AtoZ Diseases

What is this condition?

This condition refers to any vaginal bleeding that deviates from the normal menstrual cycle before menopause begins. These deviations include menstrual bleeding that’s abnormally infrequent, abnormally frequent, excessive, deficient, or irregular (bleeding between periods). Occasionally, symptoms of menstruation occur without external bleeding (called cryptomenorrhea).

Abmnormal Premenopausal bleeding may merely be troublesome or can cause severe hemorrhage; the prognosis depends on the underlying cause. Abnormal bleeding patterns often respond to hormonal or other therapy.

What Causes it?

• Causes of abnormal premenopausal bleeding vary:
• Abnormally frequent or infrequent bleeding usually results from failure to ovulate because of endocrine or other disorders.
• Excessive bleeding usually results from local lesions, such as uterine tumors, polyps in the endometrium (uterine lining), and endometrial hyperplasia. It may also result from inflammation of the uterus or fallopian tubes and failure to ovulate.
• Deficient bleeding results from local, endocrine, or other disorders or from blockage caused by partial obstruction by the hymen (a membrane at the vaginal opening) or cervical obstruction.
• Bleeding between periods is most commonly no more than a slight bleeding from the endometrium during ovulation. However, it may also result from local disorders, such as malignant uterine tumors, cervical erosions, polyps (which tend to bleed after intercourse), or inappropriate estrogen therapy. Complications of pregnancy can also cause premenopausal bleeding. Such bleeding may be mild or severe .
• Cryptomenorrhea may result from an abnormally closed hymen or cervical narrowing.

What are its symptoms?

Bleeding not associated with abnormal pregnancy is usually painless. but it may be severely painful. When bleeding is associated with abnormal pregnancy, other symptoms include nausea, breast tenderness, bloating, and fluid retention. Severe or prolonged bleeding causes anemia, especially in women with underlying disease (such as a blood disorder) and in women receiving anticoagulants.

How is it diagnosed?

The typical clinical picture confirms abnormal premenopausal bleeding. The doctor will take a health history. Special tests identify. the underlying cause. These may include lab tests of blood hormone levels, endometrial sampling to rule out malignant tumors, a pelvic exam, and a Pap test. A complete blood count helps to eliminate anemia as a cause.

If testing rules out pelvic and hormonal causes of abnormal bleeding, further blood studies may help to determine clotting abnormalities.

How is it Treated?

Treatment depends on the type of bleeding abnormality and its cause. Menstrual irregularity alone may not require therapy unless it interferes with the woman’s attempt to achieve or avoid conception or leads to anemia. When it does require treatment, the drug Clomid induces ovulation. Electrocautery, chemical cautery, or cryosurgery can remove cervical polyps; dilation and curettage, uterine polyps. Organic disorders – such as cervical or uterine cancer – may require hysterectomy, radium or X-ray therapy, or both of these treatments, depending on the site and extent of the disease. Of course, anemia and infections require appropriate treatment.

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What is this Condition?

Hypogonadism results from decreased androgen production in men. which may impair sperm production and cause infertility, and inhibit the development of normal secondary sex characteristics. The symptoms of androgen deficiency depend on the person’s age at onset.

What Causes it?

Primary (hypergonadotropic) hypogonadism results from damage to testicular structures, specifically the Leydig cells, which secrete testosterone, and the seminiferous tubules, which produce sperm. The pituitary gland responds to this damage by secreting more gonadotropins to try to maintain sperm production. Primary hypogonadism occur, in persons with Klinefelter’s syndrome, Reifenstein’s syndrome, Turner’s syndrome, and Sertoli-cell-only syndrome.

Secondary (hypogonadotropic) hypogonadism results from impairment of a complex hormonal regulatory mechanism between the pituitary gland and hypothalamus that reduces gonadotropin secretion. Secondary hypogonadism occurs in persons with hypopituitarism isolated follicle-stimulating hormone deficiency, isolated luteinizing hormone deficiency, Kallmann’s syndrome, and Prader-Willi syndrome.

Depending on the person’s age at onset, hypogonadism may cause eunuchism (complete gonadal failure) or eunuchoidism (partial failure).

What are its Symptoms?

Symptoms vary with the specific cause of hypogonadism. In a chile some characteristic findings include delayed closure of the epiphyses (ends of long bones) and immature bone age; delayed puberty; infantile penis and small, soft testicles; below-average muscle development and strength; fine, sparse facial hair; scant or absent underarm, pubic and body hair; and a high-pitched, effeminate voice. In an adult hypogonadism diminishes the sex drive and potency and causes regression of secondary sex characteristics.

How is it Diagnosed?

An accurate diagnosis requires a detailed history, a physical exam, and hormonal studies. Chromosomal analysis may determine the specific cause. Testicular biopsy and semen analysis determine sperm production, identifY impaired sperm formation, and assess low levels of testosterone.

How is it Treated?

Treatment depends on the underlying cause and may consist of hormone replacement, especially with testosterone, methyltestosterone, or human chorionic gonadotropin for primary hypogonadism and with human chorionic gonadotropin alone for secondary hypogonadism. Fertility cannot be restored after permanent testicular damage. However, eunuchism resulting from pituitary-hypothalamic dysfunction can be corrected when administration of gonadotropins stimulates normal testicular function.

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What is this Condition?

An infection of the lower genitourinary tract, trichomoniasis affects about 15% of sexually active women and 10% of sexually active men. It occurs worldwide. In women, the condition may be acute or chronic. Recurrence is minimized when sexual partners are treated as well.

What Causes it?

The infecting organism, Trichomonas vaginalis, causes the disease in women by infecting the vagina, the urethra, and, possibly, the endocervix, Bartholin’s glands, Skene’s glands, or the bladder. In men, it infects the lower urethra and, possibly, the prostate gland, seminal vesicles, or epididymis.

Use of oral contraceptives, pregnancy, bacterial overgrowth, cervical or vaginal lesions, or frequent douching may predispose a woman to trichomoniasis.

Trichomoniasis is usually transmitted by sexual intercourse; less often, by contaminated douche equipment or moist washcloths.

What are its Symptoms?

Approximately 70% of women – including those with chronic infections – and most men with trichomoniasis have no symptoms. In women, acute infection may produce various signs, such as a gray or greenish yellow, possibly frothy vaginal discharge with an unpleasant odor. Other effects include severe itching, redness, swelling, tenderness, painful intercourse, painful urination, urinary frequency and, occasionally, postcoital spotting, excessive menstrual bleeding, or painful menstruation.

Such symptoms may persist for a week to several months and may be more pronounced just after menstruation or during pregnancy. If trichomoniasis is untreated, symptoms may subside but the infection persists.

In men, trichomoniasis may produce mild to severe transient urethritis, possibly with painful urination and urinary frequency.

How is it Diagnosed?

Direct microscopic examination of vaginal or seminal discharge and examination of clear urine specimens may reveal the infecting organism. A physical exam of the vagina and cervix may reveal signs of illness.

How is it Treated?

The treatment of choice for trichomoniasis is oral Flagyl to both sexual partners. Oral Flagyl may not be safe during the first trimester of pregnancy. Sitz baths may be used to help relieve symptoms.

After treatment, both sexual partners must have a follow-up exam to check for residual signs of infection.

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What is this Condition?

Genital herpes is a viral infection that causes acute inflammation of the genitalia. The first episode usually is self-limiting but may cause painful genital symptoms or even disease of the body as a whole. After the initial episode, the virus remains dormant in the body, causing recurrent outbreaks. These recurrences, which tend to be milder, may be triggered by stress, illness, and overexposure to sunlight.

What Causes it?

The usual cause of genital herpes is infection with herpes simplex virus type 2. Typically, the disease spreads through sexual intercourse, oral ­genital sexual activity, kissing, and hand-to-body contact. Pregnant women may pass the infection to their newborns during vaginal delivery.

What are its Symptoms?

About 3 to 7 days after a person is infected with herpes simplex virus. fluid-filled blisters appear, usually on the cervix and possibly on the labia, skin around the rectum, external genitalia, or vagina of the woman and on the penis or foreskin of the man. Blisters may also appear on the mouth or anus. Usually painless at first, the blisters soon erupt into painful ulcers with yellow oozing centers. Often, the lymph glands located along the top of the thigh become tender.

During the initial infection, the person may also have fever, a general ill feeling, painful urination and, in women, a white vaginal discharge.

How is it Diagnosed?

The doctor diagnoses genital herpes by examining the person and taking a history. Lab tests may show characteristic antibody and cell findings. The diagnosis is confirmed if the virus appears in fluid from blisters, or is implicated in tests that identifY specific antigens.

How is it Treated?

The drug Zovirax is effective against genital herpes. The doctor will prescribe oral Zovirax for people with first-time infections or frequent recurrences. Some people take it daily for prevention; used daily, it reduces the frequency of recurrences by at least 50%. People hospitalized with severe genital herpes and those with weak immune systems who have potentially life-threatening herpes infection may receive intravenous Zovirax.

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