Pharmahealthblog. Health and medical information

Haemorrhoids (Piles)

Many women are troubled by haemorrhoids (or piles). This is often worse in the later stages of pregnancy, and during actual labour. These are an extension of the varicose vein problem, and are actually distended veins in the lower part of the bowel. In some women they are very prominent and quite uncomfortable.

Eliminating constipation can often assist in a remarkable manner. Having unprocessed bran, ideally with muesli, for breakfast each day is good and effective therapy. Often, through the application of simple creams such as lanoline, a soothing result can be obtained. Sometimes clothing rubbing against the piles (which may prolapse) can be very uncomfortable, and local applications can reduce this. Sometimes the insertion of suppositories can assist in shrinking them.

But piles are essentially a mechanical problem, and nearly always they rectify themselves automatically when the confinement is over.

Excessive urination

In early pregnancy, the kidneys tend to produce more fluid than usual. This results in the desire to urinate far more often than normal. Indeed, so common is this symptom that it is often regarded as one of the early tell-tale symptoms of pregnancy.

Toward the end of the term, as the foetal head presses on the bladder, frequency is again quite common. This time it is a mechanical cause.

Both types of frequency are non-serious. They do not indicate disease and, apart from the transient nuisance factor, should be ignored.

Women are more prone to urinary-tract infections during pregnancy. This is often accompanied by the passage of unpleasant-smelling urine, aches and pains and possibly an elevated temperature. The fluid may contain blood, or be cloudy. The desire to pass the urine often occurs, and it is often accompanied by a burning sensation, and the desire to micturate again soon after. There is a lack of comfort, even though the bladder has been emptied.

It is important that urinary-tract infections be dealt with adequately, and medication may be necessary. Often a fever and pains over the bladder or in the back may accompany the other symptoms.

Tests may be carried out by the doctor to determine if infections are present. They will also indicate to him the best form of therapy for your particular infection.

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Pregnancy Tests.

With the advent a few years ago of reliable tests collectively referred to as “immuno-chemical tests,” it is now possible to obtain quick and accurate results. In fact, by using some forms of the test, an answer can be forthcoming in a matter of minutes!

Those that can be read after two minutes are claimed to be 92 per cent reliable. A similar test which occupies about two hours is said to be about 98 per cent accurate. These degrees of accuracy are very high. When teamed in with the patient’s history, the symptoms she describes and the results of the physician’s physical examination, it usually leaves very little doubt in anybody’s mind whether conception has or has not taken place.

Certain precautions are needed when carrying out the pregnancy tests. Ideally, it is a “first” specimen of urine taken during the initial act of urination for the day. The bottle should be clean and free from contamination by drugs or chemicals. (This could possibly give a false reading.) If there is any time-lapse between the time the urine is passed and the time of examination (and a few hours is most likely), the specimen should be refrigerated.

The doctor is seeking to prove the existence in the specimen of urine of a specific hormone called “H.C.G.” This is short for Human Chorionic Gonadotrophin. It is produced by the developing embryo, and actively circulates in the bloodstream. A certain amount is excreted in the urine. If it can be picked up by the use of the test, it is an almost certain guarantee of pregnancy.

However, it takes almost six weeks from the date of the last menstrual period for adequate amounts to be excreted in the urine. Therefore, if the test is carried out before the six-week period, it will most likely yield a negative result, even though the person may be pregnant.

A popular routine is to carry out the H.C.G. test at six weeks. If it indicates negative, and the patient shows many of the other signs of pregnancy, the test is carried out again seven to ten days after. A positive result is then probable, indicating pregnancy has actually occurred.

The doctor will most likely check to see what forms of medication (if any) you are taking. Certain drugs, it seems, can produce incorrect results with the immunochemical test.

The introduction of the simple and accurate immunological pregnancy tests has been a major step forward in the early accurate disgnosis of pregnancy.

New Blood Test for Pregnancy

Since the original urine test for pregnancy was worked out, a quicker and even more reliable one has been developed, and this is now widely used by doctors. In fact, pregnancy can accurately be diagnosed within twenty-four to thirty-six hours of conception. One does not even have to miss a period. It is called the radio immuno assay pregnancy test, or R.I.A. Pregnancy Test for short. Taking a blood sample, a special machine can detect extremely minute traces of H.C.G. circulating in the mother’s blood. It is far more delicate and accurate than the H.C.G. urine tests, and will undoubtedly replace it in due course.

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Normally, the average pregnancy consists of one single foetus. But about once in ninety cases, twins occur.

The rate at which triplets occur is 1 in 90 x 90 pregnancies, and quadruplets 1 in 90 x 90 x 90. This is the rate in Western lands. It is more common in Africa and Asia where a larger hereditary factor apparently plays a part.

There are two types of twins: “Binovular” twins occur when two separate eggs (or ova) are released and fertilized at the same time. Each foetus is a separate entity and is quite distinct from its fellow. “Uni-ovular” twins come from one single egg which has prematurely divided into two separate entities.

Twins are often diagnosed before their birth, but about 20 per cent are not recognized until the moment of delivery. Features which make a patient and the doctor suspect multiple births are mainly the size of the abdomen and womb which are larger than would be expected at any given time.

Sometimes two heads may be felt through the abdominal wall by the doctor’s examining hands. Frequently, the only sure way is by X-ray or ultra-sound examination of the womb. Two separate heads and bodies can be clearly detected in this manner.

Generally, multiple births proceed to term normally. But there is an increased risk of certain complications taking place, so the mother may be requested to attend more frequently for her prenatal examinations. Some cases end in premature labour.

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As pregnancy advances, more and more demands are made upon the mother’s reserves of iron. During the last twelve weeks a considerable amount of iron is transferred from the mother to the baby. It is essential that these depleted stores be made up to normal.

Even during normal non-pregnant life, women run a greater risk of having reduced stores of iron. Menstruation each month reduces the supply. Although a certain amount of this is made up during the subsequent month, it is very common for the level to be less than normal even early in pregnancy.

For this reason, the doctor usually orders a haemoglobin examination at an early date in pregnancy. The haemoglobin is the red material in the red blood cells, and iron is used in its manufacture. Unless this is present in normal amounts, the body (including the foetus) is unable to gain sufficient supplies of oxygen, and difficulties may be encountered.

With more severe forms of anaemia (as this condition is called), symptoms will appear. Fatigue ‘more than would normally be expected), shortness of breath, a pale complexion and swelling of the tissues (referred to as oedema) may occur.

These are very important symptoms, indicating an immediate need for treatment.

However, the doctor usually has taken the matter in hand well before these symptoms are likely to put in appearance.

Treatment is generally very successful. It is usually given in a form that can be taken orally. Many different forms are available. Some patients are sensitive to some iron salts, and changes are necessary. But usually a certain brand is available that is suitable and can be tolerated satisfactorily.

Sometimes another chemical called folic acid is in short supply, and this may be given in conjunction. It is also needed to keep the blood in good order.

By sticking to a sensible iron-rich eating routine, the risks of anaemia are far less.

An iron-rich diet is usually a vitamin-rich diet as well. If the mother-to-be acquires this naturally, the need for medication is often reduced.

The original blood test carried out at the first consultation is often repeated at the thirty-second and thirty-sixth weeks of pregnancy, for these are critical times when iron utilization is high. Any deficiencies must be brought back to normal as promptly as possible.

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This is a fairly rare event. It means that the fertilized egg fails to reach the womb on its journey from the ovary (from which it was released).

Instead, it settled at some part along the course of the Fallopian tube (sometimes called the oviduct). This odd occurrence seems more common in underdeveloped lands, where about one pregnancy in 150 ends up this way. In Western lands, the incidence is much lower, being about once in every 250 pregnancies.

The tubes are designed as pipes to transport the egg. They are certainly not meant to sustain foetal growth, and it is quite impossible for a pregnancy to continue there for any length of time.

So, symptoms of disaster are inevitable. It is merely a matter of time. Usually this is between the sixth and tenth weeks.

If the egg becomes implanted in the tube at the ovarian end, then a tubal abortion commonly occurs. This may be the least dramatic. The fertilized ovum simply dies, and is spontaneously aborted into the abdominal cavity.

If the egg is located more deeply along the tract of the tube, it increases in size, and gradually burrows into surrounding tissues. Often a major blood-vessel is finally eroded, and a sudden internal haemorrhage occurs. Blood may suddenly spread out into the pelvic cavity, often creating an emergency situation.

If this complication arises suddenly, and there is considerable blood loss, the patient will notice sudden severe pain in the lower abdominal area. Sudden collapse is common, and shock may occur due to the haemorrhaging. There may be some vaginal bleeding.

Urgent admission to hospital and medical attention is essential. With prompt diagnosis and surgical intervention results are usually satisfactory.

The key warning to any woman who appears to be in early pregnancy (one or two missed periods) is to seek prompt attention if there is any sudden onset of low abdominal pain. Call the doctor or get to a hospital.

In recent years, certain procedures have been claimed to increase the risk of tubal pregnancy. The use of the progestogen-only contraceptive pill (the so-called “mini-pill”) had this charge leveled at it at one stage.

Operations aimed at reconstituting the patency of blocked Fallopian tubes were claimed to be followed by an increased risk of ectopics.

One ectopic seems to increase the risk of another if a further pregnancy takes place. (The risk rises to about 10 per cent.) Only about 60 per cent of women who have sustained an ectopic become pregnant again.

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Back in your parents’ day this was a definite no-no. Of course, even back then there were some brave girls who went ahead and asked the boys out. And most girls did everything they could, short of actually asking, in order to get the boys they liked to ask them out. But the ‘rules’ that most people went by said that boys did the asking and girls were supposed to wait to be asked.

Nowadays things have changed. Although there are still some people who think it’s not ‘right’ or ‘proper’ for girls to do the asking, most people don’t see anything at all wrong with a girl taking the initiative. In fact, many people think it’s a great idea. Almost every boy we’ve asked has said he wished more girls would do it. Girls are often in favour of this idea too.

What if you and your best friend like the same person?

If one of you is already dating or going with this person, then we’d say that this person is ‘off limits’. But if the person isn’t ‘taken’, then the two of you need to think about how you’re going to keep your feelings for this person from getting in the way of, or maybe even ruining, your friendship. Here are some possible solutions. You could decide that you’re both going to ‘go for’ the person, but you agree ahead of time not to let it affect your friendship. You could toss a coin. You could decide to let the one with the strongest feelings have the first chance. Of course, the person you like may already be interested in one of you, so he or she may do the deciding. Or the person may not be interested in either of you, so it may not be a problem at all.

Whatever happens, try to keep a sense of humour about it. And remember, at your age romances come and go, but the friendships you make now may last a lifetime. So, don’t lose your friendship over a romance.

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Incest involves one member of a family being sexual with another family member. It may include anything from touching, feeling, or kissing the sex organs to actual sexual intercourse. Of course, it isn’t incest when a husband and wife do these things with each other. But when it happens between other family members it’s called incest.

Most victims of incest are girls who are victimized by their fathers, stepfathers, brothers, uncles, cousins, or some other male relative, although it is also possible for a girl to be victimized by a female relative. Boys can also be victims of incest, though this is less common. When incest happens to a boy, it may be either a female or a male relative who victimizes him. Incest can happen to very young children, even to babies, as well as to older children and teenagers.

Brothers and sisters often engage in some form of sex play as they’re growing up, which may involve ‘playing doctor’ or pretending to be ‘mummy and daddy’. This kind of sex play between brothers and sisters is very common and isn’t always considered incest. It isn’t necessarily a harmful thing. But being forced or pressured to have sexual contact with an older brother or sister is incest, and it can be very harmful.

Incest isn’t always a forced thing, like rape. Because of the older person’s position in the family, he (or she) may be able to pressure the child into doing sexual things without actually having to use force. Most incest victims are so bewildered by what’s going on that they simply don’t know how to stop it or prevent it from happening again.

Child molesting, like incest, may involve anything from touching, feeling or kissing the sex organs to actual sexual intercourse. (The word molest means to bother or to harm.) But child molesting is different from incest because the person doing the molesting isn’t a family member. It may be a complete stranger, a friend of the child’s parents or some other older person. Boys as well as girls may be victims of a child molester.

If you are a victim of incest or child molesting, the most important thing to do is to tell someone. This can be a difficult thing to do, particularly if you are an incest victim.

The logical people to tell are your parents. (Of course, in cases of incest by a parent, you need to tell the other parent.) However, some parents have trouble believing their children at first. If, for whatever reason, your parents won’t believe you, you might tell another relative – an aunt or uncle, a grandparent, an older sister or brother – who you feel will believe you. Or you could tell another adult—a teacher or counsellor at school, a friend’s mother or father, your vicar or priest, or any other adult you trust. You can also ring the local rape crisis centre, Incest Crisis Line, Childline or the National Society for Prevention of Cruelty to Children (NSPCC). (Look in the telephone directory or ring directory inquiries for the numbers.) The people who answer the phones are specially trained and they understand what you’re going through. (Some of them have been victims of sexual crimes themselves.) You needn’t give your name and what you say is entirely confidential, so don’t hesitate to ring.

Victims of incest or child molesting often find it hard to come forward and tell someone. Sometimes the person who committed the crime has made the victim promise to keep it a secret. But there are some promises and some secrets a person needn’t keep, and this is definitely one of them. Or the victims may find it hard to tell someone because they think that what happened is somehow their fault or that they’re to blame because they didn’t stop it from happening. But this just isn’t true. These crimes are always the fault of the older person. The victim is never to blame and is never at fault in any way. Some victims don’t tell because they fear the person will harm them or get back at them for telling. But the police or other authorities can make sure the victim is fully protected.

Incest victims sometimes hesitate to tell because incest is a crime and it’s possible that telling could get the person who has committed the crime into trouble with the police. Even though most victims hate what’s been done to them, they still may not want to see a relative sent to gaol. But doctors don’t have a legal obligation to report a crime, so the doctor can listen to your problem without reporting it to the police, though he or she will undoubtedly try to get you to agree to involve social services and even the police. Although involving the police or social services may seem like a horrifying idea, it will be better for everyone in the end and will protect any brothers or sisters who may also be suffering abuse.

Some incest victims don’t tell because they’re afraid that the family will break up, their parents will get divorced or things will get worse than they are. But if incest is going on, things are already about as bad as they could be. People who commit incest are mentally or emotionally ill, but they can be cured. The victim and the other family members also need help in dealing with the situation. None of these people can get the help they need unless the victim has the courage to take the first step and tell someone.

Most victims of incest and child molesting feel a mixture of anger, embarrassment, and shame. This can also make it hard to come forward and tell someone. But you have a right to protect yourself from being touched in ways that don’t feel right to you. So even though you may feel embarrassed, it’s important to tell someone. It’s really the best thing for everyone.

Other questions-We hope we’ve answered many of your questions in this chapter. However, you probably have questions about these subjects that we haven’t covered. If so, perhaps your mother, your father, the school nurse, your GP, one of your teachers or another adult you trust can help you find the answers. You might also contact your Brook Advisory Centre for information.

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PID is an infection of the uterus, Fallopian tubes, ovaries and/or other female pelvic organs. The disease is usually caused when gonorrhoea or chlamydia organisms or other sexually transmitted organisms make their way from the vagina up into the uterus. From there the infection may spread to the other pelvic organs. PID may be more severe in women who use the IUD. PID may cause any or all of the following symptoms: period pains; heavier periods, bleeding between periods and other menstrual irregularities; abnormal vaginal discharge; urinary pain or frequency; pain in the lower abdomen or legs; and fever, chills, vomiting or flu-like symptoms. Females may also be asymptomatic, but even these ’silent’ infections can cause serious damage to the reproductive organs. Treatment involves complete bed rest and antibiotics, and may require hospitalization and intravenous antibiotics. If the antibiotics don’t work, it may be necessary to operate and surgically remove the reproductive organs. Females who’ve had PID have a greater chance of having ectopic pregnancies. Some females who’ve had PID are troubled with chronic pelvic pain and repeated attacks of the symptoms. In rare cases PID may be so severe that it is fatal. PID is on the rise and is one of the leading causes of infertility.

Pubic lice-Pubic lice are also called ‘crabs’. This STD is caused by tiny, blood-sucking lice that can live in pubic hair or sometimes in the eyelashes. The lice may be passed through sexual contact or through contact with infected clothing, towels and bed linen. The bite of the lice causes intense itching, and if you look closely you can see the lice or the shiny, sticky eggs they attach to the hair shafts. Lice are treated by repeated shampooing of the infected area with special lotions (available from a chemist without prescription). Bed linen, towels and clothing must be boiled, dry-cleaned or isolated for two weeks to avoid re-infection. Though bothersome, crabs are not a serious health problem.

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As we explained earlier, methods such as the condom, the contraceptive sponge, spermicides and the cap and diaphragm (providing the woman knows her size) can be purchased at the chemist without a doctor’s prescription; however, other methods require a doctor’s prescription. All methods can be obtained free from any family planning clinic and from most GPs. Many family planning clinics have special youth advisory sessions to help young people learn about and obtain contraception. Young people can also attend one of the many Brook Advisory Centres.

How do people decide which method to use?

The method a couple chooses will depend on many factors, including personal preference, the woman’s health, her age, the couple’s relationship (that is, whether they just want to ’space’ pregnancies or absolutely don’t want to become pregnant), and feelings about the issues of safety, effectiveness and convenience. Most people use many different methods over the course of their lives.

Many young people begin by using a condom. The condom has the advantage of being easy to obtain and can protect against AIDS and other STDs. Later, they may switch to one of the methods that require a doctor’s prescription. Some couples prefer methods such as the IUD or pill because they don’t like to interrupt their love-making by having to use the barrier methods or spermicides. Women who don’t have intercourse very often may choose a barrier method rather than the pill, which must be taken regularly, or an IUD, which is in place constantly. The female barrier methods also have the added advantage of providing some protection against some sexually transmitted diseases. Women who are concerned about safety and side effects of methods like the pill or IUD may choose the safer barrier methods. Men or women who have completed their families may choose sterilization. Choosing a method involves weighing the relative effectiveness, convenience and safety of each method. It helps to become fully informed about all available methods before making a choice.

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This method is also called the male barrier method, the sheath, prophylactics, ‘johnnies’, ‘jolly bags’. Trench letters’, ‘Durex’ (one of many brand names) and preventives. The condom fits on the erect penis in much the same way that a glove fits over a finger. The condom is placed over the erect penis prior to intercourse. (This must be done before the penis enters the vagina.) When the male ejaculates, the sperm are trapped in the condom so they don’t enter the vagina. After intercourse, before the penis becomes soft again, the condom is held firmly at the base of the penis (to avoid spilling sperm) and the penis and condom are withdrawn from the vagina. After use, the condom is discarded.

Spermicides-These are sperm-killing chemicals that come in the form of creams, jellies,

C-films, pessaries and aerosol foams. They are placed in the top of the vagina shortly before intercourse and work by killing sperm before they can get through the cervix, into the uterus. Some types of creams and jellies are used with caps and diaphragms, others are made to be used alone. However, when used alone they aren’t very effective at preventing pregnancy, and therefore are not recommended methods.

Contraceptive foam is more effective, especially when used with a condom. A special applicator is used to insert the foam into the top of the vagina, which may be done as many as three hours prior to intercourse. If more time elapses before intercourse, if a couple decides to have sex a second time or if the woman gets up and walks round, allowing the spermicide to drip out, more foam must be added before intercourse. The foam works by acting as a barrier as well as by killing or stunning the sperm.

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