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The branch of medicine pertaining to childbirth and dealing with the anatomy and physiology of female reproductive system is called as obstetrics and gynecology respectively. A variety of disorders such as infections, tumors and connective tissue diseases may affect the reproductive parts in women at any stage of their life. These parts are as follows:
· A pair of ovaries on either side of uterus
· A pair of ducts called fallopian tubes for each ovary
· Mammary glands and breast
MedcureIndia provides guidelines to its readers on the various aspects of issues and treatment in following lines.
Mental disturbance, emotional stress and hormonal imbalance have always been blamed for the irregular and pathological functioning of the female reproductive system.
· Tumors and cysts may arise in the uterus or ovaries as a result of hormonal disturbances, trauma in the pelvis or some unknown etiology
· Uterine fibroids, fibroadenoma of the breast also follow the same principle
· Bacterial/viral/fungal infections may cause vaginal or cervical diseases due to poor hygiene maintenance.
· Fallopian tubal blockages prevent fertilization and thus termination of pregnancy
· Weak/under nourished or pathological uterus often leads to miscarriages.
Different gynecological problems may produce similar signs and symptoms. These include:
· Delayed menarche i.e onset of menstrual cycle
· Painful cycle, abdominal cramps, dizziness, nausea
· Irregular cycles, excessive to reduced to nil blood flow
· Foul and frequent vaginal discharge
· Frequent urge to urinate, painful urination
· Redness, itching, soreness in the vaginal area
· Fever, pain in the abdomen, nausea, vomiting following vaginal/cervical infections
· Bleeding after intercourse
· Swelling and pain in the breasts, discharge from nipples
· Early menopause, emotional imbalances, mood swings, weakness, pale appearance
· Miscarriages, infertility
· Surgical approach: Uterine, ovarian and breast fibromas, cysts are often resolved with a surgical approach. This often is the choice when after medications the pathology does not subside and the pain persists. However there may be a chance that the same condition may recur post operatively. The procedure may or may not be performed under general anesthesia, for example in cases of excisional biopsy of firbroadenoma or fibroids of breast, approach is done 2 cm away from the site and the fibroid removed under local anesthesia.
·Mastectomy: It involves the removal of either one or both the breasts in tote when the cancer has spread and covered a major portion of the mammary connective tissue. It is the only choice of treatment in malignancy, since chemotherapy and radiation therapy hardly have any effect on mammary tissues.
· Hysterectomy: It is the entire removal of uterus, generally an option in older women who are yet to attain menopause. The ovaries with fallopian tube are left in the place, ligated in the pelvic region. Hysterectomy procedure may also be an option in extensive cases of uterine and cervical cancer.
· Tubectomy: It is a procedure of ligation of the fallopian tubes in order to prevent the eggs from fertilizing with the sperm and travelling to the uterus for implantation. It is more of a contraceptive procedure than the one treating any pathology of the reproductive system.
·Radiation therapy and chemotherapy: Radiation therapy makes use of radiation in cases of uterine and ovarian cancer in order to cause damage and ultimately death of the tumor cells. The radiation doses however have to be kept at bare minimum levels considering the sensitivity of reproductive system. Chemotherapy in turn uses a combination of drugs which prove lethal to the cancer cells. Again the dose and frequency of such drugs must be kept at moderate levels in order to prevent iatrogenic damage to the other organs.
· Fertility treatment: Infertility occurs in females owing to tubal blockages, uterine weakness, tumors and cysts. In the recent past, a variety of modalities have been introduced to treat such cases. For example, in artificial insemination, the seminal fluid is injected artificially directly into the fallopian tube. Here the egg directly released from the ovaries is available for the sperms. This method is adopted when the vaginal health and environment does not permit the travel of sperm uptil the fallopian tube.
In vitro fertilization IVF is the process of induced fertilization outside the mother’s body in a test tube, after which the zygote is implanted into the female’s uterus and thus begins the gestational period. Intracystoplasmic sperm injection ICSI is the procedure in which seminal fluid is injected into the uterus. This semen may or may not be of the father, donor semen may also be used. It is the resort when it is the father is not fertile or the sperm count and motility is too low to penetrate the female egg. In Gamete intrafallopian transfer GIFT, ovaries are stimulated to produce eggs and one such healthy egg is placed in the fallopian tube alongwith sperm from male. The process of fertilization is allowed to take place in the tube and proceed to the uterus for implantation. Zygote intrafallopian transfer ZIFT is the process in which eggs from female and sperm from male can be extracted and fertilized in vitro. This zygote can then be placed in the fallopian tube to allow the natural process of pregnancy to take place.
Success rate pertaining to the removal of cysts and tumors of the breast and ovaries is 98.67 percent, with a mild chance of recurrence. Procedures like mastectomy and hysterectomy have excellent results with complete regression of the pathological symptoms. Management of fertility issues using the mentioned approaches show a variable success in the range of 56 to 67.89 percent with respect to females.
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