Gynaecology

Menopause

Menopause is the time in a woman's life when the function of the ovaries ceases.  

The ovaries produce eggs and female hormones. These female hormones, which in turn control the development of female body characteristics such as the breasts, body shape, and body hair. The hormones also regulate the menstrual cycle and pregnancy. Estrogens also protect the bone. Therefore a woman can develop osteoporosis (thinning of bone) later in life when her ovaries do not produce adequate estrogen.

Menopause is a gradual process of transition. Eventually the periods will completely stop as she completes this transition into menopause, and the average age of menopause is around 50 year old.

Symptoms of menopause
the symptoms of menopause can be divided into early and late onset symptoms. Early symptoms include abnormal vaginal bleeding, vaginal dryness, hot flashes, and mood changes. Late symptoms include osteoporosis, and heart disease.

Diagnosis of Menopause
Female Hormonal blood test may assist us to make a diagnosis of menopause.

Bio-Identical Hormone Replacement Therapy

BIO-IDENTICAL HORMONES are, as the name implies, identical to our own naturally occurring hormones. They can be easily produced from precursors found in plants such as soy and yam, converted to bio-identical progesterone, which can be further converted to testosterone and estradiol. These hormones are then prescribed and specifically compounded and tailor made for each patient's individual needs by the compounding pharmacist.

Hormonal Replacement Therapy 

Uses synthetic hormone. They are usually in standard dosages and do not take into account that we are unique and our hormonal needs differ. However, they are advocated for short term use in the pre-menopausal period.

HRT is effective for:
· Relief of hot flushes, night sweats, vaginal dryness, fatigue and decrease of bone density

· Improved sleep, better mood, concentration and memory

· Enhanced libido (sex drive)

· Prevention of osteoporosis

· Better maintenance of muscle mass and strength; decrease the chance of accidental fall

OSTEOPOROSIS

Early diagnosis of this condition is important to prevent bone fracture, for this is a treatable condition.

Infertility

 Infertility is usually defined by doctors as the inability to conceive after at least one year of unprotected sexual intercourse. However, many 'infertile' couples can be helped by assisted-conception treatments.

Male infertility: the causes

• Low sperm count.

• Poor sperm motility

• Poor shape (known as 'morphology'), so that an individual sperm is unable to penetrate the outer layer of an egg

• Non-production of sperm

• Coital difficulties

Female infertility: the causes

• Hormonal disorders; as a result, egg follicles might not grow within the ovary, or an egg might not be released (ovulation)

• Damaged or blocked fallopian tubes

• Endometriosis

• Excessively thick cervical mucus, which prevents sperm passing through

Assisted conception may help most (though not all) of these conditions, and there is evidence that repeated cycles of treatment can restore fertility to near normal levels.

Assisted Conception 

Ovulation drug with time coitus after tubule patentcy has been established. (Tubal patentcy can be ascertained by laparoscope or HSG-an x ray procedure).

In Vitro Fertilization

IVF is the original 'test-tube baby' technique, and probably the most widely practiced assisted-conception procedure in the world.  Although IVF was developed to treat couples whose principal cause of infertility is tubal damage, the technique has also been found useful in those with endometriosis, sperm disorders (poor sperm counts or morphology) and even unexplained infertility.