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Human Papilloma Virus (HPV)

Definition:
HPV, short for Human Papillomavirus, is a group of over 100 different kinds of viruses, some of which cause warts on the hands and feet and others which cause genital warts and cervical cancer. This health guide is about the sexually transmitted types of HPV. If you are sexually active, or thinking about becoming sexually active, your best protection is to learn the facts about how HPV is spread and how to prevent getting it.
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HPV (Human Papillomavirus) is one of the most common sexually transmitted diseases. There are many different types of HPV and more than 30 are sexually transmitted. Researchers keep track of the different types of HPV by identifying them with numbers, such as 6, 11, 16, and 18.

Some sexually transmitted HPV types may cause genital warts. Persistent infection with “high-risk” HPV types—different from the ones that cause skin warts—may progress to precancerous lesions and invasive cancer. HPV infection is a cause of nearly all cases of cervical cancer. However, most infections with these types do not cause disease.

Some types (such as 6 and 11) cause genital warts, others (such as 16 and 18) cause pre-cancerous changes on the cervix that can later lead to cancer of the cervix. In rare cases, the virus can cause other types of cancers to the vulva, vagina, and anus in girls and the anus and penis in guys.

HPV is passed on through genital contact, usually during vaginal and anal sex, as well as during oral sex. People with weakened immune systems, such as those on chemotherapy or people with HIV are more susceptible to HPV infection.

At least 1 in every 2 sexually active young women has had a genital HPV infection. Any sexually active person—no matter what color, race, gender, or sexual orientation—can get HPV. HPV is mainly spread by sexual contact. Very rarely, a mother who is infected with the HPV virus can infect her newborn baby during the delivery.

Symptoms:
It’s estimated that by the age of 27, most sexually active people have been exposed to some strain of HPV, usually without them knowing, and very rarely do doctors know which strain.

Most people with HPV don’t develop symptoms or further health problems, as in around 90 per cent of cases the body’s immune system has naturally cleared it within two years.

However, certain types of HPV (most commonly strains 6, 11, 16 and 18) can cause genital warts in men and women, while other HPV strains (especially 16, 18 and 39) can cause cellular changes that lead to cancer of the cervix and possibly other less common but serious cancers including:

•vulval cancer
•cancer of the vagina
•cancer of the penis
•anal cancer
•head and neck (tongue, tonsils and throat) cancers
It’s possible to have HPV present years after sexual contact with an infected person, and it’s also possible to be exposed to more than one strain of HPV.

There is currently no easy way to spot which people affected by HPV exposure will go on to develop cancer or other serious health problems.

Very rarely, a pregnant woman can pass HPV to her baby during birth and the child can develop recurrent respiratory papillomatosis – a chronic lung condition where growths block the airways.

Causes:
*The infected area of your body remains totally normal (called latent or inactive infection). You may never know about it, but you may give the infection to others. Your body then usually clears the infection.

*Bumps, called genital warts, can be seen in your genital area. They almost never lead to cancer.

*Changes in the cells of your cervix can result in an abnormal Pap test. Most of the time, if you are a teenager, your body will clear the HPV and the Pap test will become normal again over several years. However, sometimes the HPV infection persists in your cervix which can lead to cervical cancer. This is why your doctor will want to see you for follow-up visits if you have had an abnormal Pap test.

Risk Factors:
*You had sexual contact at an early age.

*Either you or your sexual partners have had many different sexual partners at any time.

*You or any of your sexual partners have had a history of sexually transmitted diseases.

*Any of your sexual partners did not wear a condom.

HPV and cancer risks:
We don’t fully understand the way in which HPV affects cells. Both high-risk and low-risk strains of HPV can cause the growth of abnormal cells, but only the high-risk types of HPV appear to lead to cancer.

Several types of cancer (up to five per cent worldwide), while linked to other risk factors, are now also associated with HPV exposure:

•cervical cancer (the most common HPV-associated cancer)
•vulval and vaginal cancer (40 to 70 per cent linked to HPV)
•penile cancer (possibly 40 per cent linked)
•anal cancer (around 85 per cent linked)
•cancers of the head and neck (although most are linked to tobacco and alcohol use, it’s now thought about 25 per cent of mouth and 35 per cent of throat cancers may be linked to HPV exposure (in particular HPV strain 16)

Diagnosis:
Sometimes it’s hard to know if you have HPV. Although genital warts are usually seen on, around, or inside your vagina or anus, they may be small and hard to see. And you may not have any symptoms such as pain or bleeding.

In March 2003, the U.S. Food and Drug Administration (FDA) approved a test manufactured by Qiagen, which is a “hybrid-capture” test, as the primary screening tool for detecting HPV cervical infection as an adjunct to Pap testing. The test may be performed during a routine Pap smear. It can detect the DNA of the 18 HPV types that most commonly affect the cervix and distinguish between “low” and “high-risk” HPV types, but it cannot determine the specific HPV types.

According to the National Cancer Institute, “testing samples of cervical cells is an effective way to identify high-risk types of HPV that may be present. The FDA has approved an HPV test as a follow-up for women who have an ambiguous Pap test and, for women over the age of 30, for general cervical cancer screening. This HPV test can identify at least 13 of the high-risk types of HPV associated with the development of cervical cancer. The test can detect high-risk types of HPV even before there are any conclusive visible changes to the cervical cells.”

The recent outcomes in the identification of molecular pathways involved in cervical cancer provide helpful information about novel bio- or oncogenic markers that allow monitoring of these essential molecular events in cytological smears, histological or cytological specimens. These bio- or onco- markers are likely to improve the detection of lesions that have a high risk of progression in both primary screening and triage settings. E6 and E7 mRNA detection PreTect HPV-Proofer, (HPV OncoTect) or p16 cell-cycle protein levels are examples of these new molecular markers. According to published results these markers, which are highly sensitive and specific, allow to identify cells going through malignant transformation.

Other testing:
Although it is possible to test for HPV DNA in other kinds of infections, there are no FDA-approved tests for general screening in the United States or tests approved by the Canadian government, since the testing is inconclusive and considered medically unnecessary.

Genital warts are the only visible sign of low-risk genital HPV, and can be identified with a visual check. These visible growths, however, are the result of non-carcinogenic HPV types. 5% acetic acid (vinegar) is used to identify both warts and squamous intraepithelial neoplasia (SIL) lesions with limited success by causing abnormal tissue to appear white, but most doctors have found this technique helpful only in moist areas, such as the female genital tract. At this time, HPV test for males are only used in research.

Treatment:
There is currently no specific treatment for HPV infection. However, the viral infection, more often than not, clears by itself. According to the Centers for Disease Control and Prevention, the body’s immune system clears HPV naturally within two years for 90% of cases. However, experts do not agree on whether the virus is completely eliminated or reduced to undetectable levels, and it is difficult to know when it is contagious.

Health management is based on prevention, by advising condom use and vaccination.

There is treatment for some of the diseases that HPV can cause, including:

•Genital warts, which can be cauterised or treated chemically.
•Abnormal cervical cells, which can be removed by various techniques.

Treatments for genital warts range from acid medicines, to creams, to laser therapy. The treatment will remove visible warts and unwanted symptoms such as itchiness. The type of treatment your doctor recommends will depend on the number, location and size of the warts and the cost and side effects of the different treatments. It’s important to talk with your health care provider about treatment choices and what type of follow-up you will need. Tell your health care provider if you think you are pregnant so that the right therapy is chosen.

Do NOT use over-the-counter “wart medicine” on genital warts. (These medicines are not meant for the very sensitive skin around your genital area).

Prevention:
Condoms offer some protection against genital infection,  but any exposed skin can transmit the virus. In short, condoms are not 100% effective in preventing HPV. Genital HPV infection is the most frequent sexually transmitted disease in the world.

Vaccines:
Two vaccines are available to prevent infection by some HPV types: Gardasil, marketed by Merck, and Cervarix, marketed by GlaxoSmithKline. Both protect against initial infection with HPV types 16 and 18, which cause most of the HPV associated cancer cases. Gardasil also protects against HPV types 6 and 11, which cause 90% of genital warts.

The vaccines provide little benefit to women who have already been infected with HPV types 16 and 18—which includes most sexually active females. For this reason the vaccine is recommended primarily for those women who have not yet been exposed to HPV during sex. The World Health Organization position paper on HPV vaccination clearly outlines appropriate, cost-effective strategies for using HPV vaccine in public sector programs.

Both vaccines are delivered in three shots over six months. In most countries they are approved only for female use, but are approved for male use in countries like USA and UK. The vaccine does not have any therapeutic effect on existing HPV infections or cervical lesions.

Women should continue to seek cervical screening, such as Pap smear testing, even after receiving the vaccine. Cervical cancer screening recommendations have not changed for females who receive HPV vaccine. Without continued screening, the number of cervical cancers preventable by vaccination alone is less than the number of cervical cancers prevented by regular screening alone.

Both men and women are carriers of HPV. Possible benefits and efficacy of vaccinating men are being studied. According to a study by Harvard University Medical School, to vaccinate boys may not be cost effective, especially if a widespread vaccination of girls continues.

No efficacy trials for children under 15 have been performed. Duration of vaccine efficacy is not yet answered by rigorous methodologic trials. Cervarix efficacy is proven for 7.4 years with published data through 6.4 years while Gardasil efficacy is proven for 5 years. Age of vaccination is less important than the duration of efficacy.

Condoms:
The Centers for Disease Control and Prevention says that male “condom use may reduce the risk for genital human papillomavirus (HPV) infection” but provides a lesser degree of protection compared with other sexual transmitted diseases “because HPV also may be transmitted by exposure to areas (e.g., infected skin or mucosal surfaces) that are not covered or protected by the condom.”

Studies have suggested that regular condom use can effectively limit the ongoing persistence and spread of HPV to additional genital sites in individuals who are already infected. Thus, condom use reduces the risk that already infected individuals will progress to cervical cancer or develop genital warts.

Microbicides:
Ongoing research has suggested that several inexpensive chemicals might serve to block HPV transmission if applied to the genitals prior to sexual contact. These candidate agents, known as topical microbicides, are currently undergoing clinical efficacy testing. A recent study indicates that some sexual lubricant brands that use a gelling agent called carrageenan prevent papillomavirus infection in animal model systems. Clinical trial results announced at the 2010 International Papillomavirus Conference indicate that a carrageenan-based personal lubricant called Carraguard is effective for preventing HPV infection in women. The results suggest that use of carrageenan-based personal lubricant products, such as Divine No 9, Bioglide and Oceanus Carrageenan may likewise be effective for preventing HPV infection.

Oral infection:
A review of scientific studies in healthy subjects has found carcinogenic HPV in 3.5% of the studies subjects and HPV16 in 1.3%. Men have higher prevalence of oral HPV than women.

Oral HPV infection is associated with HPV-positive oropharyngeal cancer. Odds of oral HPV infection increases with the number of recent oral sex partners or open-mouthed kissing partners. Nonsexual oral infection through salivary or cross transmission is also plausible

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/hpv.shtml
http://www.youngwomenshealth.org/hpv.html
http://en.wikipedia.org/wiki/Human_papillomavirus

http://www.hivandhepatitis.com/recent/2009/060909_d.html

What are the health consequences of HPV

http://w-cancer.com/anal-cancer/

http://e-cervicalcancer.com/human-papilloma-virus-cervical-cancer/

Enhanced by Zemantahttp://bryanking.net/human-papilloma-virus-hpv/

Female Genital Mutilation

Alternative Names: Female genital cutting (FGC), female circumcision, or female genital mutilation/cutting (FGM/C)

Definition:
Female Genital Mutilation is defined by the World Health Organisation as “all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons”[neutrality is disputed] The term is exclusively used to describe traditional or religious procedures on a minor, which requires the parents’ consent because of the age of the girl.

When the procedure is performed on and with the consent of an adult, it is generally called clitoridectomy, or it may be part of labiaplasty or vaginoplasty. It also generally does not refer to procedures used in sex reassignment surgery, and the genital modification of intersexuals.

It’s one of the most political areas of women’s health. Worldwide it’s estimated that well over 120 million women have been subjected to it. Supporters of the practice say it’s an important part of cultural and religious life, and some compare it to the practice of male circumcision that is more widely accepted in the Western world, but opponents say that not only is it potentially life-threatening – it’s also an extreme form of oppression of women.

In some countries where it’s more widely practised it’s officially illegal – those who persist in the practice in Senegal will now face a prison term of between one and five years, for example. But it’s still carried out quietly, within the family and out of sight of officials.

Female Genital Mutilation is predominantly practiced in Northeast Africa and parts of the Near East and Southeast Asia,It’s also known to take place among immigrant communities in the USA, Canada, France, Australia and Britain, where it’s illegal. In total it’s estimated that as many as two million girls a year are subjected to genital mutilation.

Opposition is motivated by concerns regarding the consent (or lack thereof, in most cases) of the patient, and subsequently the safety and long-term consequences of the procedures. In the past several decades, there have been many concerted efforts by the World Health Organization (WHO) to end the practice of FGM/C. The United Nations has also declared February 6 as “International Day of Zero Tolerance to Female Genital Mutilation“.

Procedures: World Health Organization categorization
FGC consists of several distinct procedures. Their severity is often viewed as dependent on how much genital tissue is cut away. The WHO—which uses the term Female Genital Mutilation (FGM)—divides the procedure into four major types  (you may seethe  Diagram ), although there is some debate as to whether all common forms of FGM fit into these four categories, as well as issues with the reliability of reported data

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Type I:

The WHO defines Type I FGM as the partial or total removal of the clitoris (clitoridectomy) and/or the prepuce (clitoral hood); see Diagram 1B. When it is important to distinguish between the variations of Type I cutting, the following subdivisions are proposed: Type Ia, removal of the clitoral hood or prepuce only (which some view as analogous to male circumcision and thus more acceptable); Type Ib, removal of the clitoris with the prepuce. In the context of women who seek out labiaplasty, there is disagreement among doctors as to whether to remove the clitoral hood in some cases to enhance sexuality or whether this is too likely to lead to scarring and other problems.

Type II:
The WHO’s definition of Type II FGM is “partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora. When it is important to distinguish between the major variations that have been documented, the following subdivisions are proposed: Type IIa, removal of the labia minora only; Type IIb, partial or total removal of the clitoris and the labia minora; Type IIc, partial or total removal of the clitoris, the labia minora and the labia majora.

Type III:Infibulation with excision
The WHO defines Type III FGM as narrowing of the vaginal orifice with creation of a covering seal by cutting and repositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation).” It is the most extensive form of FGM, and accounts for about 10% of all FGM procedures described from Africa.[28] Infibulation is also known as “pharaonic circumcision”.

In a study of infibulation in the Horn of Africa, Pieters observed that the procedure involves extensive tissue removal of the external genitalia, including all of the labia minora and the inside of the labia majora. The labia majora are then held together using thorns or stitching. In some cases the girl’s legs have been tied together for two to six weeks, to prevent her from moving and to allow the healing of the two sides of the vulva. Nothing remains but the walls of flesh from the pubis down to the anus, with the exception of an opening at the inferior portion of the vulva to allow urine and menstrual blood to pass through; see Diagram 1D. Generally, a practitioner recognized as having the necessary skill carries out this procedure, and a local anesthetic is used. However, when carried out “in the bush”, infibulation is often performed by an elderly matron or midwife of the village, without sterile procedure or anesthesia.

A reverse infibulation can be performed to allow for sexual intercourse or when undergoing labor, or by female relatives, whose responsibility it is to inspect the wound every few weeks and open it some more if necessary. During childbirth, the enlargement is too small to allow vaginal delivery, and so the infibulation is opened completely and may be restored after delivery. Again, the legs are sometimes tied together to allow the wound to heal. When childbirth takes place in a hospital, the surgeons may preserve the infibulation by enlarging the vagina with deep episiotomies. Afterwards, the patient may insist that her vulva be closed again.

Women who have been infibulated face a lot of difficulty in delivering children, especially if the infibulation is not undone beforehand, which often results in severe tearing of the infibulated area, or fetal death if the birth canal is not cleared (Toubia, 1995). The risk of severe physical, and psychological complications is more highly associated with women who have undergone infibulations as opposed to one of the lesser forms of FGM. Although there is little research on the psychological side effects of FGM, many women feel great pressure to conform to the norms set out by their community, and suffer from anxiety and depression as a result (Toubia, 1995). “There is also a higher rate of post-traumatic stress disorder in circumcised females” (Nicoletti, 2007, p. 2).

A five-year study of 300 women and 100 men in Sudan found that “sexual desire, pleasure, and orgasm are experienced by the majority (nearly 90%) of women who have been subjected to this extreme sexual mutilation, in spite of their being culturally bound to hide these experiences.”

Type IV:other types
There are other forms of FGM, collectively referred to as Type IV, that may not involve tissue removal. The WHO defines Type IV FGM as “all other harmful procedures to the female genitalia for non-medical purposes, for example, pricking, piercing, incising, scraping and cauterization.” This includes a diverse range of practices, such as pricking the clitoris with needles, burning or scarring the genitals as well as ripping or tearing of the vagina. Type IV is found primarily among isolated ethnic groups as well as in combination with other types

Reasons for female genital mutilation:
The reasons for female genital mutilation include a mix of cultural, religious and social factors within families and communities.

*Many communities may not even question the practice or may have long forgotten the reasons for it. Others, however, assertively justify the practice. For example, mothers who have their daughters circumcised believe they are doing the right thing-because their children would become social outcasts if they did not get circumcised. Another less common reason given for infibulation or excision is decreasing a woman’s sexual desire in order to preserve virginity. Infibulation is intended to dull women’s sexual enjoyment, and it appears to be extremely effective.

*Where FGM is a social convention, the social pressure to conform to what others do and have been doing is a strong motivation to perpetuate the practice.

*FGM is often considered a necessary part of raising a girl properly, and a way to prepare her for adulthood and marriage.

*FGM is often motivated by beliefs about what is considered proper sexual behaviour, linking procedures to premarital virginity and marital fidelity. FGM is in many communities believed to reduce a woman’s libido, and thereby is further believed to help her resist “illicit” sexual acts. When a vaginal opening is covered or narrowed (type 3 above), the fear of pain of opening it, and the fear that this will be found out, is expected to further discourage “illicit” sexual intercourse among women with this type of FGM.

*FGM is associated with cultural ideals of femininity and modesty, which include the notion that girls are “clean” and “beautiful” after removal of body parts that are considered “male” or “unclean”.
*Various works of fiqh (Islamic jurisprudence) support the removal of the female prepuce. For example, the fourteenth-    century text ‘Umdat al-Salik wa-‘Uddat al-Nasik, translated as The Reliance of the Traveller, writes, “Circumcision is obligatory (O: for both men and women). For men it consists of removing the prepuce from the penis, and for women, removing the prepuce (Ar. bazr) of the clitoris (n: not the clitoris itself, as some mistakenly assert). (A: Hanbalis hold that circumcision of women is not obligatory but sunna, while Hanafis consider it a mere courtesy to the husband.)”

*[Muslim 003,0684] […] Abu Masa then said, “When is a bath obligatory?” Aisha responded, “You have asked the right person. Mohammed has said that a bath is obligatory when a man is encompassed by a woman and their circumcised genitalia touch.”

*Religious leaders take varying positions with regard to FGM: some promote it, some consider it irrelevant to religion, and others contribute to its elimination.
Local structures of power and authority, such as community leaders, religious leaders, circumcisers, and even some medical personnel can contribute to upholding the practice.

*In most societies, FGM is considered a cultural tradition, which is often used as an argument for its continuation.

*In some societies, recent adoption of the practice is linked to copying the traditions of neighboring groups. Sometimes it has started as part of a wider religious or traditional revival movement.

*In some societies, FGM is being practiced by new groups when they move into areas where the local population practice FGM

Cultural & Religious Aspects:
A Greek papyrus from 163 B.C. mentions both boys and girls in Egypt undergoing circumcision and it is widely accepted to have originated in Egypt and the Nile valley at the time of the Pharaohs. Evidence from mummies has shown both Type I and Type III FGC present.

Al-Azhar Supreme Council of Islamic Research, the highest religious authority in Egypt, issued a statement saying FGM/C has no basis in core Islamic law or any of its partial provisions and that it is harmful and should not be practiced.”

Coptic Pope Shenouda, the leader of Egypt’s minority Christian community, said that neither the Qur’an nor the Bible demand or mention female circumcision.

Medical Consiquence:
Among practising cultures, FGC is most commonly performed between the ages of four and eight, but can take place at any age from infancy to adolescence. Prohibition has led to FGC going underground, at times with people who have had no medical training performing the cutting without anesthetic, sterilization, or the use of proper medical instruments. The procedure can lead to death through shock from excessive bleeding. The failure to use sterile medical instruments may lead to infections.

Other serious long term health effects are also common. These include urinary and reproductive tract infections, caused by obstructed flow of urine and menstrual blood, various forms of scarring and infertility. Epidermal inclusion cysts may form and expand, particularly in procedures affecting the clitoris. These cysts can grow over time and can become infected, requiring medical attention such as drainage.[39] The first episode of sexual intercourse will often be extremely painful for infibulated women, who will need the labia majora to be opened, to allow their partner access to the vagina. This second cut, sometimes performed by the partner with a knife, can cause other complications to arise.

A June 2006 study by the WHO has cast doubt on the safety of genital cutting of any kind.   This study was conducted on a cohort of 28,393 women attending delivery wards at 28 obstetric centers in areas of Burkina Faso, Ghana, Kenya, Senegal and The Sudan. A high proportion of these mothers had undergone FGC. According to the WHO criteria, all types of FGC were found to pose an increased risk of death to the baby (15% for Type I, 32% for Type II, and 55% for Type III). Mothers with FGC Type III were also found to be 30% more at risk for cesarean sections and had a 70% increase in postpartum hemorrhage compared to women without FGC. Estimating from these results, and doing a rough population estimate of mothers in Africa with FGC, an additional 10 to 20 per thousand babies in Africa die during delivery as a result of the mothers having undergone genital cutting.

In cases of repairing the damage resulting from FGC, called de-infibulation when reversing Type III FGC, this is usually carried out by a gynecologist. See also Pierre Foldes, a French surgeon, who developed modern surgical corrective techniques.

HIV:
Relatively little research has been conducted on the effect female genital alteration may have on HIV prevalence.  Some studies have found increased risk of HIV among women who had undergone FGC. Other studies have found no statistically significant associations, or have identified more complex patterns. Two studies have reported that FGC is associated with decreased risk of HIV.

Kanki et al. (1992) reported that, in Senegalese prostitutes, women who had undergone FGC had a significantly decreased risk of HIV-2 infection when compared to those who had not.  Klouman et al. (2005), studying women in Tanzania, found that among women who had undergone FGC the odds of being HIV positive were roughly twice those among women who had not. However, both HIV and FGC were strongly associated with age; when controlling for age, the association was no longer statistically significant.

Brewer et al. (2007) found that in virgins, FGC was associated with a higher prevalence of HIV infection (3.2% vs 1.4%), which the authors attributed to non-sterile procedures. Among sexually experienced women, FGC was associated with lower HIV prevalence (5.5% vs 9.9%). The authors suggested two possible reasons: that an HIV-specific immunity might be acquired through FGC procedures, and mortality of those infected at the time of FGC would reduce HIV prevalence in surviving adults.  Maslovskaya et al. (2009) found that FGC was associated with higher risk of HIV among women whose first-union partner was younger or the same-age, but it was associated with lower risk of HIV among women whose first-union partner was older than the women herself.  Yount et al. reported that, although FGC and HIV were not directly related, FGC was indirectly related to HIV via a number of associations with other factors, including extra-union partners, early onset of sexual activity, being widowed or divorced, and having an older partner. The authors concluded that FGC “may be an early life-course event that indirectly alters women’s odds of becoming infected with HIV through protective and harmful practices in adulthood”.

Recent reviews have suggested that FGC may increase the risk of HIV.  Several mechanisms have been proposed by which FGC would expose women to greater risk of HIV. These include: non-sterile procedures (Monjok notes that the same instrument is frequently used on 15–20 girls); an increase in blood transfusions due to blood loss during the procedure itself, intercourse, or childbirth; increased anal intercourse due to difficult or painful vaginal intercourse; tearing of the vagina during intercourse;   and increased susceptibility to infectious conditions that are recognised risk factors for HIV, such as genital ulcers

Sexual Effects:
The effect of FGC on a woman’s sexual experience varies depending on many factors. FGC does not eliminate all sexual pleasure for all women who undergo the procedure, but it does reduce the likelihood of orgasm. Stimulation of the clitoris is not solely responsible for the sexual excitement and arousal of a woman during intercourse; this involves a complex series of nerve endings being activated and stimulated in and around her vagina, vulva (labia minora and majora), cervix, uterus and clitoris, with psychological response and mindset also playing a role.

Lightfoot-Klein (1989) studied circumcised and infibulated females in Sudan, stating, “Contrary to expectations, nearly 90% of all women interviewed said that they experienced orgasm (climax) or had at various periods of their marriage experienced it. Frequency ranged from always to rarely.” Lightfoot-Klein stated that the quality of orgasm varied from intense and prolonged, to weak or difficult to achieve.

A study in 2006 found that in some infibulated women, some erectile tissue fundamental to producing pleasure had not been completely excised. Defibulation of subjects revealed that a part of or the whole of the clitoris was underneath the scar of infibulation. The study found that sexual pleasure and orgasm are still possible after infibulation, and that they rely heavily on cultural influences — when mutilation is lived as a positive experience, orgasm is more likely. When FGC is experienced as traumatic, its frequency drops. The study suggested that FGC women who did not suffer from long-term health consequences and are in a good and fulfilling relationship may enjoy sex, and women who suffered from sexual dysfunction as a result of FGC have a right to sex therapy.

Psychological and Psychiatric Consequences:
In February 2010, a study by Pharos, a Dutch group which gathers information on health care for refugees and migrants, found that many women who have undergone FGC suffer psychiatric problems. This was the first study into the psychiatric and social complaints associated with female circumcision. In the study 66 questioned Dutch African women, who had been subjected to the practice, were found to be “stressed, anxious and aggressive”. It also found that they were more likely to have relational problems or in some cases had fears of establishing a relationship. According to the study, an estimated 50 women or girls are believed to be circumcised every year in the Netherlands. The report was published to mark the International day against female genital mutilation.

A study by anthropologist Rogaia M. Abusharaf, found that “circumcision is seen as ‘the machinery which liberates the female body from its masculine properties’  and for the women she interviewed, it is a source of empowerment and strength”.

Latest Psychological effects, sexual function:
According to a 2015 systematic review there is little high-quality information available on the psychological effects of FGM. Several small studies have concluded that women with FGM suffer from anxiety, depression and post-traumatic stress disorder. Feelings of shame and betrayal can develop when women leave the culture that practises FGM and learn that their condition is not the norm, but within the practising culture they may view their FGM with pride, because for them it signifies beauty, respect for tradition, chastity and hygiene.[10]

Studies on sexual function have also been small. A 2013 meta-analysis of 15 studies involving 12,671 women from seven countries concluded that women with FGM were twice as likely to report no sexual desire and 52 percent more likely to report dyspareunia (painful sexual intercourse). One third reported reduced sexual feelings.

Reversal:
In recent years, surgical techniques to reverse FGM have been developed by gynecologists such as Dr. Pierre Foldes and Dr. Marci Bowers. Techniques can include ablating scar tissue, reconstructing the labia, and drawing the internal part of the clitoris outward to compensate for clitoral excision.

FGC can now be partially reversed via a surgical technique, which gives back certain sensation to the genitalia. Clitoraid, a non-profit international organization, is in the process of building a hospital in Burkina Faso, West Africa, where women who have undergone FGC will be able to receive this procedure free of charge. The hospital will be staffed with volunteers, including surgeons who specialise in the technique

What is the future?
Due to health campaigns, female circumcision has been falling in some countries in the last decade. Several international organisations such as the World Health Organisation and the United Nations are actively working to stop the practice, and an increasing number of countries have outlawed it.

In Kenya, a 1991 survey found that 78 per cent of teenagers had been circumcised, compared to 100 per cent of women over 50. In Sudan, the practice dropped by 10 per cent between 1981 and 1990.

Several governments have introduced legislation to ensure the process is only carried out in hospitals by trained doctors.

Other countries such as Egypt have banned the operation altogether, but there is significant opposition to change because of the traditional nature of the process. Health workers think a less confrontational approach such as Ntanira Na Mugambo, which combines education with an understanding of the thinking behind female genital mutilation, could be more successful.

Ntanira Na Mugambo, also known as ‘circumcision by words’, has been developed in rural areas of Kenya by local and international women’s health organisations.

It involves a week-long programme of community education about the negative effects of female genital mutilation, culminating in a coming of age ceremony for young women.

The young women are secluded for a week and undergo classes in:

•Reproduction
•Anatomy
•Hygiene
•Respect for adults
•Developing self-esteem
•Dealing with peer pressure
Family members also undergo health education sessions and men in the community are taught about the negative effects of female circumcision.

Health workers believe the programme works because it does not exert a blunt prohibition on female genital mutilation, but offers an attractive alternative.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Female_genital_cutting
http://www.bbc.co.uk/health/physical_health/conditions/female_genital_mutilation.shtml
http://dailypostal.com/2009/06/15/female-circumcision-is-common/
http://rashmanly.wordpress.com/2009/10/14/female-genital-mutilation-shocking-wicked-evil/

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Some Health Questions And Answers

Q: I have a paunch. How can I reduce it?….CLICK & SEE

A: Spot reduction of a paunch alone is not possible. You have to attempt all-round weight reduction and toning exercises. This can be done with a judicious combination of diet and exercise. Either alone will work only in the short term.

Men tend to accumulate weight around their middle. It will probably be the first place you gain weight and the last place you lose it. The risk factors associated with a paunch are diabetes, hypertension and heart disease. In men the risk increases once the waist measurement crosses 102 cm.

No surgery
Q: My eight-year-old son has frequent attacks of tonsillitis when the weather changes or if he drinks or eats refrigerated things. The doctor says I should wait and not have them operated. Is that correct?

A: Years ago many children had their tonsils removed as they were considered a useless troublesome organ. Today, we know that the tonsils filter out harmful viruses and bacteria and prevent them from entering the body and causing disease. Surgery is seldom necessary. It is recommended if there are seven or more episodes of tonsillitis in one year, the swollen tonsils interfere with breathing or swallowing, or an abscess develops in the tonsils.

Infection occurs with bacteria and viruses. These are usually spread with close contact. The number of infections increases when the child starts school. The refrigerator probably has little to do with the frequent attacks.

The tonsils tend to decrease in size as the child grows older. Waiting and watching instead of rushing into surgery seems like a sensible option. Your doctor is right.

Safe period
Q: We are a newly married couple and do not want children. My wife dislikes condoms and refuses to take the pill. My friend advised natural family planning and the safe days. I was too embarrassed to find out the details. How do we go about it?

A: First, you have to calculate the length of your wife’s menstrual cycle. This can vary in different women and can be anywhere from 26 to 45 days. The first day of bleeding is taken as day one.

Pregnancy occurs if there is sexual intercourse around the time the egg is released. This is usually 14 days before the next period starts. The safe period is thus seven days before and seven days after menstruation. It is not a very reliable method though.

Some couples practice coitus interruptus. In this method, ejaculation takes place outside the vagina.

Medication and sterility
Q: My wife and I have been trying to have a baby for the last 20 years. She is now nearing 40. She has had two miscarriages in the past. I was given methotrexate on and off for my medical condition of psoariasis. I now think this may be the cause of our problem.

A:
Gonadotoxins are substances that interfere with sperm formation and quality. They may be chemicals, medication (both prescription and non-prescription), tobacco, alcohol and illicit drugs. The severity and reversibility of the problem depend on the duration and amount of exposure. Methotrexate is one of the medicines that can do this if taken long term.

Consult a reproductive medicine unit in a hospital near you. They will be able to work with your physician to determine the best course of action.

Memory loss
Q: I am preparing very hard for my exams. My marks used to be very good. Now the more I study the less I remember. My marks are decreasing. All these late nights are making me irritable.

A: Sleep deprivation leads to memory loss, irritability and a decline in reasoning. All the three would work against good academic performance.

Most people need around eight hours of sleep a day. Your brain automatically knows how tired you are. If you are consistently using an alarm clock to wake up, it means that you are forcing your brain to function when it is not ready. This decreases efficiency and impairs memory.

Perhaps your marks will be better if you put in 30 minutes of physical activity a day and also got rid of your alarm clock.

Source:The Telegraph (Kolkata, India)

Female Sterility

As you know, the union of sperm and ovum and the implantation of the foetus in the wall of the uterus leads to pregnancy. For its proper development, the foetus needs adequate and correct nourishment – provided through the mother’s umbilical chord. The mother therefore should be free from disease during the entire period of pregnancy – through conception and gestation. Sterility in females is thus a result of either the impairment of the ovary, uterus, fallopian tubes, or hormones controlling the functions of these organs as well as diseases suffered by the would-be mother…..CLICK & SEE

Defects in the genital organs may be structural (organic) or functional. To correct the organic defects, surgical measures have to be taken. Functional defects of the organs, termed bandbyatva in Ayurveda and caused by the simultaneous aggravation of all the three doshas, can be successfully treated by Ayurvedic medicines.

Herbal Remedies

Phala ghrita

Very effective in the treatment of this condition. Mixed with milk, it is given to the patient in a dose of two teaspoonfuls twice daily on an empty stomach. Vanga Bhasma is the medicine of choice for the treatment of this condition – given to the patient in a dose of 0.125 gm. twice daily, mixed with honey. Shilajeet is one of the most effective drugs for the cure of sterility. In a dose of one teaspoonful, twice daily.

Bala (Sida cordifolia)

Used both locally and internally. The root of this plant is boiled in oil and milk. It is used with lukewarm water as a douche. Nis brings about a change in the mucous membrane of the genital tract that aids the effective combination of ovum and sperm in the uterus. This medicated oil is also used internally in a dose of one teaspoonful in the morning with a cup of milk.

Banyan Roots :..

The tender roots of the banyan tree are one of the valuable remedies found beneficial in the treatment of female sterility where there are no organic defects or congenital deformities. The roots should be dried in the shade and finely powdered. About 20gms of powder should be mixed with milk, which should be five times the weight of the powder, and taken at night – for three consecutive nights after the monthly periods are over.

 

Jambul Leaves :

An infusion of the fresh tender leaves of the jambul tree is an excellent remedy in such cases. The infusion can be prepared by pouring 250ml of boiling water over 20gms of fresh jambul leaves and allowing it to steep for two hour. The infusion can be taken with either two-teaspoonfuls of honey or 200 ml of buttermilk.

Winter Cherry :…...CLICK & SEE

This herb is another valuable and helpful remedy. The herb should be powdered and six grams of this powder should be taken with one cup of milk for five to six nights after menstruation.

Certain nutrients, especially vitamins C & E and zinc, when supplemented into the diet have been found helpful in some cases of sterility.

Healing Options :

Ayurvedic Supplements: 1. Vita-ex Gold 2.Supari Pak 3. Shilajeet 4. Sundari Kalp Forte

Diet: Alkaline and pungent food should not be taken by person suffering from sterility. They should be given fruits and sweet things in large quantity.

Lifestyle : The bowels should be cleansed by a warm-water enema during the period of fasting and afterwards when necessary. Excessive fat often results in sterility. In such cases weight should be reduced of diet and through exercise.

Yoga : Cobra (Bhujanga Asana) 2.Vajrasana

Home Remedies

Infertility Secrets

Natural advice to cure Female Sterility

Herbal remedy

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.

Source:Allayurveda.com

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