VAGINA

Definition:

The vagina is the female organ that connects the uterus and cervix to the outside of the body.

Information:

The vagina is a muscular tube lined with mucus membranes. Its opening is between the urethra (where urine exits the body) and the anus.

The vagina allows for the flow of menstrual blood and for sexual intercourse, and is the passageway through which a baby is born. Inflammation of the vagina is known as vaginitis.

Vaginal Infections:

Infection of the vagina with one or more bacteria, yeast or protozoal organism.

Description of Vaginal Infections

Vaginal symptoms are among the most common reasons that women consult primary care physicians. Most women have a vaginal infection now and then, and many women have them often.

The vagina normally contains large numbers of organisms called Lactobacillus (or Acidophilus).Vaginal infection happen when other organisms grow and change the normal balance of organisms in the vagina.

A vaginal infection is present when the normal vaginal discharge changes color, becomes heavier or smells different, or if there is itching, burning, swelling, or redness around the vagina.
A normal discharge does not smell bad and is not accompanied by redness, swelling, or itching. Most vaginal discharges are normal. A vaginal discharge is often present at some stages in the menstrual cycle. This discharge may be most noticeable at the middle of the cycle, which is close to the time of ovulation.

The most common form of vaginal infection is called bacterial vaginosis. Women with this infection have a large number of organisms called Gardnerella Vaginalis, as well as many other organisms, in their vagina. If an infection is present, there will be a vaginal smell that is strongest after sexual intercourse, and perhaps an increased amount of thin vaginal discharge, which may be white or discolored.

A yeast infection, or Candida Vaginitis, is another common type of vaginal infection. If this is present, there may be larger amounts of thick, white discharge, or no discharge at all. Other common symptoms include itching, swelling, irritation or redness around the vaginal area.
Trichomonas vaginitis, which is sometimes called "trick," is the third most frequent vaginal infection. Like bacterial vaginosis, this infection often causes an increased amount of discharge, which may be discolored. Sometimes, the discharge smells different. Itching may be present but is less likely than with a yeast infection.

In about one of every three women with vaginal symptoms, the cause of the symptoms may be harder to find. An infection of other parts of the urogenital system may be present, such as gonorrhea, chlamydia or herpes. Low hormone levels, related to menopause, or an allergy may also cause vaginal infections

Causes and Risk Factors of Vaginal Infections:

Most vaginal infections have no apparent cause. They sometimes occur in times of stress or other illness. They also often occur (especially yeast infections) following a course of antibiotics taken for other reasons.

Some vaginal infections are a result of sexual intercourse, but the organisms covered in this topic area tend not to be ranked as seriously as other sexually transmitted diseases.

Symptoms of Vaginal Infections:

Symptoms can range from minimal discharge, odor or irritation, to copious discharge with substantial irritation and pain.

Diagnosis of Vaginal Infections:

These causes of vaginal infection can usually be easily diagnosed by your doctor in the office using simple techniques. Often, just the history and clinical presentation is enough to conclude which type of infection it is.

Treatment of Vaginal Infections:

The treatment for vaginal infections depends on the cause.
Bacterial vaginosis is often treated with a prescription medication called metronidazole (Flagyl, Protostat). This medication is taken by mouth. Sometimes it causes an upset stomach or nausea. If you drink alcohol while taking this drug, you may have nausea and vomiting. There are other medicines that may be taken by mouth for this infection, such as clindamycin (Cleocin), and there are also vaginal creams and gels.

A yeast infection is usually treated with creams and suppositories that are placed in the vagina. The length of treatment may vary from one to seven days. Some of these medicines are now available without prescription, such as miconazole (Monistat) and clotrimazole (Gyne-Lotrimin or Mycelex-G), and you may use then when you know you have a yeast infection. If the infection does not get better or comes back soon, you should see your doctor to make sure of the diagnosis and treatment.

Trichomonas vaginitis is also treated with metronidazole, taken by mouth. However, because this infection is often passed back and forth between sexual partners, it is necessary that the partner also take the medication to prevent it coming back.
Vaginal Cancer

Signs and Symptoms:

Vaginal cancer is a rare disease and makes up less than 3 percent of all gynecological cancers. There are four different types of vaginal cancer, including:
1. Squamous Cell Cancer: The most common type and usually occurs in the upper part of the vagina. It typically affects women between the ages of 50 and 70.
2. Adenocarcinoma: The second most common type and usually affects women between the ages of 12 and 30, although it occassionally occurs in women of all age groups.
3. Malignant Melanomas Sarcomas: Extremely rare forms of the disease.
It is important to know that even if you have had a hysterectomy, you can still develop vaginal cancer.

Risk Factors:

As with many cancers, the exact cause of vaginal cancer is not known for sure. However, some factors may increase a woman's risk for the disease, including:
1. Smoking
2. Age, women over the age of 50 are most commonly affected by squamous cell vaginal cancer
3. History of cervical cancer.
4. Having had a hysterectomy
5. History of genital warts caused by the human papilloma virus (HPV)
6. Having had radiation therapy to the pelvic area

In addition, research has shown that young women whose mothers took a drug known as diethylstilbestrol (DES) are at a higher risk for developing the disease. The drug DES was given to pregnant women between 1945 and 1970 to prevent them from having miscarriages.
In some cases, vaginal cancer may not cause any symptoms and is detected by an abnormal Pap smear. However, some common symptoms of the condition include:
1. Bleeding or discharge not related to menstrual periods
2. Difficult or painful urination
3. Pain during intercourse or in the pelvic area

Treatment:

Treatment for vaginal cancer typically involves surgery, radiation therapy and possibly chemotherapy. With surgery, some patients may need skin grafts and plastic surgery to make an artificial vagina. Some patients may need more than one type of treatment in combination.
At UCSF Medical Center, a team of cancer specialists and plastic surgeons work together to design the most effective treatment plan for your condition.

Surgery:

Surgery is the most common treatment for all stages of vaginal cancer. A doctor may remove the cancer using one of the following:

Laser Surgery: A narrow beam of light is used to kill cancer cells. It may be used for the very earliest stages of when the cancer has been confined to the place of its origin which is also known as in situ cancer.

Wide Local Excision: A type of surgery that removes the cancer and some of the tissue around it. A patient may need to have skin taken from another part of the body, or grafted, to repair the vagina after the cancer has been removed.

Vaginectomy: In some cases, an operation in which the vagina is removed may be recommended. When the cancer has spread outside the vagina, vaginectomy may be combined with surgery to take out the uterus, ovaries and fallopian tubes. This is called a radical hysterectomy. During these operations, lymph nodes in the pelvis also may be removed.

Exenteration: If the cancer has spread outside the vagina and the other female organs, the doctor may take out the lower colon, rectum or bladder -- depending on where the cancer has spread -- along with the cervix, uterus and vagina.

Radiation Therapy:

Radiation therapy uses X-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body, called external beam radiation therapy. Another form or radiation therapy, called internal radiation, works by placing materials that produce radiation, called radioisotopes, through thin plastic tubes into the area where the cancer cells are found. Radiation may be used alone, in combination with chemotherapy, or after surgery.

Chemotherapy:

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein. Chemotherapy is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells outside the vagina. Chemotherapy may be used in combination with radiation treatment, or alone.

Dealing with an abortion

The decision to terminate a pregnancy is never easy, and can often give rise to mixed emotions. So how do you deal with it?

Coping with your emotions

While some women might feel relieved after terminating a pregnancy, it's also very common to feel sad, guilty, even confused, especially if you felt that at another time a baby would have been right for you. Depression and grief can also figure, and may be quite intense as your hormone levels drop back after the abortion. Try not to punish yourself, or worry that you have to go through any of this alone. Remember that they are your emotions and whatever you are feeling is fine.

Before the termination happened, you will have talked to two doctors about what to do for the best. You may have also discussed it with the father of the baby, members of your family, or family planning counsellor. All this talking would have helped you come to the decision that an abortion was in your best interest, but no matter how often - or how hard - you thought about the situation, no one can predict how you'll feel afterwards.

Keep communicating

For many women who have been through the experience, the key is to keep on talking to all those people who've helped you this far. Don't be embarrassed that you're turning to them again, or worry they'll think you've made the wrong decision because you feel this way. They'll want to help. However, you may feel happier talking to someone outside the situation.

Take time

Some women take longer than others to get over terminating a pregnancy, whether it's two months, two years or longer. Everyone copes with their emotions in different ways. Some talk, others work it through on their own, but no matter how you feel, you have to face up to it, make sense of it, and deal it with it in a way that feels right to you.

Unplanned pregnancy is something nobody chooses to happen, so it's always wise to avoid risks and take precautions

Should I have a baby?

It's the biggest decision of your life, and could be the most fulfilling. Here are the major issues to consider as you work out whether it's time to become a parent.

Emotional

If you're feeling down, lonely or unloved, it's easy to think a baby will be the solution to your problems. Yes, a child may adore you unconditionally, but unless you feel good about yourself there's little chance you'll be able to meet their emotional needs in return.

You need to feel stable and fulfilled if you're going to provide a baby with a loving home. Don't be tempted to go for it as a means of filling an emotional hole. Also, be sure you feel able to talk openly about your feelings, preferably with the other potential parent of your child. Does he or she share your desire to become a parent? Is he or she prepared to make sacrifices as you are?

In addition, consider how you'd behave as a parent under pressure. Small children can behave appallingly at times, so you have to be absolutely sure you can keep your cool and not place them at risk of any kind of abuse. Of course, we learn many parenting skills by experience, but this is one issue where you have to know you won't lose it when the going gets tough.

Domestic

What kind of environment can you offer a child? If you're still living at home, at war with your parents or squeezed in with little room to breathe, will a child be able to thrive as you hope? Yes, the local authorities will seek to house a single parent or young family, but this really shouldn't be a reason for having a baby. And if you are setting up a new home, can you afford to furnish it?

Financial

Babies aren't cheap and even with careful budgeting it can be a stretch for some parents. With commitment and carefuly planning, you will find a way to fund parenthood. Just be sure to think things through with a level head.

If you're at school or college right now, for example, a baby is likely to make a tough time much tougher. Are you prepared to make sacrifices with your education, even if you plan to return to it at a later date? Juggling parenthood with a career can be equally daunting, so consider what kind of support you'd receive from your employer. Will they offer any kind of maternity (or paternity) package, over and above your statutory allowance, and just how flexible will they be when you need to leave early to relieve your childminder?

Long term

A newborn baby doesn't take up much space, eat a great deal, or demand that you give it a lift to the shops. In time, however, you'll be faced with childcare considerations, sorting out schooling and out-of-school activities. Being a parent can be as rewarding as it is demanding, of course, but it's vital that you think beyond the super-cute bundle of joy that first springs to mind when you consider having a baby.

What are the symptoms, Diagnosis and treatments of Breast Cancer?

What are the symptoms of Breast Cancer?

Screening for breast cancer by mammography (X-raying the breast) is offered every three years in the UK to all women between 50 and 64. The highest number of cases of breast cancer occurs in women between these ages.

Mammography can detect very early breast tumours, when they are too small to be felt. In fact, most of the breast cancers detected by screening are at this very early stage, when they are relatively easy to cure. Studies have shown that women who take part in screening are more likely to have breast cancer diagnosed early and more likely to have it cured and, as a result, are less likely to die from it, than women who do not take part in mammography screening.

Another method of screening available to all women is to feel the breasts for any lumps. A guide on how to do this properly can be obtained at any doctor's surgery. Women should also check for the other main symptoms:

• Change in the size or shape of a breast
  
• Dimpling of the breast skin
  
• The nipple becoming inverted
  
• Swelling or a lump in the armpit
  
• Diagnosis
  

The most important method used to diagnose breast cancer is by taking a biopsy (a tissue sample). A hollow needle is pushed into the breast lump to capture a tiny sample of the tissue. This is examined under a microscope. The shape and appearance of the cells in the tissue sample reveals whether the lump is benign, which is true of the vast majority, or if it is cancerous.

Q. How important is early detection?

A. We can currently cure six out of every seven patients who are diagnosed when their breast cancer is at the early stage. However, if they are diagnosed when it has become advanced, the cure rate falls to about one in seven. It is extremely important to catch breast cancer at an early stage.

Treatment

The main treatment for breast cancer is surgery. In most cases, conservative surgery is used, which preserves the shape and appearance of the breast. For very early breast cancer, only the lump and a small area of tissue around it is removed. For later stage breast cancer, much more tissue is removed but it is replaced with muscle to rebuild the breast. Since breast cancer cells usually spread first to the lymph node in the armpit, the surgeon will usually cut into it to check for any spread.

The surgery may be followed by a short course of radiotherapy or chemotherapy, depending on the type of tumour and how advanced it is. In most cases, the patient will be given a longer course of hormone therapy (eg tamoxifen) which reduces the risk of the cancer recurring.

The treatment for breast cancer has been improving for the last twenty years. In the early 1970's, only half of all women diagnosed with the disease survived for five years. Now, over three quarters survive for that long and most of them will live for very much longer.

Menopause: Diet for Hot Flashes

Hot flashes seem to be a personal experience for women experiencing various symptoms in menopause. Many women we talked to tried various diet remedies and supplements but results are often inconsistent. Let's look at some common diet solutions for hot flashes.

Avoid the following food items in your diet. Most women found these foods make hot flashes worse.

• Tea
  
• Coffee
  
• Alcohol
  
• Caffeine containing soft drinks
  
• Spicy foods
  
• Smoking
  

Exercise is Good for Women

A large-scale, six-year study involving 39,372 American women over age 44 confirms that exercise reduces the risk of coronary heart disease in women.

The study found that the more energy women spent exercising, the lower their risk of developing heart disease, including heart attacks, regardless of other factors.

Among the approximately 23,000 women who did not engage in any vigorous activity, women who walked as little as one hour per week had about half the risk of more sedentary women of developing heart disease.

Intensity was less of a factor than the total amount of time spent walking.