Monday, September 6, 2010

All About Oliomenorrhea (Prolonged Intervals Between Menses)

Learning About PCOs and Infertility
By Alvern Bullard

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Not being able to get pregnant when you are ready can be an emotional, frustrating experience. Unless there is prior knowledge of a possible problem, most women assume they'll have no trouble conceiving. When the home pregnancy test keeps turning up negative month after month, anger and hopelessness can set in. It's not time to give up though. Taking the time to do some research about infertility can give you an outlet for some of that frustration, and learning about PCOs and infertility in particular can help set your mind at ease. Help is available and you're certainly not alone.

After months or years of trying, you've decided it's time to find out the cause for why you're not getting pregnant. As with any medical problem, finding a cause can seem as daunting as the actual problem. Something to keep in mind though -beyond all the poking, prodding and embarrassing tests, is an answer to the problem, and once it is identified it can be attacked with an appropriate treatment. And, with appropriate treatment, the odds are very good that you'll end up with a beautiful, bouncy, bundle of baby!

One of the most common problems preventing pregnancy is PCO or Polycystic Ovarian syndrome or polycystic ovaries. Roughly 8% - 10% of women suffer from this and 25% are unaware of it until they try to get pregnant. Women with PCO usually have a high level of male hormones that prevent the ovarian follicles inside the ovaries from maturing into eggs. Since no eggs are released into the uterus, no menstruation takes place. Some of the signs of PCO are oligomenorrhea, irregular menstrual cycles: amenorrhea, total lack of periods: hirsutism, excess facial and body hair: obesity: elevated insulin levels.

It has been learned that many women suffering from PCO have high sugar levels. High sugar levels create high insulin levels and in turn, the body responds by producing more male hormones. An elevated level of male hormones prevents the production of adequate female hormones to produce ovulation. With treatment of PCOs and infertility there is a high success rate of pregnancy. It often is not a question of if a woman will get pregnant with treatment, but which treatment will be most effective.

PCOs and infertility can be caused by several things and often there is more than one factor at work. Treatment of more than one type may be necessary. Your doctor will check for a number of things and along with the usual blood screening, the tests for PCO will probably include the following:

LH:FSH ratio - Luteinizing Hormone and Follicle Stimulating Hormones lead to ovulation. Free and Total testosterone - elevated levels may indicate PCO Prolactin - elevated levels interfere with ovulation and may indicate pituitary problems. TSH - Thyroid Stimulating Hormone affects fertility. DHEAS - dehydroepiandrosterone sulfate, is created by the adrenal glands and is used by the body to make either testosterone or estrogen

Along with these blood tests, your doctor will probably order an ultrasound of your ovaries. This may be the most telling of all the tests you'll have. If you have PCO the ovaries will have a collection of small cysts, sometimes referred to as a "string of pearls". While this alone is not enough for a diagnosis, these results along with the blood tests, will give your doctor a good picture of what is causing you not to get pregnant.

The next step, of course, will be a plan of treatment. The main idea is to induce ovulation - get your body to create mature eggs. Most doctors will start out with the simplest method which will be medication or injections to help your body create more female hormones. With mature eggs dropping, pregnancy can occur naturally. If medication alone does not work there is always in-vitro fertilization.

Although the struggle to get pregnant will continue to be a difficult one, you will now have a plan of attack and the chances of success are high. Whatever method proves successful for you, once you hold that tiny bundle of joy in your arms, you'll know without doubt that it was all well worth it.

Get the ultimate low down on infertility with our complete pcos and infertility info overview exclusively on

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Sunday, August 29, 2010

All About Oliomenorrhea (Prolonged Intervals Between Menses)

The Language of Fertility
By Mel Ng

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A visit to a fertility clinic usually involves encountering terminologies that seem Greek and Latin to most of us. A little knowledge and understanding of the terms used goes a long way in appreciating what the physician or the fertility expert recommends.

Some of the terms used to define the male reproductive system are:

- Prostrate gland - this is a gland that supplies part of the fluid that is essential for the transportation of sperms.

- Vas Deferens - is the tubule that carries sperms from the epididymis to the ejaculatory duct of the penis.

- Follicle stimulating hormone - these hormones are pituitary hormones that stimulate the testicles.

Some of the physical conditions that may lead to infertility issues with males are:

- Ctyptorchidism - this is a condition where the testicles do not descend into the scrotal sacs.

- Hypospadias - is a structural abnormality of the penile shaft and can result in an opening of the underside.

- Retrograde ejaculation - this is a clinical condition in which sperms are not ejaculated in a forward direction and actually refluxes into the bladder.

Other terms that males are likely to hear about during a visit to a fertility clinic are:

- Asthenospermia - this is a condition where the movement of the sperms is hampered and this results in poor motility.

- Azoospermia - is a complete absence of sperms.

- Oligoasthenospermia - this refers to a condition where the sperm count is low coupled with poor mobility of the sperms.

- Teratospermia - is mentioned when the shape of the sperms is abnormal.

- Impotence in men - is a condition where an individual is unable to maintain an erection and has a total sperm count of less than 20 million.

Some of the treatment options that exist for males are:

- Etoejaculation - this is a process of electrical stimulation of nerves that control ejaculation and this is used to obtain semen from men with spinal cord injuries.

- Percoll - is a process in which sperms are centrifuged or washed to enable separation from debris and dead or immature sperm

- Testicularlepididymal sperm aspiration- is a surgical procedure where the testicle or epididymis is biopsied for the purposes of obtaining sperm for Intracytoplasmic Sperm Injection.

- Intracytoplasmic Sperm Injection is a process of injecting sperm into oocyte with micromanipulation technique.

Since the reproductive system of women is vastly different from that of males, the terms used are also different.

- Fallopian tubes - a pair of hollow structures leading from the area of the ovaries to the uterus. Fertilization occurs in the fallopian tubes from where the eggs travels to the uterus and settles there.

- Fimbria - are the end of the fallopian tubes and these help in picking up the egg from the ovary after ovulation.

- Corpus Luteum - an organ responsible for progesterone production in the ovary after ovulation has occurred. This helps in preparing the lining of uterus for implantation.

- Follicle - is a fluid filled structure on the surface of the ovary in which the maturing egg grows. It produces estrogen until release of the egg, after which it becomes the corpus luteum and secretes progesterone.

Some of the common problems that may occur in females are

- Anovulation - lack of ovulation.

- Amenorrhea - absence of menstruation.

- Oligomenorrhea - infrequent menses.

- Endometriosis - where the lining tissue of the uterus comes outside and lodges in the peritoneal cavity.

- Ectopic pregnancy - a pregnancy that occurs outside the uterus, usually in the fallopian tube.

Treatments for infertility in women range from surgical procedures to almost natural ones.

- Artificial insemination - this is a procedure where the prepared sperm is placed in the uterus with the help of a specialized catheter.

- Intrauterine insemination - a process that involves placing the sperm directly into the uterus.

- Blastocyst - is also known as preimplantation embryo and refers to a more developed embryo that implants into the uterine lining about a week after fertilization.

- Laparoscopy - a technique which uses a narrow lighted instrument to visualize the ovaries, uterus and fallopian tubes.

- Salpingostomy - refers to surgical procedure to create an opening at the end of blocked fallopian tube.

- Fimbrioplasty - is a surgical process where the constricted end of a fallopian tube is opened.

- Laparotomy - is a process that involves making an incision through the abdomen to allow direct visualization of the reproductive system.

- In Vitro Fertilization - is the latest technique in which the fertilization is achieved outside the body and then embryo transfer is done into the uterus.

- Gamete Intra fallopian transfer - is a variation of IVF and needs laproscopy wherein the eggs are mixed with sperms outside the body and then placed into the fallopian tube. The fertilization occurs inside the body.

Equipped with this knowledge of fertility related terms, understand and decoding what the experts tell you should not be a tough job, as it normally is.

Fertility Facts Offers extensive articles and resources on fertility, infertility, fertility treatments, getting pregnant and pregnancy.

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Sunday, August 22, 2010

All About Oliomenorrhea (Prolonged Intervals Between Menses)

Medical Question #2. Ovarian Cysts
By Al K

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Ms. L wrote me:

Hello Dr. Kavokin,

I was reading some of your literature and found it to be quite informative. I have a question that perhaps you may be able to answer: If a woman's ovarian cyst ruptures, (especially multiple cysts from PCOS) can these ruptured cysts become an infection?

Hi, MS. L

Short answer: anything can become infected. Though I do no think ruptured ovarian cyst becomes infected very often, did not hear about that. I will look more literature and probably place the answer on my website.



OK. I looked the literature.

I didn't do very extensive literature search. Should admit.
Anyway, some available books mention that ovarian cyst may become infected. However the infection is not described as the main complication in ovarian cyst rupture.

Also, I don't remember that anybody told me otherwise. Maybe there is some specialized article that says: the condition happens in one point three percent of cases with Standard Deviation of half percent. I don't know exact percentage. Need to look more. PubMed service did not give many abstracts on PCOS + infection.


So how would it look alike?

A young woman comes to ER. She is premenopausal. She complains on mild (or maybe severe) pain in her belly. ER Doctor takes history. The woman also mentions changes in her menstrual interval. Let's say regular is 28 days. Last one was delayed.

Physician puts gloves, puts jelly on gloves. Then he puts his two fingers into the female vagina.
The other hand is on belly. Then he starts to palpate.

It is named pelvic exam. Modest name. Though in Russia it is named vaginal exam, which it is.

Is it a common type of exam? Depends. They usually send you to CT (computer tomography) scan if there is severe abdominal pain. Charge 1000. Boom.

Exclude the price. Exclude delay in reading (somebody should look and interpret what is going on). Exclude radiation. CT scan gives better picture than just poking your belly.

CT scan helps to diagnose abdominal pain of uncertain origin. You can really image what is going on. Though, there are cases when physical exam gives more clues. Physical exam must be performed always. Pelvic exam is somewhat a special one.

I remember how I performed a pelvic exam in medical school. It is actually difficult even just to insert two fingers into vagina first time.
Female Gynecologist asks me: "So, what do you feel?"
Patient goes the same, encourages me:
"What do you feel, what do you feel, do you feel it?"

I guess she felt a sort of museum artifact.
Heck, I did not feel anything.

Well. Actually I felt something - aside from uterus - something round. I would say 5 cm in diameter (would it be less I probably would not feel it at all) and semi-solid on touch. Also I saw that the patient grimaces. It is tender when I push hard.

It's it. How to say that it was tuboovarian abscess (that it was) for sure, I don't know.
You really need experience to perform this type of exam. Experienced gynecologist can tell almost precisely what is going on.

Let's discuss that woman in ER. She will have tenderness on one side. Physician should be able to feel a mobile cystic mass.
(Cyst or rather cystis is Latin for bubble. Palpate is Latin for touch. It means you touch something and feel what it is).
What if the pain is severe? It often means that the cyst ruptured.
My impression is that modern ER orders CT scan right away. If you are not very sure what is going on, you will go from less expensive methods to more expensive and end up with CT anyway. Ruptured cyst causes significant pain. Here CT is indicated.

Alternatively they may order Ultrasound Exam. Transvaginal ultrasound uses the probe inserted into vagina. Ultrasound is cheaper than CT. Ultrasound visualizes cysts clearly. Though, ultrasound gives less information for excluding other pathology. Ultrasound is also safe from the radiation point of view.

In PCOS ultrasound shows increased number of small cysts in both ovaries. Usually more than five confirms the diagnosis.

Culdocentesis may give some useful information too. The name came from cul-de-sac. It's French I guess. Cul-de-sac is one of the pouches in the pelvis. Centesis means: stick a needle and draw. These days it is considered an outdated method. But if you do not have other machines, it is very useful.

If the content is blood, the ruptured cyst was probably Corpus luteum cyst. If the content is purulent the ruptured thing was probably a tubo-ovarian abscess or other pelvic inflammatory disease (PID).
Other abnormal masses can rupture as well. Teratoma gives oily fluid, endometrioma gives "chocolate" old blood.

What is a follicle?

Female body is created for reproduction and childbearing. Oocyte is the start for a new human being in the ovaries. Several layers of specialized membranes surround an oocyte.

The membranes protect the oocyte, help in feeding and nurturing of this small cell.
One of layers has a beautiful name Zona pellucida. Pellucida means shiny in Latin.

When the oocyte matures, a small bubble (follicle) filled with special fluid is formed around.
In mid-cycle the follicle bursts and the oocyte goes first into peritoneal cavity, next into ovarian tubes (fallopian tubes). The tubes lead into uterus. Tubes, by the way, have special small hair-like things inside - fimbria. They beat in one direction. They propel the oocyte into uterus.

I remember I read somewhere that there are 11000 follicles. When a girl is born, there is no more multiplication of oocytes. After the birth the follicles sit dormant. When the female goes into her reproductive age, the follicles start to grow and mature (one by one).

Only 400 of them mature.

Yeah, it should be like this. Calculate. Average cycle is 28 days. So there are around 12 cycles a year. Women start to menstruate at 13-15 years old. The menopause is around 45-55 years. Total is 30-40 years

Multiply everything together. It should be around 400.

By the way, an interesting thought.

All those discussion about abortion and Stem Cell research.
Somewhere in nineteen century the baby was considered the baby when it was born. The church even struggled to admit anything like existence of cells etc. Rare baby actually survived beyond first year.
Heck, the hypothesis that human been consists of small cells was actually admitted widely not so long ago. Maybe hundred years ago. Then, all that research happened. People learned how the fetus is created and how it grows. Now the public idea is that fertilized oocyte is already the baby.

Have you seen any oocyte under microscope? Even a human hair near an oocyte looks like a skyscraper near a real human.

Now, if the public perception had shifted this way in several decades, shouldn't we punish all women for that they recklessly loose 400 potential babies during lifetime. Isn't it a crime?

Then, maybe we should punish every man for losing millions of sperms - also potential babies.
Where did this idea come from that fertilized oocyte is the baby and non-fertilized oocyte is not?
Shouldn't we move the boundary a little bit earlier?
Need to think about that.


Ovarian follicle (follicle means small bubble in Latin) usually mature, rupture and release the oocyte that was in this follicle. Sometime the rupture delays. Then ovulation delayes. (Ovulation is rupture and release of the oocyte. Oocyte is the cell that eventually becomes the fetus after sperm gives the genetic material).

Normal cycle is divided into follicular phase (when the follicle grows) and luteal phase.
Luteum means yellow in Latin.

When the follicle ruptures (by the way rupture means burst or tearing), the oocyte goes out.

The cavity that left behind (remember it was small bubble) is filled with blood and special cells, producing hormones. These special cells grow in quantity and fill that cavity. These cells produce hormones that help the fertilized oocyte to attach and to grow in the uterus. Because they grow in quantity, they create a yellowish body in the ovary. It is literally yellowish. The name is Corpus Luteum (corpus=body, luteum = yellow).

This is normal cycle.

As we said, the follicle sometime doesn't rupture (there is a bunch of reasons). A physician should sort out several different conditions. This is an abnormal cycle.
If follicle does not rupture it becomes the follicular cyst. Cyst also means bubble in Latin. There are actually plenty of different kinds of bubbles in medical Latin. Big ones and small ones. Normal and abnormal.

OK, the cyst did not rupture. Then what happens?

Well. If cyst doesn't rupture, it usually resolves. That fluid inside the cyst is reabsorbed and the cyst collapses.

However, if the cyst ruptures, it causes acute pain. The pain comes from irritation of peritoneum (lining of peritoneal cavity) with blood and cyst content.

Why it is not painful when a regular follicle ruptures and releases the oocyte? Probably, a regular follicle is too small. In addition it doesn't cause much bleeding.

In contrast the cyst is a really big bubble (sometime 5-10 cm in diameter). If it ruptures, it instantaneously release bunch of special fluid. Plus, there is significant bleeding because there are a lot of blood vessels around to feed.

Significant is of course relative.

For example, take 5-10-20 ml of blood from a patient vein in a hospital daily. He complains about the pain from the needle mostly.

But if you get the same 10 ml of blood into peritoneum... Wow.
You will cry. There are plenty of nerve endings. Peritoneum is too touchy-feely. Tender.

Besides, the cyst has high concentration of prostaglandins. Prostaglandins, in their turn, are mediators of inflammation. They should cause significant pain directly and indirectly.

From the other hand bleeding could be really significant. Then it becomes really dangerous.

A physician also should not miss an ectopic pregnancy. Doctor will order a pregnancy test for that. If an ectopic pregnancy starts to bleed, this is really really worrisome. It seems like your blood did not left your body. However the blood is in the abdominal cavity. It left the blood vessels. It is internal bleeding. You die quickly.

Polycystic ovarian syndrome is a little bit different animal actually. Here is some genetic predisposition.

Classically: an overweight young female presents with oligomenorrhea or amenorrhea, anovulation, acne, hirsutism, and or infertility.

What is what? Poly = many. Many, many, many men.
So PCOS means bunch of those bubbles in the ovaries. The follicles did not rupture on time, as they should. Oligo means a little. Meno is derived from menses. Rrhea means flow in Latin

So olygomenorrhea = flowing a little bit (less than it should).
A- is a prefix that means "No". So, amenorrhea = no flow at all.
Hirsutism. I don't remember where it came from, but means hairy or hairiness. Actually excessive hairiness.

Causes of PCOD or PCOS (disease or syndrome) are obesity, genetic predisposition and some other causes of Luteinizing hormone (LH) excess.

There is a self-amplifying cycle:

LH stimulates theca lutein cells. Theca means sort of capsule. Doesn't really matter, just an anatomical term.
Those cells are special. They produce androstendione and testosterone. Androstendione and testosterone are actually male hormones. You know, bodybuilders use these hormones to get muscle bulk. You probably heard about those hormones. Sport doping uses testosterone.
So, athletes build their muscles and trash their liver.

Rumors say that a famous Hollywood actor used the hormones. Later he got liver transplant.
Though he always denied the use.

Anyway, female body converts androstendione into estrone (a weak estrogen). Fat cells do this. Estrone is a female hormone already.

Basically any body produces androgens (andros = man) and estrogens (female hormones). Just the proportion of those hormones makes us male or female.

The cycle happens in normal person as well.

The estrone stimulates pituitary secretion of LH.
Pituitary is a small gland in you brain. Pea Size.
It's small, but it sooooo powerful.

Pituitary has another name - hypophysis. Hypo means down, phys means growth, so this gland is growing from below the rest of the brain. Pituitary gets bunch of connections from hypothalamus.
Hypothalamus means "below thalamus".
These two areas of brain regulate almost all the hormone production in organism.

Higher levels in brain hierarchy regulate them.

Hypophysis gets a command. Then it produces some intermediate messengers and hormones.
The hormones go into blood and control whole body.

Hormones are like orders, like messages to the rest of the body.

Brain may give quick orders: Signals go through the nerves. It is like a phone order or cablegram.

Brain also regulates organism through the hormones. This is like a mail order.
Sort of if the brain sends letters by regular mail. The hypophysis is the Post Office in this case.

PCOS kicks in when a woman is obese. There are more fat cells to convert
androstendione to estrone. Estrone has such effect that it stimulates pituitary secretion of LH.
LH in its turn goes back to those theca lutein cells we discussed and turns them on again, to produce more androstendione, which is again converted into estrone.

Self-amplifying cycle

In addition, that increased level of testosterone causes the hirsutism (she becomes hairy like a male) and acne in female.
In a normal person this cycle is probably designed to support the development of fetus.
Estrogen helps placenta to grow. Placenta supports fetal growth.

However, in a person with PCOD the cycle is going out of normal control. In this case LH causes growth of the cysts in the ovaries.


Because the corpus luteum cyst is partially made by overgrowth of those theca lutein cells. LH stimulates theca lutein cells.

Also, women with PCOS have intolerance to glucose (sugar) and resistance to insulin.
It means there is a lot of insulin (hormone that helps to utilize glucose mainly).

However excessive insulin does not work. Either receptors to insulin do not work or something else, but the glucose is not utilized. Hence, energy inside the cells drops. Hence, a big pile of other problems mounts. As if it is Diabetes Mellitus. Diabetes is a different topic of discussion. For us, it is worthwhile to mention that people with diabetes are very much prone to any infection.

PCOS causes acanthosis nigricans also. Acantocytes are special skin cells.
Nigricans means black in Latin. That thing looks like thickened pigmented skin. When you touch it, it feels like velvet. Usually it happens in axilla, neck, below breast, in inner thigh and vulva. So, mostly all those places where skin folds.

The treatment for PCOS includes different medications: oral contraceptives, progesterone,
glucocorticoids, ketoconazole, spironolactone, cyproterone, flutamide, cimetidine, finasteride, ovarian wedge resection, laparascopic electoracutery, mechanical hair removal, etc.

All methods break the cycle of overproduction. The medications are either hormones themself or hormone-like substances that occupy receptor site and prevent regular hormone to work.

The medications act on different levels. Normal hormones have very complicated regulation. There are loops and feedbacks in the pathways.

To suppress a hormone production or action, you give similar hormone or another hormone or non-hormone at all, that goes to the feedback loop and breaks it and so on. It's really long separate discussion.

Basically, you either decrease hormone production or shift ratio toward female hormones.

Another way, the best probably, is weight loss. No fat cells - no conversion of andrgoens etc... You can make conclusions yourself.
It's the first line of treatment.

For a simple follicular ovarian cyst (not PCOS) doctor rules out ectopic pregnancy. Then he may send patient home and repeat pelvic exam in 6-8 weeks. Especially, if the cyst was small, less than five cm in diameter.

For larger cysts, doctor would order pelvic ultrasound.

Most follicular cyst will resolve on their own in six to eight weeks. Though, a physician may give oral contraceptives. Again, this suppresses stimulation of cyst by hormones from the hypophysis. The hormones are named gonadotropins.

If the cyst is still there after 6-8 weeks, a suspicion arises that the cyst maybe malignant. Then doctor orders other studies. CT scan. Physician may perform surgical procedures also. He looks what is this cyst really.

Corpus luteum cyst is usually not treated. However, oral contraceptives may be used.

Rupture of any kind of those cysts leads to another story. Acute pain, bleeding into peritoneum.
Sometime bleeding is very severe and is true emergency. You need also to distinguish other process in the abdomen. For example, appendicitis looks similar. You can treat mild case of non-complicated cyst rupture with just observation. Appendicitis almost always requires surgery.

There are many other problems arise. Surgeon scratches his head: what's going on? Is this this or is this that? Here is the CT scan gives big advantage.

Now, going back to the question of Ms. L.

If the cyst was infected, I don't' see a reason why a ruptured cyst wouldn't become infected.
Cyst content is very nutrient-rich. Remember? All those cells and their products are dedicated to feeding the oocyte (future baby). Should be very tasty for any bacteria.

Rupture may cause significant bleeding as well. This blood is also different from the blood in your vessels.

This blood is sitting in the pelvis, not moving, quickly clotting. Clotting prevents entry of white blood cells. "No flow" prevents entry of antibodies. Absence of flow prevents entry of other protective chemicals (complement etc).

So, it is very nutrient-rich media for bacteria growth.

They can go wild. Why not?
If a female had another pelvic infection before, that infection can flare up. In a normal person peritoneal cavity should be sterile. However, any gynecological or gastrointestinal infection may supply bacteria. Now, mix these bacteria with the content of the leaking cyst. It just destined to become infected.

Actually Ms. L later answered her own question in another e-mail. She had cysts multiple times and they became infected several times.

So, to answer the question:
Will the ruptured cyst become infected? Not necessarily. Rather not. Can it become infected?

Aleksandr Kavokin MD/PhD, Phila Aleksandr Kavokin, MD1994 Russia,PhD1997 Russia - Immunology and Allergy, postdoc at Cancer Center at Med U of South Carolina, postdoc at Yale - Cardiology, Molecular Medicine. [] [] []

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Saturday, August 14, 2010

All About Oliomenorrhea (Prolonged Intervals Between Menses)

Role of Homeopathy in Polycystic Ovarian Syndrome (PCOS)
By Dr.Santosh Joshi Platinum Quality Author

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It was originally described by Stein and Leventhal in the year 1935. They described the syndrome which has the following features

·Absence of menstruation (Amenorrhea)

·Increase in facial hair growth (Hirshutism)


·Enlarged ovaries having multiple cysts (Polycystic)

This syndrome is prevalent in the young women in the reproductive period. It is a complex disorder characterized by excessive production of hormones known as androgens by the ovaries and the adrenal glands. Due to this the ovarian follicles fail to mature.

Signs and Symptoms

·Increase in the body weight (Obesity)

·Abnormalities of menstruation. The patient can suffer from scanty menstruation (Oligomenorrhea), Absence of menstruation (Amenorrhea) and infertility. The patient comes with the complaints of irregular menses and says she doesn't get periods for 3-4 months.

·On internal examination bilaterally enlarged cystic ovaries are revealed. Sometimes due to the excess weight the ovaries may not be revealed.


·Sonography : transvaginal sonography is especially useful in obese patients

·Serum values

Luteinising hormone (LH) levels or the ratio between LH: FSH is > 3:1

(Follicle stimulating hormone. FSH)

Reversible oestradiol: Oestrone ratio. The Oestrone level is markedly low.

Androstenedione is elevated

Serum testosterone and DHEA-S may be marginally elevated.

·Laparoscopy bilaterally polycystic ovaries are detected; which is the characteristic feature of PCOS

Role of Homeopathy

As we know that the human body works on very complex mechanism.The hormones that are secreted in the body is even more complex and is very sensitive even to the slightest change that takes place in the body. If there is hormonal imbalance in the body it creates lot of problems.

When the carefully selected homeopathic remedy is administered it stimulates the body and the body in turn takes care of the problem. Homeopathic medicines help in correcting the imbalance that takes place when the body is in a diseased state. Homeopathic medicines act at the level of the psycho neuro endocrinal axis.

For finding the correct homeopathic remedy the patient has to give a complete case history including the emotional picture, ups and down in life, relationships, stress causing factors. If the patient co-operates in giving the correct information the case can be handled in an effective way.

Homoeopathy is a science based on sound logic and vast experimental data. Homoeopathy is the only medicinal science where data has been collected by proving on human beings. The principles of Homoeopathy have been derived and authenticated by vast clinical experiments and data.

The homoeopathic medicines are prepared in a standardized manner. The homoeopathic pharmacopoeia lists more than 3500 remedies, whose clinical efficiency has been proved in various clinical trials conducted all over the world. Various institutions and individuals are proving new medicines and increasing the scope of homoeopathic medicines.

For more details on Classical Homeopathy and Online consultation visit us at

Dr Santosh Joshi graduated from the University of Pune India in the year 1999-2000. With a firm grounding in classical homeopathy and the experience achieved by working with senior Homeopaths today he is handling 3 clinics in Mumbai India at Kala ghoda, Mulund and Chembur. He was an active participant in the seminars organized in pune during his college years.He has also given case presentation on Homeopathy.

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Friday, August 6, 2010

August 07, 2010 All About Women's Health - Olyomenorrhea - Menstruation - Is This Normal?

By R. L. Fielding

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What is Normal?

Each month women across the world have to deal with the uncomfortable effects of menstruation. Although women may only experience certain symptoms or varying degrees of conditions, it is important to recognize the characteristics of a normal menstruation cycle. The average length of a cycle is 28 days. However, "the cycle length may range from 20 to 45 days and still be considered normal."

Younger women in particular may find that their menstrual cycles are irregular the first few years. The typical menstruation period lasts from three to five days, though many women experience either shorter or longer periods. The most common characteristics associated with menstruation include: vaginal discharge, blood flow, vaginal odor, cramps, bloating, tenderness in breasts, difficulty sleeping, and moodiness. Although several of these symptoms are typical of PMS (i.e., premenstrual syndrome), they often persist throughout menstruation as well.

In addition to varying menstruation cycles and durations, it is normal for all women to exhibit vaginal odor, vaginal discharge, and blood flow during menstruation. Odor is strongest while perspiring and once ovulation begins and is caused when perspiration mixes with the bacteria from your skin. Wearing cotton underwear and a pantiliner, even once menstruation has ended will help to prevent vaginal odor.

During menstruation, blood flow can be light, moderate, or heavy. By the end of menstruation approximately four tablespoons to a cup of blood will be lost. This flow, which consists of blood and tissue, occurs in various forms of reds and browns. Clotting commonly occurs as well. In addition to the blood flow, women also release small amounts of clear or white vaginal discharge called leukorrhea. This discharge may alter in color and consistency during menstruation by becoming heavier and whiter (similar to an egg white consistency). Leukorrhea is a normal element of the menstruation cycle and helps to keep the vagina clean. However, other types of vaginal discharge can be dangerous. Therefore, it is important to learn the difference between leukorrhea and its more dangerous cousins in an effort to prevent vaginal discharge that can be harmful in the future.

Unhealthy Vaginal Discharge

Unhealthy vaginal discharge is generally associated with bacterial infections. Although there are several forms of such infections, each is associated with an unpleasant odor, vaginal irritation, itching, and painful urination. The most common type of unhealthy vaginal discharge is bacterial vaginosis. This discharge can be caused by the organism Gardnerella, an anaerobic bacteria, which forms in the absence of oxygen. However, Gardnerella is only one of many bacteria that can be associated with bacterial vaginosis; others include Prevotella, Bacteroides, Mycoplasma, Mobiluncus.

Bacterial vaginosis can be detected by clear, milky white, or gray discharge and vaginal odor. The discharge can be light or heavy. However, symptoms are worse near menstruation and after having unprotected sexual intercourse. When the vaginal fluid is mixed with semen, the odor intensifies. Although women who are not sexually active can develop bacterial vaginosis, it is more common in women who have had multiple sexual partners. Women may also be more apt to develop this condition after engaging in sexual intercourse with a new partner. Douching and poor feminine hygiene also increase the likelihood of developing this bacterial discharge and others. Many women who have bacterial vaginosis do not even notice the symptoms. Even in the absence of physical symptoms, however, bacterial vaginosis can be detected during a physical exam and treated with antibiotics.

A yeast infection is another form of a bacterial infection that affects many women and is caused by the fungus Candida. In fact 75% of women will incur at least one yeast infection during their lives. Vaginal discharge associated with yeast infections is white with a cottage cheese consistency. Like bacterial vaginosis, there are several reasons one may develop a yeast infection. Hormone changes, wearing tight fitting clothing or wet bathing suits for extended periods of time, diabetes, being overweight, and the use of antibiotics seem to be linked with yeast infections. Taking antibiotics not only destroys harmful bacterial but useful bacteria as well, which disrupts the body's balance. However, antibiotics can still be effective in treating unhealthy vaginal discharge.

Not only are yeast infections common, but approximately five percent of women develop such infections four or more times a year. This condition is known as RVVC (recurrent vulvovaginal candidiasis). "Although RVVC is more common in women who have diabetes or problems with their immune systems, most women with RVVC have no underlying medical illnesses." Whether a yeast infection is reoccurring or infrequent, women are encouraged to see their health care providers if an infection is suspected. Yeast infections can be cured through the use of oral pills, vaginal suppositories, and vaginal creams. Although anti-yeast creams are effective in curing yeast infections, they do not cure other types of vaginal infections. Additionally, some creams may weaken latex condoms and diaphragms.

Another major type of vaginal infection is trichomoniasis. Women experiencing this condition will exhibit similar symptoms found in yeast infections and bacterial vaginosis. However, vaginal discharge associated with trichomoniasis is typically yellowish green. Trichomoniasis is a sexually transmitted disease with an increased risk of contraction for women who have had more than one sexual partner. Men rarely exhibit symptoms, which increase the probability of reinfection for women. Like women experiencing bacterial vaginosis some women may appear asymptomatic. Therefore, taking safety precautions during sexual intercourse can reduce the risk of trichomoniasis. Both men and women can be treated with antibiotics.

The final common type of bacterial infection that affects one in five women is a urinary tract infection. Although vaginal discharge does not occur, irritation during urination is present. Cloudy and foul smelling urine, blood in urine, lower back pain, urinating in small amounts, and the need to urinate frequently are common symptoms of a urinary tract infection. Urinary tract infections affect both men and women but women are more likely to develop them. Due to the fact that women have a shorter urethra, bacteria can infiltrate the bladder more easily. Women are also more prone to urinary tract infections if they have had one previously, if their mothers or sisters have had one, are sexually active, or past menopause. Urinary tract infections can be treated with antibiotics after tests are taken from a health care provider.

To help ensure the prevention of many of the vaginal infections discussed above, douching and using heavily fragranced soaps and sprays are discouraged. The vaginal area should be kept clean by using mild soap outside the vaginal area. Wearing loose fitting clothing, cotton underwear, and pantiliners are encouraged. Other ways to reduce the risk of developing yeast and other bacterial infections include: practicing safe sex, wiping from the front to the back, reducing stress levels, and keeping diaphragms and medication applicators clean.

Other Abnormal Conditions

In addition to recognizing unhealthy forms of discharge and other infections due to bacteria, there are other elements of menstruation that women should monitor. One major cause for concern is the absence of menstruation, which is also known as amenorrhea. Adolescent girls typically begin their first menstrual cycle between the ages of 11-16. Therefore, if a girl has not begun menstruating by the age of 16, she should consult her physician. This type of condition is known as primary amenorrhea. Other women experience oligomenorrhea, which is light or infrequent menstruation. This condition is more common in young girls who have recently begun menstruating. Secondary amenorrhea occurs when women who previously experienced normal menstrual cycles have ceased to menstruate for at least three cycles. Extreme weight loss due to a serious disease, stress, eating disorders, and excessive exercise are potential causes of this absence. Difficulties with reproductive organs and hormonal problems can also affect the menstrual cycle in this way.

Although women experience varying degrees of symptoms, extreme levels should be recognized. If bleeding is excessively heavy (an average loss of blood is two ounces), occurring between menstruation periods, or periods are occurring too close together, a woman may be experiencing menorrhagia. However, it is not uncommon for young girls who have recently started the menstruation cycle to spot between periods. Extremely long periods, those lasting longer than ten days, are also characteristic of this condition. This condition is also known as DUB (i.e., dysfunctional uterine bleeding). Hormonal imbalances, fibroids and polyps could also cause these symptoms.

Cramps, another common condition of menstruation, should only cause concern if they are frequent, severely painful, and cannot be relieved with over the counter pain medication, such as ibuprofen or aspirin. Dysmenorrhea, the cause of such cramping, can either be caused from very "extreme uterine muscle contractions" or other medical conditions, such as uterine fibroids and endometriosis. These extreme contractions usually begin two to three years after menstruation has started and can last up to 32-48 hours after bleeding has begun. Treatment for both dysmenorrhea and menorrhagia is dependent upon further investigation by a physician.

Toxic Shock Syndrome

Women should also be cognizant of any sudden or major changes in their bodies during menstruation when using tampons. TSS (i.e., toxic shock syndrome) is a rare but dangerous condition that is caused by toxins of certain types of bacteria and is associated with tampon use. In fact, approximately half of TSS cases are from women using tampons and teenagers and women under 30 have an increased risk of developing TSS. Other cases of TSS have also been linked to infections following surgeries, insect bites, and burns.

The most common symptoms of TSS are vomiting, diarrhea, high temperature, dizziness, muscle aches, feeling faint, and a sunburn-like rash. TSS also causes a loss of blood pressure (called hypotension) which leads to dizziness, fainting, and ultimately may lead to a loss of function of the entire organ systems (gastro-intestinal, nervous, respiratory, etc.). If this condition develops, a health care professional should be contacted immediately. Additionally, it is important to choose the lowest necessary tampon absorbency level and to change the tampon every four to eight hours (or more if necessary). Alternating the use of tampons with feminine pads will help to decrease the risk of TSS.5 However, in women who are predisposed or susceptible to TSS, even the correct, conservative use of tampons is not a surefire way of preventing TSS. If you are predisposed to TSS consult your physician for more information on the best preventative methods.

Putting it All Together

After reading about these characteristics one may still be questioning whether her menstrual cycle is normal and healthy. Answering several questions will help to determine this answer.

- Has your cycle undergone any major changes? Although menstruation may not occur exactly on the 28th day each month (unless you are using birth control pills), it is important to fall within the range of 20-45 day cycles consistently.

- Are your periods extremely heavier or lighter than usual? It is common for the flow level to fluctuate during a menstrual period but it should be somewhat consistent from month to month.

- If you experience cramps, are they debilitating? Yes cramps can be annoying and painful but they should not prevent you from getting out of bed or participating in normal life activities each month.

- Finally, is your vaginal discharge and odor heavy and strong? If your discharge is clear and not overly foul outside of your ovulation and menstruation period, it is a good indication that the discharge is healthy.

Considering all of these factors will assist women in determining if their menstrual cycles are normal and healthy. However, all women should actively seek to prevent vaginal discharge that is outside the norm, get regular physical examinations, and question medical professionals if concerns arise. Taking these precautions will help to promote a woman's health.

This article provided by CAREFREE. To learn more about CAREFREE and how its products can help you stay fresh and confident all day, visit

About the Author

R.L. Fielding has been a freelance writer for 10 years, offering her expertise and skills to a variety of major organizations in the education, pharmaceuticals and healthcare, financial services, and manufacturing industries. She lives in New Jersey with her dog and two cats and enjoys rock climbing and ornamental gardening.

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Friday, July 30, 2010

July 31, 2010 All About Women's Health - Olyomenorrhea

What Are the Signs of a Cyst on Your Ovary?
By Carlise Meier

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Let's start by briefly defining what ovarian cyst is. By definition, it is a sac filled with fluid or sometimes semi-solid material that forms on or within one of the ovaries. The cyst that forms is usually non-cancerous but this does not mean that you should ignore the symptoms and think that they will get better in time.

If you choose to ignore the symptoms, the cyst or cysts will grow in size and they can cause unnecessary pressure on other organs in the body. While it is true that most cysts are benign, there are some that can become malignant. Other women discover it late that they are unable to seek an easy treatment for it.

What are the signs of a cyst on your ovary?

-Pain around the pelvic area
-Bloating or feeling of fullness especially in the lower abdomen
-Amenorrhea or absent periods
-Oligomenorrhea or irregular periods
-Pelvic pain during or after sexual intercourse
-Occasional spotting
-Pain when urinating or when you're eliminating
-Nausea and vomiting

Other signs of a cyst on your ovary may include unexplained weight gain, pain in the thigh area and lower back, breast tenderness and infertility or inability to get pregnant.

Your doctor can confirm the signs of a cyst on your ovary by performing a routine pelvic examination and he or she may notice a swelling in the ovaries. An ultrasound will also confirm that you are indeed affected with the disease. In rare cases, a CT scan may be required to verify ovarian cyst.

3 simple steps is all you need to end your pain and sleepless nights, you don't have to suffer anymore. Surgery is not your only option. Learn how you can eliminate your ovarian cyst now. Feel free to stop by

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Friday, July 23, 2010

July 24, 2010 All About Women's Health - Olyomenorrhea

What Causes Menstrual Disorder? - How to Treat Menstrual Disorder
By Bryan Len Platinum Quality Author

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Menstrual disorder occurs when some factors interrupt women's menstrual period. In normal function, the menstrual period continues for 3-4 days. The reasons for menstrual disorders include many factors. There are also many things that affect woman's menstruation such as the growth of the uterine lining (medically known as endometrium) and it's shedding while menstrual cycle is going on. Hormones of the brain and the ovaries rule the menstrual periods in woman in her reproductive age.

Menstrual disorder is due to many disruptions and disorders. Pregnancy is one of the very common processes as when women become pregnant, their menstrual cycle is disturbed since the uterine lining starts providing a space for the fertilized ovum to get implanted and develop. Menstrual disorder can also affect female libido and such disorders could be temporary or permanently affect the woman unless fully treated. In a long run, menstrual disorder may affect the patient's fertility.

Common menstrual disorder includes missed periods (medically known as amenorrhea), as well as menses those are markedly heavy or long (medically known as menorrhagia), very light (medically known as hypomenorrhea), with undefined frequency (called as polymenorrhea), with undefined infrequency (called as oligomenorrhea) and severely painful (dysmenorrhea).

Menstrual disorder can be due to a wide range of conditions and diseases. Commonest may include failure of the ovaries to release an ovum (called as anovulation), PCOS (polycystic ovarian syndrome), endometriosis, PID (pelvic inflammatory disorder), gestational complications, cancerous growth, and uterus disorders like polyp or fibroids. Pregnancy could be the commonest cause of a menstrual disorder.

Menstrual disorder occurs when some factors cut off the hormones that govern menstruation. Common problems include...

· Menses those are unusually long

· Remarkable infrequent periods

· Marked painful periods

· Missed menses

· Menses those are unusually heavy or light

These problems could be temporary or permanent. Moreover, many women may face some variation in menstrual period symptoms from a month to the coming one, particularly during the first few years after the menarche. Some ailments may interfere with women's capability to participate in routine activities, getting back to work or school and even to have a nap. Some menstrual disorders might also interfere with women's capability to conceive.

Physicians treating menstrual disorders might prescribe some laboratory tests and imaging or screening, study woman's medical history and go for physical examination to help determining the underlying causes of a menstrual disorder. Once the cause is found, the physician chooses the best possible treatment, if needed.

The treatment for menstrual disorder might include lifestyle modification (such as dietary changes, exercises) or medicines. If these options do not work to cease the problem, surgery (such as dilation and curettage, endometrial resection or ablation) might be advised in some cases.

Although many of underlying causes of menstrual disorder may not be prevented, woman can reduce the risks of some ailments by maintaining a healthy lifestyle, consuming natural woman friendly herbs, eating a balanced diet with plenty of dark green leafy vegetables, fresh fruits and of course, performing regular exercises.

For more information visit Premenstrual Syndrome and Menstruation Problems

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