INFERTILITY IN WOMEN

For so many people around the world, having and raising children are extremely important events in their lives. Infact, some people believe fulfilling the need for reproduction make them whole and complete.

According to recent studies by the World Health Organization (WHO), approximately 8- 10% of couples are facing some kind of infertility problem. Globally, this means that 50-80 million people are facing this problem.

Infertility is defined as the inability to get pregnant after having unprotected sexual intercourse for at least one year, for women over 35 years old – six months. It also means the biological inability to contribute to conception and it affects one in six couples. Female infertility accounts for one third of all infertility cases.

CAUSES OF INFERTILITY IN WOMEN

According to a study carried out by the health science journal1, the most common cause of female infertility is problems in the fallopian tubes followed by unknown causes, disorders of menstruation and infertility due to problems in the uterus.

 

  1. Damage to the fallopian tubes and ovaries. This can be caused by one or more of the following
  • Abnormal cervical mucus: This can prevent the sperm from reaching the egg or make it more difficult for the sperm to penetrate the egg.
  • Pelvic Inflammatory Disease
  • A previous infection
  • Polyps in the uterus
  • Endometriosis
  • Fibroids
  • A birth Defect
  • Scar tissue or adhesions
  • Chronic medical illness
  • A previous ectopic pregnancy

 

  1. Ovulation Problems
  • Hormonal imbalance
  • A tumor or cyst
  • Extremely brief or nonexistent menstrual cycle

Age, alcohol or illicit use of drugs, obesity are factors that also contribute to infertility in women.

DIAGNOSIS OF FEMALE INFERTILITY

It is advised that you see your doctor if you’ve unsuccessfully been trying to conceive for six months, when you do this, a medical examination is carried out to determine what the cause(s) might be.

PREVENTION OF INFERTILITY IN WOMEN

When infertility is caused by genetic abnormalities, there is usually nothing that can be done to prevent it. Women can however advised to avoid illicit drugs & alcohol consumption and take steps to prevent sexually transmitted infections & diseases. They should also ensure to have annual medical checkups especially when sexually active.

TREATMENT OF INFERTILITY IN WOMEN

Fertility treatment significantly improve the chances of conception but varies from woman to woman.

Fertility drugs, hormone treatment and various assisted reproductive techniques like In vitro Fertilization (IVF) AND Intra Uterine Insemination (IUI) have been employed in the treatment of infertility.

The course of treatment is usually however determined by the cause. – Some of the drugs prescribed are used to stimulate ovulation.

Reference

http://www.hsj.gr/medicine/causes-of-infertility-in-women-at-reproductive-age.pdf

WHAT YOU SHOULD KNOW BEFORE GETTING A HYSTERECTOMY

Perhaps, you have been booked to have a hysterectomy or your surgeon has hinted at it being an option of treatment for your symptoms, this blogpost answers some of the questions you might have.

If you have further questions, leave a comment down below.

WHAT IS AN ABDOMINAL HYSTERECTOMY?

 An abdominal hysterectomy is an invasive surgical procedure in which the uterus is removed, sometimes with the cervix, ovaries, ligaments and the fallopian tubes through a horizontal incision made in the lower abdomen which is 6 to 8 inches long.

The opening in the abdomen gives the surgeon easy access of the pelvic organs. In some cases, however, if the uterus is too large or bulky, a vertical incision may be made, providing the surgeon a greater access to the abdominal cavity.

WHY IS A HYSTERECTOMY PERFORMED?

There are various reasons why your doctor might have recommended a hysterectomy. Some of them are :

• Period problems such as heavy or irregular periods

• Fibroids

• Suspected or proven cancer of the womb or cervix

•A larger than normal uterus
•Endometriosis
•Chronic uterine infection
•Severe pain associated with menopause

TYPES OF HYSTERECTOMY

There are three types of hysterectomy

Your surgeon will talk to you about the most appropriate and suitable type for you.

1. SUBTOTAL HYSTERECTOMY – In this, only the uterus is removed, the cervix (neck of the womb) is left in place.

There are several potential benefits of not taking out the cervix:

• The surgery is easier and quicker.
• The risk of damage to your bladder or ureters (tubes from your kidney to your bladder) during the operation is lower.
• The risk of you suffering a prolapse of the vagina in future is reduced.
• You will lose less blood during the surgery .
• You are likely to spend less time in hospital.
• You are less likely to develop a fever after your surgery.

There are, however, some possible disadvantages:

• You may still experience spotting every month – this occurs in about 6% of women
• The cervix is a potential site for cancer in the future and you will still need regular smears

2. TOTAL HYSTERECTOMY –  Here, both the uterus and the cervix are removed.

3. TOTAL HYSTERECTOMY WITH BILATERAL SALPINGO-OOPHORECTOMY– The uterus, cervix, fallopian tubes and ovaries are all removed.

Your surgeon will discuss with you the advantages and disadvantages of removing your ovaries or leaving them in.

FACTS TO KNOW IF YOU ARE HAVING A HYSTERECTOMY.

• You will not be able to get pregnant.
• You will no longer have monthly menstrual periods.
• You will no longer have to use contraceptives.
• It may be part of a continuing treatment or it may mean the end of a health problem.


 The benefits of having a hysterectomy depend on the type and severity of symptoms that you are having. Heavy periods for example will be cured by a total hysterectomy. However, other problems like pelvic pain may not be improved or cured by hysterectomy.

Although hysterectomy is a relatively safe operation and serious side effects are not very common, it is still major surgery. You and your doctor must together weigh the benefits and risks of surgery while also giving consideration to alternative treatments.

ALTERNATIVE TREATMENTS

Depending on your circumstances, you may have been advised on alternative treatments first, such as drugs or more minor surgery. The choice of treatment depends on the nature and extent of your condition as well as personal factors.

URINARY INCONTINENCE IN WOMEN

Urinary incontinence is the involuntary release of urine. It can be very embarrassing therefore most xwomen do not report it to their doctors.

What is urinary incontinence?

It is a very common condition and affects women of all ages but there are lifestyle modifications and treatment options available.

Urinary incontinence can happen when you cough, laugh, sneeze, or jog.

There are different types of urinary incontinence and they are categorised by symptoms.


  1. STRESS INCONTINENCE
    If urine leaks out when you jump, cough, or laugh, you may have stress incontinence.  Any form of physical exertion that increases abdominal pressure also puts pressure on the bladder.  The word “stress” here means physical strain associated with leakage. Often, only a small volume of urine leaks out, however, in amore severe cases, the pressure of a full bladder overcomes the body’s ability to hold in urine. This leakage occurs because the bladder muscles are not contracting and you do not feel the urge to urinate. Stress incontinence occurs when the urethral sphincter, the pelvic floor muscles, or both of these structures have been weakened or damaged and therefore cannot hold in urine.

         2. URGE INCONTINENCE

This happens when there is the urge to pee even when the bladder is not full.

This condition involves an overwhelming need to urinate immediately, frequently followed by the leakage of urine before you can reach a bathroom.

3. MIXED INCONTINENCE

This is a combination of both types (Urge and stress incontinence)

4. REFLEX/OVERACTIVE INCONTINENCE
This occurs as a result of the contraction of the bladder muscle and then urine leaks (often in large volumes) without any warning or urge.

This usually happens because of damage to the nerves that normally warn the brain that the bladder is filled up.

Reflex incontinence usually occurs in people with serious neurological impairment from multiple sclerosis, spinal cord injury, other injuries, or damage from surgery or radiation treatment.

5. FUNCTIONAL INCONTINENCE

This is when your urinary tract functions well but other illnesses are keeping you from holding in your urine.

Certain medications, dementia, or mental illness for instance can decrease awareness of the need to find the bathroom.

WHAT FACTORS CONTRIBUTE TO THE WEAKENING OF THE PELVIC FLOOR MUSCLES?
Damage to pelvic floor muscles can be caused by a myriad of reasons including:

 •Pregnancy and birth

•Chronic and persistent coughing

•Constipation – this can lead to excessive straining in the toilet
•Obesity
•Old Age
•Lifting heavy weights

WHAT ARE THE SYMPTOMS TO LOOK OUT FOR?

The main symptom is the accidental release of urine.

If you have stress incontinence, you may leak urine when you cough, sneeze, laugh, exercise, or do similar things often in small volumes.

If you have urge incontinence, you may feel a sudden urge to urinate and the need to urinate often. With this type of bladder control problem, you may leak a larger amount of urine that can soak your clothes or stream down your legs.

If you have mixed incontinence, you may have symptoms of both problems.

DIAGNOSIS

Your doctor will ask about what and how much you drink. He or she will also ask how often and how much you urinate and leak.

Your doctor will examine you and may carry out simple tests to determine the cause of your bladder control problem.

TREATMENT
Treatment options are tailored differently for each person. It is dependent on the type of incontinence you have and how much it affects your life.  After determining the cause of the incontinence, your treatment may include exercises, bladder training, medications, or a combination of these. Some women may even need surgery.

Certain lifestyle changes can also be used to control incontinence.

CAN URINARY INCONTINENCE BE PREVENTED?

Strengthening your pelvic muscles with Kegel exercises may lower your risk for incontinence.


You should also:
•Cut back on caffeinated drinks, such as coffee

•Eat foods high in fibre to help avoid constipation

•Do not smoke or quit if you already do

•Maintain a healthy weight It is advised to keep track of your symptoms and any leaking of urine, this way, your doctor can understand your condition and find the best treatment for you.