Pseudohermaphroditism
Pseudohermaphroditism is the term normally employed to describe people born with secondary sexual characteristics. In this condition of sexual ambiguity, the individual pseudohermaphrodite possesses gonadal tissue of one sex but exhibits external phenotype of the opposite sex. The external sex organs in some of these people look intermediate between the typical vagina or penis. In some others, the appearance is that of an 'opposite' gonadal tissue. Due to this factor, pseudohermaphroditism is difficult to detect until puberty. This is a congenital condition.
The term 'male pseudohermaphrodite' is used when the testis is present; 'female pseudohermaphrodite' is used when the ovary is present. In pseudohermaphroditism the genital and sex determinations are discordant, for instance an apparently female individual may have testes, a male pseudohermaphrodite. Some symptoms of pseudohermaphroditism include, abnormal female external genitalia, enlarged clotoris, fusion of labia and sealed vagina.
In male pseudohermaphroditism, the individual has male chromosomal and gondal gender with female external genitalia. Male pseudohermaphroditism is a defect in the male embryo and usually a genetic deficit in androgen production or action. Accurate diagnosis and careful assessment of all clinical features is vital in treatment of pseudohermaphroditism conditions. The sex hormone binding glubulin suppression test using anabolic steroid is used in confirming the diagnosis. This is performed during the neonatal period. Tests involving administration of gonadotrophic hormones are also useful in determining whether the body can produce testosterone or whether the problem involves ability to use testosterone.
Surgery is sometimes performed to alter the appearance of the genitals. The modern day approach is to delay the surgery and wait for the child to mature in order to express a preference. Hormone therapy, support and counselling are other treatment methods usually employed.
Endometriosis
Endometriosis affects nearly 10% of women during their reproductive years and is a major cause for infertility. This gynecological condition occurs when the tissue lining the uterus (endometrium) grows outside the uterus. The endometrium then grows on the ovaries, fallopian tubes and outer surface of the uterus and even sometimes on the bladder, bowel, intestines, colon, vagina, cesarean and laparoscopy scars. This endometrial growth does not get regularly sloughed off with the menstrual cycle and keeps building up to form ovarian cysts. In fact endometriosis can even cause distortion of a woman's internal anatomy. While the theory of retrograde menstruation holds that some menstrual blood flows back through the fallopian tubes and grows there, it is not yet fully substantiated yet. Some women have a genetic predisposition to endoemetriosis. The role of immune system dysfunction and environmental influence on endometriosis is also being studied.
Severe pelvic pain is the characteristic symptom associated with endometriosis. This pain is felt while passing urine, during sexual intercourse and during ovulation. A woman suffering from endometriosis may notice heavy irregular bleeding and abdominal bloating. Infertility is noticed in more than 40% of women suffering from endometriosis. A pelvic examination is conducted on a woman complaining of symptoms of endometriosis. It can reveal the presence of tender nodules in the ovary regions or the posterior vaginal wall. Pelvic ultrasound is used to locate endometriosis areas. Laparoscopy can aid in checking pelvic organs for endometrial tissue. It gives a clear idea of the extent and location of endometriosis.
Hormone therapy is advocated by some as treatment against endometriosis. Birth control pills or progestins are often prescribed. This may help in tempering the estrogen production and relieving some of the signs and symptoms of endometriosis. Progesterone pills or injections can be used to treat endometriosis. The drug Danazol is also sometimes prescribed. Anti-gonodotropins produce a psedomenopausal state and can relieve some of the problems associated with endometriosis. But treatment of endometriosis with drugs is limited to about six months or so to prevent a detrimental effect on bone density. Laparoscopic surgery is yet another endometriosis treatment advocated by some doctors. The surgeon aims at removing all endometriosis lesions, cysts and adhesions. This is done is severe cases of endometriosis and infertility.
PSA blood test
The Prostrate Specific Antigen (PSA) test enables the medical practitioner to detect prostrate cancer at an early stage. Prostrate Specific Antigen (PSA) is a protein produced in small amounts in the cells of the prostrate gland. A PSA blood test helps to determine whether stage of prostrate cancer is advanced enough to perform a biopsy of the prostrate gland or not. When the prostrate gland enlarges, PSA level in the blood tends to rise. This is indicative of cancer or benign non-cancerous conditions. PSA is called biological marker or tumor. As men age, both benign prostrate conditions and prostrate cancer become more frequent. The most common benign prostrate conditions are prostatitis which is inflammation of the prostrate, and benign prostatic hyperplastia which refers to the enlargement of the prostrate. When the PSA test is combined with rectal examination, 90% of prostrate cancers can be detected. In the U.S., the American Cancer Society recommends PSA blood test at least once a year to avoid the risk of prostrate cancer.
The PSA test has been called the 'male PAP test'. The normal range for a PSA blood test is between 0 - 4 ng/ml (nanograms per milliliter). A PSA level of 4 - 10 ng/ml is considered slightly elevated. Levels between 10 -20 ng/ml are considered moderately elevated. Anything about 20 ng/ml is considered highly elevated. Although the higher the PSA level, the higher the risk of cancer, one abnormal PSA test result does not necessarily mean it is cancer that is present, as various other factors may cause PSA levels to fluctuate.
The PSA test is a radioimmunoassay. In a diagnostic laboratory, the patient's blood sample is exposed to the antibody against PSA. That moment the amount of antigen (PSA) can be measured. It should be borne in mind that a man who is undergoing hormone therapy for prostrate cancer may have a low PSA test reading during or immediately after the treatment. The low level may not be a true measurement of PSA in the patient's body. It is essential that such patients brief the doctor who may probably advise him to wait a few months after hormone treatment before having a PSA test done.
PSA test does not help a man with fast-growing tumors or aggressive cancer. It helps only in detection of small tumor and slow growing tumors which are unlikely to threaten a man's life. PSA test also cannot detect cancers spreading to the other parts of the body beforehand. There is a fear of false positives test results in PSA testing. Sometimes PSA level could be elevated but that does not necessarily mean cancer is present. A fear of false negative test result can also occur in PSA testing. That is the PSA test result will show negative even if prostrate cancer is actually present in the patient. PSA blood test is often followed by other diagnostic tests such as ultrasound, x rays and cystoscopy to determine the presence of cancer or any other problem in the prostrate.
Bibliography / Reference
| 