Hysterectomy

Hysterectomy is the surgical removal of the uterus. It is the second most commonly performed gynecological surgical procedure, after cesarean section. Removal of the uterus renders the patient unable to bear children (as does removal of ovaries and fallopian tubes) and has surgical risks as well as long-term effects, so the surgery is normally recommended only when other treatment options are not available or have failed. It is expected that the frequency of hysterectomies for non-malignant indications will continue to fall as there are good alternatives in many cases. A hysterectomy is an operation to remove a woman's uterus. It may also involve removal of the cervix, ovaries, fallopian tubes and other surrounding structures.

 A woman may have a hysterectomy for different reasons, including:

Uterine fibroids that cause pain, bleeding, or other problems

Uterine prolapse, which is a sliding of the uterus from its normal position into the vaginal canal

Cancer of the uterus, cervix, or ovaries

Endometriosis

Abnormal vaginal bleeding

Chronic pelvic pain

Adenomyosis, or a thickening of the uterus

Hysterectomy for noncancerous reasons is usually considered only after all other treatment approaches have been tried without success.

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Amenorrhea

Amenorrhea is the absence of a menstrual period in a woman of reproductive age. Physiological states of amenorrhoea are seen, most commonly, during pregnancy and lactation (breastfeeding), the latter also forming the basis of a form of contraception known as the lactational amenorrhoea method. Outside the reproductive years, there is absence of menses during childhood and after menopause.

Amenorrhoea is a symptom with many potential causes. Primary amenorrhoea is defined as an absence of secondary sexual characteristics by age 14 with no menarche or normal secondary sexual characteristics but no menarche by 16 years of age. It may be caused by developmental problems, such as the congenital absence of the uterus, failure of the ovary to receive or maintain egg cells, or delay in pubertal development. Secondary amenorrhoea (menstrual cycles ceasing) is often caused by hormonal disturbances from the hypothalamus and the pituitary gland, from premature menopause or intrauterine scar formation. It is defined as the absence of menses for three months in a woman with previously normal menstruation, or nine months for women with a history of oligomenorrhoea.

For more details regarding the session on Gynecology Congress 2020 at San Francisco,USA during April 27- 29,2020 

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Follicle stimulating hormone

Follicle stimulating hormone is one of the gonadotrophic hormones, the other being luteinising hormone. Both are released by the pituitary gland into the bloodstream. Follicle stimulating hormone is one of the hormones essential to pubertal development and the function of women’s ovaries and men’s testes. In women, this hormone stimulates the growth of ovarian follicles in the ovary before the release of an egg from one follicle at ovulation. It also increases oestradiol production. In men, follicle stimulating hormone acts on the Sertoli cells of the testes to stimulate sperm production (spermatogenesis).
The production and release of follicle stimulating hormone is regulated by the levels of a number of circulating hormones released by the ovaries and testes. This system is called the hypothalamic–pituitary–gonadal axis. Gonadotrophin-releasing hormone is released from the hypothalamus and binds to receptors in the anterior pituitary gland to stimulate both the synthesis and release of follicle stimulating hormone and luteinising hormone. The released follicle stimulating hormone is carried in the bloodstream where it binds to receptors in the testes and ovaries. Using this mechanism follicle stimulating hormone, along with luteinising hormone, can control the functions of the testes and ovaries.
For more details regarding the session in Gynecology Congress 2020 at San Francisco,USA April 27-29, 2020
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Gonadotropin Releasing Hormone 

GnRH is a neuropeptide that is produced in the hypothalamic surge and tonic centres. In the male and the female, the target tissue is the anterior pituitary gland, specifically Gonadotroph cells. In males and females, secretion of GnRH results in the release of Follicle Stimulating Hormone and Leutinising Hormone from the anterior pituitary gland.

GnRH-producing neurons are stimulated into production in response to spontaneous rhythms and by sensory impulses from sensory inputs derived from the external environment. Alterations in the internal conditions of the body can also result in altered GnRH production. For example in some species such as the sheep, there is seasonal sexual activity and the cerebral cortex, hypothalamus, pituitary and testes interact to regulate functions further along the signalling chain.

In females when the oestrogen concentration prior to ovulation reaches a certain threshold, large quantities of GnRH are released in the form of a surge. This results in a corresponding peak in LH that stimulates ovulation. In females this surge centre is often called the preovulatory centre. In males this surge centre becomes inactivated during fetal life due to the brain maturation effects of estradiol (see section below) being able to pass through the blood brain barrier in males, please see the reproductive development of the brain for more details. In males there are between 4-12 GnRH peaks per day. Plasma concentrations of LH peak approximately 10mins post GnRH surge.
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Corpus Luteum

A corpus luteum is a mass of cells that forms in an ovary and is responsible for the production of the hormone progesterone during early pregnancy.The role of the corpus luteum depends on whether or not fertilization occurs.

During ovulation, an egg is released from a dominant follicle. Following the release of the egg and subsequent fertilization, the follicle seals itself off and forms what is known as a corpus luteum. This mass of cells helps produce the hormone progesterone during early pregnancy.

The corpus luteum will continue to produce progesterone until the fetus is producing adequate levels to sustain the pregnancy, which usually occurs between 7 and 9 weeks of pregnancy.

Progesterone is essential during early pregnancy because:

·        it allows the uterus to grow without having contractions

·        it supports the growth of the lining of the uterus

·        it improves blood flow and oxygen supply

The corpus luteum is supported and maintained by the pregnancy hormone human chorionic gonadotrophin or HCG. The corpus luteum begins to decrease in size at around 10 weeks of pregnancy.

When fertilization or implantation do not occur, the corpus luteum will begin to break down. This causes a decline in estrogen and progesterone levels, leading to the start of another menstrual period.

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Progesterone

Progesterone is a hormone that occurs naturally in the body. It can also be made in a laboratory.

"Progestin" is a general term for a substance that causes some or all of the biologic effects of progesterone. The term "progestin" is sometimes used to refer to the progesterone made in the laboratory that is in oral contraceptives and hormone replacement therapy. However, all progesterone and progestin products are made in the laboratory. The term "natural progesterone" is really a misnomer. "Natural progesterones," including the prescription products Crinone and Prometrium, are made from a chemical called diosgenin that is isolated from wild yam or soy. In the laboratory, this constituent is converted to pregnenolone and then to progesterone. The human body is not able to make progesterone from diosgenin, so eating wild yam or soy will not boost your progesterone levels.

Women commonly take progesterone to help restart menstrual periods that unexpectedly stopped, treat abnormal uterine bleeding associated with hormonal imbalance, and treat severe symptoms of premenstrual syndrome (PMS). Progesterone is also used in combination with the hormone estrogen to "oppose estrogen" as part of hormone replacement therapy. If estrogen is given without progesterone, estrogen increases the risk of uterine cancer.
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Estrogen

Estrogens are hormones that are important for sexual and reproductive development, mainly in women. They are also referred to as female sex hormones. The term "estrogen" refers to all of the chemically similar hormones in this group, which are estrone, estradiol and estriol.In women, estrogen is produced mainly in the ovaries. Ovaries are grape-sized glands located by the uterus and are part of the endocrine system.

 Estrogen is also produced by fat cells and the adrenal gland. At the onset of puberty, estrogen plays a role in the development of so-called female secondary sex characteristics, such as breasts, wider hips, pubic hair and armpit hair. 

 Estrogen also helps regulate the menstrual cycle, controlling the growth of the uterine lining during the first part of the cycle. If the woman's egg is not fertilized, estrogen levels decrease sharply and menstruation begins. If the egg is fertilized, estrogen works with progesterone, another hormone, to stop ovulation during pregnancy.

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Ovarian cancer

Ovarian cancer is a type of cancer that begins in the ovaries. The female reproductive system contains two ovaries, one on each side of the uterus. The ovaries  each about the size of an almond  produce eggs (ova) as well as the hormones estrogen and progesterone.Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is more difficult to treat. Early-stage ovarian cancer, in which the disease is confined to the ovary, is more likely to be treated successfully.                                        Surgery and chemotherapy are generally used to treat ovarian cancer.

Early-stage ovarian cancer rarely causes any symptoms. Advanced-stage ovarian cancer may cause few and nonspecific symptoms that are often mistaken for more common benign conditions.Signs and symptoms of ovarian cancer may include:

·        Abdominal bloating or swelling

·        Quickly feeling full when eating

·        Weight loss

·        Discomfort in the pelvis area

·        Changes in bowel habits, such as constipation

·        A frequent need to urinate

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Endometriosis and Adenomyosis

Adenomyosis likely affects millions of women, but it’s not well understood. “It used to be thought that adenomyosis only occurred in older women, but it’s now being diagnosed earlier”.

Endometriosis and adenomyosis can cause some of the  symptoms, but what’s happening inside the body isn’t quite the same. And a woman could actually have both.In endometriosis, some of the tissue that lines the inside of the uterus travels outside of the uterus, attaches itself to other pelvic organs and continues to bleed monthly. In adenomyosis, that tissue instead embeds itself inside the wall or muscle of the uterus, causing the uterus to swell.

 Some women don’t have any symptoms, but many who are eventually diagnosed with adenomyosis are tipped off that something is wrong because of heavy periods and agonizing pain.

 Doctors used to only be able to make an adenomyosis diagnosis after a woman had her uterus removed to get rid of her symptoms, and a pathologist could see that there was indeed endometrial tissue inside the walls of her uterus.It’s hard to know how many women have this condition, and experts aren’t sure exactly what causes it. But some think that women who have been pregnant or had surgery on their uterus are at higher risk.

For more information regarding the session in Gynecology Congress 2020 April 27-29, 2020 at San Francisco,USA.
Email:gynecologycongress@frontierscongress.com
PS:https://frontiersmeetings.com/conferences/obstetrics-gynecology/