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    Fatigue and depression postnatal period


Motherhood is a huge challenge in a woman's life, followed not only by the joy of the emergence of the baby – it is a period which requires limitless devotion, responsibility and also a lot of physical strength of the woman. Fatigue after childbirth is a completely understandable and common phenomenon. Fatigue can be one of the first signs of depression. If the postnatal period features fatigue, it is important to find out, whether there is no anaemia, infection or thyroid dysfunction. With treatment of these causes the condition begins to improve. People experiencing unexplained fatigue may develop depression 3 times more often {according to the data of the WHO studies}. When after 1 year after the birth women begin to work, they often feel that their earlier feeling of well-being has not yet returned.
Fatigue causes depression and depression causes fatigue. In case of depression, the main symptoms – bad mood, decrease of interests, lack of sense of pleasure – are usually accompanied by fatigue, drowsiness and lack of energy. Neurotransmitter imbalance causes tiredness, listlessness and apathy.


Fatigue and depression causes sleeping and appetite disorders, may induce symptoms of other diseases, thus timely treatment is very important. The medical centre MAXMEDA performs patient examination, determines diagnosis and suggests treatment, which may be natural (acupuncture, homeopathic preparations) or pharmaceutical




    Cervical disease. Is it dangerous?


Cervical sores (erosions) are the most common cervical disease (diagnosed in every fourth woman). Timely detected it may be easily cured.
A healthy cervix reminds a channel. From the vaginal side it is covered by a flat pink epithelium. Erosions are bright red uneven spots, clearly distinguished from healthy epithelium. A doctor may diagnose an erosion while performing routine gynaecological examinations.
Causes. This disease is determined by genital inflammation, caused by bacteria, viruses, fungi, chlamydia and hormonal imbalances. Mechanical injuries (e.g. childbirth, abortion and other procedures) are also a common cause of cervical erosion.
Symptoms. Initially no symptoms are visible. Later the patient experiences sparse discharge, may also feel pain in lower abdomen or experience spotting after sexual intercourse or in the middle of the cycle.
Diagnosis. It is necessary to perform cytological examination. A doctor takes a sample of cells of the injured and healthy tissue. Cytology as the main type of examination allows to determine not only benign cervical lesions. The abnormal cervical cells are examined under a microscope, determining whether there is a threat of these cells becoming cancerous. Cytological smear abnormalities are studied further until an exact diagnosis is determined. Negative results are wrong in 40% of cases. This happens due to wrong smear taken of a wrong tissue or from a wrong spot, as well as poor storage conditions, etc. The most common mistake is unsuitable usage of or using unsuitable brushes or simple spatulas. The cervical canal tissue is usually not tested, while it is usually the most common place for the occurrence of the disease.


IMPORTANT TO KNOW:
1. For menstruating women oncocytological examination must be carried out in the first half of the cycle.
2. 24 hours before the examination the woman must refrain from sexual intercourse (i.e. the cervix should be untouched).
3. Vaginal secretions must be transparent, because any infection or vaginal inflammation makes it impossible to take an appropriate amount of cells, they are usually changed, thus making the test inaccurate.
In addition it is necessary to perform colposcopy. This study allows a more close examination of the cervix using a colposcope – a special optic device, which magnifies and lights the view. Sometimes the cervix is lubricated with a special solution, which removes mucus and makes the tissue lesions more visible. If the entire unhealthy changes in the cervix tissue cannot be evaluated, conization is performed. That is a surgical intervention (which requires general anaesthesia), which involves taking a cone-shaped sample of tissue from the mucous membrane of the cervix and examining it under a microscope.




If it turns out to be a cancer


The treatment depends on the tumour cell lesions.
If cancer is determined early (the so called pre-invasive stage, when the disease can be cured completely), the cervix is usually simply removed. If the disease has spread, the uterus and ovaries are removed and irradiation therapy is applied. Widespread cancer is usually treated with chemical and radiation therapy, the goal of which is to stop the development of the disease.
Attention! Cervical cancer is usually caused by HPV (human papilloma virus). This viral infection is detected by performing a cytological examination. If the patient is infected, she needs to be examined further.
The results of most of the testing show that the HPV is found in 90-100% of women with cervical cancer. The HPV prevalence in healthy women depends a lot on the age – the HPV among young (20-25-year-old), sexually active women ranges from 20 to 80 percent. However, only a small part of the women infected with HPV, from 3 to 10% (depending on the population) are carriers of the infection.  They are classified to the group of women with a high risk of cancer. It should be noted that a viral infection alone is not enough to cause cancer. Environmental pollution, the woman's hormonal condition, immune response, smoking and other factors also affect the existence and development of the infection.
HPV is divided into several groups – high risk of cancer, medium risk of cancer and low risk of cancer viruses. HPV 16, 18, 31 or 45 are often found in cervical malignant tumours and are regarded as types of high risk of cancer, meanwhile HPV 6, 11, 42, 43 or 44 are not so often found in the tumours mentioned and belong to low risk groups of viruses. HPV infection is transmitted by contact through infected genitals or anal tract. It was noted that women, whose partners had warts on their external genitals, also develop genital warts. The prevalence of HPV depends on the amount of the sexual partners and increases with the increasing number of partners. Teenagers and young women experience a higher risk to become infected with HPV with every new partner.




How quickly does the cervical cancer develop?


It develops without any symptoms for several years and women help it by not making appointments with their gynaecologists. They think that there is no need for testing if it does not hurt. Such belief is fatal. Only early detection of cervical cancer may help to avoid negative consequences.
Cervical cancer takes the second place according to patient mortality (after breast cancer). Compared to the entire Europe, Lithuania experiences the highest incidence of this disease. The risk of cervical cancer increases in women older than 30 years and usually manifests at the age of 45-55 years.
Unfavourable factors


The factors in favour of the emergence of cervical cancer are usually the following: early sexual life (beginning earlier than at 18 years), frequent change of sexual partners, the number of pregnancies and childbirth at a young age, smoking, lack of vitamin A, weakened immune system and neglect of one's health.
Prevention of cervical diseases


Women must undergo cytological examinations once a year – that is a time period, when invasive cancer does not necessarily develop. It may manifest, but there is still a possibility to cure this disease completely. A gynaecologist not always remembers, whether a cytological test was performed or when was it performed the last time. Thus every woman must remind and inquire about the results herself. Remember, that as much as 60% of women with cervical cancer not once had undergone a cytological examination!!! Also, vaccination against HPV 16, 18, 6 and 11 is already available in Lithuania, which provides protection from the causative agents of cervical cancer and genital warts. More information is available at the online website www.hpv.lt

Useful advice
1. Do not think that the worst things happen only to somebody else. It would be nice if it was true, but you must always be careful and cautious. Vigilance is a key to success in protecting oneself against cancer.
2. Never cling to the belief that ignorance is bliss, when it comes to health issues. The sooner you know, the better – doctors do not invent diseases that are not there. In order to be sure, see your doctor even in case of a slightest doubt.



Articles
Fatigue and depression postnatal period

Motherhood is a huge challenge in a woman's life, followed not only by the joy of the emergence of the baby – it is a period which requires limitless devotion, responsibility and also a lot of physical strength of the woman. Fatigue after childbirth is a completely understandable and common phenomenon. Fatigue can be one of the first signs of depression. If the postnatal period features fatigue, it is important to find out, whether there is no anaemia, infection or thyroid dysfunction. With treatment of these causes the condition begins to improve. People experiencing unexplained fatigue may develop depression 3 times more often {according to the data of the WHO studies}. When after 1 year after the birth women begin to work, they often feel that their earlier feeling of well-being has not yet returned.
Fatigue causes depression and depression causes fatigue. In case of depression, the main symptoms – bad mood, decrease of interests, lack of sense of pleasure – are usually accompanied by fatigue, drowsiness and lack of energy. Neurotransmitter imbalance causes tiredness, listlessness and apathy.

Fatigue and depression postnatal period


Fatigue and depression causes sleeping and appetite disorders, may induce symptoms of other diseases, thus timely treatment is very important. The medical centre MAXMEDA performs patient examination, determines diagnosis and suggests treatment, which may be natural (acupuncture, homeopathic preparations) or pharmaceutical


Cervical disease. Is it dangerous?

Cervical sores (erosions) are the most common cervical disease (diagnosed in every fourth woman). Timely detected it may be easily cured.
A healthy cervix reminds a channel. From the vaginal side it is covered by a flat pink epithelium. Erosions are bright red uneven spots, clearly distinguished from healthy epithelium. A doctor may diagnose an erosion while performing routine gynaecological examinations.
Causes. This disease is determined by genital inflammation, caused by bacteria, viruses, fungi, chlamydia and hormonal imbalances. Mechanical injuries (e.g. childbirth, abortion and other procedures) are also a common cause of cervical erosion.
Symptoms. Initially no symptoms are visible. Later the patient experiences sparse discharge, may also feel pain in lower abdomen or experience spotting after sexual intercourse or in the middle of the cycle.
Diagnosis. It is necessary to perform cytological examination. A doctor takes a sample of cells of the injured and healthy tissue. Cytology as the main type of examination allows to determine not only benign cervical lesions. The abnormal cervical cells are examined under a microscope, determining whether there is a threat of these cells becoming cancerous. Cytological smear abnormalities are studied further until an exact diagnosis is determined. Negative results are wrong in 40% of cases. This happens due to wrong smear taken of a wrong tissue or from a wrong spot, as well as poor storage conditions, etc. The most common mistake is unsuitable usage of or using unsuitable brushes or simple spatulas. The cervical canal tissue is usually not tested, while it is usually the most common place for the occurrence of the disease.

Cervical disease. Is it dangerous?


IMPORTANT TO KNOW:
1. For menstruating women oncocytological examination must be carried out in the first half of the cycle.
2. 24 hours before the examination the woman must refrain from sexual intercourse (i.e. the cervix should be untouched).
3. Vaginal secretions must be transparent, because any infection or vaginal inflammation makes it impossible to take an appropriate amount of cells, they are usually changed, thus making the test inaccurate.
In addition it is necessary to perform colposcopy. This study allows a more close examination of the cervix using a colposcope – a special optic device, which magnifies and lights the view. Sometimes the cervix is lubricated with a special solution, which removes mucus and makes the tissue lesions more visible. If the entire unhealthy changes in the cervix tissue cannot be evaluated, conization is performed. That is a surgical intervention (which requires general anaesthesia), which involves taking a cone-shaped sample of tissue from the mucous membrane of the cervix and examining it under a microscope.


If it turns out to be a cancer


The treatment depends on the tumour cell lesions.
If cancer is determined early (the so called pre-invasive stage, when the disease can be cured completely), the cervix is usually simply removed. If the disease has spread, the uterus and ovaries are removed and irradiation therapy is applied. Widespread cancer is usually treated with chemical and radiation therapy, the goal of which is to stop the development of the disease.
Attention! Cervical cancer is usually caused by HPV (human papilloma virus). This viral infection is detected by performing a cytological examination. If the patient is infected, she needs to be examined further.
The results of most of the testing show that the HPV is found in 90-100% of women with cervical cancer. The HPV prevalence in healthy women depends a lot on the age – the HPV among young (20-25-year-old), sexually active women ranges from 20 to 80 percent. However, only a small part of the women infected with HPV, from 3 to 10% (depending on the population) are carriers of the infection.  They are classified to the group of women with a high risk of cancer. It should be noted that a viral infection alone is not enough to cause cancer. Environmental pollution, the woman's hormonal condition, immune response, smoking and other factors also affect the existence and development of the infection.
HPV is divided into several groups – high risk of cancer, medium risk of cancer and low risk of cancer viruses. HPV 16, 18, 31 or 45 are often found in cervical malignant tumours and are regarded as types of high risk of cancer, meanwhile HPV 6, 11, 42, 43 or 44 are not so often found in the tumours mentioned and belong to low risk groups of viruses. HPV infection is transmitted by contact through infected genitals or anal tract. It was noted that women, whose partners had warts on their external genitals, also develop genital warts. The prevalence of HPV depends on the amount of the sexual partners and increases with the increasing number of partners. Teenagers and young women experience a higher risk to become infected with HPV with every new partner.

How quickly does the cervical cancer develop?


It develops without any symptoms for several years and women help it by not making appointments with their gynaecologists. They think that there is no need for testing if it does not hurt. Such belief is fatal. Only early detection of cervical cancer may help to avoid negative consequences.
Cervical cancer takes the second place according to patient mortality (after breast cancer). Compared to the entire Europe, Lithuania experiences the highest incidence of this disease. The risk of cervical cancer increases in women older than 30 years and usually manifests at the age of 45-55 years.
Unfavourable factors


The factors in favour of the emergence of cervical cancer are usually the following: early sexual life (beginning earlier than at 18 years), frequent change of sexual partners, the number of pregnancies and childbirth at a young age, smoking, lack of vitamin A, weakened immune system and neglect of one's health.
Prevention of cervical diseases


Women must undergo cytological examinations once a year – that is a time period, when invasive cancer does not necessarily develop. It may manifest, but there is still a possibility to cure this disease completely. A gynaecologist not always remembers, whether a cytological test was performed or when was it performed the last time. Thus every woman must remind and inquire about the results herself. Remember, that as much as 60% of women with cervical cancer not once had undergone a cytological examination!!! Also, vaccination against HPV 16, 18, 6 and 11 is already available in Lithuania, which provides protection from the causative agents of cervical cancer and genital warts. More information is available at the online website www.hpv.lt

Useful advice
1. Do not think that the worst things happen only to somebody else. It would be nice if it was true, but you must always be careful and cautious. Vigilance is a key to success in protecting oneself against cancer.
2. Never cling to the belief that ignorance is bliss, when it comes to health issues. The sooner you know, the better – doctors do not invent diseases that are not there. In order to be sure, see your doctor even in case of a slightest doubt.

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