Medical terminology of various female diseases of the pelvis and the genitals:

Following diseases and conditions are described in details below.

1. Cervical dysplasia

2. Birth Control

3. Sexually transmitted diseases.

4.Endometriosis

5.Infertility

6.Menopause

7.Vaginal discharge or leucorrhoea

Cervical dysplasia

Introduction:

Types of Birth Control

Birth control is a regimen of one or more actions, devices, or medications followed in order to deliberately prevent or reduce the likelihood of a woman becoming pregnant. Methods and intentions typically termed birth control may be considered a pivotal ingredient to family planning. Mechanisms which are intended to reduce the likelihood of the fertilization of an ovum by a sperm may more specifically be referred to as contraception. Contraception differs from abortion in that the former prevents fertilization, while the latter terminates an already established pregnancy. Methods of birth control which may prevent the implantation of an embryo if fertilization occurs are medically considered to be contraception. It is advised to talk with a doctor before choosing a contraceptive. If you have genetics problems or blood conditions, such as factor V leiden, certain contraceptives can be deadly.

Sexually Transmitted Diseases

Sexually transmitted diseases (STDs) are diseases or infections that have a significant probability of transmission between humans by means of sexual contact: vaginal intercourse, oral sex, and/or anal sex. Many STDs are (more easily) transmitted through the mucous membranes of the penis, vulva, and (less often) the mouth. The visible membrane covering the head of the penis is a mucous membrane, though, for those who are circumcised it is usually dry and produces no mucus (similar to the lips of the mouth). Mucous membranes differ from skin in that they allow certain pathogens (viruses or bacteria) into the body (more easily).

The probability of transmitting infections through sex is far greater than by more casual means of transmission, such as non-sexual contact—touching, sharing cutlery, and shaking hands. Although mucous membranes exist in the mouth as well as in the genitals, many STDs are more likely to be transmitted through oral sex than through deep kissing. Many infections that are easily transmitted from the mouth to the genitals or from the genitals to the mouth, are much harder to transmit from one mouth to another. With HIV, genital fluids happen to contain a great deal more of the pathogen than saliva. Some infections labeled as STDs can be transmitted by direct skin contact. Herpes simplex and HPV are both examples. Depending on the STD, a person who has has the disease but has no symptoms may or may not be able to spread the infection. For example, a person is much more likely to spread herpes infection when blisters are present than when they are absent. However, a person can spread HIV infection at any time, even if he/she has not developed symptoms of AIDS.

All sexual behaviors that involve contact with the bodily fluids of another person should be considered to hold some risk of transmission of sexually transmitted diseases. Most attention has focused on controlling HIV, which causes AIDS, but each STD presents a different situation.

As may be noted from the name, sexually transmitted diseases are transmitted from one person to another by certain sexual activities rather than being actually caused by those sexual activities. Bacteria, fungi, protozoa or viruses are still the causative agents. It is not possible to catch any sexually transmitted disease from a sexual activity with a person who is not carrying a disease; conversely, a person who has an STD received it from contact (sexual or otherwise) with someone who is infected.

Although the likelihood of transmitting diseases by sexual activities varies a great deal, in general, all sexual activities between two (or more) people should be considered as being a two-way route for the transmission of STDs (i.e. "giving" or "receiving" are both risky).

Prevention of Sexually Transmitted Diseases

Although healthcare professionals suggest that safer sex, such as the use of condoms, as the most reliable way of decreasing the risk of contracting sexually transmitted diseases during sexual activity, safer sex should by no means be considered an absolute safeguard. The transfer of and exposure to bodily fluids, such as blood transfusions and other blood products, sharing injection needles, needle-stick injuries (when medical staff are inadvertently jabbed or pricked with needles during medical procedures), sharing tattoo needles, and childbirth are all avenues of transmission. These means put certain groups, such as doctors, haemophiliacs and drug users, particularly at risk.

Human Papillomavirus (HPV)

There are over 100 types of this virus which is often asymptomatic. Nearly 3 out of 4 Americans between ages 15 and 49 have been infected. It can be contracted through one partner and remain dormant allowing it to be transmitted to another. Some types can cause cervical cancer.

Genital HPV infection is a sexually transmitted disease that is caused by human papillomavirus. Human papillomavirus is the name of a group of viruses that includes more than 100 different strains. More than 30 of these are sexually transmitted and they can infect the genital area of men and women. Approximately 20 million people are currently infected with HPV and at least 50% of sexually active men and women will acquire HPV at some point in their lives. By age 50 at least 80% of women will have acquired HPV and about 6.2 million Americans get a new HPV infection each year. Most people who have HPV don't know that they are infected. The virus lives in the skin or mucous membranes and usually causes no symptoms. Commonly some people get visible genital warts or have pre-cancerous changes in the cervix, vulva, anus, or penis. Very rarely, HPV results in anal or genital cancers. Genital warts usually appear soft, moist, pink, or flesh colored swellings. They can be raised, flat, single, or multiple, small or large and sometimes cauliflower shaped. Warts may not appear for weeks or months or not at all and the only way to diagnose them is by visible inspection. Most women are diagnosed with HPV on the basis of abnormal pap tests and there are no tests available for men. There is no cure for HPV. The surest way to eliminate risk for HPV is to refrain from any genital contact with another individual. For those who choose to be sexually active, a long term monogamous relationship with an uninfected partner is the strategy most likely to prevent future HPV infections.The next best way to help reduce risk is using a condom but the effectiveness is unknown.

What is the connection between HPV and cervical cancer? All types of HPV cause mild pap test abnormalities which do not have serious consequences. Approximately 10 of the 30 identified HPV types can lead to development of cervical cancer. Research as shown that for most women, 90% cervical HPV infection becomes undetectable within two years. Although only a small proportion of women have persistent infection, persistent infection with the high risk types of HPV is the main risk factor for cervical cancer.

A pap test can detect pre-cancerous and cancerous cells on the cervix. Regular pap testing and careful medical follow up, with treatment if necessary, can help ensure that pre-cancerous changes in the cervix caused by HPV infection do not develop into life threatening cervical cancer. The pap test used in the U.S. cervical cancer screening programs is responsible for greatly reducing deaths from cervical cancer.

Endometriosis

Endometriosis is the most common gynecological diseases, affecting more than 5.5 million women in North America alone! The two most common symptoms are pain and infertility. In this disease a specialized type of tissue that normally lines the inside of the uterus,(the endometrium) becomes implanted outside the uterus, most commonly on the fallopian tubes, ovaries, or the tissue lining the pelvis. During the menstrual cycle, hormones signal the lining of the uterus to thicken to prepare for possible pregnancy. If a pregnancy doesn't occur, the hormone levels decrease, causing the thickened lining to shed.

When endometrial tissue is located in other parts it continues to act in it's normal way: It thickens, breaks down and bleeds each month as the hormone levels rise and fall. However, because there's nowhere for the blood from this mislocated tissue to exit the body, it becomes trapped and surrounding tissue becomes irritated. Trapped blood may lead to growth of cysts. Cysts in turn may form scar tissue and adhesions. This causes pain in the area of the misplaced tissue, usually the pelvis. Endometriosis can cause fertility problems. In fact, scars and adhesions on the ovaries or fallopian tubes can prevent pregnancy. Endometriosis can be mild, moderate or severe and tends to get worse over time without treatment. The most common symptoms are:

1. Painful periods Pelvic pain and severe cramping, intense back pain and abdominal pain.
2. Pain at other times Women may experience pelvic pain during ovulation, sharp deep pain in pelvis during intercourse, or pain during bowel movements or urination.
3. Excessive bleeding Heavy periods or bleeding between periods.
4. Infertility Approximately 30-40% of women

The cause of endometriosis remains mysterious. Scientists are studying the roles that hormones and the immune system play in this condition. One theory holds that menstrual blood containing endometrial cells flows back through the fallopian tubes, takes root and grows. Another hypothesis proposes that the bloodstream carries endometrial cells to other sites in the body. Still another theory speculates that a predisposition toward endometriosis may be carried in the genes of certain families.

Other researchers believe that certain cells present within the abdomen in some women retain their ability to specialize into endometrial cells. These same cells were responsible for the growth of the woman's reproductive organs when she was an embryo. It is believed that genetic or environmental influences in later life allow these cells to give rise to endometrial tissue outside the uterus.

Experts estimate that up to one in ten American women of childbearing age have endometriosis. There is some thinking that previous damage to cells that line the pelvis can lead to endometriosis. There are several ways to diagnose endometriosis:

1. Pelvic exam
2. Ultrasound
3. Laparoscopy Usually used, most correct diagnosis
4. Blood test

Endometriosis can be treated with:

1. Pain medication
2. Hormone therapy
   1. Oral contraceptives
   2. Gonadotropin-releasing hormone(Gn-Rh)agonists and antagonists
   3. Danazol(Danocrine)
   4. Medroxyprogesterone(Depo-Provera)
3. Conservative surgery which removes endometrial growths.
4. Hysterectomy

Infertility

Infertility is the inability to naturally conceive a child or the inability to carry a pregnancy to term. There are many reasons why a couple may not be able to conceive without medical assistance. Infertility affects approximately 15% of couples. Roughly 40% of cases involve a male contribution or factor, 40% involve a female factor, and the remaining 20% involve both sexes. Healthy couples in their mid-20s having regular sex have a one-in-four chance of getting pregnant in any given month. This is called "Fecundity".

Primary vs. secondary

According to the American Society for Reproductive Medicine, infertility affects about 6.1 million people in the United States, equivalent to 10% of the reproductive age population. Female infertility accounts for one third of infertility cases, male infertility for another third, combined male and female infertility for another 15%, and the remainder of cases are "unexplained.

"Secondary infertility" is difficulty conceiving after already having conceived and carried a normal pregnancy. Apart from various medical conditions (e.g. hormonal), this may come as a result of age and stress felt to provide a sibling for their first child. Technically, secondary infertility is not present if there has been a change of partners.

Factors of Infertility

Factors relating to female infertility are:

• General factors
  • Diabetes mellitus,thyroid disorders,adrenal disease
  • Significant liver,kidney disease
  • Psychological factors
• Hypothalamic-pituitary factors:
  • Kallmann syndrome
  • Hypothalamic dysfunction
  • Hyperprolactinemia
  • Hypopituitarism
• Ovarian factors
  • Polycystic ovary syndrome
  • Anovulation
  • Diminished ovarian reserve
  • Luteal dysfunction
  • Premature menopause
  • Gonadal dysgenesis (Turner syndrome)
  • Ovarian neoplasm
• Tubal/peritoneal factors
  • Endometriosis
  • Pelvic adhesions
  • Pelvic inflammatory disease(PID, usually due to chlamydia)
  • Tubal occlusion
• Uterine factors
  • Uterine malformations
  • Uterine fibroids (leiomyoma)
  • Asherman's Syndrome
• Cervical factors
  • Cervical stenosis
  • Antisperm antibodies
  • Insufficient cervical mucus (for the travel and survival of sperm)
• Vaginal factors
  • Vaginismus
  • Vaginal obstruction
• Genetic factors
  • Various intersexuality|intersexed conditions, such as androgen insensitivity syndrome.

Combined Infertility

In some cases, both the man and woman may be infertile or sub-fertile, and the couple's infertility arises from the combination of these factors. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance.

Unexplained Infertility

In about 15% of cases of infertility, investigation will show no abnormalities. In these cases abnormalities are likely to be present but not detected by current methods. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. It is increasingly recognized that egg quality is of critical importance.

[edit]Diagnosis of Infertility

Diagnosis of infertility begins with a medical history and physical exam. The healthcare provider may order tests, including the following:

• hormone testing, to measure levels of female hormones
• laparoscopy or fertiloscopy, which allows the provider to see the pelvic organs
• ovulation testing, which detects the release of an egg from the ovary blod test.
• Pap smear and Chlamydia test, to check for signs of infection or dysplasia
• pelvic exam, to look for abnormalities or infection
• Tubal patency test by ultrasound or special X ray examination called HSG.
• Sperm examination.

Treatment

• Fertility medication which stimulates the ovaries to "ripen" and release eggs (e.g. Clomifene|clomifene citrate,FSH, LH which stimulates ovulation)
• Surgery to restore potency of obstructed fallopian tubes (tuboplasty)
• Donor insemination which involves the woman being artificially inseminated or artificially inseminated with donor sperm.
• In vitro fertilization (IVF) in which eggs are removed from the woman, fertilized and then placed in the woman's uterus, bypassing the fallopian tubes. Variations on IVF include:
  • Use of donor eggs and/or sperm in IVF. This happens when a couple's eggs and/or sperm are unusable, or to avoid passing on a genetic disease.
  • Intracytoplasmic sperm injection (ICSI) in which a single sperm is injected directly into an egg; the fertilized egg is then placed in the woman's uterus as in IVF.
  • Zygote intrafallopian transfer(ZIFT) in which eggs are removed from the woman, fertilized and then placed in the woman's fallopian tubes rather than the uterus.
  • Gamete intrafallopian transfer(GIFT) in which eggs are removed from the woman, and placed in one of the fallopian tubes, along with the man's sperm. This allows fertilization to take place inside the woman's body.
• Other assisted reproductive technology (ART):
  • Assisted hatching
  • Fertility preservation
  • Freezing (cryopreservation) of sperm, eggs, & reproductive tissue
  • Frozen embryo transfer (FET)
• Alternative and complimentary treatments
  • Acupuncture Recent controlled trials published in Fertility and Sterility have shown acupuncture to increase the success rate of IVF by as much as 60%. Acupuncture was also reported to be effective in the treatment of female anovular infertility, World Health Organization, Acupuncture: Review and Analysis of Reports on Controlled Trials (2002).
  • Diet and supplements
  • Healthy lifestyle

Menopause

 Menopause is the transition period in a woman's life when her ovaries stop producing eggs, her body produces less estrogen and progesterone, and menstruation becomes less frequent, eventually stopping altogether.