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Women's Health / Gynecology

What is amenorrhea?

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Amenorrhea is during puberty and menopause, when menstruation is absent during reproductive years.

It’s not a disease and it doesn’t mean a person is infertile, but it may be a symptom of a health condition that needs some attention.

Menstruation starts during puberty, and then usually happens around once a month until the age of 50 years. Periods cease entirely at this time, as menopause begins.

Menstruation also stops during pregnancy and it’s also normal for it to stop during breastfeeding.

It is amenorrhea if menstruation does not occur at times when people usually expect it.

Types of amenorrhea

There are two types of amenorrhea: primary and secondary.

Primary amenorrhea

Amenorrhea refers to a lack of menstruation, either because periods never started or because they stop.
Amenorrhea refers to a lack of menstruation, either because periods never started or because they stop.

Main amenorrea is when cycles during puberty do not start.

When cycles do not start by the age of 16 years, the individual should seek medical attention, according to the National Institutes of Health.

Primary amenorrhea is fairly rare. It affects less than 0.1 percent of people in the United States.

Secondary amenorrhea

This is when the cycles begin but then they cease to take place.

It is common during pregnancy or breastfeeding, but it may also mean a issue is present.

Secondary amenorrhea is estimated to affect about 4 percent of women in the U.S. over their lifetime.

One missed day is typically not a sign of a health concern, but if it occurs, many people will ask for a pregnancy test.

A doctor will consider secondary amenorrhea if an individual:

  • used to have regular periods and then does not have any for 3 months
  • used to have irregular periods and then does not have any for 6 months

Causes of amenorrhea

The cause will probably be different for primary and secondary amenorrhea.

Primary amenorrhea

One common cause of primary amenorrhea is a delayed menstrual family history. There is, however, also a genetic issue.

Genetic conditions which can stop ovaries from working properly include:

  • Turner syndrome
  • androgen insensitivity syndrome, which leads to high levels of testosterone
  • Müllerian defects

A Müllerian anomaly is a reproductive-organ malformation. The uterus and fallopian tubes are not forming as they should.

A structural issue can occur in relation to the genitals that are present from birth. The uterus and Fallopian tubes can sometimes be absent. Often there are fusion problems, where the tubes don’t work together properly.

The ovaries, breasts, and clitoris shape correctly in the Müllerian agenesis, or Mayer-Rokitansky-KusterHauser (MRKH) syndrome, but there is no vaginal opening, and the cervix and uterus may not develop properly.

In this case the usual pattern does not match reproductive development, and menstruation will not be possible.

Secondary amenorrhea

Pad in tamale hand bag
Reasons for amenorrhea include pregnancy, changes in weight and exercise, medication, and some health conditions.

Menstruation may stop for a number of reasons.

These include:

  • a gynecological disorder
  • serious illness
  • physical stress
  • having a very low body mass index (BMI)

The risk of developing secondary amenorrhea increases considerably when BMI falls below 19.

Weight loss, exercise, and stress

Severe weight loss may be the result of an eating disorder or a physical disability.

Strict exercise can cause subsequent amenorrhea. Competitive long-distance runners and experienced ballet dancers are popular here.

Severe emotional upheaval or intense stress can also cause a woman to interrupt her cycles.

Medications

Many medicines, such as progesterone-only contraception and a variety of psychiatric medications, may cause disruption of periods.

Other medicinal products which affect menstruation include:

Long-term health conditions

Amenorrhea can also result from a long-term illness, such as:

  • polycystic ovary syndrome (PCOS)
  • premature ovarian failure
  • thalamic pituitary problems

Pituitary problems or an underactive thyroid can lead to a hormone imbalance, and it can result in menstrual problems.

These could be due to:

  • a benign or cancerous tumor in the pituitary gland
  • an over- or under-active thyroid gland

Symptoms

The main symptom is a lack of menstruation.

However, depending on the cause, other symptoms may occur.

These include:

  • milky nipple discharge
  • hair loss
  • headache
  • vision changes
  • additional facial hair

In those with primary amenorrhea, there may be a lack of breast development.

Anyone who experiences these symptoms should seek medical advice.

Diagnosis

Amenorrhea is not an disease but a symptom. The doctor’s goal is to figure out why menstruation doesn’t happen.

Primary amenorrhea

If an person has not begun menstruating by the age of 16, a doctor can ask about their family history and conduct a series of tests.

This will include tests to assess the levels of the hormones in question:

  • follicle stimulating hormone (FSH)
  • luteinizing hormone (LH)
  • thyroid stimulating hormone (TSH)

They will also carry out a physical examination.

Secondary amenorrhea

Menstruation calendar
If you have had regular periods previously and then no menstruation for 3 months, consider seeing a doctor.

A secondary amenorrhea diagnosis should focus on the underlying cause of the problem.

The physician could ask questions before conducting any tests, to find out:

  • at what age menstruation started
  • whether the person is sexually active
  • if pregnancy is a possibility
  • if weight loss or weight gain has occurred, and what kind of exercise routine the person follows
  • the length and regularity of the menstrual cycle and whether bleeding is heavy or light

They may then recommend a number of tests, depending on what the cause appears to be.

These may include:

  • a pregnancy test
  • a thyroid function test
  • ovary function test
  • androgen and other hormone tests

Imaging tests may include:

  • an MRI, CT, or ultrasound scan
  • a hysteroscopy, in which the doctor passes a thin, lighted camera through the vagina and cervix to examine the uterus from the inside

Treatment

Treatment will depend on the cause.

Primary amenorrhea

Primary amenorrhea treatment will start with watchful waiting, depending on the age of the person and the ovary function test result. If there is a late menstruation family history, the cycles can start in time.

If genetic or physical problems involving the reproductive organs can require surgery. However, that won’t guarantee that there will be regular menstrual cycles.

Secondary amenorrhea

That is going to rely on the underlying cause.

Factors of lifestyle: If the individual is exercising regularly, a change in the exercise plan or diet may help stabilize the monthly period.

Stress: If an issue relates to emotional or mental stress, therapy can help.

Excessive weight loss: This can occur for multiple reasons. The individual may need a weight gaining program which is professionally monitored. If there is a possibility of an eating disorder, treatment may include a weight gain regime and counseling sessions with a psychiatrist and a nutritionist or dietitian.

Some health conditions can result in weight loss. For these, a doctor can test and offer treatment, as needed.

Underactive thyroid: If menstruation stops due to an underactive thyroid, the doctor can prescribe thyroxine, a thyroid hormone, for treatment.

Polycystic ovary syndrome (PCOS): The health care provider should recommend adequate treatment. If the PCOS has contributed to excess weight, a weight-loss diet can be prescribed.

Premature ovarian failure: Hormone replacement therapy ( HRT) can cause a return to menstruation.

Menopause: Menopause starts at age 50 but may often start as early as 40 years. That can be influenced by family history.

If the menopause begins early, the risk of osteoporosis is higher. To avoid this complication the individual may need care.

Takeaway

There are a variety of reasons why menstruation can end. It doesn’t automatically mean an person is infertile and can’t conceive.

The person should seek medical advice if normal periods cease for 3 months or more, or if irregular periods stop for at least 6 months.

Treatment is available in many situations.

Cancer / Oncology

What is cervical cancer screening: Who should get it?

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Cervical screening allows for the detection and treatment of cervical cancer in its early stages. To detect changes in the cells of the cervix and identify associated viruses, doctors utilise two major tests.

Cervical cancer occurs in the tiny area where the uterus meets the top of the vaginal canal at the lower end of the uterus. Human papillomavirus (HPV) is found in roughly 99 percent of cervical cancers, while most HPV instances do not progress to cancer. The most important risk factor for cervical cancer is having HPV.

Cervical cancer screening consists mostly on the Pap test and the HPV test.

Regular screening, according to the National Cancer Institute, lowers the risk of getting or dying from cervical cancer by 80% Trusted Source.

Because of advancements in testing and treatment, the incidence of deaths from cervical cancer in the United States is decreasing by about 2% per year.

We’ll look at how a pap test works, who should get one, and how to interpret the findings in this post.

Screening tests

cervical cancer screening

Cervical cancer screening may include HPV testing or the Pap test. At the same time, the doctor may perform a physical examination of the pelvis.

Pap smear

A healthcare expert expands the vagina using a tool they call a speculum to gain access to the cervix. They next extract a sample of cells from the cervix. They will send the cell sample to a laboratory for evaluation under a microscope.

The laboratory technicians check at the appearance of the cells. If they appear abnormal, it may be a sign that cervical cancer is in the early stages of development, known as precancer.

Early treatment can rectify these cellular alterations and prevent the emergence of cervical cancer.

HPV test

A doctor will perform the HPV test to discover the virus underlying many aberrant cellular changes that could lead to cervical cancer.

However, the HPV DNA test may identifiy numerous infections that specialists do not relate to cancer. A positive HPV test often does not guarantee that a person will go on to get cancer.

Screening criteria and recommendations

The American Cancer Society provide advice for regular cervical cancer tests in females of all ages.

21–29 years

Between these ages, a woman should receive Pap tests at 3-year intervals. HPV testing is not necessary at this point. However, a doctor may follow up a Pap test with HPV testing if results are abnormal.

In one study, 86.7 percent of people who tested positive for HPV did not acquire cancer in at least the following 10 years.

30–65 years

Doctors prescribe the following for people of these ages:

  • co-testing, or a combination of both tests, every 5 years
  • a Pap test every 3 years

The American Cancer Society warn that a combined HPV and Pap test can lead to more false positives, additional testing, and more intrusive treatments.

Over 65 years

Women who have had regular screening in the last 10 years with clean findings throughout can stop screening at this age.

However, if a test within the last 20 years has showed indicators of a dangerous precancer, screening should continue until 20 years following this precancer finding.

Women with a high risk of cervical cancer

Those who have a greater risk of cervical cancer should have more frequent testing.

This includes females with a compromised immune system, such as those with HIV or a recent organ transplant. People might also have a high risk if they received exposure to diethylstilbestrol (DES), a synthetic type of oestrogen, before birth.

After a total hysterectomy, which involves removal of the uterus and cervix, screening is no longer necessary. However, if a doctor did the hysterectomy to treat cancer, screening should continue.

Females who have gotten an HPV vaccination should continue get tests.

A person who has current or past cervical cancer or precancer will have their own screening and treatment regimen, as well as individuals with HIV infection.

A false positive result may not only cause stress but might lead to unneeded procedures that may have long-term risks. For this reason, doctors do not advocate yearly screenings.

Interpreting results

Cervical screening test results can be normal, ambiguous, or abnormal.

Normal: There were no alterations in the cells of the cervix.

Unclear: The cells appear like they could be abnormal, and the pathologist could not discover alterations that could suggest precancer. These aberrant cells could relate to HPV, an infection, pregnancy, or life changes.

Abnormal: The lab technicians identified alterations in the cervical cells. Abnormal cells do not usually signify cancer. The doctor will typically request more tests and treatment to evaluate if the alterations are turning malignant.

In an uncertain outcome, cell alterations have occurred, but the cells are very near normal and are likely to resolve without treatment. The doctor will likely order a repeat test within 6 months.

Younger people are more susceptible to low-grade squamous intraepithelial lesions (LSIL) that commonly heal without therapy.

Cervical erosion, which doctors sometimes refer to as an ectropion, may potentially lead to an uncertain result. Cervical erosion means that the cells of underlying glands can be visible on the surface of the cervix.

Erosions are widespread, especially among those individuals who are using the contraceptive pill, teenagers, or someone who is pregnant. Slight bleeding could also occur after sex.

Most occurrences of erosions resolve without therapy.

What to do following abnormal results

An abnormal result signifies that the pathologist discovered alterations in the person’s cervix. This result does not necessarily suggest that the individual has cervical cancer. In most cases, there is no cancer.

The aberrant alterations in the cervical cells are commonly attributable to HPV. Low-grade changes are mild whereas high-grade changes are more significant. Most low-grade alterations resolve without treatment.

It generally takes 3–7 years for “high-grade,” or severe, abnormalities to become cervical cancer.

Cells showing more serious alterations may potentially turn malignant unless a specialist eliminates them. Early intervention is crucial for treating cervical cancer.

Doctors will need to undertake more testing to confirm abnormal Pap or HPV test results.

Rarely, test results could reveal the presence of cervical intraepithelial neoplasia (CIN) (CIN). This word signifies that the screening discovered precancerous cells, but not that the individual has cervical cancer.

The findings may show the following:

  • CIN 1 (mild cell changes): One-third of the thickness of the skin that covers the cervix has abnormal cells.
  • CIN 2 (moderate cell changes): Two-thirds of the thickness of the skin that covers the cervix has abnormal cells.
  • CIN 3 (severe cell changes): All the thickness of the skin that covers the cervix has abnormal cells.

A doctor will need to confirm these results by requesting a biopsy.

Test difficulties

While both routine cervical screening tests are typically reliable and useful, confusing or abnormal results may represent a problem with the examination rather than the existence of altering cells.

A person may have to repeat the test due to a “inadequate” sample, implying that their results were inconclusive.

An insufficient sample could be due to:

  • too few cells being available from the test
  • the presence of an infection that obscures the cells
  • menstruation, which can make viewing the cells hard
  • inflammation of the cervix, which may obstruct the visibility of the cells

If you want to get a cervical cancer screening, you should first take care of any infections or irritation in your cervix.

Conclusion

The Pap test and the HPV test are medically recommended tests for cervical cancer. These tests reveal either cell alterations or the presence of the HPV virus, both of which indicate a higher risk of cervical cancer.

Screening is frequently quite effective, allowing for early treatment. However, the results may be ambiguous, necessitating further testing.

Every three years, females over the age of 21 should have a Pap test.

It is possible that screening will be pricey. Many insurance, on the other hand, cover testing. This site can be used by people who don’t have access to cervical cancer screening to see if they qualify for free testing under the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).

References

  • http://www.nccc-online.org/hpvcervical-cancer/cervical-cancer-overview/
  • http://www.acog.org/Patients/FAQs/Cervical-Cancer-Screening
  • https://www.cancer.gov/types/cervical/hp/cervical-screening-pdq#_1
  • https://www.cdc.gov/cancer/cervical/statistics/
  • https://www.medicalnewstoday.com/articles/254577
  • https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/des-fact-sheet
  • https://www.cdc.gov/cancer/nbccedp/
  • https://www.cdc.gov/nchs/fastats/pap-tests.htm
  • https://jamanetwork.com/journals/jama/fullarticle/2697704
  • https://www.cdc.gov/cancer/cervical/basic_info/test-results.htm
  • https://www.cdc.gov/cancer/cervical/basic_info/test-results.htm

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Cancer / Oncology

Symptoms, causes, stages, and treatment of cervical cancer

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Cervical cancer damages the womb’s entrance. The cervix is the thin section of the lower uterus, often known as the womb’s neck.

According to the American Cancer Society, clinicians in the United States will make 13,170 new cervical cancer diagnosis by the end of 2019. Cervical cancer will claim the lives of more than 4,200 women in the United States this year.

The human papillomavirus (HPV) is the most common cause of cervical cancer. HPV is successfully prevented by the HPV vaccine.

The vaccination was previously recommended for all people aged 9 to 26 years by the Centers for Disease Control and Prevention (CDC). The vaccination is now accessible for all women and men aged 26–45 who had the vaccine as a preteen, according to the CDC.

We’ll look at cervical cancer, its symptoms, and how to avoid and treat it in this post.

Early warning signs and symptoms

bleeding after sexual intercourse

A person may have no symptoms at all in the early stages of cervical cancer.

As a result, women should undertake cervical smear examinations, often known as Pap tests, on a regular basis.

A Pap test is a preventative measure. Its goal is not to identify cancer, but to reveal any cell alterations that may signify the onset of cancer so that treatment can begin sooner.

The following are the most prevalent signs of cervical cancer:

  • vaginal discharge with a strong odor
  • bleeding after sexual intercourse
  • vaginal discharge tinged with blood
  • pelvic pain
  • bleeding between periods
  • bleeding in post-menopausal women
  • discomfort during sexual intercourse

Other causes, such as infection, can cause these symptoms. Anyone who exhibits any of these symptoms should consult a physician.

Stages

Identifying a cancer’s stage is important because it allows a person to choose the most effective treatment option.

The goal of staging is to determine how far the cancer has gone and whether it has migrated to surrounding structures or further away organs.

The most frequent technique to stage cervical cancer is using a four-step system.

Stage one: There are precancerous cells present.
Stage 1: Cancer cells have spread from the surface into the cervix’s deeper tissues, as well as into the uterus and adjacent lymph nodes.
Stage 2: The cancer has spread beyond the cervix and uterus, but not to the pelvic walls or the lower section of the vaginal canal. It may or may not affect the lymph nodes in the area.

Stage 3: Cancer cells can be found in the lower section of the vaginal canal or the pelvic walls, and they can obstruct the ureters, which convey urine from the bladder. It may or may not affect the lymph nodes in the area.

Stage 4: The cancer is growing out of the pelvis and damages the bladder or rectum. The lymph nodes may or may not be affected. It will extend to distant organs, including as the liver, bones, lungs, and lymph nodes, later in stage 4.

Screening and obtaining medical attention if any symptoms arise can assist a person in receiving early treatment and increasing their chances of survival.

Causes

The uncontrolled division and development of aberrant cells causes cancer. The majority of our body’s cells have a defined lifespan, and when they die, the body regenerates new cells to replace them.

There are two issues that abnormal cells can cause:

  • they do not die
  • they continue dividing

This causes an overabundance of cells to pile up, eventually forming a lump or tumour. Why cells turn malignant is a mystery to scientists.

Some risk factors, on the other hand, may raise the risk of cervical cancer. These are some of them:

  • HPV: This is a virus that is spread by sexual contact. There are about 100 different varieties of HPV, with at least 13 of them having the potential to cause cervical cancer.
    Having a lot of sexual partners or beginning sexually active young: Cancer-causing HPV kinds are almost always transmitted through sexual contact with someone who has HPV. HPV infection is more likely in women who have had a risk of sexual partners. This raises their chances of getting cervical cancer.
  • Smoking: Cervical cancer, as well as other types of cancer, is increased as a result of this.
  • A weakened immune system: Cervical cancer is more common among people who have HIV or AIDS, as well as those who have had a transplant and are using immunosuppressive medicines.
  • Birth control pills: Long-term usage of various common contraceptive pills boosts a woman’s risk by a small amount.
  • Other sexually transmitted diseases (STD): Cervical cancer is more likely in people who have chlamydia, gonorrhoea, or syphilis.
  • Socio-economic status: In locations where income is low, rates appear to be higher.

Treatment

Surgery, radiotherapy, chemotherapy, or a combination of these treatments may be used to treat cervical cancer.

The type of treatment chosen is determined by a number of criteria, including the cancer’s stage, age, and overall health.

Early-stage cervical cancer treatment, while the cancer is still contained within the cervix, has a high success rate. The lower the success percentage, the further a cancer spreads from its original location.

Early-stage options

When the cancer has not gone beyond the cervix, surgery is a typical therapeutic option. If a doctor suspects cancer cells are present inside the body after surgery, radiation therapy may be beneficial.

Radiation therapy may potentially lower the chances of a recurrence (cancer coming back). Chemotherapy may be used if the surgeon wants to shrink the tumour to make it easier to operate on, albeit this is not a frequent technique.

Advanced cervical cancer treatment

Surgery is usually not an option when the cancer has progressed beyond the cervix.

Advanced cancer is also known as invasive cancer since it has spread to other parts of the body. This form of cancer necessitates a more intensive treatment regimen, which often includes radiation therapy or a combination of radiation therapy and chemotherapy.

Palliative therapy is used by healthcare providers in the final stages of cancer to reduce symptoms and improve quality of life.

Radiation therapy

Radiation therapy is also known as radiation oncology or XRT by some clinicians.

It entails the use of high-energy X-rays or radiation beams to kill cancer cells.

When a treating doctor uses radiation to treat the pelvic area, the following adverse effects may cause, some of which may not appear until after the therapy is completed:

Chemotherapy

Chemotherapy
FatCamera/Getty Images

Chemotherapy is the treatment of any disease with chemicals (medicine). It refers to the killing of cancer cells in this context.

Chemotherapy is used by doctors to target cancer cells that surgery can’t or won’t eradicate, as well as to alleviate the symptoms of people with advanced cancer.

Chemotherapy has a wide range of adverse effects, which vary depending on the medicine. The following are some of the most common negative effects:

Cervical cancer clinical trials

For some people, taking part in a research study may be the greatest therapy option.

Clinical trials are an essential component of cancer research. Researchers use them to see if novel treatments are safe and effective, as well as whether they are superior than existing ones.

People who take part in clinical trials help to advance cancer research and development.

Prevention

Cervical cancer can be prevented by taking a variety of precautions.

Human papillomavirus (HPV) vaccine

The association between cervical cancer and some forms of HPV is undeniable. Cervical cancer could be reduced if every female adhered to the current HPV immunisation programmes.

Cervical cancer and safe sex

Only two HPV strains are protected by the HPV vaccine. Cervical cancer can be caused by other strains. Using a condom while having sex can help prevent HPV infection.

Cervical screening

Cervical screening may help a person detect and treat signs of cancer before the condition progresses or spreads too far. Screening does not identify cancer, but it does reveal alterations in the cervix’s cells.

Having fewer sexual partners

The greater a woman’s sexual partners, the greater her risk of transmitting the HPV virus. Cervical cancer is a risk as a result of this.

Delaying first sexual intercourse

The higher the risk of HPV infection, the younger a woman is when she has her first sexual encounter. The longer she waits, the lesser her risk becomes.

Stopping smoking

Cervical cancer is more likely to develop in women who smoke and have HPV than in those who do not.

Diagnosis

Early detection of cervical cancer boosts treatment success rates.

The American College of Surgeons recommends the following screenings as part of a routine examination:

Under the age of 25: The American College of Surgeons does not suggest screening.

Between the ages of 25 and 65: For cervical cancer prevention, people should get an HPV test every five years.

Over the age of 65: Unless individuals have a high risk of cervical cancer, the ACS does not suggest screening for those who have received adequate screening in the past.

People who have had a hysterectomy with the cervix removed do not need to be screened unless they had previously had precancerous lesions or cervical cancer.

These are the general screening recommendations, although each person’s screening needs should be discussed with a doctor.

Cervical smear test

According to the American Cancer Society (ACS), approximately 13,000 new cases of invasive cervical cancer will be diagnosed in 2019. Around 4,000 women will die as a result of the disease. Regular screening, on the other hand, could avert the majority of these deaths.

Screening does not identify cancer; instead, it searches for abnormal changes in cervix cells. Some aberrant cells can develop into cancer if they are not treated.

HPV DNA testing

This test determines if the person has any of the HPV varieties that are most likely to cause cervical cancer. It entails taking cells from the cervix for laboratory examination.

Before any abnormalities in the cervical cells become visible, the test can detect high-risk HPV strains in cell DNA.

A doctor may offer additional tests if there are signs and symptoms of cervical cancer or if the Pap test indicates abnormal cells.

These include:

  • Colposcopy: A speculum and a colposcope, a lighted magnifying device, are used to examine the vagina.
  • Examination under anaesthesia (EUA): The doctor will be able to inspect the vaginal and cervix in greater detail.
  • Biopsy: Under general anaesthesia, the doctor removes a little piece of tissue.
  • Cone biopsy: For evaluation, the doctor removes a tiny cone-shaped portion of aberrant tissue from the cervix.
  • LLETZ: Diathermy, which involves heating a wire loop with an electric current, aids in the removal of aberrant tissue. After that, the healthcare provider sends the tissue to a lab for analysis.
  • Blood tests: A blood cell count can aid in the detection of liver or kidney issues.
  • CT scan: A barium liquid may be used by a medical expert to reveal any cellular abnormalities.
  • MRI: Cervical cancer can be detected in its early stages using some types of MRI.
  • Ultrasound of the pelvis: On a monitor, high-frequency sound waves generate an image of the target region.

Outlook

The stage at which a person is diagnosed with cervical cancer can assist determine their odds of surviving for at least another 5 years:

  • Stage 1: The chances of surviving at least 5 years are 93 percent in early stage 1 and 80 percent in late stage 1.
  • Stage 2: Early in stage 2, the rate is 63 percent, but by the conclusion of stage 2, it has dropped to 58 percent.
  • Stage 3: The possibilities drop from 35 percent to 32 percent at this point.
  • Stage 4: Cervical cancer people at stage 4 have a 15 to 16 percent probability of living another 5 years.

These are average survival rates, which do not apply to all people. Treatment can be effective up to stage 4 in some situations.

Sources:

  • http://www.acog.org/Patients/FAQs/Cervical-Cancer-Screening
  • https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/staged.html
  • http://www.who.int/immunization/hpv/deliver/en/
  • http://www.who.int/mediacentre/factsheets/fs380/en/
  • https://www.cancer.org/cancer/cervical-cancer/about/key-statistics.html
  • https://jamanetwork.com/journals/jama/fullarticle/2697704
  • https://www.medicalnewstoday.com/articles/159821
  • https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/survival.html
  • http://www.cancer.org/cancer/cervicalcancer/moreinformation/cervicalcancerpreventionandearlydetection/cervical-cancer-prevention-and-early-detection-h-p-v-test
  • http://www.cancer.org/cancer/cervicalcancer/detailedguide/cervical-cancer-key-statistics
  • http://www.cancer.org/cancer/cervicalcancer/detailedguide/cervical-cancer-risk-factors

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Birth Control / Contraception

Things to know about natural birth control methods

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People who can not or do not want to use hormonal birth control to avoid conception can utilize natural birth control. There are a variety of natural birth control options available, but some are less effective than hormonal contraception.

couples living happily

Birth control, often known as contraception, refers to a variety of procedures, medications, and technologies used to prevent undesired pregnancy. People looking for birth control have a range of options.

Barrier contraception prevents sperm from reaching the female egg, preventing conception. Hormonal birth control works by preventing the generation of hormones that can lead to pregnancy.

Barrier contraception can be used by someone who employs natural birth control methods like tracking ovulation and taking basal temperature measurements.

The various natural birth control methods are discussed in this page, as well as how they operate and how effective they are.

Overview

Natural birth control, often known as fertility awareness, is a way of preventing conception that does not include the use of devices or hormone modification. To anticipate ovulation, people track things like menstruation, cervical mucus, and basal temperature.

The ovary releases an egg during ovulation, which is a hormone-driven process. The person menstruates if the sperm does not fertilize the egg or if pregnancy does not occur.

The fertile window for a woman begins 5 days before ovulation. People who use contraception of any kind should be aware that sperm can survive for 2–5 days in the female reproductive tract.

A person may abstain from sex or use barrier contraception, such as a condom, throughout the ovulation period or reproductive window. Barrier birth control is hormone-free and can help prevent unintended pregnancies during a woman’s most fertile period.

People can use a calendar or an online calculator to track their ovulation cycles, such as the ovulation calculator from the Office on Women’s Health.

People who use fertility awareness approaches, on the other hand, may have a higher risk of unintended pregnancy. According to the Centers for Disease Control and Prevention (CDC), traditional fertility awareness approaches have a 2–23% failure rate. This indicates that up to 23 out of every 100 people who use this approach become pregnant each year.

Advantages and disadvantages

Before deciding to utilize natural birth control techniques, it’s a good idea to weigh the benefits and drawbacks.

Before deciding to utilize natural birth control techniques, it’s a good idea to consider the advantages and disadvantages.

Advantages

  • The majority of natural birth control options are free.
  • Devices that calculate ovulation windows are available for purchase.
  • Natural birth control has no effect on the amount of hormones produced by the body.
  • Birth control devices and prescriptions do not require a doctor’s appointment.
  • Natural birth control does not cause the same adverse effects as hormonal birth control, such as headaches and nausea.

Disadvantages

  • Natural birth control might have a failure rate of up to 23%.
  • This method’s efficacy is contingent on a person’s willingness and capacity to precisely document their menstrual cycles in order to determine an expected ovulation window.
  • People who have irregular or missing periods may find it difficult to track their fertility and may need to adopt a different method of contraception.
  • During their ovulation window, people will have to either avoid vaginal sex or utilize another kind of birth control.
  • Sexually transmitted infections (STIs) are not protected by natural birth control.

Options

A person can pick from a variety of natural birth control methods. In addition, some businesses may market goods that help people track their fertility.

However, according to the CDC, traditional natural birth control methods are only 77 percent effective at preventing unintended pregnancy. To improve the effectiveness of this kind of contraception, people may want to consider utilizing supplementary birth control methods, such as condoms.

Basal body temperature method

This method needs a person to take their temperature every day when they first wake up with a basal thermometer. People should check that an oral or digital thermometer measures in tenths of a degree Fahrenheit (°F) when measuring basal body temperature.

Ovulation is marked by a prolonged temperature increase of roughly 0.5°F. Although a person with a longer or shorter cycle may experience the temperature spike on different days, ovulation normally occurs around day 14 of a 28-day period.

To reduce the risk of an unintended pregnancy, people should use another type of contraception or refrain from vaginal sex during ovulation.

Apart from ovulation, there are other things that might affect a person’s basal body temperature, including:

  • jet lag
  • illness
  • smoking
  • stress
  • drinking alcohol

People can also buy ovulation tracking and charting kits from firms that sell them. Natural Cycles, for example, offers a fertility tracking smart app that allows people to enter data such as basal body temperature. People can also purchase a basal thermometer from the company to get more precise data.

Ovulation prediction kits

These tests look for the presence of luteinizing hormone (LH) in the urine to see if a woman is ovulating.

To determine when a person is most likely ovulating, most ovulation prediction kits detect an LH surge. Others check estrogen levels, which rise right before ovulation.

Cervical mucus method

To determine ovulation, this approach evaluates the volume and quality of cervical mucus.

Cervical mucus can be checked in a variety of methods. Before urinating, wipe the vaginal area with white toilet paper and observe the color and texture of the discharge. Another option is to check the color and texture of the discharge in your underwear or by inserting clean fingers into the vaginal canal.

The chart below lists the many sorts of discharges that a person can expect throughout the month.

ColorTextureMeaning
During menstruationdisguised by blood flownot applicableless likely to be more fertile
Directly after menstruationno mucusno mucusmay be fertile, depending on cycle length
Before ovulationyellow, white, or cloudysticky or tackymay be more fertile
Right before and during ovulationclear or looks like egg whitesslippery and stretchymost likely to be fertile
After ovulationno mucus, or cloudy mucusnone, or stickyless likely to be fertile

Rhythmic technique or calendar

This method involves calculating the most fertile times of the month by charting the menstrual cycle. A calendar or menstrual cycle app, such as Flo, can be used to automatically estimate ovulation after entering menstruation data.

To determine a person’s ovulation window, Planned Parenthood suggests using the following formula:

  1. Find the shortest tracked cycle.
  2. Subtract 18 days from the total number of days in that cycle.
  3. Use this number to count from the start – including day 1 – of the current cycle and mark that day. This is the start of a person’s ovulation window.

To have a better knowledge of when they ovulate, people should track at least 3–6 cycles. This strategy is less likely to work if a person’s cycles are normally shorter than 27 days.

Withdrawal method

The withdrawal method, also known as pulling out, is removing the penis from the vaginal opening before ejaculation.

This approach has a 4% failure rate when used perfectly. However, this approach is only 78 percent efficient in most cases. In a year, about one out of every five people will become pregnant using this approach. Because pre-ejaculate, the fluid that comes out of the penis just before ejaculation, contains sperm, this procedure has such a high failure rate.

Breastfeeding or lactation amenorrhea

Breastfeeding people can use this approach to avoid unwanted pregnancies.

This approach is only suited for people who match all three of the following criteria, according to the CDC.

  1. Those who are not menstruating — amenorrhea.
  2. Those who are exclusively or almost exclusively breastfeeding.
  3. Those who have given birth no more than 6 months previously.

According to the CDC, this is a temporary method of birth control. If a person does not fit one of the above conditions, they should use an alternative approach.

Outercourse

Any sexual action that does not include vaginal sex or allowing semen into the vagina is considered outercourse.

Some examples of outercourse are as follows:

  • using sex toys
  • dry humping or grinding
  • kissing
  • mutual masturbation

This approach, however, does not protect against all STIs. An STI can be passed from one person to another through skin-to-skin contact.

Hormonal vs. natural birth control

Individuals may wish to see a healthcare practitioner before deciding on a method of birth control to explore the effectiveness and acceptability of various choices.

Natural birth control, male condoms, and the pill, a prevalent form of hormonal birth control, are all described in the table below.

EffectivenessSide effectsSTI protectionAvailabilityCost
Natural birth control77–98% effectivenonenonewidely availablenone
Male condoms85–98% effectivenonehelps prevent STIswidely availablearound $1 each condom
The pill91–99% effective• mood swings
• nausea
• breast tenderness
• headaches
nonewidely available$0–$50 per month

Learn more about the different types of birth control.

FAQ

The following are some frequently asked questions concerning natural birth control.

Who should consider about nonhormonal, natural birth control?

Natural birth control is an option for anyone who wants to avoid an unintended pregnancy without utilizing a hormonal type of contraception.

However, a person may desire to speak with a healthcare expert about the various types of contraception available to ensure that they are selecting the best option for them.

What are the most effective natural birth control methods?

According to the CDC, all natural birth control methods, also known as fertility awareness methods, are successful in 77–98% of cases.

If a person wishes to make natural birth control more effective, they should consider using an alternative kind of contraception, such as male or female condoms.

What can I use instead of birth control?

If a person does not want to get pregnant and does not want to take birth control, they should avoid sexual behavior that involves vaginal sex or where semen might enter the vagina.

Conclusion

Natural birth control, also known as fertility awareness approaches, reduces the risk of unintended pregnancy by employing techniques such as basal body temperature, the rhythm method, and the withdrawal method. These techniques can assist in predicting a person’s ovulation window, which is the time when a person is most likely to become pregnant following vaginal sex.

Natural birth control, on the other hand, isn’t as effective as most hormonal and barrier techniques. To lower the odds of an unintended pregnancy, a person who employs fertility awareness methods may want to use another nonhormonal type of contraception, such as condoms.

Sources:

  • https://www.plannedparenthood.org/learn/birth-control/abstinence-and-outercourse
  • https://www.cdc.gov/reproductivehealth/contraception/index.htm
  • https://www.ncbi.nlm.nih.gov/books/NBK441996
  • https://www.medicalnewstoday.com/articles/natural-birth-control
  • https://www.plannedparenthood.org/learn/birth-control/condom/how-effective-are-condoms
  • https://www.nhs.uk/conditions/contraception/how-effective-contraception
  • https://www.ncbi.nlm.nih.gov/books/NBK546661
  • https://www.plannedparenthood.org/learn/birth-control/fertility-awareness/whats-calendar-method-fams
  • https://www.plannedparenthood.org/learn/birth-control/fertility-awareness/whats-cervical-mucus-method-fams
  • https://www.plannedparenthood.org/learn/birth-control/fertility-awareness/whats-temperature-method-fams

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