Diseases Treatment

What are these Conditions?

Arousal and orgasmic disorders are disorders of female sexual function. A woman with arousal disorder can’t experience sexual pleasure because she cant reach or maintain the physical responses of sexual excitement - vaginal lubrication, blood vessel congestion in the genital area, and swelling of external genitalia. In orgasmic disorder, the woman becomes sexually excited but can’t reach orgasm or has a delayed orgasm. These problems are considered disorders only if they persist or recur.

The prognosis is good when these disorders are temporary or mild and result from misinformation or stress. However, when they’re caused by intense anxiety, relationship problems, psychological disturbances, or drug or alcohol abuse in either partner, the prognosis is less certain.

What Causes them?

Any of the following factors, alone or in combination, may cause arousal or orgasmic disorder:

• drugs (central nervous system depressants, alcohol, street drugs and, rarely, oral contraceptives)

• disease (illness of the body as a whole, endocrine or nervous system diseases, or diseases that impair muscle tone or muscle contraction)

• gynecologic factors (chronic vaginal or pelvic infection or pain, congenital abnormalities, and genital cancers)

• psychological factors (performance anxiety, guilt, depression, or subconscious conflicts about sexuality)

• relationship problems (poor communication, hostility toward the partner, fear of abandonment, or boredom with sex)

• stress and fatigue.

What are their Symptoms?

The woman with an arousal disorder has slight sexual desire and responds poorly to stimulation. Typically, she lacks vaginal lubrication and signs of congested blood vessels in the genital area.

In an orgasmic disorder, the main symptom is an inability to achieve an orgasm, either totally or under certain circumstances. Many women experience orgasm through masturbation or other means but not through intercourse alone. Others achieve orgasm with some partners but not with others.

How are they Diagnosed?

To rule out physical causes of arousal or orgasmic disorders, the doctor performs a thorough physical exam, orders lab tests, and takes a medical history. When physical causes are absent, a complete psycho­sexual history is the most important tool.

How are they Treated?

An arousal disorder is hard to treat, especially if the woman has never experienced sexual pleasure. Therapy aims to help her relax and become aware of her feelings about sex, as well as to eliminate guilt and fear of rejection. Specific measures usually include sensate focus exercises, which emphasize touching and awareness of sensual feelings all over the body - not just in the genital area - and minimize the importance of intercourse and orgasm.

In orgasmic disorder, the goal is to help the woman overcome her inhibition of the orgasmic reflex. Treatment may include experiential therapy, psychoanalysis, or behavior modification. The therapist may teach the woman self-stimulation and distraction techniques, such as focusing attention on fantasies, breathing patterns, or muscle contractions to relieve anxiety. Gradually, the therapist involves the woman’s sexual partner in the treatment sessions; some therapists treat the couple as a unit from the outset.

What can a Woman with Arousal or Orgasmic Disorder do?

Consult a doctor, nurse, psychologist, social worker, or counselor trained in sex therapy. The therapist should be certified by the American Association of Sex Educators, Counselors, and Therapists or by the Society for Sex Therapy and Research. If not, ask about the therapist’s credentials.

What is this Condition?

Dysfunctional uterine bleeding refers to abnormal bleeding from the endometrium (surface lining of the uterus) that occurs without recognizable organic lesions. Prognosis varies with the cause. Dysfunctional uterine bleeding is the reason for almost 25% of all gynecologic surgeries.

What Causes it?

Dysfunctional uterine bleeding usually results from an imbalance in hormonal-endometrial interactions, in which estrogen constantly stimulates the endometrium. Disorders that cause sustained high estrogen levels include polycystic ovary syndrome, obesity, immaturity of the hypothalamic-pituitary-ovarian mechanism (in sexually mature teenagers), and failure to ovulate (in women in their late 30s or early 40s).

What are its Symptoms?

Dysfunctional uterine bleeding usually causes episodes of vaginal bleeding between periods; it may also cause heavy or prolonged periods (longer than 8 days) or shorten the menstrual cycle to less than 18 days. Such bleeding is unpredictable and can cause anemia.

How is it Diagnosed?

Dilatation and curettage (D&C) and biopsy results confirm the diagnosis. Blood tests help determine the need for blood or iron replacement.

Diagnostic studies must rule out other causes of excessive vaginal bleeding, including cancer, polyps, incomplete abortion, pregnancy, and infection.

How is it Treated?

The primary treatment, high-dose estrogen-progestogen combination therapy (oral contraceptives), is designed to control endometrial growth and reestablish a normal menstrual cycle. These drugs are usually administered four times daily for 5 to 7 days, even though bleeding usually stops in 12 to 24 hours.

In women over age 35, endometrial biopsy is necessary before thE start of estrogen therapy, to rule out endometrial cancer. Progestogen therapy is a necessary alternative in some women, such as those susceptible to the side effects of estrogen (thrombophlebitis, for example).

If drug therapy is ineffective, a D&C serves as a supplementary treatment that removes a large portion of the bleeding endometrium.

Also, a D&C can help determine the original cause of hormonal imbalance and can aid in planning further therapy.

Regardless of the primary treatment, the woman may need iron replacement or transfusions of packed cells or whole blood because of anemia caused by recurrent bleeding.

What can a Woman with Dysfunctional Uterine Bleeding do?

If you have dysfunctional bleeding, follow these guidelines:

• Be sure to follow the prescribed hormonal therapy.

• Get regular checkups to determine if your treatment is effective.

What do Doctors call these Conditions?

Hyperpituitarism

What are these Conditions?

Acromegaly and gigantism are chronic, progressive diseases marked by hormonal dysfunction and startling skeletal overgrowth. Acromegaly causes bones to thicken and grow transversely. Gigantism causes proportional overgrowth of all body tissues. These disorders usually reduce life expectancy unless treated in a timely fashion. The earliest signs of acromegaly are swelling and enlargement of the arms, legs, and face. This rare disorder occurs in men and women equally, usually between ages 30 and 50. Gigantism causes remarkable height increases of as much as 6 inches (15 centimeters) a year. Infants and children may grow to three times the normal height for their age; adults may ultimately reach a height of more than 6 feet 8 inches (2 meters).

What Causes them?

Typically, oversecretion of human growth hormone produces changes throughout the body, resulting in acromegaly or, when over­secretion occurs before puberty, gigantism. Tumors of the anterior pituitary gland may cause this oversecretion, but the causes of the tumors themselves remain unclear. Occasionally, levels of human growth hormone are elevated in more than one family member, suggesting the possibility of a genetic cause.

What are their Symptoms?

Acromegaly develops slowly and typically produces profuse sweating, oily skin, hypermetabolism, and excessive hair growth. Severe headache, central nervous system impairment, loss of sharp vision, and blindness may also result. Oversecretion of human growth hormone produces cartilaginous and connective tissue overgrowth, resulting in a characteristic hulking appearance, with an enlarged ridge over the eye and thickened ears and nose. The jaw may project so much that chewing becomes difficult. Enlargement of the larynx and paranasal sinuses and thickening of the tongue cause the voice to sound deep and hollow. Fingertips display an arrowhead appearance on X-rays, and the fingers are thickened. Irritability, hostility, and various psychological disturbances may occur. Prolonged effects of human growth hormone oversecretion include bowlegs, barrel chest, arthritis, osteoporosis, kyphosis, high blood pressure, and hardening of the arteries. Both gigantism and acromegaly may also cause symptoms similar to those of diabetes. Gigantism develops abruptly, producing some of the same skeletal abnormalities seen in acromegaly. As the disease progresses, the pituitary tumor enlarges and invades normal tissue, thereby causing the organ involved to stop functioning.

How are they Diagnosed?

The doctor will observe a person with acromegaly or gigantism for characteristic features. He or she will order blood tests to measure levels of human growth hormone, which are usually elevated. However, results of this test may be misleading. A lab test called the glucose suppression test may be ordered to obtain more reliable information. Glucose normally suppresses the secretion of growth hormone. If an infusion of glucose does not suppress the hormone level, it may indicate acromegaly or gigantism. In addition, skull X-rays, computed tomography scan (commonly called a CAT scan), arteriography, and magnetic resonance imaging (commonly called MRI) determine the presence and extent of the pituitary lesion. Bone X-rays showing a thickening of the cranium and of the long bones, as well as osteoarthritis in the spine, support this diagnosis.

How are they Treated?

Treatment aims to limit human growth hormone secretion by pituitary radiation therapy or by surgery to remove the underlying tumor. In acromegaly, surgery is mandatory when a tumor causes blindness or other severe neurologic disturbances. Postoperative therapy often requires replacement of thyroid hormones, cortisone, and gonadal hormones. Additional treatment may include administration of Parlodel and Sandostatin, which inhibit human growth hormone synthesis.

Acute otitis media is an infection, usually caused by a virus, but sometimes caused by bacteria, which inflames the cells lining the middle ear cavity. The disorder often develops when viruses from an infection of the nose and throat, such as a cold or measles, travel along the eustachian, or auditory, tube to the middle ear. Infection may also enter through a ruptured eardrum . The disorder is often associated with nasal allergy .

Middle ear infections occur often in children. At least half of them have an infected middle ear at some time, and often, repeated attacks of the problem occur.

What are the Symptoms?

There is usually a feeling of fullness in the ear, followed by severe stabbing pain. This pain may prevent sleep and many other normal activities if it is severe and persistent enough. Other symptoms are fever, and hearing loss in the affected ear. If the infection is caused by bacteria and is not treated, the pressure of pus within the middle ear may eventually burst the eardrum. This produces a pus discharge that is accompanied by sudden relief from the pain. If the infection is caused by a virus, the symptoms are similar, but the problem will usually clear up by itself without bursting the eardrum.

What should be done?

You should see your physician for treatment as soon as possible.

What is the Treatment?

Self-help: To provide some relief from pain, take aspirin and place an electric heating pad on the low temperature setting against the ear. Do not sleep with the heating pad under you. Carefully clean any pus off the pad after use to avoid re-infection.

Professional help: Your physician may pre­scribe drugs to help unblock the eustachian tube and clear up the infection.

If your eardrum is bulging, the physician may make a small cut, or myringotomy, in it to relieve the pressure and the pain. If the patient is a child, this may be done in a hospital, with a general anesthetic. The eardrum heals naturally in one to two weeks. Be sure to consult your physician before you stop any treatment. It may take as long as six weeks for the infection to clear up completely.

If a child has repeated middle ear infections, the adenoids may be acting as a reservoir of infection. In such cases, the doctor may suggest that the adenoids be removed. Persistent sinusitis also often leads to middle ear infection.

Your doctor will be able to determine if the middle ear infection has spread to the mastoid process, perhaps requiring a mastoidectomy operation.

What do doctors call this condition?

Thrombocytopenia

What is this Condition?

Low platelet counts are the most common cause of bleeding disorders. Because platelets playa vital role in blood clotting, this disorder poses a serious threat to the body’s ability to control bleeding.

The prognosis depends on how well the person responds to treatment of the underlying cause. For example, in drug-induced platelet shortage the person may recover immediately if the offending drug is withdrawn.

What Causes It?

A shortage of platelets may be congenital (present at birth) or, more commonly, acquired. In either case, the condition usually results from decreased or defective production of platelets in the bone marrow (as occurs in leukemia, aplastic anemia, or poisoning with certain drugs) or from increased platelet destruction outside the marrow caused by an underlying disorder (such as cirrhosis of the liver, disseminated intravascular coagulation, or severe infection).

Less commonly, a low platelet count results from sequestration or platelet loss. An acquired low platelet count may result from the use of certain drugs.

What are its Symptoms?

A platelet shortage typically produces a sudden onset of red spots or bruising on the skin or bleeding into any mucous membrane. Nearly all people with this disorder lack other symptoms, although some may complain of malaise, fatigue, and general weakness. In adults, large blood-filled blisters characteristically appear in the mouth. In a severe low platelet count, hemorrhage may lead to rapid heart rate, shortness of breath, loss of consciousness, and death.

How is it Diagnosed?

The doctor obtains a history (including a drug history), performs a physical exam, and orders coagulation studies to provide information on platelet count and bleeding time. If increased platelet destruction is causing the low platelet count, bone marrow studies are ordered.

How is it Treated?

The preferred treatment is to eliminate the underlying cause or, in a drug-induced platelet shortage, to discontinue the offending drug. Other possible treatments may include giving corticosteroids or immune globulin to increase platelet production. Platelet transfusions are helpful only in treating complications of severe hemorrhage.

What is this Condition?

Idiopathic thrombocytopenic purpura, a low platelet count that results from platelet destruction by the immune system, may be acute or chronic. The acute form usually affects children between ages 2 and 6; the chronic form mainly affects adults under age 50, especially women between ages 20 and 40.

The prognosis for the acute form is excellent; nearly 4 out of 5 people recover without treatment. The prognosis for the chronic form is good; remissions lasting weeks or years are common, especially among women.

What Causes it?

Idiopathic thrombocytopenic purpura may be an autoimmune disorder, because antibodies that reduce the life span of platelets have been found in nearly all persons with this disorder. The acute form usually follows a viral infection, such as German measles or chicken pox, and can follow immunization with a live virus vaccine. The chronic form is often linked to immune disorders such as lupus. It’s also linked to drug reactions.

What are its Symptoms?

symptoms include red or purple spots on the skin and mucosal bleeding from the mouth, nose, or gastrointestinal tract. Hemorrhage is rare. Purpuric lesions may occur in vital organs, such as the lungs, kidneys, or brain, and may prove fatal.

The acute form usually begins suddenly and without warning, causing easy bruising, nosebleeds, and bleeding gums. The chronic form begins gradually.

How is Idiopathic Thrombocytopenic Purpura Diagnosed?

Results of lab tests, including platelet count and bleeding time, suggest the diagnosis. Anemia may be present if bleeding has occurred. Bone marrow studies may also provide important information.

How is it Treated?

The acute form may be allowed to run its course without intervention, or it may be treated with glucocorticoids or immune globulin. For the chronic form, corticosteroids may be the initial treatment of choice. People who fail to respond within 1 to 4 months or who need a high dosage are candidates for surgical removal of the spleen. The platelet count typically increases spontaneously after this procedure.

What can a Person Suffering with this Disease Do?

Avoid aspirin and Advil, which can cause bleeding.

What are these Conditions?

Aplastic or hypoplastic anemias result from injury or destruction of stem cells, which are located in the bone marrow and function to produce new blood cells. These anemias impair production of all blood cell types (pancytopenia) or retard bone marrow development (bone marrow hypoplasia) and generally progress to fatal bleeding or infection.

What Causes them?

Aplastic anemias usually develop when damaged or destroyed stem cells hinder production of red blood cells. Less commonly, they result from damaged vessels in the bone marrow. About half of these anemias result from certain drugs, poisons (such as the solvent benzene and the drug chloramphenicol), or radiation. The rest may result from immunologic factors, serious diseases (especially hepatitis), or bone marrow cancers.

What are their Symptoms?

Symptoms of aplastic anemias vary with the severity of pancytopenia and often develop gradually. Anemia, which is a shortage of red blood cells, may cause progressive weakness and fatigue, shortness of breath, headache, pallor and, ultimately, rapid heart rate and congestive heart failure. A low platelet count leads to red or purple spots on the skin and hemorrhage, especially from the mucous membranes (nose, gums, rectum, vagina) or into the retina or central nervous system. Neutropenia (deficiency of neutrophils, a type of white blood cell) may lead to infection (fever, oral and rectal ulcers, sore throat) without inflammation.

How are they Diagnosed?

To confirm aplastic anemia, the doctor will order a series of blood tests that measure the number and size of red blood cells, the number of white blood cells, iron levels, clotting time, and other factors. Bone marrow aspiration from several sites may provide additional data.

How are they Treated?

Effective treatment must eliminate any identifiable cause and provide vigorous supportive measures, including transfusions of specific blood elements. Even after the cause is eliminated, recovery can take months. Bone marrow transplantation is the treatment of choice for anemia due to severe aplasia and for people who need continual red blood cell transfusions. Special infection control precautions are used to prevent infection in people with low white blood cell counts. If an infection develops, it may require antibiotics; however, antibiotics must be administered carefully because they tend to encourage resistant strains of organisms. Some people may need oxygen to help them breathe. Other treatments include drug therapy with steroids, which are successful in children but not in adults. Drugs that stimulate the bone marrow, such as androgens, are controversial. Antilymphocyte globulin, an experimental drug, may be used. If a person doesn’t respond to any other therapy, drugs that suppress the immune system may be tried.