Contraception

Entering the word ‘contraception’ into a search engine will result in over one million hits, from commercial sites to personal homepages and scientific sites. How can the physician find the information s/he is seeking in this overwhelming labyrinth? This review presents a guideline for quick access to practical professional information in the field of contraception and reproductive health care.

The tragic events of September 11 have, to put it mildly, thrown many people off balance. On a somewhat secondary scale, our Society was affected. The 5th Regional Meeting of ISGE in conjunction with the 2nd Brazilian Congress of Gynecologic Endoscopy took place on September 12-15, 2001.

We are entering a time in the development of the discipline of gynecologic endoscopy where there is an opportunity to build bridges, both ideologically and functionally. The science and practice of endoscopy have progressed to the point where core groups of advanced endoscopic surgeons have organized themselves in every corner of the world, not only to exchange knowledge, but also to set goals and plan for the future of the field.

A fibroid is a benign tumor of the uterus. Various terms are used to refer to the tumor, such as fibromyoma, myofibroma, leiomyofibroma, fibroleiomyoma, myoma, fibroma, and fibroid. Of these, fibroid is the most common term, although myoma is more accurate.

What are Uterine Fibroids?The walls of the uterus are made of smooth muscle called myometrium, and the inside lining, with glandular tissue, is called endometrium. “Uterine fibroid” is a slang term for leiomyoma, or often simply myoma. Fibroids are benign tumors made of smooth muscle cells.

Based on the protective effects of intrauterine devices against endometrial cancer, researchers hypothesized that IUDs may also have a protective effect against cervical cancer. However, results from epidemiological and clinical studies to date have been inconclusive.

Steroid hormones have a typical chemical structure. Their mechanism of action is through binding to a specific receptor which in the nucleus of the cell will induce effects at the genomic level.

To report rates of amenorrhea and treatment failure after global endometrial ablation and to estimate the association between patient factors and these outcomes by developing and validating prediction models.

The cervix is the part of the uterus connected to the upper vagina. It is the structure that dilates during childbirth to allow the baby to traverse the birth canal. There are two major types of cancer that develop from the cervix. Squamous cell cancers arise from the squamous epithelium that covers the visible part of the cervix. Adenocarcinomas arise from the glandular lining of the endocervical canal.

The uterus is the pelvic organ that holds the pregnancy and that bleeds each menstrual period. The cervix is that part of the uterus fixed at the top of the vagina. The normal size of the uterus is about that of a lemon. The uterus is divided into three parts. The great bulk of the uterus is composed of smooth muscle and forms a thick uterine wall.

Ovarian cancer, long considered a silent killer because of the lack of warning signs, may not be so silent. A new consensus statement released by the Gynecological Cancer Foundation reveals that women who have developed ovarian cancer may have had common disease symptoms.

The National HPV & Cervical Cancer Campaign is a public education campaign whose goal is to reduce the number of preventable deaths each year by cervical cancer through increased education, outreach and communication between women and their health care providers.

Vitamin E (alpha-tocopherol) is thought to play a role in several stages of carcinogenesis through its contribution to immunocomptence, inhibition of mutation formation and repair of membranes and DNA.

A number of case-control and cohort studies have demonstrated a relationship between high intake of foods rich in carotenoids, Tocopherols, and vitamin C with a reduced risk of certain human malignancies.

Discussion between Mark Perloe, MD, and Bruno Lunefeld, MD, on the risks associated with ovulation induction in breast cancer and ovarian cancer.

Susan is a 58-year-old woman who saw her family physician after a few weeks of mild abdominal pain and bloating. The examination of her abdomen was normal, as was a pelvic and rectal exam. Blood tests for infection, liver and gall bladder problems were also normal.

Human Papillomavirus has emerged as a distinct cause of cervical changes in young women. Its prevalence is continuously growing and is considered at epidemic proportions with 20 million Americans already infected and 5.5 million new cases reported annually. (2) (Center for Disease Control and Prevention, Tracking the Hidden Epidemics., Trends in STDs in the U.S. 2000, Atlanta, Georgia, 2000)

Obstetricians and gynecologists now have a new guide that rates the safety of different contraceptives on a scale of 1 to 4 based on an individual woman’s health status, age, and preexisting medical conditions. The new guide was issued by The American College of Obstetricians and Gynecologists (The College) and is based on the U.S. Medical Eligibility Criteria for Contraceptive Use, 2010.

The first vaccine to prevent human papillomavirus (HPV) and cervical cancer has been licensed, and in future, vaccination may be routinely offered to 10–14 year old girls. HPV is a sexually transmitted virus and some parents may refuse consent for vaccination.

Classification of Heart Diseases in Pregnancy: Incidence: 1% of all pregnancies 1-Rheumatic valve diseases (still the most common in the developing countries.) MS, MR, DM, AS, AR. 2-Congenital disorders (The most common in developed countries.) ASD, VSD, PDA, coarcitation of the aorta, Fallot's tetralogy, Eisenminger syndrome and Marfan syndrome. 3-Others: Arrhythmias, ischemic heart disease and cardiomyopathy.

New guidelines from the American College of Obstetricians and Gynecologists contain recommendations to help prevent, manage and treat blood clots in pregnant women. Blood clots are a leading cause of maternal morbidity, with pregnancy associated with a four-fold increase in the risk of thromboembolism. As such, ACOG released “Thromboembolism in Pregnancy” in the September 2011 issue of Obstetrics & Gynecology to guide clinicians in the prevention, management and treatment of blood clots during pregnancy.

Accurate diagnosis of uterine fibroids is essential in deciding if treatment is necessary, and planning appropriate treatment.n While a physical exam may suggest fibroids, other conditions such as ovarian cysts or adenomyosis may be mistaken for fibroids. For this reason, I routinely do an ultrasound examination at the time of the first visit when a woman has symptoms of abnormal bleeding or cramping, or if I feel an abnormality on examination.

The US Department of Health and Human Services announced on August 1, 2011, that women will receive preventive health services at no additional cost. This historic new guideline is an effort to improve use of preventive services and to reduce health care costs related to preventable diseases and conditions.

Hirsutism: • Not an increase in the number of hair follices but an alteration in their character. • An increase in the transformation of the vellus to terminal hair. • {Androgens will convert lanugo & vellus hair to terminal hair}.

Puberty Dr. Ashraf Fouda Damietta General Hospital Puberty It is a physiological phase lasting 2 to 5 years, during which the genital organs mature. Manifestations of puberty in the female include:

DEFINE Any deviation in normal frequency, duration or amount of menstration in women of reproductive age. NORMAL MENSES Frequency: 21-35 d Duration: 3-7 d Volume: 30-80 ml

• The name of this group of diseases was changed from "venereal diseases" to "sexually transmitted diseases" or "STDs" • Now many persons call them "sexually transmitted infections" or "STIs."

Serial BSU's • -hCG Levels Double Every 48 Hrs • < 66% Rise / 48 Hrs Consistent With Ectopic • Single Determination Not Helpful • Best If Done Within Same Laboratory • Never Rules Out Ectopic

1. Introduction • Pelvic inflammatory disease (PID) is a common cause of morbidity and accounts for 1 in 60 GP consultations by women under the age of 45