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.”
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.
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