Women’s Health

Acai berry is one of the most wonderful gifts the nature has given us. The qualities of acai berry are amazing and can be rightly said to be miracle. Acai berry can also be regarded to be true superfood of nature. Other so called superfoods can not be compared with acai berry, due to the superior quality and quantity of the food and nutritious value of acai berry. The acai berry is part of staple diet in the Amazon area of Brazil where it grows wild in the Amazon basin. Due to the presence of acai berry in the staple food of Amazon tribes, they are healthier than other people. But recently man made plantations are coming up very fast and it is cultivated on a commercial scale for the growing demand of this product.

There are many health benefits of acai berry. It is an excellent food supplement and many people are using acai berry and its products for therapeutic benefits (although it is not certified for therapeutic uses). Acai berry is most popular for its anti-oxidant properties, which is unmatched in nature. For its anti-oxidant properties it can be helpful in preventing cancer, controlling blood cholesterol, improving healing and immunity. The other health benefits of acai berry are it promotes weight loss, improve stamina and freedom from lethargy, and enhance your sexual desire and function, controls blood sugar in diabetic patients, improves symptoms of constipation, improves vitality and energy, cleanse and detoxify your body of toxins, it improves memory and also improve insomnia. There are other benefits of acai berry like it aids the digestion process, maintain a healthy blood pressure and a healthy heart.

Regular exercise is must for keeping your body fit. The best exercise is aerobic exercise. But continuation or compliance is lacking with aerobic exercise and that is the main reason for increasing use of fitness equipments by everybody from teenagers to old people. Use of fitness equipment is more popular because it can be enjoyable to exercise with modern latest fitness equipments. The benefits of exercise is well known to everybody, but very little percentage of people do regular exercise and among them lesser percentage do aerobic exercise.

Some of good quality fitness equipments are discussed here like inversion chair, inversion table. Inversion chairs are equipped with curved backrest, which extends the spine to help relieve pressure on inter-vertebral disks, vertebrae and nerve roots. Inversion chairs also has adjustable lap belt, leg lock, handlebars, rolled upholstery etc. It can be used in four inversion positions. Inversion chairs are used for treatment of back pain also for hundreds of years.

Stamina inversion table is another type of inversion equipment used in the treatment of backache like that of inversion chair. This is to make inversion easier and also to make it safer. The handles are easy to grasp and allows better leverage for the inversion to go on smoothly without any problem whatsoever. Inversion chars and inversion tables are used for decompression also.

The benefits of inversion therapy with inversion chair and inversion table are relief from back ache or back pain, improvement in blood circulation and lymphatic circulation. Improvement in blood circulation leads to better nutrition of body cells and cells can clear themselves of toxins.

Congestive dysmenorrhea is premenstrual pain in lower abdomen or back and is generally seen among sedentary women. Congestive dysmenorrhea usually occur between three to five days (some times more than five days) before starting of menstruation and is always relieved by menstrual flow (pain goes away once menstruation starts).

Congestive dysmenorrhea should be regarded as a symptom of pelvic disease at first instance and there may be some pelvic abnormality in patient with congestive dysmenorrhea. Disease like pelvic adhesion, salpingo oophoritis (inflammation of ovary and Fallopian tube), parametritis etc almost always produce congestive dysmenorrhea and this may be due to hyperaemic ovaries and covered by adhesion from inflammatory lesions. These lesions become tense during premenstrual period of menstrual cycle and cause pain. Congestive dysmenorrhea is also common symptom of certain diseases like myomas, adenomyoma, acquired retroversion of the uterus, chocolate cyst of ovaries etc. But all the patient of congestive dysmenorrhea does not have an organic disease and an example of congestive dysmenorrhea without an organic disease is premenstrual tension or premenstrual congestion syndrome.

Some patients with congestive dysmenorrhea get symptoms (pain and discomfort) referred to one of the iliac fossa usually left iliac fossa. Pain and discomfort is usually accompanied by disturbance in bowel habit (generally constipation and rarely diarrhea) and flatulence distension of abdomen (upper colon) which is due to spasm of some part of colon. Colon is palpable as a tender part of intestine in this situation. Diagnosis can be confirmed by barium enema and radiology. Frequently laxatives are taken with the mistaken idea that purgation will relieve the spasm but in reality it aggravates the condition.

The right management of this type of congestive dysmenorrhea is correct diet (avoiding carbohydrates), avoid purgatives and some anti spasmodic medicines that acts on bowel like Buscopan. These patients of congestive dysmenorrhea should be encouraged to do regular exercise as the patients are generally sedentary office worker.

Dysmenorrhea is pain during menstruation or painful menstruation. It is crampy lower abdominal discomfort that starts with the beginning of menstrual bleeding and gradually decreases over the next 12–72 hours. There may be nausea, diarrhea, fatigue, and headache and can be seen in 60% to 93% of adolescents in Western countries. beginning with the establishment of regular ovulatory cycles. It is one of the most frequent gynecological problems among women. There are reasons for the scientists to believe that dysmenorrhea increases with degree of civilization in a community.

Severe form of dysmenorrhea is most common among single women, who live sedentary lifestyle. Dysmenorrhea has some economic implication among women who suffer from it, as patients are often incapacitated from work for one or more days during every menstrual cycle. Its prevalence becomes less frequent after pregnancy and also after use of oral contraceptive pills.

Dysmenorrhea should not be regarded as a serious problem but it need to be treated adequately and its treatment is of great importance. Great importance should be given to its treatment due to its economic importance (interruption in the source of income), social life importance and also its psychological importance.

Dysmenorrhea is classified into three different groups and these three groups are:

-Congestive dysmenorrhea.

-Spasmodic dysmenorrhea.

-Membranous dysmenorrhea.

Dysmenorrhea can also be classified into two groups, primary dysmenorrhea and secondary dysmenorrhea.

Gynaecology and obstetrics is a specialized branch of medicine (can say women’s health) which deals in women health problems (gynaecology) and also pregnancy and delivery or child birth (obstetrics). Job as a gynaecologist can be very challenging as well as very rewarding. Job of a gynaecologist is challenging because like any other branch of medicine this branch is also changing rapidly and evolving very fast and to keep up to date with the subject is a challenging job in the present scenario. Job of a gynaecologist and obstetrician is rewarding because only a gynaecologist can understand and feel the satisfaction they bring to a family where he/she has delivered a new member of a family. The joy of the family and the joy for the obstetrician can not be expressed in words and if you have to understand the feeling of joy, you have to be either the parent or you have to be a gynecologist and obstetrician. Only gynaecologist can get the experience of seeing the smiling faces of parents and relatives of a new born baby. Gynaecologist get the satisfaction of job like any other doctor but the additional satisfaction they get can not be achieved by any other doctor.

A person willing to be a gynaecologist and considering a career in obstetrics and gynaecology should have a genuine and sincere concern for the health and well being of women. With out sincerity and willingness of providing service a gynaecologist can not succeed and also will not be a good gynaecologist.

Gynaecologists have a much bigger role to play in nation building also than any other doctor. They teach women how to take care during pregnancy and help delivering healthy babies. Healthy babies are the future of a nation and by presenting healthy babies the gynaecologists take a very important role in nation building. They provide the healthy foundation of a society and nation and without healthy foundation a nation can not progress.

Infrequent menstruation: It is a condition where intermenstrual cycle is prolonged to more than normal 28 days. But some women have a perfectly normal menstrual cycle at 35 days, without any problem because their fertility is intact and that is why it can not be considered as pathological.

Infrequent menstruation should be diagnosed only if the menstrual cycle is erratic and unduly prolonged and some times it prolonged to three months to four months or longer. This situation is most commonly seen at the time of menarche (first menstruation) or at the time of menopause and which can be regarded as modified amenorrhea. But normal reproductive capacity is possible within this infrequent menstrual cycle and infrequent ovulation.

In the pathological variety of infrequent menstruation the causes and finding on clinical and investigational findings are to some extent similar to amenorrhea and patient is usually obese, poorly developed secondary sexual characters, hirsute, and hypoplasia of genitals. And the most common finding in the investigation of these types of patients is subnormal functioning of ovaries.

Scanty menstruation:

In some women the menstruation lasts for only a day or two and the blood loss is also very less and require changing of diapers pf only one or two. Scanty menstruation that occurs regularly is not pathological and they are not infertile as the regularity of menstruation proves normal pituitary ovarian cycle. So if a patient of scanty menstruation has normal secondary sex characters it can be considered normal and no treatment is required, other than reassurance. If scanty menstruation is accompanied by irregular menstruation, it is suggestive of primary or secondary ovarian sub function. Depending on the history of menstruation, the primary or secondary ovarian disorder can be determined (if from the beginning the menstruation is irregular and scanty, it is due to primary ovarian disorder and if it starts later it is secondary cause). If the menstruation become suddenly erratic and scanty or no loss, it is suggestive of premature menopause. Then the treatment is same as primary and secondary amenorrhea. The patient and relatives should be convinced on this to the point of their satisfaction.

There are many causes of secondary pathological amenorrhea and they are listed below:

1. Obstruction (acquired) to the lower genital tract -lower genital tract injury due to operation, chemical burns etc. which can lead to stenosis (narrowing) of cervix and rarely of vagina.
2. Ovarian factors of secondary pathological amenorrhea:

-Polycystic ovarian disease formerly known as Stein-Leventhal syndrome; hyperthecosis ovarii etc.

- Ovarian failure or hypo hormonal amenorrhea.

- Hyper hormonal amenorrhea-due to excess estrogen as seen in metropathia hemorrhagica and may be due to therapeutic use of hormone.

- Ovarian destruction of ovaries by disease (rare cause), radiation or surgical removal of ovaries known as oophorectomy.

- Premature menopause due to auto immune disease or due to ovarian resistance syndrome.

- Masculinizing tumors of ovaries like arrhenoblastoma, adrenal like tumors, hillus cell tumor, masculinizing luteoma etc.

3. Uterine factors:

-Hysterectomy or surgical removal of uterus.

- Destruction of endometrium of uterus due to-genital tuberculosis, attachment due to excess and vigorous curettage after abortion, or due to intra cavity introduction of radium in uterus.

4. Diseases affecting pituitary:

-Basophil adenoma-Cushing’s disease.

- Acidophil tumor- which produce gigantism and acromegaly.

- Oral contraceptive pills and psychotropic drugs that cause hyperprolactinemia.

- Pituitary failure due to cyst, post partum pituitary necrosis (Sheehan’s syndrome), chromophobe adenoma, Simmond’s disease etc.

- Prolactinoma causing hormonal disturbance.

- Psychogenic causes- anorexia nervosa, stress, pituitary shock, vigorous exercise, pseudocyesis etc.

- Suppression of FSH (follicle stimulating hormone) due to persistence of luteotropic hormone as seen in Chiari-Frommel syndrome.

5. Amenorrhea due to chromosomal abnormalities.

6. Nutritional causes- due to extreme obesity or extreme nutritional deficiency.

7. Thyroid causes- hyperthyroidism, late stage of hypothyroidism.

8. Systemic diseases- diabetes mellitus, severe anemia, debilitating diseases like renal disease and fulminanting tuberculosis.

9. Adreno-genital syndrome (adrenal cortical hyperplasia), Addison’s disease (adrenal failure), adrenal cortical tumors.

The endometrium of uterus is the innermost of three layers of uterus and consists of epithelial cells.

Cervical Endometrium:

The cervix is spindle shaped and measure about 2.5 cm and bounded by external os below and internal os above. The mucosal lining of cervical endometrium is different from that of the body of the uterus and the sub mucosa is absent in cervix. The cervix is lined by high columnar ciliated epithelium. The nuclei of the epithelium are spindle shaped and near the basement membrane. The direction of cilia is downwards and toward external os. The cervical endometrial glands are racemose type and secrete mucus which is rich in fructose. The secretion is alkaline and its high pH and fructose content make it attractive to ascending spermatozoa (male sperms). The secretions rich in sucrose and high pH collects in the cervical canal as a plug and probably stops the ascending infection. In gonorrhea the gonococcus are present in the crypts of the glands.

The external os is circular in nulliparous (woman who has not born a child) woman, but after vaginal delivery there is transverse slit of the external os, which is characteristic of parous (woman who has given birth) women.

The body of the uterus differs from that of cervix both structurally and functionally. Unlike epithelium of the body of the uterus the cervical epithelium does not show changes during menstrual cycle and also during pregnancy the cervical epithelium rarely changes, unlike the epithelium of the body of the uterus which undergo dramatic change in shape and size. The cancer of the body of the uterus is adenocarcinoma od the endometrium but that of the cervix is squamous cell carcinoma (cancer) type which is highly malignant.

There is an intermediate zone between endometrium of body and the mucous membrane of the cervix, known as the isthumus which is about 6 mm in length. The endometrium of the isthumus is anatomically and functionally similar to the body of the uterus. This isthmic portion forms the lower uterine segment in late pregnancy.

The relationship between the length of cervix and the body of the uterus varies according to age. The ratio of cervix to the body is 2:1 before puberty. At puberty the ratio reverses and become 1:2. During reproductive age the ratio is between, 1:3 to 1:4. After menopause the whole of the organ (uterus) atrophy.

A skin tag is a benign growth of skin that protrudes from the skin and more commonly seen after middle age. But it can be seen at any age. The common sites where skin tags occur are neck, underarms, groin, eyelids, and under the breasts. Skin tags are also known as acrochordon, cutaneous papilloma, cutaneous tag, fibroepithelial polyp, fibroma molluscum, fibroma pendulum, papilloma colli, and soft fibroma or Templeton skin tag. Skin tags are harmless but sometimes they may cause irritation due to clothing, jwellery etc. and may cause difficulty in shaving in man and also they are not acceptable due to cosmetic reason if they are present in face or other exposed skin.

Nearly 50% of people get skin tags in their life time. Skin tags are acquired as they are not present during birth and they increase in number till 60 years of age and after that they tend to slowly become less. Why skin tags are formed is not clear, but there is a correlation of skin tags with diabetes and obesity. The size of skin tags very from size of a rice grain to as big as golf ball and the surface of skin tags are generally irregular or rough, but they can be smooth in surface. Under the microscopically skin tags have a fibrovascular core and sometime fat cells and covered with very thin epidermis (the outermost layer of skin).

The treatment of skin tag is to remove it surgically under local anesthesia. Skin tag removal has to be done under anesthesia, because they contain nerve cells and skin tag removal can not be done with out pain if anesthesia is not applied. Skin tag removal is generally done by dermatologists and if it is in the eyelids the skin tag removal is done by ophthalmologist. The procedures that are followed for skin tag removal are cauterization with an electrolysis instrument, ligation or cutting off the blood supply to the skin tag, cryosurgery, and excision with a scalpel or other surgical instrument. Skin tag removal is done routinely in an out patient setting.

Yeast infection is a common infection in women. It is also commonly known as candidiasis and it is caused by a group of fungi or yeast. There are many species of candida and the commonest to cause infection in humans is candida albicans. The yeast is a commensal and present on our skin normally. Under some conditions like warm and humid conditions as seen in vagina and oral cavity (oral candidiasis or thrush) these candida grows to large numbers and cause infection.

The sign and symptoms of yeast or candida infection depend on the type of infection and also the site of infection. In vaginal candidiasis the symptoms are white discharge from vagina, itching in vagina, and irritation of vagina and its surrounding areas. Other symptoms of vaginal candidiasis include burning during urination and pain during sexual intercourse. The symptoms of oral candidiasis are white patches on top of a red base in tongue, palate or other parts in the oral cavity. The white patches looks like milk curd, but it can not be wiped away easily. If it is wiped away with an applicator it causes bleeding from the site. It can also cause redness of tongue.

Yeast infection treatment is done with anti fungal drugs like miconazole, clotrimazole, butoconazole etc. All these anti fungal drugs are available easily as they are over the counter drugs. The drugs have to be massaged into vagina and surrounding areas for up to 7 days depending on the preparation of the anti fungal drug. But yeast infection treatment should be discontinued if irritation to vagina or surrounding areas occurs. During pregnancy anti fungal drugs should not be used and doctor should be consulted. If it is oral candidiasis or thrush it can be treated with anti fungal agent nystatin or amphotericin B.