Diagnosis & Treatment
PMS (Premenstrual Syndrome) Treatment
Premenstrual syndrome (PMS) is a group of symptoms that women commonly experience before their monthly menstrual period, usually going away after the period starts. About 85 percent of women suffer from at least one symptom of PMS during each menstrual cycle, although most cases are fairly mild and may not interfere with a woman's normal activities. Severe cases of PMS may be diagnosed as premenstrual dysphoric disorder (PMDD).
The specific cause of PMS is not known, but it is linked to the hormone changes involved in the menstrual cycle, and can also be affected by stress and emotional problems. While symptoms can vary for each woman, some of the common symptoms of PMS include:
- Breast swelling and tenderness
- Fatigue
- Difficulty sleeping
- Bloating
- Constipation or diarrhea
- Joint or muscle pain
- Acne
- Appetite changes
- Anxiety
- Depression
Women who suspect that they have a severe case of PMS and are seeking medical attention for their condition should monitor symptoms and their severity for a few months to help their doctor accurately diagnose the condition.
There are many treatments currently available for PMS, many of which involve simple life changes. Some of these changes may include calcium supplements, exercising regularly, avoiding salty or sugary foods, managing stress and avoiding smoking. Over-the-counter medications such as ibuprofen or aspirin are often effective in relieving the symptoms of PMS as well. Prescription medication may be prescribed for severe cases of PMS.
Infertility Treatment
The standard definition of infertility is the inability to conceive after 12 months of unprotected sexual intercourse. Today, this has been modified to take age into account, and now women over 35 may be considered infertile if they have failed to conceive after trying for six months.
Infertility means that a couple is not sterile but for some reason has not been able to conceive a child. Once a couple is diagnosed as infertile, the doctor will perform tests to determine the cause or causes. Then treatment can begin. Today’s technology often allows even truly infertile couples to conceive a child, sometimes with the assistance of a third party donor or surrogate.
People who consider undergoing IVF or other assisted reproductive techniques (ART) often do so after they have failed to conceive for 12 months. Others who have known risk factors for infertility or for having a child with a genetic disorder seek treatment sooner.
Reasons for this include:
Single women and same-sex couples may also seek professional assistance when attempting to conceive a child.
Infertility Evaluation
There are three conditions that need to be met for conception to be possible: sperm must be present, the fallopian tubes must be open, and ovulation must be able to occur. If one or more of these conditions is compromised, the couple suffers from “true infertility.” If all three conditions are met but the couple has failed to conceive, the diagnosis is ”sub-fertility.”
Initial evaluations are individually tailored to each patient and couple, but there are a few standard tests performed to evaluate these three critical factors. These include measurements of the hormones that regulate ovulation and egg quality, imaging tests of the fallopian tubes, and semen analysis (volume, sperm count, motility and morphology).
For about 10-20% of infertile couples, even with a thorough evaluation a cause for infertility can’t be determined. This is called “unexplained infertility” and may be caused by intermittent symptoms such as irregular ovulation or variable sperm count, or by other factors that we don’t yet understand or can’t test for. Some couples with unexplained infertility successfully conceive after treatment or even without treatment.
Male Infertility
About half of all infertile couples suffer from one or more compromised factors in the male partner. For this reason, during the initial evaluation the male partner (if there is one) will be tested for sperm production and health, including sperm count, motility and morphology; semen volume and viscosity; antibody and white blood cell count; physical abnormalities (azoospermia, blocked epididymis); and other factors that might affect the sperm’s ability to penetrate the egg. In some cases a biopsy of the testicle may be necessary. If a problem is found, treatment may involve sperm retrieval, surgery or donor insemination.
Treatment
For most patients, medical or surgical treatment improves fertility enough for conception to be successful. Treatment plans are designed to enhance some fertility factors and bypass others in an attempt to maximize the couple’s fertility potential. The three levels of treatment are:
