Month: July 2020

Puberty Problems

Posted on July 31, 2020   by   - Blog

Puberty Problems

Puberty is when there starts to be physical changes in your daughter’s body due to the increasing level of hormones. The onset of puberty is usually between 10 to 13 years. The changes include breast development, pubic hair growth, growth spurt and the start of menstrual periods. The changes will occur differently for each girl. Puberty problems are identified when these changes do not occur as expected or at the expected age range.

What are the changes that occur during the onset of puberty?

  • Breast starts developing, initially, it will be small breast buds under nipples which will fully develop in another 2 years.
  • Hair growth will appear in the armpits, pubic area and hair growth will increase on the hands and legs.
  • There may be a sudden increase in height and weight
  • Menstrual Periods will start which initially may be irregular but will later become regular.
  • They may also start experiencing a wider range of emotions too.

A puberty disorder is when the changes do not occur as they usually should or as expected.

The different type of puberty disorders are:

  • Delayed puberty – when puberty hasn’t been attained even after completing 13 years.
  • Premature menarche – when the menstrual periods have started but there are no other signs of puberty
  • Contrasexual pubertal development – when a girl starts to develop male characteristics.
  • Premature thelarche – when the girl’s breasts have started to develop but there are no other signs of puberty
  • Precocious puberty – when a girl attains puberty too early, ie before the girl completes 8 years.
  • Premature adrenarche – when pubic hair has started to appear but no other signs of puberty.

Diagnosis for puberty problems

A physical examination may be conducted followed by medical tests if necessary.

  • Thyroid levels may be tested.
  • Blood test may be taken to check the hormone levels and to identify if there are any chromosomal abnormalities.
  • MRI or CT scan to look out for any issues or abnormalities in the pituitary gland or the brain.
  • Ultrasound to examine the ovaries.
  • Determine the bone age by taking an x-ray of hand or wrist.

Causes for puberty problems

  • Heredity: Chances are if the mother had early puberty the daughter also has a probability to attain early puberty.
  • Genetic or chromosomal disorders.
  • Any issue with the pituitary or thyroid glands, ie the levels of hormones produced vary from what is required.
  • Girls who are overweight have chances of attaining puberty earlier.
  • Excessive weight loss or dieting can also affect the onset of puberty.
  • If the girl has undergone chemotherapy or radiation.
  • Presence of ovarian tumors.
  • Other underlying medical conditions or injuries of puberty

Treatment of puberty related disorders

The treatment will vary based on the cause for disorder.

  • Hormone therapy with the help of medications.
  • Surgery if any corrections are required.
  • Counselling to help deal with the emotional challenges.

For more details on puberty problems or disorders contact us.

Postmenopausal bleeding : Is it something to worry about?

Posted on July 21, 2020   by   - Blog

Postmenopausal bleeding : Is it something to worry about?

The menopause stage is when you have completed at least one year without having your periods. Postmenopausal bleeding is when you have spotting or start noticing a small amount of blood discharge after you have attained menopause. But for any form of bleeding do meet the doctor to rule out any serious issues or to start treatment for it.

What causes postmenopausal bleeding?

  • Polyps – growths inside the uterus or on the cervix but they are not cancerous. They may be the cause of bleeding after sex.
  • Endometrial atrophy – After menopause, the hormone levels will go down. Low levels of estrogen can cause thinning or inflammation of the uterine lining.
  • Endometrial hyperplasia – Thickening of the uterine lining caused by increased levels of estrogen and reduced levels of progesterone. It is likely to lead to cancer so need to diagnose and treat it soon.
  • Vaginal atrophy – Low levels of estrogen can cause thinning, dryness or inflammation of vaginal tissue.
  • Cancer but less commonly
  • Sexually transmitted diseases – Herpes can cause bleeding. Other diseases include chlamydia and gonorrhea.
  • Medications – Bleeding may be a side effect of HRT (hormone replacement therapy) or blood thinners.

How is postmenopausal bleeding diagnosed?

  • Transvaginal ultrasound: a device is placed in the vagina which sends sound waves to get an image and help to scan for any problems.
  • Endometrial biopsy – a thin tube will be used to take a sample of tissue inside the uterus which will be tested for any infections or cancerous cells.
  • Sonohysterography –  this is to determine the size of polyps by introducing salt solution inside the uterus to get a clear ultrasound image.
  • Hysteroscopy: a thin lighted tube that has a camera is passed via the vagina into the womb to check for any issues and to take a tissue sample.
  • D&C (dilation and curettage) –  in this procedure doctor opens the cervix to get a sample of uterus lining which will be sent to the lab to identify the issue.

Treatment

The treatment is based on the cause for bleeding.

  • Estrogen therapy to treat endometrial and vaginal atrophy. It may be in the form of pills, a vaginal cream to apply internally, a vaginal tablet or vaginal ring. The product will release estrogen in specific doses regularly for a few months.
  • Progestin therapy to treat endometrial hyperplasia
  • Hysteroscopy to remove polyps.
  • Hysterectomy – In this procedure parts or the whole uterus may be removed. If cancer has been identified hysterectomy will be prescribed. Some cases of endometrial hyperplasia may also require this procedure..
  • Medications – may have to stop taking the medications or change them.

If you notice any form of bleeding after menopause you need to contact your doctor to identify the issue and treat it. Not all issues may be serious but it is best to confirm the reason for it.

For more details on postmenopausal bleeding, contact us.

Factors Affecting Male Fertility

Posted on July 5, 2020   by   - Blog

Factors Affecting Male Fertility

Infertility is a widespread problem. As per the World Health Organization (WHO) estimates in 2015, 60–80 million couples worldwide suffer from infertility. Male infertility is diagnosed when, after testing both partners, reproductive problems have been found in the male.

In a study conducted by a Fertility Centre in Dubai during the 1st quarter of 2017 on a sample of 100 men of different nationalities between the age 25 and 56, it was found one in five couples in the UAE face infertility-related issues including both expatriates and Emiratis.

Infertility in men occurs when he has a lesser sperm count than expected in a sample. A normal sperm count accounts for about 15 million sperms per ml sample, according to the World Health Organization. Lower than that results in infertility.

Back in the 1980s, if couples were unable to conceive, it was women who were blamed. Men often assume their wives are infertile and the reason why they cannot conceive. But with access to more information, there is a gradual change in mindsets. More men are coming forward to own up to their infertility problems.

“I have been treating more infertility cases in men than before. Now a large number of men are coming forward to get their sperm count tested” said Dr.Shiva, Consultant Obstetrician &Gynae-Laparoscopic Surgeon, Medcare Women, and Children Hospital, Dubai

In the UAE obesity is one of the main factors for infertility in both men and women. Apart from that work environment of men, smoking, alcohol consumption, sitting down for a longer period, emotional stress, steroids used in gyms has deteriorated the quality of sperm.”Men who smoke have decreased sperm concentration and their sperm has high DNA damage” explains Dr. Shiva

Despite the decrease of tobacco smoking in the UAE, a growing trend towards e-cigarettes is also unlikely to affect the decline in fertility as e-cigarettes also deliver nicotine that has a severe impact on sperm production. Other factors include temperature and radiation exposure that can also hinder sperm production and is responsible for about half of male infertility.

Men wishing to have children must avoid damaging lifestyles that limit their chances of conception. There are also treatments available that can harvest sperm and improve its quality even in men who produce a very low sperm count. The hormone treatment plan is also available for patients to increase testosterone levels to improve sperm production and the quality of sperm to make them stronger making them more likely to be effective.

In Vitro Fertilization (IVF)can also be used in case of blocked or damaged fallopian tubes and decreased sperm count or sperm motility where fertilization process is manually done outside the body.

If you face problems in erection or evacuating, low sex drive, or other problems with sexual function or a history of testicle, prostate or sexual problems, consult your doctor.

If you want to learn more about fertility treatments, reach out to us by calling +971 56358 7610 .