Female sterility or infertility is more and more widespread in France, an increase over 20 years due in particular to environmental and behavioral factors. We take stock with Dr. Juan Berrocal, gynecological surgeon.

Definition: what is female infertility?

” Female infertility refers to the inability of a woman to procreate subject to having full, regular sex (two to three times a week) and without contraception within 12 to 24 months “, explains Dr. Juan Berrocal, gynecological surgeon. This term is relatively aggressive, some prefer to use the infertility infertility, or hypo-fertility. Naturally, a woman is fertile in a variable way according to her age . Fertility increases until the age of 25 and then stabilizes.

To start a pregnancy, the woman must have “at least”:

• Regular and good quality ovulation
• A permeable collar and tubes
• Good quality mucus
• A uterine lining (endometrium)
• Contact with sperm …

Causes of female infertility

The main causes can in particular be:

• A genital infection caused by STDs(Chlamydiae, gonococci,) or other types of germs that can affect the cervix (cervicitis) or the tubes (salpingitis).

• Salpingitis, which is acute or chronic inflammation of the fallopian tubes (ducts that connect the ovaries and the uterus), usually caused by infections. In almost half of cases, the infection is triggered by Chlamydiae. Gonococci and mycoplasma germs can also be involved. They cause tubal obliteration directly or through adhesions.
• An ectopic pregnancy (GEU): the aftereffects of an ectopic pregnancy (the tube duct is partially or totally blocked) or the consequences of surgery.
• Endometriosis, which is a gynecological abnormality: the endometrial tissue that lines the lining of the inside of the uterus, normally eliminated during menstruation, is found outside the uterus, for example in the fallopian tubes or of the peritoneum. “This tissue located outside the uterus can create inflammation in the pelvis and can block the tubes or ovaries and prevent fertilization”, insists the doctor.

• Exposure to distilbene can cause an abnormality of the tubes but also malformations of the uterus. Distilbene is a drug prescribed to about 200,000 women between 1950 and 1977. This treatment was then indicated to prevent miscarriages. Following numerous complications, its use was banned in France in 1977. This phenomenon remains exceptional.
• Ovulation disorders: In the event of anovulation, ovulation is completely absent. In case of dysovulation, it is of lower quality. Ovulation disorders involve failure or poor production of a fertilizable oocyte. They are at the origin of most cases of female infertility and concern more than 3 cases out of 10. “ The origin is often an imbalance of hormonal production, whether of ovarian origin such as polycystic ovaries but also of other organs (pituitary, adrenals, thyroid, pancreas.) They can also occur in the event of early menopause “, continues our interlocutor.
• Mechanical sequelae such as, for example, after conization for the treatment of papillomaviruses, in the case of uterine polyp or fibroma or after ovarian surgery (in case of puncture of ovarian cysts for example)
• Other pathologies such as anorexia nervosa , too rapid weight gain or liver, kidney or digestive diseases.

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Cervical mucus abnormalities

Cervical mucus is necessary for the proper functioning of fertilization because it facilitates access to the “best” spermatozoa. During ejaculation, millions of sperm enter the vagina and migrate to the uterine tubes in order to reach the oocyte and fertilize it. The first step is the passage of cervical mucus, secreted via the glands of the cervix. Cervical mucus filters sperm and only allows the most mobile, weak and abnormal to pass through.

Only a few hundred of them will eventually reach the fallopian tubes, where fertilization will take place. Poor quality of cervical mucus can be an obstacle for sperm and be a cause of reproductive difficulties. Knowing that the mucus is different in density depending on the time of the menstrual cycle (at the origin of the so-called Ogino contraception) ” The cervical mucus may be absent, in insufficient quantity, too viscous or gelled. Moreover, it may contain anti-sperm antibodies and destroy them, “observes Dr. Berrocal.

Genetic abnormalities

The Turner syndrome is a chromosomal abnormality (loss of part of a chromosome X) that results in atrophy and malfunction of the ovary.

Allergies to seminal fluid

The allergy to semen (sperm) are rare, but can be a cause of infertility.

Psychological causes?

Apart from any pathological condition, several psychological factors can negatively influence female fertility. The causes may be due to:

• A memory of a painful past event: the anniversary of the death of a loved one, a commemorative date of birth, an old trauma …
• The fear of repeating the mistakes of one’s own parents.
• Guilt felt after a voluntary termination of pregnancy (abortion).
• An unconscious fear of becoming a mother in turn
• Loss of a child
• Having had an unhappy childhood or having been abused by his parents
• About having suffered sexual violence

Age?

In women, fertility decreases from the age of 30. This can be explained by the fact that the eggs produced at this age more frequently have genetic abnormalities. Men over the age of 40 can also have reduced fertility. In men, the maximum fertility rate is 30 to 34 years / Beyond 35 to 40 years, the risks of infertility are increased.

Is it hereditary?

Overall, it can be argued that there is no hereditary infertility in women. In any case, nothing is proven except.

What are the symptoms ?

“Most often there are no symptoms. The infertility of a couple remains in 15% of cases unexplained”, notes the specialist. In some cases, we can see:

• Abnormal menstrual cycles
• Abnormally painful periods
• Painful intercourse

What treatments can be offered?

The treatments offered to depend on the causes of infertility found during medical investigations. Despite the variety of treatments available, some causes of infertility cannot be corrected. ” In women, hormonal treatments for menstrual cycle disorders can be effective, says the gynecological surgeon. Treatments such as clomiphene citrate (Clomid, by mouth) are prescribed to stimulate ovulation. In some cases, surgery may be necessary. If the fallopian tubes are blocked, an operation may remedy this disorder. ” In case of endometriosis, drugs to stimulate ovulation or in vitro fertilization may be necessary to hope to conceive a child.

The assisted reproduction techniques thus reveal sometimes necessary in cases of infertility. In vitro fertilization is the most frequently used technique. The man’s sperm are placed in the presence of the woman’s egg in the laboratory, then the embryo is reimplanted in the uterus of the future mother (IVF).

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Average times to conceive a child

At 25, a couple has an average 25% chance of achieving pregnancy each cycle, with an average time of conception of 3 to 6 months. On average, a couple succeeds in delivering a baby after 6 to 12 months. The percentage of women who have conceived a child:

• After a year of regular intercourse without contraception is 84%
• After 2 years, it is 92%
• Almost 80% of couples naturally conceive a child after 2 years. 60% of couples who experience difficulties conceive a child after 1 year.

For women and men who are at or near their ideal body weight can go out for this procedure. There exists certain localized fats that do not respond to dieting and exercise. The one fit solution for them all is liposuction.

What is Liposuction?

Liposuction is a cosmetic surgical procedure where localized fat is broken up and thus removed from the body. Liposuction is performed by making small incisions on the target area. The fat is then sucked out from here. This is done by means of a suction pump.

What is the recovery time after Liposuction?

Recovery time after liposuction is usually one to two weeks. A total of four months is necessary. After the swelling goes away, one gets to see the actual effects of the surgery. After a year of the surgery the body gets totally comfortable with the changes made.

Is Liposuction Painful?

Liposuction is painful but it is performed under general anaesthesia to ensure that patients don’t feel pain. They also prescribe painkillers for relieving pain after surgery.

Is Liposuction Permanent?

The liposuction procedure permanently removes localized fat. The patient’s body will retain its contour after liposuction, provided the patient does not gain weight.

What is Non-Surgical Liposuction?

Liposuction procedures wherein no incisions are called non-surgical liposuction procedures. These procedures are performed using laser energy, ultrasound, cryotherapy or radiofrequency.

Liposuction Recovery Tips?

Following the doctor’s post-procedure instructions helps patients to recover quickly. These will include taking sufficient rest, taking prescribed anti-biotics and pain-killers and wearing compression garments correctly. Follow the guidelines given by the surgeon and then move on. Also read about – Liposuction Surgery in Raipur

Gynecomastia is a condition in which men or boys start developing breasts also known as man boobs. There are a number of reason that contribute to it. But the prime cause of it is low testosterone levels in men. A hormonal imbalance leads to men developing female-like traits which include the development of breasts.

A swelling in the chest region of boys is seen in gynecomastia. This may happen on either side or both sides of the chest. Testosterone is responsible for male physical features and also affects a man’s sex drive and mood. When there’s an imbalance of the body’s hormones in men, including testosterone, gynecomastia can develop and give rise to man boobs or gynecomastia.

Both low testosterone and gynecomastia are often treatable using medicinal treatment or surgical treatment. The wise way to get this done is by first understanding the underlying causes for each condition.

Understanding low T

Testosterone levels normally decrease as men age. This condition is called hypogonadism, or “low T.” According to the Urology Care Foundation, 1 in 4 men over the age of 45 have low T. Having low testosterone levels can lead to several complications:

• reduced libido
• low sperm count
• erectile dysfunction (ED)
• enlarged male breasts, called gynecomastia

So, aging is the primary factor affecting the level of testosterone in men. As a result of which it is also the major culprit of gynecomastia in men.

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Understanding gynecomastia

The male body produces both testosterone and estrogen, although estrogen is usually found at low levels. Similarly, females also produce both testosterone and estrogen. But they produce estrogen in large quantity. Estrogen is what gives women female characteristics. If a man’s testosterone levels are especially low in comparison to estrogen, or if there is an excess of estrogen activity relative to testosterone, then this get troublesome for him. Then this male is prone to developing man boobs or gynecomastia.

Puberty is one phase in a man’s life when he is prone to develop gynecomastia. There occurs a noticeable change in hormonal activity in the body and gynecomastia may appear. However, it may resolve itself with time and without treatment as it goes away in a few months or weeks on its own. The excess of breast tissue may be equal in both breasts, or there may be more in one breast than the other.

As testosterone levels drop in older men, gynecomastia may develop and persist unless it’s treated. Gynecomastia affects about 1 in 4 men between the ages of 50 and 80. This condition usually isn’t harmful or serious.

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Causes of low T and gynecomastia

Low T is most often simply the result of aging. But underlying health conditions can also be the cause. Other factors that are responsible for causing gynecomastia are as follows-

• damage to cells in the testes that produce testosterone
• an accident
• inflammation (swelling)
• testicular cancer
• cancer treatment, including radiation and chemotherapy
• diseases that affect parts of the brain, such as the hypothalamus and the pituitary gland

Additionally, if you take anabolic steroids, you may also be damaging your body’s ability to manufacture testosterone. Thus, abstain from taking steroids.

Treatment

Treatment for Gynecomastia

Gynecomastia may be treated with medications such as raloxifene (Evista) and tamoxifen (Soltamox). The U.S. Food and Drug Administration (FDA) has approved these medications to treat breast cancer, but not gynecomastia. The use of drugs to treat a condition for which they are not FDA-approved is known as an “off-label” use. Off-label treatments may be safe. But one should talk about the use of these medications with one’s doctor before starting treatment.

There exist surgical solutions too. One can either go for a liposuction or a muscle excision surgery. In liposuction, the excessive fat is removed while in the excision method the muscle is cut and the extra glandular tissue is removed.

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Treatment for Low T

In addition to treating gynecomastia, one must first look forward to treating low T. Testosterone levels in men tend to decline with age. That’s why many older men try testosterone replacement therapy. Treatments are available in a variety of forms:

• skin gels
• patches
• injections

Men who receive testosterone replacement therapy usually have noticeable results. They often experience improvement in:

• energy
• sex drive
• erections
• sleep
• muscle mass

They may also see a positive change in their outlook and mood. In men who have low T, treatment with testosterone replacement therapy can resolve gynecomastia. Thus, surgical methods have a lasting effect on a man’s body and even cures gynecomastia once and for all.

Side effects of treatment

There are potential side effects to testosterone replacement therapy. Men who have breast cancer or prostate cancer should avoid undergoing testosterone replacement therapy. There has been much controversy about the treatment and it may increase the risk of developing prostate cancer.

In addition, it may increase one’s risk for cardiovascular events, lead to obstructive sleep apnea, and may also cause excess red blood cell production. In order to have a detailed analysis, one must sit with one’s doctor and discuss.

Talk with your doctor

One may feel uncomfortable discussing low testosterone and gynecomastia with a doctor but it should not be so.  According to Boston University School of Medicine, 4 to 5 million men in the United States have low testosterone. This shows that this condition is common and one must not be ashamed of it.

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The takeaway

Low T and gynecomastia are common conditions among men, and it shows after aging. Many treatment options are available which includes surgery and medicinal treatment. Discussing treatment options with one’s doctor can be helpful. Taking help from a therapist can also come in handy.  A support group of other men with gynecomastia may provide you some perspective to help cope with the condition as well. One’s quality of life can improve as low T and gynecomastia are all treatable.

Liposuction is a procedure by which one can get rid of excessive fat accumulation in the body. It alone cannot eliminate cellulite. This is because it does not help in tightening loose skin. Thus, a combination of techniques are used to get effective results. This is a quick and easy alternative to a healthy diet.

Liposuction surgery cannot be used to remove visceral fat. So, people out there who are suffering from obesity are not good enough candidates for liposuction.

Customized treatments with different techniques

Traditional liposuction is a technique in which fat is suctioned by negative pressure. It often results in swelling and bruising. The traditional cannulas have a large diameter, so the fat can be removed quickly. But this can make the skin lumpy. They even leave marks.

Power-Assisted Liposuction is one in which fat cells are detached from the surrounding tissue by means of vibrations. It causes much less damage to the surrounding tissues. The recovery period is less here and it is observed to have a less recovery time.

Laser-Assisted Liposuction is also referred to as Smartlipo and is a new technique that uses a laser. The cannula used here is mall and it does not cause much hassle.  Although this technique can cause the skin to somewhat tighten.

Ultrasound-Assisted Liposuction (UAL) is a technique in which fat cells are liquefied. This is done by using ultrasonic waves radiated via a cannula. This treatment is really effective.

Micro Liposuction: This treatment is hardly invasive. This is because it uses a very tiny cannula. This method is primarily used for treating the neckline and jawline of a person.

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Radio Frequency-Assisted Liposuction: It a newer technique in which radiofrequency. It is used to melt the fat and after this very step, the fat is removed. With this method, the skin is tightened. But one drawback of this very technique can cause the skin to droop.

The tumescent technique is a technique in which a large amount of anesthetic solution is injected in the target area. The excessive fat is removed. This causes fewer issues and is really effective. This technique gives a person full authority to carve and sculpt the skin.

Super-wet technique: This technique is similar to the tumescent technique. This technique is used when one needs to carry out a minute change in the overall contour of the body. The best fit technique is decided by the surgeon itself during the consultation period.