Pregnancy occurs when a man's sperm reaches a woman’s egg. A woman’s ovaries usually produce an egg every month. After a man ejaculates, the semen that is released contains millions of sperm; only one is needed to fertilize a woman’s egg to begin a pregnancy. Contraception or Birth control tries to prevent pregnancy by: 1) keeping the egg and sperm apart, 2) by stopping egg production, or 3) by stopping the combined sperm and egg (fertilized egg) from attaching to the lining of the uterus. According to the WHO, “a woman’s ability to choose if and when to become pregnant has a direct impact on her health and well-being”. The WHO has also acknowledged many advantages to contraception; some include:
Some of the more common methods of contraception are described below. *Remember, no matter what contraceptive you choose, you still need to use a condom to protect you from Sexually Transmitted Infections. LONG-ACTING METHODS Reversible These contraceptives can last from 3 to 10 years. There are two long-acting, reversible methods available, the IUD and the Implant. Because these methods are ‘Reversible’, a woman can become pregnant once she stops using them. These methods also do not interrupt sex. A) Intrauterine Device (IUD) There are 2 different types of IUDs available. 1) The Copper T Intrauterine Device (IUD) is a small, flexible, plastic that is shaped in the form of a “T”; it has copper wire wrapped around it.” It is placed inside the uterus to prevent pregnancy (fertilization), and can stay in for up to 10 years. 2) The Levonorgestrel Intrauterine System (LNG IUD) is also a small, plastic, T-shaped device that is placed inside the uterus. It releases a small amount of progesterone hormone each day to prevent ovulation. The LNG IUD stays in your uterus for up to 5 years. Advantages
Disadvantages
B) Implant The implant is made up of small, plastic rods about the size of a matchstick. The rods are put under the skin in the inside of the arm and they slowly release a hormone called progesterone, which prevents ovulation (the release of an egg from the ovary). They work for up to 5 years. Advantages
PERMANENT Permanent contraception, also called sterilization, prevents all future pregnancies. It is very difficult or impossible to reverse. (You must be sure that you do not want any more children before choosing sterilization as a form of birth control!) C) Female sterilization Female Sterilization also called Tubal ligation or “tying tubes” is an operation to permanently prevent pregnancy. The Fallopian tubes are blocked or sealed to prevent the eggs from reaching the sperm and becoming fertilized. The procedure can be done in a hospital or in an outpatient surgical center. Advantages
Male sterilization or Vasectomy is a form of Permanent contraception for men who will not want more children. It involves an operation to keep a man’s sperm from going to his penis, so his ejaculate never has any sperm in it that can fertilize an egg. Advantages
REGULAR ROUTINE METHODS These contraceptive methods need to be remembered between once a day and once every 3 months. All of them are reversible, do not interrupt sex, and are methods that contain hormones. E) The Pill There are two types of pills available. The Combined Oral Pill (COP) contains the hormones estrogen and progesterone. The Progesterone-only Pill (The POP or Mini Pill) only contains progesterone. A doctor usually prescribes these pills. The hormones inside them block pregnancy by preventing the ovaries from releasing an egg every month (ovulation). A pill is taken at the same time each day for 21 days, and then afterward there is a seven-day break when no pill is taken. During that week you would have a “period-type” bleed, and then you start taking the pill again after those seven days. (Some pills come in “every-day packs”; these packages have 28 pills. There are 21 active pills and seven inactive/dummy pills in a pack; one pill is taken each day without any break.) Advantages
F) The Patch The contraceptive patch is a small sticky patch that releases hormones into the body through the skin to prevent pregnancy. This skin patch is worn on the lower abdomen, buttocks, or upper arms. It releases the hormones progesterone and estrogen into the bloodstream, and blocks pregnancy by preventing the release of an egg from the ovary. A new patch is placed once a week for three weeks. During the fourth week, a patch is not worn, so you can have a menstrual period. Advantages
G) Hormonal Vaginal Contraceptive Ring The vaginal ring is a small, soft, plastic ring that you place inside your vagina. It releases a continuous dose of the hormones estrogen and progesterone (or progesterone only) into the bloodstream to prevent pregnancy. The hormones prevent the ovaries from releasing an egg. The ring is worn for 3 weeks, (every day and night), and is taken out for the week you have your period, and then you put in a new ring after 7 days. Advantages
H) Injection The contraceptive injection steadily releases hormones, which prevents the release of an egg each month (ovulation). There are two types, monthly injectables contain two hormones, (estrogen and progesterone) and are given once per month. There are also Progestin-only injectables (contain only progesterone) and are given every 3 months (eg. Depo-Provera). Advantages
SINGLE USE METHODS These methods have to be used every single time that you have sex. They are hormone free, inexpensive and are widely available. However they may interrupt sex and are not as effective as the previous methods. I) Spermicides Spermicides are sperm-killing substances inserted deep in the vagina, near the cervix, before sex. They work by causing the membrane of sperm cells to break, killing them or slowing their movement; this keeps sperm from meeting an egg. They are available in several forms (foam, gel, cream, film, suppository, or tablet). They are placed in the vagina no more than one hour before intercourse. You leave them in place at least six to eight hours after intercourse. Advantages
J) Diaphragm A diaphragm is a soft latex cup that covers the cervix (plastic and silicone diaphragms may also be available). The rim contains a firm, flexible spring that keeps the diaphragm in place. It is usually used with spermicidal cream or foam to improve effectiveness. Most diaphragms come in different sizes and require fitting by a specifically trained provider. Advantages
CONDOMS K) Male Condoms Male condoms are Sheaths, or coverings, that fit over a man’s erect penis. They work by forming a barrier that keeps sperm out of the vagina, preventing pregnancy. Condoms keep infections in semen, on the penis, or in the vagina from infecting the other partner. Condoms can only be used once. They can also be used with water-based lubricants. Advantages
L) Female condom The female condom is a sheath or lining that fit loosely inside a woman’s vagina; it is made of thin, transparent, soft film. It has flexible rings at both ends. One ring at the closed end helps to insert the condom; the ring at the open end holds part of the condom outside the vagina. They work by forming a barrier that keeps sperm out of the vagina, preventing pregnancy. It can be inserted up to eight hours before sexual intercourse. Advantages
Disadvantages
Tip#1: Anyone can use contraception! A woman can use birth control even if:
Tip#2: The Pill
Tip#3: The IUD:
Tip#4: Female Sterilization:
Tip#5: Injectables Injections are best given into the hip, the upper arm, the buttocks, or the front of the thigh. Contraceptive injections, (like many other forms of birth control that use hormones):
Tip#6: Condoms (Cannot get lost in the woman’s body) Don’ts
I hope these tips on CONTRACEPTION were helpful; Remember, your health is invaluable. By Dr. J. Lawarna Matthew Acknowledgements World Health Organization Contraception Guidelines National Health services Visit https://www.nhs.uk/conditions/contraception/what-is-contraception/ for more information
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Cancer is a condition where cells in a specific part of the body grow and reproduce uncontrollably. Cancer can start almost anywhere in the human body and can spread to other areas (this process is known as metastasis). Normally, human cells grow and divide to form new cells. When cells grow old or become damaged, they eventually die, and new cells take their place. However, when cancer develops, this organized process becomes disrupted, and abnormal, old or damaged cells survive when they should actually die. Additionally, new cells may form when they are not needed. These extra cells can divide without stopping and may form growths called tumors. Many cancers form solid tumors, which are masses of tissue; however, some cancers do not form tumors, such as cancers of the blood, like leukemias. Cancer is a genetic disease; it is caused by changes to our genes that control the way our cells function (especially how they grow and divide). Genetic changes that cause cancer can be inherited from our parents. They can also arise during a person’s lifetime as a result of damage to their DNA. This damage can be caused by certain environmental exposures including: chemicals in tobacco smoke, some infections and radiation (such as ultraviolet rays from the sun). This damage can build up over time; if a cell develops too much damage to its DNA it can start to grow and multiply out of control. There are more than 200 different types of cancer, and each is diagnosed and treated in a specific way. (See image below of some of the most popular kinds of cancer worldwide). RISK FACTORS The list below includes some of the most-studied known or suspected risk factors for cancer.
Cancer can cause many different kinds of symptoms depending on the type of cancer. Some of the most common symptoms of cancer include a slow growing bump or lump on the body, unusual bleeding and rapid unexplained weight loss. If your doctor suspects that you have cancer, he/she may recommend several tests, including blood tests and image tests (x-rays, ultrasound, CT-scans, MRI, etc.). In most cases, doctors need to do a biopsy to diagnose cancer. A biopsy is a procedure in which a sample of tissue is removed; it is then observed under a microscope (by a pathologist) to see if it is cancer. The sample is usually removed by a doctor using a needle, an endoscope or with surgery. After diagnosis, another important step is staging of the cancer. Stage refers to the extent of the cancer, such as how large the tumor is, and if it has spread. The stage of cancer can help doctors understand how serious the cancer is, the prognosis for the patient, and also helps them to make the best treatment plan. TREATMENT Chemotherapy Chemotherapy is a cancer treatment where medication is used to kill cancer cells. There are many different types of chemotherapy medication, but they all work to stop cancer cells from reproducing, which prevents them from growing and spreading in the body. Chemotherapy can be given in several ways. It can be given into a vein (intravenous chemotherapy); this is usually done in hospital and involves medicine being given through a tube in a vein in your hand, arm or chest. Chemotherapy can also be given as tablets (oral chemotherapy); this usually involves taking a course of medication at home, with regular check ups in hospital. A person may be treated with one type of chemotherapy medicine or a combination of different types. Chemotherapy usually requires several treatment sessions, which is typically spread over the course of a few months. Radiotherapy Radiotherapy is a treatment where radiation is used to kill cancer cells. It also damages cancer cells and stop them from growing or spreading in the body. Radiotherapy can be given in three ways. 1) External radiotherapy is where a machine is used to direct high-energy rays from outside the body into the tumor. Most people get external radiation therapy over many weeks, and it is done during outpatient visits to a hospital or treatment center. 2) Radiotherapy can also be given as Internal radiation (brachytherapy), where a radioactive source is put inside the body into or near the tumor. 3) Systemic radiation is another type of radiotherapy, where radioactive drugs are given by mouth or put into a vein, which is then used to treat certain types of cancer. These drugs then travel throughout the body. The type of radiation a person receives depends on the kind of cancer they have and where it is located. Uses and Side Effects Chemotherapy and radiotherapy can be used to:
As well as killing cancer cells, chemotherapy and radiotherapy can damage some healthy cells in the body. Chemotherapy can cause side effects, such as: fatigue, nausea and vomiting, diarrhea and constipation and hair loss. Some side effects of radiotherapy include skin problems such as soreness, redness, and itchiness, blistering and peeling. Tip#1: Healthy Diet Unhealthy diets can increase the risk of cancers including lung, throat, stomach and colon. Foods such as processed meat, and salt preserved food can increase this risk. Although eating healthy cannot absolutely prevent you from getting cancer, fruits, vegetables, and foods high in fiber may decrease your chance. Tip#2: Physical Activity Exercise can lower the risk of cancer (including breast and colon cancer). Exercise lowers hormones such as estrogen and insulin, reduces inflammation, and improves immune function. For sustained health benefits, try to engage in moderate intensity exercises for about 150 minutes per week, spread over 3 to 5 days. Tip#3: Healthy Weight There is consistent evidence that higher amounts of body fat are associated with increased risks of a number of cancers including stomach, pancreas, liver, kidney, thyroid and breast. Maintaining a healthy diet and exercise routine can help you to maintain a healthy weight, and decrease your risk of getting cancer. Tip#4: Smoking and alcohol Smoking has been linked to various types of cancer including cancer of the lung, mouth, throat, pancreas, bladder, cervix and kidney. Chewing tobacco has been linked to cancer of the mouth and pancreas. Deciding to quit smoking tobacco is one of the best health decisions you can make. If you choose to drink alcohol, do so in moderation. The risk of various types of cancer including cancer of the breast, colon, lung, throat and liver increases with the amount of alcohol you drink and the length of time you've been drinking regularly. Tip#5: Screening There are screening tests currently available for cervical cancer, breast cancer, and colon cancer. Women over 20 years should screen for cervical cancer by having pap smears done at least once every 3 years. Women over 49 years should also screen for breast cancer by having a mammogram done every 2 years. Persons over 49 years should also get screened for colon cancer. Tip#6: Coping with Cancer If you have been diagnosed with cancer, this may be a difficult time for you. You may click on the following links to learn more information about coping with this illness. https://www.cancerresearchuk.org/about-cancer/coping and https://www.cancer.gov/about-cancer/coping I hope this information on CANCER was useful; Remember YOUR HEALTH IS INVALUABLE. By Dr. J. Lawarna Matthew Acknowledgements Cancer research UK https://www.cancerresearchuk.org/ National Institute of Health (National Cancer Institute) https://www.cancer.gov/ World Health Organization (Global Cancer Observatory) Stress is how the brain and body respond to any demand. Every type of demand or stressor such as exercise, work, school, major life changes, or traumatic events, can be stressful. Some stress can be beneficial at times; it can provide the drive and energy needed to help people get through situations like exams or work deadlines. Stress can also be life saving in some situations. For example, in response to danger, our bodies react by releasing stress hormones (adrenaline and cortisol) into the blood, which helps us prepare to face a threat or flee to safety.
However, if someone experiences an extreme amount of stress or when the source of stress is constant, then health problems could develop. Untreated chronic stress can result in serious health conditions including, high blood pressure, heart disease, obesity and a weakened immune system. Stress can also contribute to the development of other major illnesses, such as anxiety and depression. It is important to tackle the causes of stress in your life if you can. Avoiding the problems rather than facing them can make things worse. Sometimes it may not be possible to change a stressful situation, so you may need to accept that there is nothing you can do about it and refocus your energies elsewhere. CAUSES Some common causes of stress include:
SYMPTOMS OF STRESS You may feel: Overwhelmed, irritable, anxious or fearful, tired all the time, depressed You may have: Racing thoughts, constant worrying, difficulty concentrating, difficulty making decisions You may experience: Headaches, muscle tension or pain, dizziness, sleep problems You may begin to:
STRESS MANAGEMENT By finding positive, healthy ways to manage stress as it occurs, many of the negative health consequences can be reduced. Below are a few tips to help you manage and reduce stress. Tip#1: Talk with family and friends, and ask for help. Keep in contact with friends and family. A daily dose of friendship is great medicine and talking with someone who cares may be helpful. Also, do not be afraid to ask for help from your spouse, friends, and family. Tip#2: Engage in daily physical activity Regular physical activity can improve your mood and relieve physical tension. Physically active adults have lower risk of depression and loss of mental functioning. It can also be a great source of pleasure too; try walking, swimming, biking or dancing every day. Tip#3: Get enough sleep Inadequate or poor quality sleep can negatively affect your mood, mental alertness, energy level, and physical health. Try to get at least six hours of sleep each night. Tip#4: Slow down and get organized
Tip#5: Give up bad habits Too much alcohol, cigarettes or caffeine can increase your blood pressure. If you smoke, you should make the decision to quit. If you do drink alcohol, do so in moderation. Also, try to maintain a healthy diet. Tip#6: Try not to worry Accept that there are some things that are out of your control, and that you can only do so much about a particular situation. Also, the world won't end if you do not get certain things done as planned, so try not to overthink too much. Tip#7: Learn relaxation techniques Doing things you enjoy is a natural way to relieve stress.
Tip#8: Practice Positive Self-talk Negative self-talk increases stress, while Positive self-talk can help you to calm down and control stress. Practice positive self-talk everyday. For example: Negative to Positive
Tip#9: Try Emergency stress stoppers These are actions to help you defuse stress in the moment. Here are some examples.
Tip#10: Psychological Therapy If you've tried “self-help techniques” and they are not working, or if you have suicidal thoughts, are overwhelmed or are using drugs or alcohol to cope, then you may benefit from psychological therapies like cognitive behavioral therapy (CBT). See a health care provider who may be able to provide a recommendation you. . I hope that these tips on STRESS MANAGEMENT were helpful; Remember, YOUR HEALTH IS INVALUABLE. By Dr. J. Lawarna Matthew Acknowledgements: American Heart Association National Institute of Mental Health Stress Management Society Visit http://www.stress.org.uk/ for more information Uterine Fibroids are tumors or lumps made of muscle cells and other tissue that grow in the wall of the uterus (womb). They are also called leiomyomas or myomas. Fibroids are almost always benign (meaning not cancerous). They can grow as a single tumor, or there can be many of them. The size, shape, and location of fibroids can vary also. A single fibroid can be less than 1 inch in size or can grow to 8 inches across or more. They may be present within the uterus wall, inside the uterus, on its outer surface or attached to it by a stalk-like structure (see image below). Uterine fibroids can grow very slowly or enlarge quite rapidly.
Experts still do not know what causes uterine fibroids but they have been linked to the hormones estrogen and progesterone, which are produced by the ovaries. Fibroids usually develop during a woman's reproductive years (age of 16 to 50) when estrogen levels are at their highest. They tend to shrink when estrogen levels are low, such as after the menopause. It is also thought that fibroids occur more often in overweight or obese women because being overweight increases the level of estrogen in the body. Uterine fibroids are common, appearing in up to 70% of women by age 50. Black women are three to five times at greater risk; they develop fibroids more often and at a younger age than women of other ethnic groups. Persons with a family history of fibroids are at increased risk, whereas women who have children appear to be at a lower risk. SYMPTOMS Most fibroids do not cause any symptoms, but some women with fibroids can have:
TREATMENT The most common method used to diagnose fibroids is ultrasound. If you have fibroids but do not have any symptoms, you may not need treatment. Your doctor may monitor you occasionally to see if they have grown. For women who have symptoms, treatment may depend on the woman’s age, the size of the fibroids and whether or not she wants to become pregnant. MEDICATION 1. Over the counter pain medication such as Ibuprofen and Paracetamol can be use by women with mild abdominal pain. 2. Birth control drugs can be used to help control symptoms in women who experience moderate to severe pain and heavy menstrual bleeding. These may include:
3. Tranexamic acid, Mifepristone and Ulipristal acetate (Ella/Esmya) are also medication used to treat heavy menstrual bleeding in women with fibroids. 4. Gonadotropin-releasing hormone agonists (GnRHa) are drugs that stop the menstrual cycle and can shrink fibroids. They are sometimes used before surgery to reduce the risk of bleeding. Because GnRHa have many side effects, they are used only for short periods (less than 6 months). After a woman stops taking a GnRHa agonist, her fibroids usually return to their previous size. SURGERY For women with moderate to severe symptoms, surgery may be the best form of treatment. 1. Myomectomy Myomectomy is surgery to remove the fibroids from the wall of the uterus. It removes only the fibroids and leaves the healthy tissue of the uterus in place. It is best for women who still wish to have children after treatment or who wish to keep their uterus for other reasons. You can become pregnant after a myomectomy. The surgery can be performed in many ways; it can be major surgery (involving cutting into the abdomen) or performed with laparoscopy or hysteroscopy. After myomectomy it is still possible for new fibroids to grow. 2. Hysterectomy Hysterectomy is a major surgical procedure in which the entire uterus is removed. This surgery is the only sure way to cure uterine fibroids. It is done when a woman's fibroids are large, if she has heavy bleeding, if she is near or past menopause, or if she does not want children. If the fibroids are large, a woman may need a hysterectomy that involves cutting into the abdomen to remove the uterus. If the fibroids are smaller, the doctor may be able to reach the uterus through the vagina, instead. Removal of the ovaries and the cervix at the time of hysterectomy is usually optional. NON-SURGICAL TREATMENT 1. Endometrial Ablation is a procedure that destroys the lining of the uterus. It is used to treat women with small fibroids (less than 3 centimeters). It is not often recommended for women who want to have children. 2. Uterine Artery Embolization (UAE) is a procedure where tiny particles (about the size of grains of sand) are injected into the blood vessels that lead to the uterus. The particles cut off the blood flow to the fibroid and cause it to shrink. UAE can be performed as an outpatient procedure in most cases. The effects of this procedure on fertility are uncertain. Click the link below to learn more about fibroid treatment. https://www.youtube.com/watch?v=eSJ-ztQ97Og (you may skip to 16:52) Tip#1: Maintain a healthy weight, because high levels of body fat are associated with elevated levels of estrogen. Tip#2: Exercise regularly, as this may lower your chances of uterine fibroids. Tip#3: Maintain a healthy diet. Eat a low-fat diet and try to minimize your consumption of red meat and poultry, which may build up fat in the body that could then be used to produce more estrogen. Try to occasionally replace meat with beans and legumes instead. Tip#4: Eat more cruciferous vegetables (these are green leafy vegetables such as arugula, broccoli, cabbage, cauliflower, collard greens, kale and turnip greens), and try not to over cook them. Cruciferous vegetables are rich in nutrients, including several carotenoids and vitamins, and they are a good source of fiber. They may also have a protective effect against fibroids. Studies show that these vegetables contain a group of substances (called glucosinolates), which may have anti-cancer effects as well. Tip#5: For more information about Fibroids and fertility, click the link below. https://fertilityinstitute.com/2016/08/24/do-uterine-fibroids-affect-your-fertility-and-pregnancy/ I hope these tips on UTERINE FIBROID were helpful; Remember, YOUR HEALTH IS INVALUABLE. By Dr. J. Lawarna Matthew Acknowledgement The American College of Obstetrician and Gynecologists The Fertility Institute Visit https://www.acog.org/Patients/FAQs/Uterine-Fibroids for more information. |
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