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d asherman syndrome

What is Asherman’s Syndrome?

Asherman’s syndrome, also known as Fritsch syndrome or intrauterine adhesions, is a condition where adhesions form inside the uterus causing the front and back walls to stick together. 

A normal uterine cavity and endometrial lining is necessary in order to conceive and maintain a pregnancy. Scar tissue within the uterine cavity can partially or completely obliterate the normal cavity and can interfere with conception, or increase the risk for miscarriage or other complications later in the pregnancy.

What causes Asherman’s syndrome?

  1. Damage to the uterus that causes the formation of adhesions (scar tissue). The extent of damage can vary, and there are different grades of Asherman’s syndrome severity. The adhesion formation can affect the cervix, uterine lining, the deeper layers of the uterus, or in some cases the opening of the fallopian tubes. The scar tissue may be thin or thick.
  2. Procedures involving the uterus after pregnancy, such as a D&C. Scar tissue can also be related to instrumentation of the non-pregnant uterus and to an infection involving the uterus.

Instrumentation of the uterus related to pregnancy can include:

  • Curettage for post-partum complications such as post-partum hemorrhage or retained placenta
  • Dilation and evacuation (D&E) or dilation and curettage (D&C) for a miscarriage, abortion, or retained products of conception.

Instrumentation of the uterus not-related to pregnancy can include:

  • D&C for heavy bleeding
  • Other uterine surgery

Infections involving the uterus can include:

  • Pelvic infection after a delivery, miscarriage or abortion
  • Pelvic tuberculosis (TB) is a common cause of intrauterine adhesions in the developing world.

UntitledWhat symptoms does Asherman’s syndrome cause?

Symptoms that women may have with intrauterine adhesions include:

  • Infertility
  • Recurrent pregnancy loss (miscarriage)
  • Menstrual irregularities such as very light periods (hypomenorrhea) or absence of periods (amenorrhea).
  • Cyclic pelvic pain can occur if scar tissue blocks the outflow of the menstrual blood, causing uterine cramping and pelvic discomfort or pain.

Asherman syndrome can be cured with surgery. Sometimes more than one procedure will be necessary. Women who are infertile because of Asherman syndrome may be able to have a baby after treatment. Successful pregnancy depends on the severity of Asherman syndrome and the difficulty of the treatment

 Women should be aware of the risk of Asherman’s syndrome by consulting with Specialists. Immediately Schedule an  appointment with Dr. Sarah Hussain and  be aware of the symptoms and treatment.
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Do you know what is Adenomyosis?

Adenomyosis, also referred to as uterine endometriosis, is a benign disease confined to the uterine muscle. Endometrial cells from the lining of the endometrial cavity, migrate from that lining, most commonly into the posterior side or back wall of the uterus. As these cells respond to monthly hormonal changes, blood can get trapped in the myometrium producing a hard and enlarged uterus. This is a non-cancerous condition of the uterus that can mimic many of the signs and symptoms of fibroids

Adenomyosis is most frequently seen in women in their early to middle 40s and is often associated with hormone imbalance.

Untitled Adenomyosis Types

Adenomyosis presents in two different forms.

The first type appears as solid tumors and are called Adenomyomas. This form of the disease is localized and is an encapsulated collection of endometrial cells with well defined borders. They appear much like fibroids and are often mistaken as such. Many can be safely removed from the uterus, but depending on size and location can the culprit of hysterectomy.

The second, and more common type, is the diffuse disease that spreads out within the uterine myometrium. As the endometrial cells invade the organ, the uterus becomes enlarged and hardened, making pelvic exams and intercourse very painful. At the cellular level, the uterine muscle cells are being damaged as the disease spreads and eventually will lose their ability to stretch and contract. This is the main reason for the high rate of miscarriages during the 2nd and early 3rd trimester of pregnancy.

Signs and Symptoms

The severity of the signs and symptoms associated with Adenomyosis is often directly proportional to the degree of involvement and penetration into the uterine muscle. The more the disease spreads, the greater the symptoms. Many patients with Adenomyosis can be without symptoms (asymptomatic) just like fibroids and endometriosis, but most commonly women report the following symptoms associated with their enlarged uterus:

  • Dysmenorrhea (painful periods)
  • Hypermenorrhea (heavy periods)
  • Prolonged bleeding cycles
  • Cramps
  • Large clots
  • Abdominal bloating
  • Back pain
  • Severe and Increasing Abdominal pain throughout the month
  • Painful Intercourse
  • Nausea and Vomitting

 Causes of Adenomyosis

The cause of adenomyosis  is not specific but expert theories include:

  • Invasive tissue growth Adenomyosis results from the direct invasion of endometrial cells from the lining of the uterus into the muscle that forms the uterine walls. Uterine incisions made during an operation such as a cesarean section (C-section) may promote the direct invasion of the endometrial cells into the wall of the uterus.
  • Developmental origins Adenomyosis originates within the uterine muscle from endometrial tissue deposited there when the uterus first formed in the fetus.
  • Uterine inflammation related to childbirth Another theory suggests a link between adenomyosis and childbirth. An inflammation of the uterine lining during the postpartum period might cause a break in the normal boundary of cells that line the uterus. Surgical procedures on the uterus may have a similar effect.
  • Stem cell origins Bone marrow stem cells may invade the uterine muscle, causing adenomyosis.

Regardless of how adenomyosis develops, its growth depends on the circulating estrogen in a woman’s body. When estrogen production decreases at menopause, adenomyosis eventually goes away.

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Relation between Adenomyosis and Fertility

 Many women can conceive with Adenomyosis, but due to the damage within the organ many pregnancies are lost via miscarriage. As Adenomyosis spreads into the myometrium of the uterus, monthly bleeding actually damages the individual uterine cells. These muscle cells over time lose their ability to stretch and contract. When a conception occurs and the fetus begins to the grow, the uterus can only stretch so far before it can no longer hold the pregnancy: this is when spontaneous miscarriage and/or uterine rupture occurs. As the disease spreads monthly, the damage becomes more extensive.

 If you are experiencing  any of the above symptoms then immediately make an appointment with Dr. Sarah Hussain who can palpate your uterus to determine if there are any large masses or enlargement of the uterus because of Adenomyosis and she will help you get your life back .

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diagram of vaginal polyps1

What are Cervical Polyps?

A cervical polyp is a small fleshy growth on the cervix. They are smooth, red, finger-shaped growths in the cervix, the passage between the uterus and the vagina.  They vary in size but they rarely are larger than 2cm long. They are most common in women in their 40s and 50s who have more than one child. Additionally, cervical polyps are common during early pregnancy, presumably due to higher levels of circulating hormones

Symptoms

In most cases cervical polyps do not exhibit symptoms so do not need to be treated, however if they do they tend to be the following:

  • Vaginal discharge of white or yellow mucus
  • Vaginal spotting or bleeding after sexual intercourse (post coital)
  • Vaginal spotting or bleeding between periods (inter-menstrual)
  • Vaginal spotting or bleeding after douching
  • Vaginal spotting or bleeding after menopause (postmenopausal)
  • Abnormally heavy periods (menorrhagia)

Cervical-Cancer

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Why Polyps Occur

  • Increased levels of estrogen (female sex hormone)
  • Chronic inflammation in the cervix, vagina, or uterus
  • Clogged blood vessels
  • Bacterial infection
  • Yeast infections
  • Pregnancy, miscarriage, or abortion

How are they treated?

The most common treatment is removal of the polyp during a Pelvic exam This can be done simply by gently twisting the polyp, tying it tightly at the base, or removing it with special forceps. A solution is applied to the base of the polyp to stop any bleeding.

Cervical polyps are non-dangerous unless they bleed, are very large, If you experiencing any such issues, instantly  book an appointment with Sarah Hussain who can provide better treatment for immediate cure.

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Zika Pregnancy

What is Zika Virus & CDC recommendations ?

The Zika virus, a mosquito-borne pathogen is an emerging disease spread by the bites of infected Aedes mosquitoes. Zika infections in pregnancy are believed to increase the risk of a potentially devastating birth defect. Babies born with the condition are known as microcephaly who will have smaller-than-normal heads and may have under-developed brains.

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Here are the new CDC recommendations for pregnant travelers to keep you and your baby safe:

  1. First and foremost, if you’re pregnant and considering travel to an area where people are getting the Zika virus, which you can track on the CDC’s website (current notices are in effect for Puerto Rico, Mexico, and certain countries in Central and South America), the CDC says you should postpone your plans.
  2. If Pregnant women decide to go to one of these areas or are traveling there now, protect yourself from mosquitoes in the daytime by staying in screened or air-conditioned areas, wearing clothing that covers your arms and legs, and using permethrin-treated clothing and gear, as well as insect repellents.
  3. Be sure to talk to your healthcare provider about your recent travels, and ask about Zika risks.
  4. If you’ve traveled to one of the Zika outbreak areas, be on the lookout for symptoms of the Zika virus during your trip and for two weeks after you return home. These include fever, rash, muscle aches, and conjunctivitis (red, itchy eyes). If you have any of these symptoms, see your doctor.
  5. If an ultrasound shows signs of microcephaly in your growing fetus and you’ve recently traveled to one of the affected areas, you’ll need lab tests for the Zika virus. (If you haven’t been to areas where Zika is endemic, you don’t need the tests.) The RT-PCR test looks for Zika virus DNA, and another test detects antibodies that your body makes in response to an infection. Your doctor can test a blood sample and, if you’re 14 or more weeks into your pregnancy, your amniotic fluid in order to test the baby.
  6. The CDC and state health departments will be doing all Zika lab tests, and your doctor will work with these agencies to get the results. There is no commercial in-office Zika test available yet.
  7. If the lab tests show that you have, or have had, a Zika virus infection, you’ll need to consider ultrasounds every three to four weeks to monitor your baby’s growth, as well as a referral to a specialist in infectious diseases and maternal-fetal medicine
There’s no specific treatment or cure for Zika, but Gynacology specialist such as Sarah Hussain may recommend supportive care for your baby health.
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menopause beginning 34 menopause symptoms

Do you Know Difference between Perimenopause and Menopause?

The primary factor distinguishing perimenopause from menopause is menstruation. Women in perimenopause are still producing estrogen and having periods, whereas, women who have entered menopause have not menstruated for at least 12 months.

Perimenopause is the transition from reproductive adulthood to menopause (1 year after the last menstruation). It may begin as early as age 35 and end as late as 59. It swings in hormone levels are what spark abnormal bleeding. It is also known as menopause transition or climacteric .

How do you know if you are in peri-menopause?

The common symptoms are:

  1. Menstrual irregularities: Experiencing changes in the intervals between periods or skip some periods altogether. The flow may be scanty or profuse. Ovulation may become more erratic as well. Women may be vulnerable to anemia if periods are heavy.
  2. Hot flashes and night sweats: Between 75 and 85 percent of women experience hot flashes during perimenopause. The intensity, frequency, and duration may vary.
  3. Sleep problems: Often hot flashes are to blame for the sleep disturbances or fatigue that can be linked to peri-menopause.
  4. Mood changes: Fluctuating hormones can cause mood swings, depression, irritability, difficulty handling stress or anxiety.
  5. Vaginal problems: As estrogen diminishes, vaginal tissues may lose lubrication and elasticity, making intercourse painful or uncomfortable.
  6. Bladder problems: Lower estrogen levels may leave more vulnerable to urinary tract infections or loss of tissue tone, which may also      contribute to incontinence.
  7. Decreasing fertility: Because ovulation becomes less regular, the ability to conceive may decrease. As long as women having periods, though, pregnancy remains possible
  8. Decreased libido: Sexual desire and arousal may gradually decline; however, stresses in life can also play a role, so it is essential to reduce stress. A supportive and loving partner certainly lessens the effects of hormones.
  9. Body and skin changes: Muscle mass may decrease and body fat may increase as estrogen levels fall. Abdominal fat may increase. A regular exercise program can counter these effects. Lower levels of estrogen may affect the collagen in skin, making it thinner and less elastic.
  10. Loss of bone mass: As estrogen levels decline, Women may lose bone faster than it has been replaced, increasing risk of osteoporosis. Weight bearing exercise and a diet rich in usable calcium and other minerals as well as vitamin D can help keep bones strong.
  11. Changing cholesterol levels: Declining estrogen may result in increased LDL (“bad”) cholesterol levels, and an increased risk of heart disease. Eating a diet high in fruits, vegetables, beans, and grains can help keep cholesterol levels low.
  12. Sore breasts: some women experience painful breasts just prior to and during their periods while others have sore breasts most of the time. Some women may be vulnerable to fibrocystic breasts.
  13. Migraines: severe, one-sided headaches that often include sharp pain through one eye, seeing auras, blurred vision, nausea, and vomiting.

 

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Perimenopause is common in every woman, then when to consult doctor?

  • Much heavier than normal periods, or periods accompanied by blood clots
  • Periods lasting several days longer than usual
  • Spotting between periods
  • Spotting after sex
  • Periods occurring much closer together (by several days or weeks)

Improving your lifestyle, targeting treatments and even turning to medication as needed can reduce symptoms dramatically

  • Eat less fat, more calcium
  • Exercise 30 minutes a day
  • Breathe in for 5 seconds, then out for 5
  • Ease hot flashes such as Alcohol, Smoking
  • Better Sleep
  • Balance your omegas

 Some women seek medical attention for their perimenopausal symptoms. If you are  experiencing such  symptoms that interfere with your life or well-being, such as hot flashes, mood swings or changes in sexual function that bothers you, then book an appointment with Specialist Dr. Sarah Hussain to determine your best course of  treatment. 

 

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