Archive for March 23rd, 2009

FERTILITY AND INFERTILITY: THE COUPLE

Monday, March 23rd, 2009

Additive effects. In 40 per cent of infertile couples there may be more than one factor affecting fertility. The individual factors may not necessarily make pregnancy absolutely impossible, but having more than one factor will make it less likely. For instance, if a woman has some partial blockage to her tubes, and her partner has a lowish sperm count, they may have quite a bit of difficulty getting pregnant, and present for investigation of their fertility. If the same woman had a different partner, with a normal sperm count, she may have had less trouble becoming pregnant, and might never have had her fertility investigated. The man with the lowish sperm count may have no trouble with a different partner, too; a woman who has perfectly normal tubes may get pregnant despite her partner’s relatively low sperm count.

The psychological. Some people will nor conceive, and will never be able to be given a satisfactory physical, medical explanation, like a blocked tube or something tangible like that. It is the intangible bit that is harder to measure, and to treat. Psychological factors are known to play an important part in fertility. Many people will be able to recount stories of couples who had undergone ‘thousands of tests’, and been seen by ‘hundreds of doctors’, and just when they had put their names down to adopt a baby, they miraculously fell pregnant. Perhaps the added stress of wanting something so much, and trying so hard, can work in the opposite direction and disturb fertility. The hypothalamus and pituitary gland are areas of the brain involved in fertility, and are susceptible to stress.

‘Unexplained infertility’ is the diagnosis doctors give couples in whom no specific cause is found. This can be a difficult concept to come to terms with, especially when there seem to be treatments available for other infertile couples. It does not mean that the couple will never get pregnant. Some do. It means that the factors affecting that couple’s fertility are not among those we can specifically recognize and possibly treat.

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PREGNANCY: WHAT DOES IT FEEL LIKE?

Monday, March 23rd, 2009

Feeling faint. A classic scene, repeated in many old movies, shows the beautiful young, newly married heroine fainting unexpectedly, often in a crowded place, like a shop or street. The next scene shows her, beaming and neat, holding what is meant to be a newborn baby. This is how a rather coy film-making industry used to handle the announcement and depiction of pregnancy and labour.

As we know, it is not that simple, but it is true that women in early pregnancy may be more inclined to faint than non-pregnant women. Pregnancy changes lots of parts of a woman’s body, including her cardiovascular (heart and blood vessel) system. There is a shift in the distribution of blood in her body, with relatively more going down to the pelvis than previously. There is also a hormonal effect during pregnancy on blood vessels which tends to make them more dilated, getting ready for the next change, which is an increase in the amount of blood circulating around. This increased blood volume is necessary to transfer oxygen and nutrients from the woman to her developing foetus, via the placenta.

Having an expanded space in which to hold your blood, and not yet having made the extra blood may contribute to this fainting business. Your blood pressure (the force of the blood pumping around) will be slightly lowered by these changes. That means that when you stand up quickly, it may take a second longer for the blood to reach your brain, and consequently you might faint.

There are a couple of tricks which can help with this. The first is drink more fluid. Try watery drinks, rather than tea (which has a diuretic effect, making you wee more and perhaps decreasing your fluid load). Pregnant women need extra fluid. It will help to fill up the blood vessel space, and stop the blood pressure from dropping to your boots.

Secondly, it may be worth taking a bit of extra care when you are getting up from sitting and lying. If you do it more slowly (no, you are not an invalid, only pregnant), you may feel more comfortable. Recognize that there may be a bit of adjusting your body needs to do.

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WART VIRUS: TREATMENT AND PREVENTION

Monday, March 23rd, 2009

Sometimes the warts will just go away, but it may take a while, and most people seek treatment. There is several different things people use, including grandma’s home remedies.

If people go to a doctor for treatment they may be treated with various methods. (Women should arrange to have a pap smear as well.) There are specific wart paints, like podophyllin, which the doctor can carefully put onto the warts. It is left on for a few hours and then washed off. This process can be repeated two or three times a week until they ate gone. Used properly it is safe, but should not be used for very big areas, or in pregnant women. Another treatment is freezing them, which may sting a bit for a few minutes, but the discomfort is short lived, and it can work well. (It may take a couple of applications.)

If there are heaps, particularly in women, and if they are difficult to get to, or resistant to other treatment, it may be worth considering having them either frozen, surgically burnt (cauterised), or treated with laser, undet a general anaesthetic.

Remember that the treatment is getting rid of the wart, not the virus. The virus remains in the system, and may produce more warts, or more changes in the cervix cells, so continuing to have regular pap smears, even after treatment, is very important.

Prevention. In reality, this is pretty difficult. With so much of the virus in the community, and the fact that it is spread, often without a wart being visible, it is not easy to avoid. Condoms probably offer little protection (because the virus could be transmitted from the uncovered skin near the penis), but regular check ups and pap smears will probably be more useful for women.

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SIDE-EFFECTS OF CONTRACEPTIVE PILL “THE PILL”

Monday, March 23rd, 2009

The actual incidence of serious side-effects of the pill is very small. These can be divided into groups: common and pleasant, less common and a nuisance, very rare and nasty, very rare and potentially disastrous.

Very rare and nasty—the pill should not be prescribed to women who have liver problems. This does not mean just people who don’t tike pats; anyone with a past history of liver disease or jaundice (particularly in pregnancy) should discuss this with their doctor when contemplating the pill. Active liver disease is a contraindication to the pill.

If a woman has had breast cancer diagnosed, the decision whether or not she should take the pill should be considered in consultation with her surgeon, GP and gynaecologist. This is still a controversial area, and decisions would be best made by a woman with access to specific individual information. This does not mean that the pill causes breast cancer, but there are some types of breast cancer which are thought to be potentially accelerated by oestrogen. Researchers and clinicians are still trying to sort this one out. Breast self-examination, and regular examination by a doctor are general health measures which should be undertaken by all women, whether taking the pill or not.

In a few women blood pressure may be increased by taking the pill, so this too is a condition which requires careful monitoring before starting the pill, and should be checked regularly.

 

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FEMALE ANATOMY AND PHYSIOLOGY: PUBERTY

Monday, March 23rd, 2009

Certain hormones in the body begin to increase during the early teenage years, usually beginning around 10 or 11. Consequently changes occur which are, in effect, the maturing of the sexual organs in preparation for reproduction. This stage of life is known as puberty. Most of the physical changes follow the same pattern, although there is plenty of room for individual variation. Puberty is said to be ‘precocious’ (early), if it begins before 9 years of age, and ‘delayed’ if absolutely nothing has happened by 14. There will always he people at either end of the developmental spectrum who arc just late or early developers, but the ages are used by doctors as guides. Some children who develop very early or very late may need investigation, hut this is rare.

Breast development usually starts some time before the first period. Girls (and most hoys, much to their horror) will feel what is known as a ‘breast bud’. This is a little button of tissue just under the nipple. At this time it becomes a bit bigger, and is often quite tender. Usually one side starts off before the other one, which sometimes causes alarm, but they generally catch up with one another quite soon. From this little button, the whole breast will develop. The breast goes through stages of development from immature to mature, usually between the ages of 10 and 20. All breasts, like all noses and other bits of our anatomy, have their own shape, growth rate and character. There are as many variations on ‘normal’ as there are breasts. Unless there is a very obvious problem (like completely lacking any breast development by the age of 14 to 15, or having development only on one side), most minor variations sort themselves out by the final stage of maturation.

The development of body hair usually begins around the time of breast growth. There is usually fine, sparse hair in the pubic area, which becomes coarser and thicker with time. Hair also grows in the armpits. Growing all this hair seems like a bit of a waste of time. There appears to be a reason for developing breasts and having periods, if you want to be able to reproduce, but having extra hair in odd parts of the body does not really seem to add to your ability to bear children. At least not now, but when we were slightly more primitive, and cave dwellers, for instance, we did not shower as often. Anthropologists have suggested that the body odours, which were inevitably stronger then, may have been useful, as they are for other species. Dogs, for example, can mark territories, or find out if another dog is on heat. ‘Pheromones’ is the

name given to subtle smells which we probably exude, which tell other people things about us. The messages may not even be registered consciously. It is thought that body odour, which can act as an aphrodisiac (stimulate sexual feelings), is dispersed better through body hair, which is probably why we developed it. Regardless of the reason, it grows.

The average age at which the first menstrual period arrives has changed over the years in Western society. A couple of generations ago it was usually around 14 to 1.5 years of age. Now, largely doe to better nutrition and living conditions, it is earlier, closer to 12 years.

The first periods are likely to be irregular for a while. It is not uncommon to have one, then none for a few months. After a year or two, when the ovaries start working properly, the periods tend to become more regular, and often a bit painful. If a girl has not been told what to expect, the sudden discovery of blood in her underpants or bed can be very frightening. Some parents shy away from talking to their young daughters about menstruation. However, most girls will handle the event better if prepared in some way.

Puberty is a time of rapid growth, not only on the front of the chest, but also vertically. Most teenagers have what is called a ‘growth spurt’, a fairly unglamorous name. Teenagers also change shape. Girls tend towards an ’8′ shape, and boys towards an upside down triangle. Much to the disillusionment of many, no one ends up with a body like a Barbie doll; it is physically impossible.

The hormones floating around the body also affect the skin. Acne is the curse of the teenager, or at least one of the curses. Many teenagers are at a very sensitive and vulnerable time in their lives, particularly where their appearance is concerned. Then along comes an army of pimples waging a battle on their skin.

Despite the fact that so many of their peers are going through the same thing, it does not do wonders for the self-esteem.

Not only is puberty a time of dramatic physical change, but emotional and psychological adjustment as well, as the body and mind start to grapple with new sensations and urges. It coincides with the years during which a child is starting to exert independence, and carving out a distinct personality from the material given to her or him by the family and environment. It can be an immensely traumatic time, for both the child and the parents, as they learn how to cope with changing demands and altered expectations of each other.

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