Conditions and Treatments

abnormal bleeding

Abnormal Bleeding

A normal menstrual period lasts from 2 to 7 days. The normal cycle patterns can range from 21 to 35 days. When bleeding occurs that is not part of the regular cycle; periods are longer or heavier than normal; occurs between periods; time between periods is longer than normal; or there is an absence of periods, this is called abnormal or irregular uterine bleeding. There are various causes of abnormal bleeding, but the most common is a hormone imbalance. At both ends of the menstrual life of a woman, periods may be irregular. Reasons for abnormal periods can be both normal and abnormal. The most normal reason is pregnancy. Hormone imbalance (not enough or too much of certain hormones) can also be a common reason. This can occur as a result of weight loss or gain; heavy exercise; stress; illness; or certain medications. The most common result of a hormone imbalance is loss of ovulation. If this occurs over a long period of time, a condition called endometrial hyperplasia can occur. Endometrial hyperplasia is the result of constant estrogen bombardment of the endometrium (the lining of the uterus shed every month with your period). Untreated, endometrial h yperplasia (when the lining of the uterus becomes too thick) can sometimes turn into cancer.

There are many reasons for abnormal/irregular periods. The chart below will list the most common reasons, their cause, other symptoms that may occur, diagnostic methods and treatment options. Remember, this is not a replacement for the advice of your care giver, but rather information to help you become aware of your body.

Condition Cause Other Symptoms Diagnosis Treatment Options
Polycystic ovary disease (syndrome) No ovulation Irregular bleeding, irregular periods, infertility, acne , excessive hair growth Made with examination , lab tests to check hormone levels and Ultrasound to check the ovaries. Birth control pills, progesterone supplementation every three months; infertility drugs when pregnancy desired
Pregnancy Can be normal; as a result of miscarriage or ectopic (tubal) pregnancy May have right or left lower abdominal pain; cramping Pregnancy test, sonogram If normal – observe; miscarriage may need a D&C; ectopic is a medical emergency and needs IMMEDIATE Surgery
Infections of the uterus or cervix Some Sexually transmitted diseases Pain with period, foul smelling discharge, greenish to green-yellow discharge Exam, cultures, other specific blood test Appropriate antibiotics and abstinence
IUD Irritation of the lining of the uterus. The uterus can’t stop bleeding after a period Cramping, heavy clotting If periods were normal before the IUD was placed, you may need to have it removed. If they return to normal after removal, the IUD was the cause Remove the IUD
Birth Control Pills Missed pills, newly starting the pill, improper hormone mixture for YOUR body Brown staining to bright red bleeding in the middle of the cycle; heavy to no periods Missed pills are obvious; your doctor can make the diagnosis based on the description of what your periods are like compared to before starting the pill Wait for 2-3 months after starting a new pill; change pills
Uterine fibroids Growths of smooth muscle non-cancerous tumors in the uterine muscle. These are more common in black women, but are not uncommon in white women. They are very uncommon in Oriental women Heavy periods, bleeding between cycles, problems with kidneys, increasing abdominal girth, pressure feelings in the lower abdomen, infertility Exam, sonogram, possibly MRI Depending on the size and symptoms a myomectomy(Removal of Fibroids), hysterectomy(Removal of womb), can be done.Currently injections are available for short term relief.
Blood clotting problems Von Willebrand’s Disease, Factor abnormalities, haemophilia Heavy periods; long periods lasting more than 10 days; clotting Exam, family history, appropriate blood test Treatment based on the disease
Cancer of the uterus, cervix or vagina Cancer can cause abnormal bleeding cause normal tissues are not present Heavy bleeding, bleeding with intercourse, bleeding between periods Exam, biopsy, D&C, other testing specific for the cancer looked for Surgery specific to the cancer found
Genetic abnormality in anatomy Abnormal development of the organs No periods, heavy periods Exam, sonogram, hysterosalpingogram (putting dye in the uterus to look at the anatomy of the uterus and tubes) Reconstrutive Surgery if needed.
dysfunctional uterine bleeding

Dysfunctional Uterine Bleeding

Abnormal uterine bleeding is a common presenting problem in gynae OPD. Dysfunctional uterine bleeding (DUB) is defined as abnormal uterine bleeding in the absence of organic disease. Dysfunctional uterine bleeding is the most common cause of abnormal vaginal bleeding during a woman's reproductive years. Dysfunctional uterine bleeding can have a substantial financial and quality-of-life burden.1 It affects women's health both medically and socially.

Pathophysiology

The normal menstrual cycle is 28 days and starts on the first day of menses. During the first 14 days (follicular phase) of the menstrual cycle, the endometrium thickens under the influence of estrogen. In response to rising estrogen levels, the pituitary gland secretes follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which stimulate the release of an ovum at the midpoint of the cycle. The residual follicular capsule forms the corpus luteum.

After ovulation, the luteal phase begins and is characterized by production of progesterone from the corpus luteum. Progesterone matures the lining of the uterus and makes it more receptive to implantation. If implantation does not occur, in the absence of human chorionic gonadotropin (hCG), the corpus luteum dies, accompanied by sharp drops in progesterone and estrogen levels. Hormone withdrawal causes vasoconstriction in the spiral arterioles of the endometrium. This leads to menses, which occurs approximately 14 days after ovulation when the ischemic endometrial lining becomes necrotic and sloughs.

Terms frequently used to describe abnormal uterine bleeding
  • Menorrhagia - Prolonged (>7 d) or excessive (>80 mL daily) uterine bleeding occurring at regular intervals
  • Metrorrhagia - Uterine bleeding occurring at irregular and more frequent than normal intervals
  • Menometrorrhagia - Prolonged or excessive uterine bleeding occurring at irregular and more frequent than normal intervals
  • Intermenstrual bleeding - Uterine bleeding of variable amounts occurring between regular menstrual periods
  • Midcycle spotting - Spotting occurring just before ovulation, typically from declining estrogen levels
  • Postmenopausal bleeding - Recurrence of bleeding in a menopausal woman at least 6 months to 1 year after cessation of cycles
  • Amenorrhea - No uterine bleeding for 6 months or longer

Dysfunctional uterine bleeding is a diagnosis of exclusion. It is ovulatory or anovulatory bleeding, diagnosed after pregnancy, medications, iatrogenic causes, genital tract pathology, malignancy, and systemic disease have been ruled out by appropriate investigations. Approximately 90% of dysfunctional uterine bleeding cases result from anovulation, and 10% of cases occur with ovulatory cycles.3

Anovulatory dysfunctional uterine bleeding results from a disturbance of the normal hypothalamic-pituitary-ovarian axis and is particularly common at the extremes of the reproductive years. When ovulation does not occur, no progesterone is produced to stabilize the endometrium; thus, proliferative endometrium persists. Bleeding episodes become irregular, and amenorrhea, metrorrhagia, and menometrorrhagia are common. Bleeding from anovulatory dysfunctional uterine bleeding is thought to result from changes in prostaglandin concentration, increased endometrial responsiveness to vasodilating prostaglandins, and changes in endometrial vascular structure.

In ovulatory dysfunctional uterine bleeding, bleeding occurs cyclically, and menorrhagia is thought to originate from defects in the control mechanisms of menstruation. It is thought that, in women with ovulatory dysfunctional uterine bleeding, there is an increased rate of blood loss resulting from vasodilatation of the vessels supplying the endometriumdue to decreased vascular tone, and prostaglandins have been strongly implicated. Therefore, these women lose blood at rates about 3 times faster than women with normal menses.

uterine fibroid

Uterine Fibroids

What are uterine fibroids?

Uterine fibroids are the most common, non-cancerous tumors in women of childbearing age. The fibroids are made of muscle cells and other tissues that grow within and around the wall of the uterus.

Who is at risk for uterine fibroids?

There are several risk factors for uterine fibroids:

  • African American woman are at three- to five-times greater risk than white women for fibroids.
  • Women who are overweight or obese for their height are at greater risk.
  • Women who have given birth are a lower risk.

What are the symptoms of uterine fibroids?

Many women with uterine fibroids have no symptoms. Symptoms of uterine fibroids can include

  • Heavy or painful periods, or bleeding between periods
  • Feeling “full” in the lower abdomen
  • Urinating often
  • Pain during sex
  • Lower back pain
  • Reproductive problems, such as infertility, multiple miscarriages, or early labor

Most women with fibroids do no have problems with fertility and can get pregnant. Some women with fibroids may not be able to get pregnant naturally. But advances in treatments for infertility may help some of these women get pregnant.

What are the treatments for fibroids?

If you have uterine fibroids, but show no symptoms, you many not need any treatment. Women who have pain and other symptoms might benefit from these treatments:

  • Medications can offer relief from the symptoms of fibroids and even slow or stop their growth. But, once you stop taking the medicine, the fibroids often grow back.
  • There are several types of fibroid surgery:
    • Myomectomy – Removes only the fibroids and leaves the healthy areas of the uterus in place
    • Uterine Artery Embolization (UAE) – Cuts off the blood supply to the uterus and fibroids, making them shrink
    • Hysterectomy - A more major procedure that removes the uterus; this type of surgery is the only sure way to cure uterine fibroids.
adenomyosis

Adenomyosis

Causes of Adenomyosis

The cause of adenomyosis isn't known. Some experts believe that adenomyosis results from the direct invasion of endometrial cells into the uterine walls. Sometimes an operation, such as a C-section (Caesarean section), can make this invasion of cells easier. Other experts speculate that adenomyosis originates within the uterine walls (myometrium) from endometrial tissue deposited there when the uterus was first forming in the female fetus.



Symptoms of Adenomyosis

The main symptom of this disease is no menstrual periods. Other symptoms of Amenorrhoea are is :

  • Excessive menstrual bleeding; heavy or prolonged.
  • Severe cramping or sharp, knife-like pain during menstruation (dysmenorrhea).
  • Menstrual cramps that last throughout your period and worsen as you get older.
  • Pain during intercourse.
  • Bleeding between periods.
  • Passing blood clots during your period.
  • Headache, discharge of milky nipple, hair loss, and increase in facial hair or vision changes.

Diagnosis and Tests of Adenomyosis

Pelvic examination may reveal an enlarged, slightly softened uterus, a uterine mass, or uterine tenderness.

Treatment of Adenomyosis

The treatment of Adenomyosis is the same as for andometriosis elsewhere in the pelvis, but unfortunately the response to hormonesis generally not as good. For women who do not want more children, hysterectomy is usually the best solution. The best treatment of adenomyosis surgical removal of the entire uterus.

The treatment of Adenomyosis is the same as for andometriosis elsewhere in the pelvis, but unfortunately the response to hormonesis generally not as good. For women who do not want more children, hysterectomy is usually the best solution. The best treatment of adenomyosis surgical removal of the entire uterus.

Other common treatment are as follows:

  • A hysterectomy may be necessary in women with severe symptoms who are not approaching menopause.
  • Containing progestin or a continuous-use birth control pill, often leads to amenorrhea - the absence of your menstrual periods - which may provide relief.
  • Oral contraceptives will be recommended by the doctor to treat the amenorrhoea.
  • If heavy bleeding rather than menstrual cramps is the main symptom of adenomyosis, then endometrial ablation should be considered as a treatment.

Prevention Tips of Adenomyosis

The best ways to prevent Adenomyosisis

  • You should take more and more rest.
  • You should take balanced diet.
  • You should maintain health lifestyle.
  • You should decrease your stress level.
  • You should do daily exercise , agreeable, occupation.
  • Regular hours of eating and sleeping.
pelvic pain

Pelvic Pain

Acute pelvic pain is pain that starts over a short period of time anywhere from a few minutes to a few days. This type of pain is often a warning sign that something is wrong and should be evaluated promptly.

Pelvic pain can be caused by an infection or inflammation. An infection doesn't have to affect the reproductive organs to cause pelvic pain. Pain caused by the bladder, bowel, or appendix can produce pain in the pelvic region; diverticulitis, irritable bowel syndrome, kidney or bladder stones, as well as muscle spasms or strains are some examples of non-reproductive causes of pelvic or lower abdominal pain. Other causes of pelvic pain can include pelvic inflammatory disease (PID), vaginal infections, vaginitis, and sexually transmitted diseases (STDs). All of these require a visit to your healthcare provider who will take a medical history, and do a physical exam which may include diagnostic testing.

Women who have ovarian cystsmay experience sharp pain if a cyst leaks fluid or bleeds a little, or more severe, sharp, and continuous pain when a large cyst twists. Fortunately, most small cysts will dissolve without medical intervention after 2 or 3 menstrual cycles; however large cysts and those that don't rectify themselves after a few months may require surgery to remove the cysts.

An ectopic pregnancy is one that starts outside the uterus, usually in one of the fallopian tubes. Pain caused by an ectopic pregnancy usually starts on one side of the abdomen soon after a missed period, and may include spotting or vaginal bleeding. Ectopic pregnancies can be life-threatening if medical intervention is not sought immediately. The fallopian tubes can burst and cause bleeding in the abdomen, if left untreated. In some cases surgery is required to remove the affected fallopian tube.

endometriosis

Endometriosis

What is endometriosis?

Endometriosis is the growth of cells similar to those that form the inside of the uterus (endometrial cells), but in a location outside of the uterus. Endometrial cells are the same cells that are shed each month during menstruation. The cells of endometriosis attach themselves to tissue outside the uterus and are called endometriosisimplants. These implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder, although less commonly than other locations in the pelvis. Rarely, endometriosis implants can occur outside the pelvis, on the liver, in old surgery scars, and even in or around the lung or brain. Endometrial implants, while they can cause problems, are benign (not cancerous).

Who is affected by endometriosis?

Endometriosis affects women in their reproductive years. The exact prevalence of endometriosis is not known, since many women may have the condition and have no symptoms. Endometriosis is estimated to affect over one million women (estimates range from 3% to 18% of women) in the United States. It is one of the leading causes of pelvic pain and reasons for laparoscopic surgery and hysterectomy in this country. While most cases of endometriosis are diagnosed in women aged around 25-35 years, endometriosis has been reported in girls as young as 11 years of age. Endometriosis is rare in postmenopausal women. Endometriosis is more commonly found in white women as compared with African American and Asian women. Studies further suggest that endometriosis is most common in taller, thin women with a low body mass index (BMI). Delaying pregnancy until an older age is also believed to increase the risk of developing endometriosis.

What causes endometriosis?

The cause of endometriosis is unknown. One theory is that the endometrial tissue is deposited in unusual locations by the backing up of menstrual flow into the Fallopian tubes and the pelvic and abdominal cavity during menstruation (termed retrograde menstruation). The cause of retrograde menstruation is not clearly understood. But retrograde menstruation cannot be the sole cause of endometriosis. Many women have retrograde menstruation in varying degrees, yet not all of them develop endometriosis

Another possibility is that areas lining the pelvic organs possess primitive cells that are able to grow into other forms of tissue, such as endometrial cells. (This process is termed coelomic metaplasia.)

It is also likely that direct transfer of endometrial tissues during surgery may be responsible for the endometriosis implants sometimes seen in surgical scars (for example, episiotomy or Cesarean section scars). Transfer of endometrial cells via the bloodstream or lymphatic system is the most likely explanation for the rare cases of endometriosis that develop in the brain and other organs distant from the pelvis.

Finally, some studies have shown alternations in the immune response in women with endometriosis, which may affect the body's natural ability to recognize and destroy any misdirected growth of endometrial tissue.

What are endometriosis symptoms?

Most women who have endometriosis, in fact, do not have symptoms. Of those who do experience symptoms, the common symptoms are pain (usually pelvic) and infertility. Pelvic painusually occurs during or just before menstruation and lessens after menstruation. Some women experience pain or cramping with intercourse, bowel movements and/or urination. Even pelvic examination by a doctor can be painful. The pain intensity can change from month to month, and vary greatly among women. Some women experience progressive worsening of symptoms, while others can have resolution of pain without treatment.

Pelvic pain in women with endometriosis depends partly on where the implants of endometriosis are located.

  • Deeper implants and implants in areas with many pain-sensing nerves may be more likely to produce pain.
  • The implants may also produce substances that circulate in the bloodstream and cause pain.
  • Lastly, pain can result when endometriosis implants form scars. There is no relationship between severity of pain and how widespread the endometriosis is (the "stage" of endometriosis).

Endometriosis can be one of the reasons for infertility in otherwise healthy couples. When laparoscopic examinations are performed for infertility evaluations, endometrial implants can be found in some of these patients, many of whom may not have painful symptoms of endometriosis. The reasons for a decrease in fertility are not completely understood, but might be due to both anatomic and hormonal factors. The presence of endometriosis may involve masses of tissue or scarring (adhesions) within the pelvis that may distort normal anatomical structures, such as Fallopian tubes, which transport the eggs from the ovaries. Alternatively, endometriosis may affect fertility through the production of hormones and other substances that have a negative effect on ovulation, fertilization of the egg, and/or implantation of the embryo.

Other symptoms related to endometriosis include:

  • Lower abdominal pain
  • Diarrhea and/or constipation
  • Low back pain
  • Irregular or heavy menstrual bleeding
  • Blood in the urine

Rare symptoms of endometriosis include chest pain or coughing blood due to endometriosis in the lungs and headache and/or seizures due to endometriosis in the brain.

pelvic inflammation disease

Pelvic Inflammation Disease

Diagnosis

Symptoms in PID range from subclinical (asymptomatic) to severe. If there are symptoms then fever, cervical motion tenderness, lower abdominal pain, new or different discharge, painful intercourse, or irregular menstrual bleeding may be noted. It is important to note that even asymptomatic PID can and cause serious harm. Laparoscopic identification is helpful in diagnosing tubal disease, 65-90% positive predictive value in patients with presumed PID.[3] Regular Sexually Transmitted Infection (STI) testing is important for prevention. Treatment is usually started empirically because of the serious complications that may result from delayed treatment. Definitive criteria include: histopathologic evidence of endometritis, thickened filled fallopian tubes, or laparoscopic findings. Gram-stain/smear becomes important in identification of rare and possibly more serious organisms

Differential Diagnosis

Appendicitis, ectopic pregnancy, septic abortion, hemorrhagic or ruptured ovarian cysts or tumors, twisted ovarian cyst, degeneration of a myoma, and acute enteritis must be considered. Pelvic inflammatory disease is more likely to occur when there is a history of pelvic inflammatory disease, recent sexual contact, recent onset of menses, or an IUD in place or if the partner has a sexually transmitted infection.

Acute pelvic inflammatory diseaseis highly unlikely when recent intercourse has not taken place or an IUD is not being used. A sensitive serum pregnancy test should be obtained to rule out ectopic pregnancy. Culdocentesis will differentiate hemoperitoneum (ruptured ectopic pregnancy or hemorrhagic cyst) from pelvic sepsis (salpingitis, ruptured pelvic abscess, or ruptured appendix).

Pelvic and vaginal ultrasounds are helpful in the differential diagnosis of ectopic pregnancy of over six weeks. Laparoscopy is often utilized to diagnose pelvic inflammatory disease, and it is imperative if the diagnosis is not certain or if the patient has not responded to antibiotic therapy after 48 hours.

No single test has adequate sensitivity and specificity to diagnose pelvic inflammatory disease. A large multisite U.S. study found that cervical motion tenderness as a minimum clinical criterion increases the sensitivity of the CDC diagnostic criteria from 83% to 95%. However, even the modified 2002 CDC criteria does not identify women with subclinical disease.

Treatment

Treatment depends on the cause and generally involves use of antibiotic therapy. If the patient has not improved within two to three days after beginning treatment with the antibiotics, they should return to the hospital for further treatment. Drugs should also be given orally and/or intravenously to the patient while in the hospital to begin treatment immediately, and to increase the effectiveness of antibiotic treatment. Hospitalization may be necessary if the patient has Tubo-ovarian abscesses; is very ill, immunodeficient, pregnant, or incompetent; or because a life-threatening condition cannot be ruled out. Treating partners for STIs is a very important part of treatment and prevention. Anyone with PID and partners of patients with PID since six months prior to diagnosis should be treated to prevent reinfection. Psychotherapy is highly recommended to women diagnosed with PID as the fear of redeveloping the disease after being cured may exist.It is important for a patient to communicate any issues and/or uncertainties they may have to a doctor, especially a specialist such as a gynecologist, and in doing so, to seek follow-up care.

A systematic review of the literature related to PID treatment was performed prior to the 2006 CDC sexually transmitted infections treatment guidelines. Strong evidence suggests that neither site nor route of antibiotic administration affects the short or long-term major outcome of women with mild or moderate disease. Data on women with severe disease was inadequate to influence the results of the study.

Prevention

  • Risk reduction against sexually transmitted infections through barrier methods such as condoms or abstinence; see human sexual behavior for other listings.
  • Going to the doctor immediately if symptoms of PID, sexually transmitted infections appear, or after learning that a current or former sex partner has, or might have had a sexually transmitted infection.
  • Getting regular gynecological (pelvic) exams with STI testing to screen for symptomless PID.
  • Discussing sexual history with a trusted physician in order to get properly screened for sexually transmitted diseases.
  • Regularly scheduling STI testing with a physician and discussing which tests will be performed that session.
  • Getting a STI history from your current partner and insisting they be tested and treated before intercourse.
  • Understanding when a partner says that they have been STI tested they usually mean chlamydia and gonorrhea in the US, but that those are not all of the sexually transmissible infections.
  • Treating partners to prevent reinfection or spreading the infection to other people.
  • Diligence in avoiding vaginal activity, particularly intercourse, after the end of a pregnancy (delivery, miscarriage, or abortion) or certain gynecological procedures, to ensure that the cervix closes.
dysmenorrhea

Dysmenorrhea

Visualizing the parts of the female reproductive system (see figure), one can systematically formulate a differential diagnosis of this common malady. At the cervix, stenosis, cervical polyps, and other neoplasms may obstruct the egress of blood and induce dysmenorrhea. In the uterus, polyps, fibroids, adenomyosis, and deformities such as anteflexion, retroflexion, anteversion, or retroversion may be the cause. Pelvic congestion syndrome is a possibility. The tubes may be involved by endometriosis, abscess, or ectopic pregnancy. The ovaries may be involved by the same processes as the tubes, but they should suggest the most common cause of dysmenorrhea: hormonal. Thus, any condition—thyroid, pituitary, or ovarian—that might disturb the cyclic output of estrogen and progesterone in the proper sequence may induce dysmenorrhea. Psychogenic disturbances are especially significant.

Approach to the Diagnosis
The clinical approach to dysmenorrhea is simply to rule out significant organic disease by a thorough pelvic and rectal examination. A smear and culture for gonococcus and Chlamydia should be done. A course of contraceptives or progesterone in adequate doses may then be tried. Diuretics may be indicated if examination suggests pelvic congestion. When the aforementioned measures fail, a dilatation and curettage (D & C) may be indicated. A gynecologistmay decide to do a culdoscopy, a peritoneoscopy, or an exploratory laparotomy.
Other Useful Tests

  • Sonogram (pelvic inflammatory disease [PID], ectopic pregnancy)
  • Pregnancy test
  • Fern test and basal body temperature charting (endometriosis)
  • Gynaecology consult
  • Psychiatric consult

pelvic organ prolapse

Pelvic Organ Prolapse

Overview

In pelvic organ prolapse, the vagina and the organs that surround and support it fall from their normal position. Mayo Clinic gynecologists, urogynecologists and reconstructive surgery specialists work closely together to evaluate and treat the different types of pelvic organ prolapse. Correcting this condition usually requires surgery and Mayo's surgeons have extensive experience with these procedures, including minimally invasive surgical techniques.

Diagnosis

Specialists look for symptoms of prolapse, which may include pressure in the vagina or pelvis; a lump or bulge at the opening of the vagina; and urinary, bowel and sexual dysfunction. Diagnostic evaluations include a Q-tip test, bladder function tests and pelvic floor strength tests; doctors may also use imaging tests such as an ultrasound, MRI or cystourethroscopy. Read more about pelvic organ prolapse diagnosis.

Treatment Options

Patients may benefit from a pessary (a device worn in the vagina for support), avoiding heavy lifting, Kegel exercises, estrogen supplementation, electrical stimulation and biofeedback. However, in most cases, surgery is eventually required. Mayo Clinic surgeons use vaginal and abdominal procedures to correct pelvic organ prolapse

urinary incontinence

Urinary Incontinence

Millions of women experience involuntary loss of urine called urinary incontinence(UI). Some women may lose a few drops of urine while running or coughing. Others may feel a strong, sudden urge to urinate just before losing a large amount of urine. Many women experience both symptoms. UI can be slightly bothersome or totally debilitating. For some women, the risk of public embarrassment keeps them from enjoying many activities with their family and friends. Urine loss can also occur during sexual activity and cause tremendous emotional distress.

Women experience UI twice as often as men. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference. But both women and men can become incontinent from neurologic injury, birth defects, stroke, multiple sclerosis, and physical problems associated with aging.

Older women experience UI more often than younger women. But incontinence is not inevitable with age. UI is a medical problem. Your doctor or nurse can help you find a solution. No single treatment works for everyone, but many women can find improvement without surgery.

Incontinence occurs because of problems with muscles and nerves that help to hold or release urine. The body stores urine—water and wastes removed by the kidneys—in the bladder, a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body.

Mothercare Hospital

(A.R.T. - Assisted Reproductive Technology Centre)
(I.V.F. - In-Vitro Fertilization Test Tube Baby )
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Dr.Sada Multi-speciality Hospital



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