian Cancer it is.

Screening for Ovarian Cancer / Ovarian Cancer Screening

Bloating indigestion change in appetite these may sound insignificant and common but doctors say they’re the key Symptoms For Ovarian Cancer for many years we thought that Ovarian Cancer is this silent killer because most women are diagnosed with ovarian cancer at an advanced stage 3 and 4 when the cancer had already spread in the Abdomen Ovarian Cancer can include more than one disease it can be cancer of the Ovary and Fallopian Tube patients often experience no symptoms.

 

Until the cancer has spread throughout the Pelvis and Stomach at this point and despite all the studies that were done there is no approved or screening that has shown that it makes a difference for a screening test for Ovarian Cancer to be approved and used it has to show that it’s going to allow us to diagnose those cancers early at the earlier stage to make a difference in terms of outcomes and survival and cure rates for the patients at this time study shows Screening For Ovarian cancer could cause more harm than good largest study that were that was done here.

 

In the United States showed that you hurt more women by attempting to screen for Ovarian Cancer than the women you helped but doctors are addressing a patient’s symptoms and family genetics women who have a strong family history of Ovarian and Breast Cancer should be evaluated to see if they carry genes that predispose to those cancers making it important to know your body and your family history for lee help I’m Leslie fry.

How Ovarian Cancer Is Diagnosed?

Advice that I would give to someone newly Diagnosed with Ovarian Cancer is certainly be aware of getting as much information as you can for yourself be comfortable with the institution.

 

And the doctor that you choose I think it’s a very personal decision certainly you have to be comfortable with that I think advice would be to always have hope you know that I think that she’s very good at giving that time on a new patients in the clinic.

 

When they come in they’re afraid and they’re uncertain and their family is afraid as well and not sure what to expect and so as they travel through that cancer journey sometimes they come to see me as a nurse on the floor.

 

Sometimes they get chemo to get they might get radiation and then and throughout all that it’s very important to have hope because there is the other side to that once all the treatment is finished there is there is life back on the other side.

Home Genetic Test For Ovarian Cancer / Test For Ovarian Cancer

What if you could take a Free Genetic Test researchers are hoping women at risk for Ovarian Cancer will do just that the test is simple just open the box and spit into the tube.

 

A few times they fill a small volume of spit into a tube and they put it back into the mailer that’s given to them and it gets shipped back to and the company Elizabeth Swisher is a clinician.

 

And researcher at UW Medicine in Seattle her work is focused on Cancer Genetics and the prevention of Ovarian Cancer in women it’s about 1 in 70 women will get Ovarian Cancer during their lifetime.

 

But it’s a very deadly cancer and we have no effective screening for it so unlike Breast Cancer we have no effective early detection and when women get it.

 

It’s usually advanced at the time they get their Cancer “Serena Stamper“ is worried about her risk for Ovarian Cancer the Seattle area Nurse works with Breast and Ovarian Cancer patients but she also has her own family history of the disease my paternal grandmother was diagnosed with Ovarian Cancer.

 

When she was 52 and now that I’m 46 and have children it’s become more a part of my thinking “Serena” has sent in her genetic test but has not received her results the magenta study as it’s called is screening for much more than the brca1 or 2 gene mutation.

 

We’re testing for thousands of different mutations but in 19 different genes we’re not going to prevent all Ovarian Cancers through this strategy about 20%of Ovarian Cancers hereditary but there’s a lot of lives that we can save if we identify those women who are at risk you.


What is a Cervical Cancer?

Cervical Cancer is the topic and cervical cancer most often is a squalors cell carcinoma and about 99% of the time it’s due to human Papillomavirus HPV although a very small percentage of cases have also been due to herpes virus.

 

Cervical Cancer

 

In terms of risk factors promiscuity is really a big one because HPV is sexually transmitted from person to person and also if a person has had their first intercourse at a younger age that is also considered a risk factor another risk factor for developing cervical cancer is smoking so keep those in mind as they will be mentioned on a clinical vignette in terms of the Pathology Cervical Cancer is described as CIN which is cervical Intraepithelial Neoplasia.

 

And CIN has three grades there’s grade 1 2 M 3 and grade 1 is referred to as mild cervical dysplasia and grades 2 & 3 are referred to as moderate cervical dysplasia and severe cervical dysplasia in terms of symptoms of cervical cancer not much really to say since most are a symptomatic but in advanced cases you will get irregular vaginal bleeding which is a very serious sign diagnosis of cervical cancer is actually a very important aspect because there is a established screening test known as a Pap Smear.

 

The Pap Smear detects abnormalities and cervical cells even before it becomes cancerous so this is a great way of detecting something in a very early stage if you do the Pap Smear and indeed the cells are abnormal then you would proceed to a Colposcopy and you would do a Biopsy of course as well.

 

And that will definitely give you some very important diagnostic information if you indeed have cervical cancer then it’s important to do staging to see if cancer has spread and that is done with the CT or MRI of the Abdomen and Pelvis in terms of treatment of Cervical Cancer.

 

If it’s a localized to a very small area then it can be treated with just simple excision of that area but if this cervical cancer has spread then you will need to do a more aggressive treatment with radiation and Chemotherapy and what’s important is these are not you know without their side effects.

 

For example radiation can cause premature menopause so it’s important to discuss this with the patient before treatment begins and prevention is the key in cervical cancer because the pap smears are really how you make sure that this can be prevented if routine Pap Smears are done then you can detect Abnormal Cells even before they progress.

 

The Cervical Cancer and the guidelines always seem to be changing but the most recent or current guidelines as a 2020 our women aged 21 to 65 should have a Pap Smear every three years the exception is if a woman has had a Hysterectomy then she does not need one because the Cervix has been taken out there is another part of prevention that’s important and that is a relatively new Vaccine known as the HPV Vaccine.

 

That can be given and that helps to prevent Cervical Cancer let’s take a look at a few Vignettes 34 year old woman presents for Evaluation after Diagnosis Of Cervical Cancer on a Clinical Evaluation it is apparent that the Cancer involves the upper 1/3 of the Vagina there is no parameter spread after discussion with the patient.

 

Ovarian and Cervical Cancer, uterusShe asks for a combination of External Beam Radiation and Brachytherapy and preparing for this treatment you want to discuss the possible side effects which of the following conditions is a potential side effect of radio therapy well one of the side effects of radio therapy is loss of ovarian function and premature men pause so choice next question 36 year old woman presents with 2 days of generalized malaise and low-grade fever along with severe DC Riya and clear Vaginal Discharge Chia State said she had Unprotected Intercourse with a new boyfriend 6 days ago he denied any history of Sexually Transmitted Disease.

 

She has no significant medical history and takes only Multivitamins on physical exam the patient appears quite anxious with the temperature of 38 point 9 on External Vaginal exam small ulcerative exquisitely tended and Aerith Ominous lesions are present on the Labia and several similar lesions are apparent on the Vagina Cultures are taken in a wet mount exam reveals numerous WBCs.

 

The woman is concerned about her Risk For Cervical Cancer which of the following statements concerning Cervical Cancer is correct well let’s take a look at these if she had three Consecutive Pap Smears normally the results she could have one pass for every five years that’s not really part of the new guidelines an Epidemiological Association with Herpes Virus and Cervical Cancer exists that is true Pap Smear should be performed every sick months now necessarily.

 

The diet guidelines essentially say every three years for women age 21 to 65 no association with Herpes Virus and Cervical Cancer exists well that’s the opposite of beat so the answer to this question is be a very small percentage of cases involve herpes virus 59 year old woman inquires about screening for Cervical Cancer past medical history.

 

Significant For Menorrhagia secondary to Fibroids she underwent a total Abdominal Hysterectomy three years ago she is married and has two children her only medication is a ten.

 

She does not smoke or drink in are sponse to concern about Cervical Cancer screening which of the following is most correct well remember for all women age 21 to 65 it’s recommended every three years to have a Pap Smear so the answer should be book B but there’s a very important point in the Clinical Vignette that she had Hysterectomy so because she had has directed me she has no Cervix anymore and the guideline for women who had Hysterectomy is that she does not need a Pap Smear so none of these Pap Smear choices are correct so by default he left for choice D which is indeed the correct answer she just needs an annual Pelvic exam and then finally a 26 year old woman underwent a Pap Smear which revealed low-grade Squamous Intraepithelial Lesion.

 

There was no inflammation found she was also found to be HIV Negative and a Pap Smear two years ago was negative most appropriate next step is well basically whenever you have Abnormal Cytology on a Pap Smear such as this one it’s important to proceed with a Colposcopy and a Biopsy and that will of course help give you a more important diagnostic information about the nature of the Cervical Cancer.

Warning Signs of Cervical Cancer / Signs Of Cervical Cancer

Cervical Cancer is fortunately not as common as it used to be if women do actually have Cervical Cancer they may have warning Signs of Abnormal Bleeding and especially Bleeding.

 

After Intercourse typically those women will not have had a Pap Smear for several years and that’s when we would be more concerned about a Cervical Cancer women who are at risk for cervical cancer are women that have not followed the routine screening.

 

Guidelines for Pap Smears smoking also increases your risk for Cervical Cancer because the carcinogens or the chemicals that can cause Cancer in the cigarettes are also secreted in the mucous of the Cervix and it makes it easier for those pre cancer changes to turn into a cancer so that is definitely something that women can change to decrease that risk.

 

If a woman is diagnosed with Cervical Cancer I will explain to them the diagnosis and the treatment is definitely based on how far advanced the cancer is we have a great we have great communication between the Gynecologist.

 

And the Gynecologic Oncologist so we’re able to get them in to see Dr. Rojas or Dr. Stark’s in a very timely fashion and proceed with treatment and so it’s one of those Cancers that there are very good treatment options available.

Cervical Cancer Symptoms / What are the Symptoms Of Cervical Cancer?

The most common Symptoms Of Cervical Cancer are going to be Abnormal Bleeding you can imagine that as precancerous Lee Murmurs girl on the Cervix it creates a collection of Abnormal Blood Vessels and different things like increased physical activity from strenuous work sometimes Intercourse results in a little bit of bleeding afterwards at any rate different problems that can occur that cause bleeding that bring people into their office for further evaluation.

Cervical Cancer Screening

If you are a woman between the age of 21 and 65 you should get screened for Cervical Cancer occurs most often in women over the age of 30 in Delaware Women are being diagnosed with Cervical Cancer between the ages of 40 and 64 in some cases at advanced stages because they were not getting screened Cervical Cancer can be prevented by getting regular Cervical Cancer screenings called Pap Tests.

 

Pap Test is performed in your healthcare providers office for the test you will lie down on an exam room table and place your feet and supports called stirrups.

 

The provider will insert an instrument into your Vagina to access your Cervix and obtain a small number of cells which will be sent for examination a Pap Test can tell if you have Abnormal Cells on your Cervix that could become cancer speak with your healthcare provider about the screenings.

 

That are right for you since recommendations can vary in general women ages 21 to 29 should have a Pap Test every three years women ages 30 to 65 should have a Pap Test and an HPVTest every five years when you reach age 65 your healthcare provider will tell you.

 

if you should continue your Pap Tests certain women are at higher risk you should be screened more often if you have an HIV Infection have had an organ transplant have been exposed to the drug known as DES a synthetic form of Estrogen.

 

If you have had your uterus and Cervix removed in a Hysterectomy and have no history of Cervical Cancer or pre-cancer you should not be screened if you can’t afford a Pap Test screening for life can pay the cost of the tests for you talk to your health care provider today or visit healthy Delaware org to get more facts and to get help scheduling a Pap Test.

 

  • Gynecological Health – Health Issues Specific to Womens Health

Gynecological Health: In this section we will talk about how to take a gynae history in a structured manner.

 

Gynecologic Care: Dispelling the Myths

Many people think the first time they should see a gynecologist should be when they’re an adult and that’s actually a myth. The first time the patient should see a gynecologist is between the ages of 13 to 15 years of age for their initial reproductive preventive health visit.

This allows the gynecologist the opportunity to begin to develop the patient-physician relationship, counsel about healthy behaviors, and dispel any myths and concerns.

So, I think it’s helpful for a parent to discuss with their child that they’re going to behaving their initial reproductive GYN visit, and to reiterate to them that they probably will not require an internal pelvic exam and a Pap test will not be performed.

We’re going to be discussing their menstrual cycle and prior to coming in for their office visit, it’s very helpful to track their cycle on a calendar and to bring that with them to their first office visit.

As gynecologists we like to think of the menstrual cycle as a vital sign just like you think about blood pressure, or heart rate, and an abnormality in those conditions might be indicative of a medical problem, just like an abnormal menstrual cycle might lead us to think of future potential health concerns.

Patients at a minimum would be seen on a yearly basis, however, based on their individual medical condition and needs, might be seen sooner as indicated.

You know, as patients go through their adolescent years, I think it’s important that they’re seen yearly because their needs will change as they go through adolescence.

And finally, you know, I really advocate that parents and their children have an open dialogue with one another so that they can share with both their feelings and concerns.

Role of a Doctor

  1. Listening to the patient tell her story.
  2. Generate a hypothesis.
  3. Testing the hypothesis.
    • By Interrogation 50%
    • By Examination 10%
    • By Investigation 40%
  1. If at first you don’t succeed.
  2. Go back and listen to the patient.

The role of a doctor is actually listening to the patient tell her story, and from the story we generate a hypothesis or a diagnosis.

This diagnosis, obviously, is made up of 50% by interrogation, 10% by examination, and by investigation the rest, which is 40%. If you don’t come to any conclusion, the best way of doing it is obviously we’ve missed something in the history.

The idea would be to go back to the patient and double check their history and come to a conclusion next time. The idea of this slide is to emphasize the importance of history, taking a thorough, good, structured history. 

 

Credit: Learning in 10

 

Considerations

  1. History taking sequence remains same.
  2. Should follow a logical and chronological sequence.
  3. Some unique area of focus specific to speciality.
  4. Requires sensitivity and preservation of dignity for the patient.
  5. Ensure confidentiality.
  6. Always consider possibility of pregnancy when presented with abnormal bleeding or pain.

Some considerations before we start the history. In gynae the history-taking sequence, essentially it is similar to a case would be a medical history. So, therefore, we follow a logical and chronological sequence of history of presenting complaints, past medical, surgical history, and so on.

However, in gynecology there are some specific areas that we need to focus on, and I will touch upon these in the next slide. Gynae history is a bit peculiar in the sense that it requires sensitive history and confidentiality is important.

We also have to ensure the dignity of the patient, and this should be communicated to the patient. Possibility of pregnancy should always be considered, especially when there is history of abnormal bleeding or pain, although the patient may not bring this as a diagnosis.

Presenting complaints

The Gynecological History follows the usual method of talking a history but there are specific key areas that need to be expended on. There are:

  • Menstrual History
  • Common Gynae Issues: Vaginal Discharge, Pelvic Mass, Abdominal Mass
  • Contraception and Sexual Health
  • Obstetric History
  • Uro-Gynecological History
  • Pap smear and related vaccination history
  • Past Gynae and Surgical History

We come to presenting complaints. So, as mentioned, gynae history usually follows the same sequence. However, there are some key areas that we need to focus on. I will delve into the details of these in the next few slides.

Some of these are Menstrual History, the common gynae issues— for example, vaginal discharge, pelvic mass, abdominal massContraception and sexual health is essential component of a gynae history which we shall talk about. Although Obstetric History— detailed obstetric history– is not required, we do require basic obstetric history even for a gynae complain.

Uro-gynecological history may be of relevance and will also be considered. Pap smear. Details of last pap smear and vaccination against cervical cancer would also be an essential component of this history taking. Past gynae or surgical history will obviously complete the entire history sequence.  So firstly we will consider menstrual history in details.

 

Patterns Of Abnormal Menstrual Blood Loss

  1. Menorrhagia
    • Excessive Menstrual Blood Loss At Regular Intervals
  1. Metrorrhagia
    • Frequent And Irregular Menstrual Blood Loss
  1. Polymenorrhoea
    • Regular Cycle less than 21 days
  1. Oligomenorrhoea
    • Infrequent Menstruation more than 35 days
  1. Intermenstrual Bleeding
    • Bleeding Between Menstrual Periods
    • Requires careful questioning

So there are certain patterns of abnormal menstrual blood loss, and we shall define these first. We often hear about menorrhagia. Menorrhagia means excessive menstrual blood loss at regular intervals.

There’s also a terminology that’s used quite frequently. That’s Metrorrhagia. That means frequent and irregular menstrual blood loss which may be off with the normal cycle. Polymenorrhoea. Polymenorrhoea means a cycle that occurs too frequently, that is less than 21 days.

Oligomenorrhoea means infrequent menstruation or scanty menstruation, usually occurring after more than 35 daysIntermenstrual bleeding is bleeding in between the menstrual periods and has to be defined quite clearly, whether it’s part of the cyclical pattern or not. It therefore requires careful questioning.

 

Menstrual History: Tips

  • Tell me about your menses?
  • Age at menarche
  • LMP?
  • Arrive at expected time?
  • Pattern of bleeding
  • Was last period normal?

There are tips of obtaining a good menstrual history. An easy way to begin is tell me about your menses. We also need to focus on the age of menarche usually in younger patients. Obviously, in some cases, it may not be of relevance.

The last menstrual period is very important. What is more important is to get the date of the first day of the last menstrual period, as often the patients give you the last day of the last menstrual period.

Also important to know whether the last period was normal and whether it arrived at an expected time. Also ascertain the pattern of bleeding. Was it normal or was it abnormal? Important to know how often the periods occur.

  • How often do they occur? Regularly? or Irregularly?
  • Do they “come early” or do they “come late”
  • Regular menses – range 21 to 35 days
  • Usually 28 to 30 days

Whether they are regular or irregular. We therefore have to know whether they come too early or too late. It’s important to understand that the periods don’t need– not every cycle needs to be 28 days. Periods are considered normal between 21 and 35 days. And usually for most people it happens between 28 to 30 days.

  • How long do they last for?
  • From the beginning of one period to the beginning of next period

Also, another question would be how long do they last for. And this would include counting from the beginning of one period to the beginning of next period

  • Estimate the Menstrual Loss
  • How frequently do you change your pads?
  • Pad completely soaked?
  • Clots/flooding

Further on in menstrual it is important to estimate the menstrual loss in order to diagnosis a case of menorrhagia. This can be often challenging.

Some questions that can be asked are how frequently do you change your pads? Was your pad completely soaked? Was there any clots or flooding?

If they do not understand the term clots, you can ask whether they passed any tissues or liver-like substance.

  • Are Periods Painful? Normally Painful?
  • When does pain start? (Before menses or with menses)
  • Severity…. does it keep you off work?

Peak dysmenorrhea is another important symptom, so you need to ask whether the periods are painful and are they more painful now or how bad is the pain in terms of mild, moderate, or severe.

And the timing of the pain is important as it gives you the diagnosis, whether it’s primary or secondary dysmenorrhea. Severity. To assess severity, one important question is does it keep you off work or school?

  • Change in the Period Pattern?

Also important to consider any recent change in the period pattern.

  • Any post-coital bleeding (PCB)?

Any post-coital bleeding. That is bleeding after sex. Important to know about post-coital bleeding. Post-coital bleeding can be an important sign of cervical cancer or it can be often related to a benign condition known as cervical ectropian.

  • Inter-menstrual bleeding (IMB)?
  • Ask specifically about brown or bloody discharge between periods

Inter-menstrual bleeding can be a sign of infection, can be hormonal, or can be related to polyps. Hence, it’s important to establish whether it’s cyclical or non-cyclical. 

  • Menorrhagia
  • Used loosely means Excessive Menstrual Blood Loss

Coming back to menorrhagia, as this is the most important presentation in gynecological clinic or in an related to gynae. It’s loosely defined as excessive menstrual blood loss. 

  • What is excessive menstrual blood loss?
  • Escapes from Normal Menstrual Protection
  • Large Clots – Frequently
  • Changing at night more than once
  • Last longer than 7 days “full flow”
  • Interferes with normal life or duties
  • Causes iron deficiency (anaemia)
  • Other causes excluded

What is excessive menstrual blood loss? Let’s talk about it in more depth. When the menstruation escapes the normal menstrual protection, it may be excessive. When the patient passes large clots and that too for two or three days, it can be excessive.

When the patient has to get up more than once to change her pad at night, the menstruation is considered excessive. Also, when it lasts longer than seven days of full flow. Normally the menstruation will be heavy for day two or day three and then becomes less frequent to last for a total of about 7 days on average.

Then excessive menstruation interferes with normal life or duties or leads to a change in lifestyle. For example, a patient wearing dark clothes during her menstruation for the fear of getting flooded. Also, when it leads to iron deficiency anaemia despite supplements when we have specially excluded other causes of anemia. 

Menorrhagia: HMB

  • Menorrhagia
  • Difficult to ascertain – can be subjective
  • Ask about number Towels/Pads used
  • Fully/Partially soaked

So let’s talk about obtaining a detailed history for heavy menstrual bleeding, or menorrhagia. It is very difficult to ascertain and can be subjective. However, it’s impossible or impractical to try to ascertain it objectively.

This would mean collecting menstrual material, which is impractical. Therefore, we have to ask in detail about the number of towels or pads used, whether they were fully or partially soaked.

  • Enquire about
  • Blood Cots (NOT NORMAL) – small pieces of tissue
  • “Flooding” – menstrual blood soaks through all protection
  • Abnormal and Distressing

We also need to ask about whether the blood clots were normal, whether they were small or whether they were large, and how frequently they were passed.

As mentioned, flooding is menstrual blood that soaks through all protection and stains the clothes or even bedding in extreme cases.

It is often abnormal and distressing, and sometimes the patient has to be questioned about it and will not be forth coming about this, as they may be embarrassed.

  • Do you change at night?
  • How often
  • How many nights

Getting up at night more than once usually means menorrhagia, so you have to ask how many times do they get up and do they get up every night or is it only once or twice.

  • Do your periods interfere with your life

It’s also important to know whether the heavy menstrual bleeding actually interferes with their life.

  • Have you any “accidents”

Have you had any accidents related to your periods means menstrual protection staining your clothes at time of work or school.

  • Associated Symptoms
  • Anaemia
  • Hypothyroidism

Do you have any associated symptoms of anaemia such as feeling tired, run-down. This may also be related to hypothyroidism. Hence, it’s important to ask about symptoms related to hypothyroidism as well. 

Oligomenorrhoea

  • Irregular Periods, oligomenorrhoea or amenorrhea suggests anovulation or irregular ovulation
  • Amenorrhea: Absence of Periods
  • Primary amenorrhea: Menstruation not established
  • 16 years old with secondary sexual characters
  • 14 years old with no secondary sexual characters
  • Secondary amenorrhea: Absence of menses more than six months
  • Think pregnancy
  • Specific questions (Causes of Anovulation)
  • Weight Change: Loss/Gain
  • Acne/ Greasy Skin
  • Hirsutism
  • Galactorrhea/Recurrent headaches
  • Hyperthyroid symptoms
  • Flushes may help identify ovarian dysfunction: menopause

Let’s talk about oligomenorrhoea, scanty menstruation.  Loosely, it means irregular periods and it suggests anovulation or irregular ovulationAmenorrhea means total absence of periodsAmenorrhea may be primary, which means menstruation has never been established.

If the girl is 16 years old with secondary sexual characters and has never had menses, then she suffers from primary amenorrhea. The other way to define it is when she’s 14 years old but does not have any secondary sexual characters, this would also be diagnosed as primary amenorrhea. Amenorrhea can also be secondary, which means absence of menses for more than six months in continuation.

It’s important to remember that the most important cause of secondary amenorrhea is pregnancy, so the first step would be a pregnancy test to exclude that cause. Oligomenorrhoea means infrequent periods with a cycle of more than 35 days. It’s important to ask specific questions related to anovulation.

The first question would be any recent weight change. So excessive weight loss or weight gain is important. Weight loss, as in athletes or in people who exercise heavily or in girls related to an anorexia nervosa may lead to hypothalamic suppression and, hence, amenorrhea or oligomenorrhoea. Excessive weight gain is often related to polycystic ovarian syndrome, which also is associated with anovulation and oligomenorrhoea. 

Polycystic ovarian syndrome also is associated with acne and greasy skin, and this should be a leading question. Hirsutism or abnormal hair growth, for example, on the chin or on the chest or other facial areas is also a sign of poly COS. Also important to consider would be hyper galactorrhea, and for this we need to question about galactorrhea.

That is any discharge from the breast or nipple and recurrent headaches, as this will require specific investigations, including hormones and emission. Hyperthyroid symptoms are also important and should be inquired.

Not to forget about menopause. Although menopause is expected in either late 40s or early 50s, it is not uncommon to have premature menopause in woman younger than that, and, therefore, one should always ask in an oligomenorrhoea and amenorrhea about hot flashes and night sweats.

Dysmenorrhea

  • Primary
  • Starts with menses
  • Usually 2 to 3 days
  • improves with age and after childbirth

Coming back to dysmenorrhea, let’s ask detailed questions. So as mentioned, the dysmenorrhea is considered primary when no significant cause or no organic cause for a disease is found. It usually begins with beginning of bleeding or menses, lasts for first two to three days, and usually improves once the girl matures or has children.

  • Secondary
  • Secondary pathology
  • Usually starts a few days prior to the menses

Dysmenorrhea may be secondary when it’s secondary to some second pathology such as endometriosis, fibroids, or chronic pelvic inflammatory disease. This usually begins few days prior to the menses and gets better once the bleeding begins. Obviously, this would be associated with other signs of the associated disease.

  • Severity: time off work/school?
  • Any Aggravating/Relieving Factors
  • Any effect of painkillers
  • Family history: Endometriosis

It’s important to ask about severity of dysmenorrhea, as a severe dysmenorrhea will lead to time off work or school. Is this a recurrent feature would also be an important question. Important also to consider any aggravating or relieving factors of a disease.

Do they take painkillers? If so, do they take it regularly and does it make the symptom better is important thing to consider. Also important to ask about family history of conditions such as endometriosis, as endometriosis is known to run in families. 

Vaginal Discharge

  • Duration
  • Cyclical?
  • Itchy
  • Amount
  • Colour: white/yellow/greenish/brown
  • Odour: odourless/fishy
  • Any previous history of same
  • Any treatment used
  • Other symptoms? Pain, fever, etc.

Another important presentation at the gynae clinic is vaginal discharge. Let’s talk about it next. So, important to know how long the discharge had been present for. Is it cyclical? That is, does it become more during a particular part of the cycle? As we know that during ovulation period, the discharge is thin and mucousy.

Closer to start of menstruation, the discharge becomes thick and whitish, and this is hormonal and normal. Is there any associated symptom of the discharge, for example, itch or any order? The amount of discharge is also important to document.

The color of discharge can help you with a diagnosis. So while discharge may be either physiological or related to thrush. Yellow or greenish may be related to an infection, and brown discharge may give you an idea that it may be old blood, or older blood. The odor is usually normal in case of physiological discharge.

However, the odor may be typically fishy in case of bacterial vaginosis. Is this a recurring feature, or have you had this in the past would be important to know. Have you used any treatments, as sometimes recurrent courses of antibiotics may lead to thrush, so important to know any other treatments related to treatment of infection, as often the infections can be properly treated. Any other symptoms such as pain or fever may indicate pelvic imflammatory disesase, which is an important cause of vaginal discharge. 

Mass in Abdomen

  • Duration
  • Change in size
  • Pain
  • Nausea, Vomiting, change in bowel habits?
  • Weight loss
  • Associated Symptoms: Menorrhagia, amenorrhea

Patients may present to you in the clinic with a mass in the abdomen, so let’s see what questions we need to consider. For how long has this mass been present? Has there been a change in size? Has it increased recently? Is there any associated pain or tenderness? Does it hurt when you touch?

Any associated symptoms such as nausea, vomiting, or recent constipation or diarrhea? Any weight lossWeight loss can be associated with malignancy and is an important part of the questioning.

Any other symptoms to consider would be heavy menses or amenorrhea, as heavy menses with a mass would be a feature of fibroid, and amenorrhea can be related to a pregnancy, which can often present as mass. 

Uro-gynaecological History

  • Any problems passing urine?
  • Urinary Symptoms – frequency, nocturia, dysuria, incontinence, haematuria
  • Incontinence
  • Do you ever leak urine when don’t intend to?
  • Stress Incontinence: If so, find out what provokes it. e.g. coughing, sex, exercise
  • Urge incontinence: Do you ever not make it to the toilet in time? Can you hold your urine without leaking? Do you pass small volumes frequently
  • Often a mixed picture
  • Prolapse: Associated with vaginal discomfort, feeling of something coming down

Let’s talk in brief about uro-gynaecological history. Easy way to begin is, any problems passing urine? The common urinary symptoms are urinary frequency, getting up frequently at night to pass urine, pain passing urine, any urinary incontinence, and also blood in the urine, et cetera.

Incontinence has to be defined in terms of whether it is related to stress or urge, which carries different diagnosis. So to ask about stress urine incontinence, good way to begin is do you leave urine when you don’t intend to? And is it related to, operable by certain acts, such as coughing, having sex, or heavy exercise?

This is a feature of stress incontinence. Urge incontinence is related to and usually found in post-menopausal women. Good way of questioning is do you ever make it to the toilet in time or can you hold your urine without leaking? Another way of questioning is do you pass small volumes of urine quite frequently? 

The patient may also present with a mixed picture and may require further investigation. Another presentation of uro-gynae is prolapse, so it’s important to ask about symptoms related to vaginal discomfort, feeling of a lump or something coming down, especially after exercise or heavy work. 

Obstetric history

  • Number of Previous Pregnancies
  • of children
  • Birth Weight
  • Any antenatal Problems?
  • Mode of delivery labor prolonged?
  • Relevant to prolapsed
  • Any Terminations/Miscarriage
  • Surgical/Medical
  • Gestation

Let’s talk in brief about obstetric history, which will be covered in another section but is relevant to a gynae patient as well. The number of previous pregnancies is important to know and should be documented.

It’s also important to know number of children, as some of these pregnancies may either be miscarriages or terminations. Birth of a big baby is related to prolapse. Any problems during pregnancy or labor? What was the mode of delivery?

Was the labor very prolonged? As prolonged labor and delivery of a big baby can be related to a positive of prolapse. Any terminations or miscarriage? If so, what was the procedure– whether it was surgical or medical, and at what gestation did it occur. 

Sexual history

  • Sensitive approach: Choose your words carefully
  • Begin with ”I need to ask you some personal questions….Hope that is OK?”
  • Are you or have you ever been sexually active?
  • How old were you when you first had sex?
  • Are you in a stable relationship?
  • How many partners have you had in the last six months?
  • When was the last time you had sexual intercourse?
  • Have you ever suffered from any sexually transmitted infections
  • Have you ever experienced sexual assault or incest?
  • Is there violence in any of your relationship?

Sexual history can often be intimidating.  It’s important to approach it in a sensitive and structured manner. Easy way to begin is, I need to ask you some personal questions. I hope that’s OK with you.

The patient may never have been sexually active. Therefore, this must be considered and usually one should begin with are you or have you ever been sexually active? It’s important to know the age of first intercourse.

Therefore, this should be documented. Also important to know how many partners they have had in the last six months, as having more than two partners in the six months increases the risk of having a pelvic inflammatory disease.

When was the last time you had sexual intercourse is an important leading question, as this will give you an idea of chances of pregnancy and also the risk of pelvic inflammatory disease. Also important to know whether they have had any sexually transmitted infections in the past or they’ve had any sexual assault or incest. Another important point to consider is domestic violence. Therefore, this should be questioned when appropriate.

  • Previous gynae problems
  • sexually transmitted infection, endometriosis, infertility, any gynae surgery, any polycystic ovarian disease
  • Contraception
  • Current/Past
  • Hormonal/Non-Hormonal
  • Any Problems?
  • Pap smear history
  • Date and Result of the last Cervical Smear
  • Any treatment in the past
  • Vaccine against Cervical Cancer
  • Bowl Symptoms
  • Bleeding PR, fecal incontinence, bowel habits, mucous in the stool, and difficulty emptying bowl

And, finally, few other things to consider. Previous gynae problems such as sexually transmitted infection, endometriosis, infertility, any gynae surgery, any polycystic ovarian disease may have a bearing on their history and should be inquired about. Contraception is very important.

Therefore, important to know about current as well as past contraception. Any abnormal or irregular bleeding may be related to contraception and should always be asked about.

Therefore, important to know whether the contraception is hormonal or non-hormonal. In non-hormonal contraception such as IUCD can be related to dysmenorrhea and amenorragia, and, therefore, the importance of knowing the type of contraception. Any problems with the current contraception, as they may require a change of contraception or further advice.

Pap smear history is an integral part of the gynae history. One should always ask about the date and the result of the last cervical smearAny treatment related to colposcopy or abnormal pap smear in the past. Also important in today’s world to know about any vaccine against cervical cancer.

So details of that vaccine, the duration of that, and when was the last injection taken would be important. Any bowl symptoms such as bleeding PR, fecal incontinence, bowel habits, mucous in the stool, and difficulty emptying bowl may have a bearing on the gynae diagnosis and are important to consider to complete the total gynae history.

 

  • Pregnancy Issues – Health Issues Specific to Womens Health

Pregnancy Issues: When we think about what makes a woman High Risk again we typically divide it into a maternal indication or a fetal indication or sometimes it’s the maternal-fetal pair indication.

So, thinking about maternal indications anytime a woman has an underlying medical condition people often know about high blood pressurediabetes but it could be asthma, a seizure disorder, a thyroid disorderprior history of a corrected heart problem, you know, renal diseasekidney disease, anything… any underlying medical problem – that qualifies a patient for high-risk.

 

Credit: Howard County General Hospital

 

Now within that we kind of stratify patients in terms of High Risk or Low Risk. High Risk and we can make plans accordingly. Again, any mother issue.

The other issues that can come from the maternal side is if they’ve had a prior poor obstetrical outcome or a prior adverse outcome. Examples of that could be a woman who delivered a baby at say nineteen weeks gestation.

 

Pregnancy Issues – Health Issues Specific to Womens Health

 

That’s a time when unfortunately a fetus can’t survive and so that really ends as a miscarriage and there are many reasons why that sometimes can happen, so that’s a woman that would be high-risk.

Say it’s a woman who doesn’t have high blood pressure but she developed something called Precambrian, which is the high blood pressure that’s unique to pregnancy in a prior pregnancy. She too then can be high-risk. Those are just examples. One real common one is gestational diabetes.

Every pregnant woman is at risk for gestational diabetes and everybody gets screened for that.

Now, in terms of the fetal indications. Fetal indications typically can be a chromosomal problem. People often know about Down syndrome but there are many other chromosomal problems, a structural anomaly with the fetus so when we’re doing ultrasound we can detection cranial abnormalitycardiac abnormalityrenal abnormalitybowel, pretty much any organ system that we can see by ultrasound we can and have found abnormalities in those areas and if that’s found, that doesn’t mean the pregnancy can’t go forward, doesn’t mean the mom can’t have a vaginal delivery, doesn’t mean a mom can’t deliver at term, but it does mean that to optimize outcome of that baby we want to make sure we have all the resources available at the time of delivery to make sure, again that outcome is optimized. So, that would be a high risk pregnancy.

And then we get this mother-fetal pair, you know, there’s something going on with both. An example: sometimes some of the chromosomal problems can have implications for the mother and so that pair then becomes high-risk.

That’s just one example. How do we diagnose problems that you know, would make a patient become our patient? So often, with ultrasound. So, most patients when they come to our center they are low-risk.

They’re coming to make sure everything is okay. Some people may not even understand exactly what’s going to happen here they think they’re coming to know whether they’re having a boy or girl, so with ultrasound we essentially, I always describe to patients, “We’re looking from head to toe” and what we’re looking for again are structural abnormalities that may require their baby to need special attention at the time of delivery.

There are other structural abnormalities that may group together and make us more concerned about a genetic abnormality, whether it’s a chromosomal or non-chromosomal genetic abnormality, we’re looking for signs of that.

I would share, and I think with patients it’s important for everyone to understand that ultrasound’s not 100%. You know, ultrasound doesn’t speak to how smart your baby’s going to be or anything like that. It’s really looking at structure. That’s all it’s really doing.

We know though from our experience that some of these structures, if they’re abnormal, can lend and lead itself to other diagnoses so that’s what we’re looking for.

Other things they can come up that we’re looking for has nothing to with ultrasound at all sometimes it’s something a mom has a condition that also may relate to another condition so a mom presents with say, diabetes, we know diabetes can affect many organ systems.

The heart, the kidneys, the eyes, so we do additional testing to see, how’s everything else going. We may actually identify another organ system that’s affected and that may have other implications for the pregnancy. An example of that.

If we go forward with the diabetes if we find diabetes that actually is also affecting the kidneys we know pregnancies where mom has diabetes and also kidney disease they’re at higher risk of having a preterm baby, they’re at higher risk of Precambrian, which is the high blood pressure can occur with pregnancy.

They’re at higher risk for developing fetuses that don’t grow appropriately and that will then lead us to additional testing. So, we consider ourselves to be kind of investigators and people I think often always wonder like, how do they figure that out, but it’s just because we know how things group together and how that grouping could have implications for pregnancy prognosis.

 

How to Deal With Morning Sickness During Pregnancy?

Nausea and Vomiting is very common inearly pregnancy and occurs due to associated hormonal influences it is unpleasant but does not put your baby at any additional risk and usually settles down by 16 to 20 weeks of pregnancy in most people so in some it may persist for longer so if you do suffer from nausea and vomiting.

 

Credit: Narayana Health

 

In pregnancy we do suggest a few changes to your diet and daily lifestyle that can help improve your symptoms these include getting plenty of rest as tiredness can make nausea worse if you feel nauseous the first thing in the morning then try to get up slowly if possible eat a toast or drive this kit before you wake up eat small but frequent meals that are rich in carbohydrates and low in fat like rice biscuit potatoe scrackers etc.

But keep eating and do not stop eating it very sweet and very spicy food drink plenty of fluids sipping them little by little rather than in large quantities at one time avoid smells and foods that make you sick try to ask your friends and family for support during this period as it is known to help take ginger is also known to be beneficial during.

This period wear loose comfortable clothing and sling heavy if these symptoms persist inspite of these measures we recommend a short-term course of antiemetics that is known to improve these symptoms and the safe in pregnancy some women suffer froma severe form of vomiting and pregnancy which is known as hyperemes.

Is gravidarum so you need to meet your gynecologist if you have very dark colored urine or do not pass urine for over eight hours if you are unable to keep down any foods or fluids for over 24 hours if you have abdominal pain if you have fever with the temperature about 100 point 5 degrees Fahrenheitor.

If you warm it blood in these situations we require urgent hospitalization for intravenous fluid therapy and further medications so do not worry though nausea and vomiting is trouble some in pregnancy it can be managed by a few dietary and lifestyle modifications.

 

  • Autoimmune Diseases – Health Issues Specific to Womens Health

Autoimmune Diseases – Health Issues Specific to Womens Health: We see patients primarily in that clinic with myasthenia gravis. And we have several ongoing and new trials that are starting looking at novel treatments for this disease. Myasthenia gravis is a disease that affects the muscle-nerve connection, so it’s affecting the ability of the nerve to communicate adequately with the muscle.

And it is a disease of the immune system, where a portion of the immune system is attacking a portion of the muscle and that portion, that part is what recognizes the message from the nerve. And when patients have this disease, their symptoms can fluctuate.

 

Credit: Ohio State Wexner Medical Center

 

They may have weakness of the eyes and the mouth, of the arms and the legs. And it may get worse when they’re tired, it may get worse when they’re sick with another illness. But fortunately, patients with myasthenia gravis usually respond very well to therapies.

When I’m treating patients who have immune-mediated diseases of the muscle and nerves such as myasthenia gravis or dermatomyositis or CIDP, I understand that these are scary diagnoses for patients. And I try my best to get patients to understand as much as possible about these diseases.

I try to go through the treatments that are available for the patient, so the patient can feel a sense of control and understanding about what might happen now and in the future. So one of the things that patients frequently ask is, “Is this an inherited process?”

And what I try to explain to patients is that there’s a lot about the cause or the etiology of these diseases that we don’t know. But the major question for a lot of people is, “Can my children get this disease?” And unfortunately this is something that we really don’t know.

We know that there is a tendency for immune-mediated diseases, or auto-immune diseases, to run in families, but we don’t know how to identify who might get this and who’s at risk. And this is something that there is a lot of research going on at a basic science level to understand better.

 

Why Do Women Have More Autoimmune Diseases Conditions?

 

Our immune systems are awesome. I mean, while we’re sitting on the couch shoving our faces full of Doritos or whatever, they’re recognizing pathogens and other things that don’t belong, and ousting them from our bodies. And on top of that, they remember previous intruders, and make it harder for them to invade again— all while leaving our cells and the microbes that help us alone.

Basically, our immune systems are like really good bouncers for the happening clubs that are our bodies. Except for when they’re not. Sometimes, a body’s immune system mistakenly decides its own tissues are foreign— what immunologists call autoimmunity. Currently, there are more than 80 autoimmune conditions defined by doctors.

 

Credit: SciShow

 

These include a slew of well-known conditions like LupusRheumatoid Arthritis, and Multiple Sclerosis, as well as lots of more rare ones. They tend to be chronic and are often debilitating. And taken together, they’re a leading cause of death and disability worldwide.

It’s estimated that from three to 10% of people have an autoimmune condition at some point. But if you were to put all of the people with autoimmune conditions in one room, you’d notice something. They’re almost all women. A whopping 75% of U.S. cases of autoimmunity are in people who identify as women, and rates are similar in other countries. And for some autoimmune conditions, the disparity is even higher.

Which is not only super unfair, it’s also a scientific enigma. This gender bias of autoimmunity is considered one of the great mysteries of medicine. And it’s one that researchers are fervently trying to solve, because it could reveal new ways of treating these usually incurable and often devastating conditions.

Now, we’d be remiss if we didn’t mention that part of the reason perhaps even a lot of the reason. We don’t fully understand these immunological betrayals is cultural. Conditions that predominantly affect women have been historically understudied, and studied in sexist ways when researcher shave looked at them. And, historically, clinicians as a group just haven’t taken women as seriously an issue that persists today.

But also, early work in the field of immunology threw scientists off for decades. At the turn of the twentieth century, biologist and Nobel laureate Paul Ehrlich performed a series of experiments in animals which found the animals didn’t develop antibodies in response to their own tissues.

Those are the Y-shaped proteins your immune system uses to recognize and neutralize things like bacteriaviruses,and parasites. And if Ehrlich wasn’t seeing them, clearly, autoimmune conditions couldn’t be a thing. He even coined a term based on his results: Horror Autotoxicus which literally means the horror of self-toxicity. But the thing with Nobel prize winners is that sometimes scientists heed them, when they’re wrong.

And that’s what researchers say happened with horror autotoxicus and the immunology community. Still, over time, the evidence became too clear to ignore. Like, in 1946, a British immunologist developed a test that could detect self-targeting or auto antibodies attached to the surface of a person’s red blood cells.

Then there was the discovery of rheumatoid factor— a type of auto antibody that occurs in rheumatoid arthritis and some other autoimmune diseases. Long story short, these findings piled up until finally, in 1964, the global immunology community rang in their acceptance of autoimmunity as an actual thing with an international conference.

Research into autoimmunity in the decades since has come a long way. But the mystery of why these conditions are so much more prevalent in women remains. And, just to be clear, we do mean women, not just people with two X chromosomes or a uterus and ovaries. It’s true that the bulk of autoimmune research has been conducted on people whose sex assigned at birth matches their gender identity.

But it’s also been shown that some autoimmune conditions are more common than expected in transgender women. Often, these conditions are associated with medical transitioning, but not always. And some occur at higher rates in people with what are sometimes called differences of sex development or intersex traits— where parts of their biology like their chromosomes or genitals diverge from the typical definitions of male and female.

In fact, including transgender people and people with hormonal, developmental, or chromosomal variations in immunological research has been an important part of evaluating the hypotheses for the bias in autoimmunity we’re about to discuss.

You see, researchers have been searching for the root cause of autoimmunity— one or two nearly universal or nearly universal things that are to blame for the immune system going rogue. Yes, environmental factors like diet are a big part of the equation, but the thinking is that there has to be something physiological that makes some people more likely to develop autoimmunity when exposed to those environmental factors.

Find that something, and you’ll find the best way to manage or even cure autoimmunity. And that something, presumably, tends to differ between men and women, and therefore, can explain why women are so much more prone.

This is what led to the earliest and perhaps most immediately obvious hypothesis: that autoimmunity has something to do with sex hormones— the hormones involved in sexual differentiation and reproduction. If that’s true, it could mean autoimmune conditions could be better treated by tweaking a person’s hormone levels or the pathways those hormones interact with.

But researchers don’t always agree on which sex hormones are most important, and overall, results are mixed. Like, some think it’s all about testosterone or other hormones that generally occur at higher levels in men. And There is pretty solid evidence that testosterone suppresses immune function. And scientists know for sure that increasing a person’s testosterone level reduces the number of B cells in their body— a type of white blood cell that recognizes foreign stuff, and the only type of cell that produces antibodies.

So the idea has been that since testosterone reduces B cells, and B cells produce antibodies,that may be why men generally have weaker immune responses than women… …the upside to which could be that a less aggressive immune system is also less likely to misplace its attacks.

Like, one 2018 study looked at hormones and key components of the immune system in cisgender and transgender volunteers as well as people with atypical sex chromosomes. The researchers found that even when accounting for different combinations of sex chromosomes, higher testosterone levels were associated with less interfereon alpha— an immunological protein suspected to play a role in autoimmune conditions like rheumatoid arthritis.

But that’s just one study, and research connecting hormone levels to autoimmune conditions is kind of all over the place. Other studies have suggested estrogens or other hormones that tend to be higher in women matter more. And some studies have pointed out that even if hormones modulate these conditions, they’re probably not what causes them. So many researchers think there’s something else at play— like, perhaps, sex chromosomes.

Those are the chromosomes which help steer sex development and sex hormone levels. Males usually have an X and a Y chromosome,while females usually have two Xs. But these chromosomes don’t just affect the differentiation of gonads or levels of hormones.

For example, the human X chromosome has more immune system related genes than any other chromosome. And it’s possible that autoimmunity somehow stems from those genes in a way that isn’t dependent on sex hormones. That would explain why anyone can develop autoimmunity, because everyone has an X chromosome. And, if X-linked genes are somehow the ultimate cause of autoimmunity, it would also make sense that people with two Xs are more prone to it— whether or not they’re women.

There is evidence that’s the case, too. For example, autoimmune conditions are also more common in men with Klinefelter’s syndrome— where they have two X chromosomes and a Y chromosome. In fact, the proportion of people with Kleinfelter’s syndrome is 17 times higher if you just look at men with Sjögren’s syndrome— an autoimmune condition which affects salivary and tear glands— than if you look at men in the general population.

But why the X chromosome predisposes people to autoimmune issues is up for debate, and there are several related-but-separate hypotheses. One idea is that the overproduction of certain proteins somehow triggers autoimmunity— which would be why having two X chromosomes increases the odds, but isn’t required.

And there has been some evidence for this from mouse models of multiple sclerosis— a condition where the immune system attacks the brain and spinal cord. If confirmed in people, that could indicate that the key to solving autoimmunity is to somehow reduce the abundance of proteins produced by genes on the X chromosome.

But most X-linked genes aren’t expressed more in cells with two Xs. About 85% of the genes from the extra X are turned off in each cell. So, some scientists think things related to X chromosome inactivation better explain autoimmunity.

There’s evidence that cells exposed to stress can inadvertently scramble a bit of the inactive X chromosome, for example; that causes them to spit out proteins that the immune system sees as foreign. And if that’s why the immune system is engaging in friendly fire, then finding a way to prevent the production of those scrambled bits or remove them quickly could help.

Autoimmunity could also have something to do with how the inactivation takes place. Which X chromosome gets shut off in each cell is supposed to be random, so each X gets more or less equal play in the body. But that’s not what always happens.

In some people, well over half of the cells have the same active X— a phenomenon known as skewed X chromosome inactivation. And this kind of skew has been linked to a variety of autoimmune conditions. That might be because the genetic driver of this skew also somehow triggers self-targeting— even, perhaps, in people with only one X.

So, treating autoimmunity might be a matter of figuring out what causes skewing and why. Or, it might be more about the degree of skewing. Sometimes, inactivation can be really skewed— like, more than 90% of a person’s tissues have the same X switched on.

If that happens, it’s possible that the immune system doesn’t see the slightly-different versions of proteins produced by the other X often enough to recognize them as coming from the same person.

So when the immune system does come in contact with those cells with the other X activated, it thinks they’re foreign. If that’s true, there might be a way to teach the immune system that those cells aren’t the enemy, sort of like how some allergy treatments slowly teach the immune system not to over react to allergens.

But, some studies suggest the presence of one or two X chromosomes is less important than the presence of a Y. You know, just to make things messy. After all, the Y chromosome has its own immune-related genes. And the Y chromosome itself is a bit weird because it has more repetition than other chromosomes.

One person’s Y might have just two copies of a specific gene or piece of a gene, while another has way more. They’re called Multi Copy Genes. And studies in Male Mice have found that having a higher number of these Genes can somehow affect their Female offspring’s Susceptibility to Autoimmune Disease. But research in this area is still really new, so scientists aren’t sure what about them drives that result.

Still, if genes on the Y chromosome have something to do with autoimmune susceptibility, that could reveal unexpected treatments— even for people who don’t have one. So the secrets to solving autoimmunity could lie in further study of the Y chromosome. Or the X chromosome. Or hormones.

The thing is, after decades of research, there just doesn’t seem to be a single thing that connects all cases of autoimmunity. It’s possible—even likely— that different conditions arise for different reasons, so you simply can’t lump lupus in with,say, rheumatoid arthritis.

But there might be bigger evolutionary dynamic sat play— something that does bring together all these seemingly different explanations. One of the most recent hypotheses to explain autoimmunity is that it all of this ultimately comes down to pregnancy… or lack thereof.

The researchers who proposed the idea have dubbed it the pregnancy compensation hypothesis. And basically, it posits that autoimmune conditions are so prevalent now because people with uterus’s are spending less of their lives pregnant.

Pregnancy is a remarkable feat for the human body— and not just because it means producing a new human. It means people have to harbor cells that are half-foreign for months without their immune systems ousting them.

That could be what drove differences in how immune systems function between people with uterus’s and people without— whether those differences are enacted by sex chromosome genes, hormone levels, or whatever.

But more importantly, this might suggest that being pregnant alters the immune system in a way that helps rein in over-eager immune cells. And the total number of pregnancies per person has dropped dramatically in just the last 50 years. So, it could be that a system that evolved for handling lots of pregnancies has gotten thrown out of whack without them.

That would explain why these conditions are so prevalent now and seem to be becoming more prevalent overtime. This is a new idea, so it hasn’t really been tested yet, but immunologists seem to agree that it’s promising. And if autoimmune conditions are ultimately tied to pregnancy, there could be a whole other suite of treatments to consider.

I mean, not just getting pregnant, but science is awesome, so there might be ways to reap the immune benefits without having kids, like mimicking the molecular pathways that occur during pregnancy. So there you have it, or maybe, there you don’t have it.

We still don’t fully know why women are so much more likely to have autoimmune conditions than men. But the good news is that the investigation is well underway. and the reason we haven’t figured it out is because it’s very complicated.

 

  • Depression and Anxiety – Health Issues Specific to Womens Health

 

Depression and Anxiety: If you’ve ever experienced anxiety and depression— in the clinical sense, I mean — you’ll know that they can feel really different. With anxiety, you’re all ramped up. And with depression, you can feel very down. Yet they tend to go together. And a lot of medications, especially certain types of antidepressants, can be used to treat both.

We still don’t know a ton about how exactly anxiety and depression work in the brain — or how antidepressants work to treat them. But over time, psychologists have come to realize that the two types of conditions are surprisingly similar. They may feel very different in the moment. But they actually have a lot of symptoms in common, and involve some very similar thought patterns.

They might even have similar brain chemistries. So if you’re looking to understand a little more about how anxiety and depression manifest themselves — whether for yourself or for someone else in your life — those connections are a good place to start.

 

Credit: SciShow Psych

 

Depression and Anxiety aren’t really specific disorders — they’re generic terms for types of disorders. But the most common, and most closely linked, are major depressive disorder, or MDD, and generalized anxiety disorder, or GAD.

In any given year in the U.S., where it’s easiest to find detailed statistics, about 7% of the population will have MDD, and about 3% will have GAD. Lots of those people have both: About 2/3 of people with major depression also have some kind of anxiety disorder, and about 2/3 of people with generalized anxiety disorder also have major depression.

And whether you have one or the other or both,the same medications are often at the top of the list to help treat it — usually antidepressants. Unsurprisingly, psychologists have noticed these statistics. But for a long time, we’ve thought of generalized anxiety and major depression as very different things, and understandably so.

Probably the most noticeable symptom of anxiety is arousal, which in psychology is a technical term rather than a specifically sexual thing. It basically just means being on high alert— whether psychologically, with increased awareness, or physically, with things like a racing heart and sweaty palms.

Arousal isn’t part of major depression,though. And there’s a key symptom of MDD that doesn’t usually show up in generalized anxiety: low positive affect, which is the technical term for not getting much pleasure out of life and feeling lethargic and just kind of … blah.

So there are important differences between anxiety and depression, which is part of why they’re still considered separate classes of disorders. But when you look at the other symptoms, you start to realize that major depression and generalized anxiety have almost everything else in common.

There’s restlessnessfatigueirritability,problems with concentrationsleep disturbances … the list goes on. And that’s just in the official diagnostic criteria. So for decades, psychologists have been examining the models they use to describe anxiety and depression in the brain to see if they point to a similar source for both types of disorders.

They’ve come up with lots of different ideas, as researchers do, but the most common ones tend to center around the fight or flight response to stress. Fight or flight kicks in when you’re confronted with something your mind sees as a threat, and it automatically prepares you to either fight or run away. And when you think about it, anxiety and depression are just different types of flight.

Psychologists often characterize anxiety as a sense of helplessness, at its core, and depression as a sense of hopelessness. Anxiety might feel like you’re looking for ways to fight back. But part of what makes it a disorder is that it’s not a short-lived feeling that’s easily resolved once you have a plan.

Of course, as with all things mental health,anxiety disorders can be deeply personal and won’t feel the same for everybody. But clinical anxiety does tend to be more pervasive. The worry sticks around and starts to takeover your life because it doesn’t feel like something you can conquer.

So anxiety and depression might just be slightly different ways of expressing the same flight response: Helplessness or Hopelessness. And maybe that’s part of why they so often go together. That connection also shows up on the biochemical side of the stress response.

There are a lot of hormones involved in this response, and their effects interact in super complex ways that scientists still don’t fully understand. But both depressive and anxiety disorders are closely associated with an oversensitive stress response system.

Researchers think that’s one reason both of these types of disorders are so much more common in people who’ve experienced major stresses like Trauma or Childhood Abuse. Those stressors could make their stress response system more sensitive.

The main hormones involved aren’t always the same, but the changes can cause some of the same symptoms — problems with sleep, for example. So anxiety and depression seem to be two sides of a similar reaction to stress, in terms of both thought processes and hormones.

Still, that doesn’t really explain why some antidepressants can treat both anxiety and depression. Because those medications primarily affect neurotransmitters, the molecules your brain cells use to send messages to each other. If you thought we had a lot left to learn about how the stress response works, we know even less about what the brain chemistry of anxiety and depression looks like, or how antidepressants help.

But if the thought processes and physical responses that go along with these disorders aren’t quite as different as they seem on the surface, it makes sense that the brain chemistry would be similar, too. And that’s exactly what scientists have found.

More specifically, lots of studies have pointed to lower levels of the neurotransmitter known as serotonin as a major factor in both anxiety and depression. Researchers have even identified some more specific cellular receptors that seem to be involved in both.

There’s also some evidence that the way the brain handles another neurotransmitter, nor epinephrine, can be similar in both anxiety and depression. Since most antidepressants work by increasing serotonin levels, and some of them also affect nor epinephrine, that could explain why they’re so helpful for both anxiety and depression.

Although again, there’s a lot we don’t know about their exact mechanisms. Ultimately, there’s no denying that in the moment, anxiety and depression can seem like very different feelings. And if someone has both types of disorders— well, it’s easy to see how that could feel overwhelming.

Like, it’s hard enough treating generalized anxiety or major depression on their own. And it’s true that it is often harder to treat these conditions when someone has both. But maybe not twice as hard. After all, Anxiety and Depressive disorders have a lot in common, from their symptoms to the basic brain chemistry behind them to some of the treatments that can help.

The fact that they often go together can be really tough. But understanding more about why that is has also pointed us toward better treatments and more effective therapies, that really can help.

 

  • Health Technology for Women – Health Issues Specific to Womens Health

Health Technology for Women: In spite of the slogan of diversity pinned on the flag of many tech companies, the field is dominated by men. With the Big Bang TheorySilicon Valley and The Social Network, it’s easy to imagine Silicon Valley as a bunch of guys in hoodies and flip-flops, solving big problems, with women as sidekicks rather than protagonists.

Women hold only 11 percent of executive position sat Silicon Valley companies and only own 5 percent of startups. And it shows. The majority of the period tracker apps fail women miserably. Fitness trackers and wearable are useless when it comes to pregnancy.

Most of our apps were designed and developed without the input of their future consumers. And it’s not like there’s no demand. In the health category, period tracking appears reportedly the fourth most popular. Yet it took years for Fit bit and Apple Watch to add it as a feature. And on the app side, a recent study showed that 95% of Menstrual Cycle tracking apps are inaccurate for patient use – and almost none of them cite medical literature or health professional involvement.

 

Credit: The Medical Futurist

 

But women’s health is not only about period Tracking and Pregnancy. A lot less consideration is given to other female health problems as well, such as menopausecancer detectionbreastfeeding troublestroubles around bladder control, and a lot more. While digital health companies already appeared in these areas, their number is quite low, and they’re usually struggling to get funded.

Let’s take a look at Next Gen Jane, a San Francisco based start-up that promises to get insights into female reproductive health from menstrual blood in order to detect early biomarkers for endometriosiscervical cancer or other conditions. They struggled to get funding for years. So if there’s demand, and these issues affect half of the population, why do only 10 percent of investor money go to women-led startups?

Why do tech companies overlook features specific to women? It’s terrible to see how digital health is failing those in need, so here’s a wake-up call! Fem tech investors, women’s health advocates,as well as fitness wearable manufacturers step forward and create solutions that serve the entire population.

Source Link:

 

  1. Heart Disease

  2. Breast Cancer

  3. Ovarian and Cervical Cancer

  4. Gynecological Health

  5. Pregnancy Issues

  6. Autoimmune Diseases

  7. Depression and Anxiety

  8. Health Technology for Women

Health Technology for Women – Health Issues Specific to Women’s Health

Health Technology for Women

Health Technology for Women: In spite of the slogan of diversity pinned on the flag of many tech companies, the field is dominated by men. With the Big Bang Theory, Silicon Valley and The Social Network, it’s easy to imagine Silicon Valley as a bunch of guys in hoodies and flip-flops, solving big problems, with women as sidekicks rather than protagonists.

 

Women hold only 11 percent of executive position sat Silicon Valley companies and only own 5 percent of startups. And it shows. The majority of the period tracker apps fail women miserably. Fitness trackers and wearable are useless when it comes to pregnancy.

 

Most of our apps were designed and developed without the input of their future consumers. And it’s not like there’s no demand. In the health category, period tracking appears reportedly the fourth most popular. Yet it took years for Fit bit and Apple Watch to add it as a feature. And on the app side, a recent study showed that 95% of Menstrual Cycle tracking apps are inaccurate for patient use – and almost none of them cite medical literature or health professional involvement.

 

Credit: The Medical Futurist

 

But women’s health is not only about period Tracking and Pregnancy. A lot less consideration is given to other female health problems as well, such as menopause, cancer detection, breastfeeding troubles, troubles around bladder control, and a lot more. While digital health companies already appeared in these areas, their number is quite low, and they’re usually struggling to get funded.

 

Let’s take a look at Next Gen Jane, a San Francisco based start-up that promises to get insights into female reproductive health from menstrual blood in order to detect early biomarkers for endometriosis, cervical cancer or other conditions. They struggled to get funding for years. So if there’s demand, and these issues affect half of the population, why do only 10 percent of investor money go to women-led startups?

 

Why do tech companies overlook features specific to women? It’s terrible to see how digital health is failing those in need, so here’s a wake-up call! Fem tech investors, women’s health advocates,as well as fitness wearable manufacturers step forward and create solutions that serve the entire population.

Health Technology for Women