Monday, December 18, 2006

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Menopause and Hot Flashes and Evening Primrose Oil--Does It Work?


by Patsy Hamilton






Numerous studies have been conducted concerning alternative treatments for menopause and hot flashes, and evening primrose is one of the natural products that have been studied. According to surveys, control of hot flashes is the number one reason that women seek treatment during the years leading up to and following menopause.

Because so much scientific research has been conducted concerning the safety and effectiveness of non-hormonal treatments for control of hot flashes, several research groups have gone to the effort of compiling the published data. You might call these the �studies of the studies�. You might wonder why all of this is necessary. There are several reasons, but the primary one is that hot flashes respond to placebo. The majority of studies confirm that women taking placebo experience about a 20% reduction in hot flash symptoms. So, researchers interested in promoting a specific product can honestly say things like �women using product X reported a reduction in hot flash symptoms.�

A recent search for studies published at Pub Med, a service of the National Library of Medicine and the National Institutes of Health, concerning menopause and hot flashes and evening primrose returned 20 results. Evening primrose oil is claimed to provide a variety of health benefits, including the control of hot flashes, but finding contemporary medical literature to support these claims is difficult.

In 1994, researchers at the Keele University in England enrolled 56 menopausal women suffering from hot flashes at least three times a day to complete a six month study of the effectiveness of evening primrose for control of hot flashes. Only 35 women completed the study. 18 of them took 500 mg of evening primrose oil with 10 mg of vitamin E twice a day, while 17 took a placebo. After analyzing the dairies of the participants, researchers concluded that evening primrose offered no benefit over placebo in treating menopausal hot flashes. On the average, the women taking placebo experienced 0.7 less hot flashes per day, while women taking evening primrose experienced 0.5 less per day.

One of the �studies of the studies� was completed in 2002 by researchers at Columbia University in New York. These researchers used a number of different sources to accumulate information relating to menopause and hot flashes, and evening primrose was again mentioned. In total the researchers selected 58 different studies that were randomized, placebo-controlled clinical trials. They came to the following conclusions. Dong quai, evening primrose oil, vitamin E and acupuncture do not affect hot flashes.

On the other hand, the researchers believed that black cohosh showed promise for the control of hot flashes, but they were wary to recommend it, because safety data concerning the herb had not been accumulated at that time. Since then, studies have shown that black cohosh has no negative side effects and has no estrogen like affects on breast or uterine cancer cell lines. Black cohosh is currently recommended by most practitioners, whereas evening primrose is not believed to be effective. For more information about menopause and hot flashes, and evening primrose and black cohosh, please visit the Menopause and PMS Guide.

Patsy Hamilton was a health care professional for over twenty years before becoming a freelance writer. Currently she writes informational articles for the Menopause and PMS Guide. Read more at http://www.menopause-and-pms-guide.com

Article Source: http://EzineArticles.com/?expert=Patsy_Hamilton



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Hormone Balancing and the Risks for Heart Disease


by Jackie L. Harvey






Risk factors for heart disease are primarily the same in women as they are in men. Smoking, high blood pressure, excessive weight, sedentary lifestyle (little or no exercise), high Homocystine levels, diabetes, high cholesterol, age and family history of heart problems all increase a woman's chances of having heart disease.

The one addition for women is HRT. Since July 2002 HRT can be considered a risk for heart disease according to the WHI study which evaluated PremPro a premarin and provera combination therapy which was gaining popularity with medical practitioners.

Research shows that anovulatory cycles and lowered progesterone levels occur prior to menopause. Then progesterone levels after menopause and continue to fall to close to zero. Estrogen, on the other hand, falls only 40 to 60 percent with menopause.

A woman's passage through menopause then results in a greater loss of progesterone than of estrogen. It is believed that perhaps the increase in heart disease risk after menopause is due more to progesterone deficiency than to estrogen deficiency. Dr. John R Lee author of the book �What Your Doctor May Not Tell You About Menopause� states that in his clinical experience, lipid profiles improve when bio-identical progesterone is supplemented. The synthetic versions of progesterone called progestins or progestagens do not offer the same effects. In fact, the WHI study and more recent studies from Harvard and the UK all point to the fact that HRT- Estrogen plus a progestin increases a woman�s risk for heart disease and may even contribute to heart disease.

Bio-identical progesterone on the other hand appears to increase the burning of fats for energy and, in addition, has anti-inflammatory effects. Both of these actions would be protective against coronary heart disease. Progesterone protects the integrity and function of cell membranes, whereas estrogen allows an influx of sodium and water while allowing loss of potassium and magnesium. Progesterone, a natural diuretic, promotes better sleep patterns and helps us deal with stress. When one reviews the known actions of progesterone, it is clear that many of its actions are also beneficial to the heart.

The key to reducing a woman�s risk of heart disease is to maintain a balance of hormones in her body and at the same time actively pursue a program to prevent heart disease.

Steps to take would be:

1. Use a Saliva test to determine the status of estradiol and progersterone.

2. If either are deficient increase progesterone levels first using a bio-identical cream.

3. Increase Fiber in the diet and use a supplement like Fiber Source 7 which has the additional advantage of containing probiotics. High fiber diets have been shown to improve hormone levels and to assist with heart health.

4. Increase EFA�s in the diet. Essential Fats promote good hormone production as well as heart health.

5. Increase the consumption of fruits and vegetables focusing on greeny leafy vegetables and cruciferous vegetables which contain anti oxidants and indole-3-carbinol. Taking a fruit and vegetable concentrate and an indoles supplement in addition to eating more makes sense to guarantee you are getting all the nutrients needed and to fill the gaps in your diet. 6. Using a calcium/magnesium supplement for your bones and for your heart health is often suggested in prevention programs.

We must take charge of our health. Prevention is always the best medicine. It is never too late to make lifestyle changes. Exercise, a healthy diet and the right supplements and perhaps a little hormone balancing can all ensure that we don�t fall victim to the silent killer that is relentlessly stalking our heart and ultimately � our life.

This Article Is Copywright 2006 Jackie L. Harvey & Saliva Testing com

Jackie Harvey is a nutritional speaker who shares her interest and information on hormone health and hormone saliva testing throughout North America in her popular "Let's Talk About Hormones" seminar. Visit her website SalivaTesting.com for a schedule of events in your area and for more information about her Best Selling 1-hour DVD "Let's Talk About Hormones with Jackie Harvey". Click For More information on Women's Hormone Saliva Testing and Saliva Test Kits.

Article Source: http://EzineArticles.com/?expert=Jackie_L._Harvey



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All You Wanted To Know About Menopause and Its Prevention


by Venkata Ramana






Menopause occurs when a women stops ovulating and her
periods ceases. Most women reach menopause between 45 and
55 years, with an average age around 50. But about 1%
reaches it before 40, which is known as premature menopause
or premature ovarian failure.

For women in their teens and 20�s the loss of their
fertility is devastating. They will also experience a long
period of postmenopausal life, and hormonal replacement
therapy may be advised.

Symptoms:

� Menstrual cycle changes � Changes in the bleeding pattern
� Hot flushes � Sweats � Urinary problems such as
incontinence or increased frequency of urination. � Dry
vagina � Mood changes � Weight changes etc

Are some of the basic symptoms.

Prevention:

We can prevent early Menopause, by preventing unwanted
surgeries, of the uterus or the ovaries unless there is
strong indication for their removal. Such Surgeries can
lead to autoimmune diseases such as diabetes, Rheumatoid
arthritis and thyroid disorders. Conserving even a single
ovary can help in preventing the onset menopause.

Urban women have access to information or counseling, but
unfortunately the women in rural areas of Asia have no such
knowledge. The good news for those who would like to rule
out doubts about the onset of menopause will soon be
available in the form of LH Kits ( Leutinizing hormone ) to
check their ovulation especially used with infertility
patients. While stress cannot be over emphasized, it has a
role in temporary or prolonged cessation of periods.

Treatment:

Generally early menopause too is treated in a similar way
as menopause itself, through HRT ( Hormone Replacement
Therapy ), life style modification,calcium and good
nutrition.

HRT � It must be borne in mind that an extensive study
shows that HRT is not a protection against heart diseases
as was believed before and infact not quite the �happy
pill� � that women had thought is given up to the age of
menopause.

Venkata Ramana is a Health Enthusiast. Visit any of his Health and Pregnancy websites and gain maximum Information to stay fit and healthy.

Article Source: http://EzineArticles.com/?expert=Venkata_Ramana



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Some Causes of Infertility in Woman


by Low Jeremy






There are many factors that will relate how a woman develops infertility. While it is prevalent among Americans, no data can truly present the actual intensity or prevalence of this condition.

Infertility is definitely not a physical disease. Unlike simpler conditions like flu or the more complex ones such as those of cancer, symptoms of infertility are not focused on the obvious signs.

In fact, a woman need not undergo a series of comprehensive tests and examinations before she can truly be diagnosed of infertility. The same goes with men only differing in one thing, male infertility is much more difficult to be spotted unless obvious presentations of erectile dysfunction are seen.

Pelvic Inflammatory Disease or PID

This is presumed to be the most common cause of infertility. This arises from internal infections that are caused by bacteria penetrating into the internal reproductive organs of a female. The typical organs affected are those surrounding the pelvic area but when aggravated, infections may also radiate into the neighboring intestines. Infertility associated with PID is definite if the portion affected is the fallopian tube, a condition that is medically termed as salpingitis.

Endometriosis

According to data gathered from medical literature, nearly 30% of all infertility cases in women is covered by this condition. This is characterized with the presence of the endometrial tissue in parts other than the uterus. This tissue is the one women discharge during menstrual cycle.

Having this condition however does not actually suggest the likelihood of being unable to conceive. But it may largely contribute to the development of the disease

Polycystic Ovarian Syndrome

This is the condition characterized by the over-production of androgens in the female's system. This occurrence will drive the lowering in the release of other hormones such as Follicle Stimulating Hormone and Luteinizing Hormone which will eventually caused the stoppage of mature egg production.

Early Menopause or Premature Ovarian Failure

This is the premature depletion of follicles in women during ages prior to her 40th years. This is characterized by long periods of irregular menstrual flow. This condition is very much comparable with true menopause since both impede a woman to produce eggs.

Idiopathic Hypogonadotropic Hypogonadism

This is rarely the case among infertile women. This is identified when there is 'no' production of LH and FSH. Thus, the impossibility of developing egg cells. There are actually no physical symptoms that will help conclude the presence of this condition. Most cases of Idiopathic Hypogonadotropic Hypogonadism fall under unknown infertility cases.

This content is provided by Low Jeremy and may be used only in its entirety with all links included. For more info on Infertility, please visit http://infertility.articlekeep.com

Article Source: http://EzineArticles.com/?expert=Low_Jeremy



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Sunday, December 17, 2006

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Menopause Issues, And A Safer Solution


by Robert Emler






The most classic symptoms of menopause include night sweats, difficulty sleeping, vaginal dryness, depression, and mood swings. A United States study showed nearly sixty percent of women had hot flashes as early as two years before menstruation stopped. Other symptoms in the per menopause/menopause time frame include poor handling of stress, a more obvious pre-menstrual syndrome, weight gain, water retention bloating, and problems with memory. These symptoms are related to the changes that are occurring in the body with the reducing levels of estrogen and progesterone.

Menopause can last one or two twelve month mistral cycles before menopause runs through its course. Most cases of menopause do how ever run there course in the twelve month cycle. There are a few cases of menopause that do last longer then the normal twelve month cycle.

Menopause can be managed with diet and exercise. Exercising strengthens the muscles and bones and helps circulate the blood. It gives a better mental outlook and aids in a better night�s sleep. Exercise can also give relief as well as a calming effect; reduce stress and increase vitality, concentration and alertness. Weight lifting exercises can help against bone loss and osteoporosis. It also improves posture, balance and muscle tone.

The question as to whether or not to use hormone replacement therapy has now become a very complex issue. Thirty percent of menopausal women in are taking hormones, commonly given to relieve the side effects. In the Women's Health Initiative over fifteen thousand women were studied for almost six years, but the study was prematurely stopped when it was discovered that the combination of estrogen/progesterone replacement therapy resulted in an unfavorable risk to benefit analysis.

There is no doubt that the therapy did benefit women's hot flashes and other menopause issues. Unfortunately the study also revealed a definite increased risk of developing endometrial uterus cancer, breast cancer, blood clots, and a risk of stroke and heart attacks. There was also question as to whether the use of hormone replacement therapy could be linked to gallbladder disease, ovarian cancer, colon cancer and even an increased incidence of memory loss. Some of these risks were directly linked to the time hormone replacement therapy was taken. In layman�s terms, the longer a person takes hormone replacement therapy the higher is the risk of possibly conceiving one of these deadly diseases.

A lot of women studied experienced positve results from eating soy products. Because soy contains isoflavones, a natural plant estrogen, this can help offset the drop in the body�s estrogen that occurs when going through menopause. In turn this can relieve hot flashes and night sweats. Sources of soy include tofu, soymilk, soynuts, soybeans and soy protein powders. Black Cohosh, Vitamin E and herbs such as Dong Quai, Evening Primrose Oil and Red Clover diminish hot flashes, night sweats and other symptoms.

Robert Emler: I have an Aunt that used the method of hormone replacement therapy for dealing with menopause. As a result I feel that is why she developed breast cancer two years after receive this type of treatment. My aunt was not only just an aunt to me. She was my confider and my best friend. When she developed breast cancer I watched here struggle severely with this disease. I can honestly say that the disease took its toll on me more than her. I hated to watch her have to go through this type of pain and hurt. My aunt was and always will be the best person I know in this world. For safer alternative methods of dealing with the symptoms of menopause go to http://ment2pause.com

Article Source: http://EzineArticles.com/?expert=Robert_Emler



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Medical Question #2. Ovarian Cysts


by Al K






Ms. L wrote me:

Hello Dr. Kavokin,

I was reading some of your literature and found it to be quite informative. I have a question that perhaps you may be able to answer: If a woman's ovarian cyst ruptures, (especially multiple cysts from PCOS) can these ruptured cysts become an infection?


Hi, MS. L

Short answer: anything can become infected. Though I do no think ruptured ovarian cyst becomes infected very often, did not hear about that. I will look more literature and probably place the answer on my website.

Sincerely,

Alex

OK. I looked the literature.

I didn't do very extensive literature search. Should admit.
Anyway, some available books mention that ovarian cyst may become infected. However the infection is not described as the main complication in ovarian cyst rupture.

Also, I don't remember that anybody told me otherwise. Maybe there is some specialized article that says: the condition happens in one point three percent of cases with Standard Deviation of half percent. I don't know exact percentage. Need to look more. PubMed service did not give many abstracts on PCOS + infection.

Anyway.

So how would it look alike?

A young woman comes to ER. She is premenopausal. She complains on mild (or maybe severe) pain in her belly. ER Doctor takes history. The woman also mentions changes in her menstrual interval. Let's say regular is 28 days. Last one was delayed.

Physician puts gloves, puts jelly on gloves. Then he puts his two fingers into the female vagina.
The other hand is on belly. Then he starts to palpate.

It is named pelvic exam. Modest name. Though in Russia it is named vaginal exam, which it is.

Is it a common type of exam? Depends. They usually send you to CT (computer tomography) scan if there is severe abdominal pain. Charge 1000. Boom.
Done.

Exclude the price. Exclude delay in reading (somebody should look and interpret what is going on). Exclude radiation. CT scan gives better picture than just poking your belly.

CT scan helps to diagnose abdominal pain of uncertain origin. You can really image what is going on. Though, there are cases when physical exam gives more clues. Physical exam must be performed always. Pelvic exam is somewhat a special one.

I remember how I performed a pelvic exam in medical school. It is actually difficult even just to insert two fingers into vagina first time.
Female Gynecologist asks me: "So, what do you feel?"
Patient goes the same, encourages me:
"What do you feel, what do you feel, do you feel it?"

I guess she felt a sort of museum artifact.
Heck, I did not feel anything.

Well. Actually I felt something - aside from uterus - something round. I would say 5 cm in diameter (would it be less I probably would not feel it at all) and semi-solid on touch. Also I saw that the patient grimaces. It is tender when I push hard.

It's it. How to say that it was tuboovarian abscess (that it was) for sure, I don�t know.
You really need experience to perform this type of exam. Experienced gynecologist can tell almost precisely what is going on.

Let's discuss that woman in ER. She will have tenderness on one side. Physician should be able to feel a mobile cystic mass.
(Cyst or rather cystis is Latin for bubble. Palpate is Latin for touch. It means you touch something and feel what it is).
What if the pain is severe? It often means that the cyst ruptured.
My impression is that modern ER orders CT scan right away. If you are not very sure what is going on, you will go from less expensive methods to more expensive and end up with CT anyway. Ruptured cyst causes significant pain. Here CT is indicated.

Alternatively they may order Ultrasound Exam. Transvaginal ultrasound uses the probe inserted into vagina. Ultrasound is cheaper than CT. Ultrasound visualizes cysts clearly. Though, ultrasound gives less information for excluding other pathology. Ultrasound is also safe from the radiation point of view.

In PCOS ultrasound shows increased number of small cysts in both ovaries. Usually more than five confirms the diagnosis.

Culdocentesis may give some useful information too. The name came from cul-de-sac. It's French I guess. Cul-de-sac is one of the pouches in the pelvis. Centesis means: stick a needle and draw. These days it is considered an outdated method. But if you do not have other machines, it is very useful.

If the content is blood, the ruptured cyst was probably Corpus luteum cyst. If the content is purulent the ruptured thing was probably a tubo-ovarian abscess or other pelvic inflammatory disease (PID).
Other abnormal masses can rupture as well. Teratoma gives oily fluid, endometrioma gives "chocolate" old blood.

What is a follicle?

Female body is created for reproduction and childbearing. Oocyte is the start for a new human being in the ovaries. Several layers of specialized membranes surround an oocyte.

The membranes protect the oocyte, help in feeding and nurturing of this small cell.
One of layers has a beautiful name Zona pellucida. Pellucida means shiny in Latin.

When the oocyte matures, a small bubble (follicle) filled with special fluid is formed around.
In mid-cycle the follicle bursts and the oocyte goes first into peritoneal cavity, next into ovarian tubes (fallopian tubes). The tubes lead into uterus. Tubes, by the way, have special small hair-like things inside - fimbria. They beat in one direction. They propel the oocyte into uterus.

I remember I read somewhere that there are 11000 follicles. When a girl is born, there is no more multiplication of oocytes. After the birth the follicles sit dormant. When the female goes into her reproductive age, the follicles start to grow and mature (one by one).

Only 400 of them mature.

Yeah, it should be like this. Calculate. Average cycle is 28 days. So there are around 12 cycles a year. Women start to menstruate at 13-15 years old. The menopause is around 45-55 years. Total is 30-40 years

Multiply everything together. It should be around 400.

By the way, an interesting thought.

All those discussion about abortion and Stem Cell research.
Somewhere in nineteen century the baby was considered the baby when it was born. The church even struggled to admit anything like existence of cells etc. Rare baby actually survived beyond first year.
Heck, the hypothesis that human been consists of small cells was actually admitted widely not so long ago. Maybe hundred years ago. Then, all that research happened. People learned how the fetus is created and how it grows. Now the public idea is that fertilized oocyte is already the baby.

Have you seen any oocyte under microscope? Even a human hair near an oocyte looks like a skyscraper near a real human.

Now, if the public perception had shifted this way in several decades, shouldn't we punish all women for that they recklessly loose 400 potential babies during lifetime. Isn't it a crime?

Then, maybe we should punish every man for losing millions of sperms - also potential babies.
Where did this idea come from that fertilized oocyte is the baby and non-fertilized oocyte is not?
Shouldn't we move the boundary a little bit earlier?
Need to think about that.

Anyway.

Ovarian follicle (follicle means small bubble in Latin) usually mature, rupture and release the oocyte that was in this follicle. Sometime the rupture delays. Then ovulation delayes. (Ovulation is rupture and release of the oocyte. Oocyte is the cell that eventually becomes the fetus after sperm gives the genetic material).

Normal cycle is divided into follicular phase (when the follicle grows) and luteal phase.
Luteum means yellow in Latin.

When the follicle ruptures (by the way rupture means burst or tearing), the oocyte goes out.

The cavity that left behind (remember it was small bubble) is filled with blood and special cells, producing hormones. These special cells grow in quantity and fill that cavity. These cells produce hormones that help the fertilized oocyte to attach and to grow in the uterus. Because they grow in quantity, they create a yellowish body in the ovary. It is literally yellowish. The name is Corpus Luteum (corpus=body, luteum = yellow).

This is normal cycle.

As we said, the follicle sometime doesn�t rupture (there is a bunch of reasons). A physician should sort out several different conditions. This is an abnormal cycle.
If follicle does not rupture it becomes the follicular cyst. Cyst also means bubble in Latin. There are actually plenty of different kinds of bubbles in medical Latin. Big ones and small ones. Normal and abnormal.

OK, the cyst did not rupture. Then what happens?

Well. If cyst doesn't rupture, it usually resolves. That fluid inside the cyst is reabsorbed and the cyst collapses.

However, if the cyst ruptures, it causes acute pain. The pain comes from irritation of peritoneum (lining of peritoneal cavity) with blood and cyst content.

Why it is not painful when a regular follicle ruptures and releases the oocyte? Probably, a regular follicle is too small. In addition it doesn't cause much bleeding.

In contrast the cyst is a really big bubble (sometime 5-10 cm in diameter). If it ruptures, it instantaneously release bunch of special fluid. Plus, there is significant bleeding because there are a lot of blood vessels around to feed.

Significant is of course relative.

For example, take 5-10-20 ml of blood from a patient vein in a hospital daily. He complains about the pain from the needle mostly.

But if you get the same 10 ml of blood into peritoneum... Wow.
You will cry. There are plenty of nerve endings. Peritoneum is too touchy-feely. Tender.

Besides, the cyst has high concentration of prostaglandins. Prostaglandins, in their turn, are mediators of inflammation. They should cause significant pain directly and indirectly.

From the other hand bleeding could be really significant. Then it becomes really dangerous.

A physician also should not miss an ectopic pregnancy. Doctor will order a pregnancy test for that. If an ectopic pregnancy starts to bleed, this is really really worrisome. It seems like your blood did not left your body. However the blood is in the abdominal cavity. It left the blood vessels. It is internal bleeding. You die quickly.

Polycystic ovarian syndrome is a little bit different animal actually. Here is some genetic predisposition.

Classically: an overweight young female presents with oligomenorrhea or amenorrhea, anovulation, acne, hirsutism, and or infertility.

What is what? Poly = many. Many, many, many men.
So PCOS means bunch of those bubbles in the ovaries. The follicles did not rupture on time, as they should. Oligo means a little. Meno is derived from menses. Rrhea means flow in Latin

So olygomenorrhea = flowing a little bit (less than it should).
A- is a prefix that means "No". So, amenorrhea = no flow at all.
Hirsutism. I don't remember where it came from, but means hairy or hairiness. Actually excessive hairiness.

Causes of PCOD or PCOS (disease or syndrome) are obesity, genetic predisposition and some other causes of Luteinizing hormone (LH) excess.

There is a self-amplifying cycle:

LH stimulates theca lutein cells. Theca means sort of capsule. Doesn't really matter, just an anatomical term.
Those cells are special. They produce androstendione and testosterone. Androstendione and testosterone are actually male hormones. You know, bodybuilders use these hormones to get muscle bulk. You probably heard about those hormones. Sport doping uses testosterone.
So, athletes build their muscles and trash their liver.

Rumors say that a famous Hollywood actor used the hormones. Later he got liver transplant.
Though he always denied the use.

Anyway, female body converts androstendione into estrone (a weak estrogen). Fat cells do this. Estrone is a female hormone already.

Basically any body produces androgens (andros = man) and estrogens (female hormones). Just the proportion of those hormones makes us male or female.

The cycle happens in normal person as well.

The estrone stimulates pituitary secretion of LH.
Pituitary is a small gland in you brain. Pea Size.
It's small, but it sooooo powerful.

Pituitary has another name - hypophysis. Hypo means down, phys means growth, so this gland is growing from below the rest of the brain. Pituitary gets bunch of connections from hypothalamus.
Hypothalamus means �below thalamus�.
These two areas of brain regulate almost all the hormone production in organism.

Higher levels in brain hierarchy regulate them.

Hypophysis gets a command. Then it produces some intermediate messengers and hormones.
The hormones go into blood and control whole body.

Hormones are like orders, like messages to the rest of the body.

Brain may give quick orders: Signals go through the nerves. It is like a phone order or cablegram.

Brain also regulates organism through the hormones. This is like a mail order.
Sort of if the brain sends letters by regular mail. The hypophysis is the Post Office in this case.

PCOS kicks in when a woman is obese. There are more fat cells to convert
androstendione to estrone. Estrone has such effect that it stimulates pituitary secretion of LH.
LH in its turn goes back to those theca lutein cells we discussed and turns them on again, to produce more androstendione, which is again converted into estrone.

Self-amplifying cycle

In addition, that increased level of testosterone causes the hirsutism (she becomes hairy like a male) and acne in female.
In a normal person this cycle is probably designed to support the development of fetus.
Estrogen helps placenta to grow. Placenta supports fetal growth.

However, in a person with PCOD the cycle is going out of normal control. In this case LH causes growth of the cysts in the ovaries.

Why?

Because the corpus luteum cyst is partially made by overgrowth of those theca lutein cells. LH stimulates theca lutein cells.

Also, women with PCOS have intolerance to glucose (sugar) and resistance to insulin.
It means there is a lot of insulin (hormone that helps to utilize glucose mainly).

However excessive insulin does not work. Either receptors to insulin do not work or something else, but the glucose is not utilized. Hence, energy inside the cells drops. Hence, a big pile of other problems mounts. As if it is Diabetes Mellitus. Diabetes is a different topic of discussion. For us, it is worthwhile to mention that people with diabetes are very much prone to any infection.

PCOS causes acanthosis nigricans also. Acantocytes are special skin cells.
Nigricans means black in Latin. That thing looks like thickened pigmented skin. When you touch it, it feels like velvet. Usually it happens in axilla, neck, below breast, in inner thigh and vulva. So, mostly all those places where skin folds.

The treatment for PCOS includes different medications: oral contraceptives, progesterone,
glucocorticoids, ketoconazole, spironolactone, cyproterone, flutamide, cimetidine, finasteride, ovarian wedge resection, laparascopic electoracutery, mechanical hair removal, etc.

All methods break the cycle of overproduction. The medications are either hormones themself or hormone-like substances that occupy receptor site and prevent regular hormone to work.

The medications act on different levels. Normal hormones have very complicated regulation. There are loops and feedbacks in the pathways.

To suppress a hormone production or action, you give similar hormone or another hormone or non-hormone at all, that goes to the feedback loop and breaks it and so on. It's really long separate discussion.

Basically, you either decrease hormone production or shift ratio toward female hormones.

Another way, the best probably, is weight loss. No fat cells - no conversion of andrgoens etc� You can make conclusions yourself.
It's the first line of treatment.

For a simple follicular ovarian cyst (not PCOS) doctor rules out ectopic pregnancy. Then he may send patient home and repeat pelvic exam in 6-8 weeks. Especially, if the cyst was small, less than five cm in diameter.

For larger cysts, doctor would order pelvic ultrasound.

Most follicular cyst will resolve on their own in six to eight weeks. Though, a physician may give oral contraceptives. Again, this suppresses stimulation of cyst by hormones from the hypophysis. The hormones are named gonadotropins.

If the cyst is still there after 6-8 weeks, a suspicion arises that the cyst maybe malignant. Then doctor orders other studies. CT scan. Physician may perform surgical procedures also. He looks what is this cyst really.

Corpus luteum cyst is usually not treated. However, oral contraceptives may be used.

Rupture of any kind of those cysts leads to another story. Acute pain, bleeding into peritoneum.
Sometime bleeding is very severe and is true emergency. You need also to distinguish other process in the abdomen. For example, appendicitis looks similar. You can treat mild case of non-complicated cyst rupture with just observation. Appendicitis almost always requires surgery.

There are many other problems arise. Surgeon scratches his head: what's going on? Is this this or is this that? Here is the CT scan gives big advantage.

Now, going back to the question of Ms. L.

If the cyst was infected, I don't' see a reason why a ruptured cyst wouldn't become infected.
Cyst content is very nutrient-rich. Remember? All those cells and their products are dedicated to feeding the oocyte (future baby). Should be very tasty for any bacteria.

Rupture may cause significant bleeding as well. This blood is also different from the blood in your vessels.

This blood is sitting in the pelvis, not moving, quickly clotting. Clotting prevents entry of white blood cells. "No flow" prevents entry of antibodies. Absence of flow prevents entry of other protective chemicals (complement etc).

So, it is very nutrient-rich media for bacteria growth.

They can go wild. Why not?
If a female had another pelvic infection before, that infection can flare up. In a normal person peritoneal cavity should be sterile. However, any gynecological or gastrointestinal infection may supply bacteria. Now, mix these bacteria with the content of the leaking cyst. It just destined to become infected.

Actually Ms. L later answered her own question in another e-mail. She had cysts multiple times and they became infected several times.

So, to answer the question:
Will the ruptured cyst become infected? Not necessarily. Rather not. Can it become infected?
Yes.

Aleksandr Kavokin MD/PhD, Phila
appendicitis_disease@yahoo.com
http://www.appendicitis.uni.cc/
Aleksandr Kavokin, MD1994 Russia,PhD1997 Russia - Immunology and Allergy, postdoc at Cancer Center at Med U of South Carolina, postdoc at Yale - Cardiology, Molecular Medicine.
http://kavokin.com
http://www.geocities.com/aging_rejuvenation/ http://www.geocities.com/appendicitis_disease/

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