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Sexually Transmitted Infections (STIs)
Females are more vulnerable / prone to getting sexually transmitted infections due to their anatomy (surface area of exposure is larger in women).

Herpes is spread by direct skin to skin contact. For example, STIs if you have a cold sore and kiss someone, you can transfer the virus from your mouth to theirs. If you have active genital herpes and have vaginal or anal intercourse, you can transfer the virus from your genitals to your partner’s. Finally, if you have a cold sore and put your mouth on your partner’s genitals (oral sex), you can give your partner genital herpes.

Herpes also can be spread through sexual contact at times when there are no obvious signs or symptoms. Herpes is often transmitted by people who are unaware that they are infected or by people who simply don't recognize that their herpes infection is in its active phase.

What are the symptoms of STIs?
Often there are no signs or symptoms. So if you’ve had sex with someone you think is infected with a STIs, a test from the doctor may be the only sure way to tell if you’re infected.

Because STIs can affect anyone, it’s important to know what to look for in yourself and others. Be alert to body changes in the genital area. These warning signs might appear right away, or they might not show up for weeks or even months or they may come and go. Even if the signs and symptoms do disappear, the disease might still be active. STIs usually do not go away on their own.

Here are some signs or symptoms that may mean you have an STIs Women bear a disproportionate burden of STIs–related complications, including pelvic inflammatory disease, infertility, potentially fatal ectopic pregnancies, and cancer of the reproductive tract. Left untreated in women, it can cause pelvic inflammatory disease which is associated with ectopic pregnancy and even sterility.

What is Menopause?
Menopause, unlike menstruation, is often viewed by the medical profession as a disease rather than a natural part of ageing. It refers to the end of menstruation, but also commonly refers to symptoms that may begin a few years before periods stop. These may include hot flashes, mood swings, insomnia, breast tenderness and fatigue.

There is no consensus within the medical community about the risks and benefits associated with hormone replacement therapy. More research is needed to help women make this difficult decision in the face of conflicting data.

Breast Self Examination
How does one perform self examination of the breast?
A breast self examination is easiest in the shower, using soap to smooth your skin. Look for dimpling. Using light pressure, check for lumps near the surface. Using firm pressure to explore deeper tissues. Squeeze each nipple gently, if there is any discharge–especially if it is bloody–consult your doctor.

Any time you find a new or unusual lump in your breast, have your doctor check it to make sure it is not cancerous or pre–cancerous. Most lumps are benign and do not signal cancer. The best test for distinguishing a cyst from a solid tumor is ultrasound, a needle biopsy may also be done.

A baseline mammogram with a low–dose X–ray of the breast is sometimes recommended for women between the ages of 35 and 40. Most women should also get a mammogram every other year beginning around age 40. Women at risk for breast cancer should consult their doctor for the best schedule. Any risk of developing cancer from mammography is clearly offset by the benefits: Breast lumps can be identified on a mammogram up to two years before they can be felt.

Several tests can help distinguish a benign lump from a malignant tumor. Feeling the lump may provide clues. A benign cyst may feel like a round, slippery bean, whereas a tumor may feel thicker and may cause dimpling of the skin above it. Since malignant and benign lumps tend to have different physical features, imaging tests such as mammography and ultrasonography can often rule out cancer. The only way to confirm cancer is to perform needle aspiration or a biopsy and to test the tissue sample for cancer cells.

In the event of malignancy, you and your doctor need to know how far along the cancer is. Various tests are used to check for the presence and likely sites of metastasis. Cancer cells can be analyzed for the presence or absence of hormone receptors, to find out if the cancer is likely to respond well to hormone therapy. Other tests can help predict the likelihood of metastasis and the potential for recurrence after treatment.

What is the treatment for breast cancer?
Treatment of breast cancer depends on how advanced the cancer is, the age of the patient, and her health. In most cases breast cancer is treated surgically, followed usually by some combination of radiation therapy, chemotherapy, or hormone therapy.

The standard surgical procedure for breast cancer was once radical mastectomy–total removal of the breast and the surrounding fat, muscle, and lymph nodes. However this has fallen out of favor now and is done in only very rare cases. For many women whose breast cancer is detected early and is still localized, lumpectomy–removal of the cancerous lump and the lymph nodes under the arm–is now the preferred treatment. Followed by appropriate radiation therapy, chemotherapy, and hormone therapy, lumpectomy has proved as effective as radical mastectomy for early breast cancer and is much less disfiguring.

In cases where the tumor is more than 1.1 cm in size, modified selective mastectomy is advocated. In this procedure, the tumor and surrounding breast tissue are removed, but most of the muscle on the chest wall is left intact–which is less disfiguring than radical mastectomy.


Pap Examination
Pap Smears Can Save Your Life
No cancer screening test in medical history is as effective for early detection of cancer as the Pap examination. Sadly, 80 percent of women who die of cervical cancer have not had a Pap examination in five years or more.

A Pap examination is a simple procedure in which your physician painlessly obtains cells from the surface of your cervix, often using a special brush to sample the area where most cancers begin to develop. The cells are placed on a glass slide, which is sent to a laboratory. At the laboratory, the cells are stained and then examined under a microscope by specially trained cytotechnologists. If an abnormality is found, a pathologist, a physician who specializes in laboratory medicine, studies the cells and makes the final interpretation.

Its primary purpose is to detect early cervical cancer and pre–cancerous conditions. An abnormal Pap smear often means pre–cancer, a change that can lead to cervical cancer if left untreated. If cancerous or pre–cancerous cells are found, the next step is a more thorough examination of your cervix, during which your physician will obtain tissue biopsies for a pathologist to study.
Sometimes, an abnormal Pap smear means there are uncertain cell changes that could be pre–cancerous or could be entirely benign, needing no further investigation. A Pap examination also may detect infections such as bacteria, yeast or viruses. One kind of sexually transmitted virus is important to detect because of its link to cervical cancer. This virus is human papillomavirus (HPV), sometimes called “Condyloma” or genital warts.

Every woman should have an annual Pap examination when she becomes sexually active or turns 18 years old–whichever comes first. Regular Pap examinations should continue after menopause and after a hysterectomy (removal of the uterus) To ensure that the cells your physician obtains during the exam are adequate for evaluation, you should abstain from sexual activity and avoid using vaginal douches or lubricants for 48 hours before the examination. Pathologists recommends that you have yearly Pap and pelvic examinations. Cervical cancer takes time to develop into a deadly disease. The pelvic exam is added insurance, it can help detect signs of cancer in female organs other than the cervix. Any woman can develop cancer of the cervix, but you are at a higher risk if. You have had multiple sex partners or a male partner who has had multiple female partners. If your partner has had sex with other women, you are at high risk even if you have had only one partner.

Osteoporosis in Women
Osteoporosis is a condition of weakened bone sometimes called brittle bone disease. The bone that is present is biologically normal, but there is a deficiency on the amount of bone substance. There are other very rare conditions where the bone is not normal, and may or may not be mechanically weaker.

These fractures come about from the loss of bone substance, most of which is lost after menopause. Men and other women are more protected, but from time to time can also have osteoporosis. There is a close relationship between the strength of the bone supporting the joint prosthesis and the long–term success of the implant. We are only now realizing how important the surrounding bone is in protecting the joint implant from loosening and other damage.

Typically bone loss starts after menopause, and progresses over time. All bone loss is bad, but as bone loss progresses complications can arise, such as fractures, curvature of the spine, and back pain. While some risk factors for osteoporosis and not under our control, like our age and gender, our ancestry, and our family health history, other risk factors can be affected by our behavior. These include smoking, excessive alcohol consumption, lack of exercise, and avoidance of calcium rich foods. If you have suffered a bone fracture, especially of the hip, wrist or spine, bones that are most frequently involved with osteoporosis, you probably already have some osteoporosis. In this circumstance, treatment for bone weakness is justified and is very important.

Treatment for osteoporosis Simple measures that are important for good bone health is an adequate dietary intake of calcium, 1200 mg per day is recommended.
An 8 oz. Glass of milk has 300 mg of calcium. Along with calcium, it is important to take at least 400 units of vitamin D, found in all over–the–counter multivitamins. Another simple measure is to get daily weight–bearing exercise, such as a walking program.

Newer drugs which are not hormones can be used when hormone replacement is too risky, associated with too many side effects or is not working to maintain bone strength. After treatment is started, a bone density test should be repeated every 2 years. If drugs are necessary for bone maintenance, they may be necessary for a lifetime, although this has not yet been decided.

Diet
Lifestyle Medications Raloxifene (Evista)
If cannot take HRT Side–effects, precipitate hot flashes, same venous Thrombosis risk of estrogen Benefits of estrogen without stimulation of uterine or Breast tissue.

Hot or Cold compression for joints? Do you ever wonder?
Cold reduces blood to the area it is applied to and heat brings more blood to the area it is applied to. Heat reduces muscle spasm and therefore is useful in situations where muscles are tight such as a stiff neck or back. Muscle ache after exercise. During excessive exercise beyond what one is accustomed to comfortably do, muscles can get sore. If the exercise is very intense, there may not be enough blood flow to eliminate all the chemicals produced as side products, these are needed to be eliminated. It is these accumulated chemicals that cause this type of muscle ache. Over the next few hours these chemicals are gradually eliminated through the blood and the muscles are no longer sore. Since it is blood supply that helps eliminate the chemicals that cause the pain, it makes sense to use heat to help sore muscles after exercise. Add to that the effect heat has in relaxing tight muscles and a hot bath (or any form of heat) makes great sense here. In fact it is from this use of heat that heat became so popular.

When an injury occurs, tissues are damaged and bleeding occurs. Here, heat would increase blood flow and increase the bleeding. Instead cold will reduce blood flow to the area and therefore reduce bleeding which is good. Also as you recall, cold numbs the area it is applied to which in the case of an injury is an added benefit.

Inflammation (tendonitis, bursitis, etc.) means that more blood is going to an area as a reaction to some problem there. That is why an inflamed area of skin is red and painful. Applying heat to an inflamed area will send more blood to the area making it even more inflamed. Cold on the other hand will reduce the blood and numb the pain. In the case of inflammation, cold is the right choice. People so frequently misuse one or the other that I thought it would be helpful to explain what each does and when it is best to use one or the other and even situations when both may work.


Irregular Periods
Normal Menstrual Cycles (Periods)
Normal menstrual cycles begin at the age of 10–14 years and for the first 3–4 years the menses can be slightly irregular since the whole process which controls these cycles has not yet fully matured.

After this the normal menstrual cycle is usually regular (every 25–35 days) and bleeding may be erratic and heavy. This certainly needs to be investigated.How do normal periods occur?
Several factors work together to produce normal periods. The ovaries (glands situated beside the uterus) produce an egg every month. This developing egg produces a hormone (estrogen) which thickness the inner layer of the uterus. The egg matures and then ruptures and another hormone (progesterone) is now produced. This hormone scrapes off the entire layer which has been built up earlier and throws it out in a controlled manner and periods result. Since the whole process is well controlled by the specific hormones, the bleeding will occur at the expected date and will last for a finite time. The whole process of development, ripening and breaking open of the egg is called ‘Ovulation’.

What happens if there is no ovulation?
If the egg formation does not occur properly the entire process occurs in an uncontrolled fashion. The secretion from the developing egg does not occur in a normal manner and hence the development and discarding of the layer of the uterus does not take place properly. This leads to heavy and irregular periods. This is called ‘An ovulation’.

What causes an ovulation?
There are a large number of causes for an ovulation and we will advise you he appropriate tests for finding the exact cause. One must remember that excessive weight is one of the most important causes and you must make an attempt to lose weight by diet and exercise. Remember that there are no medicines to lose weight.

Polycystic Ovarian Disease (PCOD)
Another important and common cause for irregular periods is a problem of the ovary called polycystic ovarian disease (PCOD). In PCOD the structure of the ovary is faulty and this is associated with an imbalance in the hormonal levels. This does not allow the egg to develop normally and thus leads to an ovulation as explained above.
This disorder results not only in irregular periods but also makes pregnancy more difficult to achieve and may also make you more prone to develop excess body hair and pimples. If you are overweight you also have an increased risk of developing diabetes and blood pressure later on in adult life.

Treatment of PCOD
It may not be possible to cure this problem entirely but we can treat it easily with good results. Moreover such problems are known to go away after a pregnancy. This means that you may have to be on treatment for quite some time. The type of treatment will be chosen carefully by us based on your needs. Although no one would like to treated with medicines for long, rest assured that it is in your best interests. A number of people may advise you that it is not correct to use any hormonal treatments. such advice may be well meant but not necessarily correct. Any treatment that has been scientifically thought out and designed will not produce untoward effects. We are trying to help your fight your problem. Please be sure to discuss your queries with us.