Menopause

Menopause

It is the time when a women’s period stops. Women allover the world interpret menopause differently, their fears and concerns about menopause vary by culture. Some women fear a loss of their spouses’ sexual interest when they can no longer have children or due to increased complaints from sexual act due to vaginal soreness and dryness others worry about their mental health and fear losing control of their emotions. Too many women have been victims of cultures and societies that have not taken their symptoms seriously. Medicine has found solutions to help women passing though this interval.

Menopause happens between 45 – 55 years old. It is due to depletion of her eggs. During her reproductive life, the eggs are responsible for releasing Estrogen and other hormones which have many good effects on her body. The decreased hormones level and especially estrogen leads to  Vaginal dryness and thinning of the vaginal lining which can reduce arousal during sex and increase friction which in turn may produce burning or irritation , The woman becomes more vulnerable to urinary infections , Breasts may lose some of their bulk , Skin may become a little less elastic , Hot flushes, Psychological symptoms such as mood swings and insomnia, Sweating attacks ,Heart diseases are increased due to increased LDL (Bad cholesterol) , A decrease in testosterone levels thus decreasing sex libido , loosing bone density rapidly, increasing your risk of osteoporosis and fractures , frequent and sudden urge to urinate followed by an involuntary loss of urine or the loss of urine with coughing, laughing or lifting.

However, a lot of women move through menopause with little or no symptoms.

Menopause Checkup

Menopause is confirmed by elevated FSH levels and declining estrogen levels. Regular annual checkup at the doctor is done by:

  • Bone densometry using DEXA machines or sometimes using ultrasound measuring of the bones of the heel as a screening method.
  • Breast mammogram is an x-ray test that produces an image of the inner breast tissue on film. It shows normal and abnormal structures in the breasts.
  • Breast self-examination on a monthly basis and regular examination by a doctor.
  • Blood cholesterol and lipid profile for fear of heart diseases.
  • Heart checkup and blood pressure.
  • Pap smear is a medical procedure in which a sample of cells from a woman’s cervix is collected and examined under a microscope to look for pre-malignant (before-cancer) or malignant (cancer) changes.

Possible treatments for menopause

  • Hormone replacement therapy consists of estrogens or a combination of estrogens and progesterone. It is used to control the symptoms of menopause but unfortunately it has side effects so the decision about hormone therapy is very individual in which the patient and doctor must take into account the inherent risks and benefits of the treatment. It is currently recommended that if hormone therapy is used, it should be used at the smallest effective dose for the shortest possible time.
  • Alternatives to Hormone Replacement
    • For hot flashes: Several drugs offer limited relief: synthetic progesterone and androgen, methyldopa.
    • For painful intercourse due to vaginal dryness: Applying a vaginal cream or vaginal tablets with estrogen once or twice a week can be of help.
    • Bone loss: Bisphosphonates, Raloxifene, Calcitonin, Vitamin D, estrogen, calcium.
    • Psychological Depression: Counseling and low dose anti depressants.
  • Lifestyle and home remedies Fortunately, many of the signs and symptoms associated with menopause are temporary. Take these steps to help reduce or prevent their effects:
    • Heart diseases: Stop smoking, regular aerobic exercise, and eat a diet low in saturated fats and plenty whole grains, fruits and vegetables.
    • Hot flashes: regular exercise, dress in layers and try to pinpoint what triggers your hot flashes. For many women, triggers may include hot beverages, spicy foods, alcohol, hot weather and even a warm room. Other options of treatment include aromatherapy, homeopathy, acupuncture, herbal medicines and massage.
    • Decrease vaginal discomforts: Use vaginal lubricants or moisturizers. Staying sexually active also helps. Other options include the consumption of phytoestrogens, found in soy-based foods.
    • Optimize your sleep. Avoid caffeine and plan to exercise during the day, learn relaxation techniques.
    • Urinary tract infections: Drinking plenty of fluids and urinating as frequently and completely as possible.
    • Strengthen your pelvic floor muscles by Kegel exercises.
    • Eat well:  Eat a well balanced diet and increase your calcium and vitamin D intake.
    • Don’t smoke.
    • Exercise regularly.
    • Schedule regular checkups with your doctor.

Pros of Menopause

  • You no longer have to deal with monthly menstrual cycles, which are often accompanied with cramping and bloating.
  • You can have sex safely because you no longer worry about getting pregnant.
  • Relationships get stronger because women communicate more with their partner.
  • Reaching menopause is a sign that you are physically and emotionally mature enough to handle all the tuff stuff that life has to dish out with grace and elegance.

Urinary Incontinence

Urinary incontinence is the unintentional loss of urine. It can be Stress incontinence when the bladder can’t handle the increased compression during exercise, coughing. It can also be Urge incontinence if caused by a sudden, involuntary bladder contraction. Overflow incontinence in which the bladder becomes too full because it can’t be fully emptied, is a rarer type of the disorder.

What are causes of UI?

Women are most likely to develop incontinence either during pregnancy and childbirth, or after the hormonal changes of menopause, because of weakened pelvic muscles. Pelvic trauma, spinal cord damage, caffeine, or medications, including cold preparations and diet drugs that are available over-the-counter, can also cause episodes of UI. Diseases which affect the nerves that control the bladder, such as multiple sclerosis, can be associated with UI.

Other factors that contribute to bladder incontinence include decreased mobility or impaired thinking (such as forgetfulness, confusion, or senility), particularly in combination with drugs such as sedatives, sleeping pills, and alcohol.

What treatments are recommended for UI?

Treatment for UI depends on the type of incontinence, its causes, and the capabilities of the patient. Here are commonly recommended treatments:

  • Pelvic muscle rehabilitation – to improve pelvic muscle tone and prevent leakage by :
    • Regular pelvic Kegel exercises.
    • Biofeedback in conjugation with Kegel exercises help people in awareness and control of their pelvic muscles.
  • Pelvic floor electrical stimulation. Mild electrical pulses stimulate muscle contractions. Should be done in conjunction with Kegel exercises.
  • Behavioral therapies – to help people regain control of their bladder.
    • Bladder training teaches people to resist the urge to void
    • Toileting assistance uses routine or scheduled toileting, habit training schedules, and prompted voiding to empty the bladder regularly to prevent leaking.
  • Pharmacologic therapies – to improve incontinence medically.
  • Surgical therapies – to treat specific anatomical problems.
    • Sling procedures, bulking injections (such as collagen) and other surgical procedures support or move the bladder to improve continence.
Urinary Incontience
Urinary Incontience

Genital prolapse

Pelvic organ prolapse is the descend into or outside of the vaginal canal or anus of any of the pelvic floor organs. You may hear them referred to in these ways:

  • Cystocele: A prolapse of the bladder into the vagina, is the most common condition
  • Urethrocele: A prolapse of the urethra (urine-carrying tube)
  • Uterine prolapse
  • Vaginal vault prolapse: prolapse of the vagina
  • Enterocele: Small bowel prolapse
  • Rectocele: Rectum prolapse

What Causes genital prolapse?

Anything that increases pressure in the abdomen can lead to prolapse. Common causes include: Pregnancy, labor, Obesity, chronic cough and constipation.

What are the symptoms?

Some women notice nothing at all, but others report these symptoms:

  • A feeling of pressure or fullness in the pelvic area
  • A backache low in the back if it is the uterus
  • Painful intercourse due to drop of rectum or uterus
  • A feeling that something is falling out of the vagina if it the uterus
  • Urinary problems such as leaking of urine if it is the bladder
  • Constipation if it is the rectum.

How can genital prolapse be prevented?

  • Do Kegel exercises daily to maintain good muscle strength in your pelvic area
  • Maintain a healthy weight
  • Avoid constipation
  • Do not smoke

How is genital prolapse treated?

Treatment depends on how severe the symptoms are. Treatment can include:

  • Behavioral treatments, such as doing Kegel exercises designed to strengthen the pelvic floor muscles.
  • Mechanical treatments, such as inserting a small plastic pessary into the vagina to provide support for the drooping organs.
  • Surgical treatment, either to repair the affected tissue or organ or to remove the organ (such as removal of the uterus by hysterectomy).
Genital Prolapse
Genital Prolapse

Pelvic Pain

Pelvic pain is a common complaint among women. It is categorized as either acute (sudden and severe), or chronic (lasting over a period of months or longer). Pelvic pain may originate in genital or extra genital organs in and around the pelvis, or it may be psychological (pain sensation and no physical problem is present).

What causes pelvic pain?

Pelvic pain may have multiple causes, including:

  • inflammation or direct irritation of nerves caused by acute or chronic trauma, fibrosis, pressure, or intraperitoneal inflammation
  • muscular contractions or cramps of both smooth and skeletal muscles
  • psychogenic factors, which can cause or aggravate pain
  • causes of acute pelvic pain may include: Ectopic pregnancy, pelvic inflammatory disease, twisted or ruptured ovarian cyst, miscarriage or threatened miscarriage, urinary tract infection, appendicitis, ruptured fallopian tube
  • causes of chronic pelvic pain may include: Menstrual cramps, endometriosis, uterine fibroids, adhesions or scar tissue between the internal organs in the pelvic cavity, endometrial polyps and cancers of the reproductive tract

How is pelvic pain diagnosed?

Diagnosis includes a good medical history (which includes the character of the pain) and physical exam. In addition some diagnostic procedures may include the following:  Blood tests, pregnancy test, urinalysis, culture of cells from the cervix. Non invasive imaging techniques like an ultrasound, MRI. Laparoscopy to see the whole pelvic area. X-ray to produce images of bones and internal organs.

How to treat pelvic pain?

Specific treatment will be determined based on your age, overall health, and medical history, cause of the disease, type and severity of the symptoms and your tolerance for specific medications. Generally treatment usually includes antibiotics, anti inflammatory and pain medication. In cases of severe infection, hospitalization may be required to administer intravenous antibiotics. Occasionally, surgery is necessary. If a physical cause cannot be found, psychotherapy is recommended. Relaxation exercises or physical therapy is always recommended.

Pelvic Pain
Pelvic Pain

Abnormal vaginal bleeding

Abnormal vaginal bleeding is a flow of blood from the vagina that occurs either at the wrong time or in inappropriate amounts. Normal ovulation is necessary for regular menstrual periods.

What conditions cause abnormal vaginal bleeding in women who are ovulating regularly?

  • Excessively heavy menstrual period
    • Non-cancerous causes: uterine fibroids or polyps, intrauterine devices, blood clotting disorders and certain medications, especially those that interfere with blood clotting.
    • Cancerous Causes: It can be a sign of endometrial cancer or the precancerous endometrial hyperplasia (thickened endometrial lining), it is more common above the age of 40.
  • Menstrual periods that is too frequent
    • Pelvic inflammatory disease or Endometriosis. Sometimes, the cause is unclear and the woman is said to have dysfunctional uterine bleeding.
  • Menstrual periods at irregular intervals
    • benign growths in the cervix, such as cervical polyps, infections of the uterus and use of birth control pills. Perimenopause (the time period approaching the menopausal transition) is often characterized by irregular menstrual cycles
  • Spotting between menstrual periods
    • Women who are ovulating normally can experience spotting between menstrual periods. Hormonal birth control methods as well as IUD may sometimes lead to spotting between periods.
    • Psychological stress, certain medications such as anticoagulant drugs, and fluctuations in hormone levels may all be causes of light bleeding between periods.

What conditions cause abnormal vaginal bleeding in women who are NOT ovulating?

Anything interfering with normal ovulation can cause abnormal vaginal bleeding, examples are chronic medical illness or severe medical or emotional stress, malfunction of a part of the brain-hypothalamus, Anorexia nervosa(an eating disorder associated with excessive thinness) or Polycystic ovarian syndrome(hormonal problem) may cause anovulation and irregular periods.

What conditions cause abnormal vaginal bleeding after menopause?

Any vaginal bleeding is considered abnormal and doctor’s consultation should be immediate to rule out the serious causes like endometrial cancer or the precancerous endometrial hyperplasia (thickening of the uterine lining).

What causes vaginal bleeding during or after sexual intercourse?

Injuries to the vaginal wall or vaginal opening during intercourse.  Infections or Lowered estrogen levels in peri-menopausal or postmenopausal women may cause the lining of the vagina to become thinned and easily inflamed or infected. Anatomical lesions, such as tumors or polyps on the cervix or vaginal wall may lead to vaginal bleeding during or after intercourse.

What diagnostic tests are used to evaluate abnormal vaginal bleeding?

Diagnosis includes a medical history and physical exam. During the pelvic examination, the physician attempts to detect cervical polyps or any unusual masses in the uterus or ovaries.  In addition some diagnostic procedures may include the following:  Tests should be performed to know the hormonal status of the woman, pregnancy test as routine if the woman is pre menopausal. Pap test to rule out cervical cancer, culture of cervical and vaginal discharges to rule out infections. Blood tests to evaluate thyroid function, liver function, or kidney function abnormalities. A pelvic ultrasound is also performed. An endometrial biopsy is also beneficial.

How is abnormal vaginal bleeding treated?

Treatment for irregular vaginal bleeding depends on the underlying cause.

  • If the cause of the bleeding is lack of ovulation, doctors may prescribe either progesterone to be taken at regular intervals, or an oral contraceptive, which contains progesterone, to achieve a proper hormonal balance
  • If the cause of irregular vaginal bleeding is a precancerous change in the lining of the uterus, progesterone medications may be prescribed to reduce the buildup of precancerous uterine lining tissues in an attempt to avoid surgery.
  • When a woman has been without menses for less than six months and is bleeding irregularly, the cause may be menopausal transition. During this transition, a woman is sometimes offered an oral contraceptive to establish a more regular bleeding pattern, to provide contraception until she completes menopause, and to relieve hot flashes.
  • Benign growths are removed surgically to control bleeding.
  • If the cause of bleeding is infection, antibiotics are necessary.
  • If bleeding is excessive and cannot be controlled by medication, a surgical procedure called dilation and curettage (D&C) may be necessary.
  • Occasionally, a hysterectomy is necessary when hormonal medications cannot control excessive bleeding. However, unless the cause is pre-cancerous or cancerous, this surgery should only be an option after other solutions have been tried.

Pelvic Inflammatory Disease PID

PID can affect the uterus, fallopian tubes, and/or the ovaries. It can lead to pelvic adhesions and scar tissue that develops between internal organs, causing ongoing pelvic pain and the possibility of an ectopic pregnancy. Left untreated, infertility can develop and might also lead to chronic infection. In addition, if PID is not diagnosed early enough, peritonitis and inflammation of the walls of the abdominal and pelvic cavity may develop.

What are the most common risk factors for pelvic inflammatory disease?

  • Although women of any age can develop PID, sexually active women between the ages of 20 and 31 are at the greatest risk of acquiring the disease through sexually transmitted bacteria.
  • Women who use intrauterine devices (IUDs) are also at an increased risk.

What are the symptoms of PID?

The symptoms may resemble other conditions or medical problems. Consult your physician for diagnosis. The following are the most common symptoms diffuse pain and tenderness in the lower abdomen, pelvic pain, increased foul-smelling vaginal discharge, fever and chills, vomiting and nausea and pain during sexual intercourse.

How is PID diagnosed?

  • Diagnosis includes a medical history and physical exam.
  • In addition some diagnostic procedures may include the following:
    • microscopic examination of samples from the vagina and cervix
    • Pap test that involves microscopic examination of cells collected from the cervix
    • ultrasound
    • Laparoscopy . Using the laparoscope to see into the pelvic area, the physician can determine the locations, extent, and size of the endometrial growths.
    • Culdocentesis – a procedure in which a needle is inserted into the pelvic cavity through the vaginal wall to obtain a sample of pus.

How to treat PID?

Specific treatment will be determined based on your age, overall health, and medical history, cause of the disease, type and severity of the symptoms and your tolerance for specific medications. Generally treatment usually includes oral antibiotics. In cases of severe infection, hospitalization may be required to administer intravenous antibiotics. Occasionally, surgery is necessary.

Pelvic inflammatory disease
Pelvic inflammatory disease

Vaginitis

Vaginitis refers to any inflammation or infection of the vagina. This is a common gynecological problem found in women of all ages.

What are the most common types of Vaginitis?

  • Yeast infection by a species of Candida fungus or Bacterial vaginosis, both normally living in vagina. Something happens that upset the balance leading to overgrowth of Candida or bacterial vaginosis and infection occurs.
  • Vaginitis by the parasite Trichomoniasis vaginalis, Chlamydia Vaginitis by the bacteria Chlamydia trachomatis,  Gonococcal Vaginitis by the bacterium Neisseria gonorrhea and viral Vaginitis by Herpes simples and human papiloma virus. All are sexually transmitted diseases
  • Vaginitis  irritation by an allergic reaction to, or irritation from  vaginal sprays, douches, or spermicidal products, perfumed soaps, detergents, or fabric softeners
  • The other type of “atrophic Vaginitis,” usually results from a decrease in hormones because of menopause, surgical removal of the ovaries, radiation therapy, or even after childbirth particularly in breastfeeding women. Lack of estrogen dries and thins the vaginal tissue, and may also cause spotting.

What are the most common risk factors for Vaginitis?

It is common in pregnant woman .It is also common in women who have un-controlled diabetes , using an immunosuppressant medication , using high-estrogen contraceptives , thyroid or endocrine disorder  , an antibiotic course or women who are undergoing corticosteroid therapy, which slows the immune system

What are the symptoms of Vaginitis?

The symptoms may resemble other conditions or medical problems. Consult your physician for diagnosis.

  • For Candida the most common symptoms may include a thick, white, cottage cheese-like vaginal discharge, watery and usually odorless , itchiness and redness of the vulva and vagina
  • For bacterial vaginosis the most common symptoms may include a milky, thin discharge at times, or a heavy, gray discharge, “fishy” odor.
  • For Trichomoniasis the most common symptoms may include a frothy musty-smelling, greenish-yellow discharge, itching in and around the vagina and vulva, burning during urination, discomfort in the lower abdomen, and pain during intercourse, some women are asymptomatic.
  • For Chlamydia the most common symptoms may include increased vaginal discharge, light bleeding, especially after intercourse, pain in the lower abdomen or pelvis, burning during urination, pus in the urine, redness and swelling of the urethra and labia, some women are asymptomatic.
  • For Gonococcal infection the most common Symptoms may include: yellowish or bloody vaginal discharge, painful or burning urination, vaginal bleeding during intercourse and lower abdominal pain during intercourse.
  • For noninfectious Vaginitis the most common symptoms may include vaginal itching, vaginal burning, vaginal discharge, pelvic pain (particularly during intercourse).
  • For viral herpes the most common symptoms may include pain in the genital area associated with lesions and sores visible on the vulva, or vagina, but occasionally are inside the vagina and can only be found during a pelvic examination, for viral human papillomavirus (HPV) the most common symptoms may include painful warts to grow on the vagina, rectum, vulva, or groin. However, visible warts are not always present, in which case, the virus is generally detected by a Pap test.

How is a Vaginitis diagnosed?

In addition to a complete medical history and physical and pelvic examination, diagnostic procedures often include a microscopic examination of the vaginal discharge.

How to treat Vaginitis?

Specific treatment will be determined based on your age, overall health, and medical history, cause of the disease, type and severity of the symptoms and your tolerance for specific medications. Generally treatment may include:

  • For Candida:  anti-fungal, vaginal creams and suppositories, antibiotics
  • For Bacterial vaginosis: oral antibiotics. It is important that pregnant women receive prompt treatment as bacterial vaginosis can cause complications during pregnancy
  • For Trichomoniasis both partners must be treated by taking oral antibiotics. It is important for pregnant women to receive prompt treatment as Trichomoniasis can cause complications during pregnancy.
  • For Chlamydia: oral antibiotics. It is especially important for pregnant women infected with Chlamydia to be treated, as the consequences for a newborn that has passed through the birth canal of an infected mother are quite serious.
  • For Gonococcal Vaginitis if left untreated, Gonococcal infections can lead to serious conditions such as pelvic inflammatory disease increasing risk of infertility, pelvic adhesions, chronic pelvic pain, and ectopic (tubal) pregnancy. Because of these risks, early treatment of the infection with antibiotics is essential.
  • Treatment for noninfectious Vaginitis generally includes estrogen creams or oral tablets, which can restore lubrication and decrease soreness and irritation.
Vaginitis
Vaginitis

Cervicitis

Cervicitis is an irritation of the cervix caused by a number of different organisms.

What are the most common risk factors for Vulvitis?

Chronic Cervicitis is common in women following childbirth. It is also often associated with pregnancy, probably due to an increased blood supply to the cervix as a result of increased hormone levels. Less commonly, Cervicitis is caused by sensitivities to certain chemicals, including those in spermicidal, latex, and tampons.

What are the symptoms of Cervicitis?

The symptoms may resemble other conditions or medical problems. Consult your physician for diagnosis. The following are the most common symptoms pelvic pain, backache, urinary problems, pus-like discharge, as the cervical erosion worsens cervical ulceration may develop.

How is Cervicitis diagnosed?

Diagnosis includes a medical history and physical exam. In addition some diagnostic procedures may include the following: Pap test, biopsy, culture of cervical discharge

How to treat Cervicitis?

Specific treatment will be determined based on your age, overall health, and medical history, cause of the disease, type and severity of the symptoms and your tolerance for specific medications. Generally treatment may include: antibiotics, silver nitrate to destroy damaged cells in cervical erosion, cryosurgery – a probe that is very cold, to freeze and kill abnormal cells.

Cervicitis
Cervicitis

Vulvitis

Vulvitis is inflammation of the vulva, the soft folds of skin outside the vagina.

What are the most common risk factors for Vulvitis?

Any woman with certain allergies, sensitivities, infections, or diseases can develop Vulvitis.  Girls who have not yet reached puberty and postmenopausal women sometimes develop Vulvitis, possibly because of inadequate levels of estrogen. It may be caused by certain toilet papers, perfumed soaps and shampoos, certain laundry detergents, certain douches and powders, swimming pool water or wearing a wet bathing suit for a long time, certain synthetic undergarments.

What are the symptoms of Vulvitis?

The symptoms may resemble other conditions or medical problems. Consult your physician for diagnosis. The following are the most common symptoms, redness and swelling on the labia and other parts of the vulva.

How is Vulvitis diagnosed?

Diagnosis includes a medical history and physical exam. In addition some diagnostic procedures may include the following: blood tests, urinalysis, and tests for sexually transmitted diseases (STDs), Pap smear.

How to treat Vulvitis?

Vulvitis
Vulvitis

Specific treatment will be determined based on your age, overall health, and medical history, cause of the disease, type and severity of the symptoms and your tolerance for specific medications.

Vulval Cancer

The vulva is the external portion of the female genital organs. Vulvar cancer is a rare disease that can occur on any part of the external organs, but most often affects the labia majora or labia minora.

What are the most common risk factors for uterine cancer?

Vulvar cancer is common over the age of 50. It can result from chronic Vulvar inflammation, infection with the human papillomavirus (HPV), lichen sclerosis, melanoma or atypical moles on non-Vulvar skin and Vulvar intraepithelial neoplasia (VIN). It is also common among smokers.

What are the symptoms of Vulvar cancer?

The symptoms may resemble other conditions or medical problems. Consult your physician for diagnosis. The following are the most common symptoms, constant itching or pain, changes in the color and the way the vulva looks, bleeding or discharge not related to menstruation

How can Vulvar cancer be prevented?

The cause of Vulvar cancer is not currently known, however, Suggestions for prevention include: Delay onset of sexual activity. Use condoms. , Do not smoke. , Have regular physical checkups. , Have routine Pap tests and pelvic examinations. , Routinely check entire body for irregular growth of moles.

How is Vulvar cancer diagnosed?

Vulvar cancer is diagnosed by biopsy, removing a section of tissue for examination in a laboratory by a pathologist.

How to treat Vulvar cancer?

The treatment depends upon whether the cancer has spread to involve other tissues in the pelvis or not. It also depends on the general health of the patient and permission for operations.

Generally treatment for patients with cancer of the vulva may include surgery :

  • laser surgery to destroy abnormal cells
  • Excision of the cancer cells and a margin of normal appearing skin around it.
  • vulvectomy – surgical removal of part of all of the tissues of the Vulvar
  • radiation therapy or chemotherapy
Vulval cancer
Vulval cancer

Vaginal Cancer

The vagina is the birth canal. Cancer of the vagina is a very rare kind of cancer in women.

What are the most common risk factors for uterine cancer?

Half of women affected are older than 60, with most between ages 50 and 70.  A history of exposure to diethylstilbestrol (DES) as a fetus or cervical cancer or precancerous conditions

or uterine prolapse is a risk factor. Infection with human papillomavirus (HPV) infection has been associated with vaginal cancer. Problems like vaginal adenosis or vaginal irritation raises vaginal cancer risks.

What are the symptoms of vaginal cancer?

The symptoms may resemble other conditions or medical problems so consult your physician for diagnosis. The following are the most common symptoms, bloody discharge and bleeding during sexual intercourse or bleeding from the vagina after the menopause.

How is vaginal cancer diagnosed?

Vaginal cancer can be detected visually, using a magnifying instrument called a colposcope.

A biopsy is always necessary to confirm the diagnosis, and then further tests such as scans can also be used to determine the extent to which the cancer has already spread.

How can vaginal cancer be prevented?

  • Avoid being infected with HPV, a sexually transmitted virus.
  • Sexual partner should always wear a condom correctly during intercourse. Recent research shows that condoms provide some protection against HPV.
  • Limit the amount of sexual partners.
  • Pap smear may also be able to detect some cases of vaginal cancer before symptoms are experienced so attend regular gynecological checkups and Pap smear.

How to treat vaginal cancer?

The treatment depends upon whether the cancer has spread to involve other tissues in the pelvis or not. It also depends on the general health of the patient and permission for operations.

surgery, including:

  • laser surgery to remove the cancer, including LEEP (loop electro excision procedure)
  • local excision to remove the cancer
  • (partial) vaginectomy to remove the vagina
  • Chemotherapy – the use of anticancer drugs to treat cancerous cells.
  • Radiotherapy is aimed at destroying tumor cells that the gynecologist cannot see.
Vaginal cancer
Vaginal cancer

Uterine cancer

The uterus is a hollow pear-shaped organ in the woman’s lower abdomen. Cancer of the uterus is the most common cancer of the female reproductive tract. Cancer of the uterus is not common during the child bearing period. It usually occurs around the time of menopause. Because it grows slowly and women are alerted abnormal bleeding from the vagina, most cancers are detected and treated at an early stage and cure rates following surgery are very high.

What are the most common risk factors for uterine cancer?

Uterine cancer is common around the age of 50 or over. A history of endometrial hyperplasia (thickened uterine inner lining) is a risk factor. Medical problems like being overweight or being diabetic or hypertensive can result in uterine cancer. History of other cancers or taking tamoxifen for breast cancer treatment or prevention or taking estrogen replacement therapy without progesterone (ERT) is a risk factor.

What are the symptoms of cancer of the uterus?

The symptoms may resemble other conditions or medical problems so consult your physician for diagnosis. Symptoms will vary according to whether or not the woman is still having periods. If she is still having periods then the cancer may make her periods more irregular or heavier. If her periods have stopped, then any bleeding from the vagina is abnormal and should be investigated.

How is cancer of the uterus diagnosed?

Diagnosis includes a medical history and physical exam, including a pelvic exam to feel the vagina, rectum, and lower abdomen for masses or growths. The only certain means of diagnosis is a biopsy by dilation and curettage or hysteroscopy. Ultrasound examination is a very useful tool since it enables a doctor to identify uterine cancer and certain features that might make him or her suspect a cancer.

How can uterine cancer be prevented?

  • Use birth control pills.
  • Maintain a healthy weight and participate in physical activity.
  • Ask your doctor if he/she can prescribe you progesterone.
  • Talk with your doctor about how often you should be screened for uterine cancer especially if you have factors that increase your risk of getting the cancer.
  • See your doctor right away if you have abnormal bleeding from the vagina.

How is cancer of the uterus treated?

The treatment depends upon whether the cancer has spread to involve other tissues in the pelvis or not. It also depends on the general health of the patient and permission for operations.

surgery, including:

  • Hysterectomy – surgical removal of the uterus, usually with removal of the tubes and ovaries. The five-year survival rates following surgery are over 70 per cent.
  • Chemotherapy – the use of anticancer drugs to treat cancerous cells.
  • Radiotherapy is aimed at destroying tumor cells that the gynecologist cannot see.
  • Hormonal therapy
Uterine cancer
Uterine cancer

Ovarian cancer

The ovaries are 2 female reproductive organs located in the pelvis, one on each side of the uterus. They produce eggs and the female hormones which control the development of female body characteristics and regulate the menstrual cycle and pregnancy. Ovarian cancer is a disease of unknown cause.

What are the most common risk factors for ovarian cancer?

Ovarian cancer is most common in menopausal women (over 50 years of age). Rarely, ovarian cancer can run in families. Sometimes infertility or having a first child after the age of 30 is a risk factor .Also personal history of breast or colon cancer is a risk factor.

What are the symptoms of ovarian cancer?

The symptoms may resemble other conditions or medical problems so consult your physician for diagnosis. The following are the most common symptoms of ovarian cancer: general discomfort in the lower abdomen, weight loss, diarrhea or constipation, or frequent urination, bleeding from the vagina or build up of fluid around the lungs, which may cause shortness of breath.

How is ovarian cancer diagnosed?

Ovarian cancer may be discovered by chance during a routine gynecological examination or it may be discovered because the tumor has grown so large that you can feel it, or because it is pressing on the bladder or intestines.

Diagnosis includes a medical history and physical exam, including a pelvic exam to feel the vagina, rectum, and lower abdomen for masses or growths. The only certain means of diagnosis are either an operation or a biopsy. Ultrasound examination is a very useful tool since it enables a doctor to identify an ovarian tumor and certain features that might make him or her suspect a cancer.

How can ovarian cancer be prevented?

  • healthy diet (high in fruits, vegetables, grains, and low in saturated fat)
  • birth control pills
  • pregnancy and breast feeding

How to treat ovarian cancer?

The treatment depends upon whether the cancer has spread to involve other tissues in the pelvis or not. It also depends on the general health of the patient and permission for operations.

– surgery, including:

  • Surgery to remove the uterus, both Fallopian tubes and ovaries.
  • Pelvic lymph node dissection – removal of some lymph nodes from the pelvis.
  • Chemotherapy – the use of anticancer drugs to treat cancerous cells.
  • Radiotherapy is aimed at destroying tumor cells that the gynecologist cannot see.
Ovarian cancer
Ovarian cancer

Cervical Cancer

What is cancer cervix?

The cervix is the lower part of the uterus and acts as a gate to the uterus.

What are the most common risk factors for cervical cancer?

Cervical cancer is commonest among the over 50s but it can affect all age groups. A viral infection of the cervix is present in most cases (especially Human papiloma virus). Smoking appears to increase a woman’s risk of developing cervical cancer, and there may also be a link to the numbers of sexual partners a woman has had at a young age.

What are the symptoms of cervical cancer?

The symptoms may resemble other conditions or medical problems so consult your physician for diagnosis. Symptoms of cervical cancer usually do not appear until abnormal cervical cells become cancerous and invade nearby tissue. While sometimes no symptoms are seen, most cause the woman to experience bleeding between her periods or after sex.

How is cervical cancer diagnosed?

Cervical cancer can only be diagnosed through a biopsy of the cervix which is obtained by loop electrosurgical excision, colposcopy or cone biopsy.

How can cervical cancer be prevented?

  • Routine, annual pelvic examinations and Pap tests can detect precancerous conditions that often can be treated before cancer develops. Invasive cancer that does occur wouldlikely be found at an earlier stage. Follow up on abnormal Pap smears is equally important.
  • Limit the amount of sexual partners you have.
  • Quit smoking
  • Get the HPV vaccine. The vaccine is most effective when given to young women before they become sexually active.

How is cervical cancer treated?

The treatment depends upon whether the cancer has spread to involve other tissues in the pelvis or not. It also depends on the general health of the patient and permission for operations.

– surgery, including:

  • Cryosurgery – using a very cold probe to freeze and kill cancer cells.
  • Laser surgery – use of a powerful beam of light to destroy abnormal cells.
  • LEEP (loop electro excision procedure)
  • Hysterectomy – surgery to remove the uterus, including the cervix.
  • Radiotherapy is aimed at destroying tumor cells that the gynecologist cannot see.
  • Chemotherapy – the use of anticancer drugs to treat cancerous cells.
Cancer Cervix
Cancer cervix