Empowering Women's Health: Insights from a Gynecologist
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– Anovular menstruation is when an egg does not come out of the ovary during the menstrual cycle.
– Chronic anovulation is a common cause of infertility.
– Ovulation is the release of the egg from the ovary, typically on day 14 of a 28-day menstrual cycle.
– Ovulation is regulated by hormones including gonadotropin-releasing hormone, follicle-stimulating hormone, and luteinizing hormone.
– After ovulation, the egg travels through the fallopian tube to reach the uterus.
– Progesterone is produced to prepare the uterine lining for pregnancy.
– Low progesterone levels during anovulatory cycles can cause significant bleeding.
– Symptoms of anovulation include missing periods, irregular periods, lack of cervical mucus, abnormal periods (heavy or light), and irregular basal body temperature.
– Girls who have just started their periods and women approaching menopause are at higher risk of anovulatory cycles.
– Other factors increasing the risk for anovulation include excessive exercise patterns.
– Anovulation is caused by an imbalance of hormones involved in ovulation.
– Hormonal disorders and circumstances such as hyperandrogenism, hypogonadotropic hypogonadism, hypothyroidism, hyperprolactinemia, low levels of gonadotropin-releasing hormone, and certain medications can cause anovulation.
– Irregular periods are a common sign, and diagnosis can be done through blood tests and pelvic organ examination.
– Treatment involves lifestyle changes, adjusting current medications, and potentially using a human chorionic gonadotropin injection.
– Treatment options for anovulation include hormonal medications such as clomiphene citrate, follicle-stimulating hormone injections, and gonadotropin-releasing hormone agonists and antagonists injections.
– If these treatments are unsuccessful, options such as intrauterine insemination or in vitro fertilization are available for those trying to conceive.
– Anovulatory bleeding can cause irregular, prolonged, and heavy bleeding.
– The return to ovulation after an anovulatory cycle can vary from person to person.
– Women with an anovulatory cycle typically do not experience ovulation but may experience bleeding due to hormonal changes.
– Lifestyle modifications can help naturally treat an anovulatory cycle, such as improving sleep quality, balancing hormones naturally, and adjusting dietary habits.
– Ovaries play a role in menstruation and conception by producing eggs and hormones.
– Around 1000 immature eggs are lost every month during menstruation.
– There are four phases of ovulation: menstrual phase, follicular phase, ovulatory phase, and luteal phase.
– Ovulation can be induced using medication like Clomiphene citrate.
– The egg can live for 12 to 24 hours after ovulation, and the fertile window for pregnancy is five days before until one day after ovulation.
– Ovulation can cause abdominal pain and light bleeding. The pain depends on which ovary is releasing the egg.
– Anovulation is when the ovaries don’t release an egg, causing irregular or absent periods.
– It is common for young girls, women approaching menopause, and women with regular cycles to experience anovulation.
– Anovulation occurs when hormonal levels are out of balance.
– Potential causes of anovulation include PCOS, weight issues, over-exercising, thyroid and pituitary disorders, and certain medications.
– Symptoms of anovulation may include heavy periods, irregular bleeding, or no bleeding at all.
– To diagnose anovulation, it is recommended to track your menstrual cycle and discuss any concerns with a doctor. They may also recommend blood tests to measure hormone levels.
– The treatment for anovulation varies depending on the underlying cause. Weight loss or weight gain, depending on whether the person is overweight or underweight, can help regulate periods.
– Fertility drugs may be prescribed if lifestyle changes do not work, and the person is otherwise healthy to conceive.
– Getting pregnant with anovulation can be challenging, but treating underlying conditions such as polycystic ovary syndrome (PCOS) and hypothyroidism can increase the chances of pregnancy.
– In some cases, the assistance of a fertility specialist may be necessary.
– A subseptate uterus is a mild form of congenital uterine anomaly.
– It is often considered a normal variant.
– The condition involves the presence of a partial septum within the uterus.
– The septum does not extend to the cervix.
– The angle of the central point of the septum is acute (<90°).
- The external uterine contour is uniformly convex or has an indentation <10 mm.
- The prevalence of a septate uterus is approximately 55% among uterine anomalies.
- It is classified as a class V Müllerian duct anomaly.
- A septate uterus is associated with subfertility, preterm labor, and reproductive failure in approximately 67% of cases.
- 15% of women with recurrent pregnancy loss have a septate uterus.
- Concurrent renal anomalies may be associated with a septate uterus.
- A septate uterus is considered a type of uterine duplication anomaly that results from the partial or complete failure of resorption of the uterovaginal septum after fusion of the paramesonephric ducts.
- There are different subtypes of a septate uterus, including a partial septum (subseptate uterus) and a complete septum that extends to either the internal or external cervical os.
- Hysterosalpingogram alone has an accuracy of only 55% in differentiating a septate uterus from a bicornuate uterus.
- Ultrasound can show that the echogenic endometrial stripe is separated at the fundus by the septum, which is isoechoic to the myometrium. The external uterine contour should be convex, flat, or mildly concave.
- MRI is considered the preferred imaging modality for diagnosing a septate uterus. On MR images, the septate uterus appears normal in size, and each endometrial cavity appears smaller than a normal cavity. The septum may be composed of fibrous tissue, myometrial tissue, or both.
- The treatment for a septate uterus involves shaving off the septum during hysteroscopy (metroplasty) to form a single uterine cavity without perforating the uterus. Resection of the septum in the uterus has been shown to improve outcomes, with a reported decrease in the spontaneous abortion rate from 88% to 6% after hysteroscopic metroplasty. Differential diagnosis considerations for a septate uterus include a bicornuate uterus, and it is important to differentiate between the two due to different clinical and interventional approaches. Ultrasound or MRI may also be used for diagnosis.
– PCOS is a condition in which the ovaries produce an abnormal amount of androgens, male sex hormones.
– Women with PCOS may have many small cysts in their ovaries.
– The condition can cause problems with a woman’s menstrual cycle and lead to symptoms such as missed or irregular periods, excess body hair, weight gain, acne, and infertility.
– PCOS may be caused by insulin resistance and can run in families.
– Diagnosis of PCOS involves a medical history, physical exam, pelvic exam, ultrasound to check for cysts, and blood tests.
– Treatment typically involves medication to help manage symptoms and prevent health problems.
– Women with PCOS are at higher risk for developing type 2 diabetes, high blood pressure, heart problems, and uterine cancer.
– Seeking medical care is recommended if experiencing missed or irregular periods, excess hair growth, acne, and weight gain.
– Treatment options depend on various factors such as age, severity of symptoms, and desire for pregnancy.
– For those planning to become pregnant, treatment may involve changes in diet, increased physical activity, and medications to induce ovulation.
– For those not planning to become pregnant, treatment may include birth control pills, diabetes medication to lower insulin resistance, changes in diet and activity, and medications to manage other symptoms such as hair growth or acne.
– Cosmetic treatments such as electrolysis and laser hair removal can help manage physical symptoms.