Acquired immune deficiency syndrome is more commonly known as AIDS. It is caused by the human immunodeficiency virus (HIV). There are two types of HIV, type 1 and type 2; infection with either form can lead to AIDS, although HIV-2 seems to be a less aggressive form of the virus.

While HIV is infectious, it is not as contagious as some other viruses such as the common cold or influenza. It cannot, for example, be caught simply by touching and normal social contact, and is not spread by coughs and sneezes.

It is usually transmitted by the mixing of body fluids mainly blood, semen, and vaginal secretions. The most common route of transmission is through sexual inter course but it may also be passed on via blood transfusions and the sharing of needles by intravenous drug users.

The virus is also found in saliva and tears, although the concentration of viral particles is too low to be infectious. HIV affects all racial and social groups, as well as both heterosexuals and homosexuals.

AIDS weakens the body’s natural immune system to such an extent that it is unable to fight off opportunistic infections or control cancerous growths. AIDS sufferers often succumb to diseases that rarely cause any illness in the general population.

How Can I Tell IF I AM Hiv Positive?

The body’s response to infection with HIV is to produce antibodies, although they may take up to three months to appear. You would only be identified as HIV positive when antibodies are detected in your blood. For that reason, if you take an AIDS test too soon after possible exposure, it can be negative. It is usually recommended that you take a test about six months after you suspect infection may have taken place.

An HIV-positive person does not necessarily have AIDS, which may take up to ten years to develop, during which time he or she may remain well. It is therefore possible for people to be unaware they are HIV positive and to pass on the virus unknowingly.

Where Did Hiv Come From?

There are many theories about how the virus first entered the human population. HIV probably arose as a variant of a virus affecting Mrican monkeys and apes. It was able to cross over to infect the human population of Mrica, from where it spread to the rest of the world. Although it originally affected the homosexual community in the West, heterosexual transmission is now the main form of transmission worldwide.

How Can I Prevent It?

• The main route of HIV infection is through sex. It may be passed through both vaginal and anal intercourse. Sexual transmission may be prevented, however, by the use of good quality condoms. Spermicides actually kill the AIDS virus so they must always be used.
• Theoretically, sexual intercourse with only one infected individual is enough to pass on the HIV virus. Since it is impossible to tell whether an individual is HIV positive from his or her appearance, precautions must be used with all new sexual partners.
• Intravenous drug users can pass on the virus by sharing needles and syringes, so sharing needles should always be avoided.
• HIV has also been transmitted through infected blood products; the major group to be infected in this way were hemophiliacs. Now, however, all blood products are screened for HIV in most developed countries.
• Transmission from an HN-positive mother to her baby may also occur during pregnancy, birth, or breast-feeding.

Women And HIV

Women need to be assertive in order to protect themselves from HIV. The practice of “safe sex” should be compulsory for everyone until such time as you are able to confirm that your partner is HIV negative. Since it can take up to three months to produce antibodies, it’s best to practice safe sex until this “window of infection” is passed, and it should only be relaxed if your partner does not engage in any other potential high-risk activity such as intravenous drug use or unprotected intercourse with another person.

What Is The Treatment?

• Following a diagnosis of HIV, treatment is begun to try to slow down the rate of viral replication. Various drugs are prescribed to achieve this aim, and different combinations are being researched and developed all the time.
• These treatments have side effects but they do seem to decrease the rate of HIV multiplication in the body.
• Treatment of opportunistic infections depends on the specific agent infecting the patient. High-dose antibiotics and antiviral drugs are often given routinely to prevent an infection from taking hold.

Can HIV/AIDS Be Cured?

• Although the progression of HIV infection to AIDS may be slowed down, there is still no cure for AIDS, nor is there a vaccine to prevent infection with HIY. The problem is compounded because HIV attacks the immune system the route by which the body is usually able to fight infections and cancers. HIV-1 and 2 also seem to consist of various subtypes, which makes the likelihood of finding a universal vaccine remote.
• Death is nearly always due to over-whelming pneumonia or Kaposi’s sarcoma. The brain may be affected terminally giving rise to an illness resembling dementia.

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These are benign tumors in the muscle lining the uterine wall. They vary in size and number; they can be anything from the size of a pea to as large as a tennis ball. About one woman in five develops fibroids by the time she is 45 years old.

There is often no reason for concern because the fibroids may never grow large enough to distort the uterus and present symptoms to alarm you. However, if you are having difficulty in conceiving, they may be interfering with your fertility by blocking the fallopian tubes. Large fibroids cause the muscular coating of the uterus to feel lumpy and bumpy to the doctor when he examines your abdomen during routine pelvic examinations.

Should I See The Doctor?

If you are having difficulty conceiving, if you have increasing pain or bleeding with your menstrual periods, or if you have any other change in your normal cycle, see your doctor at once.

What Might The Doctor Do?

• Your doctor will first perform a routine pelvic examination and question you about any symptoms you may have experienced.
• If she feels that your condition warrants it, she may then refer you to a gynecologist for further investigation and tests, which will probably include an ultrasound scan of your uterus or a laparoscopy.

What Is The Treatment?

• Fibroids are treated according to the seriousness of the symptoms and whether you wish to conceive. Once you are past child bearing days, the fibroids usually shrink and disappear anyway.
• If you want children and the fibroids are numerous, your doctor may suggest a myomectomy. This removes the fibroids from the uterine lining and leaves the uterus intact and back in its usual shape.
• If the symptoms are difficult and you do not plan to get pregnant in the future, a hysterectomy might be advised. This should be considered as a last resort and only after at least two opinions and discussion with your doctors.
• Antiestrogen hormone treatments may be given. These make fibroids shrink, but can only be given for a period of six months because of the risk of osteoporosis, and are only given before a myomectomy.

What Can I Do?

• Fibroids are the most common reason for hysterectomy operations in the United States , so make sure your condition requires an operation of such a radical nature. If you are suffering from profound anemia, or have unbearable symptoms, obviously you should consider it; otherwise, you should look for alternatives.
• There is a high incidence of uterine cancer in women who suffer from benign fibroids, so any unusual bleeding or other irregularity in your menstrual pattern should be investigated immediately.

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Strictly speaking, menopause is your last menstrual period, but you only become aware of this in retrospect, when you haven’t had a period for a year. The average age of menopause in this country is 52, although it is not unusual to experience it during your early 40s or mid-50s.

Stages of Menopause

Menopause is also sometimes called the “climacteric.” It encompasses three distinct stages: premenopause, the beginning of the climacteric (usually the early 40s) when periods may become heavy or irregular; perimenopause, the stage (usually a few years) on either side of your last period when physical symptoms such as hot flushes begin and periods become more irregular; and postrnenopause, which encompasses the rest of your life, after your periods stop.

Can I Predict My Menopause ?

Most menstrual periods stop gradually. A few years before menopause, they may become irregular: you have them for several months then skip a month or two, then start again, with the interval between becoming longer and longer until eventually they stop completely. If you are over 50 and have not had a period for over six months, you have probably reached menopause.

There is no way that you can predict when your last period will be. The age at which you first menstruated could be significant, and the earlier you start, the later you finish. The age at which your mother experienced menopause may also affect when you have yours, although this is difficult to prove. Whether you took the oral contraceptive pill and the age at which you had your first and last child do not affect the timing.

It seems most likely that each one of us has our own built-in biological clock that dictates both when we start to menstruate and when we stop, although a variety of physical factors including diet, smoking, and obesity can either slow the clock down or speed it up.

Premature Menopause

A premature natural menopause, which occurs before the age of 35, is very rare, affecting less than one percent of women. Surgical removal of the ovaries (oophorectomy) is the most common cause of premature menopause and is carried out for a variety of reasons, such as a ruptured ectopic pregnancy or ovarian cancer. It is usually done as part of a total hysterectomy, which entails removal of both the ovaries, the fallopian tubes, and the uterus. Other factors that can cause an artificial menopause include radiation therapy (for stomach and pelvic cancers and, rarely, mumps).

For natural menopause, hormone replacement therapy is given immediately to offset possible problems arising from the earlier-than-usualloss of estrogen. Estrogen replacement therapy is used if the uterus has been removed.

Late Menopause

Anyone still menstruating after the age of 55 is considered to have a late menopause. Late menopause can have health consequences, too, since your body is exposed to estrogen for longer than normal, which, theoretically, carries a slightly increased risk of uterine and breast cancer. You can protect yourself against this risk by making sure that you receive regular mammograms and pelvic examinations.

What Happens During The Climacteric?

Many women experience the symptoms of estrogen deficiency during the time that menstruation begins to decline. Periods become less and less frequent and then menstruation finally stops. Old-fashioned phrases like the “change of life” imply that menopause means an unavoidable decline in life. This is not so. In fact, most women find that life improves.

What Causes Menopausal Symptoms?

The decline in monthly menstrual periods is only a symptom of a parallel decline in the production of female hormones, particularly estrogen, by your body. What started at puberty with a first period and a change in your physical shape, now wanes as ovarian activity falls off and you fail to ovulate. Nearly all the symptoms of menopause may be attributed to these decreasing levels of estrogen in your blood.

Should I See The Doctor?

Three out of four menopausal women have symptoms that are worth treating and that should be treated. Don’t grin and bear it. Decide to have the menopause you want, and seek medical advice and treatment. Don’t ignore self-help remedies: there are many to try (see overleaf). By far the most common menopausal symptoms are hot flushes, night sweats, and vaginal dryness; these can lead to other symptoms, such as insomnia and reduced sexual desire.However, if any of the symptoms trouble you, make sure that you see your doctor immediately. It is never normal to have frequent heavy or painful periods nor to pass blood clots during menopause, so do consult your doctor if you experience any of these symptoms.

What Might The Doctor Do?

By far the majority of women manage to cope with menopause reasonably easily. Because of the unsympathetic attitude of some male doctors, however, many women view it as something to be suffered and not worth treating. This is not so. Hormone replacement therapy can replace the estrogen deficiency so that the symptoms disappear. HRT is more than 90 percent effective. If you feel your doctor isn’t being very helpful or sympathetic, or wont let you try hormone replacement therapy, go to another doctor.

With the end of the protective effects of female hormones, women are at equal risk with men from heart disease. Plenty of exercise and a low-fat diet with healthy combinations of foods will help to keep this problem at bay. Some emotional problems cannot be treated with hormone therapy alone and your doctor may prescribe tranquilizers and counseling to get you through the roughest patch.

Are There Natural Remedies?

You don’t always have to rely on medical doctors. Complementary therapies, such as homeopathy, aromatherapy, herbalism, yoga, and massage, all offer treatments for menopausal symptoms.

Homeopathic remedies

Many women consult homeopathic practitioners to relieve menopausal symptoms. Remedies administered in minute doses include Lachesia for hot flushes; Pulsatilla for insomnia, premenstrual syndrome, and joint pain; Sepia for dry vagina, thinning hair, and prolapse; Sulfur for itchy vulva and skin; Bryonia for PMS and breast pain; and Belladonna for night sweats.

Aromatherapy remedies

Essential oils from certain flowers and plants are also believed to relieve symptoms. Oils from cypress, geranium, and rose are recommended for heavy menstrual periods; avocado and wheatgerm for dry skin; juniper, lavender, and rosemary for muscle and joint pain; lavender and peppermint for headaches; basil for fatigue; neroli and lavender for insomnia; lemon-grass for premenstrual syndrome; and clary sage and rose for depression.

Guidelines for taking herbs

If you’re interested in herbal remedies, consult a trained herbalist, but also bear the following points in mind:

• Always use herbs in moderation.
• Stop using them if you experience any side-effects.
• Assess each herb’s efficacy over a week or so.
• Start by taking an herb in tea form. Increase the amount from half a cup a day to several cups over a period of a week.
• If you’re taking medication, check with your doctor before taking an herbal remedy.
• Don’t defer seeking medical advice because you are using an herbal remedy.

What Can I Do?

A good diet is as important in maintaining health during and after menopause as at any other time of your life. In particular, calcium levels and vitamin D need to be kept up after menopause to avoid thinning and brittle bones a condition that can lead to osteoporosis.

Never view yourself as over the hill. Keep up your self-respect and self-assurance with your work, or retrain or get involved in voluntary activities. This is often the time in your life when your children leave home, adding extra stress when you may be least capable of coping with it.

On the other hand, many women experience a new lease on life once they are freed of reproductive responsibilities. We hear all the time about women who really come into their own in middle age. Those women who have a positive view of menopause suffer fewer symptoms less seriously. Remember that it marks the end of one phase of your life and the beginning of another. It should not be a time for sadness and regret; in fact, it should be a time for looking forward to enjoying new interests and new experiences.

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Amenorrhea is the medical term for an absence of menstrual periods. It is described as primary if they have never started, and secondary, when normal menstruation is interrupted for four months or more. Amenorrhea does not necessarily mean you are ill; it does usually mean that you are not producing eggs and so cannot conceive.

What Causes It?

Primary amenorrhea is usually due to late onset of puberty, although it can also be caused by a disorder of the reproductive or hormonal system. The most common reason for secondary amenorrhea is pregnancy. If the hormonal balance is interrupted for any other reason, however, menstrual periods may stop. So, for example, many women who breast-feed find that their periods do not start again until they wean their babies.

More seriously, amenorrhea can be a side effect of being grossly underweight, such as with anorexia nervosa. This will be suspected if your weight is as much as 26lb (12kg) below average for your height and frame. Stress, chronic ailments such as thyroid disease, and long-term medication with drugs such as tranquilizers and antidepressants can also cause amenorrhea, as can excessive physical training.

Amenorrhea is, of course, a permanent condition after menopause, or if you undergo a hysterectomy with removal of your ovaries.

Should I See The Doctor?

The tendency to start menstruation late may be inherited, so if your mother started her periods late, don’t worry if you aren’t developing at the same rate as your friends. However, if you are 16 and have not yet menstruated, contact your doctor to check that there is no abnormality. If your periods suddenly stop, pregnancy could be the cause, so do a pregnancy test first before contacting him. See your doctor if your periods have been absent for six months and you are not pregnant or menopausal.

What Might The Doctor Do?

• If you have never had a menstrual period, your doctor will probably give you a physical examination and take a blood sample to measure the level of pituitary hormones. (The pituitary hormones include those responsible for menstruation.)
• With secondary amenorrhea, once pregnancy is excluded, you should receive a full medical examination by a specialist, and if you are taking any long-term medications, these should be checked out and stopped if necessary.
• Your doctor may arrange for you to have an X ray to make sure that your pituitary gland is healthy.
• If you are not ovulating, and not pregnant, he may suggest that you take a course of fertility drugs or pituitary hormones.

What Can I Do?

• The lack of periods is not dangerous and in most cases there is no cause for alarm; be patient and they will start up naturally.
• You may need to change your lifestyle to correct any dietary or physical problems, if these are the cause.

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The medical term for the beginning of menstruation is menarche. The advent of menarche (usually about the age of 12 in developed countries) signals that a girl is entering her fertile life. Cyclical female hormone production starts and ovulation each month is a possibility, although few girls ovulate consistently in their first year or two of menstruation.

After ovulation, progesterone begins to show its effects. Vaginal secretions become thicker, opaque, more rubbery, and definitely have a fishy odor. The breasts enlarge, become heavy and tender, and toward menstruation the nipples may tingle and feel sore. This is perfectly normal and the effects subside on or before the beginning of bleeding. Progesterone can cause acne like spots on the face at this time of the month, and very few of us escape without having one or two of these at some point in our lives. They should disappear when the menstrual period starts.

Harmonal Effects

Hormone production is not smooth in the beginning and may result in peaks and valleys, explaining why a teenage girl can become rebellious, moody, confused, and mixed up. It also leads to the maturing of a girl’s body and the appearance of adult characteristics, such as breasts and pubic hair.

The regular production of female hormones results in various changes in our bodies throughout the month. In the first half of the cycle, estrogen is produced, which makes the skin bloom and raises our mood so that we feel that we can tackle anything. It also affects the appearance of vaginal discharge prior to ovulation; at this time of the month it is thin, clear, and runny, with very little odor.

Menstrual Problems

Most of the time, monthly periods follow a predictable pattern. For most women some of the time, however, problems can and do occur, particularly during the early years of menstruation and in the premenopausal years, as the body prepares itself for menstruation to cease. Disorders can range from premenstrual syndrome (which about 75 percent of us suffer from at one time or another in our lives) to painful periods (dysmenorrhea).

Menstrual Hygiene

Menstruation is no longer the taboo subject it once was. When I was young, it was said that young girls shouldn’t wash their hair or bathe during menstruation because the blood might go to the brain. This is nonsense, and the general rule should be to bathe as often as you want to, or at least shower or spongebathe, so that you feel comfortable. Wash yourself with ordinary soap and water.

For protection, some girls prefer to use sanitary napkins and these are ideal to begin with, but you might also want to consider tampons, which can be more comfortable, hygienic, and discreet. One good way to experiment with tampons is to try them at the same time as a friend. I remember doing so with one of my college friends as we stood in adjacent toilets and gave running commentaries to each other on our progress. If you do use tampons, don’t forget about them; they should be changed every four to six hours.

Menstruation And Sex

To protect yourself from sexually transmitted diseases, it is best to use a condom when having intercourse with any new partner, but it is even more important during menstruation. This is because blood-borne viruses such as HN, hepatitis B, and hepatitis C are transmitted more easily by unprotected sex during menstruation than at any other time of the month.

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