Endometriosis Health Dictionary

This drug inhibits pituitary gonadotrophin secretion (see PITUITARY GLAND; GONADOTROPHINS) and is used in the treatment of ENDOMETRIOSIS, MENORRHAGIA and GYNAECOMASTIA. The dose is usually of the order of 100 mg twice daily and side-effects may include nausea, dizziness, ?ushing and skeletal muscle pain. It is mildly androgenic (see ANDROGEN).... danazol

A hormone that stimulates the PITUITARY GLAND to secrete three hormones: gonadotrophic, luteinising and follicle-stimulating. Gonadorelin can be made arti?cially and given by intravenous injection. It is used to stimulate the OVARIES when treating infertile women, and to investigate suspected disease of the HYPOTHALAMUS. Analogues of the hormone (buserelin and goserelin) are chemically similar and can be used to suppress release of gonadorelin, so cutting the production of pituitary hormones. The two analogues are given to treat

ENDOMETRIOSIS, breast cancer (see BREASTS, DISEASES OF) and prostate cancer (see PROSTATE GLAND, DISEASES OF).... gonadorelin

A synthetic drug chemically related to the hypothalmic hormone gonadorelin.

Goserelin is used to treat breast cancer and prostate cancer, fibroids, infertility, and endometriosis.

Adverse effects include loss of bone density after prolonged application.... goserelin

This is diagnosed when a couple has not achieved a pregnancy after one year of regular unprotected sexual intercourse. Around 15–20 per cent of couples have diffculties in conceiving; in half of these cases the male partner is infertile, while the woman is infertile also in half; but in one-third of infertile couples both partners are affected. Couples should be investigated together as e?ciently and quickly as possible to decrease the distress which is invariably associated with the diagnosis of infertility. In about 10–15 per cent of women suffering from infertility, ovulation is disturbed. Mostly they will have either irregular periods or no periods at all (see MENSTRUATION).

Checking a hormone pro?le in the woman’s blood will help in the diagnosis of ovulatory disorders like polycystic ovaries, an early menopause, anorexia or other endocrine illnesses. Ovulation itself is best assessed by ultrasound scan at mid-cycle or by a blood hormone progesterone level in the second half of the cycle.

The FALLOPIAN TUBES may be damaged or blocked in 20–30 per cent of infertile women. This is usually caused by previous pelvic infection or ENDOMETRIOSIS, where menstrual blood is thought to ?ow backwards through the fallopian tubes into the pelvis and seed with cells from the lining of the uterus in the pelvis. This process often leads to scarring of the pelvic tissues; 5–10 per cent of infertility is associated with endometriosis.

To assess the Fallopian tubes adequately a procedure called LAPAROSCOPY is performed. An ENDOSCOPE is inserted through the umbilicus and at the same time a dye is pushed through the tubes to assess their patency. The procedure is performed under a general anaesthetic.

In a few cases the mucus around the cervix may be hostile to the partner’s sperm and therefore prevent fertilisation.

Defective production is responsible for up to a quarter of infertility. It may result from the failure of the testes (see TESTICLE) to descend in early life, from infections of the testes or previous surgery for testicular torsion. The semen is analysed to assess the numbers of sperm and their motility and to check for abnormal forms.

In a few cases the genetic make-up of one partner does not allow the couple ever to achieve a pregnancy naturally.

In about 25 per cent of couples no obvious cause can be found for their infertility.

Treatment Ovulation may be induced with drugs.

In some cases damaged Fallopian tubes may be repaired by tubal surgery. If the tubes are destroyed beyond repair a pregnancy may be achieved with in vitro fertilisation (IVF) – see under ASSISTED CONCEPTION.

Endometriosis may be treated either with drugs or laser therapy, and pregnancy rates after both forms of treatment are between 40–50 per cent, depending on the severity of the disease.

Few options exist for treating male-factor infertility. These are arti?cial insemination by husband or donor and more recently in vitro fertilisation. Drug treatment and surgical repair of VARICOCELE have disappointing results.

Following investigations, between 30 and 40 per cent of infertile couples will achieve a pregnancy usually within two years.

Some infertile men cannot repair any errors in the DNA in their sperm, and it has been found that the same DNA repair problem occurs in malignant cells of some patients with cancer. It is possible that these men’s infertility might be nature’s way of stopping the propagation of genetic defects. With the assisted reproduction technique called intracytoplasmic sperm injection, some men with defective sperm can fertilise an ovum. If a man with such DNA defects fathers a child via this technique, that child could be sterile and might be at increased risk of developing cancer. (See ARTIFICIAL INSEMINATION; ASSISTED CONCEPTION.)... infertility

A progestogen drug used to treat endometriosis and certain types of breast cancer and uterine cancer (see uterus, cancer of). It is sometimes used to treat menstrual disorders such as amenorrhoea (absence of menstruation). Medroxyprogesterone can also be used as a contraceptive, administered by injection at 3-monthly intervals (see contraception, hormonal methods of). Possible adverse effects include weight gain, swollen ankles, and breast tenderness.... medroxyprogesterone

A progestogen drug used primarily in some oral contraceptives. Norethisterone is sometimes prescribed to postpone menstruation. It is also used to treat premenstrual syndrome, menstrual disorders such as menorrhagia, endometriosis, and certain types of breast cancer. It is occasionally given by injection as a long-acting contraceptive. Possible side effects include swollen ankles, weight gain, depression and, rarely, jaundice.... norethisterone

Pain or discomfort during or just before a period. Primary dysmenorrhoea is common in teenage girls and young women. It usually starts 2–3 years after menstruation begins but often diminishes after the age of 25. The exact cause is unknown. One possibility is excessive production of, or undue sensitivity to, prostaglandins, hormonelike substances that stimulate spasms in the uterus. Secondary dysmenorrhoea is due to an underlying disorder, such as pelvic inflammatory disease or endometriosis, and usually begins in adult life.

Cramp-like pain or discomfort in the lower abdomen occurs, sometimes with a dull ache in the lower back. Some women have nausea and vomiting. Mild primary dysmenorrhoea is often relieved by analgesic drugs. In severe cases, symptoms can usually be relieved with oral contraceptives or other hormonal preparations that suppress ovulation. Treatment of secondary dysmenorrhoea depends on the cause.... dysmenorrhoea

Commonly referred to as D and C, a gynaecological operation to scrape away the lining of the UTERUS (ENDOMETRIUM). The procedure may be used to diagnose and treat heavy bleeding from the womb (ENDOMETRIOSIS) as well as other uterine disorders. It can be used to terminate a pregnancy or to clean out the uterus after a partial miscarriage. D and C is increasingly being replaced with a LASER technique using a hysteroscope – a type of ENDOSCOPE.... dilatation and curettage

Milk Thistle tea is a type of herbal tea made from the plant with the same name: milk thistle. The plant has many health benefits, therefore making the tea good for your body. Find out more about the milk thistle tea in this article. About Milk Thistle Tea The main ingredient of the milk thistle tea is, of course, the milk thistle; it is made from the seeds of the plant. The milk thistle is a flowering plant of the daisy family, an annual or biennial herb which grows in the Mediterranean regions of Europe, North Africa and the Middle East. The stem is tall, branched but with no spines, and has large, alternate leaves. At the end of the stem, there are large flower heads, disk-shaped and pink-purple in color. The fruit of the plants consists of a black achene with a white pappus. The name of the plant comes from the way its leaves look. The edges of the leaves are streaked with milky-white veins. How to prepare Milk Thistle Tea You can easily prepare a cup of milk thistle tea in no more than 10 minutes. First, boil the water necessary for a cup of milk thistle tea. Add one teaspoon of milk thistle tea seeds and then, add the hot water. Let it steep for 4-7 minutes, depending on how strong you want the flavor of the tea to be. During summer, you can also try the iced tea version of the milk thistle tea. Place 6 teaspoons into a teapot or a heat resistant pitcher and then pour one and a half cups of boiled water. Let it steep for 5 minutes. Meanwhile, get a serving pitcher and fill it with cold water. Once the steeping time is done, pour the tea over the cold water, add ice, and then pour more cold water. Add sugar, honey or anything else you want to sweeten the taste. Benefits of Milk Thistle Tea The main health benefit of the milk thistle tea is related to its effectiveness in protecting the liver, thanks to one of its components, Silymarin. Silymarin is the main active ingredient of the milk thistle tea, working both as an anti-inflammatory and as an antioxidant. It helps with cirrhosis, jaundice, hepatitis, and gallbladder disorders. It also detoxifies the liver, as well as helping it by cleansing the blood. If you’ve got type 2 diabetes, drinkingmilk thistle tea might help you a lot, as well. Some of the benefits of milk thistle tea, related to diabetes, are:decrease in blood sugar levels, improvement in cholesterol and improvement in insulin resistance.  Also, by lowering the LDL “bad” cholesterol levels, milk thistle tea can help lower the chances of developing heart diseases. Other health benefits of milk thistle tea involve increasing the secretion of the bile in order to enhance the flow in the intestinal tract, helping to ease kidney and bladder irritations, and helping to remove obstructions in the spleen. Milk Thistle Tea side effects Despite its important health benefits, don’t forget that there are also a few side effects you might experience when drinking milk thistle tea. If you regularly drink milk thistle teafor a long period of time, it might end up having laxative effects. That can easily lead to diarrhea and, in some rare cases, it can also lead to nausea, gases, and an upset and bloating stomach. You should avoid drinking milk thistle tea if you know that you have a ragweed allergy. In this case, it can cause a rash or lead to more severe allergic reactions. Milk thistle tea also isn’t recommended to women who are pregnant or breast feeding. The main ingredient of milk thistle tea, the milk thistle herb, may mimic the effects of estrogen. Because of this, some women should avoid drinking milk thistle tea. This refers to women who have fibroid tumors or endometriosis, as well as women who are suffering from breast, uterine, and/or ovarian cancer. Also, don’t drink more than six cups of milk thistle tea (or any other type of tea) a day. Otherwise, it won’t be as helpful as it should be. The symptoms you might get are headaches, dizziness, insomnia, irregular heartbeats, vomiting, diarrhea and loss of appetite. Try the milk thistle tea! As an herbal tea, it helps you stay healthy, especially by protecting your liver. Still, don’t forget about the few side effects.... discover the milk thistle tea

Absence or defects of the uterus

Rarely, the UTERUS may be completely absent as a result of abnormal development. In such patients secondary sexual development is normal but MENSTRUATION is absent (primary amennorhoea). The chromosomal make-up of the patient must be checked (see CHROMOSOMES; GENES): in a few cases the genotype is male (testicular feminisation syndrome). No treatment is available, although the woman should be counselled.

The uterus develops as two halves which fuse together. If the fusion is incomplete, a uterine SEPTUM results. Such patients with a double uterus (uterus didelphys) may have fertility problems which can be corrected by surgical removal of the uterine septum. Very rarely there may be two uteri with a double vagina.

The uterus of most women points forwards (anteversion) and bends forwards (ante?exion). However, about 25 per cent of women have a uterus which is pointed backwards (retroversion) and bent backwards (retro?exion). This is a normal variant and very rarely gives rise to any problems. If it does, the attitude of the uterus can be corrected by an operation called a ventrosuspension.

Endometritis The lining of the uterine cavity is called the ENDOMETRIUM. It is this layer that is partially shed cyclically in women of reproductive age giving rise to menstruation. Infection of the endometrium is called endometritis and usually occurs after a pregnancy or in association with the use of an intrauterine contraceptive device (IUCD – see CONTRACEPTION). The symptoms are usually of pain, bleeding and a fever. Treatment is with antibiotics. Unless the FALLOPIAN TUBES are involved and damaged, subsequent fertility is unaffected. Very rarely, the infection is caused by TUBERCULOSIS. Tuberculous endometritis may destroy the endometrium causing permanent amenorrhoea and sterility.

Menstrual disorders are common. Heavy periods (menorrhagia) are often caused by ?broids (see below) or adenomyosis (see below) or by anovulatory cycles. Anovulatory cycles result in the endometrium being subjected to unopposed oestrogen stimulation and occasionally undergoing hyperplasia. Treatment is with cyclical progestogens (see PROGESTOGEN) initially. If this form of treatment fails, endoscopic surgery to remove the endometrium may be successful. The endometrium may be removed using LASER (endometrial laser ablation) or electrocautery (transcervical resection of endometrium). Hysterectomy (see below) will cure the problem if endoscopic surgery fails. Adenomyosis is a condition in which endometrial tissue is found in the muscle layer (myometrium) of the uterus. It usually presents as heavy and painful periods, and occasionally pain during intercourse. Hysterectomy is usually required.

Oligomenorhoea (scanty or infrequent periods) may be caused by a variety of conditions including thyroid disease (see THYROID GLAND, DISEASES OF). It is most commonly associated with usage of the combined oral contraceptive pill. Once serious causes have been eliminated, the patient should be reassured. No treatment is necessary unless conception is desired, in which case the patient may require induction of ovulation.

Primary amenorrhoea means that the patient has never had a period. She should be investigated, although usually it is only due to an inexplicable delay in the onset of periods (delayed menarche) and not to any serious condition. Secondary amenorrhoea is the cessation of periods after menstruation has started. The most common cause is pregnancy. It may be also caused by endocrinological or hormonal problems, tuberculous endometritis, emotional problems and severe weight loss. The treatment of amenorrhoea depends on the cause.

Dysmenorrhoea, or painful periods, is the most common disorder; in most cases the cause is unknown, although the disorder may be due to excessive production of PROSTAGLANDINS.

Irregular menstruation (variations from the woman’s normal menstrual pattern or changes in the duration of bleeding or the amount) can be the result of a disturbance in the balance of OESTROGENS and PROGESTERONE hormone which between them regulate the cycle. For some time after the MENARCHE or before the MENOPAUSE, menstruation may be irregular. If irregularity occurs in a woman whose periods are normally regular, it may be due to unsuspected pregnancy, early miscarriage or to disorders in the uterus, OVARIES or pelvic cavity. The woman should seek medical advice.

Fibroids (leiomyomata) are benign tumours arising from the smooth muscle layer (myometrium) of the uterus. They are found in 80 per cent of women but only a small percentage give rise to any problems and may then require treatment. They may cause heavy periods and occasionally pain. Sometimes they present as a mass arising from the pelvis with pressure symptoms from the bladder or rectum. Although they can be shrunk medically using gonadorelin analogues, which raise the plasma concentrations of LUTEINISING HORMONE and FOLLICLE-STIMULATING HORMONE, this is not a long-term solution. In any case, ?broids only require treatment if they are large or enlarging, or if they cause symptoms. Treatment is either myomectomy (surgical removal) if fertility is to be retained, or a hysterectomy.

Uterine cancers tend to present after the age of 40 with abnormal bleeding (intermenstrual or postmenopausal bleeding). They are usually endometrial carcinomas. Eighty per cent present with early (Stage I) disease. Patients with operable cancers should be treated with total abdominal hysterectomy and bilateral excision of the ovaries and Fallopian tubes. Post-operative RADIOTHERAPY is usually given to those patients with adverse prognostic factors. Pre-operative radiotherapy is still given by some centres, although this practice is now regarded as outdated. PROGESTOGEN treatment may be extremely e?ective in cases of recurrence, but its value remains unproven when used as adjuvant treatment. In 2003 in England and Wales, more than 2,353 women died of uterine cancer.

Disorders of the cervix The cervix (neck of the womb) may produce an excessive discharge due to the presence of a cervical ectopy or ectropion. In both instances columnar epithelium – the layer of secreting cells – which usually lines the cervical canal is exposed on its surface. Asymptomatic patients do not require treatment. If treatment is required, cryocautery – local freezing of tissue – is usually e?ective.

Cervical smears are taken and examined in the laboratory to detect abnormal cells shed from the cervix. Its main purpose is to detect cervical intraepithelial neoplasia (CIN) – the presence of malignant cells in the surface tissue lining the cervix – since up to 40 per cent of women with this condition will develop cervical cancer if the CIN is left untreated. Women with abnormal smears should undergo colposcopy, a painless investigation using a low-powered microscope to inspect the cervix. If CIN is found, treatment consists of simply removing the area of abnormal skin, either using a diathermy loop or laser instrument.

Unfortunately, cervical cancer remains the most common of gynaecological cancers. The most common type is squamous cell carcinoma and around 4,000 new cases (all types) are diagnosed in England and Wales every year. As many as 50 per cent of the women affected may die from the disease within ?ve years. Cervical cancer is staged clinically in four bands according to how far it has extended, and treatment is determined by this staging. Stage I involves only the mucosal lining of the cervix and cone BIOPSY may be the best treatment in young women wanting children. In Stage IV the disease has spread beyond the cervix, uterus and pelvis to the URINARY BLADDER or RECTUM. For most women, radiotherapy or radical Wertheim’s hysterectomy – the latter being preferable for younger women – is the treatment of choice if the cancer is diagnosed early, both resulting in survival rates of ?ve years in 80 per cent of patients. Wertheim’s hysterectomy is a major operation in which the uterus, cervix, upper third of vagina and the tissue surrounding the cervix are removed together with the LYMPH NODES draining the area. The ovaries may be retained if desired. Patients with cervical cancer are treated by radiotherapy, either because they present too late for surgery or because the surgical skill to perform a radical hysterectomy is not available. These operations are best performed by gynaecological oncologists who are gynaecological surgeons specialising in the treatment of gynaecological tumours. The role of CHEMOTHERAPY in cervical and uterine cancer is still being evaluated.

Prolapse of the uterus is a disorder in which the organ drops from its normal situation down into the vagina. First-degree prolapse is a slight displacement of the uterus, second-degree a partial displacement and third-degree when the uterus can be seen outside the VULVA. It may be accompanied by a CYSTOCOELE (the bladder bulges into the front wall of the vagina), urethrocoele (the urethra bulges into the vagina) and rectocoele (the rectal wall bulges into the rear wall of the vagina). Prolapse most commonly occurs in middle-aged women who have had children, but the condition is much less common now than in the past when prenatal and obstetric care was poor, women had more pregnancies and their general health was poor. Treatment is with pelvic exercises, surgical repair of the vagina or hysterectomy. If the woman does not want or is not ?t for surgery, an internal support called a pessary can be ?tted – and changed periodically.

Vertical section of female reproductive tract (viewed from front) showing sites of common gynaecological disorders.

Hysterectomy Many serious conditions of the uterus have traditionally been treated by hysterectomy, or removal of the uterus. It remains a common surgical operation in the UK, but is being superseded in the treatment of some conditions, such as persistent MENORRHAGIA, with endometrial ablation – removal of the lining of the uterus using minimally invasive techniques, usually using an ENDOSCOPE and laser. Hysterectomy is done to treat ?broids, cancer of the uterus and cervix, menorrhagia, ENDOMETRIOSIS and sometimes for severely prolapsed uterus. Total hysterectomy is the usual type of operation: it involves the removal of the uterus and cervix and sometimes the ovaries. After hysterectomy a woman no longer menstruates and cannot become pregnant. If the ovaries have been removed as well and the woman had not reached the menopause, hormone replacement therapy (HRT – see MENOPAUSE) should be considered. Counselling helps the woman to recover from the operation which can be an emotionally challenging event for many.... uterus, diseases of

A drug derived from the female sex hormone progesterone. It is used to treat premenstrual syndrome and menstrual problems (see menstruation, disorders of). It is also given together with an oestrogen drug as hormone replacement therapy following the menopause. Dydrogesterone is sometimes prescribed for endometriosis or to prevent miscarriage. Adverse effects include swollen ankles, weight gain, breast tenderness, and nausea.... dydrogesterone

Another method of helping infertile couples. In over half of women diagnosed as infertile, the Fallopian tubes are normal, and in many it is unknown why they cannot conceive – although some have ENDOMETRIOSIS.

Eggs are obtained and mixed with the partner’s semen, then introduced into the woman’s Fallopian tubes for fertilisation to take place. The fertilised egg travels to the uterus where IMPLANTATION occurs and pregnancy proceeds. A variation of GIFT is zygote intrafallopian transfer (ZIFT) in which early development of the fertilised eggs happens in the laboratory before the young embryo is transferred to the Fallopian tubes. GIFT is best used in couples with unexplained infertility or with minor degrees of male or female cervical factor infertility. The success rate is about 17 per cent. (See also ARTIFICIAL INSEMINATION.)... gamete intrafallopian transfer (gift)

Surgical removal of the uterus. It is performed in order to treat fibroids, and cancer of the uterus (see uterus, cancer of) or cervix (see cervix, cancer of). It may also be performed to relieve heavy menstrual bleeding or endometriosis, and to remove a prolapsed uterus (see uterus, prolapse of).

The most common type is a total hysterectomy, in which the uterus and cervix are removed. Occasionally, the fallopian tubes and ovaries are removed as well. For cervical cancer, a radical hysterectomy is performed, in which the uterus, cervix and pelvic lymph nodes are removed. Hysterectomy may be performed through the vagina or through an incision in the abdomen.... hysterectomy

A group of drugs similar to progesterone hormone. The drugs are used in oral contraceptives, are prescribed to treat menstrual problems (see menstruation, disorders of), and are included in hormone replacement therapy (HRT). Progestogen drugs are also used to treat premenstrual syndrome, endometriosis, and hypogonadism, and are sometimes used as anticancer drugs. Adverse effects include weight gain, oedema, headache, dizziness, rash, irregular periods, breast tenderness, and ovarian cysts.... progestogen drugs

Menstrual pain is known for its acute and localized action on the abdominal area. However, not all women suffer from this affection.The good thing about menstrual pain, however, is that this is not a chronic disease and that it can go away as quickly as it came to you. All you have to do is treat it properly and wait for your body to respond. If the pain is very powerful and you need to put a stop to it, you may want to try taking an herbal treatment, in which case Raspberry leaf tea, Corn silk tea and Wild yam tea could be the answer. How Teas for Menstrual Pain Work Most of these Teas for Menstrual Pain involve helping your body release the right amount of endorphins in order to fight localized pain. Although menstrual pain is probably the most popular cause of distress for women around the world, alternative medicine found new ways to fight it alongside with traditional medicine. However, choosing one of these Teas for Menstrual Pain will only make your system healthier, without having to worry for possible side effects. The main characteristic of these Teas for Menstrual Pains is that they have a pleasant taste and fragrance and that they are generally safe, unlike traditional medicines. A cup of raspberry leaf tea brings relief to your abdominal area, by calming the muscles and increasing the uterus action. Efficient Teas for Menstrual Pain If you have a heavy menstrual flow or a severe pain crisis during periods, you may find out that the following Teas for Menstrual Pain could be the right answer to your problems: - Cramp Bark Tea – thanks to its antispasmodic and anti-inflammatory properties, Cramp Bark Tea is one of the best Teas for Menstrual Pain there is! Unfortunately, it’s rather inaccessible to the European public. However, if you find a shop that specializes in Cramp Bark products, hold on to it! Cramp Bark Tea can also be used as a detoxifier and a good face cleanser; when used topically, it may bring relief to your skin sores. - Raspberry Leaf Tea – this is a tea that may also come in hand in case you want to perform natural cosmetic procedures at home. Just soak a compress in Raspberry Leaf Tea and apply it on your face for 5 minutes to open and clean your pores. However, a cup of Raspberry Tea per day will improve your general health, bringing relief to those of you who are suffering from severe menstrual pain. - Corn Silk Tea – on this Teas for Menstrual Pain list, Corn silk Tea use needs extra caution. It is true that it can calm your menstrual pain, but you also need to measure the amount of tea you drink in order to avoid other complications: Corn Silk Tea is a very powerful urinary stimulant. - Wild Yam Tea – one of the most dangerous Teas for Menstrual Pain, Wild Yam Tea can bring relief to all kinds of pain, starting with menstrual pain, stomach pain and ending with migraines and severe headaches. However, don’t take this tea if you have protein S deficiency or a hormone-sensitive condition, such as breast cancer, uterine fibroids or endometriosis. Teas you should avoid During menstruation, you may want to avoid all teas based on a high level of acids, such as green or black teas . They will only make your pain insufferable, by increasing your stomach acidity and also your heart beat. Teas for Menstrual Pain Side Effects When taken according to specifications, these Teas for Menstrual Pain are rarely dangerous. However, if you’ve been taking one of them for a while and you’re experiencing some unusual reactions from your body, talk to a doctor as soon as possible. In high dosages, these teas may cause urinary dysfunctions, nausea, headaches and vomiting. First, make sure you’re not allergic to the tea you’re about to take in order to avoid other health complications. Once you have the green light from your doctor, give these Teas for Menstrual Pain a try and enjoy their wonderful benefits wisely!... teas for menstrual pain

Clear-eye. Salvia sclarea L. French: Orvale. German: Muskatsalvee. Spanish: Salvia sylvestre. Italian: Salvia Sclarea. Part used: herb.

Action: anticonvulsive, sedative, stomachic, mucilage, antifungal, oestrogenic.

Uses: Weak stomach, indigestion, mild spasm, sleeplessness from over-excitability. A mucilage from the seeds is used as a soothing emollient for the eyes to allay inflammation or assist in removal of a foreign body. Old-time gardeners placed a single seed in the eye for removal of speck of dust. Is not advised for cases where orthodox oestrogens are prescribed. Menopause.

Preparations: Internal – Practitioner use only.

Liquid Extract. Dose, 2 to 4ml. Thrice daily, in water. Aromatherapy. Essential oil, as an inhalant for hysteria, panic states.

To enhance relaxation of a hot bath – 5-10 drops. The oil is not used internally in the presence of uterine cancers, cysts, fibroids or endometriosis. ... clary

n. see endometriosis.... adenomyosis

n. a *gonadorelin analogue used for the treatment of endometriosis, to help in the management of advanced prostate cancer, and in the treatment of infertility by in vitro fertilization. Possible side-effects include hot flushes, headache, emotional upset, and loss of libido.... buserelin

(CPP) intermittent or constant pain in the lower abdomen or pelvis of at least six months’ duration, not occurring exclusively with menstruation or intercourse and not associated with pregnancy. It may be caused by an underlying gynaecological condition, such as *endometriosis or adhesions, but bowel or bladder disorders (e.g. irritable bowel syndrome, interstitial cystitis), visceral hypersensitivity, and psychological conditions may all contribute.... chronic pelvic pain

n. painful sexual intercourse experienced by a woman. It may be related to *vaginismus or caused by underlying disease, such as endometriosis or pelvic inflammatory disease. See apareunia.... dyspareunia

n. a complex *ovarian cyst, usually with ‘chocolate’ material (altered blood) inside and associated with *endometriosis. A history of cyclical enlargement of the nodule and painful periods is highly suggestive. There is a characteristic ground-glass appearance on transvaginal ultrasound and these cysts may be associated with a raised *CA125 level. Endometriomas are not amenable to medical therapy and should be surgically excised.... endometrioma

False Unicorn root. Blazing Star root. Chamaelirium luteum LA Gray. Parts used: roots, rhizome. Keynote: female reproductive system.

Constituents: helonin, saponins, chamaelirin.

Action. Powerful uterine tonic. Emmenagogue. Adaptogen. (Simon Mills) Precursor of oestrogen. Anthelmintic, diuretic, emetic.

Uses: Weakness of female reproductive organs. Absent or painful periods. Endometriosis, leucorrhoea, morning sickness, female sterility, inflammation of the Fallopian tubes, vaginitis, pruritus. Symptoms of the menopause: hot flushes, heavy bloated feeling, headache, depression, and to maintain normal fluid balance. Ovarian neuralgia. Spermatorrhoea in the male. Threatened abortion: miscarriage.

Preparations: Thrice daily. Average dose: 1-2g.

Combines well with Beth root. (F. Fletcher Hyde)

Tea. Does not yield its properties to simple infusion.

Decoction. Half-1 teaspoon to each cup water gently simmered 20 minutes. Dose: half-1 cup.

Liquid extract BHC Vol 1. 1:1 in 45 per cent ethanol. Dose: 1-2ml.

Tincture BHC Vol 1. 1:5 in 45 per cent alcohol. Dose: 2-5ml.

Powder. Equal parts Helonias and Beth root: 500mg (two 00 capsules or one-third teaspoon).

Popular combination. Tablets/capsules. Powdered Helonias BHP (1983) 120mg; powdered Parsley BHP (1983) 60mg; powdered Black Cohosh BHP (1983) 30mg; powdered extract Raspberry leaves 3:1 – 16.70mg. (Gerard House)

Note: Large doses may cause vomiting. ... helonias

Phytoestrogens. Oestrogens are steroid sex hormones secreted mainly by the ovary, and in smaller amounts by the adrenals, testes and placenta. They control sexual development and regulate the menstrual cycle. In puberty they are responsible for pubic hair and secondary female sex characteristics.

Some herbs, having a similar effect, are known as oestrogenics, and which are given usually during days 1 to 14 of the menstrual cycle for oestrogen-deficiency disorders: night sweats, hot flushes, urinary and menopausal problems.

This group should not be given to patients taking oestrogens of orthodox pharmacy, or in the presence of growths on the female organs: fibroids, endometriosis, cancer, cysts. It has an important role in the metabolism of amino acids, vitamins and minerals.

More than 300 plants are known to possess oestrogenic activity including wholewheat and soya products.

Important oestrogenics: Aniseed, Beth root, Black Cohosh, Elder, Don quai, Evening Primrose, Fennel, Helonias (False Unicorn root), Hops, Liquorice, Sage, Sarsaparilla, True Unicorn root (Aletris). Any one, or more in combination, may be used for symptoms of the menopause or oestrogen deficiency.

The closer we enhance ovarian and uterine function to give true hormone replacement, the more effective is the science of phytotherapy.

See: OSTEOPOROSIS. ... oestrogens

Discomfort in the abdomen. Mild abdominal pain is common and is often due to excessive alcohol

intake, eating unwisely, or an attack of diarrhoea. Pain in the lower abdomen is common during menstruation but is occasionally due to a gynaecological disorder such as endometriosis. Cystitis is a common cause of pain or discomfort in the abdomen. Bladder distension as a result of urinary obstruction may also cause abdominal pain.

Abdominal colic is pain that occurs every few minutes as one of the internal organs goes into muscular spasm in an attempt to overcome an obstruction such as a stone or an area of inflammation. The attacks of colic may become more severe and may be associated with vomiting (see abdomen, acute).

Peptic ulcer often produces recurrent gnawing pain. Other possible causes of abdominal pain are infection, such as pyelonephritis, and ischaemia (lack of blood supply), as occurs when a volvulus (twisting of the intestine) obstructs blood vessels. Tumours affecting an abdominal organ can cause pain. Abdominal pain can also result from anxiety.

For mild pain, a wrapped hot-water bottle is often effective. Pain due to peptic ulcer can be temporarily relieved by food or by taking antacid drugs. Abdominal pain that is not relieved by vomiting, persists for more than 6 hours, or is associated with sweating or fainting requires urgent medical attention. Urgent attention is also necessary if pain is accompanied by persistent vomiting, vomiting of blood, or passing of bloodstained or black faeces. Unexplained weight loss or changes in bowel habits should always be investigated.

Investigation of abdominal pain may include the use of imaging tests such as ultrasound scanning, and endoscopic examination in the form of gastroscopy, colonoscopy, or laparoscopy.... abdominal pain

(GIFT) a procedure for assisting conception, suitable only for women with healthy Fallopian tubes. In over 50% of women in whom infertility is diagnosed, the tubes are normal but some other factor, such as endometriosis, prevents conception. Using needle *aspiration, under laparoscopic or ultrasonic guidance, ova are removed from the ovary. After being mixed with the partner’s spermatozoa, they are introduced into a Fallopian tube, where fertilization takes place. The fertilized ovum can subsequently become implanted in the uterus.... gamete intrafallopian transfer

(GnRH, gonadorelin) a peptide hormone produced in the hypothalamus and transported via the bloodstream to the pituitary gland, where it controls the synthesis and release of pituitary *gonadotrophins. It may be used to test the ability of the pituitary to produce gonadotrophins. *Gonadorelin analogues are used to treat endometriosis, fibroids, some types of infertility, and prostate cancer.... gonadotrophin-releasing hormone

Pain during sexual intercourse, known medically as dyspareunia, which can affect both men and women. Pain may be superficial (around the external genitals) or deep (within the pelvis).

In men, superficial pain may be due to anatomical abnormalities such as chordee (bowed erection) or phimosis (tight foreskin). Prostatitis may cause a widespread pelvic ache, a burning sensation in the penis, or pain on ejaculation.

Scarring (after childbirth, for example) and lack of vaginal lubrication, especially after the menopause, may cause painful intercourse in women. Psychosexual dysfunction may also cause pain during intercourse. Vaginismus, a condition in which the muscles of the vagina go into spasm, is usually psychological in origin. Deep pain is frequently caused by pelvic disorders (such as fibroids, endometriosis, ectopic pregnancy, or pelvic inflammatory disease due to sexually transmitted infections), disorders of the ovary (such as ovarian cysts), and disorders of the cervix. Other causes are cystitis and urinary tract infections.Treatment is directed at the underlying cause of the pain.

If the discomfort is psychological in origin, special counselling may be needed (see sex therapy).... intercourse, painful

An abnormality in the monthly cycle of menstrual bleeding. Menstrual disorders may be a sign of a problem in the pelvic area, such as fibroids, endometriosis, or pelvic inflammatory disease, but the cause is often unknown.

Dysmenorrhoea (painful periods) is the most common type of menstrual disorder. Other types of menstrual disorder are amenorrhoea (absence of menstruation), polymenorrhoea (too frequent menstruation), oligomenorrhoea (infrequent periods or scanty blood loss), and menorrhagia (excessive bleeding).

Some women have extreme variations in the length of menstrual cycles or menstrual periods, or in the amount of blood lost (see menstruation, irregular).... menstruation, disorders of

A group of oral drug preparations containing one or more synthetic female sex hormones, taken by women in a monthly cycle to prevent pregnancy. “The pill” commonly refers to the combined or the phased pill, which both contain an oestrogen drug and a progestogen drug, and the minipill, which contains only a progestogen. Oestrogen pills include ethinylestradiol; progestogens include levonorgestrel and norethisterone. When used correctly, the number of pregnancies among women using oral contraceptives for one year is less than 1 per cent. Actual failure rates may be 4 times higher, particularly for the minipill, which has to be taken at precisely the same time each day.

Combined and phased pills increase oestrogen and progesterone levels. This interferes with the production of two hormones, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which in turn prevents ovulation. The minipill works mainly by making the mucus lining of the cervix too thick to be penetrated by sperm.

Oestrogen-containing pills offer protection against uterine and ovarian cancer, ovarian cysts, endometriosis, and irondeficiency anaemia. They also tend to make menstrual periods regular, lighter, and relatively pain-free. Possible side effects include nausea, weight gain, depression, swollen breasts, reduced sex drive, increased appetite, leg and abdominal cramps, headaches, and dizziness. More seriously, there is a risk of thrombosis causing a stroke or a pulmonary embolism. These pills may also aggravate heart disease or cause hypertension, gallstones, jaundice, and, very rarely, liver cancer. All oral contraceptives can cause bleeding between periods, especially the minipill. Other possible adverse effects of the minipill include irregular periods, ectopic pregnancy, and ovarian cysts. There may be a slightly increased long-term risk of breast cancer for women taking the combined pill.

Oestrogen-based pills should generally be avoided in women with hypertension, hyperlipidaemia, liver disease, migraine, otosclerosis, or who are at increased risk of a thrombosis. They are not usually prescribed to a woman with a personal or family history of heart or circulatory disorders, or who suffers from unexplained vaginal bleeding. The minipill or a lowoestrogen pill may be used by women who should avoid oestrogens. Combined or phased pills may interfere with milk production and should not be taken during breast-feeding. Certain drugs may impair the effectiveness of oral contraceptives. (See also contraception.) ... oral contraceptives

n. a *tumour marker that can be detected by a simple blood test and is particularly useful in the diagnosis of ovarian cancer and also for subsequently monitoring its response to treatment. In a patient being evaluated for a pelvic mass, a CA125 level greater than 65 is associated with malignancy in approximately 90% of cases (see risk of malignancy index). A number of benign conditions, including endometriosis and heart failure, can also cause elevations of the CA125 level, as can cancers other than ovarian cancer, including malignancies of the endometrium, lung, breast, and gastrointestinal tract.

CA19-9 n. a substance whose presence in the bloodstream can be increased in certain cancers, such as pancreatic cancers, and is increasingly used as a *tumour marker in blood tests.... ca125

(GnRH analogue, LHRH analogue) any one of a group of analogues of *gonadotrophin-releasing hormone (gonadorelin), which stimulates release of the gonadotrophins luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary gland. They are more powerful than the naturally occurring hormone, initially increasing the secretion of gonadotrophins by the pituitary: this acts to block the hormone receptors and to inhibit the release of further gonadotrophins, which suppresses production of oestrogens and androgens. Gonadorelin analogues include *buserelin, *goserelin, leuprorelin, and triptorelin. They are used in the treatment of endometriosis, fibroids, and some types of infertility. GnRH analogues are also used in the treatment of advanced prostate cancer. After causing an initial rise in plasma testosterone for approximately ten days the level then falls to the same low level as that achieved by castration. Because the initial flare in testosterone may cause an acute enlargement of the cancer, *anti-androgens are given usually for the first two weeks following the first injection of the gonadorelin analogue.... gonadorelin analogue

(IVF) fertilization of an ovum outside the body, the resultant *zygote being incubated to the *blastocyst stage and then implanted in the uterus. The technique, pioneered in Britain, resulted in 1978 in the birth of the first test-tube baby. IVF may be undertaken when a woman has blocked Fallopian tubes, unexplained infertility, endometriosis, or ovulation disorders; it is also carried out for purposes of surrogacy and egg donation. The mother-to-be is given hormone therapy causing a number of ova to mature at the same time (see superovulation). Several of them are then removed from the ovary through a laparoscope. The ova are mixed with spermatozoa and incubated in a culture medium until the blastocyst is formed. The blastocyst is then implanted in the mother’s uterus and the pregnancy proceeds normally. IVF is regulated by the *Human Fertilisation and Embryology Act 1990 via the Human Fertilisation and Embryology Authority.... in vitro fertilization

n. abnormally heavy bleeding at menstruation, which may or may not be associated with abnormally long periods. Menorrhagia may be associated with pelvic inflammatory disease, tumours (especially fibroids) in the pelvic cavity, endometriosis, or the presence of an IUCD. In some cases no obvious pathology can be demonstrated; heavy, prolonged, or frequent uterine bleeding not associated with pelvic or systemic disease is known as dysfunctional uterine bleeding. Medical treatment for menorrhagia includes *NSAIDs, *antifibrinolytic drugs, and hormonal therapy, such as progestogen-only pills, gonadorelin analogues, or the *IUS (Mirena). Surgical treatments include *endometrial ablation and hysterectomy. In some extreme cases a blood transfusion may be necessary.... menorrhagia

(menses) n. the discharge of blood and of fragments of *endometrium from the vagina at intervals of about one month in women of child-bearing age (see menarche; menopause). Menstruation is that stage of the *menstrual cycle during which the endometrium, thickened in readiness to receive a fertilized egg cell (ovum), is shed because fertilization has not occurred. The normal duration of discharge varies from three to seven days. In anovular menstruation, discharge takes place without previous release of an egg cell from the ovary. Vicarious menstruation is bleeding from a mucous membrane other than the endometrium when normal menstruation is due. Retrograde menstruation is the backflow of blood and endometrial cells through the Fallopian tubes (see endometriosis). See also amenorrhoea; dysmenorrhoea; menorrhagia; oligomenorrhoea.

mental1 adj. relating to or affecting the mind.

mental2 adj. relating to the chin.... menstruation