Female cyclists :How to Protect Your Sexual Health When Riding ?

Female cyclists:

How to Protect Your Sexual Health When Riding ?

Previous studies have shown that riding a bicycle regularly can take a serious toll on men's sexual health, and new research from Yale University in the US suggests the same holds true for women.

This week, the New York Times reported on a recent study that had one major finding: the lower the handlebars, the greater the trouble for women.

If a woman has to lean forward more to reach low handlebars, she is putting more pressure on sensitive areas, which can lead to numbness and potentially cause sexual dysfunction.

The study, published last month, tested 48 women, each a dedicated rider who pedaled a minimum of 10 miles (16 km) a week, but often much more. Researchers noted that riders who lean forward, flatten their backs and place their hands on the “drop bars” of a bicycle, aiming for a more aerodynamic position, reported more problems with numbness in the pelvic area.

While raising the handlebars seems a logical solution (though not an easy one for serious riders), female riders, like male riders, may also face problems with the seat.

While more research needs to be done on female cyclists, Steven M. Schrader, a scientist at the National Institute for Occupational Safety and Health, suggests that one way to reduce the pressure on the perineum, a part of the body he said was never meant to withstand sustained pressure, is to use a bicycle saddle without a nose -- which lack the sleekness of a standard seat but could spare you some agony.

While Schrader's prior research on these types of seats with male riders has shown positive results, he suggests the seats might benefit women as well. “If you don’t put weight there,” he told the New York Times, “there’s no pressure.” (Source : AFP Relaxnews)

For some no-nose saddle models, check out :

BiSaddle,

the Spiderflex,

the I.S.M,

and others at HealthyCycling.

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VAGINISMUS

VAGINISMUS


Vaginismus [vaj-uh-niz-muh s] is considered a disorder of sexual dysfunction.The disorders is an involuntary spasm of the muscles surrounding the vagina. The spasms close the vagina. Vaginismus can cause vaginal penetration during sex is difficult or impossible, and vaginal pain is common during sexual intercourse or an attempted pelvic exam. Vaginismus is also closely related to any of the other forms of dyspareunia in that any type of general sex pain may trigger vaginismus. Most women with vaginismus cannot tolerate sexual intercourse, and some cannot tolerate using tampons. It has several possible causes, including past sexual trauma or abuse, psychological factors, or a history of discomfort with sexual intercourse. Sometimes no cause can be found. 

Vaginismus Involuntary Tightness - In the diagram [1] on the left, the effects of vaginismus are illustrated with the tightening of the pelvic floor muscles and the resulting tightness of the vagina. On the right, the pelvic floor is relaxed and intercourse is possible without pain.

There are two types of vaginismus; primary (i.e. lifelong) and secondary (occurring after a period of normal sexual function). When a woman has never at any time been able to have pain-free intercourse due to vaginismus tightness, her condition is known as primary vaginismus. Vaginismus can also develop later in life, even after many years of pleasurable intercourse.

This type of condition, known as secondary vaginismus, is usually precipitated by a medical condition, traumatic event, childbirth, surgery, or life-change (menopause). Although these women will remember that penetrations used to be fine, they are now faced with painful/impossible intercourse and gynecologic exams. The cause for their secondary vaginismus is the loss of lubrication and elasticity in the vagina, making them feel just as isolated and hopeless as those with primary vaginismus.

Although a woman can easily diagnose her vaginismus, medical evaluation is recommended as the following information is not intended to be used in lieu of proper medical care. Doctors base the diagnosis on symptoms and a subsequent pelvic examination, done as gently as possible. Women are taught how to touch her genital area, gradually moving closer to her vagina and becoming used to touching it without causing pain, and then to insert progressively larger cones. These exercises may enable women to have sexual intercourse without pain.

There are a variety of factors that can contribute to vaginismus. These may be psychological or physiological, and the treatment required can depend on the reason that the woman has developed the condition. As each case is different, an individualized approach to treatment is useful. Treatment involves extensive therapy that combines education, counseling, and behavioral exercises.

Typically, treatment includes relaxation, Kegel exercises (pelvic floor muscle contraction and relaxation) and individual and partner involvement in a series of at-home exercises, including repeated practice with insertion (dilation) training. Each woman moves at her own pace and decides when she is ready for the next step. Pain and discomfort are avoided throughout the treatment.

The other treatment of vaginismus is treating with hypnosis. In general, hypnotherapy tends to focus on overcoming the vaginismus itself, as opposed to resolving any causes or conflicts behind it. Hypnosis is unsurpassed at dealing with unconscious processes. This is why is useful to help sports people excel - their brain can be trained to control their muscles in precisely the right way. Similarly, hypnosis can be used to treat high blood pressure because it relaxes the body like no other method can.

A good news for patient with vaginismus that reported new treatment to use botolinum toxin (botox). Botox is a relatively new treatment for vaginismus, first described in 1997. Ghazizadeh and Nikzad reported on the use of botulinum toxin in the treatment of refractory vaginismus in 24 patients. In this study, Dysport (a type of Botox) 150-400 mIU (Ipsen Ltd, United Kingdom) was used. 23 patients were able to have vaginal examinations one week post procedure showing little or no vaginismus.

If you have pain associated with intercourse or difficulties with successful vaginal penetration, contact your health care provider. When a physician or gynecologist is consulted, involuntary spasm during pelvic examination can confirm the diagnosis of vaginismus, and the physician will rule out any physiological causes for the condition. When psychological causes are suspected, referral should be made to a psychologist or psychiatrist.

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FEMALE DYSPAREUNIA

FEMALE DYSPAREUNIA


Other name : Painful sexual intercourse

Dyspareunia (dis-puh-ROO-ne-uh) is the medical term for painful intercourse — which is defined as persistent or recurrent genital pain that occurs just before, during or after intercourse and that causes you personal distress. The pain can be in the genital area or deep inside the pelvis. The pain is often described as sharp, burning or similar to menstrual cramps. It can have many causes.

Symptoms of dyspareunia include : Pain with every penetration; even while putting in a tampon, Pain with certain partners or just under certain circumstances, New pain after previously pain-free intercourse, Superficial (entry) pain, Deep pain during thrusting, which is often described as "something being bumped", Burning pain or aching pain. [1]

Diagnosis

The diagnosis is based on the woman's description of the problem, including when and where the pain is felt, and on the results of a physical examination. The genital area is gently but thoroughly examined for possible causes, such as signs of inflammation or abnormalities. A doctor may touch the area gently with a cotton swab to determine where the pain occurs. The doctor checks the tightness of the pelvic muscles around the vagina by inserting one or two gloved fingers into the vagina. To check the uterus and ovaries, the doctor then places the other hand on the lower abdomen. A rectal examination may also be done. [2]

Clinical Features of dyspareunia

Dyspareunia needs to be addressed from an integrated patient-centered perspective. This review analyzes the organic causes of pain during intercourse. Factors that are often under evaluated in the clinical setting include hormonal, inflammatory, muscular, iatrogenic, neurologic, vascular, connective, and immunitary causes. Psychosexual factors, such as vaginismus, loss of libido, arousal disorders and sexual pain-related disorders, often overlap. A preliminary clinical approach aimed at integrating different biological and psychosexual etiologies in a comprehensive manner is discussed in this article. [Graziottin A, 2001, J Sex Marital Ther;27(5):489-501]

Young women complaining of dyspareunia usually have a history of OC (oral contraception) use, recurrent thrush and adverse reactions to common foods or chemicals. Correctable laboratory findings include zinc, magnesium, copper, B vitamin, essential fatty acid deficiencies, positive gut fermentation tests and decreased pancreatic exocrine secretion and often a variety of cervical or vaginal infections. The Royal College of General Practitioners Oral Contraception Study found that stopping to co-habit was twice as common among users as among control women.3 Much disruption to family life could have been, and still could be, prevented by a more realistic awareness of the adverse effects of progesterones on women’s health. [Grant, E C G; in Biochemical and microbiological investigations needed for female dyspareunia, June 5, 2004]

Causes

Physical causes of dyspareunia include [3]:

Because there are numerous physical conditions that can contribute to pain during sexual encounters, a careful physical examination and medical history are always indicated with such complaints. In women, common physical causes for coital discomfort include infections of the vagina, lower urinary tract, cervix, or fallopian tubes (e.g., mycotic organisms (esp. candidiasis), chlamydia, trichomonas, coliform bacteria); endometriosis; surgical scar tissue (following episiotomy); and ovarian cysts and tumors.

In addition to infections and chemical causes of dyspareunia such as monilial organisms and herpes, anatomic conditions, such as hymenal remnants, can contribute to coital discomfort (Sarrell and Sarrell 1989). Estrogen deficiency is a particularly common cause of sexual pain complaints among postmenopausal women, although vaginal dryness is often reported by lactating women as well. Women undergoing radiation therapy for pelvic malignancy often experience severe dyspareunia due to the atrophy of the vaginal walls and their susceptibility to trauma. Vaginal dryness is sometimes seen in Sjögren's syndrome, an autoimmune disorder which characteristically attacks the exocrine glands that produce saliva and tears.

Dyspareunia is now believed to be one of the first symptoms of a disease called Interstitial Cystitis (IC). Patients may struggle with bladder pain and discomfort during or after sex. For men with IC, pain occurs at the moment of ejaculation and is focused at the tip of the penis. For women with IC, pain usually occurs the following day, the result of painful, spasming pelvic floor muscles. Interstitial cystitis patients also struggle with urinary frequency and/or urinary urgency.

Psychosocial causes of dyspareunia include [4]:

1. Prior sexual trauma. Many women who have been raped or sexually abused as children have dyspareunia. Even when a woman wishes to have sex with someone later, the act of intercourse may trigger memories of the trauma and interfere with her enjoyment of the act. Vaginismus also often occurs in such women.
2. Guilt, anxiety, or tension about sex. Any of these can cause tense vaginal muscles and also prevent arousal from occurring. People who were raised with the idea that sex is bad may be more prone to have this problem. Fear of pregnancy may make arousal difficult.
3. Prior physical trauma to the vaginal area. Women who have had an accidental injury or surgery in the vaginal area may become sensitive to penetration. Vaginismus is common in these cases, as well.
4. Depression or anxiety in general. Either of these can lead to loss of interest in sex. This can be experienced by either sex.
5. Problems in a relationship. Dyspareunia may occur when a woman feels her sexual partner is abusive or emotionally distant, she is no longer attracted to her partner, or she fears her partner is no longer attracted to her. Men, too, can lose interest in sex because of prior emotional trauma in a relationship; however, the result is usually impotence, rather than dyspareunia.
6. Vasocongestion. Vasocongestion can occur when either partner frequently becomes aroused but does not reach orgasm. Vasocongestion is a pooling of blood in dilated blood vessels. Normally, the pelvic area becomes congested with blood when a person becomes sexually aroused. This congestion goes away quickly after orgasm. If there is no orgasm, the congestion takes much longer to resolve.

Prevention [5] :

1. Good hygiene and routine medical care will help to some degree.
2. Adequate foreplay and stimulation will help to ensure proper lubrication of the vagina.
3. The use of a water-soluble lubricant like K-Y Jelly may also help. Vaseline should not be used as a sexual lubricant because it is not compatible with latex condoms (it causes them to break), it is not water soluble, and it may encourage vaginal infections.
4. Practicing safe sex can help prevent sexually transmitted diseases.

Treatment of Dyspareunia

Treatment is aimed at identifying and properly treating the underlying disorder. Medications are prescribed to treat infections, if they exist. If an allergy to latex is suspected, alternative methods of contraception should be considered. If the spermicide is causing discomfort, try a different brand or consider using alternate methods of birth control. A water-based lubricant may help ease discomfort and friction. However, avoid oil-based lubricants, such as petroleum jelly, since they dissolve the latex in condoms and may actually promote infection. Insertion of a graduated set of dilators into the vagina may be used to treat vaginismus. Pain during intercourse due to an episiotomy generally subsides over time. Psychological counseling may be advised if no underlying physical abnormalities can be identified. [6]

More specific treatment depends on the cause, as in the following [7] :

1. Thinning and drying of the vagina after menopause: Estrogen applied as cream, inserted into the vagina as a pill or in a ring, or taken by mouth (as part of hormone therapy)
2. Infections: Antibiotics, antifungal drugs, or other drugs as appropriate
3. Cysts or abscesses: Surgical removal
4. A rigid hymen or another congenital abnormality: Surgical correction
5. Prolapse of the uterus: Insertion of a pessary, which resembles a diaphragm, into the vagina to support and reposition the uterus. Sometimes surgery is needed.

Because this disorder involves chronic pain, treatments are becoming more comprehensive, including management of stress and emotional reactions to the pain.

VULVOVAGINITIS

VULVOVAGINITIS


Other Names : Vaginitis; Vaginal inflammation; Inflammation of the vaginal.

Vulvovaginitis (pronounced:vul-vo-vah-juh-ni-tus) is an inflammation of the vagina. It can that can result in discharge, itching and pain, and is often associated with an irritation or infection of the vulva. It is usually due to infection.

In the pathophysiology of vagina; A normal vaginal discharge consists of 1-4 mL of fluid that is white or transparent, thick, and odorless. This physiologic discharge is formed by sloughing epithelial cells, normal bacteria, and vaginal transudate. The discharge may be noticeable during pregnancy, oral contraceptive pill use, or at mid menstrual cycle, close to the time of ovulation.

The pH of vagina is maintained by lactobacillus, which produces hydrogen peroxide and lactic acid; diphtheroids; and Staphylococcus epidermidis. Lactobacillus is found in 62-88% of women. The normal pH of vaginal secretions is 4.0-4.5. Vaginal pH may increase with age, phase of menstrual cycle, sexual activity, contraception choice, pregnancy, presence of necrotic tissue or foreign bodies, and use of hygienic products or antibiotics.

The normal vaginal epithelium cornifies (develops into a thickened layer of epithelial cells) under the influence of estrogen, protecting women against infection.

Traditionally, the 3 classic entities of vaginitis include bacterial vaginosis, Trichomonas infection, and candidiasis. Other microorganisms may cause vulvovaginitis, or it may be caused by allergic reaction, irritation, injury, low estrogen levels, and certain diseases. Risk factors for bacterial vaginosis include using an intrauterine device (IUD), being of a non-white race, prior pregnancy, first sexual activity at an early age, having multiple sexual partners, and having a history of sexually transmitted diseases. Persons at an increased risk for candida vulvovaginitis include those who have had previous candida infections, frequent sexual intercourse, use birth control pills, have AIDS, are pregnant, are taking antibiotics or corticosteroids, are diabetic, use douches, use perfumed feminine hygiene sprays, wear tight clothing, or use vaginal sponges or an IUD.

Symptoms

• Irritation and itching of the genital area
• Inflammation (irritation, redness, and swelling) of the labia majora, labia minora, or perineal area
• Vaginal discharge
• Foul vaginal odor
• Discomfort or burning when urinating

Causes

Premenarchal; Nonspecific - No defined etiologic agent or poor perineal hygiene, Chemical irritants (eg, bubble baths, lotions),Vaginal foreign bodies, Pinworm infection, GABHS infection, Skin conditions - Eczema, psoriasis, seborrhea, Etiologies usually associated with women of childbearing age - Bacterial vaginosis, Trichomonas species, Candida species, and gonorrhea (Many of these are associated with sexual abuse).

Childbearing age; Sexual contact especially with multiple sexual contacts, No method of birth control, History of STD, Bacterial or fungal infections such as G vaginalis (bacterial vaginosis), Candida species, and Trichomonas species, Chemical irritants, Recent broad-spectrum antibiotics such as tetracycline, ampicillin, and cephalosporins, Pregnancy.

Postmenarchal - Atrophic vaginitis (most common cause of vulvovaginitis in postmenarchal women).

Diagnosis

To diagnose vulvovaginitis, the physician will examine the vagina (using a speculum to keep the vagina open) and take a sample of the vaginal discharge for tests and microscopic analysis. Diagnosis may be difficult because there are many different causes of vulvovaginitis.

Diagnosis is made with microscopy (mostly by vaginal wet mount) and culture of the discharge after a careful history and physical examination have been completed. The color, consistency, acidity, and other characteristics of the discharge may be predictive of the causative agent.

Drugs Used to Treat This Disorder

The cause of the infection determines the appropriate treatment. It may include oral or topical antibiotics and/or antifungal creams, antibacterial creams, or similar medications.

Some drugs for example that can used to treat this disorder :

Butoconazole
2% cream; 5 g intravaginally for 3 days,
2% cream; 5 g (Butaconazole1-sustained release), single intravaginal application

Clotrimazole
1% cream; 5 g intravaginally for 7–14 days,
100 mg vaginal tablet for 7 days,
100 mg vaginal tablet; 2 tablets for 3 days)

Miconazole
2% cream 5 g intravaginally for 7 days,
100 mg vaginal suppository; one suppository for 7 days,
200 mg vaginal suppository; one suppository for 3 days,
1,200 mg vaginal suppository, one suppository for 1 day

Nystatin
100,000-unit vaginal tablet, 1 tablet for 14 days

Tioconazole
6.5% ointment 5 g intravaginally in a single application
0.4% cream 5 g intravaginally for 7 days
0.8% cream 5 g intravaginally for 3 days
80 mg vaginal suppository, 1 suppository for 3 days

Fluconazole
150 mg oral tablet, 1 tablet in single dose

Antihistamine drug; if an allergic reaction is involved.

A topical estrogen cream; for women who have irritation and inflammation caused by low levels of estrogen (postmenopausal).

Note : See your physician ! Along with medical treatment, you must be encouraged to avoid etiological agents and to make necessary changes in your habits.

Andi Surya Amal
Independent Author, Pharmacist, to study Medical Pharmacology and formulation

THE FEMALE REPRODUCTIVE SYSTEM; DISEASES AND DISORDERS

The Female Reproductive System; Diseases and Disorders

Women are commonly dealing with many different diseases and disorders that pertain to the reproductive system. Here are some of the most common:

Vulvovaginitis

Vulvovaginitis (pronounced:vul-vo-vah-juh-ni-tus) is an inflammation of the vulva and vagina. It may be caused by irritating substances such as laundry soap, bubble baths or poor hygiene such as wiping from back to front. Symptoms include redness and itching in these areas and sometimes vaginal discharge. It can also be caused by an overgrowth of candida, a fungus normally present in the vagina.

Nonmenstrual Vaginal Bleeding

Nonmenstrual vaginal bleeding is most commonly due to the presence of a foreign body in the vagina. It may also be due to urethral prolapse, a condition in which the mucous membranes of the urethra protrude into the vagina and forms a tiny, donut shaped mass of tissue that bleeds easily. It can also be due to a straddle injury or vaginal trauma from sexual abuse.

Ectopic Pregnancy

Ectopic Pregnancy occurs when a fertilized egg or zygote doesn't travel into the uterus, but instead grows rapidly in the fallopian tube. Women with this condition can develop severe abdominal pain and should see a doctor because surgery may be necessary.

Ovarian Tumors

Ovarian tumors, although rare, can occur. Women with ovarian tumors may have abdominal pain and masses that can be felt in the abdomen. Surgery may be needed to remove the tumor.

Ovarian Cysts

Ovarian cysts are noncancerous sacs filled with fluid or semi-solid material. Although they are common and generally harmless, they can become a problem if they grow very large. Large cysts may push on surrounding organs, causing abdominal pain. In most cases, cysts will pass or disappear on their own and treatment is not necessary. If the cysts are painful and occur frequently, a doctor may prescribe birth control pills to alter their growth and occurrences. Surgery is also an option if they need to be removed.

Polycystic Ovary Syndrome

Polycystic ovary syndrome is a hormone disorder in which too many hormones are produced by the ovaries. This condition causes the ovaries to become enlarged and develop many fluid filled sacs or cysts. It often first appears during the teen years. Depending on the type and the severity of the condition, it may be treated with drugs to regulate hormone balance and menstruation.

Trichomonas Vaginalis

Trichomonas vaginalis inflammatory condition of the vagina usually a bacterial infection also called vaginosis.

Dysmenorrhea

Dysmenorrhea is painful periods.

Menorrhagia

Menorrhagia is when a woman has very heavy periods with excess bleeding.

Oligomenorrhea

Oligomenorrhea is when a woman misses or has infrequent periods, even though she has been menstruating for a while and is not pregnant.

Amenorrhea

Amenorrhea is when a girl has not started her period by the time she is 16 years old or 3 years after puberty has started, has not developed signs of puberty by 14, or has had normal periods but has stopped menstruating for some reasons other than pregnancy.

Toxic shock Syndrome

Toxic shock syndrome is caused by toxins released into the body during a type of bacterial infection that is more likely to develop if a tampon is left in too long. It can produce high fever, diarrhea, vomiting, and shock.

Candidasis

Candidasis symptoms of yeast infections include itching, burning and discharge. Yeast organisms are always present in all people, but are usually prevented from "overgrowth" (uncontrolled multiplication resulting in symptoms) by naturally occurring microorganisms.
At least three quarters of all women will experience candidiasis at some point in their lives. The Candida albicans organism is found in the vaginas of almost all women and normally causes no problems. However, when it gets out of balance with the other "normal flora," such as lactobacilli (which can also be harmed by using douches), an overgrowth of yeast can result in noticeable symptoms. Pregnancy, the use of oral contraceptives, engaging in vaginal sex after anal sex in an unhygienic manner, and using lubricants containing glycerin have been found to be causally related to yeast infections. Diabetes mellitus and the use of antibiotics are also linked to an increased incidence of yeast infections. Candidiasis can be sexually transmitted between partners. Diet has been found to be the cause in some animals. Hormone Replacement Therapy and Infertility Treatment may be factors.

There are also cancer's of the female reproductive system, such as:
1. Cervical cancer
2. Ovarian cancer
3. Uterine cancer
4. Breast cancer

Endometriosis

Endometriosis is the most common gynecological diseases, affecting more than 5.5 million women in North America alone! The two most common symptoms are pain and infertility. In this disease a specialized type of tissue that normally lines the inside of the uterus,(the endometrium) becomes implanted outside the uterus, most commonly on the fallopian tubes, ovaries, or the tissue lining the pelvis. During the menstrual cycle, hormones signal the lining of the uterus to thicken to prepare for possible pregnancy. If a pregnancy doesn't occur, the hormone levels decrease, causing the thickened lining to shed.

When endometrial tissue is located in other parts it continues to act in it's normal way: It thickens, breaks down and bleeds each month as the hormone levels rise and fall. However, because there's nowhere for the blood from this mislocated tissue to exit the body, it becomes trapped and surrounding tissue becomes irritated. Trapped blood may lead to growth of cysts. Cysts in turn may form scar tissue and adhesions. This causes pain in the area of the misplaced tissue, usually the pelvis. Endometriosis can cause fertility problems. In fact, scars and adhesions on the ovaries or fallopian tubes can prevent pregnancy. Endometriosis can be mild, moderate or severe and tends to get worse over time without treatment. The most common symptoms are:

1. Painful periods Pelvic pain and severe cramping, intense back pain and abdominal pain.
2. Pain at other times Women may experience pelvic pain during ovulation, sharp deep pain in pelvis during intercourse, or pain during bowel movements or urination.
3. Excessive bleeding Heavy periods or bleeding between periods.
4. Infertility Approximately 30-40% of women

The cause of endometriosis remains mysterious. Scientists are studying the roles that hormones and the immune system play in this condition. One theory holds that menstrual blood containing endometrial cells flows back through the fallopian tubes, takes root and grows. Another hypothesis proposes that the bloodstream carries endometrial cells to other sites in the body. Still another theory speculates that a predisposition toward endometriosis may be carried in the genes of certain families.

Other researchers believe that certain cells present within the abdomen in some women retain their ability to specialize into endometrial cells. These same cells were responsible for the growth of the woman's reproductive organs when she was an embryo. It is believed that genetic or environmental influences in later life allow these cells to give rise to endometrial tissue outside the uterus.

Adapted from : Wikibooks ; December 19, 2009

PREGNANCY WITH ASSISTED REPRODUCTIVE TECHNOLOGY

Pregnancy With Assisted Reproductive Technology

Assisted reproductive technology (ART) is the use of reproductive technology to treat infertility. This is today the only application of reproductive technology to increase reproduction that is used routinely.

Assisted Reproductive Technology (ART) procedures are used to overcome infertility. It includes infertility treatments in which eggs and sperm are handled in the laboratory to establish a pregnancy. Women who undergo those procedures are more likely to deliver multiple-birth infants than those who conceive naturally. This report presents the most recent national data and state-specific results. [MMWR 2009;58(SS05):1–25]

Some of the reproductive technologies available to infertile women include :

1. In vitro fertilisation (IVF)

In vitro fertilisation (IVF) is conception within a test tube (or similar). The woman undergoes ovulation induction and a number of eggs are removed. This is done through the vagina under ultrasound control. The collected eggs are then mixed with previously collected sperm from the woman's partner and placed in a special incubator. The fertilised eggs are then implanted into the woman's uterus via a thin tube inserted through the cervix.

Since 1983, when the first infant was conceived from in vitro fertilization (IVF) in the United States, the use of IVF and related procedures (assisted reproductive technology) has increased substantially. [MMWR 2002;51(05):97–101]

Variations on IVF include:

1. Use of donor eggs and/or sperm in IVF. This happens when a couple's eggs and/or sperm are unusable, or to avoid passing on a genetic disease.
2. Intracytoplasmic sperm injection (ICSI)in which a single sperm is injected directly into an egg; the fertilized egg is then placed in the woman's uterus as in IVF.
3. Zygote intrafallopian transfer (ZIFT) in which eggs are removed from the woman, fertilized and then placed in the woman's fallopian tubes rather than the uterus.
4. Gamete intrafallopian transfer (GIFT) in which eggs are removed from the woman, and placed in one of the fallopian tubes, along with the man's sperm. This allows fertilization to take place inside the woman's body.

2. Surgery

Usually, an egg released during ovulation is ushered down the fallopian tube. If it meets with a sperm on its journey, conception may occur. Female infertility can be caused by obstructions within reproductive organs. Some of the problems that can be addressed by surgery include:

1. Fibroids - non-malignant tumours growing inside the uterus.
2. Polyps - overgrowths of the uterine lining (endometrium), which can be caused by fibroids.
3. Endometriosis - the growth of endometrial tissue outside of the uterus. This misplaced tissue can block the fallopian tubes.
4. Salpingitis - the fallopian tube becomes inflamed and scarred by bacterial infection.

3. Ovulation induction

Irregular or absent periods may indicate that ovulation is irregular or absent too. However, even women with regular periods may skip ovulation every now and then. Ovulation can be induced with a range of drugs in a tablet or injection form. The drug schedule includes synthesised versions of gonadotrophins, the hormones released by the pituitary gland in the brain that prompt the ovaries to release an egg every menstrual cycle. However, the drugs tend to trigger the release of a number of eggs per cycle, which means the risk of having a multiple pregnancy is about 20 per cent. Sometimes, the response to synthesised gonadotrophins may be excessive, leading to a condition known as ovarian hyperstimulation syndrome. The symptoms include oedema (fluid retention), abdominal pain and bloating. Regular blood tests are used to help fine-tune the dosage and minimise the risk of ovarian hyperstimulation syndrome from occurring.

4. Other assisted reproductive technology:

a. Assisted hatching
b. Fertility preservation
c. Freezing (cryopreservation) of sperm, eggs, & reproductive tissue
d. Frozen embryo transfer (FET)

Pregnancy isn't always possible

Despite the sophistication of assisted reproductive technologies, pregnancy doesn't always happen. It depends on a range of factors, including the reasons for the woman's infertility, her age and the type of technology used.

Potential health risks

Some of the problems associated with the use of assisted reproductive technologies include:
1. Ovarian hyperstimulation syndrome
2. Associated risks of multiple pregnancies
3. Increased risk of premature labour and low birth weight
4. Increased risk of caesarean delivery.

Ethics

Many issues of reproductive technology have given rise to bioethical issues, since technology often alters the assumptions that lie behind existing systems of sexual and reproductive morality. Also, ethical issues of human enhancement arise when reproductive technology has evolved to be a potential technology for not only reproductively inhibited people but even for otherwise reproductively healthy people.

THE FEMALE REPRODUCTIVE ORGANS

THE FEMALE REPRODUCTIVE ORGANS

(Click for to see Images of “The Female Reproductive Anatomy”, before you read the text below)

The article is a simple review of the female reproductive organ. There are two parts on female sexual anatomy; internal and external organs. The female sexual anatomy and its composite parts allow women to become pregnant, bear children and other biological functions.

A. Internal Organs
Key organs for female reproduction are protectively located deep within the body. These include:

Ovaries
Location : Pelvic region on either side of the uterus.
Function : Provides an environment for maturation of oocyte. Synthesizes and secretes sex hormones (estrogen and progesterone).
Description : A woman normally has a pair of ovaries that resemble almonds in size and shape. They are home to the female sex cells, called eggs, and they also produce estrogen, the female sex hormone. Women’s ovaries already contain several hundred thousand undeveloped eggs at birth, but the eggs are not called into action until puberty. Roughly once a month, starting at puberty and lasting until menopause, the ovaries release an egg into the fallopian tubes; this is called ovulation. When fertilization does not occur, the egg leaves the body as part of the menstrual cycle.

Fallopian tubes
Location : Extending upper part of the uterus on either side.
Function : Egg transportation from ovary to uterus (fertilization usually takes place here).
Description: These are narrow tubes that are attached to the upper part of the uterus and serve as tunnels for the ova (egg cells) to travel from the ovaries to the uterus. Conception, the fertilization of an egg by a sperm, normally occurs in the fallopian tubes. The fertilized egg then moves to the uterus, where it implants into the lining of the uterine wall.

Uterus
Location : Center of pelvic cavity.
Function : To house and nourish developing human.
Description : The uterus is located in the pelvis of a woman’s body and is made up of smooth muscle tissue. Commonly referred to as the womb, the uterus is hollow and holds the fetus during pregnancy. Each month, the uterus develops a lining that is rich in nutrients. The reproductive purpose of this lining is to provide nourishment for a developing fetus. Since eggs aren’t usually fertilized, the lining usually leaves the body as menstrual blood during a woman’s monthly period.

Cervix
Location : The lower narrower portion of the uterus.
Function : During childbirth, contractions of the uterus will dilate the cervix up to 10 cm in diameter to allow the child to pass through. During orgasm, the cervix convulses and the external os dilates.
Description :The lower part of the uterus, which connects to the vagina, is known as the cervix. Often called the neck or entrance to the womb, the cervix lets menstrual blood out and semen into the uterus. The cervix remains closed during pregnancy but can expand dramatically during childbirth.

Vagina
Location : Canal about 10-8 cm long going from the cervix to the outside of the body.
Function : Receives penis during mating. Pathway through a womans body for the baby to take during childbirth. Provides the route for the menstrual blood (menses) from the uterus, to leave the body. May hold forms of birth control, such as an IUD, diaphragm, neva ring, or female condom.
Description : The vagina has both internal and external parts and connects the uterus to the outside of the body. Made up of muscle and skin, the vagina is a long hollow tube that is sometimes called the “birth canal” because, if you are pregnant, the vagina is the pathway the baby will take when it’s ready to be born. The vagina also allows menstrual blood to leave a woman's body during reproduction and is where the penis deposits semen during sexual intercourse.

B. External Parts
The entrance to the vagina is surrounded by external parts that generally serve to protect the internal organs; this area is called the vulva. The vulva consists of the following:

Labia majora
Location : Outer skin folds that surround the entrance to the vagina.
Function : Lubrication during mating
Description : The labia majora enclose and protect the other external reproductive organs. Literally translated as "large lips," the labia majora are relatively large and fleshy, and are comparable to the scrotum in males. The labia majora contain sweat and oil-secreting glands. After puberty, the labia majora are covered with hair.

Labia minora
Location : Inner skin folds that surround the entrance to the vagina.
Function: Lubrication during mating
Description : Literally translated as "small lips," the labia minora can be very small or up to 2 inches wide. They lie just inside the labia majora, and surround the openings to the vagina (the canal that joins the lower part of the uterus to the outside of the body) and urethra (the tube that carries urine from the bladder to the outside of the body).

Clitoris
Location : Small erectile organ directly in front of the vestibule.
Function : Sexual excitation, engorged with blood.
Description : The clitoris is a sensitive organ located above the vaginal opening. The clitoris does not directly affect reproduction, but it is an important part of the female sexual anatomy; many women need clitoral stimulation to orgasm.

Mons veneris
Location : Mound of skin and underlying fatty tissue, central in lower pelvic region.
Description : The mons veneris, Latin for "mound of Venus" (Roman Goddess of love) is the soft mound at the front of the vulva (fatty tissue covering the pubic bone). It is also referred to as the mons pubis. The mons veneris is sexually sensitive in some women and protects the pubic bone and vulva from the impact of sexual intercourse. After puberty it is covered with pubic hair, usually in a triangular shape. Heredity can play a role in the amount of pubic hair an individual grows.

Perineum
Location : Short stretch of skin starting at the bottom of the vulva and extending to the anus.
Description : The perineum is the short stretch of skin starting at the bottom of the vulva and extending to the anus. It is a diamond shaped area between the symphysis pubis and the coccyx. This area forms the floor of the pelvis and contains the external sex organs and the anal opening. It can be further divided into the urogenital triangle in front and the anal triangle in back.The perineum in some women may tear during the birth of an infant and this is apparently natural. Some physicians however, may cut the perineum preemptively on the grounds that the "tearing" may be more harmful than a precise cut by a scalpel. If a physician decides the cut is necessary, they will perform it. The cut is called an episiotomy.

This knowing describes the importance of good health of the female reproductive system: the organs involved in the process of reproduction, hormones that regulate a woman's body, the menstrual cycle, ovulation and pregnancy, the female's role in genetic division, birth control, sexually transmitted diseases and other diseases and disorders.