By restricting unprotected sexual intercourse to the infertile portion of the menstrual cycle, a woman and her partner can prevent pregnancy. During the fertile portion of the menstrual cycle, the couple may use barrier contraception or abstain from sexual intercourse.

Advantages

* There are no drug-related side effects to FA. There are no side effects at all, besides those that may occur from inserting fingers into the vagina for cervical observation (as some FA methods recommend).

* FA is free or very low-cost. Users may buy a chart, calendar, basal thermometer, or software, or employ a coach. The direct costs are low when compared to other methods.

* FA can be used with barrier contraception so that intercourse may continue through the fertile period. Unlike barrier use without FA, practicing FA can allow couples to use barrier contraception only when necessary.

Disadvantages

*Use of a barrier method is required on fertile days, otherwise the couple must abstain. To reduce pregnancy risk to below 1% per year, there are an average of 13 days where abstinence or barriers must be used during each cycle. For women with ”very” irregular cycles& — such as those common during breastfeeding, perimenopause, or with hormonal diseases such as PCOS – abstinence or the use of barriers may be required for months at a time. Many couples may not have the motivation or discipline to abstain or use barriers for long periods of time.

*Fertility awareness does not protect against sexually transmitted disease.

Effectivenes

s

The effectiveness of fertility awareness, as of most forms of contraception, can be assessed two ways. ”Perfect use” or ”method” effectiveness rates only include people who follow all observational rules, correctly identify the fertile phase, and refrain from unprotected intercourse on days identified as fertile. ”Actual use”, or ”typical use” effectiveness rates are of all women relying on fertility awareness to avoid pregnancy, including those who fail to meet the “perfect use” criteria. Rates are generally presented for the first year of use. Most commonly the Pearl Index is used to calculate effectiveness rates, but some studies use decrement tables.

The failure rate of fertility awareness varies widely depending on the system used to identify fertile days, the instructional method, and the population being studied. Some studies have found actual failure rates of 25% per year or higher. At least one study has found a failure rate of less than 1% per year with continuous intensive coaching and monthly review, and several studies have found actual failure rates of 2-3% per year.

When used correctly and consistently with ongoing coaching, some studies have shown some forms of FA to be 99% effective, the same as oral contraceptives.

From ”Contraceptive Technology”:

* Post-ovulation methods (i.e. abstaining from intercourse from menstruation until after ovulation) have a method failure rate of 1% per year.

* The symptothermo method has a method failure rate of 2% per year.

* The cervical mucus-only methods have a method failure rate of 3% per year.

* Calendar rhythm has a method failure rate of 9% per year.

* The Standard Days Method has a method failure rate of 5% per year.

Reasons for lower typical-use effectiveness

Several factors account for typical use effectiveness being lower than perfect use effectiveness:

* mistakes on the part of those providing instructions on how to use the method (instructor providing incorrect or incomplete information on the rule system)

* mistakes on the part of the user (misunderstanding of rules, mistakes in charting)

* conscious user non-compliance with instructions (having unprotected intercourse on a day identified as fertile)

The most common reason for the lower actual effectiveness is not mistakes on the part of instructors or users, but conscious user non-compliance, i.e., the couple knowing that the woman is likely to be fertile at the time, but engaging in sexual intercourse nonetheless. This is similar to failures of barrier methods, which are primarily caused by non-use of the method.

Adapted from the Wikipedia article Fertility awareness, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

No related posts.

FSH regulates the development, growth, pubertal maturation, and reproductive processes of the human body.

* In both ”males” and ”females”, FSH stimulates the maturation of germ cells.

* In ”males”, FSH induces Sertoli cells to secrete inhibin and stimulates the formation of sertoli-sertoli tight junctions (zonula occludens).

* In ”females”, FSH initiates follicular growth, specifically affecting granulosa cells. With the concomitant rise in inhibin B, FSH levels then decline in the late follicular phase. This seems to be critical in selecting only the most advanced follicle to proceed to ovulation. At the end of the luteal phase, there is a slight rise in FSH that seems to be of importance to start the next ovulatory cycle.

Like its partner LH, FSH release at the pituitary gland is controlled by pulses of gonadotropin-releasing hormone (GnRH). Those pulses, in turn, are subject to the oestrogen feed-back from the gonads.

Effects in females

FSH stimulates the growth and recruitment of immature Ovarian follicles in the ovary. In early (small) antral follicles, FSH is the major survival factor that rescues the follicles from apoptosis (programmed death of the somatic cells of the follicle and oocyte). In the luteal-follicle phase transition period the serum levels of progesterone and estrogen (primarily estradiol) decrease and no longer suppress the release of FSH, consequently FSH peaks at about day three (day one is the first day of menstrual flow). The cohort of small antral follicles is normally suff

In addition, there is evidence that gonadotrophin surge-attenuating factor produced by small follicles during the first half of the follicle phase also exerts a negative feedback on pulsatile luteinizing hormone (LH) secretion amplitude, thus allowing a more favorable environment for follicle growth and preventing premature luteinization.

(As a woman nears perimenopause the number of small antral follicles recruited in each cycle diminishes and consequently insufficient Inhibin B is produced to fully lower FSH and the serum level of FSH begins to rise.)

When the follicle matures and reaches 8-10& mm in diameter it starts to secrete significant amounts of estradiol. Normally in humans only one follicle becomes dominant and survives to grow to 18-30 mm in size and ovulate, the remaining follicles in the cohort undergo atresia. The sharp increase in estradiol production by the dominant follicle (possibly along with a decrease in gonadotrophin surge-attenuating factor) cause a positive effect on the hypothalamus and pituitary and rapid GnRH pulses occur and an LH surge results.

The increase in serum estradiol levels cause a decrease in FSH production by inhibiting GnRH production in the hypothalamus. The decrease in serum FSH level causes the smaller follicles in the current cohort to undergo atresia as they lack sufficient sensitivity to FSH to survive. Occasionally two follicles reach the 10& mm stage at the same time by chance and as both are equally sensitive to FSH both survive and grow in the low FSH environment and thus two ovulations can occur in one cycle possibly leading to non identical (dizygotic) twins.

Effects in males

FSH stimulates maturation of seminiferous tubules and spermatogenesis.

FSH enhances the production of androgen-binding protein by the Sertoli cells of the testes by binding to FSH receptors on their basolateral membranes, and is critical for the initiation of spermatogenesis.

Adapted from the Wikipedia article Follicle-stimulating hormone, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

No related posts.

Acephalgic migraines can occur in individuals of any age. Though there are some individuals—more commonly male—who only experience acephalgic migraine, frequently patients also experience migraine with headache. Generally, the condition is more than twice as likely to occur in females than males. Although not listed as such in the ”International Classification of Headache Disorders”, pediatric acephalgic migraines are listed along with other childhood periodic syndromes by W.A. Al-Twaijri and M.I. Shevell as “migraine equivalents”, which can be good predictors of the future development of typical migraines. Individuals who experience acephalgic migraines only in childhood are highly likely to develop typical migraines as they grow older. Among women, incidents of acephalgic migraine increase during perimenopause.

Scintillating scotoma is the most common symptom. Also frequently reported is monocular blindness. Acephalgic migraines typically do not persist more than a few hours and may last for as little as 15 seconds. On rare occasions, they may continue for up to two days.

Acephalgic migraines may resemble transient ischemic attacks or, when longer in duration, stroke. The concurrence of other symptoms such as photophobia and nausea can help determining the proper diagnosis. Occasionally, patients with acephalgic migraine are misdiagnosed as suffering epilepsy with visual seizures, but the reverse misdiagnosis is more common.

Adapted from the Wikipedia article Acephalgic migraine, under the G. N. U. Free Documentation License. Please als

No related posts.

Oligomenorrhea can also be a result of prolactinomas (adenomas of the anterior pituitary). It may also be caused by thyrotoxicosis, hormonal changes in perimenopause, Prader-Willi Syndrome, and Graves disease. “Endurance exercises such as running or swimming can affect the reproductive physiology of women athletes. Female runners, swimmers and ballet dancers menstruate infrequently in comparison to nonatheletic women of comparable age or not at all (amenorrhea). The degree of menstrual abnormality is directly proportional to the intensity of the exercise. For example, Malina et al., (1978) have shown menstrual irregularity is more common, and more severe among tennis players than among golfers” (modified by a student paper written by A. Lord) Breastfeeding has also been linked to irregularity of menstrual cycles due to hormones which delay ovulation.

Women with polycystic ovary syndrome (PCOS) are also likely to suffer from oligomenorrhea. PCOS is a condition in which the ovaries become filled with small cysts. Women with PCOS show menstrual irregularities that range from oligomenorrhea and amenorrhea on the one hand to very heavy, irregular periods on the other. The condition affects about 6% of premenopausal women and is related to excess androgen production.

Other physical and emotional factors also cause a woman to miss periods. These include:

emotional stress,

chronic illness,

poor nutrition,

eating disorders such as anorexia nervosa,

excessive exercise,

estrogen-secreting tumors,

illicit use of anabolic steroid dru

http://www.answers.com/topic/oligomenorrhea

Eating disorders can also result in oligomenorrhea. Although menstrual disorders are most strongly associated with Anorexia nervosa, Bulimia nervosa may also result in oligomenorrhea or amenorrhea. There is some controversy regarding the exact mechanism for the menstrual dysregulation, since amenorrhea may sometimes precede substantial weight loss in some anorexics; thus some researchers hypothesize that some as-yet unrecognized neuroendocrine phenomenon may be involved, and the menstrual irregularities may be related to the biological undergirding of the disorders, rather than a result of nutritional deficiencies.

Adapted from the Wikipedia article Oligomenorrhea, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

No related posts.

A physician needs to investigate the cause of anovulation. Common causes are:

#Polycystic ovary syndrome

#Hypothalamic dysfunction

#Perimenopause

#Ovulatory dysfunction

#Thyroid disorders

#Hyperprolactinemia

With excessive or prolonged bleeding the diagnosis has to be made by a physician on a speedy basis. Other causes of gynecological bleeding need to be excluded, specifically bleeding related to pregnancy, leiomyoma, and cancer of the cervix or uterus.

Adapted from the Wikipedia article Anovulatory cycle, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

No related posts.

There is no laboratory test or unique physical findings to verify the diagnosis of PMS. The three key features are:

* The woman’s chief complaint is one or more of the emotional symptoms associated with PMS (most typically irritability, tension, and/or unhappiness).

* Symptoms appear predictably during the luteal (premenstrual) phase, reduce or disappear predictably shortly before or during menstruation, and remain absent during the follicular (pre-ovulatory) phase of the menstrual cycle.

* The symptoms must be severe enough to disrupt or interfere with the woman’s everyday life.

To establish a pattern, a woman’s physician may ask her to keep a prospective record of her symptoms on a calendar for at least two menstrual cycles. This will help to establish if the symptoms are, indeed, limited to the premenstrual time and are predictably recurring. A number of standardized instruments have been developed to describe PMS, including the ”Calendar of Premenstrual syndrome Experiences (COPE)”, the ”Prospective Record of the Impact and Severity of Menstruation (PRISM)”, and the ”Visual Analogue Scales (VAS)”.

.

In addition, other conditions that may better explain symptoms must be excluded. A number of medical conditions are subject to exacerbation at menstruation, a process called ”menstrual magnification.” These conditions may lead the patient to believe that she has PMS, when the underlying disorder may be some other problem, such as anemia, hypothyroidism, eating disorders and substance abuse

Although there is no universal agreement about what qualifies as PMS, two definitions are commonly used in research programs:

* The National Institute of Mental Health research compares the intensity of symptoms from cycle days 5 to 10 to the six-day interval before the onset of menses. To qualify as PMS, symptom intensity must increase at least 30% in the six days before menstruation. Additionally, this pattern must be documented for at least two consecutive cycles.

* The definition formulated at the University of California at San Diego requires both affective (emotional) and somatic (physical) symptoms during the five days before menses in each of three consecutive cycles, and must not be present during the pre-ovulatory part of the cycle (days 4 through 13). For this definition, affective symptoms include symptoms like depression, angry outbursts, irritability, anxiety, confusion, and social withdrawal. Somatic symptoms include symptoms like breast tenderness, abdominal bloating, headache, and swelling of hands and feet.

Adapted from the Wikipedia article Premenstrual syndrome, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

No related posts.

Olivia (Jennifer Aniston) is a single, cash-strapped woman working as a maid in Los Angeles in order to make ends meet. She is surrounded by a support network of well-off friends consisting of Franny (Joan Cusack) – a stay at home mom with a large trust fund; Christine (Catherine Keener) – a successful television writer; Jane (Frances McDormand) – a fashion designer; and their respective husbands.

While the disparity in financial situations between Olivia and her friends creates some friction, each woman is facing her own individual struggles. Olivia can’t seem to find love or money and resorts to questionable tactics to satisfy both. Franny’s inherited money sometimes causes tension between her and her accountant husband, who likes to spend it. Christine’s marriage is falling apart because she and her husband can’t communicate effectively. Finally, Jane is becoming increasingly unpleasant to be around, possibly because of perimenopause and her husband’s sexual ambiguity. Together, these women attend charity benefits, have lunch, lean on each other, and wade their way through life.

Adapted from the Wikipedia article Friends with Money, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

No related posts.

Pregnancy over age 50 has become more possible for women, due to recent advances in assisted reproductive technology, such as egg donation. Typically, a woman’s fecundity ends with menopause, which by definition is 12 consecutive months without having had a period. Perimenopause usually begins between ages 40 and 51, this is when the periods become irregular & eventually stop altogether (men, in contrast, generally remain fertile throughout their lives, although the risk of genetic defects is greatly increased due to the paternal age effect). Pregnancy over age 35 is associated with increased risks.

In the United States, between 1997 and 1999, 539 births were reported among mothers over age 50, 194 being over 55. According to statistics from the Human Fertilisation and Embryology Authority, in Britain, more than 20 babies are born to women over age 50 per year through in-vitro fertilization.

Adapted from the Wikipedia article Pregnancy over age 50, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

No related posts.

Hot flashes, a common symptom of menopause and perimenopause, are typically experienced as a feeling of intense heat with sweating and rapid heartbeat, and may typically last from two to thirty minutes for each occurrence. The sensation of heat usually begins in the face or chest, although it may appear elsewhere such as the back of the neck, and it can spread throughout the whole body. Some women pass out if the effects are strong enough. In addition to being an internal sensation, the surface of the skin, especially on the face, becomes hot to the touch. This is the origin of the alternative term “hot flush,” since the sensation of heat is often accompanied by visible reddening of the face. Excessive flushing can lead to rosacea.

The hot-flash event may be repeated a few times each week or constantly throughout the day, with the frequency reducing over time. Hot flashes may begin to appear several years before menopause starts and last for years afterwards. Some women undergoing menopause never have hot flashes. Others have mild or infrequent flashes. The worst sufferers experience dozens of hot flashes each day. In addition, hot flashes are often more frequent and more intense during hot weather or in an overheated room, the surrounding heat apparently making the hot flashes themselves both more probable and more severe.

Severe hot flashes can make it difficult to get a full night’s sleep (often characterized as insomnia), which in turn can affect mood, impair concentration, and cause other physical problems. When hot flashes occur at night, they are called &#

Adapted from the Wikipedia article Hot flash, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

No related posts.

Sleep hyperhidrosis, more commonly known as the night sweats, is the occurrence of excessive sweating (hyperhidrosis) during sleep. The sufferer may or may not also suffer from excessive perspiration while awake.

Sleep hyperhidrosis may occur at any age, but is most commonly seen in early adulthood.

Night sweats may occur for genetic reasons and may be relatively harmless. However, they can be distressing and disrupt sleep patterns if severe; the patient may be frequently awakened due to the discomfort of damp sleepwear, or if the patient sleeps in the nude, due to damp sheets.

One of the most common causes of night sweats in women over 40 is the hormonal changes related to menopause and perimenopause. This is a very common occurrence during the menopause transition years and while annoying, it is not necessarily dangerous or a sign of underlying disease. Some women experience night sweats during pregnancy due to hormonal changes.

While some causes of night sweats may be relatively harmless, others may not and can be a sign of a serious underlying disease. While there can be several possible causes of excessive sweating at night, it is important to distinguish night sweats due to medical causes from those that occur simply because the sleep environment is too warm, either because the bedroom is unusually hot or because there are too many covers on the bed.

A night sweat caused by a medical condition or infection can be described as ‘severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environm

True night sweats with medical causes should be properly investigated by a physician. There are many ways to help relieve night sweats. By keeping a cool glass of water on the night stand and wearing moisture wicking pajamas, many people suffering from night sweats have found relief.

Adapted from the Wikipedia article Sleep hyperhidrosis, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

No related posts.