Infertility Treatment

Infertility Causes

Cervical Cancer

Cervical cancer is an uncommon type of cancer that develops in a woman’s cervix. The cervix is the entrance to the womb from the vagina.

Cervical cancer often has no symptoms in its early stages. If you have symptoms, they would probably be unusual vaginal bleeding, which can occur after sex, in-between periods or after the menopause.

Abnormal bleeding doesn’t mean that you definitely have cervical cancer, but it should be investigated by your GP as soon as possible. If your GP suspects you might have cervical cancer, you should be referred to see a specialist.

Over the course of many years, the cells lining the surface of the cervix undergo a series of changes. In rare cases, these precancerous cells can become cancerous. However, cell changes in the cervix can be detected at a very early stage and treatment can reduce the risk of cervical cancer developing.

During screening, a small sample of cells is taken from the cervix and checked under a microscope for abnormalities.  This test is called a cervical smear or Pap-smear.

An abnormal smear test does not mean you definitely have cancer.  Most abnormal results are caused by an infection or the presence of treatable precancerous cells rather than cancer itself.

It is recommended that women who are between the ages of 25 and 49 are screened every three years, and women between the ages of 50 and 64 are screened every five years.

Almost all cases of cervical cancer are caused by the human papillomavirus (HPV). HPV is a very common virus that’s often spread during sex.

There are more than 100 different types of HPV, many of which are harmless. However, some types of HPV can disrupt the normal functioning of the cells of the cervix and can eventually trigger the onset of cancer.

Two strains of the HPV virus called HPV 16 and HPV 18 are known to be responsible for 70% of all cases of cervical cancer. These types of HPV infection have no symptoms, so many women will not realise they have the infection.

However, it is important to be aware that these infections are relatively common and most women who have them don’t develop cervical cancer

Using condoms during sex offers some protection against HPV, but it cannot always prevent infection.

If cervical cancer is diagnosed at an early stage, it’s usually possible to treat it using surgery. In some cases it’s possible to leave the womb in place, but it may need to be removed. The surgical procedure used to remove the womb is called a hysterectomy.

Radiotherapy is an alternative to surgery for some women with early stage cervical cancer. In some cases it is used alongside surgery

More advanced cases of cervical cancer are usually treated using a combination of chemotherapy and radiotherapy.

Some of the treatments used can have significant and long-lasting side effects, including early menopause and infertility.

Many women with cervical cancer will have complications. Complications can arise as a direct result of the cancer or as a side effect of treatments such as radiotherapy, surgery and chemotherapy.

Complications associated with cervical cancer can range from the relatively minor, such as minor bleeding from the vagina or having to urinate frequently, to life-threatening, such as severe bleeding or kidney failure.

Remember that early detection and treatment of an HPV-infection can save your life. So, if you’re sexually active with multiple partners or your partner has/had multiple partners, it is wise to have regular checkups at your gynecologist.

I wish you the best of health!

Alyaa Gad

Inducing Labor Naturally

Only around 5% of babies are born on their expected delivery date and about half of them in the 2 weeks after the EDD.

If you’ve reached or passed your expected delivery date (40 weeks of pregnancy), natural methods of induction are possible to stimulate labour or to ripen the cervix, especially when this is done to avoid undergoing a caesarean section.

Every development day your baby spends in your womb is important, particularly for their lung development, but after the 42-weeks mark, it becomes dangerous for the baby to stay inside the womb, and labor has to be induced.

But please be warned that: Inducing labor before 39 weeks increases the risk of complications of prematurity including difficulties with respiration, infection, feeding, jaundice, neonatal intensive care unit admissions, and perinatal death.

Important note prior to trying any labor induction method is to get a medical checkup and to have an approval from your doctor, especially if your pregnancy is high-risk.

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So here are some methods for natural induction of labour

1. Sex

Sex is commonly suggested for natural induction due to semen containing prostaglandins – which help to ripen the cervix.  But just make sure that ejaculation happens inside the vagina and that the membranes are intact (in other words, your water didn’t break).

Also, the female orgasm can be effective.

Orgasm induces the release of oxytocin– the labour hormone.  So, feel free to pleasure yourself.

2. Acupuncture

Acupuncture has been used successfully to induce labor in overdue pregnancy.

Induction using acupuncture generally works within 6-48 hours of having your treatment. You might end up needing one to three sessions though.

3. Acupressure and Induction Massage

A Traditional Chinese Medicine practitioner can show your partner how to apply acupressure or  induction massage to induce labor.

4. Nipple Stimulation

Nipple stimulation produces oxytocin and can produce some strong effects, so you can try stimulating your nipples (including your areola, as a baby would when sucking) with your fingers, massaging one at a time. You can also ask your partner for some help!

Massage the first nipple for 5 minutes, then wait around 15 mins before doing more.

5. Evening Primrose Oil (EPO) زيت زهرة الربيع المسائية

Evening Primrose Oil has similar effect to prostaglandin, which helps to induce labor.

It can be used orally and/or vaginally.

An oral dosage is 2 of 500mg capsules daily.

If you are taking  it vaginally, you can do it by inserting 2 capsules directly to the cervix before bed.

You might like to wear a pad or liner as it can get messy.

6. Castor Oil

Castor oil acts as a stimulant to the bowels, which irritates the uterus and causes contractions.

The side effects from castor oil can include:

  • diarrhea
  • vomiting

Some practitioners do not recommend castor oil because of potential side effects like dehydration (from loose stools and/or vomiting), fetal distress and meconium in the baby.

It is always wise to talk to your midwife or doctor about how to use castor oil before doing so.

You can blend the castor oil with various fruit juices and ice. Though the higher volume of drink, the more you have to drink. Some women prefer just to do shots of castor oil and wash it down with juice or another drink. Some suggest that you use a warmer drink to remove the oily film from your mouth. You can also add it to an omelet with salsa.

Typically mothers spend a lot of time in the bathroom with diarrhea before noticing contractions. Though these contractions do not always progress to full blown labor. This can be seen as a type of cervical ripening agent anyway, which is a good step towards inducing labor soon.

7. Black Cohosh عشبة الكوهوش السوداء

Black Cohosh is a herb used to encourage contractions and facilitate labour. Please note that the wrong dose may cause problems, so always consult your therapist.

8. Raspberry Leaf ورق التوت

You can drink it as a tea. It’s safe and can be taken from the 12th week of pregnancy.

9. Spices: Curry and Cinnammon

Can get the labour started. But be aware of the fact that it can cause diarrhea. Add to a meal of your liking.

10. Dates!

A study has found out that the consumption of 6 dates daily in the last 4 weeks before labour significantly reduced the need for induction and augmentation of labour.

11. Pineapples: eat fresh pineapples.

Tropical fruits like pineapple, mango and papaya contain an enzyme that is said to help soften the cervix, stimulate muscle contractions, and for shortening labor.

Eating large amount of fresh pineapple can also kick start your digestive system, which is also said to be a way to kick start labor.

12. Walking, and belly dancing help, but take some rest the night labour starts.

I wish you the best of health!

Alyaa Gad

Varicocele

Varicoceles are varicose veins of the testes, one or two testes. So, What are varicose veins, what does that mean?

In order to understand what varicose veins means, we have to understand first what arteries and veins are like and what the difference between them is.

Let’s have a look at this sheet. You’ll see here: the heart would be pumping blood into the arteries. And the arteries would be ending in capillaries, and the capillaries end up forming the veins. And the veins take the blood back to the heart. The effect of the heart pump affects only the arteries. So, the strength of the pumping, you can feel it in the arteries. So, the arteries have always the blood gushing through them easily, if they are in good condition

But then the heart pump effect stops exactly at the capillaries, and then there’s no power sending back the blood to the heart through the veins, other than the movement of the muscles and the effect of the valves present in the wall of those veins. Those valves work like gates. Those gates open for the blood to go up, then close again.

So, let’s suppose that these valves have something wrong with them, so these doors are kind of broken or have bad hinges, so the valves are not working properly. This means that the blood will droop back or seed back through them and then this causes the veins to elongate and become tortuous and visible, and also less functional. And here we call this varicose veins.

Varicose veins can happen in the legs for example, or elsewhere, like, around the testes. So actually the varicose veins of the testes, varicocele, means that the veins around the testes, the valves thereof, are affected in a way that the blood is stagnating there and the blood vessels are tortuous and elongated and looking different from the normal healthy ones. So, the problem is that the blood is stagnating there.

15% of men might have varicocele. It might cause no problem at all, but it also might cause complaints like feeling of pain or heaviness by the end of the day, but the major problems that we are concerned about related to varicocele are two thing.

One is the lack of development of the testes, so, the testes will remain too small and the function thereof will also be stagnating. What makes your male hormones, it will be delayed and this will affect the whole development as a man. And in this case we will have to seek medical help.

The other aspect is that it might be affecting your fertility. So, couples who are complaining of delayed pregnancy, we have to check the husband for varicocele problems. One of the symptoms that you could be seeing on the appearance of the testes is the bag of worms image.

Now, are there any risk factors for having varicocele? Yes. Some people believe that wearing very tight clothes, lack of exercise and chronic constipation might be affecting your circulation around that area. So, a healthy lifestyle, avoiding tight clothes and heaving healthy bowel movement is very important. Also: sporting. Don’t forget to sport. Drinking enough fluids will help you also avoid developing varicocele.

One more thing is that people suspect that the high temperatures resulting from varicocele but also resulting from using for example the laptop on your legs for a long time might be contributing to the problem and contributing to the problem of infertility. So, if you want to avoid that please keep the computer away from your legs and also try to take colder showers. That will help also avoid the complications.

So, the complications are actually infertility and small testes, and dysfunctional therefore. This will affect their functions in the future and your manly appearance in the end. We want to avoid that.

The treatment depends on your age and the problem you’re having with it. So, if you’re a teenager we would like to monitor how good the testes are growing and this will mean that you’ll have to have follow-up on regular basis with your doctor.

Sometimes we will have to do surgery to do something with the veins. We actually either embolize the veins or ligate them. In the end we will have to get rid of the veins that have the problem. This also might be of negative effect on your fertility and as testes function. So, in the end the surgical treatment also has it’s side effects, but sometimes we will have to do it in order to avoid other problems. Also, the surgical treatment does not guarantee, that it will not recur. It might recur and we will have to see another solution for it

So for prevention of varicocele my advice to you is to avoid constipation, avoid putting the laptop computers on your lap, put it on the table always, also drink a lot of fluids, do sports, avoid hot showers, saunas, tight clothes and have enough sleep, that’s also very important.

I wish you all the best!

Alyaa Gad

Sickle Cell Anemia

Sickle Cell Anemia is a disease that affects the red blood cells. Anemia means: a problem with the blood cells. And sickle cell is one disease that makes the blood cells look like sickles or crescent.

A normal blood cell would look a bit like a donut. It’s circular in shape and has three very important features. It has iron on it that binds temporarily to oxygen, until it reaches the tissues of the body and then releases the oxygen. Number 2 is that it lives up to ninety days, three months, and then it brakes down and the body remakes new cells. And then also it’s very flexible. So, if it goes into the small capillaries, the small blood vessels, it can bend itself to fit into the very tiny blood vessels.

On the other hand, a patient with sickle cell anemia, his cells look like this, like crescents. They have three main defects. The iron on it cannot bind so well to oxygen, so the oxygen will remain in the blood without being able to get into the tissues. That’s one thing that causes the tissues of the body to lack oxygen in the patient. Number 2 is that it only lives ten to twenty days. So, a long period of time when the patient’s body is missing red blood cells. Number 3, the third and very important problem, is that the red blood cells that are normal can go into the big blood vessels easily, and then bend themselves to go through the tiny blood vessels. They’re very flexible. No let’s see what happens with the sickle cells. The sickle cells go easily through the big ones, big blood vessels, and then get stuck at the edge of the small blood vessels. They cannot get inside. They’re not flexible enough. And then they cause clumping here, and then in the end this organ will lack the blood supply, whatever it is. It can be the brain or hand or the penis or any tissue that is unlucky to have this attack of shortage of blood supply.

And as a result you’ll have attacks of hypoxia, which means lack of oxygen arriving to the tissues, and this can cause severe pain, sometimes death of the tissue or at least an infection occurring there.

So, the sickle cell patient mainly has anemia problems, because he’s lacking always red blood cell functions, so he’s always tired, having short breath, headaches, is always pale, sometimes he’s yellow skinned, because the sickle cells, when they die, the breakdown material is yellow in color. And then another thing is that he’s suffering from pain all the time, because these attacks are happening, so the cells are getting stuck at the edge of the tiny blood vessels. So you’re always expecting the patient to end up having either an attack of pain or an attack of being very tired and not able to function normally. Let alone other diseases that can occur, several infections in the lung can occur. So, the patient is continuously in need of medical care and checkup and prevention of certain diseases.

Another problem is the delayed growth of young people, because of the lack of blood supply to their organs. So, a sickle cell patient unfortunately is in need of continuous medical care to help the growth and prevent complications.

Currently there’s no permanent treatment of sickle cell anemia, but we try to give medications to prevent medication and also vaccinations to help the patient overcome, or not catch, infections all the time. There’s new lines of gene therapy and bone marrow transplantations, but it’s very important to also screen before marriage, do premarital screening to expect the outcome of the marriage and explain that to the parents. So, health education is very important. We also need to diagnose early if the child will be having the disease, so we can take a sample from the amniotic fluid to find out whether the mother is carrying a child with the disease.

In the treatment of sickle cell anemia we are highly depending on the health education of the parents and the caregivers of the child, so that we would prevent complications. So, early diagnosis, proper treatment and prevention will help the child grow up in a healthy way and we will help them have as much normal life as possible. So, don’t forget health education is the most important thing you should have if you find out that your child is carrying the disease.

I wish you the best of health!

Alyaa Gad

Uterine Fibroids (Myomas)

Uterine fibroids are benign tumors of the uterus. “Benign” means that they are not cancer. They are swellings that happen in the muscle area of the uterus. And these swellings can be anywhere in that muscle. And the size can vary also. And that will decide the symptoms and the complaints you might have.

So “myo” is “muscle”, “oma” is “swelling”, that’s why a myoma is a muscle swelling and fibroid is; the fibres of the muscle will have some swelling in them.

Who gets them? About 80-90% of the women by the age of 50 will have had myomas. Some women will never notice them and other might have life-threatening situations because of them.

The causes are not known of why we have or develop these myomas, but we are assuming that oestrogen has a major role in affecting them, so their growth. So the more oestrogen you have (the female hormone), the more chances of growing a bigger size of those myomas.

Genetics play an important role. Number 1 role is that you might inherit it from your mother or a related woman in the family on your mother’s side. So if your mother, your aunt or your sister have had it, you probably will develop it. Another reason is weight gain. If you are overweight you might develop it, because this will increase the oestrogen in the blood.

Women who have had their menarche very early (started menstruating very early in their lives), we expect that they might be having a higher chance of developing myomas.

The symptoms and the complaints due to myomas will depend on the size and the location of the tumors. So let’s see, on this painting of Dr. Netter, how this will happen. So you might have a tumor or a myoma in the middle of the uterus, in the middle layer and you might not notice much.

Another one might block the fallopian tube and then will affect the fertility.

Another one might fill in the area of the uterus and then affect also the growth of your baby if you are pregnant – or the position of the baby. It might even block the exit of the baby and then we’ll have to do a caesarean section to get the baby out.

One might also even stick out of the vagina and we can see it outside the uterus.

Here’s another one that is actually coming outside of the uterus and then twisting around itself and might be life-threatening to the patient.

The size, as you can see, varies from some millimetres and some can grow to as big as a watermelon or football.

As you can see here, also the baby’s growth is affected by this tumor, also the position.

This tumor has been developing gangrene, and then we have a major life-threatening situation for the lady.

This lady’s tumor is totally blocking her uterus and then she might be not able to get pregnant.

And this lady’s myoma is sticking out of her abdominal wall, and then it looks very disturbing of course, and also could threaten her life.

Here we can see that the myomas can also grow to affect the colon, if they press on the colon, and the rectum might even block it and in the end you will develop constipation and severe pain, abdominal pain.

You can also have back pain due to the weight of the uterus pulling on the ligaments hanging on the backbones, and then you’ll have a lot of pain.

Another problem that, if it’s very heavy, it might press on the urinary bladder and then you will be having the urge to urinate more often.

Yet another problem is that if they’re very big and filling this area sexual intercourse will be very painful.

And another problem they cause is that they’re cosmetically not pretty if they grow very big. You will develop a big belly any people might think you’re pregnant, but you’re not. It’s that myoma.

They also suck a lot of blood out of your system. So when you are having your menstruation you’ll be bleeding a lot. That’s another problem. And the result of this: you will have prolonged menstruation periods and heavy ones. And that will make you loose a lot of iron from your body, and you will have, in the end, iron deficiency anaemia. So most women who have big myomas also suffer at the end from iron-deficiency anaemia.

So, how can we help? How can we solve the problem? We need to first diagnose it. So I would suggest that all women who have had family history of myomas to seek medical help to diagnose it using ultra-sound. So, pelvic ultra-sound is #1 way to diagnose it. You will go to the gynaecologist and he will or she will have a probe either into the vagina or trans-abdominal and will look at your abdomen from inside and diagnose it.

How do we treat the myomas? Many doctors will just observe you and watch and wait. So they will ask you to come back every six months to check if the myoma has grown and then decide on what to do with it.

And if you have problems the doctor will prescribe medications. The medications are usually hormones, so birth control pills or other hormones. You might also have an (Intrauterine device) IUD inserted into the uterus. They will also try to correct your iron. You might take iron tablets or injections, and that will help a lot in feeling better and correcting your shortness of breath, being tired and so on.

The alternative to medication or medical treatment is surgical treatment. We have two options. Either to remove the uterus as a whole – they will not remove the ovaries, only the uterus. And this is the perfect solution if you want to permanently get rid of the myomas.  They will never grow back. But of course that’s when you are maybe older and have decided not to have children anymore. Because you will not be able to have children after hysterectomy. The other option is to have myomectomy. “Myomectomy” means: cutting only the myomas. So they will remove only the myomas. Either through open abdominal surgery or endoscopy or through the vagina. This will be decided between you and your doctor.

The latest development in the field of surgery or minor procedures or treating the myomas is UAE. Uterine Artery Embolization. It’s a procedure that cuts off the flow to a uterine fibroid causing it to shrink. It’s not a surgical procedure, it’s a minimally invasive procedure during which a thin tube that’s called a “catheter” is inserted into an artery in the growing and is guided using x-ray cameras. Once it’s there the doctor injects very small particles through the tube. The particles will clog the blood vessels that feed the fibroids. That causes them to shrink over time and die out in the end.

Not all women are candidates for every procedure. Some women are not allowed to undergo certain surgeries, and that’s why you’ll have to decide with your doctor.

If you have problems with your myomas please seek medical help because it affects your life-style and life quality a lot. So don’t hesitate to seek medical help.

I wish you the best of health. Thank you.

Alyaa Gad

Kegel exercise

Kegel Exercise is away to train and improve the muscle tone of your pelvic floor. It was named after Dr. Arnold Kegel, an American gynaecologist, and it’s meant to improve your sexual function as well as the control over your urine and faeces. This applies to men and women.

So, the benefit of Kegel Exercise is mainly to treat some cases of urinary incontinence in women, and also fecal incontinence (very mild cases), and also to treat pelvic prolapse, especially in women who have suffered severe prolapse with the pregnancy. You can train the pelvic muscles to improve the muscle tone. Also to improve your sexual function as a woman who has difficulties reaching orgasm, or after giving birth and you’re noticing that your vagina has become a bit wider than normally. In men we can treat fecal and urinary incontinence (minor cases of it), and also we can help men, by doing it, to improve or laten their ejaculation, so for premature ejaculation; it’s a way to delay the ejaculation.

So this exercise strengthens the pubococcygeus muscle and also the levator ani muscle. Mainly these two muscles are affected by this exercise you’re making.

You can do it without any tools, but women can use balls, like this one for example, and they can introduce it into the vagina and do the exercise.

What we need to know now is how to do it. First you need to find the pelvic floor muscles. Let’s see here. They’re supposedly here in women, in this area, in the lower part of the pelvis, and by men you can see it with the arrow.

What you need to do is learn how to find the muscle, and the first time you find it; it would be easy to do it while you’re urinating. Try mid-stream to stop the urine from flowing. So, stop it mid-stream. So what happens is that when you stop it you’ve actually made the muscle contract. This muscle is what we’re looking for. So what you need to do is contract it as strong and often as possible but not during urination or defecation. Only the first time, when you try to locate it. Don’t make a habit of it cause this might cause problems.

Second thing is to perfect your exercise. So you do it as often as possible, and concentrate that you’re only working on that muscle and not working with other muscles, like abdominal wall or leg muscles or anything. Just that muscle. So try to count and find the muscle and keep contracting it.

The third step is to maintain your focus, so, only that muscle, and to keep repeating. So repeat: Ten seconds the contraction, and then ten seconds relaxed, and then ten seconds contraction… Try to make it as many times as possible, at least three time a day.

When to do this and where? When you’re sitting at your desk or when you’re reading emails, or in the car or when you’re waiting for the bus. You can just do the exercise about anywhere you want.

This method is not recommended for people with urinary tract infections, chronic constipation or prostate problems.

Try to repeat Kegel Exercise as often as possible and you’ll find results within 4-5 months.

Best of luck!

Alyaa Gad

Testicular Self Exam

TSE or Testicular Self Examination is a way to examine your testes to find out if they have a normal or an abnormal condition.

We actually check for lumps or any swellings or abnormalities in the testes and an early detection can save your life. So if you do it once a month and if you know what to look for you might be able to save your life. Testicular cancer is one of the most common cancers in young men between 15 and 35 years of age. So, you check regularly, to know what’s normal, and then if there’s something abnormal you’ll be able to detect it.

So let me show you how to do that examination. Right after the shower, or even during the shower, you can do the examination by standing straight and holding the testes with one hand at the top and the other hand is checking if they’re both sides at the same level. You might find that one is higher than the other, that’s ok. But you just have to check, what is normal in your case and remember that. So, if the right one is higher, you remember, or the opposite.

And then you’ll be holding with one hand, say the left hand, and with the right hand you check the right side. Initially you’ll start to fell it and then you’ll feel that something is like running, escaping from you. And gradually you’ll start to learn to hold it tight and fell what’s inside that bag. This bad is called the scrotum. So, with rolling movements between two fingers you will start to feel what’s inside. And once you finish the right side, you hold the top with the right hand and then do the left hand to check the left side, with a rolling movement, in a circle.

Now, what do we actually look for? What should you be feeling inside? Let’s see.

This is an example of what you should be feeling. Inside the scrotum you’ll feel on testis on the right, and the normal size is about 5×2.5cm (2.5x1inch). In the bag of this bag you’ll find yet another structure, and that is called the epididymis. You will actually find sort of on top back of the testes another mass, and that’s normal. That’s the epididymis, and on the other side as well.

Sometimes you might be feeling that one testis has gotten slightly bigger. If you have any pain or feeling that it’s gotten bigger than normal you should contact your doctor. Sometimes you might also feel that one of the testes is smaller than the other, but this is abnormally small, or both have been shrinking very strangely, you’re not used to it, this is also a sign that you should see the doctor.

You might also find a small swelling in the size of a pea, right on the surface, so you feel it from outside, and this is a strange swelling. This is an abnormal swelling. This needs contact with a doctor. And also maybe a swelling even this size, as small as a rice, also this is strange.

So, what you need to do is get used to the normal feel of your body, of your testes, so that you would immediately know if there’s something abnormal there. Usually you would feel the surface, and its very soft and there’re no swelling or tumors. There’s only a mass in the back, and that’s the epididymis

Another thing you might feel is the sensation that there is a bag of worms at the back of the testes, and that’s a sign of varicocele. This is also a problem that demands us to seek medical help.

What should you be feeling? So, let’s see what’s normal.

This is a normal testis, so you see here, this is the front side and it’s a normal, soft egg-like structure, and in the back there’s a group of tubes, very small tubes, collecting together, called the epididymis, this is the two structures that you feel. So, what’s abnormal is to feel a swelling or a change in size, so, has gotten very much bigger or very much smaller than normal. Or if you notice any lumps, any tumors in the size of a pea or rice or bigger or smaller. Or if it changes in color, so the color suddenly changed to blue or very red, this is not normal. If there’s pain that you’re not used to, this is abnormal, and if the testis is not there or has never been there, please remember that, so, any change in the position of it, please tell us. And this bag of worm sensation, this is a sign of varicocele.

Do it every month to save your life maybe one day.

All the best!

Alyaa Gad

Menopause

So, what is the menopause? Menopause stands for “menstruation stopping”. “Meno” → menstruation, “pause” → pausing.

All women will experience menopause at a certain point of their life, as they get older. It means that your ovaries are actually shrinking, producing less and less estrogen, that’s the female hormone. The ovaries are also losing their main function and that is making eggs for you to have babies with them. The average age of reaching the menopause is about 50, so ‘round the age of 50 you will start experiencing special symptoms that are a sign that you are going into your menopause. These symptoms that happen before the menopause and maybe after it’s complete, we call it perimenopausal symptoms.

Some women would experience menopause earlier, younger than 40, and in this case we call it early menopause. These women might be having a certain disease like ovarian failure or have had cancer and have had radiation therapy or have undergone hysterectomy, and all this can lead you to also going through your menopause.

The menopause itself is a physiological phenomenon but can cause some health problems and some symptoms that might bother you as you go through it.

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What are the symptoms of menopause? How do you know that you are going through the menopause?

The first thing you might notice is that your periods will be different. You might have abnormal vaginal bleeding, which means that your period will be heavier or lighter, or more frequent, or less frequent

You will also notice hot flashes, which are waves of feeling very hot all over your body, and sweaty, and red, and it might be embarrassing sometimes. At night you might notice night sweats, which might disturb your sleeping pattern and give you insomnia.

Sometimes you will also notice vaginal dryness or itchy vagina and you will experience maybe some difficulties having sexual intercourse.

You might also suffer from stress incontinence, which means that as soon as you cough or sneeze you might leek some urine.

You might also experience fatigue, lack of concentration, mood swings and other symptoms, because you’re feeling sad, depressed that you’re getting a bit older.

There’s also a fact that when the estrogen is less you will experience the effect of relatively more testosterone in your body, and that’s the male hormone, which means that you’ll experience some acne, also some hair on your chin or moustache area.

You might also experience some weight gain, especially around the area of your tummy, so, in the abdomen here, or sometimes around the waist. This is a defense mechanism from your body, because the fat is being stored around the area where actually the estrogen can be stored from the ovary. So it’s actually a reserve for your hormones. So, what you need to do there is not panic, just chance your diet habits a bit and do some sports and everything will be fine

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What are the complications of menopause?

What we worry about is more also the complications that might happen with the menopause. These complications are two main things: that you might be having a higher chance of getting blood problems like clods or heart diseases, and you might also have problems with your bones, so you might have osteoporosis, which means that you are more prone to breaking your bones easier. We also heave to deal with that.

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What are the treatment options for menopause?

There are actually no blood tests to diagnose the menopause. We actually find out that the lady is going through her menopause by hearing her history and knowing the symptoms she’s suffering from. The most important thing is to replace or try to correct the levels of the estrogen in your blood.

Medicine is offering options from hormonal replacement therapy, so we give the women estrogen and progesterone, but the problem is that it has side effects and some women are not allowed to take it – those with history of cancer or health problems that might be affected by estrogen, if you take extra of it or synthetic estrogen.

There is a new line of treatment called bioidentical hormone replacement therapy, which is using estrogens that are actually from natural sources, and they’re doing very well in this line and hopefully we would be able to treat a lot of women with them.

There’s also the oral contraceptive pills, the birth control pills. Some women use them, because they have hormones in them, and are happy with the results.

There’s also vaginal creams containing estrogen that you can use to treat vaginal dryness or itchiness.

And some women who are suffering from psychological problems can use antidepressants, and all under the medical supervision of your doctor.

You might be able to receive collagen injections at your doctor’s office to treat the urinary incontinence.

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What are the alternative therapies for menopause?

There are also alternative home treatments for menopausal symptoms. First of all, we can use plant estrogens, so, female hormones that are available from plants. So, what are those? Any soy products, you can have those in the form of capsules or eating certain things like beans chickpeas and lentils. Those contain soy, isoflavones or fitoestrogens that are very good for you in very minimal levels. They’re not as much as you would get from the doctor’s prescription drugs but they are estrogens, from natural sources. But always consult your doctor, even before using natural products.

Also vitamin E is very good for your over-all wellbeing and your skin condition, so I would suggest that you use vitamin E for your skin, just as lotion but also to administrate in capsules.

I would also suggest using omega 3 capsules. They would be containing also vitamin E added. Also, if you use anything with vegetable oils, they are your friends, so, olive oil and all the other vegetable oils containing very good amounts of vitamin E that is very good for your skin.

There’s also natural things like black cohosh or wild yam. Women use it, but it’s not scientifically proven yet that they are good for their menopausal symptoms. But some women are happy with the results. It comes in capsule forms or in cream forms. You can read the instructions and consult your doctor about them. Some women also are happy with the results of acupuncture, and that’s all alternative treatments, but it’s worth trying.

Changes in your lifestyle are very important. You have to sport more, because sports will bring your hormones into balance and also keep your weight and will make you feel good about yourself, which is very important. There is also the right nutrition. Try to eat healthy stuff like nuts, ginger is very good, and all types of seeds are very good for you.

For your over-all health, especially bone health, you have to concentrate on getting more vitamin D3 that’s the sun vitamin. You can sit in the sun, or use it in capsule form. And it could be a good idea to add calcium, extra calcium, to your diet, either in tablet form or take more dairy products. Some women also use whole food multivitamin capsules if they have a hectic lifestyle, which is also a good idea if they are not able to eat healthy food all the time.

Some women who suffer from urine incontinence say that they are very happy with Kegel exercise.

In Japan women suffer very little from the menopause, and it could be because of their lifestyle; healthy soya products, probably they’re more active than Western women. Also the fact that the Japanese culture values the woman as she gets older, because her role in life is not only bearing children. So I’d like you to think that as we get older we have a different role in life and life is still beautiful and it doesn’t mean that all the stereotypes of beauty have to apply to all of us. We just have to have some peace in our lives. Sport, eat well, and everything will be fine.

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Enjoy life!

Alyaa Gad