endometriosis causes

endometriosis causes

Cause of endometriosis is unknown. Some experts believe that travel a piece of the lining of the uterus once again through the fallopian tubes, and pass in the pelvic cavity (space inside the pelvis that contains the genitals). A small piece of tissue can provide the surfaces of the genitals. During the menstrual period, and the tissue bleed, just like the endometrium inside the uterus. Blood gets trapped in the fabric of place. Can become swollen and the surrounding tissue inflamed. Over time, scar tissue and cysts can form.
Back menstruation theory (transtubal migration theory) suggests that during menstruation some of the tissue during the menstrual support of the fallopian tubes, and implants in the abdomen, and grow. Some experts believe that all women experience some menstrual tissue backup and that the immune system or hormonal problem allows this tissue to grow in the women who develop endometrial cancer. Another theory suggests that endometrial tissue is distributed from the uterus to other parts of the body through the lymphatic system or through the blood system. A genetic theory suggests that it may be in the genes of certain families or that some families may be predisposing factors of the lining of the uterus.
Transplant surgery has also been mentioned in many cases where I found the lining of the uterus abdominal scars, although it has also been found in such scars when accidental implantation seems unlikely. Another theory suggests that remnants of tissue from the fetus when a woman may later develop into endometriosis, or that some adult tissues retain the ability to have the embryo to transform reproductive tissue in certain circumstances.
Lining of the uterus may be caused by something called "menstrual flow back", which in some tissues to speak to women during the period of inflows to the basin. While most women who get some periods of menstrual flow backwards, and not all of these women of the lining of the uterus. Researchers are trying to detect other factors that may cause tissue to grow in some women, but not in others. Lining of the uterus as it happens in rare cases, men also seems it can not be cured by a hysterectomy seems that this idea is very far-fetched.
There is another theory about the cause of endometriosis is that it is hereditary. Can this disease may be hereditary, or it can result from genetic errors, which makes some women more likely than others to develop the condition. If researchers can find the specific gene or genes relevant to the lining of the uterus in some women, genetic testing may allow health care providers to detect endometriosis much earlier, or even prevent it from happening at all.
Researchers to explore other possible causes as well. Hormone estrogen, a hormone involved in the reproductive cycle of females, and it seems to promote the growth of the lining of the uterus. Research is continuing to consider in the lining of the uterus and disease of the endocrine system. Another view is that in some women, their immune system does not remove the menstrual fluid in the pelvic cavity properly, or chemicals made by areas of endometriosis may irritate or promote growth of more areas. Other researchers are studying the role of the immune system to stimulate either the reaction of the lining of the uterus or the lining of the uterus that may be an autoimmune disease. Other research focused on determining whether environmental factors, such as exposure to man-made chemicals, cause inflammation of the lining of the uterus. Further research in an attempt to understand what, if any, factors influence the course of the disease.
Dr. Deborah Metzger has been working on the idea that the lining of the uterus is in fact an allergic reaction. We found that patients with apparently a large number of allergies, including sensitivity to their own hormones such as progesterone, LH, estrogen, and also to candida (yeast). Theoretically, for patients who are sensitive to hormones, estrogen levels can be treated with progesterone or in the form of a "pill" actually cause the lining of the uterus to become much worse, depending on the particular sensitivity to them, and a pill that they take. By addressing these allergies, and sometimes combined with surgical excision, they found that this seems to provide relief.
Another important area of the National Institutes of Health Research is the search for signs of the lining of the uterus. These signs are materials submitted by, or in response to endometriosis that health care providers can be measured in the blood or urine. If you find signs, can health care providers to diagnose endometriosis by testing women's blood or urine, which may reduce the need for surgery.

endometriosis and pregnancy

Endometriosis and Pregnancy

Lining of the uterus and pregnancy are often used in reference to how the lining of the uterus interferes with a woman of the effort to become pregnant. Lining of the uterus is growing cells lining the uterus (the endometrium of the Interior) in places outside the uterus, such as the abdomen - but can transplant cells lining the uterus in any number of places.
These small islands of the "lining of the uterus" (or cells) scatter themselves through the fallopian tube, and planted themselves to the other surfaces such as the uterus and bladder and other pelvic organs.
Endometriosis pregnancy becomes very difficult, partly because of the pain of these cells can cause in general is misplaced, in part because these cells could fill important pathways in and around the uterus.
This increase in the size of tumors, and when the women and menstruation, and growth rates become very painful and inflammed. Often, these growth rates cause scarring, which is painful in itself.
Lining of the uterus and pregnancy-related difficulties in the conception and avoid abortion associated with hormonal imbalance, according to the Harvard-trained physician Dr. John R. Lee.
Women with endometriosis that are able to get pregnant, we find that pregnancy improves the lining of the uterus, and sometimes even causing permanent relief of symptoms.
Most sources of medical information to say that the hormone estrogen helps the growth of the cell, and that "a lot" estrogen encourages "a lot" of cell growth. Since the hormone estrogen causes the cells to multiply, the hormone estrogen is thought to be a factor that causes inflammation of the lining of the uterus.
The hormone progesterone is needed in the body of a woman for a healthy pregnancy in order to survive. , Controls and procedures progesterone of estrogen. May increase estrogen and / or too little progesterone be relevant to the uterus, according to Dr. Lee.
A common question is - does not help to get rid of pregnancy, the lining of the uterus? Again, according to Dr. John R. Lee has decades of experience - with endometriosis in women to delay pregnancy until the age of 30, and they are often unable to get pregnant. When pregnancy occurs, pregnancy often leads to slow progress in the lining of the uterus, and sometimes even treat it.
"Unopposed" estrogen or "estrogen dominance", is linked to the growth of abnormal cells in the lining of the uterus, even in some cases leading to cancer of the lining of the uterus. Surgical attempts to remove these cells lead to divergent results, because some cells will be too small to see or simply removed, and will grow again.
The safest and best way to prevent or slow down the lining of the uterus in the opinion of Dr. Lee is the use of supplementary natural progesterone. Natural progesterone will slow down or stop the proliferation of cells lining the uterus.
He treated a number of endometriosis patients with natural progesterone, and noted a great success. Dr Lee advised women to use natural progesterone cream from day 6 to day 26 of each month, using one ounce (ounce) cream every week. Patients reported that more than one group 4-6 months, and monthly pain slowly began to subside.
Dr Lee recommended this approach since other medical treatments that are not successful and have complications and side effects. Lining of the uterus is healing of the menopause.
This is excellent news, because with the natural progesterone cream, you can do something about the lining of the uterus and improve the experience - without the use of synthetic drugs or surgery.
Today, women should be aware of the side effects that can produce many of the synthetic estrogen that is administered by itself. If progesterone levels are limited, can result in the symptoms such as nausea, vomiting, headache, fluid retention, and weight gain.
Here is a list of recommendations involving changes to diet, supplements, natural progesterone and other proposals - read more about the lining of the uterus. Lining of the uterus and fibroids is mostly because of the "estrogen dominance", according to Dr. Lee.
Estrogen dominance is defined as if there is a lot of the hormone estrogen in the body, but balanced the proper amount of progesterone.
Dr. Lee recommends 2-3% Pacific natural progesterone cream, and this is the model that is the easiest and most effective to use. Each of the creams listed below and the recommended amount of natural progesterone.
This hormone is in the form of topical cream, which is applied directly - and absorbed by - in the skin. Progesterone is a natural bio-identical, which means that it is the same as making your body. It's more secure, and has no side effects when used correctly, they become more effective, and greater benefits and protective gear.
I take this woman is free on the Internet to the hormone profile health test ...
This clinic used the women's safe and effective natural remedies to treat the problems of pregnancy the lining of the uterus and other women health problems.
Once you have taken the hormone profile test, and see what is recommended for you to begin giving your body the support it is likely missing.
Why in the lining of the uterus and hormonal imbalance can be signs that the body does not get the support they need. Most women do not need synthetic drugs to regain their health.
Use the link below to take a free online "Hormone Profile" test. Then select the recommended treatment plan based on your responses appropriate for the symptoms and severity.
Begin today to restore your health and your life ... Read what other women have to say about their success with the elimination of symptoms. What You Must Know what to do now. The woman takes the 'Hormone Health' test here.
Balance your hormones yourself!
Natural progesterone supplementation has very positive benefits and has no known side effects. Women have been used safely over the past 30 years.
Massage 1 / 4 to 1 / 2 teaspoon of cream twice a small per day in any of the following areas: hands, arms and abdomen of the Interior, the face, neck, thighs, buttocks and chests to accommodate the rotating application sites.
And natural progesterone can be absorbed into the bloodstream, on an ongoing basis as the body needs them.
That gives you 20-25 mg of progesterone per 1 / 4 teaspoon of the cream, which is almost the same body you will be producing eggs.
Use for 21 days or as needed. Stopped for a period of 7 days (when you're having your period), and repeat every month.
Review or order from the recommended suppliers of natural progesterone cream.
Progesterone and estrogen hormones and are vital to the life and well-being of every woman. Natural progesterone balances and opposes the effects of unwanted side of estrogen.
If the body experiences a "lack of progesterone," facing hormonal imbalance, which includes the difficulties of pregnancy, the lining of the uterus.
Suppliers recommended on this site produces natural progesterone cream with the amount of natural progesterone (2-3% region) recommended by Dr. Lee.
Women's health for the sale of books - go here to review the books with information on the lining of the uterus and hormonal imbalance.
Most of these books selected are authored by physicians with decades of experience in the use of natural progesterone supplements to eliminate premenopause and menopause symptoms.
You will find many books for women suffering from fibroids, endometriosis and the difficulties of pregnancy.
Will give you the facts on the lining of the uterus and fibroids. It gives detailed information about how to change diet and exercise, stress reduction, vitamins, herbs, and medical and surgical treatments.
Dr. Lark in clinical practice spilled over 28 years, and she authored 11 books in the field of health and healing, and what she has to tell you - you need to know whether fibroids in the uterus and the lining of the uterus, and pregnancy in the uterus and is calling you.
While the names of natural and synthetic hormones are different can be overwhelming at first, persevere with the new vocabulary of terms such as estradiol and cortisol will enable you to communicate more effectively with doctors.
Entire chapter devoted to the benefits of supplements, natural progesterone cream, and it urges women to get the saliva tests for proper evaluation of the levels of the hormone.
Dieting and exercise recommendations is simple, the reasons for the reduction of fat and sugar, meat and vegetables with more vitamins by adding high-quality - read more about the best vitamins for women here.
Lining of the uterus is a painful condition and the lining of the uterus is not clear why - it seems that the disease of the century 20th. Endometriosis Research Center showcase the lining of the uterus, which is a painful reproductive and immunological disease affecting more than 7 million women and adolescents in North America alone, with nearly 80 million people all over the world.
This organization was founded in 1997 to meet the growing need for international disease research, education and awareness and providing support to patients.
Disease can be painful to make the woman in their late teens or unable to care for herself or her family, attend work, school, or social functions, or go about her normal routine.
Lining of the uterus can have a negative impact on every aspect of the lives of women of their self-esteem and relationships have the ability to reproduce. To use natural progesterone cream is a safe alternative! Read more about how they affect the progesterone levels infertility.

normal ovary ultrasound

normal ovary ultrasound

Technology
This test can be done abdominally, transvaginally, or both. And imaging the abdomen tend to give more room for display, but less detail, especially for structures deep in the pelvis and partly hidden by the pubic symphysis. If abdominal scan, a full bladder is a useful and transmits sound very well through the water. In this case, and the bladder as a full voice "window" in the tub. Full bladder also helps to raise the structures of the basin so that from behind the symphysis and the view. If the survey transvaginally, and the full bladder makes the examination more difficult it is to pay the uterus and ovaries and tubes away from the vaginal adapter.
While the implementation of the scan, you may use the vaginal probe as if it were your fingers investigation, and pressure on different structures to see whether the tender or fixed in place. Similarly, you may not use your other had abdominal pressure, and thus structures closer to the investigation vaginalis. This type of dynamic ultrasound scanning can provide information that might miss otherwise.
Ultrasound changes
When you perform this type of scan, and modify various settings of the equipment can have a significant impact on improving the image and clarified in detail.
* An increase in the higher frequency ultrasound will give the best resolution, but poorer depth of penetration. In patients suffering from obesity, and the penetration depth is very important and the decision may need to be somewhat sacrificed in order to see all the structures.
* To increase the gain (amplification) will feature more echoes that appear on the screen, especially at the lower end of the picture, but the results an increase in gain more artifacts. This will reduce the gains and clear up some of the artifacts (especially in the public fibrosis), but with some loss of signal, especially in the depth of the tissue.
* Coordination can be variety of distances. Set focus just below the structure of the deeper you want to see clearly.
* Field of view can be widened or narrowed. And narrower field of vision, and generally the more the image quality was within the field.
Normal uterus
Starting from conception through the development of the uterus in a long axis. You should see the endocervical canal linking the tape lining of the uterus.
Measurement of the uterus in three dimensions, a length, width and depth.
Sweep the uterus both height and presentation, and evaluation of myometrium from the presence of fibroids. Small masses in the cervical fibrosis and cysts Nabothian and not of clinical importance.
Lining of the uterus
Lining of the uterus, or "tape", which differs in texture and thickness with cycyle menopause.
Cervical abnormalities
Fibroid is the most common abnormalities seen uterus using ultrasound. These masses are the latest round in the myometrium or drop out of the myometrium.
Normal ovaries
Normal ovaries appear lateral to the uterus, and differ in their relative position within the basin. In this example, the ovary lies in the position just above the classic ships. In other cases, it may be too far from the ovaries of this site.
During the reproductive years, and the ovaries and usually easily identified by the presence of small ovarian follicles. As mentioned the menstrual cycle, and many of the ovarian follicles are recruited and grow to 8-12 mm in diameter. Then, one dominant follicle is usually selected continues to grow in the 2-4 mm / day, even up to about 25 mm (22-30). Then it releases the egg and the partial collapse, luteum formation of the court.
If there is any internal bleeding in the cavity of bag, and corpus luteum takes on the irregular ", a piece of bread on the World Wide Web" appearance that resolves quickly. This is known as bleeding corpus luteum bag and innocent, though it has a somewhat disturbing emergence of ultrasound.
At menopause, and ovarian follicles are no longer growing and the ovary may become difficult to identify.
Similar results can be seen between the long-term users of the pill by mouth, although the changes are generally not dramatic.
Ovarian Abnormalties
There are a large number of cases of ovarian abnormalities to be seen, including abscesses, and solid tumors, and endometriomas.

Hpv Colposcopy

Hpv Colposcopy

I understand how you feel. After a year and a half ago I went through the same thing. I had a colposcopy and frightened. The nurse gave me ibuprofen after the procedure. I felt that I had menstrual cramps, and it was bitten to sit for a few hours. With it and established procedures to resolve vinegar on the cervix to see abnormal cells. They usually biopsy abnormal cells to see whether cancerous. You have cells taken from 2 areas of my cervix and returned as mild dysplasia, which undestood I am fine / pre-cancerous. The doctor explained it to me, such as transitional cell and non-formal, which can be anything, or it can lead to cancer. Watching nipple (6 months later) came back normal and so did the nipple I had about 5 months. As far as the LEEP, which is whether some cancer cells are ... I think. It takes some of the cones to get out of the cervix to remove the distortions.
The doctor told me my body would fight the human papilloma virus in a similar way it is fighting the flu. My immune system will suppress it. I did some reading and found that vegetables may help as well as exercise. I was going to try anything I could. I did increase my exercise and my vegetables. I did not try vitamin supplements, so I'm not sure if they will work.
I too was so confused about everything. I discovered about a year ago on the HPV pay big screen television. My doctor did not even know that much about it. I had to tell her I found a lot of my information on the Centers for Disease Control Web site, and said she would have to check it out. I hope to be able to answer some of your own.

Adenomyosis Pregnancy

Adenomyosis Pregnancy

Back in early June of this year, I had my yearly gyno exam. I was slightly worried as over the last several months I noted that my periods were getting progressively heavy. My doctor sent me for an ultrasound as she felt as though my uterus might be slightly enlargedEnlarged adenoids
Enlarged prostate.
I went and had the ultrasound and the technician found a large polyp, a diffusely thickened endometrium and a very slightly enlargedEnlarged adenoids
Enlarged prostate uterus. Oh, and one benignBenign ear cyst or tumor
Benign positional vertigo cyst.
My gyn told me I needed to get the polyp removed and also needed to get a D&C. On the day of surgery, my gyn sat down and told me that she thought I may be dealing with adenomyosis. Up until this point, I have to say I had not experienced any discomfort or pain. Again, the only thing I was dealing with were progressively heavy periods. I started to panicPanic disorder
Panic disorder with agoraphobia as she was throwing around words like incurable and hysterectomyHysterectomy
Hysterectomy series... all of this immediately prior to surgery.
I had the surgery in mid-July and have not been the same since. I have a constant dull pain in the middle of my pelvicKegel exercises
Pelvic adhesions
Pelvic inflammatory disease (pid)
Pelvic laparoscopy
Prostatitis nonbacterial
Uterine prolapse area, weird urinary issues, pressure, some spotting, brown discharge, what feels like pressure on my tailbone. I've also been dealing with lots of anxiety over the concern of having chronic pain and having to get a hysterectomy to ever feel like myself again.
Also, I went to see a second doctor who sent me for a follow up ultrasound (after the surgeries in August) and my uterus was not enlarged whatsoever and my endometrium was 6mm. Correct me if I'm wrong, but once a uterus is enlarged by adenomyosis, can it shrink back to normal size? My original gyn told me no.
a. Is it really possible for adenomyosis to progress to no discomfort to chronic discomfort in a matter of 5-6 weeks? I find it highly unlikely, however this is basically what I have experienced.
b. Would pregnancy provide any relief to adenomyosis symptoms? I ask because I am 7 weeks pregnant and I have not witnessed any relief to my symptoms whatsoever.
A couple of thoughts--It is very good that you had the polyp removed--those need to be taken out and biopsied to rule out problems. It also probably permitted the conception, or at least will not cause you problems like a miscarriage, etc.
Adenomyosis is a "pathologic diagnosis" in other words, it can't be diagnosed for certain without removing the uterus--we can only guess that it might be there before surgery, and we usually guess that when we can't find anything else to blame the problems on. It is a variant of endometriosis, and is not cancerous.
I was not there for the discussion that you had with your first doctor, but I would not recommend that you stay with that person, as it sounds like the two of you were on very different wavelengths. Make sure you thoroughly trust your doctor!
Your ultrasound findings could be consistent, as "slightly enlarged" by one tech could be "normal" by another tech. The endometrium should be normal after a D&C, which basically scrapes off the excess tissue.
Finally, there are lots and lots of options for treating heavy periods/bleeding, eg. endometrial ablation, so make sure that all of those have been discussed with you to your satisfaction before you agree to a hysterectomy. Also, make sure you have all the children you want!
As for your new symptoms it is impossible to say at this point whether that is pregnancy-related, or not--only time will tell.

Adenomyosis Uterine

Adenomyosis Uterine

The occurrence of a new menstrual pain periodically in the contract of 40 and can be attributed to inflammation of the lining of the uterus, uterine fibroids, partial or narrowing of cervical adenomyosis. Even now most likely cause of this painful menstrual cramps at this time is adenomyosis. This is sometimes called the International lining of the uterus or the lining of the uterus of the Interior.
Since this is the problem is most likely that your doctor will want to rule in or rule out with tests diagnositic, let us focus on adenomyosis.
What is adenomyosis?
Adenomyosis know the existence of endometrial glands and tissues supporting the muscles of the uterus where it usually will not happen. When that is subject to the growth of thyroid tissue during the menstrual cycle, and subsequent rupture, could be the old tissue and blood can not get out of the muscles, and the flow out of the cervical part of the normal menstruation. This global blood and tissues of the uterus cause pain in the form of menstrual cramps. It also produces abnormal uterine bleeding and some of the blood in the end avoid muscle and results in selecting a location for long periods. For a picture of what looks like a simplified adenomyosis, see pictures () in one location gynecologist.
Adenomyosis occurs more often in the decade of 40's, perimenopausally. Samples in a hysterectomy, can be found on adenomyosis be from 15% to 25% of the time (1, 2). Change in the glandular cells lining the uterus in adenomyosis are often incomplete in the second half of the menstrual cycle (phase luteal), and as a result, adenomyosis may not be very responsive to repression by progesterone. About 50% of adenomyosis are the symptoms although it does not run deeper into the muscles of the uterus, it tends to be more likely to produce symptoms (3, 4). It is also often associated with fibroids (5), and is often associated with other conditions, such as ovarian cysts, and depression and even cancer gynecology (6) that can cause pain in the pelvis.
How is the diagnosis of adenomyosis?
Until recent years, it was said that adenomyosis was diagnosed only by a pathologist examines the sample hysterectomy. Now magnetic resonance imaging (MRI) can accurately diagnose adenomyosis, despite the fact that many doctors feel this is too expensive to use the test routinely. Patterns of adenomyosis as recognized by the before and seems to be magnetic resonance imaging are either scattered in all parts of the uterus (about 66%) or focal lesions (33%) that do not occur only in places and one or two (7). If treatment is not a hysterectomy is being considered in adenomyosis, then MRI should be used to diagnose the disease and if coordination is shown, then surgical amputation of the lining of the uterus without doing a hysterectomy may be considered.
You can use a special ultrasound Doppler color flow can also be used for the diagnosis of adenomyosis (8). Sometimes it has difficulty to distinguish smaller fibroids (smooth muscle) of adenomyosis but are able to capture about 80% of the existing lesions. In-depth discussion on the pre-ultrasound diagnosis of surgical adenomyosis, see (and Presurgical diagnosis of diffuse Adenomyosis by Helen Bickerstaff, MB, BChir.
Uterus and take samples of uterine needle has also been used for the diagnosis of adenomyosis (9), but there seems to be within the clinical process because they miss a lot of areas in the muscle lining of the uterine glands, uterus, where they can find. When used in conjunction with ultrasound, and they may be able to pick areas that are positive (10). The most important concept in diagnosis is to keep in mind that since adenomyosis produce symptoms of pain and / or abnormal bleeding, only 50% of the time (11), just an imaging study found no evidence of adenomyosis, does not mean that the focus is causing the pain. This may be physiological adenomyosis is a condition found in women after pelvic pain but not necessarily the cause of pain, a total of (12).
Caesarean section does not link the issue of in vitro or adenomyosis?
There is some evidence that women who have had Caesarean sections may be at risk was slightly higher (about 2 to 1) for adenomyosis 13). Theoretical basis for this would be when construction operations are performed inside the uterus, and this may allow the lining of the uterus to the bottom of the workbook muscles of the uterus. This is known to occur in the incisions in the abdomen with a caesarean section in the lining of the uterus, which is sometimes mentioned in the cracks and must be eradicated (14).
Another factor that had been proposed as a possible associated factor, causing the adenomyosis is tubal ligation. Under this theory, the natural flow of the cells lining the uterus back in those allocated to the development of women lining of the uterus is blocked due to the process of connecting pipes faloppian. This would increase the pressure in the uterus and the strength of some of these cells to the bottom of the uterine muscles and consequently the development of adenomyosis. There is some support for this concept that women who have adenomyosis may be more frequent a tubal ligation (15).
In one study, there were also a higher incidence of adenomyosis in a woman who had termination of pregnancy (16). Presumably, most of these have been implemented by extending the suction and C, and again we have the concept of the uterus may result in organs in the lining of the uterus that grows deep in the muscles. It is important to remember that there is no pregnancy is also considered a risk factor (17).
What are the treatments for adenomyosis is hysterectomy?
Factors can be released Gonadotropin (for example, Lupron ®) can be used for the treatment of adenomyosis, but the problem is that adenomyosis seems to recur after stopping treatment. It can be used, however, to reduce the amount of adenomyosis and then the rest of the areas can be resected if, for example, a woman wants to get pregnant (18). The device can progesterone contraceptive intrauterine pregnancy can also be used to improve the irregular bleeding and avoid hysterectomy (19).
The question of whether endometrial ablation may be a treatment for adenomyosis, or perhaps even that it could make matters worse? This was seen in one study and found that endometrial ablation was nearly the same success rate improving heavy menstrual periods (approximately 60%) and whether or not adenomyosis was present (20). Thus, if the bleeding is severe, rather than menstrual cramps is one of the major symptoms of adenomyosis, and endometrial ablation should be considered a treatment.
Hysteroscopic endometrial ablation and can sometimes remove the adenomyosis superficial, but in order to remove most of the areas of coordination adenomyosis, which is more in-depth, either laparoscopic or open amputation amputation of myometrial myometrial there is a need to get rid of the symptoms (21).
Hysterectomy is a very successful for the treatment of adenomyosis?
One might think that a hysterectomy would cure the pain in 100% of women with adenomyosis undergoing this surgery, but in fact, studies that do not appear specifically in the treatment of pain rate for women with adenomyosis undergoing hysterectomy. Generally, when the uterus is the pelvic pain in origin, hysterectomy significantly improves pain in 75-80% of cases (22, 23).
Conservative surgery for adenomyosis is about 50% effective (24), so it is still likely that a hysterectomy is more successful in treating this disease, although we do not know with certainty what is the success rate of hysterectomy. Are likely to be a hysterectomy at least 80% or more effective. For all types of chronic pelvic pain, and non-surgical treatment and can be good, although the rate of recovery is not as high as hysterectomy (25).

Treatment for Cervical Dysplasia

Treatment for Cervical Dysplasia

Doctors use a few different approaches doctors when treating cervical dysplasia. The goal of treatment is to remove abnormal areas of the cervix before they possibly become cancerous, but not all cases of cervical dysplasia require medical treatment.
Watching and Waiting
For women with mild to moderate cervical dysplasia, "watching and waiting" is often the prescribed treatment. "Watching and waiting" simply means that a Pap smear or colposcopy/biopsy will be performed every 6 to 12 months to monitor the dysplasia. Mild to moderate dysplasia often resolves itself within two years without medical treatment.
Loop Electrosurgical Excision Procedure (LEEP)
Sometimes called a LLETZ, a LEEP is a procedure that uses an electrically charged wire loop to remove abnormal cells from the cervix. This type of treatment is typically used in cases of high grade cervical dysplasia.
Conization
Conization is a treatment option for some women with high grade cervical dysplasia. Conization removes a cone shaped piece of tissue from the cervix. It is also called a cone biopsy and can be used to help diagnose cervical cancer.
Cryosurgery
Cryosurgery is another method used to treat high grade cervical dysplasia. Abnormal cells are removed by a gas that then freezes them. Cryosurgery is also referred to as cryotherapy.
Follow-Up After Treatment for Cervical Dysplasia
After being treated for cervical dysplasia, following up with doctor's recommendation is essential. The doctor will recommend a follow-up plan based on the patholgy report from the LEEP or conization.
Common recommendations following treatment is a regular colposcopy and cervical biopsy every 6 to 12 months. Cervical dysplasia can return, so following the doctor's follow-up recommendation is very important.

Fertility Problems

Fertility Problems

You may have fertility problems if you have not been able to get pregnant after trying for at least 1 year. Another word for this is infertility. Infertility may not mean that it is impossible to get pregnant. Often, couples conceive without help in their second year of trying. Some do not succeed, but medical treatments help many couples.
Age is an important factor if you are trying to decide whether to get testing and treatment for fertility problems. A woman is most fertile in her late 20s. After age 35, fertility decreases and the risk of miscarriage goes up.
* If you are younger than 35, you may want to give yourself more time to get pregnant.
* If you are 35 or older, you may want to get help soon.
What causes fertility problems?
Fertility problems can have many causes. In cases of infertility:1
* About 50 out of 100 are caused by a problem with the woman?s reproductive systemClick here to see an illustration.. These may be problems with her fallopian tubes or uterus or her ability to release an egg (ovulate).
* About 35 out of 100 are caused by a problem with the man's reproductive systemClick here to see an illustration.. The most common is low sperm count.
* About 5 out of 100 are caused by an uncommon problem, such as the man or woman having been exposed to a medicine called DES before birth.
* In about 10 out of 100, no cause can be found in spite of testing.
Should you be tested for fertility problems?
Before you have fertility tests, try fertility awareness. A woman can learn when she is likely to ovulate and be fertile by charting her basal body temperature and using home tests. Some couples find that they simply have been missing their most fertile days when trying to conceive.
If you are not sure when you ovulate, try this Interactive Tool: When Are You Most Fertile?Click here to see an interactive tool..
If these methods don't help, the first step is for both partners to have some simple tests. A doctor can:
* Do a physical exam of both of you.
* Ask questions about your past health to look for clues, such as a history of miscarriages or pelvic inflammatory disease.
* Ask about your lifestyle habits, such as how often you exercise and whether you drink alcohol or use drugs.
* Do tests that check semen quality and both partners' hormone levels in the blood. Hormone imbalances can be a sign of ovulation problems or sperm problems that can be treated.
Your family doctor can do these tests. For more complete testing, you may need to see a fertility specialist.
How are fertility problems treated?
A wide range of treatments is available. Depending on what is causing the problem, you may be able to:
* Take a medicine that helps the woman ovulate.
* Have a procedure that puts sperm directly inside the woman (insemination).
* Have a surgery that corrects a problem caused by endometriosis or blocked fallopian tubes.
* Have a procedure that might increase the man?s sperm count.
If these options are not possible or don't work for you, you may want to consider in vitro fertilization (IVF). During an IVF, eggs and sperm are mixed in a lab so the sperm can fertilize the eggs. Then the doctor puts one or more fertilized eggs into the woman?s uterus. Many couples try IVF more than once.
Treatment for fertility problems can be stressful, costly, and hard on your body. Before you start testing, make some decisions about what you want to do. You may change your mind later, but it?s a good idea to start with a plan.
* Learn all you can about the tests and treatments, and decide which you want to try. For example, some couples agree to try medicines but don't want surgery or other treatments.
* Find out how much treatments cost and whether your insurance will cover them. If you don't have insurance coverage, decide what you can afford.
Treatments for infertility can increase your chances of getting pregnant. But they also increase your chance of having more than one baby at a time (multiple pregnancy). Be sure to discuss the risks with your doctor.
Fertility problems can put a lot of strain on a couple. It may help to see a counselor with experience in infertility. Think about joining an infertility support group. Talking with other people with the same issue can help you feel less alone.

Ovulation Fertility

Ovulation Fertility

Menstruation, Ovulation, and Fertility

The menstrual cycle is an average of 28 days, although it is normal to vary between 23 and 35 days. The cycle is counted from the first day of your period. Ovulation is the release of the egg from the ovary. This usually occurs at about day 14 of the cycle. Once released, the egg is fertile for up to 48 hours. If the egg is not fertilized, then the lining of the uterus will disintegrate, causing a period. By knowing your menstrual cycle, it is possible to approximate when you will be most fertile.
The Menstrual Cycle
* The cycle begins on the first day of menstruation, when the lining of the uterus (also called the endometrium) is shed as menstrual blood. This is caused by a decline in the hormones estrogen and progesterone, which occurs when the egg from the previous cycle is not fertilized.
* The decrease in estrogen and progesterone causes the pituitary to release follicle stimulating hormone (FSH). The follicles are the structures inside the ovaries that produce the eggs. Each month, one follicle matures to release the egg for that cycle.
* FSH is produced during days 1-13 of the cycle, causing the follicle to produce estrogen. Estrogen causes the endometrium to grow and thicken in preparation for the fertilized egg. The mucus produced by the cervix (usually noticed as vaginal secretions) becomes thin, clear, and watery.
* Rising levels of estrogen cause the pituitary to release luteinizing hormone (LH), which stimulates the follicle to release the egg into the fallopian tube (oviduct). This is called ovulation, and it usually occurs on day 14 of the menstrual cycle.
* After ovulation, the follicle turns into a structure called the corpus luteum, which produces progesterone, causing the lining of the uterus to thicken more in preparation for the fertilized egg.
* If the egg is not fertilized, the production of estrogen and progesterone drops sharply, which triggers the shedding of the endometrium, and the next period.
* If the egg is fertilized, it will usually implant in the uterus within 3-4 days after ovulation.
Fertility
You will be most fertile around 2 weeks after the beginning of your last period. This period of fertility will last for about 2 or 3 days afterwards. It is important to remember that sperm can live inside your body for up to 5 days. This means that if you have unprotected sex 5 days before your most fertile day, you can still become pregnant.

risk of miscarriage

risk of miscarriage

Pregnant women who take certain types of painkillers, including aspirin, are up to 80 percent more likely to miscarry, scientists said on Friday.
But paracetamol is not a risk, regardless of how often it is used during pregnancy, they added.
Researchers in California interviewed more than 1,000 women shortly after they became pregnant and asked them about their reproductive history and their use of painkillers. They found that use of aspirin and other non-steroid based anti-inflammatory drugs (NSAIDs) increased the risk of miscarriage by 80 percent.
The risk was much higher when NSAIDs were taken close to the time of conception. Paracetamol, aspirin, and other NSAIDs such as ibuprofen, all suppress fatty acids which are needed for the successful implantation of an embryo in the womb.
But NSAIDs act on the whole body, paracetamol acts only on the central nervous system, which may explain why it has no effect on pregnancy, the researchers said.
These findings will need confirmation,” said the authors of the research, which appears in this week’s edition of the British Medical Journal.
Meanwhile, it may be prudent for physicians and women who are planning to be pregnant to be aware of this potential risk and avoid using NSAIDs around conception.”
Other studies have shown that pregnant women who take low-doses of aspirin are less likely to have a still-birth or develop the life-threatening condition of pre-eclampsia.

Five Steps For Preventing Miscarriage

Five Steps For Preventing Miscarriage:

As someone who has experienced two early miscarriages, I can say having a miscarriage is really, really hard.

Not only did I have to deal with the feeling of loss, confusion, and sadness. But I also had to work through the resentment towards my pregnant friends that would “fall” pregnant every time they sneezed. It has gotten better over the years, but some days it can still be hard.

That is why I want to share with you five steps you can take (and have been shown through scientific studies) to decrease your chances of having another loss and preventing miscarriage by creating a healthy, baby friendly body.

1. Prepare for Conception:

Preparing ahead of time for your pregnancy is the key to decreasing the chances of a miscarriage. There are steps you can take to reduce the chances of another pregnancy loss, but they must be begun months before you become pregnant again. The first step is to prepare your body with a Fertility Cleanse. Fertility cleansing helps to cleanse the liver of old toxins and excess hormones, rid the uterus of any “old” contents, and cleansing the blood.

2. Eat a Nutrient Dense Fertility Diet:

The next step is to nourish and build up your body to be a healthy, baby-friendly body. This can easily be done through eating a nutrient dense Fertility Diet. What you eat has an impact on:

* The health of your eggs
* Your hormonal balance
* Creates a healthy placenta
* Decreases chances of a miscarriage
* Builds nutrient storage for baby
* Creates healthy reproductive system

You will want to make sure you are eating a fertility diet consistently for at least 90 days before you begin trying to conceive for your best chances of creating a healthy pregnancy. You can learn how to eat a nutrient dense fertility diet here.

3. Build a Healthy Foundation:

One of the major foundational steps to increasing your changes of having a healthy pregnancy is to take some basic vitamins, minerals, and EFA’s. There are specific vitamins and minerals that are necessary for a healthy reproductive system, hormonal balance, and ovulation.

Building a healthy foundation is a two punch step. You will want to be taking a multivitamin and omega 3 supplements. But the key here is not to just take any multivitamin. The best multivitamin to take for fertility and pregnancy is a prenatal multivitamin. But be careful when you are choosing which one to take. NOT ALL SUPPLEMENTS ARE CREATED EQUAL. Make sure you are taking a whole food prenatal multivitamin.

Essential fatty acids are also extremely important for miscarriage prevention through creating a healthy body. EFA’s, specifically omega 3’s, are responsible for many fertility actions. But specifically for aiding in possibly preventing miscarriage - they help to reduce inflammation, aid in hormone balance, and are essential for healthy eggs, just to name a few.

4. Apply Self Fertility Massage:

Another important element of promoting a healthy conception is to increase the circulation to the uterus. From our daily lifestyles of not exercising enough, exercising too much, sitting at a desk all day, pretty much life… can decrease the circulation to the uterus. You see the left leg and the uterus share the same major artery with most of the blood going to the legs, especially when we live in a stressful state of fight or flight ( our bodies sends all the blood to the muscles and brain in preparation for running away or fighting), the circulation to the uterus will be compromised.

Through applying a simple massage method called Self Fertility Massage you are able to increase the circulation to the uterus, clear adhesions, clear congestion (if you have endometriosis, PCOS, clotty and dark periods, and heavy cramps during your period, I am talking to you). You will want to use this technique to your program.

5. Follow a supplement and herbal program:

*Note: These are traditional therapies for miscarriage. There are no guarantees being made that they will stop a miscarriage. Most miscarriages are meant to happen due to issues with the fetus. These herbs will not stop a miscarriage that is meant to happen. They are helpful with miscarriages that are caused from stress, poor diet, trauma, weak uterine muscles, or low progesterone levels. Herbs help to provide extra nourishment and strength needed to nourish a depleted body. If you think you are having a miscarriage consult your doctor right away.

Bed rest and removal of stress factors is the most important first step to take. Get off of your feet.

Vitamin E in doses up to 600I.U per day (use only 50 IU if you have high blood pressure, heart disease, or diabetes)

If your recurrent miscarriages are due to any of the three reasons, there are natural remedies that have been shown to help decrease the chances recurrent miscarriages.

* Immunological
* Hormonal ( low progesterone)
* Chromosomal (you could have some impact, it matters if it is the egg)

Preventing Miscarriage

preventing miscarriage:

There is no time during pregnancy when nutrition is unimportant. Of the nine months of gestation, however, the first three are the most important. During this first trimester the baby grows to about three inches in length and weighs about one ounce. Its sex is determined. It can open and close its mouth and kick and squirm - but as yet is too small for 'mom' to feel it carrying on.

This is the time for mom and dad to visit the doctor and/or midwives to discuss birthing options. (Don't just 'go along' with whatever the doctor does 'routinely'. Do some research now on labor positions, drugs, fetal heart monitoring, episiotomy, labor and delivery place, birth attendants, breast feeding, rooming in, vitamin K, erythromycin or silver nitrate, etc., etc..) A visit to an herbalist is also a good idea - just to make sure all of the nutrients are being supplied in the most easily assimilated form. I generally caution pregnant women away from synthetic prenatal vitamins and iron. Often these vitamins are candy coated and so hard that very few people can digest them. They tend to pass right through - whole. Synthetic iron usually causes bowel movements to turn black. It also causes constipation and/or diarrhea. (A dose to three mg. has been documented as causing death in young children.)

During pregnancy there are some herbs which should not be used at all and several others that may be used very carefully. Most herbs are totally safe when used in moderation and with wisdom. Herbs to avoid are rue and pennyroyal. Both of these herbs can cause miscarriages and many other severe complications of pregnancy. Herbs that need to be used with caution include black cohosh, blessed thistle, blue cohosh, cramp bark, damiana, dong quai, false unicorn, ginseng, licorice, sarsparilla, saw palmetto, squaw vine and yarrow. These herbs all contain steroid-like constituents which could possibly affect the secondary sex characteristics of the baby.

Another herb to be careful with is golden seal ".. one of the active ingredients is hydrastine, which contracts the uterus when taken in large quantities. Don't take more than 1/4 tsp. or one 00 capsule per day." (1)

The first trimester is the period during which most miscarriages occur. Early warning symptoms of miscarriage are cramping and bleeding. Most doctors will say they can do nothing to prevent the inevitable, and while herbs don't always result in a live birth after a threatened miscarriage, the benefits are usually pretty good anyway.

The herbalists rule of thumb is "Herbs will stop it if it can be stopped. If not, then the herbs will speed it along and help mom recover faster".

There are many causes of miscarriage including malnutrition, hormone imbalance, and emotional factors. More than one cause is often involved.

Nutritional requirements of pregnant women are very high. To get the amount of nutrients required the diet must be loaded with healthy, whole, live foods. Herbs and other nutritional supplements may be used to enhance the diet. Fresh vegetables, fresh fruits, whole grains, sprouts, butter (not margarine), dairy products (if they are tolerated), nuts, seeds, organically raised animal protein (to avoid the hormones and antibiotics used in producing commercial animals) and yogurt are the types of foods to be eaten.

This is definitely a time to avoid smoking and smoke/exhaust filled areas, refined and lifeless non-foods, coffee, tea, alcohol, artificial sweeteners, deep fried foods, products made with white flour, white sugar and artificial colors. All of these items deplete vitamins and mineral reserves and weaken the whole body. Good nutrition can help prevent miscarriage.

The following chart adapted from Earl Mindell's Vitamin Bible for Your Kids shows his R.D.A. for pregnant women.

Nutrient:

• Vitamin A

• Vitamin D

• Vitamin E

• Vitamin C

• Vitamin B1

• Vitamin B2

• Vitamin B6

• Vitamin B12

• Folic Acid

• Niacin

• Calcium

• Phosphorus

• Magnesium

• Supplemental Iron

• Iodine

• Zinc
  

Recommended Daily Allowance:

1000 IU
400-500 IU
80-100 IU
80-100 mg.
1.5 mg.
1.5 mg.
2.6 mg.
8-10 mg.
16 mg.
16 mg.
1200 mg.
1200 mg.
450 mg.
30-60 mg.
175 mcg.
20 mg. (1)

Remember that these amounts are only to maintain, not to improve health.

Some of the herbs that can be used to fill in nutritional gaps are:

1. Red Raspberry - Acts as a uterine tonic, contains many vitamins and minerals including calcium, magnesium, iron and B-Complex.

2. Yellow Dock - Blood purifier and glandular tonic. Contains many nutrients, a few of which are organic iron, vitamins A & C, calcium and magnesium.

3. Liquid Chlorophyll - General tonic for the whole body, but especially the blood.

4. Combination of Alfalfa, Kelp and Dandelion - Glandular balancer, general tonic, provides all vitamins and minerals including iron, calcium, magnesium, iodine, B-complex vitamins, eight essential amino acids and vitamin C.

5. Combination of Kelp, Dulse, Watercress, Wild Cabbage, Horseradish and Horsetail - Good for the heart, bowels, fluid retention (keeps sodium and potassium balanced which is necessary for proper nerve impulse transmission), rich source of potassium and other trace minerals.

6. Rosehips - Good for blood, nerves, heart and capillary integrity, excellent source of vitamins A, B-complex and C, also Rutin (for tissue elasticity), calcium and iron. It can be used like a "one-a-day" vitamin for children.

Of course good natural source vitamins can also be used to prevent miscarriages and enhance the health of both mom and babe. Some that I have found useful are:

1. Vitamin E
2. Zinc
3. Vitamin B6
4. B-Complex

Another cause of miscarriage is hormone imbalance. When I'm muscle testing a client and detect a hormone problem, I work with the anti-miscarriage herbs to prevent a miscarriage. Once the miscarriage is threatening, I have had success working with frequent doses of feverfew, lobelia, red raspberry, catnip and an herbal combination of golden seal, capsicum, false unicorn, ginger, uva ursi, cramp bark, squawvine, blessed thistle, and red raspberry. Many of these herbs are not recommended for long term use during pregnancy because of their affect on hormones. In miscarriages, however, the natural hormones are deficient, unbalanced or ineffective.

Doctor Christopher reflects on lobelia in these words: "Lobelia is a selective herb. When a fetus is dead, or in an extremely weakened condition, lobelia will cause it to abort. However, if the fetus is well and healthy, and the mother is weak, it will cause the mother to heal and strengthen, enabling her to carry the child until the proper time for delivery. Lobelia accurately and intelligently selects which way to go. It is truly a 'thinking' herb." (2)

Specific herbs in the anti-miscarriage formula which act with intelligence to stop cramping include false unicorn and cramp bark.

I generally muscle test to determine the best dose for mom, but when my client is at home or miles away, I encourage her to go to bed and I rely on inspiration to recommend dosages. When a miscarriage is active (bleeding and/or cramping) herbs should be taken every two hours around the clock. When symptoms have ceased, the herbs should be taken four times a day during waking hours for one to two weeks. If the miscarriage does happen, continue the herbs four times a day for three to seven days to help mom get her strength back. Rest and relaxation are vital in the event of miscarriage or threatened miscarriage.

Emotions can also cause miscarriages. A mom in a high stress situation (perhaps unmarried, financial problems, health problems, unstable marriage, unwanted pregnancy, etc.) is more likely to miscarry. Dr. Thomas Verny indicates that a very young fetus is aware of stress outside the womb. He theorizes that some fetuses may choose to die rather than inflict further stress and pain on their mothers or themselves.

When a pregnant woman is under stress, she not only depletes her own vitamin and mineral reserves and her own adrenal and glandular strength, but she drains these things off her baby.

Possible therapies for stress in pregnancy and threatened miscarriage include Bach Flower Remedies, herbs and vitamins, nutrition, massage, and introspection.

1. Bach Flower Remedies - Flower petal extracts that help to heal the emotional hurts of life. I like to use Rescue Remedy along with any other flowers that seem to fit the individual situation. Many books are available on Bach Flower Remedies.

2. Herbs and Vitamins - I have discussed specific herbs and vitamins for these purposes already. They are vitally important.

3. Nutrition - During stressful times, and especially miscarriage, the diet should be as simple, natural and easy to digest and assimilate as possible. Fruit, raw and gently cooked vegetables, sprouted grains, cultured dairy products and broths or light soups should make up the bulk of the diet. I recommend avoiding animal flesh, cheese (except yogurt cheese and crumbly cheeses), milk, breads and such during such situations.

4. Massage - Any mild form of massage can be beneficial at this time. The key is to keep it gentle and relaxing.

5. Introspection - (Self talk and baby talk) - This amounts to digging deep into yourself. Do you really want this baby? Why or why not? Share your answers with your partner and the baby.

I have used all these therapies with clients. We have had pregnancies that doctors said wouldn't last the night go to term and produce beautiful children. We have also had miscarriages speed up and end quickly with not medical intervention required, resulting in a very healthy mom. Remember the rule of thumb. Herbs will stop it if it can be stopped. If not, then the herbs will speed it along and help mom to recover faster.

after a miscarriage

after a miscarriage

your health after miscarriage
HCG Levels
Most women can expect their levels to return to a non-pregnant range about 4 - 6 weeks after a pregnancy loss has occurred. This can differentiate by how the loss occurred (spontaneous miscarriage, D&C procedure, abortion, natural delivery), and how high the levels were at the time of the loss.
Health care providers usually will continue to test HCG levels after a pregnancy loss to ensure they return back to 5.0.
tiredness
It is normal to feel emotionally and physically drained following a miscarriage. If possible take a few days off work, and if you can't, make sure you get to bed early, plan rests where possible and postpone anything that isn't urgent.
Make yourself your first priority.
bleeding
If your miscarriage is complete, you can expect your bleeding to taper off rapidly, i.e. over the next week it should get lighter and lighter and stop. All bleeding and spotting should have stopped by seven days. If it persists or is heavier than a normal period, this indicates something is wrong, see your doctor. While you are still bleeding it is important that you shower, not bath, and that you do not swim in public pools because of the risk of contracting an infection.
pain
When the miscarriage is complete, or after a D&C all pain should cease. Again, see your doctor if you have continuing pain.
temperature
Temperature indicates infection which can result in infertility. If you have one see your doctor urgently. You will be treated with antibiotics and possibly a D&C (or repeat D&C).
discharge
If you are having an offensive discharge this could also indicate infection so get checked out.
lactation
This is normal if the pregnancy has lasted longer than 12 weeks and will stop by itself.
menstrual cycle
You may resume a normal cycle immediately with the next period 28 days after the miscarriage but there is a great personal variation,
and it can take up to 6 or 7 weeks for your period to return, especially if you had a "natural" miscarriage (i.e. no D&C or tablets).
It still may take a few cycles before your regular pattern is re-established.
Ovulation can occur 14 days after a miscarriage so you may wish to take precautions.
sex
Sexual intercourse should be avoided until bleeding has stopped to prevent the risk of infection. Even though your cervix will be closed again, sperm can travel up through it and introduce infection into the uterus, which is still healing.
contraception
If you do not wish to become pregnant immediately, you should start using contraception straight after the miscarriage. Note: The pill should be commenced at the time of the miscarriage. You will not be safe until you have taken the tablets for 14 days.
the physical symptoms of grief
Many women find they experience physical symptoms of grief as well as the emotional aspects. These vary greatly from person to person, and include:
* disturbed sleep and eating patterns
* unexplainable tiredness
* unexpected tears
* disturbing dreams and mental confusion
Be gentle and patient with yourself during this time and take comfort in knowing that these symptoms are normal.

Miscarriages

Miscarriages

Miscarriage occurs in 15% of all pregnancies.
Spontaneous abortion (SAB), or miscarriage, is the term used for a pregnancy that ends on it's own, within the first 20 weeks of gestation. The medical name spontaneous abortion (SAB) gives many women a negative feeling, so throughout this article we will refer to any type of spontaneous abortion or pregnancy loss under 20 weeks as miscarriage.
Miscarriage is the most common type of pregnancy loss, according to the American College of Obstetricians and Gynecologists (ACOG). Studies reveal that anywhere from 10-25% of all clinically recognized pregnancies will end in miscarriage. Chemical pregnancies may account for 50-75% of all miscarriages. This occurs when a pregnancy is lost shortly after implantation, resulting in bleeding that occurs around the time of her expected period. The woman may not realize that she conceived when she experiences a chemical pregnancy.
Most miscarriages occur during the first 13 weeks of pregnancy. Pregnancy can be such an exciting time, but with the great number of recognized miscarriages that occur, it is beneficial to be informed about miscarriage, in the unfortunate event that you find yourself or someone you know faced with one.
There can be many confusing terms and moments that accompany a miscarriage. There are different types of miscarriage, different treatments for each, and different statistics for what your chances are of having one. The following information gives a broad overview of miscarriage. This information is provided to help equip you with knowledge so that you might not feel so alone or lost if you face a possible miscarriage situation. As with most pregnancy complications, remember that the best person you can usually talk to and ask questions of is your health care provider.
Why do miscarriages occur?
The reason for miscarriage is varied, and most often the cause cannot be identified. During the first trimester, the most common cause of miscarriage is chromosomal abnormality - meaning that something is not correct with the baby's chromosomes. Most chromosomal abnormalities are the cause of a faulty egg or sperm cell, or are due to a problem at the time that the zygote went through the division process. Other causes for miscarriage include (but are not limited to):
* Hormonal problems, infections or maternal health problems
* Lifestyle (i.e. smoking, drug use, malnutrition, excessive caffeine and exposure to radiation or toxic substances)
* Implantation of the egg into the uterine lining does not occur properly
* Maternal age
* Maternal trauma
Factors that are not proven to cause miscarriage are sex, working outside the home (unless in a harmful environment) or moderate exercise.
What are the chances of having a Miscarriage?
For women in childbearing years, the chances of having a miscarriage can range from 10-25%, and in most healthy women the average is about a 15-20% chance.
* An increase in maternal age affects the chances of miscarriage
* Women under the age of 35 yrs old have about a 15% chance of miscarriage
* Women who are 35-45 yrs old have a 20-35% chance of miscarriage
* Women over the age of 45 can have up to a 50% chance of miscarriage
* A woman who has had a previous miscarriage has a 25% chance of having another (only a slightly elevated risk than for someone who has not had a previous miscarriage)
What are the Warning signs of Miscarriage:
If you experience any or all of these symptoms, it is important to contact your doctor or a medical facility to evaluate if you could be having a miscarriage:
* Mild to severe back pain (often worse than normal menstrual cramps)
* Weight loss
* White-pink mucus
* True contractions (very painful happening every 5-20 minutes)
* Brown or bright red bleeding with or without cramps (20-30% of all pregnancies can experience some bleeding in early pregnancy, with about 50% of those resulting in normal pregnancies)
* Tissue with clot like material passing from the vagina
* Sudden decrease in signs of pregnancy
The different types of Miscarriage:
Miscarriage is often a process and not a single event. There are many different stages or types of miscarriage. There is also a lot of information to learn about healthy fetal development so that you might get a better idea of what is going on with your pregnancy. Understanding early fetal development and first trimester development can help you to know what things your health care provider is looking for when there is a possible miscarriage occurring.
Most of the time all types of miscarriage are just called miscarriage, but you may hear your health care provider refer to other terms or names of miscarriage such as:
Threatened Miscarriage: Some degree of early pregnancy uterine bleeding accompanied by cramping or lower backache. The cervix remains closed. This bleeding is often the result of implantation.
Inevitable or Incomplete Miscarriage: Abdominal or back pain accompanied by bleeding with an open cervix. Miscarriage is inevitable when there is a dilation or effacement of the cervix and/or there is rupture of the membranes. Bleeding and cramps may persist if the miscarriage is not complete.
Complete Miscarriage: A completed miscarriage is when the embryo or products of conception have emptied out of the uterus. Bleeding should subside quickly, as should any pain or cramping. A completed miscarriage can be confirmed by an ultrasound or by having a surgical curettage performed.
Missed Miscarriage: Women can experience a miscarriage without knowing it. A missed miscarriage is when embryonic death has occurred but there is not any expulsion of the embryo. It is not known why this occurs. Signs of this would be a loss of pregnancy symptoms and the absence of fetal heart tones found on an ultrasound.
Recurrent Miscarriage (RM): Defined as 3 or more consecutive first trimester miscarriages. This can affect 1% of couples trying to conceive.
Blighted Ovum: Also called an anembryonic pregnancy. A fertilized egg implants into the uterine wall, but fetal development never begins. Often there is a gestational sac with or without a yolk sac, but there is an absence of fetal growth.
Ectopic Pregnancy: A fertilized egg implants itself in places other than the uterus, most commonly the fallopian tube. Treatment is needed immediately to stop the development of the implanted egg. If not treated rapidly, this could end in serious maternal complications.
Molar Pregnancy: The result of a genetic error during the fertilization process that leads to growth of abnormal tissue within the uterus. Molar pregnancies rarely involve a developing embryo, but often entail the most common symptoms of pregnancy including a missed period, positive pregnancy test and severe nausea.
Treatment of Miscarriage:
The main goal of treatment during or after a miscarriage is to prevent hemorrhaging and/or infection. The earlier you are in the pregnancy, the more likely that your body will expel all the fetal tissue by itself and will not require further medical procedures. If the body does not expel all the tissue, the most common procedure performed to stop bleeding and prevent infection is a dilation and curettage, known as a D&C. Drugs may be prescribed to help control bleeding after the D&C is performed. Bleeding should be monitored closely once you are at home; if you notice an increase in bleeding or the onset of chills or fever, it is best to call your physician immediately.
Prevention of Miscarriage:
Since the cause of most miscarriages is due to chromosomal abnormalities, there is not much that can be done to prevent them. One vital step is to get as healthy as you can before conceiving to provide a healthy atmosphere for conception to occur.
* Exercise regularly
* Eat healthy
* Manage stress
* Keep weight within healthy limits
* Take folic acid daily
* Do not smoke
Once you find out that you are pregnant, again the goal is to be as healthy as possible, to provide a healthy environment for your baby to grow in:
* Keep your abdomen safe
* Do not smoke or be around smoke
* Do not drink alcohol
* Check with your doctor before taking any over-the-counter medications
* Limit or eliminate caffeine
* Avoid environmental hazards such as radiation, infectious disease and x-rays
* Avoid contact sports or activities that have risk of injury
Emotional Treatment:
Unfortunately, miscarriage can affect anyone. Women are often left with unanswered questions regarding their physical recovery, their emotional recovery and trying to conceive again. It is very important that women try to keep the lines of communication open with family, friends and health care providers during this time.

Curettage Pregnancy

What is a Dilation and Curettage

Dilation and Curettage is a method of treatment that is applied in women in order to diagnose the ailment and carry out surgery in case of excessive bleeding in the uterus. This diagnostic process falls in the category called Common Diagnostic and Treatment Surgery. Often operated on women this is also a method for assessing cancerous growth in the uterus. The surgical method becomes a necessity if uterus states too bleed excessively which is quite common in women.
Dilation and curettage is a common surgical process that is allied on women particularly in a case of excessive bleeding where it is caused by abortion. Even in a case of miscarriage where some contents remains inside the uterus and causes it to bleed this method is used. The process although very common is critical at the same time, so depending on the patients overall condition it is either operated in the hospital or in private medical chambers. The patient has to be given a doze of mild or strong anesthesia before being operated to reduce the pain.
The uterus wall is covered with endometrial tissues that start to get thick during the early menstruation and in the pre natal stage when the ovulation is about to take place it stops getting further thick to allow the process of conceiving by the woman. But if it becomes a false pregnancy in ways like a miscarriage or abortion or even if the pregnancy does not take place then it starts to bleed.
Following symptoms are seen before the doctor decides to go for a D&C surgery.
Often women suffer from excessive bleeding and also extended period of menstrual cycles. This is when the doctors regard this as a problem and advices a check up. It becomes more common in case of young woman who has just entered the menstrual cycle or otherwise in older woman who is in their menopausal state. Excessive bleeding from the uterus can be symptomatic to internal tumors too. It indicates that there can be some sort of growth that may or may not be cancerous can be inside the uterus. Polyps or the Fibroid tumors are common problems in most women and these growths can be easily operated and removed by applying the Dilation and Curettage method.
But excessive uterine bleeding can also be a symptom of cancerous growth. Slightly older women are more susceptible to the risks of cancer. This is known as eudiometrical cancer that normally happens in women who has entered their menopausal state. A hysteroscopy is another method to find out the cause in the body region that holds the most delicate organs in women known as cervix, vagina, and uterus.

Surgical Abortions

Surgical Abortions

A surgical abortion is a medical procedure that involves minor out-patient surgery. You are not "put under" for this procedure so the risks often associated with anesthesia are not associated with this procedure. You are sedated and given pain killers during the procedure but you remain awake and conscious during the abortion. You may be offered NO2, nitrous oxide, to help with any discomfort during the procedure. There are two different types of surgical abortion, early pregnancy surgical abortion performed between 6-14 weeks, and late pregnancy surgical abortion performed between 15-19 weeks. Most medical professionals will not perform abortions any later than 19 weeks except in instances where the mother's life is at risk.
Surgical abortions can not be performed any earlier than 6-7 weeks after the first day of your last regular period. This means that if you discover your pregnancy early on you will have to wait to have a surgical abortion. Some people find this waiting very hard. Women and girls who discover their pregnancy earlier than 6-7 weeks and are certain they want to terminate the pregnancy may opt to have a medical abortion. For many women and girls it is mentally easier to terminate a pregnancy early when the pregnancy has not yet become a fetus or embryo and is still a simple cell mass. Medical abortions (using pills) can not be performed any later than 7 weeks after the first day of your last period.
When you opt for a surgical abortion expect at least 3-4 visits to the the doctor or clinic. The first visit will be a long one, 1-2 hours, and will include verification of the pregnancy, an ultra-sound to identify the date of conception (to see if you are far enough along for a surgical abortion), blood testing, a pap smear to rule out STDs like chlamidya and cancers, and counselling to explain the procedure and address your feelings on the issue. Most medical professionals will want you to go away and think about the decision for at least 24 hours to ensure that it is really what you want to do.
If you are having an early pregnancy abortion (6-14 weeks) your second visit will be the procedure. You should eat 2-3 hours before going in for the procedure. You will be given a sedative to ease your nerves and dull the pain. You will be offered NO2 to be self-administered during the procedure as you feel you need it. The doctor will slightly dilate your cervix in order to insert the cannula, a small straw like suction device. You may feel slight discomfort as the cervix is dilated or you may feel nothing at all. The doctor will then begin to suction out the pregnancy. You will not see any of the tissue but you will hear the equipment operating. You will feel some cramping during the suctioning, this cramping may be mild or severe. There is no way to predict how the cramping will be for you but you will be offered NO2 to help manage the pain. The suctioning itself lasts from 5-10 minutes. The cramping may last longer but usually stops with the suctioning. In rare cases cramps may last a few days, although they are no longer severe.
A surgical abortion at 15-19 weeks is similar but much more involved and includes one extra visit prior to the surgery. At this visit the cervix will be opened using 3-4 osmotic dilators and you will be sent away for 24 hours. This is because the cervix must be opened wider in later term abortions and the dilators take 24 hours to work. Once the cervix is dilated the abortion is performed as described above only forceps may be needed to remove extra fetal tissue and the suctioning will last longer, 10-30 minutes. Cramping may be more severe as may your emmotional reaction to the procedure.

Termination of Pregnancy

Termination of Pregnancy

Termination of pregnancy (TOP) is a medically directed miscarriage prior to independent viability, using pharmacological or surgical means.
Doctors may have strongly held personal beliefs concerning abortion. Current GMC guidance states
Epidemiology
Incidence
One third of all pregnancies are terminated worldwide. According to Department of Health statistics2:
* In 2006 193,700 abortions were performed, compared with 186,400 in 2005, a rise of 3.9%. This was equivalent to an age-standardised abortion rate of 18.3 per 1,000 resident women aged 15-44.
* The highest age-standardised abortion rate in 2006 was 35 per 1,000 women aged 19.
* The under 16 abortion rate in the same year was 3.9.
* The under 18 rate was 18.2.
* The NHS funded 87% of abortions in 2006; of these, just over half (55%) took place in the independent sector under NHS contract.
* 89% of abortions were carried out at under 13 weeks gestation; 68% were at under 10 weeks.
* Medical abortions accounted for 30% of the total compared with 24% in 2005.
* Only 1% of UK abortions conducted in 2006 were due to grounds of a risk of severe mental or physical handicap in the child.
Legal requirements
The1967 Abortion Act allows termination before 24 weeks of gestation if it:
* Reduces the risk to a woman's life or
* Reduces the risk to her physical or mental health or
* Reduces the risk to physical or mental health of her existing children or
* The baby is at substantial risk of being seriously mentally or physically handicapped
Most terminations are performed under the second of these criteria. There is a general debate in political and public circles currently that the upper gestational age limit ought to be reduced from 24 weeks to 22 or 20. This is due to the realisation that advances in neonatal care are improving the survival rates of some premature infants born around this time, setting up an environment of moral concern that babies that could survive are having their lives ended. 4-dimensional ultrasound also appears to show 20 week gestation fetuses displaying complex behaviours, prompting a call for a shift from viability as the main criterion, towards sentience.3 Currently, the BMA does not favour a reduction in the gestational age limit for TOP.4
There is no upper limit on gestational time if there is:
* Risk to the mother's life
* Risk of grave, permanent injury to the mother's physical/mental health (allowing for reasonably foreseeable circumstances)
* Substantial risk that, if the child were born, it would suffer such physical or mental abnormalities as to be seriously handicapped. Such TOPs must be conducted in an NHS hospital.
* <1% style="font-weight: bold;">TOP in girls under 16 years
Form HSA1 must be signed by 2 doctors in girls under 16 years age. GMC guidelines are that girls <16 style="font-weight: bold;">Confirm the patient is pregnant.
Counsel to help her reach the decision she will least regret.
Ask her to consider the alternatives (e.g. adoption), ask about her partner (but note that the partner can not consent to, or refuse termination).
Ideally, allow time for her to consider and bring her decision to a further consultation. However, remember that the RCOG guidelines state that 'the earlier in pregnancy an abortion is performed, the lower the risk of complications. Services should therefore offer arrangements that minimise delay'.
If she chooses termination:
* Screen for chlamydia (25% post-op salpingitis if untreated)
* Discuss future contraceptive needs (start pill next day or insert IUD)
* Check Rhesus status, if negative needs anti-D
* Offer follow-up, may be problems around time she would otherwise have delivered.
RCOG guidelines6
* All women should have access to a clinical assessment
* There should be arrangements to minimise delay, eg direct access from referral sources other than GPs
* All women should be offered an assessment appointment within 2 weeks of referral (ideally within 5 days)
* All women should undergo an abortion within 2 weeks or the decision to proceed (ideally 7 days)
* No women should wait longer than 3 weeks from initial referral to time of her abortion.
Blood tests
Pre-abortion assessment should include:
* Measurement of haemoglobin level
* Determination of ABO and Rhesus blood groups
* Screening for other conditions as clinically indicated e.g. haemoglobinopathies, Hepatitis B virus, HIV
* Cervical screening
Ultrasound scanning
All services must have access to scanning, as it can be a necessary part of pre-abortion assessment, particularly where gestation is in doubt or where extrauterine pregnancy is suspected. However, ultrasound scanning is not considered to be an essential prerequisite of abortion in all cases,6 although there is some evidence to suggest routine transvaginal US would be beneficial7; where a woman may just be within the gestational age limit for a medical termination, accurate ultrasound dating may improve the range of options available.8When ultrasound scanning is undertaken, it should be in a setting and manner sensitive to the woman's situation. It is inappropriate for pre-abortion scanning to be undertaken in an antenatal department alongside women with wanted pregnancies.6
Complications of termination
The most common complications are:
* Infection; up to 10% of termination reduced by prophylactic antibiotics or pre-procedure screening for infection.
* Cervical trauma; 1%, lower when termination is performed early.
Uncommon complications are:
* Haemorrhage - 1.5/1000
* Perforation of uterus - 1-4/1000
* Failed termination - 2.3/1000 surgical, 6.0/1000 medical
No clear evidence to link abortion and breast cancer or subsequent infertility or pre-term delivery.
Neonatal death occurring after TOP. Very rare but does occur and can usually be attributed to deficiencies in clinical practice.9
Psychological effects
Only small proportion of women experience long-term adverse psychological sequelae. Although early distress is common it is usually a continuation of the symptoms present before the abortion. There is also evidence of the negative effects on both the mother and the child where abortion has been denied.
The abortion procedure
Ideally services should offer a choice of methods for the relevant gestational age.
Antibiotic prophylaxis6 and/or infection screening with treatment using metronidazole 1g rectally at time of abortion, plus doxycycline 100 mg BD for 7 days starting post-abortion, or metronidazole 1 g rectally at the time of abortion plus azithromycin 1 g orally on the day of abortion.
At under 7 weeks gestation
Avoid conventional suction termination.
Medical abortion using mifepristone plus prostaglandin is appropriate, e.g. Mifepristone 600 mg orally followed 36-48 hours by Gemeprost 1 mg vaginally.
This has been found to be safe, effective and with no adverse outcomes for subsequent pregnancies.10
Early surgical abortion using rigorous published protocol may be appropriate.
At 7-15 weeks' gestation
Medical abortion is appropriate as described above between 7 and 9 weeks.
Conventional suction termination is appropriate at 7-15 weeks although medical abortion may be preferable above 12 weeks.
Local anaesthesia for suction termination may be safer than general anaesthesia.
Cervical priming using gemeprost or mifepristone is beneficial in surgical termination and should be used routinely in women <18>10 weeks.
Surgical evacuation of the uterus is only necessary if clinical evidence of incomplete abortion.
Terminations at greater than 15 weeks gestation
Dilatation and evacuation, preceded by preparation, is safe and effective when undertaken by expert hands.
Medical abortion may be preferable alternative using mifepristone 600 mg orally followed 36-48 hours later by gemeprost 1 mg vaginally every 3 hours to max 5 pessaries.
Aftercare
Medical
Anti-D IgG to all non-sensitised RhD-negative women.
Discuss contraception and supply if accepted.
Written
List of possible symptoms highlighting those that need urgent medical attention with 24-hour number where it can be obtained.
Also, a letter with enough details to allow another doctor to be able to deal with any complications.
Arrange follow-up appointment within 2 weeks and further counselling for small number of women who experience long-term distress.