Have you been lately experiencing pain and burning sensation in your vaginal area, which seems to get worse after intercourse? If yes, you might be affected by a condition known as Vulvodynia. Read on to find out all about the disease, including its possible causes, symptoms, diagnosis, treatment options and more.

Vulvodynia Definition

The term “Vulvodynia” refers to a chronic or persistent painful sensation around the vulval (vaginal) opening that seem to arise without any apparent cause.

The condition can persist for many months or even years. It is also known by the name Vestibulodynia.

Vulvodynia ICD9 Code

The ICD9 Code for this disorder is 625.7. The ICD9 group 625 is designated for pain and other conditions of the female genital organs.

Vulvodynia Incidence

The condition can affect women within the age group 20-60 and even above. As per an Australian study, the disorder often originates early and has its highest prevalence in women below 25 years of age. The average age of onset for the primary cases of the condition is 19 years.

According to estimates, the disorder affects anywhere from 200,000 to six million women. The condition was once supposed to affect females primarily of white origin. Now, women of Hispanic and African-American origin are known to be affected in an equal measure.

Vulvodynia Types

The pain may be localized to a particular spot (such as vaginal opening or vestibule) or may be generalized, i.e. felt in the entire area. Depending on the location of pain, Vulvodynia is categorized into two subtypes:

Generalized Vulvodynia

It is characterized by painful symptoms in various regions of the vulva, arising at varying periods of time. The pain may be continuous or intermittent. Touching or pressing the affected area may or may not act as a trigger factor for the symptoms although doing so may worsen the pain.

Vulvar Vestibulitis Syndrome

It refers to pain in the vestibule, or the entry point of the vagina. This is often experienced as a burning sensation and arises only after the vestibule is pressed or touched, as occurs at the time of intercourse.

Vulvodynia Symptoms

The condition is marked by irritation, burning or painful sensations around the vaginal aperture that makes it difficult for affected individuals to sit for long durations or have sex. Patients may also experience other sensations in their vaginal opening, such as stinging, itching, throbbing or even rawness.

The painful sensations experienced may be sporadic or continuous and may persist for many months or even years. However, the difficulties may vanish all of a sudden and as rapidly as they originate. The vulvar tissue may look slightly swollen in some patients. In the majority of sufferers, however, it appears normal.

A similar condition, known as Vulvar Vestibulitis, may lead to painful sensations only when pressure is exerted over the region that surrounds the vaginal entrance.

Vulvodynia Causes

Doctors are yet in the dark regarding the exact causes of this condition. However, they have pinpointed certain contributory factors. These include:

• Past cases of vaginal infections
• Irritation of or injury to the nerves around the vulvar area
• Changes in hormone levels
• Allergies or a localized hypersensitivity of the patients’ skin

The majority of women affected by the disease are found to have a medical history of vaginal yeast infections or recurrent vaginitis.

Some women with the disease are found to have been victims of sexual abuse. However, the majority of sufferers do not have any contributory factors. The condition is not sexually transmitted. It is not a sign of cancer.

Vulvodynia Risk Factors

Certain possible factors, that may increase the risk of occurrence of this disorder, include:

• Irritable bowel syndrome (IBS)
• Fibromyalgia
• Chronic bladder infections
• Vaginal infections
• Human papillomavirus in vulval biopsy
• Long-term use of topical vulval preparations

Vulvodynia Diagnosis

Patients are usually asked a number of questions to allow doctors have a better understanding of their medical history and also to let them know about the nature, location and extent of the problems.

As part of the evaluation, physicians may also perform the following exams:

Cotton swab test

In this exam, a physician uses a moist cotton swab to gently rub over the vulvar region of patients and check for particular localized areas of pain.

Pelvic exam

In this test, physicians visually examine the vagina and the external genitals of patients for signs of infection or some other cause of the problems. Even in the absence of a visual evidence of infection, a physician may extract a few cells from the vagina as samples to test them for vaginal infection, such as bacterial vaginosis or yeast infection.

Vulvodynia Differential Diagnosis

The differential diagnosis for Vulvodynia involves distinguishing its symptoms from those of similar conditions, which include:

• Allergic vulvitis
• Lichen sclerosus
• Vulval atrophy
• Vaginismus
• Lichen planus
• Pudendal canal syndrome
• Vulval intraepithelial neoplasia
• Chronic candidal vulvovaginitis

Vulvodynia Treatment

The treatment for this disorder aims to alleviate the symptoms. There is no one-size-fits-all curative method for the condition and a varying combination of treatments seems to work well for each sufferer. The symptoms may take several weeks or even months to improve noticeably.

The curative options may involve:

Medicines

Chronic pain may be lessened with the implementation of anticonvulsants and tricyclic antidepressants. Patients may find relief from itching sensations with the use of antihistamines.

Local anesthetics

Medicines like Lidocaine ointment may provide temporary relief from symptoms. A physician is likely to recommend application of Lidocaine half an hour before intercourse to reduce discomforts. However, the sexual partner of a woman applying Lidocaine may experience temporary numbness after sexual contact.

Nerve blocks

Women who suffer from chronic pain, and do not respond to other curative methods, may benefit from local nerve block injections.

Biofeedback therapy

This curative technique helps reduce pain by teaching sufferers how to control the specific responses of their body. This therapy actually aims to help patients relax their pelvic muscles to reduce the painful sensations. In women affected with Vulvodynia, the pelvic muscles tend to contract in anticipation of pain and can actually give rise to chronic pain.

Pelvic floor therapy

Many Vulvodynia sufferers face difficulties with the pelvic floor muscles that support the bladder, bowel and uterus. Pelvic floor therapy involves teaching patients a system of exercises that may provide relief from painful symptoms.

Surgery

In cases where pain is specifically localized to the hymenal ring, surgery to remove affected tissue and skin (known as Vestibulectomy) helps alleviate pain in some women.

Vulvodynia Home Treatment

The home remedies for curing this condition involve:

Cold compresses

Direct application of cool compresses over the external genital region may help reduce itchiness and pain.

Hot baths

Taking sitz baths for 2-3 times a day, for 5-10 minutes in each session, can also provide relief from symptoms. However, affected women should avoid spending a lot of time in hot water as it may cause itching and discomforts.

Gentle washing

Washing the vulvar area gently with plain water and patting the region dry can also help alleviate the symptoms. After bathing, application of a preservative-free emollient (like plain petroleum jelly) can be beneficial. One should avoid harshly scrubbing or washing the affected region, to prevent irritating it.

Avoiding certain activities

Avoiding some activities, such as riding on horseback or motorbikes, can benefit women affected by this condition by preventing irritation and compression of the vulvar area.

Use of antihistamine

Using an antihistamine may help alleviate itchiness and allowing patients to rest better.

Use of lubricants

Sexually active women should apply lubricants prior to indulging in sexual activities involving vaginal penetration.

Avoiding use of tight garments

Tight undergarments prevent flow of air to the genital region and often lead to increase in moisture and temperature which leads to irritation. Wearing white cotton underwear can increase ventilation and promote dryness of the vaginal region. It is better to sleep without underwear during night. Nylon underwear and tight-fitting pantyhose can irritate the region and restrict air-drying of the vulvar skin.

Vulvodynia Coping and Support

Support groups and counseling can be beneficial for many sufferers. Patients may find it useful to talk with other women suffering from the same condition. Consulting others can help them get more information and understand that they are not the only ones to be affected by this disorder. Those who are not comfortable with support groups may ask their physicians about good counselors whom they can get in touch with and benefit from.

Those experiencing painful sensations in their genital region should consult their doctor or contact a reputed gynecologist. It is important that physicians rule out the presence of skin ailments, microbial infections or medical issues such as diabetes that might be the possible causes of vulvar pain and irritation. Once doctors evaluate the particular symptoms experienced by sufferers, they can recommend ways or treatment options that can help them manage the painful sensations.

National Vulvodynia Association

Patients of Vulvodynia can get in touch with the National Vulvodynia Association. It is a non-profit organization set up with the objective of helping women affected by Vulvodynia and other associated ailments.

The registered address and contact details of this organization have been provided below:

National Vulvodynia Association

PO Box 4491

Silver Spring, MD 20914-4491

301-299-0775 (phone)

301-299-3999 (fax)

Vulvodynia Prognosis

In researches conducted on select groups of women, the majority of sufferers have been found to report of improvement with proper treatment. Proper cure helps alleviate pain and other problems associated to this condition.

Vulvodynia Complications

The condition may result in the following complications for its sufferers:

• Depression
• Anxiety
• Reduced quality of life
• Sexual dysfunction
• Sleep disturbances
• Problems in maintaining relationships
• Past history of sexual abuse
• Changed perception of body image

The disorder can be painful and quite frustrating for its sufferers and can reduce their sexual activity, thus giving rise to emotional difficulties. The fear of having pain during sex can cause muscular spasms in the area around the vagina (Vaginismus).

If you suspect yourself to be having problems similar to Vulvodynia, do not feel embarrassed or hesitate to seek treatment. Treated timely, the condition can cause less pain and discomfort and allow patients to lead a better quality of life.

References:

http://www.patient.co.uk/doctor/Vulvodynia.htm

http://www.mayoclinic.com/health/vulvodynia/DS00159

http://women.webmd.com/guide/vulvodynia

http://www.bbc.co.uk/health/physical_health/conditions/vulvodynia1.shtml

What is Placental Abruption?

Placental abruption is a pregnancy-related complication in which the placental lining separates from the uterus of expecting mothers. It is the most commonly occurring pathological factor responsible for late pregnancy bleeding. In human patients, this refers to the anomalous separation after twenty weeks of gestation prior to the birth. The disorder affects both the mother and the fetus and is a major contributor to the incidence of maternal mortality worldwide.

The condition is also referred to as abruptio placentae.

Placental Abruption Causes

The exact causes of this condition are not fully known. It is believed that abnormal blood supply within the uterus or the placenta may play an important role. However, the causes for the suspected abnormalities are not clear.

Some of the known factors behind the condition include:

Uterine decompression

Sudden loss of the amniotic fluid from uterus can cause suction of the placenta from the uterine wall. This is known as uterine decompression. It can be caused by the birth of first twins or multiple births and/or rupture of the amniotic membranes due to excessive amniotic fluids.

Abdominal trauma

A traumatic injury to the abdomen might tear the placenta from the uterine wall. Such injuries can be caused by a car accident, a fall or an assault.

Placental Abruption Risk Factors

There are a number of risk factors that can increase the propensity of a placental abruption. These include:

• Diabetes
• Multiparity
• Hypertension
• Pre-eclampsia
• Alcohol abuse
• Thrombophilia
• Amniocentesis
• Uterine fibroids
• Certain infections
• Maternal smoking
• Abdominal trauma
• Multiple pregnancies
• Short umbilical cord
• Cocaine intoxication
• Uterine abnormalities
• Retroplacental fibromyoma
• Previous Caesarean section
• Intrauterine growth restriction
• Prolonged rupture of the membranes
• Premature rupturing of the membranes
• A previous instance of placental abruption
• Polyhydramnious or excessive amniotic fluid
• Medical procedures like amnioreduction and external cephalic version
• Maternal trauma caused by motor vehicle accidents, falls assaults, or nosocomial infections.
• Maternal age. Pregnant women younger than the age of 20 or even older than the age of 35 have a greater chance of suffering from this abruption

Placental Abruption Symptoms

This condition can lead to complications both for the mother and the baby. The various signs and symptoms of placental abruption are listed below:

• Pallor
• Early water breaking
• Inertness of the baby
• Pain within the uterus
• Abdominal tenderness
• Retroplacental clotting
• Tender and/or hard uterus
• Continuous abdominal pain
• Occasional vaginal bleeding
• Continuous pain in the lower back area
• Fetal distress, such as abnormal heart rhythm
• Possible disproportionate enlargement of the uterus
• Painful sensations in the abdomen or belly whenever touched
• Frequent uterine contractions without any intermediate periods of resting

Placental Abruption Clinical Manifestation

Placental abruption may be partial or complete. The condition is classified into a number of subtypes based on the symptoms and their severity.

Class 0

These are asymptomatic cases. Diagnosis is conducted by locating a proper blood clot or by studying a depressed area in a delivered placenta.

Class 1

These are mild conditions and comprise of a total of 48% of all placental abruption cases. The characteristic features include:

• No fetal distress
• No coagulopathy
• Slightly tender uterus
• Normal maternal heart rate and BP
• No vaginal bleeding or maybe mild vaginal bleeding

Class 2

These are moderate abruptions that represent nearly 27% of all cases. Features include:

• Fetal distress
• Hypofibrinogenemia
• None or possibly moderate vaginal bleeding
• Maternal tachycardia, along with orthostatic changes in heart rate and BP
• Moderate to severe uterine tenderness along with probable tetanic contractions

Class 3

These are severe abruptions comprising around 24% of all cases. Characteristics include:

• Fetal death
• Coagulopathy
• Maternal shock
• Hypofibrinogenemia
• Quite painful tetanic uterus
• No vaginal bleeding or heavy vaginal bleeding

Placental Abruption Diagnosis

While diagnosing placental abruption, the doctor will first conduct a thorough physical examination of the pregnant woman and study her previous medical history to see if there were any previous instances of placental rupture. He or she will then conduct any or all of the following tests:

• Pelvic exams
• Platelet count
• Fibrinogen levels
• Prothrombin time
• Vaginal ultrasounds
• Complete blood count
• Abdominal ultrasound
• Partial thromboplastin time
• Monitoring of the fetal heartbeat
• Internal examination of vagina and cervix by using a speculum

Placental Abruption Differential Diagnosis

The differential diagnosis of abruptio placentae includes isolating its symptoms from similar signs produced by the following health conditions:

• Vaginitis
• Vasa previa
• Preeclampsia
• Ovarian Cysts
• Preterm labor
• Placenta Previa
• Ovarian Torsion
• Acute appendicitis
• Ectopic Pregnancy
• Pregnancy Trauma
• Hypovolemic Shock
• Hemorrhagic Shock
• Blunt Abdominal Trauma
• Labor accompanied by bleeding
• Disseminated Intravascular Coagulation

Placental Abruption Treatment

Doctors suspect a placental abruption when a pregnant women experiences sudden local abdominal pain that is either accompanied or not accompanied by bleeding. The fundus might be monitored as a rising fundus is indicative of bleeding. Ultrasounds might be conducted to rule out the possibility of a placenta praevia, although it is not the diagnostic proof of an abruption. A physician might prescribe Rhogam in case the patient is Rh-negative.

Treatment modes will depend on the severity of blood loss as well as the condition of the fetus. It may include administration of intravenous fluids and blood transfusions. If the age of fetus is less than thirty-six weeks, and neither the mother nor the fetus is experiencing any problems, the doctor would simply monitor the fetus closely in the hospital until it reaches maturity or any changes in fetal condition can be observed. The fetus may develop abnormal heart rates or the mother may experience symptoms of shock, both of which should be treated immediately.

The fetus may need to be delivered immediately in case the mother or the fetus is in distress or the fetus has reached maturity. Emergency cesarean section might be needed in such cases. Blood volume replacement for maintaining blood pressure as well as blood plasma replacement for maintaining fibrinogen levels might become necessary. A vaginal birth is generally preferred over a caesarean section as long as there are no signs of fetal distress. Caesarean sections are contraindicated in disseminated intravascular coagulation cases. The mother might be kept in hospital for a close observation for any signs of postpartum hemorrhage if the baby is premature and there were only signs of miniature placental separation. Hysterectomy might be necessary in case of excessive bleeding from the uterus. The mother is released after a few days in case there are no signs of bleeding and there are no adverse health issues in the mother.

Placental Abruption Complications

Excessive blood loss can eventually lead to shock as well as cause death of the baby or the mother. If bleeding continues to occur after delivery and the blood loss cannot be controlled, the mother may require a hysterectomy. Other complications that might ensue from a placental abruption include:

• Stillbirth
• Premature birth
• The need for blood transfusion
• Deprivation of nutrients for the baby
• Renal failure or failure of other organs
• Disseminated intravascular coagulation (blood clotting problems)
• Reduced oxygen flow to the baby which could result in brain damage

Placental Abruption Prognosis

The outcome for the disorder depends on the following factors:

• Whether the patient has received treatment
• The quality of the treatment received
• The severity of abruption

Maternal deaths caused by placental abruption are rare in the Western countries. Prognosis for the fetus is much worse; nearly 15% of fetuses in UK have been known to die following an abruption. Without any medical intervention, as it happens in different parts throughout the world, abruptio placentae have a high rate of maternal mortality. The conditions that might increase the risk of fatality for both the baby and the mother include:

• No labor
• Closed cervix
• Excessive blood loss
• Delayed diagnosis and medical intervention
• Concealed uterine bleeding during pregnancy

Placental Abruption Prevention

Although the potentiality of a placental abruption cannot be completely eliminated it can, however, be reduced. During her months of maternity, a pregnant woman should avoid taking any form of:

• Alcohol
• Tobacco
• Non-prescribed medicines
• Cocaine
• Other street drugs

She should also avoid any hectic activity that can cause serious physical trauma. For example, while traveling by a car, she should wear a seatbelt and avoid any possibility of falls. Women suffering from high blood pressure (hypertension) or who have previously experienced a placental abruption but want to conceive should be closely monitored by a doctor. The risks of a placental abruption can be further reduced by sticking to a good, healthy diet that includes folic acid. Symptoms of pregnancy-induced high blood pressure should be checked by consulting with a doctor. If there are other serious conditions like diabetes, they should be managed as well under close medical supervision.

Placental Abruption Pictures

These pictures will give you a clearer idea of what happens during a placental abruption.

Picture 1 - Placental Abruption

Picture 2 - Placental Abruption Image

Placental abruption often leads to serious birth-related complications for and even death both a mother and her fetus. Thus, timely medical treatment is essential to facilitate proper management of the complications and allow affected mothers to have a proper delivery.

References:

http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Placental_abruption

http://www.nlm.nih.gov/medlineplus/ency/article/000901.htm

http://www.mayoclinic.com/health/placental-abruption/DS00623

http://en.wikipedia.org/wiki/Placental_abruption

A Blighted ovum is the reason behind half of all miscarriages that occur in the first trimester of pregnancy. Learn all about this abnormal condition and get detailed information on its causes, symptoms, diagnosis and treatment.

What is a Blighted ovum?

It is an abnormal condition that occurs in the very early stages of pregnancy or the first trimester (initial three months of pregnancy). It may develop in the first few weeks of pregnancy, often even before a woman knows she is pregnant.

The condition is also known as “Anembryonic gestation.”

Blighted ovum ICD 9 Code

The ICD 9 Code for this health issue is 631.

Blighted ovum Incidence

The condition is reported to occur in 16-30% of all pregnancies. According to 50-60% of all miscarriages in the first trimester occur due to abnormalities in chromosome that occur during that stage of pregnancy.

Blighted ovum Causes

The problem occurs when a placenta and membrane develops from a fertilized egg but no embryo originates. This only means that the egg does not fully develop into a baby. According to doctors, the condition arises due to abnormalities of chromosome in the fertilized egg – possibly associated to Trisomies 16 and 22. In a 1993 study, chromosomal abnormalities were detected in 67% of miscarriages occurring due to Anembryonic gestation. The condition may also result from poor quality of egg or sperm or an abnormal division of cells. The problem may also occur due to advanced age as the condition has been found to be more common in older women.

Although the exact mechanism is not fully known, the disorder is believed to occur due to an aberration of nature. When a sperm fertilizes an egg, the division of its cells begins to occur. In normal cases, some of the cells develop into the embryo while others grow into membranes and placenta. Sometimes, however, the cells that were originally meant to turn into the embryo fail to develop completely – possibly due to too few or too many chromosomes. The other cells have a normal growth and develop into placenta and membranes. Thus, the gestational sac continues to grow bigger inside the uterus and the placenta begins to form. It is only after some time that the body recognizes the absence of a baby inside the sac.

Blighted ovum Symptoms

The condition usually leads to a miscarriage. The body of a woman reacts to the abnormalities in chromosome and stops the pregnancy. The fetus does not develop into a healthy infant.

In many cases, a woman with this health issue shows signs of a full-blown pregnancy and does not exhibit any symptoms of miscarriage. If a Blighted ovum goes wrong naturally, a woman shows typical symptoms of miscarriage.

Women with this condition may experience various signs of pregnancy, such as a late or missed menstrual period, and also a positive test for their maternity. The hCG (Human Chorionic Gonadotropin) is a hormone produced by the placenta after implantation. In women with Blighted ovum, the level of this hormone can continue to increase as the placenta may grow on for a short while even in the absence of an embryo.

As hCG levels keep on increasing in such women, they are usually confident of having a normal pregnancy. Even without a baby, the placenta can continue to enlarge in size. The pregnancy hormones can also keep on rising, thus making women sure of being pregnant. It is not until an ultrasound examination has been made that an empty gestational sac is noticed.

In some cases, however, women with Blighted ovum might suffer from health problems like bleeding, minor vaginal spotting or minor abdominal cramps. These are the signs of a miscarriage. Although not all cases of bleeding during the first trimester are symptoms of a miscarriage, it is better to visit a doctor as soon as such problems are experienced during early pregnancy.

Blighted ovum Diagnosis

When small in size, the gestational sac in case of a blighted ovum looks normal from the outside. It cannot be differentiated from pregnancy sacs observed I normal women during the first trimester. The sac must be enlarged enough so that one can detect the absence of normal elements in the embryo.

The condition is generally discovered when a woman begins to show signs of miscarriage in the first three months of her pregnancy (first trimester). It may also be detected during an ultrasound exam at some time in the first trimester. If a woman does not exhibit any symptoms of miscarriage, the problem may remain undetected until the early stages of the second trimester when a heart rate monitor does not detect any heartbeat of a baby.

An ultrasound examination is usually the preferred method of diagnosis for this disorder. In an ultrasound examination, the image of a Blighted ovum generally shows only a gestational sac. In some cases, however, an egg sac and a fetal pole might also be noticed. But true Blighted ova do not contain either of these structures. Only a void can be seen in place of where the embryo should have been.

An analysis of hCG levels is generally not useful. This is due to the fact that the levels may rise in the same way as in normal pregnancies.

The criteria for the diagnosis of a Blighted ovum are:

• Failure to detect an embryo in a pregnancy sac, which is at least 20 mm in size, through a Transabdominal ultrasound examination.
• Failure to detect an embryo in a pregnancy sac that is around 18mm or more in size through a Transvaginal ultrasound.
• Failure to detect a yolk sac in a pregnancy sac that is 13mm or more in size.

There might also be other indications, such as:

• Irregularities in the outline of the gestational sac
• Absent or incomplete decidual reaction
• Presence of fluid in the sac

Blighted ovum Treatment

Many women with this problem may opt for a D&C (Dilation and Curettage) as opting for natural recovery might result in weeks of waiting. D&C is an operative procedure in which surgeons dilate the cervix and scrapes the uterine lining mildly to empty the uterus of its contents. This surgical process is also often referred to as ERPC (Evacuation of Retained Products of Conception). It can be carried out as a medical induction of miscarriage or as a day procedure. D&C may help resolve the problem completely and also help a mother emotionally disconnect herself from the pregnancy. It might also be useful if she wants a pathologist to analyze the tissues and deduce the actual reason of the miscarriage.

If surgery is not preferred by patients, doctors might use a medicine (like Misoprostol) on an outpatient basis. The drug may, however, take a few days to make the body expel all the tissues. The use of this medication may give rise to side effects, such as bleeding. With surgery as well as medications, there is risk of abdominal cramps or pain. These can be treated.

Some women prefer to let the body expel the tissues naturally, without the use of operative procedure or medicines. Although this is a personal decision, it is best to consult a doctor in this regard. Many women opt for a natural miscarriage. Those going the natural way should be monitored by a doctor until the completion of their miscarriage. An woman option for natural miscarriage is likely to experience typical symptoms of a stillbirth.

Blighted ovum Prognosis

The periods begin once again after the miscarriage occurs. Although there are no physical problems, the condition might lead to emotional trauma and be a cause of much anxiety during the next pregnancy. Most women are assured only when physicians confirm a heartbeat in a heart rate monitor. It is only then that the pregnancy is confirmed and the possibility of a successful delivery is reported to be much better.

Blighted ovum Complications

As mentioned earlier, this condition does not lead to any health issues. However, many affected women are found to suffer from emotional trauma due to a miscarriage. Although there is not an actual existence of a baby, the fact that there has been an unsuccessful pregnancy and a conception is seen as the main cause of grief among sufferers. Such emotional scars usually heal after a successful pregnancy in future.

Blighted ovum Prevention

Unfortunately, this condition cannot be prevented. Couples might seek genetic testing in case of multiple early pregnancy losses. However, this problem often occurs only once in life and occurs again only rarely. Following cases of miscarriage due to this problem, doctors usually recommend patients to wait for at least 1-3 menstrual cycles before attempting to conceive again.

A deficiency in the progesterone hormone is believed to be one of the causes of miscarriage in the early stages of pregnancy. Use of progesterone supplements has been found to reduce the risk of early pregnancy loss in women suffering from recurrent cases of miscarriage. Consult with your doctor and test the level of your progesterone as soon as possible, if you believe a deficiency of the hormone to be the underlying cause.

Blighted ovum Misdiagnosis

In a few cases, pregnant women are misdiagnosed with this condition. In many cases, women who go for an ultrasound scan before the 8th week of their pregnancy are misdiagnosed of early pregnancy failure. If the dates of pregnancy are even slightly off, a pregnancy that is capable of being successful can often be misdiagnosed for a Blighted ovum.

If you are pregnant, you can follow these tips to avoid being wrongly diagnosed of this health issue.

• Wait till the 11th or 12th week of your pregnancy before going for an ultrasound scan. However, this is not recommended if you are experiencing abdominal pain or other complications such as infection. An earlier ultrasound scan might be extremely necessary in such cases.
• Do not bother about changing hCG levels. Alteration in the level of this hormone is a poor indicator of blighted ovum.
• Do not worry excessively about the symptoms that you might be experiencing during pregnancy.
• Many healthcare providers believe that it is better to have a miscarriage before ten weeks of pregnancy. However, it is safer to wait as most misdiagnosed blighted ova are observed by ten weeks.
• If you are not having any complications and are unsure about terminating your pregnancy, get a second opinion. Consult another doctor to know whether he or she seconds the opinion of the first.

Pregnancy after Blighted ovum

Most women with this problem wish to provide their body and mind with some rest before opting for pregnancy again. It is usually only after sometime that a woman feels emotionally ready to become pregnant again. After having a Blighted ovum, women are likely to have their menstrual period again in four to six weeks following their miscarriage or removal of tissues.

While doctors feel that one can try becoming pregnant after the first period, it is safer to wait until a complete menstrual cycle has occurred.

Blighted ovum Pictures

Two images of a Blighted ovum are given below. The first image displays the condition in the 8+4 week and shows the gestational measuring 17 by 11 mm and located close to the center of the uterus. It is quite smaller than it should have been at that stage of pregnancy. The second image shows the condition in the 7+4 week and displays a pregnancy sac measuring 13 mm which is located much near to the fallopian tube. The measurement is appropriate to a gestational age of about 5 weeks.

Picture 1 – Blighted ovum

Picture 2 – Blighted ovum Image

If you are experiencing pain and cramps in the abdomen, get in touch with a physician as soon as possible. It is not advisable to neglect your health in pregnancy and the sooner you address the issues, the better it will be for you. If you are diagnosed with a Blighted ovum, do not hurry into a miscarriage. Take your time and get a second opinion from another doctor. Take your decision only after a second confirmation.

References:

http://en.wikipedia.org/wiki/Anembryonic_gestation

http://www.mayoclinic.com/health/blighted-ovum/AN00418

http://www.americanpregnancy.org/pregnancycomplications/blightedovum.html

http://www.babyhopes.com/articles/blighted-ovum.html

http://www.blighted-ovum.com

Premenstrual Dysphoric Disorder (PMDD) is an acute menstrual condition affecting 3-8% women of menstrual age. Go through this article to find out all about the causes, symptoms, diagnosis, treatment options and more about this disorder.

What is Premenstrual Dysphoric Disorder?

It is a serious type of premenstrual syndrome arising in women before menstruation. Primarily associated with the luteal phase of the menstrual cycle, the disorder gives rise to severe mental and physical complications such as:

• Irritability
• Depression
• Tension
• Rapid breathing
• Headache

The condition is listed as a type of depressive disorder in the DSM-IV. The manual does not provide any specific information about the condition and it is included in the appendix of DSM-IV as a disorder that requires further study.

Premenstrual Dysphoric Disorder Incidence

PMDD is relatively rare compared to many other similar disorders. It affects only 3% to 8% women with regular menstrual cycles.

Premenstrual Dysphoric Disorder Causes

The exact etiology of PMDD is still being researched by scientists. However, certain factors have been supposed to be responsible for the development of this condition. These include:

Genetic factors

PMDD is often believed to be an inherited condition. Heredity is supposed to be an important factor which is responsible for the development of this disease. According to studies, identical twins have greater chances of having the disease as compared to non-identical twins. Women suffering from this syndrome are more likely to have daughters with the ailment.

Estrogen receptor alpha genes have some variants that are associated with the disorder. Women having these genetic variants have greater chances of suffering from PMDD. Studies also show that the disorder only affects women with a variant of the gene COMT or Catechol-O-methyl transferase. COMT regulates the functioning of a vital regulator of mood known as the prefrontal cortex.

Disorders

Women suffering from some bipolar disorder are often reported to have this illness.

Other factors

PMDD may also be a result of various psychological, cultural and social factors. However, these factors alone cannot cause the condition. They only work as stimulators.

Premenstrual Dysphoric Disorder Risk Factors

Some of the factors that increase the risk of having this condition include:

• Family history of the disorder
• History of severe Premenstrual Syndrome in the family
• SAD or Seasonal Affective Disorder
• Severe depression
• Stress

Premenstrual Dysphoric Disorder Signs and Symptoms

The symptoms of PMDD arise after ovulation (the middle of every monthly cycle) and worsen during the week or a few days before menstruation. These tend to disappear by themselves a few days after the beginning of menstruation. A PMDD patient displays the symptoms in this pattern almost every month. The condition can also cause various flu-like symptoms.

Following symptoms are studied when diagnosing PMDD. All the symptoms may not be present in the patient at a specific time and they may also vary from one month to another. According to the DSM IV criteria, PMDD can be confirmed when at least five of these symptoms are present (including a minimum of one symptom from the first four).

• Deep sadness and despair
• Intense tension and anxiety
• Panic attacks
• Intense sensitivity to criticism and rejection
• Rapid, severe mood changes
• Crying uncontrollably several times for short periods
• Severe anger and irritability
• Increased interpersonal conflicts
• Reduced interest in relationships and daily activities
• Chronic fatigue
• Difficulty in concentrating
• Forgetfulness
• Increased craving for some certain foods
• Insomnia (inability to sleep) or Hypersomnia (excessive sleep)
• Sensation of being overwhelmed and out of control

PMDD is also manifested through some physical symptoms, which include:

• Breast tenderness and swelling
• Gastrointestinal upset
• Weight gain
• Acne
• Headaches
• Heart palpitations
• Muscle and joint pain
• Swelling of the face and nose
• Bloating

Premenstrual Dysphoric Disorder in Teenagers

According to many studies, teenagers are more prone to this disease. The offset of this disorder often occurs during adolescence. Young girls suffering from severe PMS often develop the symptoms of PMDD. In around 5% of all teenagers, this condition interferes many of their daily activities.

Premenstrual Dysphoric Disorder Prevention

The precautions one can take to prevent this ailment include:

• Following a nutritional and well balanced diet plan including lots of vegetables, fruits and whole grains
• Exercising a lot
• Drinking plenty of water
• Managing stress
• Avoiding caffeine, sugar and alcohol

Premenstrual Dysphoric Disorder Tests and Diagnosis

Before actually diagnosing PMDD, a thorough physical examination of a patient is carried out to eliminate the possibility of some underlying psychiatric condition (which might be causing the symptoms). It is also ensures that the symptoms are not a result of any other physical causes.

Once the possibility of a psychiatric and physical disorder has been ruled out, the patient is asked to make a chart of the daily symptoms experienced by her over a period of at least two months. The charting is done to make sure that the occurrence of the symptoms is actually related to the menstrual cycle and are also recurring in nature. A woman is positively diagnosed with PMDD if she experiences the symptoms from the time of ovulation to the first few days of menstruation. Diagnosis can also be confirmed if these symptoms tend to recur almost every month.

Premenstrual Dysphoric Disorder Treatment and Medication

The treatment for PMDD focuses on preventing its symptoms. The various treatment options used for remedying the condition include use of:

Antidepressants

Various PMDD symptoms including fatigue, sleep problems and food cravings can be cured by using SSRIs or Selective serotonin reuptake inhibitors like Fluoxetine (Prozac), Sertraline (Zoloft) and Citalopram (Celexa). Escitalopram, another similar drug, is also used sometimes for treating the disorder. However, it is generally avoided as it causes various side effects. SSRI medicines can be taken all month or only during the phase between ovulation and period.

However, the antidepressant medicines that are generally prescribed to PMDD patients are not recommended to be used by pregnant and breastfeeding women. Due to this reason, one should receive psychotherapy and natural treatments to handle the symptoms during pregnancy and when breastfeeding. Following a balanced diet and maintaining a healthy lifestyle also helps to keep the symptoms in check.

Birth Control Pills

Birth Control Pills stop ovulation while stabilizing hormone fluctuations. Combination oral contraceptives comprising of Drospirenone are often considered to be more effective that regular birth control pills. These pills lower the levels of estrogen hormone, thus giving relief to PMDD sufferers. At present, various third-generation lower-estrogen contraceptives including Mircette, Ortho Try-Cyclen Lo, Ortho Tri-Cyclen and their different genetic forms are used for the purpose. Yasmin, another new pill, and its lower dose Yaz have been proved to be able to control the problems caused by PMDD.

Hormone Therapy

It is used for completely stopping the menstrual cycle of a woman in severe stages of the condition.

Nutritional Supplements

Daily consumption of 1,000 milligrams supplemental and dietary calcium can help to reduce the emotional and physical symptoms of the disease. Vitamin B-6, L-tryptophan and magnesium are also used for treating the condition.

Psychotherapy

It can help patients to deal with the symptoms of the disorder. The stress reduction, relaxation and meditation techniques taught in Psychotherapy are very effective in treating the condition.

Premenstrual Dysphoric Disorder Natural Treatments

Various herbal remedies are used for effectively controlling both the physical and psychological symptoms of PMDD. Herbal and homeopathic medications are able to restore the hormonal balance of a sufferer. Unlike conventional medications, these remedies do not give rise to any side effects.

Medicinal herbs including Sweet Fennel (Foeniculum vulgare), Lemon Balm (Melissa officinale) and Pasque Flower (Pulsatilla vulgaris) help promote hormonal balance, stability of mood and feeling of wellbeing in women during the premenstrual days.

Premenstrual Dysphoric Disorder Prognosis

Proper treatment can cure this syndrome completely. In most cases, the symptoms do not come back again. in some patients, however, the symptoms tend to persist (although these are not very severe).

Premenstrual Dysphoric Disorder and Premenstrual Syndrome

Premenstrual Syndrome or PMS is a common condition that affects around 75% women. PMS leads to the occurrence of several behavioral and physical symptoms in a recurring pattern during the menstrual cycle. PMDD is a very severe type of Premenstrual Syndrome. Although causing similar symptoms, the condition is found to give rise to much more serious consequences as compared to those of PMS.

Premenstrual Dysphoric Disorder and Menopause

Menopause is the period when a woman has her last menstrual cycle. The average age for menopause is 51 years, although it can occur at anytime between the late 40′s and the late 50′s. Menopause occurs earlier if the ovaries become non-functional or are surgically removed due to some reason. The symptoms of PMDD generally go away after menopause. However, there are many other disorders which lead to similar effects that persist even after menopause. A woman may experience symptoms similar to PMDD if she undergoes hormone-replacement therapy after menopause.

Premenstrual Dysphoric Disorder and Endometriosis

PMDD and Endometriosis are often mistaken for each other due to the similarity of the symptoms that they produce in women. These two disorders, however, are different in a few respects. The symptoms of Endometriosis can occur at anytime although they are generally most severe at the time of menstruation. PMDD symptoms, on the other hand, occur only between the time of ovulation and the first few days of period.

Premenstrual Dysphoric Disorder Complications

Women suffering from the disease are more likely to develop other conditions including postpartum depression in case they are not treated properly. Fortunately, PMDD does not cause infertility.

Premenstrual Dysphoric Disorder is a serious chronic condition that requires proper treatment. Women having this condition continue to experience severe symptoms that return every month and hamper their daily life unless diagnosed and treated in time. There are numerous support groups that provide guidelines to PMDD patients about how to cope with the symptoms. If you have a PMDD sufferer in your home, get early medical treatment and support to ensure faster recovery for your patient.

References:

http://www.mayoclinic.com/health/pmdd/AN01372

http://www.thirdage.com/hc/c/premenstrual-dysphoric-disorder

http://psychcentral.com/lib/2009/premenstrual-dysphoric-disorder/

http://www.nlm.nih.gov/medlineplus/ency/article/007193.htm

http://health.nytimes.com/health/guides/disease/premenstrual-dysphoric-disorder/overview.html

Is an acute pelvic pain and small leakage of urine or stool affecting your life? You are likely to be suffering from Pelvic Floor Dysfunction (PFD), a condition that you should know all about – including its causes, symptoms, diagnosis and treatment.

Pelvic floor dysfunction Definition

It is a condition where the muscles of the pelvic floor become very loose, or tight, causing a host of other problems within the pelvis. Pelvic floor describes a network of ligaments, muscles and other tissues that protect the organs inside the pelvis including bladder, rectum, vagina and prostate. In this condition these tissues may become affected to a great or small extent, causing acute discomfort in the pelvic region.

Pelvic floor dysfunction Incidence

This is not exactly a gender-specific condition, although a larger percentage of the affected population consists of women. Men and children may also develop this pelvic disorder. 70% of patients with interstitial Cystitis have pelvic floor dysfunction, which is popularly known as Prostatodynia in men.

Pelvic floor dysfunction Symptoms

Some of the common symptoms of this condition, observed in both men and women, are:

Picture 1 – Pelvic floor dysfunction

Fecal incontinence

It is the inability to control the regular bowel movements, causing accidental leakage of stool or feces from the rectum. Patients may even feel that they cannot have a complete bowel movement at one time. They always have a tendency to have several bowel movements within a short span of time. In some cases, affected individuals may lose complete bowel control.

Urinary incontinence

Patients may also suffer from involuntary leakage of urine due to loss of bladder control. These frequent episodes of urine leakage may even occur while sneezing, laughing or lifting a heavy object. There is recurrent urgency to urinate despite low urine output or none. Intense pain during urination can often be quite distressing.

Pelvic organ prolapse

It is a common symptom in women where the pelvic organs such as uterus, urinary bladder or small bowel may fall down or slip out of place (prolapse). Such organs generally protrude through the vagina or the rectum, putting extensive pressure on the lower abdomen.

Sexual dysfunction

Some patients may experience difficulty and pain during an intercourse or sexual stimulation.

Defecatory dysfunction

It is an abdominal condition that develops into chronic constipation when there is a prolapse of the rectum. This makes it difficult to empty the bowels completely.

Chronic pelvic pain

There may be persistent pain in the pelvic region, the area below the bellybutton and between the hips. This is a common symptom in women that might last longer than six months.

Vulvodynia

Chronic pain may develop around the vulva, the opening of the vagina, without any definite cause. Patients may experience burning sensation and find it bothersome to sit at one place for longer duration.

Pelvic floor dysfunction Causes

It is generally not a gender specific disorder, and can affect both men and women. Major causes of this dysfunctioning of the pelvis are normally gender-specific. However, there are certain causes that are common to both the genders.

Causes of PFD in Men

In men, Non-bacterial Prostatitis is generally only one cause for this particular pelvic condition. It is a chronic disorder that causes long-term pain due to inflammation of the prostate gland or other sections of the lower urinary tract or genital area.

Causes of PFD in Women

Some of the possible causes in women, especially in new mothers, are:

Vaginal delivery

Pelvic floor muscles may get weakened in some women after delivery that specifically takes place through the vagina. This is the most common cause of urinary incontinence.

Menopause

During this phase, production of estrogen may decrease in many women, causing erosion and loosening of the pelvic floor muscles and connective tissues. This in turn increases susceptibility of these muscles to decreased elasticity and suppleness.

Pelvic inflammatory disease

It is an inflammation of the reproductive organs such as uterus, fallopian tubes, ovaries or cervix, owing to some form of sexually transmitted disease (STD). Bands of scar or fibrous tissue may develop in these organs, causing acute pelvic pain.

General Causes of PFD

Some of the common general causes are:

Obesity

Excess accumulation of body fat may have an adverse effect on the functioning of the pelvic floor muscles. Increased body weight causes heaviness and builds up intense pressure within the pelvis.

Urinary tract infection

Continuous leakage of the bladder or vaginal prolapse can be associated to a host of bacterial infections that may occur anywhere along the urinary tract including ureters, urethra and kidneys.

Irritable bowel syndrome

This particular intestinal disorder may lead to abdominal cramps and changes in bowel movements. Due to this intermittent stress on the rectum, the pelvic floor muscles go through excessive strain.

Endometriosis

In this condition, the tissue that lines the uterus grows outside it and attaches itself to the pelvic organs such as the ovaries, and fallopian tubes. This tissue gets further thickened and breaks down, causing excess bleeding and exerting pressure on the pelvic floor muscles.

Interstitial cystitis

Chronic inflammation of the tissues of the bladder wall may affect the muscles of the pelvis, causing extreme pelvic pain and urinary urgency.

Trauma

Past injuries, below the waist or involving the spine, may also result in weakening of the pelvic floor muscles.

Poor posture

During anterior posterior tilt, the pelvis is highly tilted in the forward direction. This causes the lower back to extend to a larger degree. This is a typical cause of protrusion of the pelvic organs, especially in pregnant women and obese men.

Tail bone/Coccyx fracture

Coccyx is the lowest section of the backbone or spine and is composed of four fused vertebra, or spine bones, that curves gently into the pelvis. A broken tail bone is actually a fracture of the coccyx that may injure the muscles of the pelvic floor.

Joint dislocation

Dislocation of sacroiliac joint, lower back, coccyx, or hip joints may also cause improper functioning of these pelvic muscles.

Pelvic floor dysfunction Diagnosis

The diagnosis of this disorder involves a thorough physical examination and an extensive analysis of the medical history of the affected individuals. Based on the type of symptoms present in the patients, different diagnostic tests and examinations are conducted.

Defecating proctogram

It is an imaging technique that helps visualize the entire process of defecation in real time with the aid of a fluoroscope. Patients are given an injection of a thick liquid, such as barium, that can be detected using an x-ray image intensifier and a CCD video camera. The movement of the pelvic floor muscles and the rectum are recorded while these patients attempt to empty the given liquid from the rectum. These visual images are then displayed on a monitor or screen that can viewed by the physicians. Individuals who are suffering from this disorder will not be able to relax the pelvic floor muscles and prevent the passage of the liquid from the rectum.

Uroflow test

The flow rate of the urine during voiding or urinating can be determined using this method. Weak flow of urine, or delay in emptying the bladder, indicates malfunctioning of the pelvic floor.

Cystourethroscopy

It is a surgical procedure involving use of a specialized endoscope called Cytoscope to examine the inside of the urethra and bladder. Any abnormality in the urinary tract as well as an enlarged prostate problem in men can be easily assessed with the aid of this particular technique.

Magnetic Resonance Imaging (MRI)

MRI images of the pelvic area could reveal some defect in the reproductive organs of both men and women.

Bladder function test/Urodynamic test

Urinary incontinence can be detected by evaluating the function and efficiency of the bladder. In this process, electrodes are placed in the rectum to measure the electrical activity of the muscles while the bladder fills with urine. Mild or severe involuntary contractions of the bladder can be evaluated by using this out-patient procedure.

Pelvic floor dysfunction Treatment

The treatment of this disorder involves one or more of these treatment options:

Physical therapy

Therapeutic measures primarily aid in relaxing the pelvic floor muscles and avoiding maximum stress on them. Biofeedback is a specialized physical therapy that could help in the improvement of pelvic floor muscle coordination. Various techniques are used in this particular curative method. Some patients are trained to expel a small balloon that is placed in the rectum. Another technique involves placing a small probe in the rectum or vagina. In a few cases, electrodes may also be placed on the anal or rectal region as well as on the abdominal wall. These devices are able to detect any muscle contraction or relaxation and give a visual feedback of the muscular action. This in turn aids the patients to understand the muscle movement and improve on it, thus enabling proper muscle coordination.

Medication

Low-doses of muscle relaxants are often prescribed by physicians to relieve the patients of different symptoms arising from this disorder.

Surgery

Rectal prolapse, a condition causing the tissue lining the rectum to protrude into the anal opening, could be a possible cause for pelvic floor dysfunction. In women, rectocele can also cause loosening of the pelvic muscles where the end of the rectum pushes through the vaginal wall. In such cases, surgery is highly recommended to correct these rectal defects that are generally carried out under general anesthesia.

Pelvic floor dysfunction Exercises

In case of considerable pain, patients must perform few exercises to treat urinary and fecal incontinence.

Picture 2 – Pelvic floor dysfunction Image

• Patients must sit, stand or lie with the knees slightly apart. The pelvic floor muscles under the bladder must be gradually tightened as hard as possible. Affected individuals must stay in this position for sometimes and then relax. This step must be repeated at least five times. This is called slow pull-ups.
• The above exercise must now be performed at a faster pace and must be repeated for at least five times. This particular exercise is known as fast pull-ups.
• Five slow pull-ups and fast pull-ups must be performed in a cyclic order for around 5 minutes.
• The above exercises must be strictly done three times a day.
• Each of the above exercise must be performed for at least five minutes at different positions like sitting, standing or lying down.
• The duration of these exercises should be slowly increased as the muscles become stronger.
• While exercising muscles of the back, thigh, or buttocks should never be squeezed.
• These exercises can also be done while performing various routine activities, such as answering the phone or washing the dishes.
• After several weeks of workouts, pelvic floor muscles tend to become stronger. Patients may find themselves squeezing these muscles for a longer time without feeling any form of strain.
• Physicians generally advise to do these exercises for at least three months. Patients can see the improvement in 8-20 weeks.

Pelvic floor dysfunction is not a fatal condition and can be well managed by performing some simple exercises under the guidance of a good physiotherapist. In case of severe pelvic pain, immediate medical care should be availed to get quick relief from the painful symptoms, affecting the normal life of the patients.

References:

http://en.wikipedia.org/wiki/Pelvic_floor_dysfunction

http://www.fascrs.org/patients/conditions/pelvic_floor_dysfunction/

http://ibs.about.com/od/causesofibs/a/What-Is-Pelvic-Floor-Dysfunction.htm

http://www.ehow.com/about_5512635_pelvic-floor-definition.html

What is Follicular Cyst?

It is an odontogenic cyst that arises from the epithelium of the dental lamina and the tooth bud. It is actually another name for Follicular ovarian cyst and is by far the most frequent type of cyst associated with the ovary.

Its width may range from a few millimeters to 15 centimeters or even 6 inches.

Follicular Cyst Meaning

The ovary is part of the reproductive organ of the female body. It comes in pairs and contains eggs. A very sensitive part of the body, it is prone to several illnesses and complications. This includes ovarian cysts. Fortunately most of the cysts developing in various parts of the ovary, including the follicle, are diagnosed as malign. This means that the cyst can be removed without endangering the life of the woman.

Types of Follicular Cyst

Follicular cyst is not limited to the ovaries and may develop in various parts of the body. According to the region of their development, these cysts are classified into various types like:

Picture 1 – Follicular Cyst

Ovarian Follicular Cyst

It is by far the most known type of follicular cyst in the world. It may develop even when ovulation does not occur. Generally, these cysts do not produce any symptoms and resolve in a few months.

Follicular Infundibular Cyst

This type of cyst occurs in the skin – the overlying portions of the epidermis. It manifests as a single lesion but may soon erupt in multiple forms. Due to its development on various areas, such as face, neck, scalp or trunk it is referred to by various other names, such as:

• Epidermoid cyst
• Epidermal inclusion cysts
• Epidermal cysts

The size of these vesicles may vary from two millimeters to even five centimeters. These growths often appear with a gray, yellowish, or brown cheesy material within it that eventually erupts on its own.

Follicular Cyst Causes

This vesicle normally develops during the time of ovulation. Studies reveal that in some cases the sac of the ovary holding the egg fails to break for some reason. Due to this, it does not open and release the egg. This creates an unhealthy environment within the ovarian area making it an ideal place for cyst growth. Due to the pH level of the ovary, some of the cysts simply dissolve on their own after three months. Some cysts may, however, need to be physically removed to help prevent further complications.

Ovarian Follicular Cyst Causes

Some of the factors that may cause the development of ovarian follicular cysts are:

Hormonal Imbalance

Estrogen and progesterone are the two main hormones produced in the follicles that guarantee a timely release of the egg. If an imbalance of these hormones occurs within the ovary, the follicle would fail to receive the signal that it needs to release the egg. It would grow abnormally in size and continue to become larger until it becomes a fully developed ovarian follicular cyst. It is best to seek medical assistance to maintain normal hormonal balance in your body to avoid getting these cysts.

Unhealthy Diet

Food plays an important role in the development of these growths. As a popular saying goes, “you are what you eat.” Studies reveal that individuals who consume very acidic foods, refined carbohydrates, and processed foods (containing too many toxins) are most likely to suffer from this disorder. The toxins need to be flushed out of the system by supplying the body with enough raw and fresh foods. A failure to do this would result in disorders, such as cysts.

Failed Ovulation Process

As aforementioned, the follicles would most likely develop into cysts if ovulation does not occur. The vesicles are likely to disappear on their own. However, if you feel any pain and discomfort near your ovarian section it is best to see your gynecologist for diagnosis.

Women having a family history of this cyst are most likely to suffer from it. Those having an irregular menstrual cycle and having their period before the age of 11 may also be at a higher risk.

Follicular Infundibular Cyst Causes

The exact cause of development of these vesicles is not known. Exposure to sun is believed to have a role in the occurrence of this type. These cysts are also found to develop more in females and those over 60 years of age. Hence, gender and age are supposed to be possible factors for the growth of these abnormal structures.

Follicular Cyst Symptoms

Some of the common symptoms experienced in this condition are:

Pain

The pain is normally felt near the pelvic region. Pain may be triggered due to the fast growth of the cyst that causes the twisting and eventual disruption of the blood supply. It may soon result in bleeding or rupture of cyst. When this occurs, patients are likely to complain of sharp shooting pain in only one side of the body (where the cyst is most likely to be located). At times, this pain may be experienced in the middle of the menstrual cycle quite close to the time of ovulation.

Abdominal Bloating and Cramps

A feeling of fullness is another common symptom of this condition. It may be experienced due to pressing of the cyst on the pelvic organs. Some women may even suffer from nausea due to the abdominal pressure and intense pain that they may experience.

Irregular Bleeding

Although this is a rare symptom of follicular ovarian cyst, women often complain of extremely heavy menstrual flow with spotting in between their periods. Some would experience a delayed cycle followed by a very painful menstrual flow.

Follicular Cyst Complications

Although most follicular cysts are diagnosed as benign, women suffering from them should not be too comfortable with their condition. It is necessary for them to consult their physician because of the various risks it may bring to their health.

Ovarian Cyst Rupture

This is the most common cause of internal bleeding or hemorrhage in women. Immediate medical care is needed due to the possible complications that may arise from it. The pain experienced by affected woman is unbearable and is not to be ignored.

Increased Growth Size

If the cyst grows in size, it would hamper the function of other organs near the ovary. It may cause severe damage to the ovary and cut off its blood supply. This is a very dangerous situation. If doctors recommend an immediate surgery for the removal of follicular ovarian cyst, patients should go ahead and follow the advice without any hesitation.

Infertility

Not being able to be a mother is the most depressing thing for most women. Doctors and researchers are continuously trying their best to find treatment options that would save the reproductive organ of the woman and remove difficulties in child-bearing. Even in case of small cysts, effective methods would cure the problem and reduce the possibility of infertility.

Cancer

Although rare, there is a possibility of cancerous developments from this condition. Eliminate the risks of infecting other cells of the body and seek medical assistance at the soonest.

Follicular Cyst Treatment

The treatment of these cysts may vary depending on the type that one is suffering from and the health condition of the patient. Know about the common treatment methods for both types of this condition:

Picture 2 – Follicular Cyst Image

Ovarian Follicular Cyst Treatment

This type of vesicles can be cured by:

Surgery

Large cysts, which are in danger of getting ruptured and twisting the ovary, would require surgical removal. If the size of the cyst is less than two and half inches, a Laparascopy may be carried out.

Hormonal Therapy

This is recommended by physicians to make the cysts dissolve naturally. The body has to gain hormonal balance to get rid of the abnormal chunk of cells inside your ovary. Hormonal therapy is likely to restore this balance and regulate hormone levels in the body. Women are generally advised by physicians not to take birth control pills during the hormonal therapy as it would complicate the balance that the treatment is aimed to accomplish.

Healthy Lifestyle

Apart from medical treatment, healthy diet, proper sleep, exercise and stress-management measures should be implemented. Diets rich in fruits and vegetables will also help get rid of the toxins within the body.

Follicular Cyst Infundibular Treatment

The treatment for this type of vesicles includes:

Alkaline Treatment

Those suffering from infundibular follicular cysts may apply alkalize pH water along with sea salt on the affected area to help get rid of it. Lowering the acidity of the skin will help eliminate possibilities of further development of this unwanted cyst. It can help increase capillary action and thus remove problems of obstruction.

Drinking Plenty of Water

Drink enough water to get rid of toxins within the body. You may add sea salt to the water you drink for increased potency.

Hot compression

If you feel pain then a mild hot compress applied on it for 15 to 20 minutes will help relieve you from the discomfort. In any case, it is always best to see a doctor for the appropriate diagnosis.

If you suspect yourself to be experiencing symptoms of this disorder, get in touch with a doctor as early as possible. Timely treatment will help you keep all complications at bay and get cured of this condition faster than you can imagine.

References:

http://en.wikipedia.org/wiki/Follicular_cyst_of_ovary

http://www.emedicinehealth.com/ovarian_cysts/article_em.htm

http://www.nlm.nih.gov/medlineplus/ency/article/001504.htm

http://www.ovarian-cyst-symptoms.info/Follicular-Cyst.html

Breast engorgement is one of the most common breast feeding problems faced by women. Read and know more about the causes, symptoms, diagnosis and treatment of this disorder.

What is Breast Engorgement?

Breast engorgement is a condition where breasts of new mothers become full of milk resulting in pain and inflammation. This problem is quite common during the first few weeks after delivery. During this period, the colostrum changes to mature milk and as a result the breasts of the affected woman become full of milk. In case the extra milk of a woman is not consumed by her baby due to any reason, it can result in breast engorgement.

Causes of Breast Engorgement

Picture 1 – Breast Engorgement

The most common cause of this disorder is an imbalance between the production and the consumption of breast milk by an infant. This can occur when a mother does not feed her child properly at regular intervals. This can be due to lack of time, busy schedule, lack of information or any other problem. It is also observed in cases where there is obstruction in the milk duct of a woman. The obstruction can occur due to extreme pressure on the breasts due to tight clothes or incorrect sleeping positions.

Symptoms of Breast Engorgement

Know about some of the most commonly observed symptoms of this condition:

• The breasts appear fuller and firmer. Some amount of engorgement is observed in every woman. However, if some pain is also experienced due to this condition, it suggests need of immediate attention.
• Swelling, pain and inflammation may be observed at the affected part.
• A low grade fever is also associated with the some cases of this disease. Generally, a rise of about 1 to 2 degrees is observed in the affected woman within the first week of delivery.
• Swollen lymph nodes in the armpit.
• Apoptosis (self-destruction of cells) which further gives birth to decrease in milk production.
• In some cases, flattening of the nipples has also been observed. This results in inefficient nursing.
• Fatigue and loss of appetite had also been observed in some patients.
• In case the engorgement occurs due to an obstruction of milk ducts in a woman, her infant may feel it hard to suck the milk.
• If appropriate measures are not taken to prevent breast engorgement, problems such as Mastitis (breast inflammation) may also occur.

Diagnosis of Breast Engorgement

There are no specific tests for diagnosing this condition. The disease is simply recognized with the aid of associated symptoms.

Treatment of Breast Engorgement

A number of options are available for the treatment of this condition. These include:

Warm compress and hot showers

The most commonly used technique is using a warm compress on the breasts before feeding. This improves the flow of the milk from the breasts. Alternatively, you may also take a shower with warm water before feeding. While practicing this technique you should, however, remember to take the precaution of avoiding heat application for more than 3 minutes as it can have a negative effect on milk flow.

Gentle massage

If you notice that the child is facing problems while sucking the milk, you should press your breasts gently with your hands. This will help release milk in a smooth manner without any accumulation.

Cold packs

In order to relive swelling or pain, you should apply cold packs or crushed ice to your breasts before and after nursing.

Medications

In so far as medication is concerned acetaminophen or ibuprofen is often prescribed to relive painful symptoms associated with engorged breasts. However, you should take these medications only after consulting a doctor.

Prevention of Breast Engorgement

Although fullness of breast is a common problem with most women, does not occur in every one. There are certain precautions that you can follow to prevent your breasts from becoming painful or hard due to engorgement:

Picture 2 – Breast Engorgement Image

• Take care of your first breast feeding session. Feed your child with your breast milk within 2 hours of delivery. You may ask the medical staff in the hospital (where you have given birth) to assist you in this process.
• Avoid skipping your feeding sessions. Instead, feed your child at regular intervals. Generally, feeding an infant with breast milk for 8-10 times a day is sufficient for preventing engorgement. You should also keep a watch on your infant and feed him immediately as soon he gives clues about being hungry. Even if you are a working woman, you should arrange your schedule in a way that lets you incorporate regular feeding sessions in between.
• Never haste during the feeding process. This does not allow the baby to drain the breast properly. If you want to prevent the chances of breast engorgement, you should let your baby suck for at least 20 minutes. Contact a doctor in case you notice that he is not willing to consume for more than 5-10 minutes.
• In case you have skipped a feeding session, press your breasts to get the milk out. You can even make use of breast pumps to drain the milk on particular occasions.
• Avoid feeding your baby with the aid of bottles. Even if feeding with bottle is unavoidable due to emergencies, you should not forget to release your milk by hand press.
• Use the right technique for breastfeeding. This involves sitting in the right position while feeding to encourage the infant to drain out the milk completely. This can prevent breast engorgement.
• Avoid wearing tight clothes or bra. Tight clothes encourage engorgement of breasts by causing obstruction of the milk duct in women. Always wear well fitted bra to support yourself and avoid constriction.

Although a common and discomforting problem, Breast engorgement is not a serious condition. With proper treatment and preventive measures, it can be cured or kept at bay. At times, simple lifestyle changes can help one avoid recurrence or even development of this condition.

References:

http://en.wikipedia.org/wiki/Breast_engorgement

http://kellymom.com/bf/concerns/mother/engorgement/

http://www.breastfeeding.com/breastfeeding-questions/breastfeeding-issues/qa/what-is-engorgement.aspx

http://www.webmd.com/parenting/baby/tc/breast-engorgement-topic-overview

http://www.babycenter.com/0_engorged-breasts_231.bc

Anorexia Nervosa (AN) is a relatively common condition that is said to affect around 1% of all schoolgirls and female university students in the U.S. Read on to know all about the disease, including its causes, symptoms, diagnosis and treatment.

Anorexia Nervosa Definition

It is a kind of eating disorder that makes people suffer from an obsession about their body weight and physical appearance. This has a direct impact on the amount of food that they eat. A person with this condition refuses to eat enough food to attain or retain an extremely thin body shape. This has a direct impact on his/her health.

“AN” is considered to be a psychological condition.

Anorexia Nervosa History

The condition was described as early as 1684. However, it was not until 1870 that it was actually identified and medically reported. In 1873, the disease was named by Sir William Gull who was personal physician to Queen Victoria. But it was much later, in the 1970s, that AN began to be more popularly known. This happened due to increasing media reports about young women who were refusing to eat to maintain an ideal body shape. In 1978, the renowned psychologist Hilde Bruch published “The Golden Cage: the Enigma of Anorexia Nervosa “. The book dealt with cases of 70 young women who actually suffered from this problem. It raised great awareness of the disorder. The untimely demise of renowned singer Karen Carpenter due to AN in 1983, at only 32 years of age, further brought the ailment into public attention.

Anorexia Nervosa Incidence

The condition reportedly arises in one of out of every 200 females. Approximately 1 out of every 2000 males is said to have this disorder. As per statistics, around 90-95% patients of this disease are women.

Who Develops Anorexia Nervosa?

The condition is mainly found to affect adolescent boys and girls who wish to attain an ideal body type as projected by mass media. However, it is found to be more common in women. Females are likely to suffer from this disease more than men. Women from urban societies and upper class, especially those who are educated or working professionals, are more vulnerable to this syndrome.

Picture 1 – Anorexia Nervosa

Although this syndrome tends to arise in pre or post puberty period, it may occur at any time during the life of a person. The problem is primarily evident in teenagers and young adults. However, it may also develop in older individuals. The disorder may affect celebrities, athletes, actors, models, dancers and TV personalities who are forced to maintain a thin figure due to professional requirements. AN can also affect normal people, usually adolescent boys and girls, who try to imitate these personalities.

Anorexia Nervosa Causes

It is not known what exactly causes this condition. The development of this disorder is generally associated to a number of factors, such as:

Genetics

“AN” is supposed to be a hereditary condition. Approximately one fifth of all sufferers of this disease are found to have a relative who suffers or has suffered from any type of eating disorder. People having a family history of anorexia are at greater risk of developing AN.

Stress

Incidents giving rise to extreme mental trauma or stress during pre or post puberty, such as failure in exams or death of a loved one, can also lead to this syndrome.

Hormonal abnormalities

The disorder may also result from abnormalities in Serotonin, a chemical in the brain that is said to cause depression.

Peer pressure

These days, mass media such as TV, lifestyle magazines and newspapers give more importance to body shape. Images in television and magazines portray an ideal body image in the form of a thin, reed-like figure. Such images are glorified and projected as being ideal. People with such figures are portrayed as perfect, successful, more loved and happy. Young individuals, who crave attention, want to attain such a body type to be loved. The problem is compounded by fat people being generally ridiculed for their obese shape. Young boys and girls, even those who are thin, tend to fear that they would be similarly humiliated if they did not look “perfect.” Peer pressure is one of the most major causes for the rise in incidence of AN.

Anxiety disorder

The problem also arises in people who suffer from any type of anxiety disorder as a child.

Anorexia Nervosa Symptoms

The effects of the disease are physical as well as psychological. Some of the classic physical signs and symptoms of this condition include:

• Extreme weight loss
• Dry skin and mouth
• Thinning hair
• Fatigue
• Depression
• Low blood pressure
• Loss of bone strength
• Loss of body fat
• Osteoporosis
• Bloated
• Abnormal cardiac rhythms
• Reduced or absent menstrual periods
• Cold or inflamed hands and feet
• Yellowing of skin that also gets covered with fine hair
• Wasting of body muscles

The behavioral symptoms associated with this disorder involve:

• Have a distorted body image
• Moving food around the plate instead of having them
• Cutting foods into small pieces
• Going to the toilet immediately after meals
• Refusal to eat when other people are present
• Working out all the time, even during sickness, bad weather or an extremely busy schedule
• Using diet pills to reduce appetite
• Using diuretics or water pills to release urine
• Using laxatives and enemas to have a bowel movement

Anorexia Nervosa Diagnosis

The diagnosis for this condition involves observation of the physical symptoms and the behavioral problems associated with AN. Physicians check whether the body weight of the patient is less by 15% or more than normal, keeping factors like age and height in mind.

Doctors must perform tests to find out the actual cause of weight loss and the extent of damage resulting from the problem. Majority of these tests have to be repeated from time to time to check the health of the patient. These medical examinations may include:

• Albumin test
• Electrolyte test
• Total protein tests
• Thyroid function tests
• Urinalysis
• Kidney function tests
• Liver function tests
• CBC (Complete Blood Count)
• Electrocardiogram (ECG or EKG)
• Bone density test to detect thin bones (Osteoporosis)

Anorexia Nervosa Diagnostic Criteria

The Diagnostic and Statistical Manual of Mental Disorders (DSM), brought out by the American Psychiatric Association, clearly mentions the diagnostic criteria for this condition:

• Refusal of the patient to maintain a body weight that is considered to be normal for his/her age and height
• Having a deep fear of becoming fat, even when the person is underweight
• Refusal to understand the gravity of weight loss problems
• Absence of menstrual period for three cycles or more

The abovementioned symptoms should be exhibited by a person before he or she can clearly be classified as a sufferer of Anorexia Nervosa.

Anorexia Nervosa Treatment

The condition has several types of treatment. The type of cure depends on the stage of the condition.

Picture 2 – Anorexia Nervosa Image

If the condition is at its most severe stage and is believed to give rise to life-threatening consequences, it is seen as a medical emergency. This form of Anorexia is seen as life-threatening if the patient is found to suffer from deep psychiatric problems or physiological issues like:

• Heart rhythm disturbance
• Dehydration
• Electrolyte imbalance

The treatment of AN initially involves use of ways that help the patient get back to a normal body weight. Effective recovery from an eating disorder is only possible when the patient achieves a proper body weight and learns about right nutrition. A dietician can guide patients about proper meal plans, calorie requirements and a healthy diet.

In some cases, psychotherapy may also be used to address psychological problems caused by this disorder. Psychotherapy can involve any one of the following:

• Individual therapy – It is highly effective in helping patients deal with the thoughts and behavior associated with the condition. Sufferers can gain self-esteem and deal with negative feelings in a more positive way.
• Family-based therapy – In this process, family members are involved into the therapy to make sure that patients follow a healthy eating habit at home.
• Group therapy – It involves forming interactions between various AN sufferers under the careful observation of experienced mental healthcare providers.

Medicines are not found to be effective in treating this disorder. However, psychiatric drugs and antidepressants may help cure associated mental ailments like anxiety or depression.

Anorexia Nervosa and Bulimia Nervosa

AN is often confused with Bulimia Nervosa (BN), another condition that has been on the rise in the last few years. However, unlike AN where patients go on self-starvation mode, BN is characterized by episodes of binge-eating followed by periods of self-induced vomiting. AN patients tend to be good students, perfectionists and almost always obey their parents. However, those suffering from BN are overweight, eat high amounts of food and suffer from guilt and depression at a later stage. This mental anxiety makes them force themselves to purge. On the other hand, Anorexia Nervosa is typically characterized by reduced food intake, rigorous exercise and the fear of becoming fat.

How to Prevent Anorexia Nervosa?

There is no definite preventive measure for this disorder. Those noticing their friends or family members exhibiting signs of AN should take them to any primary care physician. A proper diagnosis can help identify this condition and prevent its gradual deterioration. Therefore, although the disorder cannot be prevented from developing its deterioration can be checked with early medical assistance.

Anorexia Nervosa Risk Factors

Certain factors can enhance the risk of getting this condition. These include:

Genetics

Some people are genetically predisposed to this ailment. Alterations in some genes can make some people more susceptible to this disorder than others.

Adolescence

Generally, adolescents and teenagers are found to be at greater risk of having this condition. This occurs partly due to hormonal changes that their bodies go through at the time of puberty. It also arises as a result of increased exposure of an insecure mind to an ideal body shape as projected by media and peers.

Gender

As already mentioned, females are found to be at greater risk of suffering from this disease. However, many boys are also being increasingly found to be exhibiting signs of AN due to increasing social pressures.

Anorexia Nervosa Complications

AN can give rise to a number of complications, such as:

• Anemia
• Cardiac problems
• Kidney ailments
• Electrolyte abnormalities (such as low sodium, potassium or chloride levels in blood)
• Absence of menstrual periods (in females)
• Reduced testosterone level (in males)
• Gastrointestinal problems (such as nausea, bloating or constipation)
• Loss of bones, leading to heightened risk of fractures in later stages of life

In acute cases, the condition may also result in death of sufferers. This may occur due to electrolyte imbalance in the body or abnormal cardiac rhythms (Arrhythmia).

Health Problems Associated With Anorexia Nervosa

A host of physical as well as mental disorders are associated with this ailment. These include:

• Anxiety disorders
• Depression
• Drug abuse
• Obsessive-compulsive disorders
• Personality disorders

If the condition leads to severe malnourishment of the patient, vital organs of the body (such as the kidneys heart and even the brain) may suffer damage. This impairment may not be completely reversible, even when the condition is brought under control.

Anorexia Nervosa Pictures

Take a look at these images to know how patients of this syndrome look like. Feel free to use these Anorexia Nervosa photos for your reference.

Anorexia Nervosa is a complicated condition that often takes a long time to recover from. Even though its symptoms may subside, patients of AN can be vulnerable to the disorder and may suffer from its recurrence during periods of acute stress. Due to this reason, it is recommended for AN patients to undergo periodic checkups or therapies during stressful periods. Proper eating habit and constant monitoring have been found to be helpful in curing even very serious cases of this disorder.

References:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001401/

http://www.medicinenet.com/anorexia_nervosa/article.htm

http://www.umm.edu/altmed/articles/anorexia-nervosa-000012.htm

http://www.mayoclinic.com/health/anorexia/DS00606

What is Nabothian cyst?

Nabothian cyst is lumps or cyst filled with mucus that grows on the cervical surface. It is normally 2 to 10 millimeters in diameter and consists of mucus that is amber yellow or pale yellow in color.

Picture 1 – Nabothian Cysts

Generally Nabothian cyst is formed with the re-growth of new tissue on cervix after childbirth. The new tissue closes the openings of the Nabothian glands and traps their mucous discharge in tiny follicles under the skin. Nabothian cyst is frequently found on a woman’s cervix after childbirth. They are also sometimes found in menopausal women with thinning cervical skin. In some rare occasions, Nabothian cyst is connected to chronic cervicitis, a form of long term cervix infection.

Nabothian cyst is frequently referred to as epithelial inclusion cyst, Nabothian follicles and mucinous retention cyst.

Nabothian Cyst Causes

A woman’s cervix is lined with cells and glands that secrete mucus. The glands can get covered by certain skin cells known as squamous epithelium. This can result in the secretions getting accumulated on the cervix forming smooth, round bumps. These bumps are called Nabothian cysts.

Nabothian Cyst Symptoms

Nabothian cyst appears as small-sized, white, raised bumps that can appear singly or in clusters. The cyst normally does not create any symptoms unless they become exceptionally large.

Nabothian Cyst Diagnosis

Nabothian cyst is mostly discovered by the health care provider during a routine pelvic exam. A small rounded lump or a collection of lumps is discovered on the cervix’s surface. The woman may also notice the cyst herself while inserting a cervical cap or a diaphragm, or when going through a cervix check up. Sometimes, a colposcopy exam may be necessary to distinguish these cysts from other similar bumps on the cervix’s surface. If the cysts have got an abnormal appearance, the doctor may choose to do a biopsy to check for the presence of mucus-producing cancer.

Nabothian cyst Treatment

Nabothian cysts are normally considered harmless and hence they do not require any treatment. The cysts generally go away automatically and in some very rare cases do they pose as a persistent threat. Some women find that these cysts appear and disappear in accordance to their monthly menstrual cycle.

Sometimes Nabothian cysts grow very large in their size and develop secondary symptoms. There are two well-known methods used to remove Nabothian cyst, namely Cryotherapy and Electrocautery. In Cryotherapy, the cyst is frozen using liquid nitrogen. The process of Electrocautery makes the use of a heated probe for destroying the cyst.

Nabothian Cyst Duration

Nabothian cysts are normally considered to be a long term condition. Some of the cysts might get bigger with time.

Nabothian Cyst Prevention

Nabothian cyst is considered a common occurrence for women after childbirth. There is no known ways to prevent the development of these cysts.

When to contact a medical professional

Since Nabothian cyst is quite normal and they do not have any observable symptoms, normally a woman having them is unaware of the fact that she is having them. However, it is advisable for a woman to visit her gynecologist for regular checkups, as these cysts are normally detected during routine pelvic examinations.

Nabothian Cyst Possible Complications

Nabothian cyst can sometimes become so big in size that they can enlarge or block the cervix and make it difficult to conduct a Pap smear test.

Nabothian cyst may bleed if they are tampered with.

Nabothian Cyst Prognosis

Nabothian cyst is not known to cause any harm to the patient; they is in fact a benign condition. However, sometimes new cyst can develop even after the old ones are removed by Cryotherapy or Electrocautery.

Nabothian Cyst Pictures

Here are some images that show the growth of the Nabothian cyst on the cervix.

Picture 2 – Nabothian Cyst Image

Picture 3 – Nabothian Cyst Photo

Nabothian cyst is a benign condition that can be easily dealt with when diagnosed early. These cysts do not normally pose as a serious threat.

References:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002482/

http://en.wikipedia.org/wiki/Nabothian_cyst

http://health.nytimes.com/health/guides/disease/nabothian-cyst/overview.html

http://www.drugs.com/health-guide/nabothian-cyst.html

What Are Inverted Nipples?

It is an abnormal syndrome that is characterized by a nipple that retracts into the breast rather than pointing outwards. In some people, the nipple tends to protrude temporarily on stimulation. In others, there is no inversion with or without the presence of an external stimulus. Both women and men can suffer from this problem.

The condition is occasionally also known as “Invaginated Nipple”.

Inverted Nipples Grades

This disorder is categorized into three grades or varieties, based on factors like:

• The ease of protraction of the nipple
• The degree of fibrosis existing in the breast
• The damage that fibrosis (excess fibrous connective tissue) causes on the milk ducts

Depending on these factors, Inverted nipple can be classified into

Grade 1

In this grade, the nipples that can be easily protracted (pulled out) by pressing the region around the aureola with finger. These types of inverted nipples rarely retract and keep their projections. However, these nipples may occasionally project even without finger pressure or manipulation. In this form, milk ducts are not generally compromised and it is possible to breast-feed. Fibrosis is believed to be minimal or absent in this case and the nipples do not exhibit any soft-tissue deficiency. The mammary gland ducts are usually normal and do not exhibit any sign of retraction. Grade 1 nipples are also known as “shy nipples”.

Grade 2

A Grade 2 nipple can also be pulled out, though not as easily as a Grade 1 nipple. It retracts after releasing the pressure. It is possible to breast-feed with this type of a nipple though it may be a very difficult process. However, some women find breastfeeding impossible with Grade 2 nipples. These types of nipples have a mild degree of fibrosis. There is moderate retraction of the lactiferous ducts. However, they do not need to be cut for releasing fibrosis. A histological examination of these nipples usually displays rich Collagenous Stromata along with lots of smooth muscle bundles. Most women with inverted nipples suffer from Grade 2 of this problem.

Grade 3

In this grade, the nipple is found to be acutely inverted and retracted. It can rarely be pulled out with physical pressure and needs surgical assistance to be protracted. Grade 3 women often have narrowed down milk ducts and find it impossible to breast-feed their infants. They may also suffer from rashes, infections or difficulties with nipple hygiene. In such women, lactiferous ducts are found to be short and seriously retracted. There is severe fibrosis involved. There is noticeable insufficiency in the amount of soft tissue in the nipple.

Inverted Nipples Causes

Nipples as well as the small circular region around them (known as the “areola”) may differ in color, shape and size. In normal cases, nipples are flat, bulging and slightly puffy. Nipples can undergo a change due to a variety of reasons. The most common causes of the condition include:

Congenital problems

In many cases, individuals are seen to be born with this condition. 10-20% of all women are supposed to be born with this problem. The most common type of nipple variations in women born with the problem are caused by a wide areola muscle sphincter or short ducts.

Weight Loss

The condition may also occur after an episode of sudden and noticeable loss of weight.

Breast disorders

Cancerous conditions affecting the breast, such as Inflammatory Breast Cancer (IBC), Paget’s disease and breast carcinoma, may also result in this problem. Inflammatory or infectious condition of the breast, such as mastitis, mammary duct ectasia or breast abscess can also give rise to this condition.

Breastfeeding

Some nipples get inverted after breastfeeding due to accumulation of scar tissues in the milk ducts. Breastfeeding is one of the three main causes of nipple inversion after birth, the other reasons being constricted milk ducts and absence of adequate skin at the base of the nipple.

Genetic variation

A change of nipple shape may also occur due to genetic disorders like Chromosome 2q Deletion, Fryns- Aftimos syndrome, Kennerknecht-Sorgo-Oberhoffer syndrome or Weaver syndrome. A congenital disease of glycosylation type 1 L & 1A can also result in this problem.

Trauma

Trauma or injury caused to the nipples by disorders, such as fat necrosis, may also lead to this condition.

Gynecomastia

This condition is characterized by extreme growth of the breasts in males. It generally arises as a result of hormonal imbalance or due to the use of some types of drugs (including certain Antihypertensives).

Holoprosencephaly

This is a congenital abnormality that results from the failure of the prosencephalon to split up into hemispheres at the time of embryonic development. It is marked by more than one midline facial defects, which includes Cyclopia (developmental abnormality characterized by the presence of only one eye) in acute cases.

Monocytosis

It is usually a sign of Monocytic Leukemia and is marked by an increase in the amount of monocytes in the bloodstream.

Some other causes of inverted nipples include:

• Tuberculosis
• Pregnancy
• Recurrent infections
• Post-surgical effects on breast
• Drooping or sagging of the breasts

Inverted Nipples Symptoms

The condition, as the name indicates, is primarily characterized by an inversion of the nipples. The nipple is indentured into the areola but often tends to pop out during pregnancy or with breast stimulation. It may also give rise to retracted nipples in which the nipple projects above the surface but starts to draw back inwards and does not show up even when stimulated.

There may also be other problems, such as nipple discharge. Clear or discolored discharge (red, green or brown) releases out of the breasts and causes embarrassment. The discharge can also be milky in color, as in Galactorrhea. The discharge may occur from one or both nipples. In some people, discharge may occur only when pressure is applied over the breast. Discharge occurring without any application of pressure is known as Spontaneous Discharge.

In many sufferers, changes may occur in the skin region surrounding the nipples. There may be redness, cracking or tenderness of the skin surface over the nipple. Rashes, dimples or puckers may also arise over the skin surface of the nipple or the darker skin region around the nipple (Areola).

Other changes that can occur in breast include:

• Tenderness in breast
• Increased warmth in breast
• Breast inflammation or irregular lump over breast

Inverted Nipples Diagnosis

The initial diagnosis of this condition involves performing a physical examination and considering the medical history of the patient. In case of a nipple discharge, health care providers may also conduct other diagnostic tests to detect the possible causes. These include:

• Thyroid function tests
• Prolactin level tests
• CT scans
• MRI scans, to detect Pituitary tumor

Some other tests that can be conducted involve:

• Ultrasound of the breast
• Mammography
• Skin biopsy (if Paget’s disease is suspected)
• Ductogram or Ductography, an x-ray examination which involves injecting Contrast dye into the affected milk duct

In some people, a biopsy of the breast may also be carried out. A Breast biopsy is necessary if

• A lump or mass is detected
• If the mammogram is found to be abnormal
• If the discharge occurs spontaneously, without exertion of any pressure on the breast

Inverted Nipples Treatment

The treatment of Inverted Nipples actually depends on the cause of the condition. Surgical repair is the standard mode of cure for many cases of nipple inversion. Nipple discharge, caused by conditions extraneous to the breast, is generally cured by:

• Changing drugs that are possibly causing the discharge
• Curing underlying disorders, such as Breast infections, Pituitary tumors and Hypothyroidism
• Removal of some or all of the ducts of the breast, which can be done after a period of surveillance or even immediately
• Biopsy and occasionally subsequent removal of any unusual findings detected on a mammogram or breast ultrasound

Steroid creams, antibiotic creams and antifungal creams are often used for treatment of any changes occurring in the skin region around the nipple.

Most women suffering from breast discharge and having a normal physical exam, mammogram or breast ultrasound may be followed up by periodic mammogram and physical exam over a period of 1 to 2 years. In some cases, a Ductogram (a special type of breast duct imaging) is performed before any other surgery.

Inverted Nipple Repair

In many cases, it is essential to perform a surgical repair of the inverted nipples. Operative techniques, that are used to rectify inverted nipples, can be classified into two types. One that leaves the milk ducts intact and another that does not leave them intact. In both cases, repair aims at reshaping the nipple and also the areola. Treatment of both can ensure that the nipple projects out of the breast.

Surgical repair improves the physical appearance of the breasts as well as maintains the sensitiveness of the nipples. The method that leaves the milk ducts intact may also help the affected woman preserve her ability to breastfeed.

Inverted Nipple Repair Cost

On an average, Inverted Nipple Repair costs anything from $2000 to $4000 in the United States. Through Medical Tourism, the surgery can be performed in the range of $1500 to $2500 in Australia. The same operation can be also conducted at a much cheaper rate in countries like India and Philippines. The price chart of various countries can be looked up over the internet.

Inverted Nipple Surgery

It is an outpatient method of treatment that is used to repair an inversion of nipples, typically resulting from a deficiency of ducts inside the nipple or a malformation of ducts that pull the nipple inward. Usually regarded as plastic surgery, this operation involves releasing the tissue inside the retracted nipple and letting it heal in an outward posture. This surgical technique is regarded as a simple procedure. However, it is not always a lasting solution for this problem.

Inverted Nipples and Hoffman Technique

The Hoffman Technique is basically a nipple stretching exercise. When performed for several times a day, it helps relax the adhesions at the basal area of the nipple. Even though the method is highly promoted for curing this condition, a study conducted in 1992 suggested something disturbing. According to it, the Hoffman technique and breast shells actually disrupt successful breastfeeding.

Inverted Nipples and Breastfeeding

Women with inverted nipples may suffer from temporary or permanent protraction (coming out) of their nipples during pregnancy, or due to breastfeeding. Majority of women with this condition are able to breastfeed their infants without complication. However, first-time mothers may experience a higher than usual pain and soreness in their breast during nursing. If affected women use proper breastfeeding technique and their infants latch on well to the areola and not the nipple, nursing may not be an issue. Using a breast pump or a similar suction device immediately before a feeding can also help draw out inverted nipples. In some women, use of a nipple shield may also help facilitate breastfeeding. Frequent stimulation in the form of foreplay (such as sucking on the nipple) may also help protract the nipple.

Inverted Nipples and Suction Cups

In some people, mild cases of Nipple Inversion can be cured with an at-home suction cups. This device uses suction power to gradually draw out the nipple. Compared to surgery, this is a simple technique that produces excellent results and allows sufferers to recover rapidly. It is considered to be an inverted nipple correction without surgery. Unfortunately, this is not a full-proof cure. This is due to the fact that in spite of suction treatment most affected people need inverted nipple surgery for correction of one or both nipples.

Inverted Nipple Prognosis

Patients find it relatively easy to recover after an inverted nipple surgery. While the time for recovery actually differs from one patient to another, most people are able to go back to work one or two days after operation. Many patients are able to return to a normal life within two weeks.

Soreness and partial loss of sensations at the surgical spot are the main issues arising in the initial days after surgery. Mild to moderate inflammation generally persist for two to three days after the process but usually disappears within three weeks.

References:

http://www.nipplerepair.com/inverted-nipples.cfm

http://health.nytimes.com/health/guides/disease/nipple-problems/overview.html

http://www.breastfeedingbasics.com/articles/flat-or-inverted-nipples

http://www.mayoclinic.com/health/medical/IM02408