Amenorrhea
Two types - primary and secondary amenorrhea
1. Primary amenorrhea: Period does not start even after attaining the age of 16 years.
2. Secondary amenorrhea: Period starts at normal age but stops afterwards.
Amenorrhea is normal only before puberty, during pregnancy, while breastfeeding, and after menopause.
Causes of primary amenorrhea:
Ø Birth defect in development of uterus or fallopian tubes
Ø Genetic disorder
Ø Problems with one of the three organs - the hypothalamus part of the brain, thyroid gland and pituitary gland
Ø Anorexia nervosa (lack of appetite)
Causes of secondary amenorrhea:
Ø Problems with the hypothalamus, pituitary gland, thyroid gland, adrenal glands, ovaries, or other parts of the reproductive system.
Ø Hormonal abnormalities
Ø Stress induced hormonal imbalance
Ø Heavy exercise
Ø Tumor in the reproductive system
Ø Scars on the inside wall/ lining of the uterus after surgery or any other infection
Secondary symptoms of amenorrhea may exist from time to time. But they are very individualized.
Diagnosis:
Primary amenorrhea – Periods have not started by age of 16
Secondary amenorrhea - No menstruation in adult women for last 3 months except pregnancy, breastfeeding and menopause.
Confirmatory tests:
Hormone levels in the blood
Diagnosis for a pituitary tumor by x-ray
Ultrasonography for possible tumors in the ovary or adrenal glands.
Amenorrhea is an abnormality. It is advisable to visit the doctor at the very beginning so that any other complications do not get aggravated.
Sunday, April 6, 2008
Abortion
Abortion or, MTP
MTP stands for Medical Termination of Pregnancy)
Methods used:
Surgical Method (surgical evacuation)
Medical Method (using drugs)
Which method to use depends on length of pregnancy and related complications.
Surgical evacuation of the uterus is the most commonly employed method of abortion (more than 90% of cases).
For 7 – 12 weeks: It is called suction and curettage. A flexible tube is inserted into the uterus by forced opening of the cervix. Using suction pumps and forceps the fetus and the placenta are removed. Mild scraping of the wall of the uterus is the last step.
However, for pregnancies of more than 18 weeks, dilation and evacuation can cause serious complications.
Medical Method (using drugs)
For less than 7 weeks: At this stage suction & curettage can be performed but the chances of continuation of pregnancy increases as the fetus is very small & may be missed during currettage.
Drug M (actual name not disclosed) and Drug P are the two drugs used. They are given orally or vaginally. Drug M blocks progesterone hormone from providing the shield necessary for continuation of pregnancy. Drug P stimulates contraction of the uterus. This combination of drugs causes abortion in about 95% of cases. Drug method is generally used for pregnancy less than 7 weeks old.
For Pregnancies more than 12 Weeks:
This is called second trimester abortion. This requires opinion of two Gynaecologists.
Drug P is used in higher doses. It is given orally or vaginally. Drug P stimulates contraction of the uterus.Once the baby and placenta are out a gentle curettage is done to ensure all the products of conception are removed.
Investigations to be done before MTP:
Hb,Cbc
Blood Group
Urine - Routine & Microscopy
Ultrasonography (to rule out abnormal & ectopic pregnancies)
Complications arising out of an abortion depend on length of the pregnancy and the method used. In general, longer the pregnancy, greater is the risk. In general drug method is riskier than the surgical evacuation. Abortion must be done at authorized clinics and hospitals. This is a very sensitive surgery. It should be done by a qualified Gynaecologist only.
MTP stands for Medical Termination of Pregnancy)
Methods used:
Surgical Method (surgical evacuation)
Medical Method (using drugs)
Which method to use depends on length of pregnancy and related complications.
Surgical evacuation of the uterus is the most commonly employed method of abortion (more than 90% of cases).
For 7 – 12 weeks: It is called suction and curettage. A flexible tube is inserted into the uterus by forced opening of the cervix. Using suction pumps and forceps the fetus and the placenta are removed. Mild scraping of the wall of the uterus is the last step.
However, for pregnancies of more than 18 weeks, dilation and evacuation can cause serious complications.
Medical Method (using drugs)
For less than 7 weeks: At this stage suction & curettage can be performed but the chances of continuation of pregnancy increases as the fetus is very small & may be missed during currettage.
Drug M (actual name not disclosed) and Drug P are the two drugs used. They are given orally or vaginally. Drug M blocks progesterone hormone from providing the shield necessary for continuation of pregnancy. Drug P stimulates contraction of the uterus. This combination of drugs causes abortion in about 95% of cases. Drug method is generally used for pregnancy less than 7 weeks old.
For Pregnancies more than 12 Weeks:
This is called second trimester abortion. This requires opinion of two Gynaecologists.
Drug P is used in higher doses. It is given orally or vaginally. Drug P stimulates contraction of the uterus.Once the baby and placenta are out a gentle curettage is done to ensure all the products of conception are removed.
Investigations to be done before MTP:
Hb,Cbc
Blood Group
Urine - Routine & Microscopy
Ultrasonography (to rule out abnormal & ectopic pregnancies)
Complications arising out of an abortion depend on length of the pregnancy and the method used. In general, longer the pregnancy, greater is the risk. In general drug method is riskier than the surgical evacuation. Abortion must be done at authorized clinics and hospitals. This is a very sensitive surgery. It should be done by a qualified Gynaecologist only.
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