Breast Cancer

Breast cancer is the cancer that forms in the breast cells. Breast cancer can attack both men and women, although it’s more prevalent in women. Public support for breast cancer awareness and funding in Kenya and globally has greatly helped improved its diagnosis and treatment. Deaths attributed to breast cancer have been managed although it remains a challenge due to the high cost of treatment.

 ImageSymptoms

Unlike ovarian cancer, breast cancer symptoms are direct and cannot be confused with other conditions. They include:

  • Lump of the breast or thickening that has a different feeling from the surrounding tissues,
  • Change in shape or size of the breast,
  • Bloody discharge through the nipple,
  • Changes to the skin of the breast,
  • Peeling, scaling of the nipple or breast skin,
  • Inverted nipple, and
  • Redness or pitting of the skin of the breast like the skin of an orange.

Causes

It is caused by abnormal growth of breast cells, which divide abnormally and do not die but accumulate forming a tumor/lump/mass. The cells may spread through the breast or lymph nodes or other body parts. Normally breast cancer starts with cells in the milk producing ducts or in the glandular tissues or in other cells within the breast. What causes this abnormal growth of the breast cells is however unknown.

 Risk factors

There are certain identified risks for breast cancer even though it is not yet clear why some people without these risks develop breast cancer while others with these risks never get cancer. This means that there is a possibility that breast cancer can result from a complex interaction of an individual’s genes and the environment. Risk factors for breast cancer include:

  • Inherited breast cancer: a considerable proportion of breast cancer is believed to be linked to gene mutations inherited through generations of a family. The inherited mutated genes causing breast cancer include breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2) which are both risk factors for ovarian and breast cancer. If you have a family history with breast cancer or other form of cancers, you may need to do a blood test to establish mutations in breast cancer genes or other genes running through the family.
  • Being a female,
  • Having your first child at an older age,
  • Having menstrual periods at a tender age,
  • Menopause onset at an older age,
  • Having a post menopausal therapy,
  • Never being pregnant,
  • Obesity,
  • Exposure to radiation,
  • Increasing age,
  • Alcohol drinking and
  • A family history with breast cancer.

Tests and diagnosis

Breast cancer can be diagnosed through:

  • Breast examination: where the doctor checks both of your breasts by feeling for lumps or any other unusual signs.
  • Mammogram: this is simply an x-ray of the breast, used to screen for breast cancer.
  • Breast ultrasound: ultra sound utilizes sound waves to produce images of structures inside the body. An ultrasound of the breasts helps differentiate solid mass from fluid filled cyst.
  • Biopsy: this is the removal of breast cells for testing through surgery. Samples are analyzed to determine whether the cells are cancerous, the type of cells involved in causing breast cancer, the aggressiveness of the cancer and whether the cells have hormone receptors or other receptors that may determine treatment options.
  • Breast Magnetic resonance Imaging (MRI): this is a machine that uses radio waves and a magnet to create pictures of the inside of the body.

The stage of breast cancer can be determined through surgery (biopsy process). Breast cancer starts from 0 to IV with 0 indicating mild while IV indicates cancer that has spread to other body parts.

Treatment and drugs

Breast cancer treatment depends on the stage of the cancer among other factors that the doctor may perceive critical. Normally treatment involves breast surgery. Surgery includes:

  • Lympectomy: this involves the removal of the breast cancer or tumor and a small portion of the neighboring healthy tissues. It is usually done for small tumors.
  • Mastectomy: this involves the removal of the entire breast. All the breast tissues are removed.
  • Removing both breasts: this involves the removal of both breasts including the healthy one if one is at an increased risk of having breast cancer on the other breast.
  • Removal of lymph nodes: lymph nodes receiving drainage from the tumor are removed.

Other common treatments include; radiation therapy, chemotherapy, hormone therapy as well as treatment drugs can be used.

It is good to discuss with your doctor on the available treatments and their effectiveness and effects. Breast cancer just like other forms of cancer is agonizing and patients need support and care.

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Menopause

Menopause is simply the termination of menstrual life. It marks the time in the life of a woman when her menstruation ceases and she can no longer get pregnant. This is a normal life process just like adolescence; it is not a disease or a condition.  A woman experiences a significant drop in the level of oestrogen in a period of 3-5 years before the menopause. This period is called peri-menopause.

Image      45 is the average age for menopause.

What Causes Menopause

Menstruation is controlled by the hormones oestrogen and progesterone; particularly oestrogen is involved in regulating menstruation while progesterone is concerned with preparation of the body for pregnancy. With age, usually in early 30’s the body starts producing less of these two reproductive hormones, causing pre-menopausal period. As time goes by, the ovaries produce less and less progesterone and oestrogen, before eventually shutting down completely and the woman no longer experiences her monthly periods. Most women experience a gradual change in menstrual periods, while some have normal cycles until they suddenly stop. The average age for menopause is usually 45 years, although some women may go up to 50’s, depending on ones’ health, lifestyle among other factors.

Symptoms of Menopause

Technically, menopause is established when a woman has not had a menstrual period for a period of one year. Symptoms however appear well prior that period is over. The symptoms are several and may vary from one individual to the other. They include;

  • Irregular periods: this is usually the primary symptom, where menstrual pattern changes significantly. Some women may experience a period as often as every fort night or three weeks while some may not experience any for months at a time. This is an early signal of menopause.
  • Lower fertility: during the peri-menopausal period in a life of a woman, the level of oestrogen drops significantly lowering the chance of becoming pregnant.
  • Vaginal dryness: when approaching menopause, the vagina becomes abnormally dry and sometimes may be itchy. Some women may also experience dyspareunia (pain during intercourse). During menopause the vagina becomes inflamed due to the thinning and shrinking of the tissues, together with reduced lubrication caused by lack of oestrogen. This condition is known as vaginal atrophy and is experienced by some women during peri-menopausal period while others experience it during post-menopausal period. Women experiencing post-menopausal vaginal dryness should seek medical advice as some may experience it even for more than a decade after their final period. However, many women shy off from talking about vaginal dryness and pain after menopause despite it being a stubborn issue.
  • Hot flashes: this is a term used to refer to a sudden feeling of heat in the upper body. It may originate from the chest, neck, or face spreading either upwards or downwards depending on its origin. A woman may sweat from such pain, increased heart rate or palpitations (irregular or stronger heart rate). This symptom is normally experienced during the first year after a woman’s final period.
  • Night sweats: this is sweat caused by hot flashes, which occur at night when a woman is sleeping. Hot flashes lasts a few minutes and anything more than this may be other health problems that may require medical advice.
  • Urinary problems: women at menopause tend to be more susceptible to urinary tract infections and may urinate often.
  • Disturbed sleep and moodiness: Sleeping problems are usually as a result of night sweats. Moodiness on the other hand results from lack of good sleep.
  • Problems focusing and learning: menopause my cause some women to have a short term memory problems and they may find it challenging to concentrate. Shortly before menopause, some women may not even be able to learn as compared to other stages of life.

Other symptoms of menopause may include; loss of breast size, more fat building up in the abdominal area and hair loss/thinning hair.

Premature Menopause

Some women experience menopause before the supposed age of 45. This is because the ovaries can fail at any age depending on various factors including:

  • Enzyme deficiencies,
  • Hypothyroidism,
  • Down’s syndrome,
  • Turner’s syndrome,
  • Radiotherapy to the pelvic area,
  • Chemotherapy,
  • Hysterectomy (surgical removal of the uterus),
  • Genetic factors, or even being a twin (twins are more likely to have premature menopause) and
  • Other diseases including TB and malaria, although the risk of ovarian failure is relatively small.

 Complications or crises that may occur with menopause

After the menopause, it is possible for the following chronic conditions to occur including cardiovascular disease, urinary incontinence (involuntary urine loss), osteoporosis, low libido, breast cancer weight gain or obesity.  

 Though menopause is not a disease, some women seek medical treatment in order to restore their fertility. There are various methods available for treatment of menopause which has their own side effects. In addition, if you are having problems with menopausal symptoms, do not shy off from seeking medical advice.

Fertility Boosters

Planning to get pregnant for the first time or wondering whether it will be as easy as it previously was is not something that most people think about. However, as many couples discover along the way of being parents, there is no guarantee that when you are mentally prepared for a child, you will have your wish outright. Even for those who had it easy during the previous pregnancy, fertility is not foreseeable.

Secondary infertility, where partners find a recurrence conception challenging after an effortless first pregnancy attempt, affects many people. This is worsened by the fact that majority of people today have unhealthy lifestyle such as junk eating coupled with stress and environmental toxicity.

Meanwhile, if getting pregnant was problematic or is problematic, here are fertility boosters tips you should be looking for, to make it less difficult the next time you want a baby.

  1. Eat regular healthy meals

Many people today juggle between work, family and remnants of social life and it may not be easy to have that healthy plate regularly due to time pressure. Eating a healthy balanced diet is important in boosting fertility as it helps in regulation of hormone levels. Particularly food rich in folic acid/vitamin C and vitamin E are fertility enhancers, as well as food containing antioxidants and certain minerals such as selenium. Besides, foods rich in Omega 3 fatty acids, such as fish promote fertility, since essential fats are required for hormone balance and healthy cell function.

2. Avoid Caffeine, Alcohol and Cigarettes

Fertility reduces in women who consume more caffeine. Though studies suggest that consumption of less than 300mg is healthy, it’s advisable to avoid caffeine. Alcohol should be avoided completely while preparing for pregnancy, as studies has shown alcohol reduces chances of getting pregnant.  In addition smoking including second hand smoking reduces fertility and increases problems in carrying a birth to term. Smoking damages eggs, decreasing the chances of falling pregnant during any particular cycle, and smokers may reach menopause several years before the normal age. It also impairs hormonal levels which affect fertility. The problem with smoking does not end when one gets pregnant. Smokers are highly probable to suffer miscarriage and difficulties during their pregnancies and also bear babies that are underweight.

3.Lose or Gain Weight

Overweight can inhibit ovulation and cause trouble with hormones, besides putting women at risk of diabetes, blood pressure and heart disease which negatively impact fertility and can lead to complications during pregnancy. Fat cells cause hormonal imbalance. They produce extra oestrogen. Hence being overweight is similar to being on contraceptives.

Consequently, being underweight can affect fertility. A normal healthy BMI ranges from 18.5-24.9. Anything lower than 18.5 is underweight. Underweight women have problems with ovulation; others menstruate irregularly, although experiencing a monthly period doesn’t necessarily mean one is fertile because one can menstruate without ovulating.

4. Exercise

Sensible levels of physical exercises daily can help improve fertility as they help in regulating hormonal levels, reduce obesity incidences, heart disease, diabetes which inhibit fertility and can lead to complication during pregnancy. Many people today spend time in the workplace sitting on their desk or in car to work or home. Exercises that can help include mild activities such as walking, bike riding, yoga and swimming. Besides, mild exercises can help increase circulation to the pelvis and the reproductive organs as reduced blood circulation is associated with ovarian aging. Intense exercises should however be avoided as women training for elite sports have often reported not having their monthly periods.

5. Have Adequate Sleep

Though this may appear funny, having adequate sleep helps in boosting fertility. According to studies, body’s level of hormone leptin, associated with fertility in women reduces in sleep deprived women.

6. Avoid Stress

Stress leads to depression, which impairs normal mental function, hence hormonal balances. Besides, when one experiences difficulties getting pregnant, they become distressed, lose appetite and engage in unhealthy lifestyles which may cause more problems with fertility. It is therefore advisable to relax and look for a way to avoid or reduce stress when preparing to be pregnant.

Ultimately, everyone wants to have it easy when they want a baby. The problem is most people fail to observe their behaviour, and some are unaware of the effects of their lifestyles on fertility. It is therefore important for one to be conscious of their lifestyles if they want to fall pregnant. Image

Endometriosis

endo1-1 Endometriosis is a very painful condition in women, which is caused by endometrium, which are the tissues lining the inside of the uterus, growing outside the uterus. It usually involves the ovaries, the tissues lining the pelvis or bowel. It is only on rare occasions does endometrial tissue spread beyond the pelvic area.

The displaced endometrial tissue acts as normal; it thickens, tears down and bleeds with each menstruation. Since this displaced tissue has no way to leave the body, it is entrapped. Where endometriosis involves the ovaries, cysts may form.  The surrounding tissues become irritated, leading to scar tissue and adhesions. Endometriosis may result to pain particularly during menstruation. It may also cause fertility related issues.

Symptoms

Endometriosis is usually characterized by:

  • Pelvic pain that occurs during menstruation. The associated pain is usually intense and persistent than the one caused by cramping. Pain may be experienced before and after period and may come alongside lower back and abdominal pain.
  • Pain during intercourse,
  • Pain with bowel movement or urination, mostly experienced during your periods,
  • excessive bleeding or heavy periods
  • Infertility.
  • diarrhea,
  • fatigue,
  • constipation,
  • nausea or bloating usually during menstrual periods.

However, endometriosis may be mistaken for other conditions that cause pelvic pain including:

  • Ovarian cysts or
  • Pelvic inflammatory disease (PID).
  • Irritable bowel syndrome (IBS). When IBS accompanies endometriosis, diagnosis can be very difficult.

What Causes ?

There is no certain cause for endometriosis but it can be explained by various factors including;

  • Retrograde menstruation: This is the most probable explanation for this condition. It entails the flow of menstrual blood stained with endometrial cells back into the pelvic cavity through the fallopian tube. Instead of being ejected from the body, the displaced endometrial cells attach to the pelvic walls and on the surfaces of pelvic organs, where they develop, thicken and bleed during each menstrual cycle.
  • Embryonic cell growth: cells lining the pelvic and the abdominal cavities come from embryonic cells. Sometimes one or more areas of the abdominal lining change into endometrial tissue, thus endometriosis can occur.
  • Surgical scar implant: after an operation such as C-section, endometrial cells can attach to a surgical cut.
  • Endometrial cells transport: the blood or the lymphatic fluid may transport endometrial cells to other body parts.
  • Immune system disorder: the immune system may not be perfect, thus make the body unable to identify and destroy endometrial tissue growing outside the uterus.

Risk Factors

There are factors that place a woman at a greater risk of developing endometriosis. These are:

  • Not giving birth in a lifetime,
  • A relative having endometriosis history or pelvic infection,
  • Any medical complication inhibiting normal flow of menstrual period out of the body
  • Uterine abnormalities.

Endometriosis normally occurs long after onset of menstruation and the symptoms disappear temporarily with pregnancy and varnish completely with menopause.

Complications

  • Endometriosis Related Infertility-Almost half of women with endometriosis have problems getting pregnant. Endometriosis may block the fallopian tube and hinder the egg from being fertilized by a sperm. It may also affect fertility indirectly by damaging the egg or the sperm. However a woman may still get pregnant and carry it to term. Doctors usually advise women diagnosed with endometriosis to have children as soon as they can as the condition may deteriorate with time.
  • Ovarian Cancer- Endometriosis increases the likelihood of developing ovarian cancer. Even though ovarian cancer lifetime risk is minimal, endometriosis increases that risk.

Diagnosis and Treatment

Physical clues of endometriosis can be achieved through a pelvic exam, an ultrasound or laparoscopy (a surgical procedure that entails an incision through the abdominal wall). Treatment of endometriosis normally entails medication or surgery. The approach taken by a physician depends upon the extent of your symptoms and plans of getting pregnant. Medication is usually recommended and surgery is mostly considered as a last resort.

Generally, endometriosis affects women in their reproductive years. If having difficulties becoming pregnant, it is good to have an endometriosis diagnosis as it is highly associated with infertility. Early diagnosis of the condition is necessary for appropriatetreatment and easy management. naturopathy-alternative-medicine-illness-natural-e1354876502320

Contraceptives and Fertility

the pillContraception or family planning can be simply defined as a way of keeping a woman’s fertility in check. Contraceptives enable a woman to keep her reproductive health in check by determining when to get pregnant. For those who are mothers already, it’s particularly important so as to birth space their children accordingly.

Nowadays, there are several methods of family planning to suit each woman depending on their taste. It is important that a woman consults a reproductive health practitioner before putting herself on any method of family planning. This is so because family planning is individualized and what suits one woman may not necessarily work for another.

Birth control methods

  1. Hormonal methods (oral pills, injections, implants and vaginal rings) – they contain synthetic hormones which stops ovaries from releasing eggs each month or by thickening cervical mucus hence sperms cannot pass through.
  • Oral pill comes in two forms; combined pill (progesterone and estrogen) and progesterone only pill.
  • The injection can last for two up to five years depending on the plan. It is advisable to visit a doctor for injections, prescriptions and placement of vaginal rings or implants to avoid any complications.
  1. Intra-uterine devices (IUD’s)these are T-shaped devices which have strings and are inserted into the uterus thus inhibiting fertilization. Examples are copper IUD and Mirena and can last up to five years.
  2. Barrier methods –they include male & female condoms, diaphragm and cervical cap. Apart from preventing pregnancy, condoms offer an added protection against STI’s.
  3. Surgical sterilization– this is a permanent method. It includes tubal ligation where a woman’s fallopian tubes are blocked hence the egg cannot reach the uterus for fertilization. Men also can undergo vasectomy whereby the sperm duct are cut and tied; hence semen does not contain sperms.
  4. Natural methods– they do not involve any family-planning medications or devices. They include rhythm and withdrawal methods. They are mostly applicable where there is no other alternative especially in war torn areas.

Factors to Consider When Choosing Contraceptive

Choosing-right-contraceptiveDr. Ann Kihara, a gynecologist, advises that before a woman settles for a particular type of family planning, there are a number of considerations to make to ensure that the method gives the maximum benefits. They include;

  • Background – these include social-economic, culture and religion. These may not allow use of certain contraceptives such as condoms whereas the financial status of a woman affects the choice made depending on its affordability.
  • The number of children – this determines whether to use a short term or long term method.
  • Existence of any medical problems such as diabetes and hypertension may hinder use of some methods.
  • Sexual activities of a woman– most women fear unwanted pregnancies over HIV/AIDS & other sexually transmitted illnesses (STI’s). Thus for women with multiple partners, it is advisable to use a method that will protect from STI’s such as condoms.
  • Effects of the method on the fertility– some methods will need for a woman to wait for sometime after withdrawal before fertility can resume.  For example implants can take up to two years before a woman can fall pregnant.

Contraceptives during breast feeding

Breast feeding is in itself considered a form of contraceptive. However this is only effective if the woman is exclusively breast feeding and that her menstruation has not resumed. The most advisable form of contraceptive to use during this time other than withdrawal method is progesterone-only pill and IUD’s.

Morning after/ emergency pill 

As the name suggests this pill should be used only when a woman has had unprotected thesex during the fertile days of the month. It should not be taken for more than once in one month otherwise it will interfere with the reproductive system. Some of its side effects include:

  • nausea,
  • vomiting,
  • headaches,
  • weight gain/loss,
  • vaginal dryness,
  • hypertension,
  • irregular menses
  • low libido.

Nutrition and contraceptives

nutGood nutrition is very essential when using contraceptives since it determines the health of future pregnancies. For instance women who bleed a lot may suffer iron deficiency hence low hemoglobin levels. Thus it’s important for women to practice healthy feeding patterns.

Use of contraceptives is part of a woman’s life thus it’s important for a woman to be well educated in order to make informed choices about their reproductive health. Always consult a medical practitioner for clarifications.