Sexual Health

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.

Many women experience vasomotor symptoms at or around the time of menopause. Hot flushes and night sweats are considered primary menopausal symptoms that may also be associated with sleep and mood disturbances, as well as decreased cognitive function.

It is easier to understand uterine and vaginal wall relaxation (prolapse) if one has a working knowledge of normal anatomy. The support system of the uterus, urethra, bladder and to some degree the rectum is the vagina, specifically the "fascia".

This depends on the types and the severity of the prolapse. Generally, most women are not aware of the presence of mild prolapse. When prolapse is moderate or severe, symptoms may include sensation of a lump inside the vagina or disturbance in the function of the affected organs, such as: Bladder: stress incontinence, urgency, frequency, incomplete emptying, dribbling, recurrent urine infections.

Perhaps the principal reason male menopause has never been in the public spotlight is because men who experience the characteristic decline in virility during middle age are reluctant or even unwilling to acknowledge the condition.

Our investigation sought to compare changes in sexual function following supracervical hysterectomy (SCH) and total abdominal hysterectomy (TAH).

About 40 years ago, doctors recognized for the first time that the restriction of fetal growth was a phenomenon that not only affected animals, but also human beings.

Questions on Contraception answered by Marta Mendez, MD

Questions on Contraception

Questions on Sex & STD's

If you’re having sex, pay close attention. Sexually transmitted diseases (STDs) are on the rise in this country and it seems that people aren’t protecting themselves properly.

For young people sex is a thrilling subject. They romanticise it, seeing it as a source of joy, but at the same time they can be very afraid of it. By the age of 16 half of the young folk in the world have had sexual intercourse.

The progestogen component of oral contraceptives (OCs) has undergone changes since it was recognized that their chemical structure can influence the spectrum of minor adverse and beneficial effects.

Fibroids and Hysterectomies used to go together like Rogers and Hammerstein. Not anymore. If your physician recommends removing your uterus as the most effective treatment for severe fibroids without first considering less invasive therapies, start singing another tune and get a second opinion!

Ultrasound is widely used to locate and size uterine fibroids. According to the recent literature, 20% of women over the age of thirty-five develop uterine fibroids. Most women with fibroids do not develop problems and this abnormal uterine growth goes unnoticed.

Mrs. Blumenthal*, a 40-year-old G1P1, had young twins at home and was also a full-time student. She delivered her twins in 1992 by C-section after conceiving through IVF. The patient had long-standing endometriosis, treated previously by three abdominal procedures (one laparotomy and two laparoscopies).

The diagnosis of uterine and/or tubal pathology as causes of female infertility represents a fundamental step in the evaluation of the infertile couple. Apart from the invasive diagnostic procedures, several others diagnostic techniques useful to the clinical evaluation of the uterine cavity and tubal anatomy are: transvaginal sonography (TVS), hysterosalpingography (HSG), hysteroscopy and hydrosonography (HDS) and laparoscopy.