Anemia is a condition that occurs when the number of red blood cells (RBC’s) and/or amount of hemoglobin found in the red blood cells drops below normal. Red blood cells and specifically the hemoglobin contained within them are necessary for the transport and delivery of oxygen from the lungs to the rest of the body. Decreased oxygen to the rest of the body can have serious effects on organs and the brain. Anemia is the most common blood condition in the U.S. It affects about 3.5 million Americans. There are more than 400 types of anemia, and women of child-bearing age are among the largest group effected by the condition.
Signs and Symptoms
Anemia can be mild or severe, and can be either a temporary condition or a chronic one, depending on the cause. The most common symptoms are:
• general sense of weakness or fatigue
• Lack of energy
• Headache
• Feeling of coldness or numbness in hands or feet
• Shortness of breath
As many symptoms are similar to other conditions, a blood test is necessary to confirm the diagnosis of anemia.
Laboratory Tests
Because symptoms may be mild or masked by other conditions, anemia is often first discovered during a complete physical which includes a Complete Blood Count (CBC). This routine test counts the number and proportion of the cells in your blood. If the CBC indicates anemia, your physician may want to follow up with a blood smear or differential test which will provide more data as to the cause of the anemia.
Share Your Symptoms with your Doctor
Although anemia is a common illness, it is nevertheless a condition that left untreated, can have a serious effect on your overall health. It is often helpful prior to a visit with your doctor that you take a moment to write down any concerns you may have, including any which might indicate that you may want to be tested for anemia.
If you are experiencing persistent trouble with sexual arousal that is causing distress to you and/or your partner, you may be experiencing what is called Female Sexual Dysfunction, or FSD. This is a complex disease, with both psychological and physical components, and can be a major stressor within intimate relationships.
Female sexual dysfunction can develop at any age, but sexual problems often happen when hormones are fluctuating, such as after having a baby or during menopause. Sexual concerns may also occur with major illness, such as cancer, cancer treatment, diabetes, history of smoking or cardiovascular disease. History of sexual assault or abuse, patient’s sexual orientation and societal and family beliefs can produce problems as well.
Symptoms Vary
· Desire disorders: you may not be interested in having sex even if you have a history of successful sexual activity. You may seldom desire sexual intimacy when it has formerly been a rewarding part of your life.
· Arousal disorders: when you don’t feel the sexual response you are accustomed to, or you start to respond but can’t keep it up to a point of orgasm.
· Orgasmic disorders: If you can’t achieve a satisfactory orgasm, have pain during orgasm, especially if this has not been a problem over time.
· Sex pain disorders: when you have pain during or after sex, you may have a sex pain disorder, which may have a muscular source, or may be related to vaginal dryness or atrophy.
· Any medical condition which may cause unrelated discomfort, such as arthritis or urinary incontinence may be a secondary factor in the diagnosis.
For a more complete overview of causes of female sexual dysfunction and other health conditions, go to www.precisiontrials.com and view “Women’s Health Conditions.”
Decreased sexual desire (Hypoactive Sexual Desire Disorder, HSDD) or low libido is common after natural or surgical menopause. Numerous studies have suggested that low dose testosterone worn as a patch and currently marketed in the UK as Intrinsa® has benefit in the treatment of HSDD. Recent data from the Aphrodite Study in which women, not on hormone replacement, were randomized to either the testosterone patch or a placebo patch for an initial 24 weeks demonstrated significant improvements in the frequency of satisfying sexual episodes for those women on testosterone. This included an increase in sexual desire, arousal, orgasm and pleasure along with a reduction in personal distress. The testosterone patch was well tolerated except for a higher incidence of hair growth. During the study four patients in the testosterone patch group were diagnosed with breast cancer introducing a possible causal relationship with breast cancer.
Currently there is no FDA drug approved for the treatment of decreased sexual desire in the US. Low libido is a complex subject and sometimes a difficult subject to discuss. The different types of female sexual dysfunctional, namely problems with desire, arousal, orgasm or pain should be differentiated from each other during a careful evaluation by a health care provider with expertise in this area. It is estimate that anywhere from 9 to 40% of women experience some form of female sexual dysfunction.
SJ Wininger, MD, FACOG
Endometriosis is the presence of uterine glands (the inner lining or endometrium of the uterus) located outside the uterus on other organs or surfaces of the body.
Pelvic Pain
The hallmark of symptomatic endometriosis is pelvic pain. This pain may be constant, cyclic (frequently starting before the period) or occur during intercourse. If the implants involve other organs such as the bladder or bowel, symptoms may include pain during urination or the constant sensation to defecate around the time of ones period. The degree of pain has been shown to correlate with the depth of endometriotic lesions as seen on laparoscopy and biopsy and less with the type and location of these implants.
Etiology
The cause of endometriosis remains unclear although leading theories include retrograde or “backward” menstrual flow out the tubes into the pelvis and spread via the blood and lymphatic vessels. All women are probably susceptible to this disease but many women eradicate early implants via their immune systems. There is a genetic predisposition (10 fold increase risk with a sister or mother who has disease) but interestingly, many women who have endometriosis incidentally found during surgery are completely pain free.
The diagnosis of endometriosis requires surgery and the visualization of implants and biopsy of surfaces that are questionable. The surgical experience of the gynecologist in identifying implants is very important although even in the best hands visualization alone can miss borderline implants or falsely identified endometriosis where there is none. Most surgery is performed with a laparoscope in an out-patient setting.
Treatment
Despite opposing opinions no evidence firmly establishes the superiority of medical or surgical therapy in the treatment of endometriosis related pain. There is also no evidence suggesting that surgical excision of implants is superior or inferior to vaporization (laser) or cautery (burning) of implants. Both surgical approaches have good initial outcomes but reoccurrence of pain is seen in nearly 45% of women after one year. Medical therapies include birth control pills, Depo-Provera, Danazol, anti-inflammatory drugs and GnRH agonist therapy (Lupron). These may be effective in relieving pain but some of these therapies are associated with significant side effects (menopause symptoms, hair growth, oily skin) and discontinuation of therapy is often associated with reoccurrence of symptoms. None of these therapies are curative and many are abandoned because of side effects.
Birth control techniques are not only important, but are a necessity for all the sexually active females who lack the desire of a pregnancy. Luckily, there are a wide variety of options available for birth control and one of the most commonly used techniques is the intake of pills. When it comes to availability, birth control pills are extremely easy to purchase in the market and drug stores. Nevertheless, you will need to visit your health care provider and undergo a routine examination to analyze what type of pill best fits you, your body, and your behavior. After you research your options, and if you plan to take the pill as a form of birth control, the first thing you need to do is to visit a gynecologist. The doctor will prescribe the best medicine which suits your body after the medical check-up, which generally involves the examination of blood pressure and weight. With the increase of inventions and discoveries, many innovative pills are available now which do not have any major side effects. Once you get the prescription from the doctor you can very easily get these pills from your pharmacy.
The typical exam and consultation usually begins with checking your blood pressure, and answering a few basic questions from your doctor regarding your health history and that of your immediate family. Other areas of common interest will include whether you’re a smoker, if you use condoms on a regular basis, and current medical conditions you might be experiencing. When you begin taking the birth control pills for the first three months, you will have to visit the health care professional who will monitor your physical behavior including if you gain or lose weight, your blood pressure, etc. Accurate and consistent monitoring will help you have a successful birth control experience. Any side effects such as spotty irregular bleeding, weight gain and other side effects should be reported immediately. In regard to cost, most birth control pills are sold between $16 and $55 on a per month basis.
Female Decreased Desire or HSDD
Hypoactive (decreased) sexual desire disorder or HSDD is characterized by a deficiency or absence of sexual fantasies and desire for sexual activity that causes marked distress or interpersonal problems (problems within a relationship). It is not simply a loss of libido which is a term that belittles the complexity of sexual relationships. Decreased desire can however be further categorized as gradual onset or lifelong. Gradual onset means that at some point in time a woman who had or experienced a fulfilling sexual life began to loose some or all interest or desire for sexual activity. Lifelong on the other hand is someone who reports never having had sexual fantasies or a desire for sexual activity ever.. There are also women who have situational decreased desire i.e. (parents-in law spend the weekends) versus those with decreased desire that is generalized and unrelated to any set of circumstances.
The hallmark of the disorder is that by definition the loss or decrease in desire causes personal distress and/or creates problems within a relationship. Often partners/spouses of those affected believe that they are no longer desired or loved when often times just the opposite exists. Many women feel guilty or inadequate and feel that there is something the matter with them. Some women fulfill their partners desire for sex simply for the sake of protecting their relationship yet they feel no desire for sex, never initiate foreplay or experience sexual fantasies.In some cases relationships become completely jeopardized.
Approximately 10-20% of women suffer from this disorder in the US and there is presently no approved treatment available. Testosterone in a transdermal (patch) delivery system is available in Europe for the treatment of decreased or absent desire in post-menopausal women. To date, the patch however has not been approved for use in the USA
Birth control pills will help prevent pregnancy, but not the transmission of HIV and other STD’s. These diseases can occur if you have unprotected sex with an infected person. No birth control method like pills and intrauterine devices can protect a person from HIV and other STD’s.
Sexually transmitted diseases are caused by viruses that are transmitted through sexual contact. Only if a barrier method is used, like a condom, will you improve your protective measures. The only birth control method that has been proven to help protect from sexually transmitted diseases is the male latex condom. Most condoms are lubricated to enhance the natural pleasure and comfort of intercourse, and there are also non-lubricated condoms that can be used for oral sex. Those who are sexually active and looking to increase their protection against STD’s should highly consider the condom as one of their best defenses. There are some product considerations regarding condoms. Condoms labeled “natural” and others “lambskin” will not protect against sexually transmitted diseases. These have tiny pores that allow body fluids to seep in, and can also allow viruses like HIV, herpes and hepatitis B to go through the condom. Non-lubricated condoms can be accompanied by using “KY Jelly”. The use of massage oil, cold cream, and oil based products for lubrication is not recommended. These may cause the condom to weaken, tear and break.
When partners decide on using condoms, it’s still very important to educate both partners on how to administer the protective barrier properly. Don’t assume the other person will automatically know how to use the condom, as most men have not had enough education or learned how to use one effectively. Ensure you and your partner use a condom for all forms of skin-to-skin sexual contact whether it be vaginal, anal or oral. Incorrectly using a condom is one of the largest reasons accidents and infections can happen. Don’t be hesitant or shy regarding your safety and your future health. Another form of protection, and the only 100% effective measure to prevent unwanted pregnancies and the transmission of sexually transmitted diseases is abstinence.
When you were a growing child, your parents would often tell you to drink your milk and get some exercise. There is a reason for this. Lack of exercise and inadequate calcium intake can make your bones weak, and weak bones are susceptible to osteoporosis.
Osteoporosis is when a person develops weak, thin and brittle bones. Weakened bones are prone to fractures. When women are post menopausal and start losing bone mass, they’re developing osteoporosis. Some older women have weakened bones and show signs of osteoporosis.
Bone is not lifeless, it is something that changes and develops from birth till we reach thirty. Diet and exercise both play a major role in determining the health of our bones. Calcium gives our bones strength and density. So does regular bone strengthening exercise like walking and jogging. In particular weight bearing exercises help keep bone mass at a healthy level. Lifting weights not only helps you look great on the outside, but it can keep your bones fit.
Bone keeps growing and developing until 30 years of age. After age 30 our bones natually begin to deteriorate. This makes it so important to build up the strength of our bones before the age of thirty. After that bones start thinning down, become porous. This process is not limited to women only, but men also.
Women are more susceptible during menopause. During menopause estrogen levels fall, and this causes loss of bone tissue. It seems that estrogen helps bones absorb calcium present in the blood. The first ten years after menopause are the most crucial since the maximum amount of bone loss happens then.
To prevent osteoporosis both men and women need to ensure that they take adequate amounts of calcium and vitamin D. Excellent sources of calcium include, milk, cheese, okra, peas, cabbage, salmon, shrimp. Calcium rich breads, juices can also be consumed. Vitamins can also be a good source of calcium.
Vitamin D plays a very important role in the bone building process. Vitamin D helps your bones absorb the calcium from your blood streatm.
Vitamin D is present in eggs, dairy products and fish. A glass of milk consumed daily can give you about one fourth of your daily requirement. Exposing your body to sunlight can help supply your body vitamin D and you can also have supplements.
Migraine headaches are considered to be a very painful, intense and sometimes chronic condition that effect both sides of the head and behind the eyes. Migraines can sometimes cause nausea, vomiting and sensitivity to light. Some migraine sufferers may see light flashes or even suffer from temporary blindness. The attacks may last a few minutes or remain for hours. Some migraine sufferers have “moments” that only appear once in a great while, while others suffer frequently. Historically, women usually suffer from migraine symptoms more than men.
The exact cause of migraines is not known. For some, migraines may be genetic or possibly be some chemical changes that trigger migraine attacks. Experts have found some common associations that trigger a migraine attack such as too much sleep or lack of sleep, skipped meals, loud noises, stress, red wine, caffeine, nitrate rich food, or food containing MSG and Tyramine. Women sufferers are also advised to maintain a food diary so they can recognize their own possible triggers and avoid them.
Whether using birth control pills make migraines worse is still not yet known. For some women, birth control pills have actually lessened their susceptibility to migraine attacks and they may notice reduced frequency and intensity of the migraine attacks. In other women, however, birth control pills have actually made their migraines worse. There is a third group of women who seem to be unaffected by birth control pills.
Herpes and human papilloma virus (HPV) are categorized as sexual transmitted diseases (STDs) that affect both men and women during sexual “skin to skin” contact. Sexual intercourse is one of the most successful and easiest ways to spread the infectious disease, yet when using condoms, the risk of contracting the infection can be reduced. Although the use of condoms can offer some protective measures, it is safe to say that there is no completely “safe sex” or protective shield for sexually active men and women.
Use of condoms to protect against Herpes or the Human Papilloma Virus.
Sexual partners who advocate the use of sexual protection, such as condoms, can reduce their chances of acquiring harmful STD’s such as human papilloma virus (HPV), HIV, chlamydia, gonorrhea, and may reduce the chances of getting pregnant. When a man or woman initially becomes infected with a specific (HPV) strain, genital ulcers such as herpes usually arise within the genital areas of the body. Because the genital region is the most likely of areas to exhibit an infectious manifestation, the regular use of condoms may also help protect a female from the development of cervical cancer.
Although there is no 100% effective protection from STD’s (other than abstinence), it is very important that condoms are used every time sexual contact occurs. In order to increase one’s protective probability, condoms must be worn and used properly. Another consideration in personal protection from the viruses is to limit their number of sexual partners. Having sexual contact with a limited number of partners (or single partner) and properly using condoms during “skin to skin” sexual behavior or intercourse increases protection and reduces the opportunities to acquire these viruses and diseases.
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