Causes of prolonged menstruation

Prolonged Periods: A Cause for Concern?

A long period probably sounds like a nuisance to anyone, but for some women, it could indicate a serious problem.

For some women, time seems to move at a glacial pace during their menstrual periods especially if they’re experiencing prolonged menstrual bleeding.

Doctors consider normal menstrual bleeding a period that lasts from three to seven days; prolonged menstrual bleeding, or menorrhagia, is defined as bleeding that goes beyond a week. Depending on the circumstances, long menstruation may be a condition that can be easily controlled with birth control hormones or one that indicates a serious underlying health issue.

The length of an average menstrual cycle for an adult woman lasts anywhere between 21 and 35 days. Younger girls just entering puberty and older women approaching menopause might notice that their periods follow irregular patterns, either lasting shorter or longer than normal or perhaps with a flow that becomes heavier or lighter.

Usually, these irregularities occur because of changes in hormone levels, especially oestrogen. Oestrogen helps build up the uterine lining, called the endometrium, which will either house a fertilized egg or become most of what is shed during a menstrual period. While irregular menstrual periods can be bothersome, these hormonal changes are common and rarely mean something more serious.

Causes

You may hear your doctor use certain medical terms when referring to irregular or prolonged menstrual bleeding. Menorrhagia describes a period that is very heavy or long lasting. Polymenorrhea refers to irregular bleeding for spans of 21 days or less. These are abnormal conditions identified after other causes, like pregnancy, have been ruled out.

Dysfssssunctional uterine bleeding (DUB) is another cause of prolonged menstruation. DUB can happen at any time during a woman’s reproductive years, but most commonly affects those over age 40. DUB indicates a hormone dysfunction, which can impact the uterine lining’s stability and lead to irregular, heavy, or prolonged menstrual bleeding.

Doctors treat DUB with hormones: estrogen, progesterone, or a combination of the two female hormones in the form of birth control pills. Besides being used as contraception, birth control pills can regulate hormone production and impact how the uterine lining grows. Birth control pills may even help treat DUB for women entering perimenopause, the stage right before menopause.

Some hormone-based birth control can impact frequency, duration, and flow levels of menstrual periods. Also, changing the type or brand of birth control you use can influence menstrual bleeding. However, you should never alter your birth control strategy on your own initiative or treat your prolonged menstruation based on how a friend with similar symptoms was treated: Every woman’s menstrual cycle is different, and a host of medical issues can affect periods.

Underlying Conditions That Cause Prolonged Menstrual Bleeding

A visit with your gynecologist or other health care professional is the first step in determining the cause of your prolonged menstrual bleeding. Your doctor will make a diagnosis after performing a series of tests.

Depending on your age, your doctor may test your blood for pregnancy, hormone levels, and thyroid function. Other diagnostic tests and procedures may include pap smears, endometrial biopsies, and ultrasounds.

Medical conditions that could be the cause of abnormal menstrual bleeding include: Uterine fibroids, non-cancerous growths of the uterus wall, endometrial hyperplasia, a thickened endometrium, a bleeding disorder, like von Willebrand disease, problems with clotting, thyroid functioning, glandular issues

Treatments

Besides birth control, treatments for abnormal menstrual bleeding include:

Medications

Hysterectomy, the surgical removal of the uterus

Endometrial ablation, the surgical removal or burning of the uterine lining

The right course of treatment depends on the cause of your prolonged menstrual bleeding and your personal circumstances, such as whether you want to become pregnant in the future. Certain procedures, like a hysterectomy, will cause infertility.

Prolonged menstrual bleeding may just be part of a bothersome pattern for some women or a sign of a medical condition that should be addressed. If something doesn’t feel right to you, always ask your doctor, and keep a detailed account of your menstrual bleeding in order to provide your doctor with another piece of the diagnostic puzzle.

Why doctors request sperm analysis

Why doctors request sperm analysis

Dr. Sylvester Ikhisemojie

Sperm analysis is usually described as seminal fluid analysis. It is one of the most commonly requested tests on bodily fluids in all hospitals and is frequently asked for in pursuit of the causes of infertility among married couples. Seminal fluid analysis is also sometimes called a seminogram. This is broadly speaking, the laboratory analysis of a sample of seminal fluid produced by a man. It analyzes the health, viability and characteristics of semen and it consists of the determination of the volume of semen produced by an adult male; the number of sperms contained in the fluid and the acidity or alkalinity of the semen produced. It also involves the examination of the shape, the motility and viability of the sperm. Semen, which is used here interchangeably with seminal fluid, is the thick whitish fluid produced by the male organ during ejaculation. In the laboratory, such a product is referred to as the ejaculate.

Seminal fluid varies in volume at ejaculation; it varies in volume between two and five milliliters but may be up to seven and a half milliliters in some men or as low as one and a half milliliters which is regarded as the lower limit of normal. Normal semen should contain a minimum of 15 million sperm cells in each milliliter of seminal fluid, a downward revision by the World Health Organisation from the old figure of 20 million.

The upper limit is in the region of 225 million per milliliter of seminal fluid. The total number of sperms in each ejaculate may therefore range between 45 and 950 million sperm cells. However, for clinical purposes, the sperm count is often expressed as a certain number of sperms per milliliter of fluid. Seminal fluid is itself made up of between 96 and 98 per cent of water. Therefore, one way of making certain that a man produces more sperm is to drink more fluids. Other ways of ensuring that are as follows; avoid genital tract infections; avoid frequent sex at less than 48 hours apart; do not engage too frequently in masturbation.

With these parameters in mind, a doctor who requests a seminal fluid analysis determines to see the above parameters reflected in the result after the man has avoided sex for at least 48 hours. Many clinicians want an even longer wait with the semen being produced on the fourth or fifth day of abstinence. In addition to the volume and the cell count, the doctor also wants to have an idea of the colour of the semen; its viscosity and whether or not it is compromised by a bacterial infection. A volume less than one and a half milliliters often means that the seminal vesicles, which transport the semen from the testes to the urethra, could be partly or completely blocked. It may also indicate the presence of an infection or certain problems with the prostate. The doctor’s knowledge of the various organisms active in that part of the body would show rather quickly whether there is a genuine infection or a contamination with bacteria. Such contamination can occur when the sample to be studied is not collected in the recommended way thereby allowing surrounding bacteria to get into the semen either within the collecting vessel or before it gets into it. When there is an established infection, such an infection is treated energetically with the required antibiotics based usually on the laboratory’s report.

The next characteristic of interest to the doctor is the physical nature of the various sperm cells also called their morphology. The prevalence of certain variants from what is considered normal is a predictor of the severity of infertility in a male. Therefore, if there are sperms with double heads; twin tails or other such abnormalities, they are not only considered as unable to fertilize an ovum but that they could even cause some damage to a foetus if such fertilisation occurs. Morphology considered acceptable is when at least 60 per cent of all the sperms are determined as normal. This is why increasingly; semen analysis is now one of the most commonly requested tests in men when investigating infertility. This is because abnormalities of the sperm are common while the test is relatively easy to perform. It is not considered to be an invasive kind of test; it is cheaply done and any trained laboratory scientist can do it reliably.

It is because of the reasons elucidated above that doctors often request the analysis of seminal fluid. Frequently, it is performed as a part of the investigation and treatment of infertility. In other cases, it is performed to determine the effectiveness or success of a vasectomy. Since the latter is very rarely performed on Nigerian men, it follows that seminal fluid analysis done in Nigeria are almost universally triggered by the investigation of infertility. Despite all of that, it remains a major task persuading many men to have that investigation done. One has worked before with senior colleagues who had to recourse to writing notes to husbands that insisted they were fine while feeling comfortable to have their wives undergo all kinds of investigations in pursuit of a pregnancy. Yet, there are some who would refuse.

The analysis of freshly ejaculated semen is one of the most useful investigations performed in the quest for unraveling the cause of a couple’s infertility. It should be performed early in the investigation of the couple. It is easy to perform and very convenient even though Nigerian men frequently resist that. It is when nothing wrong has been found with the seminal analysis that attention should turn to the woman. By a fresh ejaculate is meant one which is presented at a competent medical laboratory within one hour of being produced. At presentation in the laboratory, its colour, viscosity and volume are quickly noted as well as the time it takes it to liquefy. Only after all these are done should attention turn to the cellular count. The semen is usually produced either in the comfort of the couple’s home or at a suitable location within the laboratory or hospital. It may be the product of actual sex interrupted at the point of ejaculation to allow the emission into a sterile container; or the performance of some suitable sex act to bring the man to that point or through masturbation. In men who have become paralyzed as a result of a spinal cord injury or disease, and are unable to achieve an erection, it is possible to obtain their semen by aspiration using special needles for that purpose so that the specimen can be analyzed or used for assisted reproduction techniques.

It is important to know that semen is not the same thing as sperm even though the two terms are often used interchangeably. Seminal fluid is made up of sperm and water. The water component is made up of prostatic fluid in which the sperms swim. As we have seen above, the volume can be increased by taking in more fluids. This can also be boosted further by increasing the intake of vegetables and fruits as these will supply increased volumes of vitamin C for the increased motility of the sperms. Raised levels of the male hormone, testosterone, also promote the rise in the volume of seminal fluid. Prolonged fore-play during sexual intercourse is also thought to increase the intensity of an orgasm such that the volume of seminal fluid also rises.

Source: The Punch

Top eight testosterone-boosting foods

Top eight testosterone-boosting foods

By Chukwuma Muanya

Fish

People with low testosterone may be able to raise their levels by eating certain foods, such as ginger, fatty fish, and some vegetables.
Testosterone is a male sex hormone that plays a role in fertility, sexual function, bone health, and muscle mass.

A person’s testosterone level will fall naturally with age — by one to two percent per year — but some medical conditions, lifestyle choices, and other factors can influence the amount of this hormone in the body.

Some medical treatments can raise low testosterone levels, especially in younger men, but a person can also encourage the body to produce more by making some changes to the diet and lifestyle.

In this article, Medical News Today lists the best foods for increasing testosterone levels. We also describe products to avoid and other ways to increase testosterone production.

Top eight testosterone-boosting foods

A person with low testosterone may benefit from trying:

1. Ginger

Ginger may help increase testosterone levels and improve male fertility.

People have used ginger for medicinal and culinary purposes for centuries. Modern research indicates that this root may improve fertility in men.

According to the findings of a 2012 study, taking a daily ginger supplement for 3 months increased testosterone levels by 17.7 percent in a group of 75 adult male participants with fertility issues.

The authors suggested that ginger may also improve sperm health in other ways.

Authors of a study from 2013 report that ginger increased testosterone and antioxidant levels in a diabetic rat model in just 30 days.

2. Oysters

Oysters contain more zinc per serving than any other food — and zinc is important for sperm health and reproductive function.

Males with severe zinc deficiency may develop hypogonadism, in which the body does not produce enough testosterone. They may also experience impotence or delayed sexual maturation.

People can also find the mineral in: other shellfish; red meat; poultry; beans; and nuts.

It is important to note that zinc and copper compete for absorption. Take care when choosing supplements to avoid consuming too much of either mineral.

3. Pomegranates

The pomegranate is an age-old symbol of fertility and sexual function, and its antioxidant levels may support heart health and stress reduction.

Also, results of a study from 2012 indicate that pomegranate may boost testosterone levels in men and women.

Sixty healthy participants drank pure pomegranate juice for 14 days, and researchers tested the levels of testosterone in their saliva three times a day.

At the end of the study period, both male and female participants displayed an average 24 percent increase in salivary testosterone levels. They also experienced improvements in mood and blood pressure.

4. Fortified plant milks

Fortified plant milk is a healthy source of vitamin D. Vitamin D is an essential nutrient, and results of a study from 2011 suggest that it may increase testosterone levels in men.

It is important to note that the dosage in this study was 3,332 international units (IU) of the vitamin per day, which far exceeds the 400 IU recommended daily for healthy people.

While sun exposure is one of the best ways to get vitamin D, not everyone can spend enough time outdoors in sunny weather. In the average American diet, fortified foods provide the majority of the vitamin D.

Many plant milks, such as those made from almonds, soy, hemp, and flax, contain 25 percent of a person’s vitamin D requirement per serving. However, it is always best to verify nutritional contents by checking labeling.

Research has put to rest the concern that soy lowers testosterone levels — the bulk of the evidence shows that soy does not have this effect.

Also, some manufacturers fortify the following with vitamin D: milk and other dairy products; orange juice; and cereals.

The medical community is not convinced that vitamin D boosts testosterone levels in healthy people. A study from 2017, for example, found that the vitamin had no such effect.

It is important to remember, however, that getting enough vitamin D every day is essential for overall health.

5. Leafy green vegetables

Vegetables such as spinach, Swiss chard, and kale are rich in magnesium, a mineral that may increase the body’s level of testosterone.

Authors of a study from 2011 found that taking magnesium supplements for 4 weeks prompted an increase in testosterone levels of sedentary participants and those who were athletes. The testosterone increases were greater, however, in the active participants.

Other good dietary sources of magnesium are: beans and lentils; nuts and seeds; and whole grains.

6. Fatty fish and fish oil

The United States Department of Agriculture recommend that people eat seafood twice weekly.

Fatty fish may be especially beneficial because they are rich in omega-3 fatty acids. A person can also boost their fatty acid levels by taking fish oil or omega-3 supplements.

Results of an animal-based study from 2016 indicate that fish oil can increase the quality of semen and the serum testosterone levels in dogs by improving their fatty acid profiles. A study in mice reported similar findings.

Examples of fish that are rich in omega-3 fatty acids include: Atlantic mackerel; herring; salmon; sardines; and trout.

7. Extra-virgin olive oil

Olive oil is a staple of the Mediterranean diet, which may have many health benefits, including a reduced risk of heart disease and cancer.

The oil is rich in monounsaturated fat and vitamin E, an antioxidant. These factors likely contribute to the food’s health benefits.

Extra-virgin olive oil may also improve male reproductive health. Results of a small-scale study indicate that the oil may boost serum testosterone levels in healthy adult men.

Participants also experienced an increase in luteinizing hormone, which stimulates cells in the testes to produce testosterone.

8. Onions

Onions may provide many health benefits, from supporting the heart to slimming the waistline. They are also good sources of several nutrients and antioxidants.

In addition, onions may increase low levels of testosterone. In a 2012 study with a rat model, researchers found that a daily intake of fresh onion juice for four weeks significantly increased serum total testosterone levels.

However, determining the effects in humans will require further research.
Foods to avoid

Some foods can reduce a person’s testosterone levels. People looking to raise their levels may wish to avoid:
Processed foods

Many frozen or prepackaged meals and snacks are processed foods. They offer little nutritional value and tend to be high in calories, salt, fat, and sugar.

In particular, processed foods often contain high amounts of trans fats, which can reduce testosterone levels and impair testicular function, according to the results of a 2017 study.

Canned or plastic-packaged foods: Meal in plastic packaging in microwave

Chemicals in plastic packaging can affect testosterone levels. Foods and drinks that are canned or packaged in plastic can impact hormone levels.

For example, this can occur when people ingest chemicals, such as bisphenol A (BPA) or bisphenol S, from water in plastic bottles or reheated food in plastic containers.

Results of a study from 2013 suggest that men who work in environments with high levels of BPA have reduced levels of free testosterone and androstenedione, a hormone that can convert into testosterone or estrogen.

It is important to note that participants in this study worked in factory settings. In food packaging, BPA is present in much smaller quantities.

Nonetheless, the chemical does enter many people’s bodies. A study from 2011, for example, found BPA in the urine of 89 percent of men attending a fertility clinic.

Those with BPA in their urine also had lower levels of testosterone and thyroid stimulating hormone. When levels of this hormone are low, it can indicate hypothyroidism, a condition that can reduce testosterone in some men.

Alcohol

Moderate amounts of alcohol — such as the occasional glass of red wine — may provide some health benefits. However, drinking too much can reduce fertility in men and women.

The National Institute on Alcohol Abuse and Alcoholism in the U.S. cautions that alcohol use is linked to low testosterone levels and changes in the amounts of other reproductive hormones.

Other ways to boost testosterone

Dietary changes may increase testosterone levels, and many lifestyle changes and medical treatments can help.

A person can also increase their testosterone levels by: losing weight, for people who are overweight; exercising regularly; building muscle through resistance training; getting enough sleep; reducing stress; and speaking to a doctor about testosterone therapy.

Summary

Testosterone naturally reduces with age, but levels may also be low because of medical conditions or medications. Anyone experiencing symptoms of low testosterone should speak to a doctor.

Certain foods, including oysters, leafy greens, fatty fish, and olive oil, may encourage the body to produce more testosterone. Foods that contain zinc, vitamin D, and magnesium may be key.

A person can ensure that they are receiving the right nutrients by following a balanced diet.

Exercising and reducing stress can also help boost low testosterone. To see results, most people require a combination of approaches.

Credit: The Guardian

Ten surprising health benefits of sex

Ten surprising health benefits of sex

The perks of sex extend well beyond the bedroom.

By Kara Mayer Robinson
Sex not only feels good. It can also be good for you. Here’s what a healthy sex life can do for you.

1. Helps Keep Your Immune System Humming
“Sexually active people take fewer sick days,” says Yvonne K. Fulbright, PhD a sexual health expert.

People who have sex have higher levels of what defends your body against germs, viruses, and other intruders. Researchers at Wilkes University in Pennsylvania found that college students who had sex once or twice a week had higher levels of the a certain antibody compared to students who had sex less often.

You should still do all the other things that make your immune system happy, such as:

Eat right.
Stay active.
Get enough sleep.
Keep up with your vaccinations.
Use a condom if you don’t know both of your STD statuses.
2. Boosts Your Libido
Longing for a more lively sex life? “Having sex will make sex better and will improve your libido,” says Lauren Streicher, MD. She is an assistant clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine in Chicago.

For women, having sex ups vaginal lubrication, blood flow, and elasticity, she says, all of which make sex feel better and help you crave more of it.

3. Improves Women’s Bladder Control
A strong pelvic floor is important for avoiding incontinence, something that will affect about 30% of women at some point in their lives.

Good sex is like a workout for your pelvic floor muscles. When you have an orgasm, it causes contractions in those muscles, which strengthens them.

4. Lowers Your Blood Pressure
Research suggests a link between sex and lower blood pressure, says Joseph J. Pinzone, MD. He is CEO and medical director of Amai Wellness.

“There have been many studies,” he says. “One landmark study found that sexual intercourse specifically (not masturbation) lowered systolic blood pressure.” That’s the first number on your blood pressure test.

5. Counts as Exercise
“Sex is a really great form of exercise,” Pinzone says. It won’t replace the treadmill, but it counts for something.

Sex uses about five calories per minute, four more calories than watching TV. It gives you a one-two punch: It bumps up your heart rate and uses various muscles.

So get busy! You may even want to clear your schedule to make time for it on a regular basis. “Like with exercise, consistency helps maximize the benefits,” Pinzone says.

6. Lowers Heart Attack Risk
A good sex life is good for your heart. Besides being a great way to raise your heart rate, sex helps keep your estrogen and testosterone levels in balance.

“When either one of those is low you begin to get lots of problems, like osteoporosis and even heart disease,” Pinzone says.

Having sex more often may help. During one study, men who had sex at least twice a week were half as likely to die of heart disease as men who had sex rarely.

7. Lessens Pain
Before you reach for an aspirin, try for an orgasm.

“Orgasm can block pain,” says Barry R. Komisaruk, PhD, a distinguished service professor at Rutgers, the State University of New Jersey. It releases a hormone that helps raise your pain threshold.

Stimulation without orgasm can also do the trick. “We’ve found that vaginal stimulation can block chronic back and leg pain, and many women have told us that genital self-stimulation can reduce menstrual cramps, arthritic pain, and in some cases even headache,” Komisaruk says.
8. May Make Prostate Cancer Less Likely
Going for the gusto may help ward off prostate cancer.

Men who ejaculated frequently (at least 21 times a month) were less likely to get prostate cancer during one study, which was published in the Journal of the American Medical Association.

You don’t need a partner to reap this benefit: Sexual intercourse, nocturnal emission, and masturbation were all part of the equation.

It’s not clear that sex was the only reason that mattered in that study. Lots of factors affect cancer risk. But more sex won’t hurt.

9. Improves Sleep
You may nod off more quickly after sex, and for good reason.

“After orgasm, the hormone prolactin is released, which is responsible for the feelings of relaxation and sleepiness” after sex, says Sheenie Ambardar, MD. She is a psychiatrist in West Hollywood, Calif.

10. Eases Stress
Being close to your partner can soothe stress and anxiety.

Ambardar says touching and hugging can release your body’s natural “feel-good hormone.” Sexual arousal releases a brain chemical that revs up your brain’s pleasure and reward system.

Sex and intimacy can boost your self-esteem and happiness, too, Ambardar says. It’s not only a prescription for a healthy life, but a happy one.

WebMD Feature

How to manage chlamydia infection

How to manage chlamydia infection

Rotimi Adesanya

Chlamydia is a sexually transmitted infection caused by bacteria known as ‘Chlamydia trachomatis’. The disease, which affects both men and women, is spread by having unprotected vaginal, anal or oral sex with an infected person. It is also transferred to newborn babies from infected mothers.

Most people infected chlamydia don’t notice any symptoms and so they don’t know they have it. Research suggests that 50 per cent of men and 70-80 per cent of women don’t get symptoms at all with an infection. They can pass it to others without knowing it. If a pregnant woman has chlamydia, it can be passed to her baby during birth.

Symptoms

A big problem with chlamydia is that it often produces no symptoms. If left undetected and untreated, complications can occur. People who have the disease can still transmit the infection, even if they don’t have any symptoms themselves. When symptoms do occur, they may not appear until several weeks after having sex with an infected person.

Women: They frequently develop abdominal or chronic pelvic pain and the continued spread of the disease. Other symptoms are burning desire to urinate, an abnormal vaginal discharge, blood in the urine, urinary urgency (feeling an urgent need to urinate) and increased urinary frequency can occur if the urethra is infected.

Men: Chlamydia can be difficult to spot in men because the symptoms are rare and not consistent between men. More common symptoms include a white, cloudy or watery discharge from the tip of the penis, difficulty or pain during urination, swollen and sore testicles.

Newborn: Pregnant women infected with chlamydia can pass the infection to their babies during childbirth. This could result in the baby developing conjunctivitis (eye infections) and pneumonia (chest infections).

Complications

Women: If it isn’t treated, the infection can sometimes spread to other parts of the body and lead to serious long-term health problems, such as pelvic inflammatory disease, ectopic pregnancy (in which a pregnancy develops outside the uterus, such as in the fallopian tubes) and infertility (not being able to have children), due to infection and scarring of the fallopian tubes.

Men: If left untreated, chlamydia can cause internal scarring of the genitals, a lower sperm count with less fertile sperm, and can lead to additional health conditions.

Newborn: Chlamydia can lead to blindness or complicated pneumonia in the newborn baby.

Diagnosis

If you think there is a chance you might have chlamydia, getting tested early on is important, and so is avoiding spreading it to others. Testing for the infection is done with a urine test for men. Women can have a urine test or a swab taken from the cervix or vagina. Treatment normally involves antibiotic drugs.

Treatment

Chlamydia can be cured with the right treatment. If your doctor detects c the infection, it can usually be treated with special class of antibiotics. It is important that you take all of the medication your doctor prescribes to cure the infection. When taken properly it will stop the infection and could decrease your chances of having complications later on.

It is advisable for infected persons to avoid having sex while taking the antibiotics for a week so that he or she does not pass on the infection to someone else or become re-infected. It is recommended that the infected person do another test for chlamydia three months later to make sure there is no re-infection. Anyone who has had sex with an infected person in the past six months should also be tested and may need treatment at the same time. This is called contact tracing.

As Chlamydia is transmitted through unprotected sex, the doctor may suggest that you undergo screening for other sexually transmitted infections and if necessary, you and your partner(s) treated.

Prevention

Having oral sex or anal sex with someone who has chlamydia can result in infection of the throat or the rectum, thereby causing pain and a discharge of pus or mucus that could be painful when you urinate, an unusual discharge from the penis, vagina or rectum or, in women, bleeding between periods or after sex.

One can getting infected with chlamydia (and other sexually transmitted infections) by practising safe sex. This means using a condom during vaginal or anal sex.

The universal method of prevention of sexually transmitted infections is the ‘ABC’tip.

A–Abstinence

B–Be Faithful to a partner who is also faithful to you

C–Condoms: Use them correctly.

Credit: The Punch