Family Planning
THE PILL
The birth control pill is a pill that you have to take every day at the same time each day. It contains hormones that prevent pregnancy. There are many types of birth control pills. A health care professional can help you choose the right one for you. If you miss a pill, you need to know what to do. Read the directions that came with your pack of pills. You also may want to contact your health care professional.
PATCH
The patch is a small adhesive patch that is worn on the skin. It contains hormones that are slowly released into your body through the skin. A new patch is worn for a week at a time for 3 weeks in a row. During the fourth week, a patch is not worn, and you will have your menstrual period.
INJECTION
This injection is given in the upper arm or buttock every 2 or 3 months. It contains hormones that prevent pregnancy.
NUVA RING
The ring is a flexible plastic ring that you insert into the upper vagina. It releases hormones into your body. It is worn inside the vagina for 21 days and then removed for 7 days. During those 7 days, you will have your menstrual period. Then you insert a new ring.
IMPLANON
The implant is a small plastic rod about the size of a matchstick that a health care professional inserts under the skin of the upper arm. It releases a hormone that prevents pregnancy. The implant is approved for up to 3 years of use.
MIRENA AND IUCD
The IUD is a small, T-shaped plastic device that is inserted into and left inside the uterus. The IUD must be inserted and removed by a health care professional. There are two types of IUDs. One is a hormonal IUD. Hormonal IUDs are approved for up to 5 years of use. The second type is the copper IUD. It is approved for 5 to 10 years of use.
CONDOMS
Condoms come in male and female versions. The male condom (“rubber”) covers the penis and catches the sperm after a man ejaculates. The female condom is a thin plastic pouch that lines the vagina. It prevents sperm from reaching the uterus. Condoms work better to prevent pregnancy when used with a spermicide. Spermicides should only be used if you are at low risk of HIV infection.
Womens Health
VAGINAL DISCHARGE
Vaginal discharge can be normal, if it has a bad smell or associated with vaginal itching it may be an infection that can be treated with various antibiotics or antifungal treatment. Fowl smelling vaginal discharge associated with lower abdominal pain can be infection in the tubes and need to be treated urgently. This is to prevent future tubal pregnancy or sepsis.
PELVIC ORGAN PROLAPSE
Pelvic organ prolapse is a condition that is more common in postmenopausal women. Risk factors include pregnancy, vaginal delivery and menopause. It usually becomes a problem when the women have discomfort (feeling that something is falling out) or difficulty in passing stool or urine.
PAPSMEER
This is a test that is performed on the cervix (mouth of the uterus). It is performed by a doctor who inserts a speculum, which is a small instrument, into the vagina, sees the cervix, and with a small brush, gently removes some cells for testing.
MENOPAUSE
The average age for menopause is 51 yrs. Common symptoms are hot flushes, nightsweats, decrease in libido and vaginal dryness. Hormone replacement therapy can be used for the symptoms. It has many advantages, but certain risk factors like breast cancer and bloodclots should be discussed with your gynaecologist.
BREAST CANCER
It is important to go for yearly mammograms from the age of 50. If you have a family history of breast cancer you should start getting a mammogram or breast sonar at least 10 years before the diagnosis of your relative.
URINARY INCONTINENCE
Incontinence is the loss of bladder control and can involve leaking urine, wind or faeces.
Urinary incontinence is a very distressing condition that more women develop later in life though it can happen at any age. Having children does increase chances of developing urinary incontinence. There are several types of urinary incontinence – stress urinary incontinence, urge urinary incontinence or overactive bladder and mixed urinary incontinence. The different types of incontinence are treated differently. Speak to your doctor if you have these symptoms to decide on the best treatment option for you.
Adolescent care
YOUR FIRST PERIOD
Most girls start their first period around the ages of 12 and 14, by that time your body will have started to change to become more like an adults, this is called puberty.
FIRST TIME AT THE GYNAECOLOGIST
Once a woman/girl becomes sexually active she should see a gynae. The gynaecologist will advise her on contraception and protection against sexually transmitted diseases (STIs).
A woman/girl of any age, whether sexually active or not, should see a gynae if she, or her mother, thinks something might be wrong – for example, an unusual discharge, abnormal periods, etc.
PAINFUL PERIODS
Some girls have a cramping pain in the lower abdomen or back or breast tenderness just before and during their periods. Some girls get headaches or feel dizzy. Some get nausea or diarrhea.
To help ease cramps, you can try the following:
• Take ibuprofen or Mefenamic acid. Always follow the directions on the bottle about how much to take.
• Exercise.
• Place a heating pad, warm water bag or other source of heat on your abdomen or lower back.
SEXUALLY TRANSMITTED DISEASES
Sexually transmitted diseases (STDs) and venereal diseases (VDs), are infections commonly spread by sex, especially vaginal intercourse, anal sex and oral sex. Most STDs initially do not cause symptoms and this can result in a greater risk of passing the disease on to others.
THE MORNING AFTER PILL
If you have sex without using any birth control, if the birth control method did not work (for instance, the condom broke during sex), or if you are raped, you can use emergency birth control to prevent pregnancy. Emergency birth control is available in pill form or as a copper IUD. The pills must be taken or the IUD inserted within 5 days of having unprotected sex.
Gynaecological problems
ABNORMAL UTERINE BLEEDING
A variety of things can cause abnormal uterine bleeding. Pregnancy is a common cause. Polyps or fibroids (small and large growths) in the uterus can also cause bleeding. Rarely, a thyroid problem, infection of the cervix, or cancer of the uterus can cause abnormal uterine bleeding. In most women, abnormal uterine bleeding is caused by a hormone imbalance. When hormones are the problem, doctors call the problem dysfunctional uterine bleeding, or DUB. Abnormal bleeding caused by hormone imbalance is more common in teenagers or in women who are approaching menopause. Bleeding after your menopause is always abnormal and need to be investigated by your gynaecologist.
ENDOMETRIOSIS
Endometriosis is a condition where endometrial tissue (lining on the inside of the uterus) also grows outside the uterus. These growths or implants can occur in the pelvis on reproductive organs, bladder or bowel. Endometriosis is common and occurs in about 1 in 10 women. It develops between the ages of 12 and 50, which are the reproductive years of most women. The disease is controlled by the female hormones.
HYSTERCTOMY
These procedures concern the removal of the uterus through an abdominal or vaginal incision. Indications for hysterectomy include abnormal menstrual bleeding, uterine pathology and uterine prolapse. Whether an abdominal or vaginal hysterectomy should be performed, will depend on previous births and will be discussed with you by your doctor after your consultation. Please remember the following may complicate surgery:
• Intra-operative bleeding
• Pelvic organ i.e. bladder or bowel injury
• Secondary infection of incision or operation area
• Bladder infection
• Wound haematoma
Above mentioned will be diagnosed (as soon as possible) and manage as soon as possible
PCOS
Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.
The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.
Infertility
A couple has the problem of infertility when one or both partners cannot contribute to conception, or that a woman is unable to carry a pregnancy to full term. It is often defined as not conceiving after 12 months of regular sexual intercourse without the use of birth control.
There are various ways to improve your chance of getting pregnant. This includes ovulation induction, intrauterine insemination and invitro fertilisation. If none of these options work there is adoption and surrogacy that can be explored.