Women's Reproductive Health: How To Maintain It?

Women's reproductive health is an integral part of the overall health of the body, which implies the absence of diseases of the reproductive system, the ability to reproduce the offspring, as well as the opportunity to live a full sexual life and receive satisfaction from it. Female reproductive health depends on many factors: heredity, lifestyle, occupational hazards, diseases of other organs and systems. In this article, we will examine the main criteria of reproductive health and the factors that affect it.

Factors Affecting Reproductive Health of a Woman

The main criteria for reproductive health are fertility rates, as well as maternal and child mortality. In the modern world, for many years, there has been a trend towards a decrease in the birth rate, a deterioration in the quality of medical care in obstetrics and gynecological hospitals (due to a sharp decline in funding). Women's reproductive health is given special attention since she is born with a set of egg buds, which will gradually mature. They are very sensitive to the action of harmful factors, under the influence of which mutations can pass through the eggs.

Factors that destroy the woman's reproductive health include:

• bad habits (smoking, drug addiction, alcohol abuse);
• sexually transmitted diseases (HIV, chlamydia, gonorrhea, syphilis);
• environmental factors (pollution of the atmosphere, water, soil);
• erratic sexual behavior;
• abortions, which affect the psychological and reproductive health.

Impaired reproductive function in women

The reproductive period of a woman is a segment of life during which a woman is able to conceive, bear and give birth to a child. It is characterized by a monthly maturation of the ovum. In the absence of fertilization, menstruation occurs. Women's reproductive health problems are caused by an increase in the number of gynecological diseases that lead to infertility or miscarriage (spontaneous abortion, undeveloped pregnancies).

We examined the causes that lead to a violation of the reproductive function of women. A healthy lifestyle, correct sexual behavior, prevention of abortion (prevention of unwanted pregnancy) play a big role in maintaining the reproductive health.

Some statistics

Unfortunately, statistics have recently been disappointing. Currently, the younger generation is at risk of developing infertility. This primarily applies to children and adolescents who start early sex, drink alcohol and drugs. In turn, early sexual life leads to the risk of sexually transmitted diseases (STDs), the risk of infection with the human immunodeficiency virus (HIV infection) increases.

Rates of early abortion rates have increased. So, out of 10 pregnancies, 7 ends with abortions, with every 10 abortions performed in girls aged 15-19 years! There is a high incidence of complications after abortion, especially if the first termination of pregnancy is performed at a young age. This leads to diseases of the reproductive system, in particular, the number of menstrual cycle disorders increases, chronic inflammatory diseases of the female sexual sphere appear.

In recent years, the incidence and prevalence of diseases of the circulatory system, nervous system, urogenital organs in future parents have increased.

The number of young girls and boys leading an unhealthy lifestyle is increasing. These are people with tobacco addiction, who use alcohol and drugs, which has a huge negative impact on their reproductive health.

Accepting the statistics, we can conclude that at the beginning of the reproductive (childbearing) period, every teenager already has at least one chronic disease that directly or indirectly affects his reproductive health. And here, as they say, "a healthy tree does not grow from a sick seed", naturally, it is difficult to expect that a healthy child will be born from sick parents.

Therefore, the state of reproductive health is now a subject of interest not only for medicine but for the entire world community since it is directly related to the health of children, and, consequently, to the future of the country. Only by solving the health problem of young people entering the reproductive age can we expect the birth of a healthy generation.

How to maintain the reproductive health?

So, what is needed in order to maintain the reproductive health and be calm for your children even before pregnancy?

1. Safe and effective protection against unwanted pregnancy is necessary. Currently, there is a large selection of contraceptives of both hormonal and non-hormonal nature. The girl who enters into sexual relations should consult a gynecologist about choosing a certain method of contraception. You can buy birth control pills online at mybirthcontrolonline.com;
2. Prevention, timely diagnosis, and treatment of sexually transmitted diseases. The most common is dysbiosis (bacterial vaginosis, urogenital candidiasis), chlamydia, trichomoniasis, and vaginitis, which are often manifested by the syndrome of prolonged copious leucorrhoea. It is inadmissible to engage in self-medication of such diseases since the disease becomes neglected and becomes difficult to cure afterward. Therefore, any woman who has an active sex life must undergo a preventive examination at a gynecologist every six months;
3. Avoid abortion;
4. Timely and correct treatment of chronic diseases of the pelvic organs;
5. Treatment of erosions and pseudo-erosions in girls should be done before pregnancy;
6. Careful planning of pregnancy by both partners;
7. A healthy lifestyle of future parents;
8. Compliance with the rules of personal hygiene in girls and women;
9. Preventative measures to strengthen the immunity of future parents;
10. Balanced nutrition.

It is known that part of the vitamins and trace elements we use are directly related to the reproductive sphere. Here we will talk in more detail about the nutrition of future parents.

What vitamins will help maintain a good reproductive health?

• Vitamin A plays an important role in the synthesis of progesterone, an intermediate product of sex hormones. If the body lacks vitamin A, there is a violation of spermatogenesis in men and a decrease in sexual desire and infertility in women. Sources of vitamin A: butter, egg yolk, liver;
• Vitamin E. The scarcity of this vitamin in the body leads to a reduction in the formation of sperm in men and to uterine dysfunction in women contributes to premature termination of pregnancy. Sources of vitamin E: various vegetable oils, milk, eggs;
• Vitamin C improves the "quality" of sperm and increases the motility of spermatozoa. In healthy testicles, the concentration of vitamin C is high. Clinical studies confirm that using a high dose of vitamin C can cure the common cause of male infertility - sperm agglutination (clumping of spermatozoa). In women, supplementation with vitamin C increases the possibility of conception and reduces the risk of miscarriage during pregnancy and complications of pregnancy. Source of vitamin C: many plant products (blackcurrant, dog rose, gooseberry, citrus);
• Zinc, manganese, selenium. The lack of these elements can lead to a variety of complications of pregnancy, including miscarriage, toxicosis, fetal growth retardation, an increased likelihood of neural tube defects. Sources: green vegetables with leaves, meat, and offal, grains of cereals and legumes, nuts, vegetable oils, eggs, seafood;
• Folic acid is essential for the proper development of the fetus. Deficiency of folic acid in the period before conception and during the first trimester of pregnancy can lead to congenital defects of the fetal nervous system. Sources of folic acid are mainly products of vegetable origin (beans, spinach, asparagus, lettuce);
• Polyunsaturated fatty acids are necessary for the cells of any living organism for their normal vital activity. Unfortunately, the body itself does not produce such acids. Polyunsaturated fatty acids reduce the level of cholesterol, strengthen the immune system and contribute to the proper development of the nervous system of the unborn child. In addition, they play a key role in ovulation, especially during the release of the egg and its readiness for fertilization. Sources: vegetable oils from the ovary of wheat, linseed oil, sunflower, soybeans, peanuts; almonds, avocado, sea fish;
• Iodine is needed primarily for the normal functioning of the thyroid gland, the dysfunction of which leads to hormonal imbalance and may be one of the causes of infertility. During pregnancy, iodine is crucial, especially in the first six months, and therefore it is absolutely necessary to ensure its adequate intake. When a woman lacks this mineral, the child threatens the development of cretinism, which is characterized by mental retardation, deaf-mute, speech impairment, and physical retardation. Iodine is found in seafood;
• Vitamin B6. For some women who have been taking birth control pills for a long time, the ability to conceive is decreased after the end of the treatment. This may be due to a deficiency of vitamin B6, involved in the exchange of estrogens. Vitamin B6 enters the human body with meat, dairy and is synthesized by the intestinal microflora.

Summarizing the above mentioned, I would like to draw attention to the fact that the birth of a child should not be an accident but a regularity based on the preservation of your health, because health is the most important wealth!

Now you know how to properly monitor your health, what you need to pay attention to. I hope that the acquired knowledge will help you to properly maintain your reproductive health. Remember that the health of the future generation depends on you and your way of life!

Amiodarone-induced Hypersensitivity Pneumonitis

Amiodarone, a derivative ofbenzo-furan, has been in wide use since 1967 as an antianginal and antiarrhythmic drug, and its multiple side effects are well known. However and unexpectedly, it is only since 1980 that several dozen cases of lung disease associated with the use of this drug have been reported.

We present here a case of pneumonitis which developed after nine years of treatment with amiodarone. Several biologic findings favor an immunologic origin of the disease (hypersensitivity due to amiodarone).

Case Report

An 81-year-old man complained of loss of weight, fatigue, and effort dyspnea for a few months. In 1954, at age 52, he had had a myocardial infarction. In 1974, at 72, angina and arteritis of the legs were diagnosed and he was treated, irregularly and intermittently, with dipyridamole and pentoxifylline. For the last nine years he had been taking amiodarone regularly (200 to 400 mg per day, cumulative dose 985 g).

Clinical findings were negative except for a few crepitations at the base of the right lung; his general condition was good and temperature normal. The chest x-ray film showed small opacities of the interstitial type disseminated over both lungs, especially at the periphery. The x-ray film in 1972 had been normal. Tests of respiratory function pointed to a purely restrictive syndrome (vital capacity reduced to 83 percent predicted) with a Pa0₂ of 11.2 kFa (84 mm Hg), a slightly increased alveolo-arterial gradient of 3.1 kPa (23 mm Hg) and hypoxia of effort of 9.2 kFa (69 mm Hg); static recoil pressures at 90 and 60 percent of total lung capacity are increased respectively at 18.82 and 2.88 cm H,0 (normal values: 7.75 and 2.74). Results of bronchofiberoscopy were normal. Corneal deposits, detected four years earlier, were seen again with the slit lamp. Sputum and serologic tests for the presence of bacterial, viral or mycotic infection were negative. Tuberculin skin test was negative. Polyclonal hyperglobulinemia was found by electrophoresis and immunoelectrophoresis. Immunoglobulin G levels (radial immunodiffusion) were increased to 21.94 g/L (normal values: 9.50-16.70). Complement and total IgE titers were normal. No auto-antibodies to lung were found by immunofluorescence (negative at titer 1/5).

Ibe patients HLA phenotype was as follows: All, B5; A-, B13. The levels of the angiotensin-converting enzyme in serum and alveolar lavage fluid were normal. The total and differential blood counts were normal, with 7,800 white blood cells, of which 34 percent were lymphocytes (2,652 lymphocytes/pil). Among these, there were 44 percent T helper (1,166/jjlI) and 14 percent T suppressor (371/) lymphocytes with a ratio T helper/T suppressor lymphocytes of 3.18. Bronchoscopy was performed with a flexible fiber-optic instrument (Olympus BF-B3) and bronchoalveolar lavage was performed according to the usual technique using 0.9 percent saline solution until 100 ml were recovered; the alveolar lavage fluid cell count was 150.10³ cells/ml, with 31 percent lymphocytes, 62.5 percent macrophages, and 6.5 percent polymorphs. Helper T lymphocytes were 24 percent and suppressors 48 percent in lavage fluid with an inverted ratio of 0.50.

An intradermal test with 0.10 ml of a solution of 5 mg/ml of amiodarone in benzyl alcohol provoked an erythema of 13 mm with induration at six hours, whereas an erythema of only 6 mm was obtained in two other patients treated with amiodarone, but without pneumonitis. The patients' basophil degranulation test was positive (78 percent) in the presence of400 ng/ml amiodarone. The lymphoblastic transformation test in the presence of 1 M-g/ml of amiodarone was positive in peripheral blood lymphocytes, with a stimulation index of 3.5.

The migration of peripheral blood leukocytes in the presence of 1 jig/ml of amiodarone was inhibited by 45 percent with the capillary tube technique of Soborg and Bendixen. The migration of peripheral blood leukocytes from agarose micro-droplets in the presence of different concentrations (8 logs) of amiodarone was studied with a photoelectric procedure. The percentage migration inhibition was calculated for each antigen concentration as compared to the migration of the same cells in medium without amiodarone. Migration inhibition of 15, 50 and 20 percent was observed at amiodarone concentrations of 0.01 jig, 0.1 (ig and 1 M-g/ml respectively (Fig 1). The leukocyte migration inhibition test with the photoelectric procedure was negative in two other patients under treatment with amiodarone for two years but without pneumopathy.

Discussion

This pulmonary side effect of amiodarone therapy is beginning to become known, but its mechanism is not clear. Fibrosis is generally found on pathologic examination of the lungs,' for which a toxic mechanism has been suggested by some authors. The long half-life (28 days) of amiodarone and its structural similarity to certain antidepressive drugs known to cause “toxic” cellular changes are in favor of this hypothesis.

However, in some cases at least, a hypersensitivity mechanism cannot be excluded for the following reasons. It is well known that fibrosis may be the final stage of an allergic granulomatosis after a relatively long period of contact with the offending antigen (nine years in our patient). Moreover, deposits of the third fragment of complement have been observed in this type of pneumonitis. Furthermore, in our patient, lymphocytosis and inversion of the helper/suppressor ratio in alveolar lavage fluid are good indications of hypersensitivity pneumonitis and have already been described in other drug pneumopathies of this type, as well as in extrinsic allergic alveolitis due to inhaled antigens. The positive late skin reaction and positive lymphoblastic transformation test, and the presence of the lymphokine leukocyte inhibitory factor (LIF) may be suggestive of the presence of cell-mediated hypersensitivity, while the positive basophil degranulation test would suggest concomitant sub-clinical hypersensitivity of the immediate type.

For the clinician, the early diagnosis of amiodarone lung implies the immediate cessation of treatment with the drug and the prescription of corticosteroids for some weeks, which generally leads to cure of the drug-induced pneumonitis. If this lung complication is not diagnosed early enough, death may occur, of which there are a dozen examples in the literature. Half appear to be directly related to the drug.

Pulmonary complications, therefore, should be watched for when long-term treatment with amiodarone is prescribed, with surveillance of these patients at regular intervals.

Figure 1. The inhibition of the migration of peripheral blood leukocytes in presence of different concentrations of amiodarone. The migration of peripheral blood leukocytes from 1 μ  agarose microdroplets was studied with a photoelectric procedure. Percentage of inhibition was calculated as compared to the migration of the same cells in normal medium without amiodarone. Eight logs of concentrations of amiodarone are shown. Concentrations of log 1 (10 ill/ml), or more, are toxic for peripheral blood leukocytes.