Blog about medicines and adverse drug reactions.
May 8th, 2009 admin
Consumer organisations usually recommend that the first step to finding a health practitioner who suits your needs is a recommendation from someone whose judgement you trust. Your general practitioner may know of a gynaecologist who has expertise in treating your condition; although general practitioners sometimes ask patients if they know of anyone suitable. In this case, you might like to put forward the name of a gynaecologist who has been recommended to you by other women in your family or by your friends. If you have any doubts about whether the specialist recommended has suitable experience, you can check whether he or she belongs to the relevant professional association, such as the national College of Obstetricians and Gynaecologists, and then ring that association and check that his or her training and qualifications are adequate.
The consumer guide Choice advises patients choosing a practitioner in alternative medicine to check if the relevant professional association has a code of ethics, disciplinary procedures for practitioners who break the code, and a complaints procedure for dissatisfied clients. ‘These factors aren’t a guarantee’, Choice says, ‘but indicate the organisation is serious about maintaining high professional standards.’
It does not bode well if you feel inhibited, rushed or unsettled with a particular practitioner or if he or she does not treat you with respect, dignity and consideration for your privacy. This is your cue to look elsewhere for help. Equally, it is reasonable to bypass any practitioner who suggests a treatment that seems extreme or very expensive, who speaks in incomprehensible jargon or who recommends a single treatment for all women. Sometimes a practitioner will recommend a particular treatment not because it is particularly well suited to your needs but because he or she is able to give that treatment or it is available nearby. Questioning your practitioner about why one particular treatment is preferable to others can be revealing.
April 23rd, 2009 admin
Drugs for Inducing Ovulation
This is usually the first line of treatment if it is discovered that you are not ovulating but your fallopian tubes and your partner s sperm are normal. A number of drug treatments are available, designed to stimulate ovulation, correct the hormone balance and ensure the release of an egg. These drugs do not actually make you more fertile: they only work during the month they are being taken.
Clomiphene citrate stimulates ovulation if you are not ovulating and it is also used if you have infrequent periods and long cycles. It is taken for five days early on in the cycle.
This drug should not be used for more than six cycles, as there is an increased risk of ovarian cancer with 12 or more cycles of clomiphene treatment.
One of the side-effects of clomiphene can be multiple births. Although this drug is easy to administer, since it is taken by mouth and could be given by a GP, the Royal College of Obstetricians and Gynecologists recommends that it should only be given where ultrasound monitoring can be done at the same time. Monitoring also means that the dose can be altered, depending on your response to the drug. You may suffer other side-effects from clomiphene, such as bowel upsets, bloating, headache, dizziness, breast discomfort, blurred vision, hot flushes and depression. Unfortunately clomiphene also increases the miscarriage rate.
Human Chorionic Gonadotrophin (hCG)
This hormone should be produced naturally in the early stages of pregnancy. It works in the same way as luteinising hormone (LH) by causing the dominant follicle to release its egg. It can be used in conjunction with clomiphene. This is given as an injection and there are no known side-effects.
Human Menopausal Gonadotrophin (hMG)
This is one of the most potent ovulation drugs in use, and is derived from the urine of post-menopausal women. It combines both FSH and LH and is given by injection. This drug is often used for women who have not had any success with clomiphene. It is also used for women who have amenorrhea (no periods). There is an increased risk of multiple births so careful monitoring is needed.
As with clomiphene, there can be a higher miscarriage risk and also premature labour. Mood swings, depression and breast tenderness may also be experienced. There are dangers of hyper-stimulation, where the ovaries can become enlarged and cause abdominal pain. Extreme hyper-stimulation can be life-threatening and fluid accumulates in the chest and abdominal cavity. You should be monitored closely, and doctors will withhold treatment if there are too many follicles present or if your oestrogen level is too high. In this case, the cycle will be abandoned.
April 23rd, 2009 admin
Endometriosis and miscarriage
Until recently it was thought that women with endometriosis were more likely to have a miscarriage than other women. But the results of recent studies indicate that endometriosis is not a cause of miscarriage and that infertile women with endometriosis are no more likely to have a miscarriage than infertile women in general.
Treatments available for infertility due to endometriosis
Less than a decade ago those who were infertile due to endometriosis may have been destined to never become pregnant. Due to the advancement of drug therapies and programmes such as in-vitro fertilisation (TVT), gamete intra fallopian transfer (GIFT) and related programmes, infertility does not necessarily mean that you will never conceive.
Usually the first thing is to try to conceive for a year without using contraception. A Melbourne IVF specialist says that approximately 10% to 15% of couples will not conceive in that time. ‘At that stage we feel that it is time to start investigations and try to pinpoint any problem’, he said.
The first step is to get a referral to a gynecologist. Most women with endometriosis will already be under a specialist who may also manage their infertility investigation but they may be referred to an infertility specialist.
March 23rd, 2009 admin
The physical. Having successful intercourse is pretty important in getting pregnant. Successful intercourse does not mean sky rockets and waves crashing on the beach type stuff. It means that penile-vaginal intercourse should take place, resulting in the deposition of semen at the cervix. This should preferably happen around the time of ovulation, to maximize the chances of conception. That sounds more like instructions from a car manual, but the gist of it is true.
If a couple want to increase their chances of becoming pregnant in a particular cycle, there are a few commonsense bits of advice that may help. Recognizing when ovulation is likely to occur and having intercourse near that time is a good idea. No you don’t have to do it three times a day for the week, just every couple of days or so is OK. Concentrating on having intercourse before ovulation rather than after makes sense, because sperm live longer than eggs. It is not recommended that you ‘save up’ (avoiding intercourse for several days or weeks) before ovulation, because this means that the sperm may be old and not as viable when they actually get out to do their business.
Couples tend to be older these days when they start having families, so they tend to have the sexual patterns appropriate to their age group. It may seem depressing, but the fact is that most couples have intercourse less frequently with age. Younger, excited, vigorous and carefree adolescents and young adults would average more sex per week than an older, stable couple. Given that information, you could expect the younger couple to perhaps take less time to conceive. So couples planning to conceive sometimes need to change their sexual patterns.
March 23rd, 2009 admin
Headaches. Some women do notice more headache in early pregnancy than at other times. Women who get migraine headaches may find they are more frequent in pregnancy, or may have them less often. Non-migraine headaches may also increase.
The blood vessel changes that lead to fainting may contribute to this symptom. Certainly some women get headaches on the oral contraceptive pill, so there may also be an effect from the hormones directly. And don’t forget that stress may tend to give you a headache. There may be several reasons for feeling stressed. Being pregnant could be one of them.
So to relieve these headaches you might want to try some form of relaxation (such as resting, yoga, meditation, listening to a relaxation tape, massage— there are many ways to do it). If the headache is severe, or you are worried by it, it would be a good idea to see a doctor to check that there is no other cause. If you want to relieve it with medication you can take paracetamol (for example Panadol) in the recommended doses (one to two tablets, every four hours as necessary, up to a maximum of eight tablets a day).
March 23rd, 2009 admin
A nuisance, and compared to some of the other things you can catch by having sex, it’s not too bad. Not pleasant, but it won’t kill you, make you infertile or give you cancer.
These are tiny insects, and, unlike all the other bugs discussed so far, can be seen with the naked eye. They like hairy areas, and can be passed from one pubic region to another. They bite the skin, cause an itchy bite, and lay eggs which attach to the shafts of the hairs (nits). It may be days or weeks from initial infective contact until you feel itchy or sore, or notice any insects. Some people have them without ever being aware of them. They can potentially (but probably rarely), be transmitted through non-sexual contact, and on bedding, towels and clothes.
If you have an itch, or bites or a rash in the underpants area, have a close look.
This is often difficult to do yourself, so you may need some help. It is not a bad idea to go to a doctor for this, but some people are happy to diagnose and treat crabs themselves, if they can identify the tiny insects or the nits attached to pubic hairs. BUT don’t forget the rule of STDs; they travel together. Having crabs may be an indication that you have a chance of being infected with another bug, so it would be a good idea to have a thorough check up for other STDs.
There are lotions available from pharmacies (not on prescription, so anyone can buy them over the counter), which specifically get rid of pubic lice, or lice anywhere on the body. You put the lotion on the affected area, leave it on for several hours, then wash it off. It is a good idea to repeat this in twenty-four hours, and maybe a week later, in case there were some eggs which hatched in that time. All your bedding, underpants and sexual contacts should be treated at the same time, or the bugs could come back. Washing bedding, etc., in hot water and preferably drying it in the sun is recommended.
Be careful out there! Taking care with washing and hygiene helps, but sometimes the devils will sneak through.
March 23rd, 2009 admin
The actual incidence of serious side-effects of the pill is very small. These can be divided into groups: common and pleasant, less common and a nuisance, very rare and nasty, very rare and potentially disastrous.
Very rare and potentially disastrous—the hormones in the pill can affect the blood, slightly increasing its natural tendency to form clots. Other, more frequently implicated things which influence the thickness of the blood are a family history of blood-dotting disorders, age, smoking, and immobility.
The formation of a clot in the body can have potentially fatal consequences, depending on where it is. A clot in the brain causes a stroke, in the lungs it is called a pulmonary embolus, and in the leg it is called a deep vein thrombosis (which has the potential to dislodge, and go to the lungs). All these things can happen to people who do not take the pill. The risk, however, is marginally altered by increased hormone levels, as in pregnancy and pill-taking. If you add to this a further factor, like smoking (the most common), the odds rise a little further, although the actual incidence of clots is small. This is perhaps the best argument against smoking while taking the pill, particularly after the age of 35.
If one thing has to go, don’t give up the pill. Give up smoking.
A 39-year-old, overweight, smoking, pill-taker with a broken leg, whose sister had a pulmonary embolus, would be considered at very high risk for developing a clot.
It has been suggested that the risk of heart attack, in older women, may be slightly affected by the pill. More important, it seems, are the combining factors, like age, smoking, family history, lifestyle, and cholesterol and triglyceride (blood fat) levels.
Although these nastier side-effects are rare, they are worth mentioning, if only to point out that the pill, increased age and smoking don’t mix well. Most doctors will prescribe the pill to non smokers to the age of 40, or 45 or older. Doctors will usually be less keen to prescribe the pill to smokers over the age of 35.
March 23rd, 2009 admin
Apparently during the first few days after birth some little girl babies will pass a small amount of slightly bloody mucus from the vagina on to a nappy. This is often greeted with panic by the mother and father unless they have been warned about it, or someone reassures them. The ‘bleeding’ is a normal reaction to the maternal hormones to which the baby has been exposed while in the uterus. This is not the first menstrual period. It is, however, a thought-provoking experience. They have the potential to reproduce, just as they have so recently been the products of reproduction. It is like looking into endlessly reflecting mirrors.
The first menstrual period (called menarche), excites different emotions in different cultures. In some it is celebrated as a step to womanhood. In others it is seen as a taboo subject; if it is ignored it will go away. If probably will, in about thirty-five years. Before then most women will have experienced an average of 450 menstrual periods, and may have suffered a variety of problems with menstruation.