Sexual Health

A Randomized Comparison of Group Cognitive-behavioral Therapy, Surface Electromyographic Biofeedback, andVestibulectomy in the Treatment of Dyspareunia Resulting from Vulvar Vestibulitis

Vulvodynia, also known as burning vulva syndrome, is characterised by sensory abnormalities of the vulva and the surrounding tissue, such as an unpleasant burning and itching sensation, or a painful response to a stimulus that is not usually painful such as sexual intercourse or the touch of a cotton swab.

Chronic pelvic pain is generally used to describe a condition of pelvic discomfort not solely associated with menstruation, of more than 6 month's duration, and of a severity sufficient to cause disability in some form.

A 26 year-old woman delivered her first baby, weighing 7 pounds, 6 ounces, without difficulty after 35 minutes of pushing. Although her doctor used perineal stretching (gentle stretching of the area between the vagina and anus) and lubricants during delivery, there was a small, second-degree tear of the vagina and perineum as the baby's shoulders delivered.

Chronic pelvic pain can be defined as cyclic or non-cyclic pain of six or more months in duration that localises to the anatomical pelvis and is severe enough to cause functional disability and require medical or surgical treatment.

Pelvic pain must be diagnosed accurately if the pelvic pain is to appropriately treated. In order to determine the cause of pelvic pain obtain the history of the pelvic pain. An examination is done.

Infertility is a disease that affects the reproductive organs of both men and women. It impairs one of the body’s most basic functions: the ability to have children. Infertility affects about 6.1 million people in the United States alone; ten percent of the reproductive-age population-both men and women.

The International Consensus adopted by the IFFS is an up-to-date focus on modern techniques of Assisted Medical Procreation (AMP), with respect to the reasons for which they have been proposed, the conditions for their realization and their possible risks.

Human beings are remarkably fertile. Most females are capable of conceiving and bearing children beginning in their mid-teen years. While women in industrialized societies usually bear children in their 20s and 30s, women can give birth well into their 40s and beyond.

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Pelvic pain Menopause PMS Infertility Recurrent Pregnancy Loss Prolactin Polycystic Ovaries Pelvic SurgeryEndometriosis Fibroids Reversal of Tubal Ligation Ectopic Pregnancy Multiple Gestation Endometrial Polyps Preimplantation Genetic Diagnosis (PGD)

The purpose of this proposal is to outline suggested clinical pathways for the management of infertility and common reproductive endocrinology problems. The goal is to create an approach that provides the greatest success while using limited resources in the most cost-effective fashion.

All week, you would plan what to wear and think of how it was going to be. Your heart beat with excitement as you thought of what might happen that night... The day of the date arrived, you took special care with your hygiene. You placed perfume behind your knees, etc. made sure you wore your prettiest and cleanest lingerie, and you were ready.. So, was he, as he too planned for this special night. "Pleasurable Anticipation"

A study published in the Journal of the American Medical Association asserts that 43% of American women are experiencing some sort of sexual dysfunction during a 12 months period. As a result, female sexuality has become the new mass media debate. With all that exposure many women are wondering if something is wrong with them? What’s going on?

Designer estrogens, SERMS, are two terms currently being used to describe the actions of a medication that acts as an estrogen on one tissue and an anti-estrogen on others. The ideal estrogen medication would switch of or off the effects of estrogen at different sites in the woman's body.

Does hysterectomy mean a woman's sex life is ruined? Here, Paul Indman, MD, shares his take: orgasm is still in the cards for many women.

Patients with endometriosis can have symptoms varying from constant excruciating pelvic pain to no symptoms whatsoever. Paradoxically, the extent of endometriosis has no correlation to the amount of pain a women will experience. Some women with severe endometriosis do not have any symptoms and may not know they have endometriosis until a pelvic mass is detected on a routine pelvic examination or a problem with infertility is discovered.

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.

Uterine prolapse or dropped womb is a condition in which the uterus drops downward in the pelvis below its normal position. The uterus may drop slightly and remain above the introitus (vaginal opening, grade 1). It may drop further so that the cervix or lower portion of the uterus reach the region of the introitus (grade 2). In the most severe form, the cervix or even the entire uterus bulges out of the introitus (grade 3). Uterine prolapse is the indication for hysterectomy in 16% of cases in the U.S.

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 Pap test is a screening test for malignant and premalignant changes of the cervix. A positive result indicates that there may be a problem and that further diagnostic procedures must be done. The Pap test is not a diagnostic test. It cannot be used to exclude a cancer of the cervix for a person who has symptoms that could be due to a cervical cancer.

The Papanicolaou (Pap) test is the best screening test we have in medicine. Countries that perform the test, like the USA, prevent over 90% of cervical cancers. Pap tests should not detect cervical cancer, because it is the cervical cancer we want prevent. Our goal is to detect pre-cancerous changes, and treat cases in their pre-cancerous state. Earlier findings require less costly and less painful treatment.

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.

When chlamydia or gonorrhea is diagnosed in female patients, obstetricians and gynecologists should also prescribe antibiotics for the male partners. This recommendation comes from The American College of Obstetricians and Gynecologists in efforts to reduce the high reinfection rates associated with these sexually transmitted infections (STIs).

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.

• The following guidance is evidence based. • Developed by the National Collaborating Centre for Women's and Children's Health • Developed at October 2003, valid till 2007 • The grading scheme used for the recommendations (A, B, C, D, good practice point [GPP], and NICE 2002)

• 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."

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

CLINICAL PICTURE •Vaginal Bleeding I. Speculum Examination:The vagina is full with clots, portio exophytic or shows. Carcinoma crater surface bleeding stronger after touching.II. Palpation:Often large tumor that fills the small pelvis.

2. Direct microscopy: >10 WBC in vaginal fluid (in the absence of T.V.): sensitive indicator of cervical inflammation caused by C.T. or N.G., with a high negative predictive value.