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Hypertension

HYPERTENSION MANAGEMENT!!!

By definition hypertension is sustained elevation in blood pressure where the benefit of intervention outweighs the risk. Hypertension management has seen several trends and advancements in recent years, with a focus on a more holistic and individualized approach. Some current trends in hypertension management include:

1. Personalized Treatment Plans: Healthcare providers are increasingly recognizing the importance of tailoring hypertension treatment plans to individual patients. This approach takes into account the patient’s unique risk factors, medical history, and lifestyle, allowing for more precise and effective management.

2. Lifestyle Interventions: Lifestyle modifications are becoming a cornerstone of hypertension management. These include dietary changes (such as the DASH diet, which is rich in fruits, vegetables, and low-fat dairy products), increased physical activity, stress reduction, and weight management. Lifestyle interventions are often recommended in conjunction with medication.

3. Combination Therapy: Many patients with hypertension require multiple medications to achieve their blood pressure goals. Combining medications from different classes can improve efficacy while minimizing side effects. Fixed-dose combination drugs are increasingly prescribed for convenience.

Choose Single Pill Combinations(SPCs) at any step. Start with dual combination therapy in most patients. For instance, ACE(angiotensin converting enzyme) inhibitors or ARB(angiotensin 2 receptor blockers) + CCB(calcium channel blockers) or Diuretic(water pill).

Start with mono-therapy only in selected patients, i.e Low risk hypertension and BP <150/95 mmHg, or high normal BP and very high CV risk, or frail patients and/or advanced age. Also, it’s worth noting that beta blockers(atenolol, metoprolol) can be used as mono-therapy or at any step of combination.

4. Home Blood Pressure Control: There is a growing emphasis on patients taking an active role in their care. This includes home blood pressure monitoring, which provides valuable data for both patients and healthcare providers. This allows for more frequent and convenient follow-up care.

Diagnosis of hypertension:

At the first visit measure blood pressure in both arms. If the difference in readings between arms is more than 15mmHg, repeat the measurements. If the difference in readings between arms remains more than 15mmg on the second measurement, measure subsequent blood pressures in the arm with the higher reading and document.

Patient Preparation:

* Have an empty bladder and rest quietly for at least 5 minutes.
* No coffee or smoking in last 30 mins.
* Do not talk or text. Sit with back supported and both feet flat on the floor. Legs should not be crossed.
* BP cuff should be placed on bare arm above antecubital fossa
* The arm with the cuff should be supported on a flat surface e.g table or a pillow if patient is lying face upwards.
* The machine should be placed at the level of the heart

These trends reflect a more comprehensive and patient-centered approach to hypertension management, with a focus on prevention, lifestyle, and individualized care to reduce the risk of cardiovascular complications. Healthcare providers are increasingly focusing on educating patients about the risks of hypertension and the importance of adherence to treatment plans. Patient engagement and understanding play a crucial role in managing hypertension effectively. Drug therapy is a common approach to managing hypertension (high blood pressure), and it typically involves the use of medications to lower blood pressure and reduce the risk of cardiovascular complications. However, some individuals may develop a condition known as resistant hypertension.

What is Resistant Hypertension?

Resistant hypertension is a subset of high blood pressure that doesn't respond adequately to treatment with conventional antihypertensive medications. It is diagnosed when a person's blood pressure remains above 140/90mmHg despite taking three different types of blood pressure medications, including a diuretic (water pill) at their highest doses. Several factors can contribute to resistant hypertension:

1. Medication Non-Adherence: Sometimes, patients may not take their prescribed medications as directed, leading to inadequate blood pressure control.

2. Secondary Hypertension: Underlying medical conditions, such as kidney disease, hormonal disorders, or obstructive sleep apnea, can contribute to high blood pressure and may be more challenging to treat.

3. Lifestyle Factors: Unhealthy lifestyle habits like a high-sodium diet, excessive alcohol consumption, and physical inactivity can worsen hypertension.

4. Medication Interactions: Some individuals may experience medication interactions that reduce the effectiveness of antihypertensive drugs.

5. Genetic Factors: Genetic predisposition can make certain people more resistant to the effects of blood pressure medications.

Drug Therapy for Resistant Hypertension:

When dealing with resistant hypertension, healthcare providers may employ various strategies:

1. Medication Adjustments: This may involve optimizing the dosage or type of existing medications or adding new classes of drugs to the treatment regimen.

2. Identifying Underlying Causes: Determining and addressing any underlying conditions contributing to hypertension, such as kidney disease or hormonal imbalances.

3. Lifestyle Modifications: Encouraging patients to make lifestyle changes like reducing salt intake, losing weight, exercising, and limiting alcohol consumption.

4. Medication Compliance: Ensuring that patients are adhering to their medication regimen and addressing any barriers to compliance.

5. Referral to Specialists: In some cases, a patient may be referred to a hypertension specialist or nephrologist for further evaluation and management.

It's essential for individuals with resistant hypertension to work closely with their healthcare providers to find the most effective treatment plan. Managing resistant hypertension often requires a combination of medications and lifestyle changes, and it can be a complex and ongoing process to achieve optimal blood pressure control and reduce the risk of cardiovascular complications.

Here's the correlation between hypertension management and drug therapy, as well as the concept of resistant hypertension:

1. Hypertension Management with Drug Therapy:
– Hypertension management often begins with lifestyle changes such as a healthy diet, regular exercise, weight control, and reduced sodium intake.
– If lifestyle modifications alone do not effectively control blood pressure, healthcare professionals may prescribe antihypertensive medications.
– There are various classes of antihypertensive drugs, including diuretics, beta-blockers, ACE inhibitors, angiotensin II receptor blockers (ARBs), calcium channel blockers, and others.
– The choice of medication depends on the individual's specific condition, as well as factors like age, underlying health conditions, and potential side effects.

2. Resistant Hypertension:
– Resistant hypertension is a condition where blood pressure remains elevated despite the use of three or more different antihypertensive medications at optimal doses, including a diuretic.
– Resistant hypertension can be classified into two main categories:
I. True Resistant Hypertension: This is when blood pressure remains high despite optimal therapy.
II. Pseudo-Resistant Hypertension: In some cases, high blood pressure may be related to factors such as poor medication adherence, white coat syndrome (elevated blood pressure in a medical setting), or secondary causes like kidney disease.

The correlation between hypertension management and drug therapy is that medications are often a crucial component of controlling blood pressure, especially when lifestyle changes are insufficient.
– For individuals with resistant hypertension, the correlation is more complex. Resistant hypertension may necessitate a more intensive drug therapy regimen, careful evaluation to identify underlying causes, and the addition of other medications or interventions.

In summary, hypertension management often involves drug therapy as part of a comprehensive treatment plan. For individuals with resistant hypertension, additional measures, investigations into potential underlying causes, and adjustments to drug therapy may be needed to achieve blood pressure control. It's crucial for individuals with resistant hypertension to work closely with their healthcare provider to find an effective treatment strategy.

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Orgasming When Pregnant: Everything You Need to Know

Introduction

Pregnancy is a beautiful and transformative journey for many women, marked by physical and emotional changes. One aspect of pregnancy that often raises questions and curiosity is the topic of orgasms. Can pregnant women safely experience orgasms, and are there any considerations or precautions to keep in mind? In this article, we’ll explore the topic of orgasming during pregnancy, offering insights, guidance, and addressing common concerns.

1. Is It Safe?

The short answer is yes, orgasms are generally considered safe during pregnancy. Orgasms do not harm the baby or the uterus, as they are well-protected by the amniotic fluid and the cervix. In fact, some women may find that sexual activity and orgasms become more enjoyable during pregnancy due to increased blood flow to the pelvic area, heightened sensitivity, and changes in hormones.

2. Benefits of Orgasms During Pregnancy

a. Stress Reduction: Pregnancy can bring about various stressors, both physical and emotional. Orgasms release endorphins, which can help reduce stress and anxiety.

b. Better Sleep: Many pregnant women experience difficulty sleeping. The relaxation that follows an orgasm can contribute to better sleep quality.

c. Improved Bonding: Sharing intimate moments with a partner can strengthen your emotional connection during a time when it’s easy to become preoccupied with pregnancy-related concerns.

d. Pain Relief: Orgasms can provide temporary relief from common pregnancy discomforts such as backaches and cramps.

3. Changes and Considerations

While orgasms during pregnancy are generally safe, it’s essential to be mindful of changes in your body and any potential complications. Here are some considerations:

a. Increased Sensitivity: Some women may experience heightened sensitivity in their breasts and genitals during pregnancy. It’s essential to communicate with your partner about what feels comfortable and enjoyable for you.

b. Positions: As your pregnancy progresses, you may need to experiment with different sexual positions to find what is most comfortable. Positions that avoid putting pressure on your abdomen are generally recommended.

c. Consult Your Healthcare Provider: If you have a high-risk pregnancy or a history of complications, it’s a good idea to consult your healthcare provider before engaging in sexual activity, including orgasms. They can provide personalized guidance based on your specific situation.

4. When to Exercise Caution

In some cases, it’s advisable to exercise caution or abstain from sexual activity, including orgasms. These situations may include:

a. High-Risk Pregnancy: If you have been classified as having a high-risk pregnancy, your healthcare provider may recommend avoiding sexual activity to reduce the risk of complications.

b. Bleeding or Preterm Labor: If you experience bleeding, preterm labor contractions, or other concerning symptoms, seek immediate medical attention and refrain from sexual activity until cleared by your healthcare provider.

c. Decreased Libido: Hormonal changes during pregnancy can lead to fluctuations in libido. If you have a decreased interest in sexual activity or find orgasms uncomfortable, it’s entirely normal, and you should not feel pressured to engage in sexual activity.

Conclusion

Orgasming during pregnancy is generally safe and can even offer several benefits, including stress reduction and improved bonding with your partner. However, it’s essential to stay attuned to your body’s changes, communicate openly with your partner, and consult your healthcare provider if you have any concerns or complications. Ultimately, the most crucial aspect is to prioritize your comfort and well-being during this transformative time in your life.

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World Hepatitis Day 2023

Hepatitis is an inflammatory condition of the liver. It is commonly the result of viral infection, but there are other possible causes of hepatitis which includes autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins and alcohol. Autoimmune hepatitis is a disease that occurs when your body makes antibodies against your liver tissue.

FIVE MAIN VIRAL CLASSIFICATIONS OF HEPATITIS.

– Hepatitis A; This type of hepatitis is an acute short term disease.

– Hepatitis B; This is often an ongoing, chronic condition.

– Hepatitis C; This is among the most common blood borne viral infections and it presents as a long term condition.

– Hepatitis D; This is a rare form of hepatitis that only occurs in conjunction with hepatitis B infection. The hepatitis D virus causes liver inflammation.

-Hepatitis E; This is a waterborne disease. It is found in areas with poor sanitation and typically results from ingesting fecal matter that contaminates the water supply.

SYMPTOMS OF HEPATITIS

* Fatigue
* Flu-like symptoms
* Dark urine
* Pale stool
* Abdominal pain
* Loss of appetite
* Unexplained weight​

TREATMENT

Treatment to prevent hepatitis infection after exposure. If you know you’ve been exposed to the hepatitis virus and aren’t sure if you’ve been vaccinated, call your doctor immediately. An injection of immunoglobulin (an antibody) given within 12 hours of exposure to the virus may help protect you from getting sick with hepatitis. Because this treatment only provides short-term protection, you also should get the hepatitis vaccine at the same time, if you never received it.

Treatment for acute hepatitis infection If your doctor determines your hepatitis infection is acute — meaning it is short-lived and will go away on its own — you may not need treatment. Instead, your doctor might recommend rest, proper nutrition and plenty of fluids while your body fights the infection. In severe cases, antiviral drugs or a hospital stay is needed to prevent complications.

Treatment for chronic hepatitis infection Most people diagnosed with chronic hepatitis infection need treatment for the rest of their lives. Treatment helps reduce the risk of liver disease and prevents you from passing the infection to others. Treatment for chronic hepatitis may include:

*Antiviral medications. Several antiviral medications — including entecavir (Baraclude), tenofovir (Viread), lamivudine (Epivir), adefovir (Hepsera) and telbivudine (Tyzeka) — can help fight the virus and slow its ability to damage your liver. These drugs are taken by mouth.

*Interferon injections. Interferon alfa-2b (Intron A) is a man-made version of a substance produced by the body to fight infection. It’s used mainly for young people with hepatitis B who wish to avoid long-term treatment or women who might want to get pregnant within a few years, after completing a finite course of therapy. Interferon should not be used during pregnancy.

*Liver transplant, If your liver has been severely damaged, a liver transplant may be an option. During a liver transplant, the surgeon removes your damaged liver and replaces it with a healthy liver.

PREVENTION

There are many ways you can reduce your chances of getting hepatitis:

*Get the vaccines for hepatitis

*Use a condom during sex.

*Don’t share needles to take drugs.

*Practice good personal hygiene such as thorough hand-washing with soap and water.

*Don’t use an infected person’s personal items.

*Take precaution when traveling to areas of the world with poor sanitation. (Make sure to get your vaccines.)

*Drink bottled water when traveling.

*It is very important that you take preventive steps too if you work in places like nursing homes, dormitories, daycare centers, or restaurants where there you have extended contact with other people and a risk of coming into contact with the disease.

SUPPLEMENTS FOR HEPATITIS

Milk Thistle

Helps protect the liver cell and reduces inflammation that can damage the liver.

Curcumin

This is a chemical in turmeric, the spice that gives many curries their flavor and yellow hue. It can help the body fight inflammation.

Probiotics

These are beneficial bacteria that help maintain the health of the gut and aid in digestion.

Licorice Root

This root helps to slow the growth of liver cancer.

 

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Menopause

Menopause is the time that marks the end of your menstrual cycles. It’s diagnosed after you’ve gone 12 months without a menstrual period. Menopause can happen in your 40s or 50s.

Menopause is a natural biological process. But the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or affect emotional health. There are many effective treatments available, from lifestyle adjustments to hormone therapy.

Symptoms.
In the months or years leading up to menopause (perimenopause), you might experience these signs and symptoms:
-Irregular periods.
-Vaginal dryness
-Hot flashes
-Chills
-Night sweats
-Sleep problems
-Mood changes
-Weight gain and slowed metabolism
-Thinning hair and dry skin
Loss of breast fullness

Causes.
Menopause can result from:

1)Naturally declining reproductive hormones:
As you approach your late 30s, your ovaries start making less estrogen and progesterone — the hormones that regulate menstruation — and your fertility declines.

In your 40s, your menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent, until eventually — on average, by age 51 — your ovaries stop releasing eggs, and you have no more periods.

2)Surgery that removes the ovaries (oophorectomy):
Your ovaries produce hormones, including estrogen and progesterone, that regulate the menstrual cycle. Surgery to remove your ovaries causes immediate menopause. Your periods stop, and you’re likely to have hot flashes and experience other menopausal signs and symptoms. Signs and symptoms can be severe, as hormonal changes occur abruptly rather than gradually over several years.

Surgery that removes your uterus but not your ovaries (hysterectomy) usually doesn’t cause immediate menopause. Although you no longer have periods, your ovaries still release eggs and produce estrogen and progesterone.

3)Chemotherapy and radiation therapy:
These cancer therapies can induce menopause, causing symptoms such as hot flashes during or shortly after the course of treatment. The halt to menstruation (and fertility) is not always permanent following chemotherapy, so birth control measures may still be desired. Radiation therapy only affects ovarian function if radiation is directed at the ovaries. Radiation therapy to other parts of the body, such as breast tissue or the head and neck, won’t affect menopause.

Treatment.
Menopause requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and preventing or managing chronic conditions that may occur with aging. Treatments may include:

1)Hormone therapy:
Estrogen therapy is the most effective treatment option for relieving menopausal hot flashes. Depending on your personal and family medical history, your doctor may recommend estrogen in the lowest dose and the shortest time frame needed to provide symptom relief for you. If you still have your uterus, you’ll need progestin in addition to estrogen. Estrogen also helps prevent bone loss. Long-term use of hormone therapy may have some cardiovascular and breast cancer risks, but starting hormones around the time of menopause has shown benefits for some women. Talk to your doctor about the benefits and risks of hormone therapy and whether it’s a safe choice for you.

2)Vaginal estrogen:
To relieve vaginal dryness, estrogen can be administered directly to the vagina using a vaginal cream, tablet or ring. This treatment releases just a small amount of estrogen, which is absorbed by the vaginal tissues. It can help relieve vaginal dryness, discomfort with intercourse and some urinary symptoms.

3)Low-dose antidepressants:
Certain antidepressants related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs) may decrease menopausal hot flashes. A low-dose antidepressant for management of hot flashes may be useful for women who can’t take estrogen for health reasons or for women who need an antidepressant for a mood disorder.

4)Gabapentin (Gralise, Horizant, Neurontin):
Gabapentin is approved to treat seizures, but it has also been shown to help reduce hot flashes. This drug is useful in women who can’t use estrogen therapy and in those who also have nighttime hot flashes.
Clonidine (Catapres, Kapvay). Clonidine, a pill or patch typically used to treat high blood pressure, might provide some relief from hot flashes.

5)Medications to prevent or treat osteoporosis:
Depending on individual needs, doctors may recommend medication to prevent or treat osteoporosis. Several medications are available that help reduce bone loss and risk of fractures. Your doctor might prescribe vitamin D supplements to help strengthen bones.

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Maca

Maca is a plant that grows in central Peru in the high plateaus of the Andes Mountains.
It has been cultivated as a vegetable crop in this area for at least 3000 years.

Maca is a relative of the radish and has an odor similar to butterscotch.
Its root is used to make medicine.

Maca root is added to food to boost libido and energy.
It has also been studied as a remedy for sexual dysfunction, depression, hair loss, hot flashes, and fertility.

Maca root has become a very popular supplement known for its potential benefits for fertility, libido, menopause, and more.

Maca is a plant that some populations in Peru have used for thousands of years as a food and medicine.

In the last few decades, maca has grown in popularity around the world as a natural remedy for certain health issues, including infertility and low sex drive.

Maca supplement is sold as a powder you can add to foods or drinks. It also comes as gelcaps.
People take maca by mouth for “tired blood” (anemia); chronic fatigue syndrome (CFS); and enhancing energy, stamina, athletic performance, and memory.

People also take maca by mouth for:

Female hormone imbalance,

Menstrual problems, Symptoms of menopause, Improving fertility, and Sexual dysfunction caused by antidepressants,

Weak bones (osteoporosis), Depression,

Stomach cancer,

Leukemia,

HIV/AIDS,

Tuberculosis,

Erectile dysfunction (ED), to arouse sexual desire, and to boost the immune system.

USES OF MACA

•Sexual dysfunction caused by antidepressant drugs. Early research suggests that taking maca twice daily for 12 weeks slightly improves sexual dysfunction in women taking antidepressants.

• Male infertility:
Early research shows that taking a specific maca product daily for 4 months increases semen and sperm count in healthy men.

• Postmenopausal conditions:                                                                                                                                                                           Taking Maca daily for 6 weeks slightly improves blood pressure and some aspects of mood, including depression and anxiety, in postmenopausal women.

• Sexual desire:                                                                                                                                                                                                            Taking maca product daily for 12 weeks can increase sexual desire in healthy men.

• Tired blood (anemia).                                                                                                                                                                                              •  Leukemia.
• Chronic fatigue syndrome (CFS).
• Improving energy and athletic performance.
• Improving memory.
• Depression.
• Female hormone imbalance.
• Menstrual problems.
• Symptoms of menopause.
• Osteoporosis.
• Stomach cancer.
• Tuberculosis.
• Boosting the immune system.

POSSIBLE SIDE EFFECTS

Little is known about the safety and risks of short-term or long-term use of maca.
Since it is a natural food, it is generally believed to be safe in large doses.

* If you have one of the following conditions, you should not take maca without consulting your healthcare provider:

• Breast, uterine, or ovarian cancer.
• Endometriosis
• Uterine fibroids
• Thyroid disease

As with many other supplements, maca hasn’t been tested for safety in pregnant people, nursing mothers, children, those with medical conditions, or those who are taking medications.

Written by Osuegbu Lilian Nkechi

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Chasteberry Extract

CHASTEBERRY

Chasteberry is also known as Vitex (Vitex agnus-castus) is a plant used in herbal medicine. It’s often used to remedy women’s health problems. Vitex supplements typically contain extracts of the fruit and/or seed of the plant.

In the past, chasteberry extracts were used to treat a variety of gynecological disorders and skin conditions.

Today, chasteberry is promoted as a dietary supplement for symptoms of premenstrual syndrome, breast pain associated with the menstrual cycle, infertility, and other conditions.

HEALTH BENEFITS OF CHASTEBERRY

The relief of menstrual symptoms is the primary use of chasteberry as a nutritional supplement. Additional uses of this herb include support for reproductive and breast health.

  • Breast health

Chasteberry may also help relieve periodic breast discomfort, especially those caused by the menstrual cycle. This type of chasteberry extract is typically combined with other herbs.

  • Menstrual support

Chasteberry is often used to relieve menstrual symptoms, especially cramps, food cravings and swelling. It may also help support bouts of anxiety, stress and irritability.

  • Reproductive health support

Women who are trying to get pregnant may also take oral supplements of chasteberry extract. This regimen is typically followed for at least three months.

FORMS OF CHASTEBERRY

Chasteberry is available in liquid, capsules, and tablets.

 

Source: Healthline

written by Sarah Amah

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Gonorrhea

Gonorrhea is an infection caused by a sexually transmitted bacterium that infects both males and females. Gonorrhea most often affects the urethra, rectum or throat.

In females, gonorrhea can also infect the cervix.

Gonorrhea is most commonly spread during vaginal, oral or anal sex. But babies of infected mothers can be infected during childbirth.

In babies, gonorrhea most commonly affects the eyes.

CAUSES

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. They thrive in warm, moist environments, and the infection can develop in any of the body’s mucous membranes, including those in the genitals, mouth, throat, eyes, and rectum.

Gonorrhea can pass from person to person through sexual contact that involves the penis, vagina, anus, or mouth. It can pass on without a male ejaculating. Gonorrhea can also transmit to a newborn during delivery.

SYMPTOMS

Many people with gonorrhea have no symptoms.

Those who do often experience a burning sensation during urination.

A person with a penis might also notice:

?️white, green, or yellow discharge

?️pain or swelling in the testicles

?️inflammation or swelling of the foreskin

A person with a vagina might have:

?️increased vaginal discharge and bleeding between periods.

?️Rectal symptoms may also occur if a person has anal sex.

These may include:

– discharge

– itching around the anus

– soreness

– bleeding

– pain during bowel movements

If gonorrhea results from oral sex, the infection can be located in the throat, but it may cause no symptoms. Gonorrhea is a bacterial infection, and if semen or vaginal fluid that contains this bacteria enters the eye, the person may develop conjunctivitis, commonly called “pink eye.”

COMPLICATIONS

Untreated gonorrhea can lead to major complications, such as:

?️Infertility in women.

?️Infertility in men.

?️Infection that spreads to the joints and other areas of your body.

?️ Increased risk of HIV/AIDS.

?️ Complications in babies.

TREATMENT

Everyone with gonorrhea needs treatment to stop the infection from progressing. The treatment involves antibiotics.

The Centers for Disease Control and Prevention (CDC) recommends a single dose of 500 milligrams of intramuscular ceftriaxone (Rocephin).

* Addition of 3 days dose of azithromycin 500mg or 1g

* 5 days dose of ofloxacin 200mg or levofloxacine 500mg can also be used

* A immune defense supplement can also be added

PREVENTION

Abstaining from sex, using a condom if you have sex and being in a mutually monogamous relationship are the best ways to prevent sexually transmitted infections.

 

Written by: Ruth Olusegun

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Menopause

Menopause is the time that marks the end of your menstrual cycles. It’s diagnosed after you’ve gone 12 months without a menstrual period. Menopause can happen in your 40s or 50s.

Menopause is a natural biological process. But the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or affect emotional health. There are many effective treatments available, from lifestyle adjustments to hormone therapy.

Symptoms

In the months or years leading up to menopause (perimenopause), you might experience these signs and symptoms:

  • Irregular periods
  • Vaginal dryness
  • Hot flashes
  • Chills
  • Night sweats
  • Sleep problems
  • Mood changes
  • Weight gain and slowed metabolism
  • Thinning hair and dry skin
  • Loss of breast fullness

Signs and symptoms, including changes in menstruation can vary among women. Most likely, you’ll experience some irregularity in your periods before they end.

Skipping periods during perimenopause is common and expected. Often, menstrual periods will skip a month and return, or skip several months and then start monthly cycles again for a few months. Periods also tend to happen on shorter cycles, so they are closer together. Despite irregular periods, pregnancy is possible. If you’ve skipped a period but aren’t sure you’ve started the menopausal transition, consider a pregnancy test.

When to see a doctor

Keep up with regular visits with your doctor for preventive health care and any medical concerns. Continue getting these appointments during and after menopause.

Preventive health care as you age may include recommended health screening tests, such as colonoscopy, mammography and triglyceride screening. Your doctor might recommend other tests and exams, too, including thyroid testing if suggested by your history, and breast and pelvic exams.

Always seek medical advice if you have bleeding from your vagina after menopause.

Causes

Menopause can result from:

  • Naturally declining reproductive hormones. As you approach your late 30s, your ovaries start making less estrogen and progesterone — the hormones that regulate menstruation — and your fertility declines.

    In your 40s, your menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent, until eventually — on average, by age 51 — your ovaries stop releasing eggs, and you have no more periods.

  • Surgery that removes the ovaries (oophorectomy). Your ovaries produce hormones, including estrogen and progesterone, that regulate the menstrual cycle. Surgery to remove your ovaries causes immediate menopause. Your periods stop, and you’re likely to have hot flashes and experience other menopausal signs and symptoms. Signs and symptoms can be severe, as hormonal changes occur abruptly rather than gradually over several years.

    Surgery that removes your uterus but not your ovaries (hysterectomy) usually doesn’t cause immediate menopause. Although you no longer have periods, your ovaries still release eggs and produce estrogen and progesterone.

  • Chemotherapy and radiation therapy. These cancer therapies can induce menopause, causing symptoms such as hot flashes during or shortly after the course of treatment. The halt to menstruation (and fertility) is not always permanent following chemotherapy, so birth control measures may still be desired. Radiation therapy only affects ovarian function if radiation is directed at the ovaries. Radiation therapy to other parts of the body, such as breast tissue or the head and neck, won’t affect menopause.
  • Primary ovarian insufficiency. About 1% of women experience menopause before age 40 (premature menopause). Premature menopause may result from the failure of your ovaries to produce normal levels of reproductive hormones (primary ovarian insufficiency), which can stem from genetic factors or autoimmune disease. But often no cause of premature menopause can be found. For these women, hormone therapy is typically recommended at least until the natural age of menopause in order to protect the brain, heart and bones.

Complications

After menopause, your risk of certain medical conditions increases. Examples include:

  • Heart and blood vessel (cardiovascular) disease. When your estrogen levels decline, your risk of cardiovascular disease increases. Heart disease is the leading cause of death in women as well as in men. So it’s important to get regular exercise, eat a healthy diet and maintain a normal weight. Ask your doctor for advice on how to protect your heart, such as how to reduce your cholesterol or blood pressure if it’s too high.
  • Osteoporosis. This condition causes bones to become brittle and weak, leading to an increased risk of fractures. During the first few years after menopause, you may lose bone density at a rapid rate, increasing your risk of osteoporosis. Postmenopausal women with osteoporosis are especially susceptible to fractures of their spine, hips and wrists.
  • Urinary incontinence. As the tissues of your vagina and urethra lose elasticity, you may experience frequent, sudden, strong urges to urinate, followed by an involuntary loss of urine (urge incontinence), or the loss of urine with coughing, laughing or lifting (stress incontinence). You may have urinary tract infections more often.

    Strengthening pelvic floor muscles with Kegel exercises and using a topical vaginal estrogen may help relieve symptoms of incontinence. Hormone therapy may also be an effective treatment option for menopausal urinary tract and vaginal changes that can result in urinary incontinence.

  • Sexual function. Vaginal dryness from decreased moisture production and loss of elasticity can cause discomfort and slight bleeding during sexual intercourse. Also, decreased sensation may reduce your desire for sexual activity (libido).

    Water-based vaginal moisturizers and lubricants may help. If a vaginal lubricant isn’t enough, many women benefit from the use of local vaginal estrogen treatment, available as a vaginal cream, tablet or ring.

  • Weight gain. Many women gain weight during the menopausal transition and after menopause because metabolism slows. You may need to eat less and exercise more, just to maintain your current weight.

Treatment

Menopause requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and preventing or managing chronic conditions that may occur with aging. Treatments may include:

  • Hormone therapy. Estrogen therapy is the most effective treatment option for relieving menopausal hot flashes. Depending on your personal and family medical history, your doctor may recommend estrogen in the lowest dose and the shortest time frame needed to provide symptom relief for you. If you still have your uterus, you’ll need progestin in addition to estrogen. Estrogen also helps prevent bone loss. Long-term use of hormone therapy may have some cardiovascular and breast cancer risks, but starting hormones around the time of menopause has shown benefits for some women. Talk to your doctor about the benefits and risks of hormone therapy and whether it’s a safe choice for you.
  • Vaginal estrogen. To relieve vaginal dryness, estrogen can be administered directly to the vagina using a vaginal cream, tablet or ring. This treatment releases just a small amount of estrogen, which is absorbed by the vaginal tissues. It can help relieve vaginal dryness, discomfort with intercourse and some urinary symptoms.
  • Low-dose antidepressants. Certain antidepressants related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs) may decrease menopausal hot flashes. A low-dose antidepressant for management of hot flashes may be useful for women who can’t take estrogen for health reasons or for women who need an antidepressant for a mood disorder.
  • Gabapentin (Gralise, Horizant, Neurontin). Gabapentin is approved to treat seizures, but it has also been shown to help reduce hot flashes. This drug is useful in women who can’t use estrogen therapy and in those who also have nighttime hot flashes.
  • Clonidine (Catapres, Kapvay). Clonidine, a pill or patch typically used to treat high blood pressure, might provide some relief from hot flashes.
  • Medications to prevent or treat osteoporosis. Depending on individual needs, doctors may recommend medication to prevent or treat osteoporosis. Several medications are available that help reduce bone loss and risk of fractures. Your doctor might prescribe vitamin D supplements to help strengthen bones.
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Candidiasis

Candidiasis is a fungal infection caused by a yeast (a type of fungus) called Candida. Some species of Candida can cause infection in people; the most common is Candida albicans. Candida normally lives on the skin and inside the body, in places such as the mouth, throat, gut, and vagina, without causing any problems. Candida can cause infections if it grows out of control or if it enters deep into the body (for example, the bloodstream or internal organs like the kidney, heart, or brain).

Types of candidiasis

1- INVASIVE CANDIDIASIS

2- VAGINAL CANDIDIASIS

3- CANDIDA OF THE MOUTH, THROAT AND ESOPHAGUS

At normal levels, the fungus is not problematic. However, when Candida begins to grow uncontrollably, it can cause an infection known as CANDIDIASIS

Few factors that can lead to candida overgrowth

* Taking antibiotics

* Eating a diet high in sugar and refined carbs

* High alcohol intake

* A weakened immune system

* Taking oral contraceptives

* Diabetes

* High stress levels

SYMPTOMS

* Oral Thrush

* Tiredness and Fatigue

* Recurring Genital or Urinary Tract Infections

* Digestive Issues

* Joint Pain

* Skin and Nail Fungal Infections

MEDICATIONS

1- Taking an antifungal medications like clotimazole, fluconazole etc

2- Taking antibiotics medications

3- Insertion of an antifungal and antibiotics pessery

4- Taking supplement to boost the immune system and probiotics medications

5- Maintaining a good hygiene

6- Using of antifungal and antibiotics cream if necessary

Written by: Ruth Olusegun
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Sexually Transmitted Diseases (STDs)

Sexually transmitted diseases (STDs), or sexually transmitted infections (STIs), are infections that are passed from one person to another through sexual contact. The contact is usually vaginal, oral, or anal sex. But sometimes they can spread through other intimate physical contact. This is because some STDs, like herpes and HPV, are spread by skin-to-skin contact.
Causes of Sexually Transmitted Diseases (STDs)
STDs can be caused by bacteria, viruses, and parasites.
Types of STDs
Some common types of STDs include:
 – Chlamydia
It is caused by bacteria called Chlamydia trachomatis. It can infect both men and women. Women can get chlamydia in the cervix, rectum, or throat. Men can get chlamydia in the urethra (inside the penis), rectum, or throat.
 How do you get chlamydia?
You can get chlamydia during oral, vaginal, or anal sex with someone who has the infection. A woman can also pass chlamydia to her baby during childbirth. Chlamydia is more common in young people, especially young women.
What are the symptoms of chlamydia?
Symptoms in women include:
• Abnormal vaginal discharge, which may have a strong smell
• A burning sensation when urinating
• Pain during intercourse
People at higher risk should get checked for chlamydia every year:
• Sexually active women 25 and younger
• Older women who have new or multiple sex partners, or a sex partner who has a sexually transmitted disease
• Men who have sex with men (MSM)
What other problems can chlamydia cause?
In women, an untreated infection can spread to your uterus and fallopian tubes, causing pelvic inflammatory disease (PID). PID can cause permanent damage to your reproductive system. This can lead to long-term pelvic pain, infertility, and ectopic pregnancy. Women who have had chlamydia infections more than once are at higher risk of serious reproductive health complications.
Babies born to infected mothers can get eye infections and pneumonia from chlamydia. It may also make it more likely for your baby to be born too early.
Untreated chlamydia may also increase your chances of getting or giving HIV/AIDS
– Genital herpes
Genital herpes is a sexually transmitted disease (STD) caused by a herpes simplex virus (HSV). It can cause sores on your genital or rectal area, buttocks, and thighs. The virus can spread even when sores are not present. Mothers can also infect their babies during childbirth.
Symptoms of herpes are called outbreaks. You usually get sores near the area where the virus has entered the body. The sores are blisters which break and become painful, and then heal. virus can be more serious in newborn babies or in people with weak immune systems. Repeat outbreaks are common, especially during the first year. Over time, you get them less often and the symptoms become milder. The virus stays in your body for life.
Correct usage of latex condoms can reduce, but not eliminate, the risk of catching or spreading herpes. If your or your partner is allergic to latex, you can use polyurethane condoms. The most reliable way to avoid infection is to not have anal, vaginal, or oral sex.
 – Gonorrhea
The bacteria that cause gonorrhea can infect the genital tract, mouth, or anus. You can get gonorrhea during vaginal, oral, or anal sex with an infected partner. A pregnant woman can pass it to her baby during childbirth.
In women, the early symptoms of gonorrhea often are mild. Later, it can cause bleeding between periods, pain when urinating, and increased discharge from the vagina. If untreated, it can lead to pelvic inflammatory disease, which causes problems with pregnancy and infertility.
In men, gonorrhea can cause pain when urinating and discharge from the penis. If untreated, it can cause problems with the prostate and testicles.
 – HPV
They can also spread through other intimate, skin-to-skin contact. Some of these types can cause cancer.
There are two categories of sexually transmitted HPV. Low-risk HPV can cause warts on or around your genitals, anus, mouth, or throat. High-risk HPV can cause various cancers: Cervical cancer, anal cancer, some types of oral and throat cancer, vulvar cancer, vaginal cancer, penile cancer.
Others
– Syphilis
– Trichomoniasis
– HIV/AIDS
What are the treatments for sexually transmitted diseases (STDs)?
Antibiotics can treat STDs caused by bacteria or parasites. There is no cure for STDs caused by viruses, but medicines can often help with the symptoms and lower your risk of spreading the infection.
Can sexually transmitted diseases (STDs) be prevented?
Women can try to keep themselves STDs free in several ways:
• Avoid exposure to infected bodily fluids. This may mean abstaining from sex or avoiding transfer of bodily fluids in other ways like using barrier devices like condoms, or not sharing needles. Correct usage of latex condoms greatly reduces, but does not completely eliminate, the risk of catching or spreading STDs.
• Another option is mutual monogamy between people who have no prior sexual experience or who are STD free. Although this arrangement does not eliminate all risks, it can significantly limit exposure to STDs/Is.
• Vaccines:There are vaccines to prevent HPV and hepatitis B.
The most reliable way to avoid infection is abstinence for single persons.


Written by: Chinonye Machie
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