“You’ve haven’t lived until you’ve broken a sweat in 10-degree weather,” says Bruns, laughing.

Her psychological discomfort was almost as unsettling as the physical symptoms of perimenopause, the period preceding the onset of menopause.

“I was caught up short. I was so young and now I was grappling with that ‘old lady’ thing,” says Bruns, now 52, a Ridgefield resident.

Each day, 6,000 women enter menopause, defined as a woman’s final period. but unlike their mothers or even older sisters, they are less likely to be prescribed hormone replacement therapy. in the 1990s, hormone replacement therapy, or HRT, was the standard treatment to relieve hot flashes and other menopausal symptoms.

Between 1999 and 2002, about a quarter of all women older than 40 were taking hormones, according to the National Women’s Health Network. but a 2002 study, since challenged, linked HRT to higher rates of breast cancer, heart disease and stroke, changed the dynamic.

Today, most menopausal women don’t undergo hormone replacement therapy, says Dr. Amy Johnson, an obstetrician and gynecologist at Hartford Hospital.

Despite the hot flashes, night sweats and just plain sleepless nights, like many women Bruns decided to go it alone, endure perimenopause and menopause without hormones.

“I never thought about hormone replacement therapy because information about HRT was all over map,” Bruns says.

Although Bruns’ symptoms were annoying, they weren’t debilitating. they never got to the point where they prevented her from raising her family or re-entering the workforce.

“My symptoms weren’t keeping me from anything,” she says. “I had a lot of distractions. Raising three teenagers and going back to work.”

Alternative Therapies

While Bruns eschewed hormone replacement therapy, she tried everything else.

“I was a complete consumer,” says Bruns. “I took black cohosh. I tried mega-doses of vitamins. I rubbed wild yam cream into my thighs. I purchased every book on menopause. if nothing else it kind of helps you know you’re not alone.”

There are myriad over-the-counter remedies, but results vary. Some women swear that black cohosh or other herbs have helped ease symptoms. in many cases, studies have proved inconclusive or researchers suspect the placebo effect. whether you’re considering adding phytoestrogens, herbal supplements or vitamins to your diet, the bottom line is first check with your health care provider.

Here’s what’s available, according to the North American Menopause Society.

Black Cohosh: This over-the-counter herb has shown some ability to ease hot flashes, but the jury is still out. a couple of small trials show some benefit. Larger trials show no benefit, Hartford Hospital’s Johnson says.

With the knowledge that people age 45 and older represent the fastest-growing STD population, new Mexico health experts are urging residents to take steps to prevent infection.

Advertisement

“Sexual health is everyone’s responsibility,” said Tara Misra, health educator for the University of new Mexico (UNM). People need to educate themselves about STDs, become familiar with their bodies and use protection, she said. It also is recommended that “people get into a pretty regular habit of being tested,” particularly when starting new relationships, Misra said. Dr. Joel Teicher, an obstetrician/gynecologist at ABQ Health Partners, said late-life divorce and post-divorce dating are factors driving STDs in older people. Chlamydia, a bacterial infection that often shows no symptoms, is “far and away the most-common” STD he sees. “STDs are equal opportunity infectors,” said Dr. Peggy Spencer of UNM’s Student Health and Counseling. “The germs don’t know how old you are. anyone who has sex can get an STD. It’s more about your behavior than your age. if you have unprotected sex at any age you might catch something.”

Back to other news for July 2011

Uterine fibroids are very common illness amongst women in all countries around the world and women should be aware of the most common fibroids symptoms. Knowing the symptoms of uterine fibroids can help stopping further health complications while its time.

Very often, mainly at the early stages when the fibroids are small, women may experience no fibroids symptoms at all. Lacking the symptoms may be the main reason why women don’t know they have them. The best way to find out whether you do or do not have the uterine fibroids is simply visiting your gynecologist regularly for a preventative check up.

When the fibroids symptoms appear, they often manifest during the menstruation, causing unusually heavy and long lasting bleeding. Fibroids in uterus that are larger size often cause cramps and abdominal pain. The pain is often described as heaviness similar to pregnancy pain.

The pain caused by this illness can be very intense and limiting your life. It can force you to take too many days off your work and result in problems at work. You may go through embarrassing experiences like having a stain on your clothes due to heavy bleeding. You may also suffer from anemia because of the blood loss. Pain during intercourse also belongs to the fibroids symptoms.

What appears too is frequent and urgent urination. Also blocked urine flow can appear when the fibroids are too close to the bladder. This can sometimes result in uncontrollable leakage of urine. Fibroids too close to rectum can cause a constipation. Because the fibroids growth develops a pressure on organs around them, they can squeeze nerves and cause a back pain too.

To rarer symptoms belongs edema (the accumulation of fluid) in the feet and ankles followed with legs pain.

Infertility is also connected to uterine fibroids problems. This varies case to case and is dependent on the exact fibroids’ location. Getting pregnant with the fibroids still can happen but often result in pregnancy complications. Fibroids in pregnant women can cause a heavy bleeding and affect the position of the fetus. another uterine fibroids symptom for pregnant women is higher risk of miscarriage and/or premature labor.

If your fibroids are small, you will probably not have the fibroids symptoms present in their worse manifestation. in any case, if you would like to elude the awful fibroids symptoms, infertility problems and future health complications (that could include fibroids removal during the surgery or hysterectomy), investigate available fibroids treatment as soon as possible.

*** GOOD NEWS! *** if You or Someone You love is Suffering from Uterine Fibroids Pain, I would like to recommend you to try “The Naturally Uterine Fibroids Cures.” With this method, Thousands of Women Worldwide have Been Successful With Eliminating Their Fibroids Pain and other Related Symptoms Within 12 Hours, Got Rid of Their Uterine Fibroids Permanently Within 2 Months & Regain their Natural inner Balance! Medical Researcher, Alternative Health and Nutrition Specialist, Health Consultant and former Uterine Fibroids Sufferer will Teach you “How to Permanently Eliminate Fibroids Pain and other Related Symptoms with Naturally method & Faster than You Ever thought possible!” Learn more about this method at “The Naturally Uterine Fibroids Cures.“

please i need to know the symptoms of an STD for girls. that dont include bumps or sores… Do they cause blood after sex?

You are too stupid to be having sex, honestly.
There are many different STIs and they all have different symptoms, retard. we can't just say 'these are the symptoms of all STIs.'
Blood after sex could easily be a matter of your ill-advised partner humping too hard. but I'd recommend you go to a doctor anyway so that you might actually get yourself educated. someone as ignorant as you has no business doing anything that could result in a baby.

Any kind of pus discharge or foul odor could be a symptom of an STD. you really should get checked out because some STD's don't have immediate symptoms. I've never heard of blood after sex but does it hurt during sex? Check with your gynecologist as soon as you can. the sooner you get checked, the better you'll feel.

Most STDs have no symptoms for months or even years after someone gets infected. you can not tell if someone has an STD just by looking at them. the only way to find out if you have an STD is to get tested for STDs.

If shes too easy shes got cheesy

One on the most memorable persons in my medical career for whom I have had profound sympathy was a beautiful fifteen year old girl who lost both her ovaries to cysts.

I was a medical student and assisted a gynecologist in the operation.  It meant she could not have children and was thrown into artificial menopause.  (Recall my article on menopause).  I honestly had to fight the tears from showing in my eyes.

WHAT ARE OVARIAN CYSTS?

They are fluid-filled sacs in or on the surface of one or both ovaries.  Remember these are where the woman’s eggs are found and are released every month in the child bearing years.  Many women have ovarian cysts at some time of another, but they usually cause little of no discomfort and are harmless, and most disappear without treatment in a few months.  Some produce serious symptoms, however, especially those that have ruptured.  Rarely, they can be life- threatening.

Most women are likely to have no symptoms at all.  if they do, the symptoms may mimic other conditions such as pelvic inflammatory disease (PID), an infection affecting the reproductive organs, endometriosis, where tissue from the womb abnormally implants elsewhere in the system of even outside it, ectopic pregnancy, (pregnancy in the wrong place), or ovarian cancer.

Appendicitis or some large bowl disorders can appear as a ruptured cyst.  One should still be watchful for any suspicious change in the area of one’s reproductive system, because a cyst may cause some of the following signs and systems.

•    Menstrual irregularities•    Fullness or heaviness of your abdomen•    Pressure on your rectum or bladder – difficulty emptying your bladder completely•    Pelvic (below the waist) pain – a constant or occasional dull ache that may be felt in the lower back and thighs.•    Pelvic pain also: 1) just before your period begins of just before it ends.2) during intercourse (dyspareunia).

An immediate visit to the doctor or Emergency Room is warranted if there isa)    sudden, sever abdominal or pelvic painb)    pain accompanied by fever of vomiting.

Each month, the ovaries grow cyst-like structures called follicles.  these produce the female hormones, estrogen and progesterone, and release an egg (ovulation).

Occasionally, a normal follicle just keeps growing, becoming a functional cyst, meaning that it began during the normal function of the menstrual cycle.  There are two types of functional cysts.  before I go into these, allow me to try to explain what really goes on with hormones, your brain and the ovaries.

During the first half of a menstrual cycle (the first 13 or so days in a normal 28-day cycle there is no estrogen circulating in the blood.  Then, at about mid cycle, there is a rise in estrogen and as a result, a message goes to a part of your brain, the hypothalamus, to produce a hormone, the FSHRH (Follicle stimulating hormone releasing hormone).  these hormones travel to another area of the brain, the front part of the pituitary gland to produce the Follicle Stimulating Hormone (FSH), to allow the follicle to grow, and the Leutenizing Hormone (LH), to cause the egg to be released from the ovary.  the final part, 14 days, of the cycle, is the luteal phase.

ONE TYPE OF CYST IS THE FOLLICULAR CYST.

When the LH surge does not occur, a follicular cyst begins because the follicle doesn’t rupture or release its egg; it grows and turns into a cyst.  these are usually harmless, seldom cause pain and often disappear on their own after two or three periods.

THE OTHER TYPE IS THE CORPUS LUTEUM CYST.

When the LH surge does occur and the egg is released, the ruptured follicle begins to produce large amounts of estrogen and progesterone in preparation for possible conception.  It is now called the corpus luteum.  sometimes, however the egg’s escape opening seals off and fluid accumulates in the follicle, causing the corpus luteum to expand into a cyst.  It usually goes away on its own in a few weeks, but can grow to almost four inches in diameter.  It can bleed into itself or twist the ovary, producing pelvic or abdominal pain.  It may rupture if it fills with blood, causing internal bleeding and sudden, sharp pain.  By the way, the fertility drug clomiphene (clomid), used to induce ovulation, increases the risk of a corpus luteum cyst developing after ovulation.

If you’ve followed the reasoning so far, a follicular cyst precludes pregnancy – the egg is not released to be fertilized.  But a corpus luteum cyst doesn’t prevent or threaten a pregnancy – the egg is already released but the opening gets resealed.

If you experience severe or colicky pain in your lower abdomen, with fever and vomiting.  There are symptoms of shock such as cold, clammy skin, rapid breathing, lightheadedness or weakness, indicating an emergency is on your hands.  get to the doctor!!

SCREENING AND DIAGNOSIS

A cyst may be found during a pelvic exam.  if one is suspected, further testing may be advised to determine type or need for treatment.  we want to find out certain things to help diagnostic and management (how to handle) decisions.  for instance, what size is it? Is it fluid-filled, solid or mixed?  Fluid-filled cysts aren’t likely to be cancerous.  Solid, or a mixture of fluid filled and solid may require further evaluation to check for cancer.

To identify the type of cyst, we may want to do the following:•    Pregnancy test.  Remember I said you will not get pregnant with a follicular cyst; a positive test means a corpus luteum cyst.•    Pelvic Ultra Sound Scan.  I dare say that a good number of women reading this know this well.  this produce can identify a cyst, its size, location, and whether solid of fluid filled.•    Laparoscopy.  this, too, is well known.  A slim lighted instrument inserted through a small cut below the navel can see the ovaries and remove a cyst.•    CA125 blood test.  this is cancer antigen 125, which is increased in cases of ovarian cancer.  So if you are at risk of ovarian caner and you have a cyst that is partially solid, a high CA125 could be especially important.  however high CA125 levels can be found in non-cancerous conditions like fibroids, PID, and endometriosis.

Yes.  A large one can cause abdominal discomfort.  if it presses on your bladder, you urinate frequently because the bladder’s capacity is reduced.  this symptom is often due to bladder  infection, but bear a cyst in mind if there are reasons to be suspicious.  see the doctor.

There are other types of cysts which are much less common but which may be found on pelvic examinations.  Cysts or ovarian masses occurring after menopause may be cancerous.

The less common cysts are:Dermoid cysts: these may contain tissue such as hair, skin or teeth because they are formed from cells that produce human eggs. Rarely cancerous, they may become large and cause painful twisting of the ovary.  you must be thinking ‘how gross!’Endometriomas: these cysts develop from endometriosis, mentioned earlier.Cystadenomas: these may be filled with a watery liquid or a mucous material.  They may grow as large as 12 inches (one foot) in diameter, and cause ovarian twisting.

HOW DO WE TREAT CYSTS?

This depends on your age, type and size of your cysts, and symptoms.  the options:Watchful waiting: Regular examinations and monitoring for size by this method or ultra sound is all that’s needed a lot of times.Birth control pills: these reduce the chance of new cysts developing in future menstrual cycles.  the added benefit of reducing your risk of ovarian cancer also make them useful.  the risk decreases the longer you take birth control pills.Surgery: this is done if: a cyst is large and causes symptoms, does not look like a functional cyst, is growing, persists through more than a few cycles.  either a cyst can be removed (cystectomy) or if necessary, one or both ovaries (oophorectomy).  Remember that a cyst after menopause suggests cancer, so surgery is almost always done in this case.

None definite.  Just get regular examinations, so that any change in your ovaries can be diagnosed as early as possible.  Pay attention to changes in your cycle, and especially any changes or symptoms that persist for more than a few cycles.  Basically, talk to us about any concerns to do with your menses.

See you next week.

Dr. Victor Emanuel has been an educator of medical professionals in training, and the public, for over 20 years in Dominica. the contents of his articles are based on facts and research conducted, and not of his opinion.

Copyright 2011 Dominica News Online, Andrews Publishing co. Ltd. all Rights Reserved. this material may not be published, broadcast, rewritten or distributed.

I just got my results back from my gynecologist and the nurse said I have a mild form of HPV which is making my test come up abnormal. She said it's the kind that 80% of women have. I'm very upset and confused and have been looking for answers. Could anyone shed some light on what this all means? thanks!

DUBAI – Urinary Tract Infection (UTI) is the most common type of infection in pregnancy with an overall incidence of eight per cent, according to an expert.

Evidence shows that there are significant physiological changes occurring in pregnancy which predispose one to UTI, such as an increase in the volume of urinary bladder and decrease in the tone of urinary bladder in pregnancy favoring urinary stasis in urinary bladder, said Dr Humera Bint Raees, Specialist Gynecologist, Zulekha Hospital, Sharjah.

Similarly, 70 per cent of pregnant women pass glucose in their urine which again favours UTI. moreover, difficulty in maintaining good hygiene due to gravid distended abdomen and decreased intake of water, especially in the first three months of pregnancy due to nausea and vomiting are other predisposing factors for this common ailment, she said.

Urinary infection can be present without any symptom and bacteria are found in urine incidentally or it can be present with various symptoms. “Normally frequency of urine is one of the common symptoms of UTI. but in pregnancy, it is insignificant because the distended abdomen presses the urinary bladder and pregnant woman experience it without UTI,” said Dr Humera.

Other symptoms may be urgency to pass urine, inability to control urine, lower abdominal pain, and pain while passing urine or presence of blood in urine. “If untreated this infection may ascend to the kidneys and may present with nausea, vomiting, fever with shivering and pain in flanks which is a serious condition that necessitates an immediate intervention,” she added.

Untreated urinary infection in pregnancy can lead to low birth weight babies (preterm babies), developmental delay or mental retardation in newborns. On the other hand in mothers, it can lead to high blood pressure, anemia, preterm labor and infections of womb in pregnancy. during pregnancy, if urinary tract infection is confirmed during the routine screening of women, it must be treated promptly and eradicated completely, advised the doctor.

In this regard, an increase in oral intake of fluids up to three litres per day decreases incidence of UTI because of the flushing effect on bacteria present in the urinary bladder, said Dr Humera.

“moreover, intake of cranberry juice decreases the chances of UTI because it inhibits the stasis of bacteria in urinary bladder. The most important point is to take a course of regular antibiotic at least for seven days on the doctor’s advise, if the UTI is diagnosed.”

If the patient is suffering from persistent or recurrent urinary tract infection in spite of adequate treatment, the patient needs to undergo further investigations for upper urinary tract (kidneys and ureters) to rule out any other causes such as renal stones or other urinary tract abnormalities.

This is my story. I have been having post-coital bleeding (bleeding after sex) for about 7 years already. I have been told by several doctors that there is nothing wrong with me. I go for my yearly pap smear and they are always normal. I also have clear to light yellow vaginal discharge for all these years. I was told recently by one gynecologist that Ihave a cervical polyp and that's why I am having the bleeding. I have another appointment but is not until 1 month from now. I would like to know if anyone had similar symptoms with cervical polyps…It's just hard to believe that polyps can cause these symptoms for so many years. I am 31 and I have 2 kids, one 10 year old and a 3 month old baby, during my prenatal visits my doctor was the one that told me about the polyp. I just wonder why I was never told by any of the other doctors I have been seeing for the same problems. I am very concerned. Please just comment if you have had cervical polyps or someone you know. Thank you in advance.

“You are leaning toward ovarian cancer?! but I had my ovaries removed in a complete hysterectomy 23 years ago!!”

I am a retired school principal with a doctorate in Educational Leadership. I love people and enjoy helping others. I have always been a very active person and very healthy until getting ovarian cancer.

I am now a survivor of early stage ovarian cancer for almost two years. I want to help others become more aware of ovarian cancer, especially the symptoms and the lack of screening tests. Breast cancer has mammograms; other gynecologic cancers can be screened with a pap smear. but there is nothing yet for screening ovarian cancer.

The symptoms we now know often mimic so many others, but if they persist for more than a few weeks, see your gynecologist for a pelvic exam, trans-vaginal ultrasound and a CA 125 blood test.

Unfortunately, I explained my symptoms away and convinced myself it wasn’t anything to worry about. perhaps, I can help others recognize the silent symptoms so they will discuss them with their gynecologists.

One of the symptoms of ovarian cancer that I experienced was bloating. Well, for many of us women, bloating is something we are very familiar with and tend to dismiss with monthly periods, eating too much popcorn or peanuts, or just retaining water.

Another symptom is unexplained weight loss or weight gain. I was watching my weight, eating right, and exercising regularly, but began gaining weight. I called my doctor to see if my new medicine was causing the weight gain. although he said no, I didn’t follow up on the cause.

Abdominal pain is also a silent symptom. Years ago, I mentioned abdominal pain to my gynecologist. After numerous tests that showed nothing, she said it was probably the “phantom ovary”—similar to someone having a leg amputated but still feeling pain from it. Eventually, the pain went away. When it returned, I referred to it as the “phantom ovary” and gave it no further thought.

A persistent lack of energy or fatigue— I was feeling unbelievably tired the weekend before my diagnosis. but my husband and I are always on the go—I thought I just needed to slow down a bit.

Back pain is also a symptom that I had. my back often hurts and I have had two back surgeries. When I began having back pain, again I dismissed it as normal back pain due to so much lifting with 3 grandchildren.

Did you know that • Ovarian cancer occurs in 1 out of 71 women? • Ovarian cancer is very treatable when it is detected early, but 81% of cases are not diagnosed until the cancer has spread or advanced? • 3 out of 4 women will be diagnosed with ovarian cancer in the later stages where the survival rate is only 25%? • 50% of women diagnosed with ovarian cancer will die within 5 years; among African American women that number increases to 54%. • Ovarian cancer has been labeled the “silent killer” because the signs and symptoms are linked with many other types of illnesses and because there is not a test, a vaccine or an accurate screening tool? • Chances of ovarian cancer increase with menopause, a family history of ovarian, breast or colon cancer, or not bearing a child.

Many gynecologists do not ask their patients about ovarian cancer symptoms, and many patients are unaware of the symptoms to ask questions. as students in the medical field who are hearing this, perhaps you will ask your patients specific questions. Finding ovarian cancer in its earliest stages makes a big difference in survival! With early detection, the survival rate of five years or longer is greater than 90%.

I began having severe abdominal pains right after I went to bed. Five or six hours later, my husband took me to the emergency room where we both thought the doctor would give me an antibiotic and send me home. that was not the case. He found a mass that needed to be removed and had called in a surgeon. the surgeon said there were three possibilities of what he would find in surgery: • Colon cancer • Diverticulitis • Ovarian cancer When he said he was leaning toward ovarian cancer, I was shocked. “You are leaning toward ovarian cancer?! but I had my ovaries removed in a complete hysterectomy 23 years ago!!” the doctor shrugged his shoulders and said that’s what he thought it was. to me, this was the kiss of death! I had always heard that no one survived ovarian cancer. thank goodness this isn’t so, and more good news is on the horizon as more advanced research continues.

After I had been diagnosed with ovarian cancer, I wondered why I had not taken the CA 125 test during my annual gynecological exams. I thought this was a screening test for ovarian cancer. I did not know there was no test for ovarian cancer. I also thought a Pap smear would give some indications!

The surgeon and oncologist removed an ovarian tumor mass about the size of a golf ball. it was localized—the entire tumor was removed and it did not appear that any cancer spread beyond the tumor. a more extensive pathological report gave more details, and the course of action was determined. the oncologist said it was at a stage between 1 and 2. I had chemotherapy of carbo-platinum and taxotere every 21 days for six months.

The oncologist also said that even without the ovaries, it was still ovarian cancer and was treated and managed as ovarian cancer. There are not many cases like mine. a general gynecologist might see 1 or 2 in a lifetime; my cancer hospital sees a handful each year.

Had I not gone to the emergency room for what I thought was a diverticulitis flare-up, I wonder how long it would have been before I would be diagnosed with ovarian cancer? That’s why it’s a blessing—mine was caught in the early stages! until we have a screening test for ovarian cancer, we need to spread the awareness symptoms to all women and all doctors and nurses, which will help with early detection for more women, and that will save more lives!