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Definition of Terms
Menstruation
Menarche
Menopause
Outline
Cycle Abnormalities and Disorder
Ovulation
Oligoovulation
Anovulation
Menstruation
Hypomenorrhea
Polymenorrhea
Metrorrhagia
Menorrhagia
Oligomenorrhea
Amenorrhea
Menstruation
The
terms
"menstruation"
and
"menses"
are
derived
from
theLatinmensis(month), which in turn relates to theGreek mene(moon).
menstrual bleeding,menses,catameniaor aperiod.
The flow of menses normally serves as a sign that a woman is not pregnant.
Eumenorrhea
denotes normal, regular menstruation that
lasts for a few days (usually 3 to 5 days, but
anywhere from 2 to 7 days is considered
normal).
The
averageblood
lossduring
menstruation is 35 milliliters with 1080
ml considered normal.
Menarche
The beginning of the menstrual function
The average age of menarche in humans
is 1213 years, but is normal anywhere
between ages 8 and 16.
Factors such as heredity, diet and overall
health can accelerate or delay menarche.
Menopause
The cessation of menstrual cycles at the end of a
woman's reproductive period .
The average age of menopause in women is 52 years,
with anywhere between 45 and 55 being common.
Menopause before age 45 is consideredprematurein
industrialized countries.
The age of menopause is largely a result of genetics;
however, illnesses, certain surgeries, or medical
treatments may cause menopause to occur earlier.
Menstrual cycle
thephysiological changes that can
occur
in
fertilewomenfor
the
purposes
of
sexual
reproductionandfertilization
under the control of theendocrine
system, necessary forreproduction
Ovulation
In crease levels of Luteinizing Hormone
Matures the egg and weakens the wall of the
follicle in the ovary, causing the fully developed
follicle to release itssecondary oocyte
The secondary oocyte promptly matures into
anootidand then becomes a matureovum. The
mature ovum has a diameter of about 0.2mm.
Which of the two ovariesleft or rightovulates
appears essentially random; no known left and
right co-ordination exists.[Occasionally, both
ovaries will release an egg; if both eggs are
fertilized, the result isfraternal twins
Ovulation
After being released from the ovary and into the peritoneal
space, the egg is swept into thefallopian tubeby thefimbria,
which is a fringe of tissue at the end of each fallopian tube.
After about a day, an unfertilized egg will disintegrate or
dissolve in the fallopian tube.
Fertilization by aspermatozoon, when it occurs, usually takes
place in theampulla, the widest section of the fallopian tubes.
A
fertilized
egg
immediately
begins
the
process
ofembryogenesis or development. The developing embryo
takes about three days to reach the uterus and another three
days to implant into the endometrium. It has usually reached
theblastocyst stage at the time of implantation.
In some women, ovulation features a characteristic pain
calledmittelschmerz
(German
term
meaningmiddle
pain).The sudden change in hormones at the time of
ovulation sometimes also causes light mid-cycle blood flow.
Ovulation
Luteal phase
secretory phase
after ovulation, theres a significant production of Progesterone
Progesterone plays a vital role in making theendometrium
receptive toimplantationof theblastocystand supportive of the
early pregnancy; it also has the side effect of raising the woman's
basal body temperature .
After ovulation, thepituitary hormonesFSH and LH cause the
remaining parts of the dominant follicle to transform into the
corpus luteum, which produces progesterone. The increased
progesterone in the adrenals starts to induce the production of
estrogen. The hormones produced by the corpus luteum also
suppress production of the FSH and LH that the corpus luteum
needs to maintain itself. Consequently, the level of FSH and LH fall
quickly over time, and the corpus luteum subsequently atrophies.
Important to remember
women arefertilefor about 2448 hours
around the time of ovulation.
Progesterone levels remain high unless the
egg goes unfertilized, in which case the egg
is re-absorbed and progesterone levels fall.
In this event, progesterone levels continue to
fall until day 28, when progesterone reaches
its lowest level, menstruation occurs, and the
cycle repeats. This turning point almost
always occurs 14 days after ovulation.
Review
Denotes normal, regular menstruation
that lasts for a few days (usually 3 to 5
days, but anywhere from 2 to 7 days is
considered normal).
Eumenorrhea
The averageblood lossduring
menstruation
35 milliliters with 1080 ml
considered normal
Review
beginning of the menstrual function
Menarche
The cessation of menstrual cycles at the
end of a woman's reproductive period .
Menopause
thephysiological changes that can occur
in fertilewomenfor the purposes of
sexual reproductionandfertilization
Menstrual Cycle
Review
The lining of the uterus grow
Follicular
Increase levels of Progesterone
Luteal
increased libido
ovulation
Experience middle pain
Ovulation
Review**
Increase estrogen
Follicular
Decrease FSH
Luteal
increased LH
ovulation
It causes light mid cycle blood flow
Ovulation
Question
Whats the Essence
of being a woman?
Infertility
means not being able to get
pregnant after one year of trying or,
six months, if a woman is 35 or older.
women who can get pregnant but are
unable to stay pregnant may also be
infertile.
varicocele (VAIR-ih-koh-seel).
- This happens when the veins on a
man's testicle(s) are too large. This
heats the testicles. The heat can
affect the number or shape of the
sperm.
Drugs
Toxin
Smoking
Radiation
Mumps
age
stress
poor diet
athletic training
beingoverweightor underweight
smoking
excess alcohol use
sexually transmitted infections (STIs)
health problems that cause hormonal changes,
such as polycystic ovarian syndrome and
primary ovarian insufficiency
Hysterosalpingography (HIS-tur-oh-sal-ping-GOGHru-fee):
This is an X-ray of the uterus and Fallopian tubes.
Doctors inject a special dye into the uterus through
the vagina. This dye shows up in the X-ray. Doctors
can then watch to see if the dye moves freely
through the uterus and Fallopian tubes. This can
help them find physical blocks that may be causing
infertility. Blocks in the system can keep the egg
from moving from the Fallopian tube to the uterus.
A block could also keep the sperm from reaching
the egg.
Laparoscopy (lap-uh-ROS-kuhpee):
A minor surgery to see inside the
abdomen. The doctor does this with a
small tool with a light called a laparoscope
(LAP-uh-roh-skohp). She or he makes a
small cut in the lower abdomen and inserts
the laparoscope. With the laparoscope, the
doctor can check the ovaries, Fallopian
tubes, and uterus for disease and physical
problems. Doctors can usually find scarring
and endometriosis bylaparoscopy.
Gonadotropin-releasing
hormone
(Gn-RH)
analog:These medicines are often used for women who
don't ovulate regularly each month. Women who ovulate
before the egg is ready can also use these medicines. GnRH analogs act on the pituitary gland to change when the
body ovulates. These medicines are usually injected or
given with a nasal spray.
Metformin (Glucophage):Doctors use this medicine for
women who haveinsulin resistanceand/or PCOS. This drug
helps lower the high levels of male hormones in women
with these conditions. This helps the body to ovulate.
Sometimes clomiphene citrate or FSH is combined with
metformin. This medicine is usually taken by mouth.
Bromocriptine (Parlodel):This medicine is used for
women with ovulation problems due to high levels of
prolactin. Prolactin is a hormone that causes milk
production.
Remember
Many fertility drugs increase a
woman's chance of having twins,
triplets, or other multiples. Women
who are pregnant with multiple
fetuses have more problems during
pregnancy. Multiple fetuses have a
high risk of being born too early
(prematurely). Premature babies are
at a higher risk of health and
developmental problems.
Review
Infertility means not being able to get
pregnant after one year of trying or, six
months, if a woman is 35 or older.
True
What causes infertility in men?/women?
What increases a mans risk of
infertility?/ women?
How does aging affect a womans
chance of having a baby
Review**
What are the common tests of
fertility in women?
What medicines are used to treat
infertility in women?
What is the side effect of fertility
drugs?
Description:
OVA-MIT belongs to the triphenethylene
clans of compound derived from
diethylstilbetrol which displays a variety of
estrogenic and anti-estrogenic activities.
OVA-MIT is used primarily in ovarian
stimulation in female infertility due to
anovulation (e.g. due to polycysticovarian
syndrome).
Pharmacological Effects:
OVA-MIT competitively blocks estradiol binding to
its receptor but the specific pharmacological
activity it produces depends upon the specific
tissues and the cellular end point measured.
Initial animal studies with clomiphene citrate
showed slight estrogenic activity, but the most
striking effect was the inhibition of the pituitarys
gonadotropic function. In both male and female
animals, Clomiphene citrate acted as
contraceptive.
MECHANISM OF ACTION:
OVA-MIT Clomiphene citrate binds with
estrogen receptor and prevents the binding
of estrogens.
OVA-MIT stimulates ovulation in women
with an intact hypothalmic-pituitary-ovarian
axis and adequate endogenous estrogens
who have failed to ovulate.
OVA-MIT also has been used in men to
stimulate gonadotroropin release and
enhance spermatogenesis.
Clomiphene Citrate
OVA-MIT
Composition:
50 mg Clomiphene Citrate
Action:
- a non-steroidal agent that stimulates pituitary
gonadotropic hormones, which stimulate the maturation
and endocrine activity of the ovarian follicle
Indications:
- for the treatment of ovulatory failure in women desiring
pregnancy
- oligospermia (low sperm count)
ABSORPTION &
EXCRETION:
OVA-MIT clomiphene citrate is well
absorbed following oral
administration and eliminated
primarily in the feces and to lesser
extent, in the urine.
The half-life is 5-7 days.
DOSAGE &
ADMINISTRATION:
The usual dose of OVA-MIT is 50mg daily for 5
days, starting on or about 5th day of
menstrual cycle or at any time if there is
amenorrhea.
If ovulation does not occur, a course of
100mg daily for 5 days may be given.
In oligospermic patients, recommended
dosage is 25mg once daily for 60-90 days.
CONTRAINDICATIONS:
Patients with liver disease or a history of liver
dysfunction, endometrial carcinoma, or ovarian cyst
(other than polycystic ovary), undiagnossed abnormal
uterine bleeding.
Manufactured by:
Remedica Ltd., Cyprus
Php 99.85/tab
Target Doctors
OB-Gynecologist
Urologist
FM
IM
Comparative Price
Analysis
BRAND NAME
PRICE
PRICE DIFFERENCE
Clomid
244.75
144.90
Clostil
190.00
90.15
Clomiphene Generic
178.50
78.65
Ovamit
99.85
CLOMIPHENE CITRATE
OVA-MIT
50mg tablet
NOW,
PRODUCTIVE
THANK YOU...
PF Rigucira