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Saturday, April 20, 2024
Reproductive Functions

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Adnexal masses are lumps that occur in the adnexa of the uterus, which includes the uterus, ovaries, and fallopian tubes. They have several possible causes, which can be gynecological or nongynecological.

An adnexal mass could be:

  • an ovarian cyst
  • an ectopic pregnancy
  • a benign tumor
  • a malignant tumor

A family doctor can usually manage benign masses. However, prepubescent and postmenopausal individuals will need to see a gynecologist or oncologist.

Malignant adnexal masses require treatment from a specialist.

In this article, we discuss the characteristics of adnexal masses. We also review how doctors diagnose and treat adnexal them.

Symptoms

People report different symptoms, depending on the cause of the adnexal mass.

People with an adnexal mass may report:

  • severe lower abdominal or pelvic pain that is usually on one side
  • abnormal bleeding from the uterus
  • pain during sexual intercourse
  • worsening pain during a period
  • painful periods
  • abnormally heavy bleeding during periods
  • abdominal symptoms, including a feeling of fullness, bloating, constipation, difficulty eating, increased abdominal size, indigestion, nausea, and vomiting
  • urinary urgency, frequency, or incontinence
  • weight loss
  • lack of energy
  • fatigue
  • fever
  • vaginal discharge

Different causes of adnexal masses may have similar symptoms, so doctors usually conduct further investigations to determine the exact cause.

Once the doctor has worked out the cause of the adnexal mass, they can recommend treatment and management.

Causes

Adnexal masses include a variety of different conditions that range in severity from benign growths to malignant tumors.

The cause of adnexal masses could be gynecological or nongynecological.

Some of the causes of adnexal masses include:

  • Ectopic pregnancy: A pregnancy where the fertilized egg implants somewhere outside the uterus.
  • Endometrioma: A benign cyst on the ovary that contains thick, old blood that appears brown.
  • Leiomyoma: A benign gynecological tumor, also known as a fibroid.
  • Ovarian cancer: These tumors of the ovary may be ovarian epithelial cancers that begin in the cells on the surface of the ovary or malignant germ cell cancers that begin in the eggs.
  • Pelvic inflammatory disease: Inflammation of the upper genital tract, which includes the uterus, fallopian tubes, and ovaries. It occurs due to an infection.
  • Tubo-ovarian abscess: An infectious adnexal mass that forms because of pelvic inflammatory disease.
  • Ovarian torsion: A gynecological emergency involving a complete or partial rotation of the tissue that supports the ovary, which cuts off blood flow to the ovary.

Diagnosis

A doctor may diagnose an adnexal mass by:

  • taking a complete medical history
  • asking questions about symptoms
  • conducting a physical examination
  • obtaining blood samples

Most of the time, people will need a transvaginal ultrasound to allow doctors to evaluate the characteristics of an adnexal mass.

Females who have had a positive pregnancy test result and report abdominal or pelvic pain and vaginal bleeding might have an ectopic pregnancy. An ovarian torsion causes sudden, severe pain with nausea and vomiting. Immediate medical attention is necessary to treat both an ectopic pregnancy and ovarian torsion.

People with pelvic inflammatory disease or a tubo-ovarian abscess may experience gradual pelvic pain with nausea and vaginal bleeding.

Early ovarian cancer may sometimes present with nonspecific symptoms. Sometimes, doctors may only detect cancer when the tumor has become malignant.

Malignant tumors may have one or several of the following characteristics:

  • a solid component of the tumor
  • parts of the tumor have thick divisions larger than 2–3 centimeters separating them
  • they are present on both sides of the reproductive tract
  • the presence of fluid filled lumps

Treatment

A doctor will choose the most appropriate treatment depending on the cause of the adnexal mass. Women with an ectopic pregnancy will have to end their pregnancy. A doctor may choose one of the following procedures:

  • the administration of a single or two-dose intramuscular methotrexate
  • laparoscopic surgery
  • a salpingostomy or salpingectomy, which are surgical procedures involving the fallopian tubes

Doctors have not yet determined the optimal management of an endometrioma, according to a study that featured in Obstetrical & Gynecological Survey.

Currently, the possible treatments for an endometrioma include:

  • watchful waiting
  • medical therapy
  • surgical intervention
  • inducing ovulation and using assisted reproductive technology in females with infertility

People with pelvic inflammatory disease will require courses of intravenous antibiotics, which may include:

  • cefotetan (Cefotan)
  • cefoxitin (Mefoxin)
  • clindamycin (Cleocin)

Some people can receive treatment outside of the hospital setting with oral doxycycline (Vibramycin) and intramuscular ceftriaxone (Rocephin) or another third generation cephalosporin antibiotic. In some cases, doctors will need to add oral metronidazole (Flagyl).

In the past, tubo-ovarian abscesses required surgical removal of the uterus, ovaries, and fallopian tubes. However, doctors can now prescribe broad-spectrum antibiotics. A person with a ruptured tubo-ovarian abscess may still require surgery.

Ovarian torsion is a gynecological emergency. The only treatment is surgery to prevent severe damage to the ovaries and fallopian tubes.

People with leiomyomas or fibroids may receive hormonal treatments or nonsteroidal anti-inflammatory drugs to control the symptoms. Once a person stops taking medication, the symptoms may return, and the fibroids may continue to grow. Surgery is the most successful treatment for fibroids.

The treatment options for ovarian cancer include surgery, chemotherapy, and targeted therapy. Oncologists will consider the following factors before recommending a treatment plan:

  • the type of ovarian cancer and how much cancer is present
  • the stage and grade of the cancer
  • whether the person has a buildup of fluid in the abdomen causing swelling
  • whether surgery can remove the whole tumor
  • genetic changes
  • the person’s age and general health status
  • whether it is a new diagnosis, or if cancer has come back

Risk factors

Risk factors depend on the cause of the adnexal mass. Females with ovarian masses have an increased risk of developing ovarian torsion. More than 80% of females with ovarian torsion have masses of 5 cm or larger.

Doctors diagnose fibroids in about 70% of white females and more than 80% of black females by the age of 50 years. Other factors may increase a person’s risk of developing fibroids, such as:

  • starting periods early in life
  • using oral contraceptives before 16 years of age
  • an increase in body mass index (BMI)

Ovarian cancer can run in families. People with a family history of ovarian cancer may have an increased risk of developing ovarian cancer. Other risk factors include:

  • inherited genetic changes
  • hereditary nonpolyposis colorectal cancer
  • endometriosis
  • postmenopausal hormonal therapy
  • obesity
  • tall height

The likelihood of developing cancer also tends to increase with age.

Summary

Adnexal masses are lumps that doctors may find in the adnexal of the uterus, which is the part of the body that houses the uterus, ovaries, and fallopian tubes. Not all masses are cancerous, and they do not all require treatment.

Different types of adnexal mass can share many of the same symptoms. As a result, doctors need to collect a full medical history and data from physical examinations, blood tests, and medical imaging, including transvaginal ultrasounds.

Doctors need to pinpoint the location and cause of an adnexal mass to determine the appropriate management and treatment.

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New studies have shown that the ethanolic root bark extract of African cherry may damage fertility in men. African cherry is a plant, which has been used in traditional/alternative medicine in Nigeria to treat several health problems, as various parts of this herb have been proved to have a wide range of therapeutic effects.

The plant is a rich source of natural antioxidants, which have been established to promote health by acting against oxidative stress related disease such as; diabetics, cancer and coronary heart diseases.Its bark is used for the treatment of yellow fever and malaria while the leaf is used as an emollient and for the treatment of skin eruption, stomachache and diarrhea. The cotyledons from the seeds are used as ointments in the treatment of vaginal and dermatological infections in Western Nigeria and also possess anti-hyperglycemic and hypolipidemic effects, among other health benefits.

However, studies have shown that African cherry herbs can also have anti-fertility effects in men.Botanically called Chrysophyllum albidum, African star apple, which belongs to the plant family Sapotaceae is an edible tropical fruit known by various tribal names. It is called Utieagadava in Urhobo; Agbalumo in Yoruba; Udala in Ibo, Efik and Ibibio; Ehya in Igala, Agwaluma in Hausa tribes of Nigeria.

In southern Benin, it is called Azongogwe or Azonbobwe in local language.Several studies have been conducted to investigate the antifertility effect of the ethanolic root bark extract of C. albidum on the hormonal levels (pituitary-testicular axis) and caudal epididymal fluid parameters in wistar rats.

A study titled: “The effect of Chrysophyllum albidum fruit on testicular functions in rats” investigated the effects of C. albidum fruit methanol extract on the reproductive functions of male Wistar rats. Fifteen male Wistar rats were divided into three and received distilled water, which also served as control and extract respectively for 28 days via oral gavage.

The sperm count, motility, percentage sperm aberration, histology of testes and epididymides were examined by microscopy. The results showed the serum levels of luteinising hormone (LH), follicle‐stimulating hormone (FSH) and testosterone were quantified using ELISA. However, the sperm count significantly increased in, while the serum testosterone level decreased.

Findings from the study showed that the architecture of sections of testes and epididymides showed anomalies. C. albidum fruit adversely altered reproductive functions of male Wistar rat. Also, another study published in International Journal of Applied Research in Natural Products by Nigerian researchers validated the antifertility effect of extracts of African cherry in men.

The study is titled: “Antifertility Effects of Ethanolic Root Bark Extract of Chrysophyllum Albidum in Male Albino Rats. According to the researchers, the present study was conducted to investigate the antifertility activity of the ethanol root bark extract of Chrysophyllum albidum on sperm parameter and hormonal levels in rats. Eighteen male rats were divided into three groups of six animals each, as each group were administered distilled water that serve as control, ethanol root bark extract on a daily basis. The caudal epididymal sperm count; motility and sperm morphology were observed compared with the control.

The result showed that ethanol extract of the root bark of C. albidum suppresses the hormonal levels and sperm production in rats, according to the study.The researchers conclude that the study demonstrated that the root bark of ethanolic extract of C. albidum produces a pronounced inhibition of serum testosterone and gonadrophins concentration.

However, these extract had antifertility effect on the testes of albino wistar rats and could be further investigated for possibility of developing a cheap, acceptable and easy available male contraceptive.The researchers said: “The findings of the present study showed that the ethanolic root bark extract of C. albidum could significantly alter the fertility potential of male rats. The fact that there was significant increase in body weight

(p<0.05) on treated animals does not rule out the possibility of a systemic toxicity at the doses treated due to behavioral alterations observed within the treated groups which showed progressive decrease in agility. Furthermore, the significant increase in body weight (p<0.05) indicates that the extract may have toxic effect on the rats. The analysis of caudal epididymal fluids of these treated rats revealed a concomitant decrease in the sperm concentration which may be due to the inhibition in spermatogenesis which has been reflected here by the low count.” [ad] The researchers observed that the “present study also reveals a significant decrease in sperm motility, which focuses the direct effect of the extract on matured and stored sperm in epididymis, also increased abnormal sperm morphology.”Another study evaluated the effects of ethanolic leaf extract of Chrysophyllum albidum on hormones and sperm analysis of laboratory rats. The study titled: “Ethanolic Leaf Extract of Chrysophyllum albidum on sperm analysis, hormonal profile, SOD and testicular histology of adult male wistar rats” was published in the Agriculture And Biology Journal of North America. The researchers in their findings showed that “C. albidum leave extract reduced serum levels of gonadotrophins probably by affecting hypothalamic- pituitary-gonadal axis. The treatment does not cause suppression of spermatogenesis but decrease the hormonal profile. The researchers from Faculty of Basic Medical Sciences, Madonna University, River State concluded that the “C. albidum leave extract reduced serum levels of gonadotrophins probably by affecting hypothalamic- pituitary-gonadal axis. The reduced levels of FSH, LH and T do not have effect on the testicular spermatogenesis for 21 days. However there was an increase in the SOD enzyme activities above the control level thereby improving its antioxidative capacity.”

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The muscles, ligaments, and tissues of the pelvic floor support the bladder, rectum, and sexual organs. When the supportive structures weaken or become especially tight, doctors describe it as pelvic floor dysfunction. It is a common health issue.

When a person has pelvic floor dysfunction, the organs in the pelvis may drop. They often press down on the bladder or rectum, causing a leakage of urine or stool. Or, a person with this condition may have trouble urinating or passing stool.

Keep reading to learn more about pelvic floor dysfunction — including the symptoms, treatments, and some exercises that may help.

What is pelvic floor dysfunction?

The pelvic floor is made up of muscles, ligaments, and tissues that surround the pelvic bone. The muscles attach to the front, back, and sides of the bone, as well as to the lowest part of the spine, called the sacrum.

The function of the pelvic floor is to support the organs in the pelvis, which can include the:

  • bladder
  • rectum
  • urethra
  • uterus
  • vagina
  • prostate

People with pelvic floor dysfunction may have weak or especially tight pelvic floor muscles.

When the muscles tighten, or spasm, people may have trouble urinating or passing stool. When they weaken, the organs within the pelvis may drop and press down on the rectum and bladder.

The table below outlines several common types of pelvic floor dysfunction.

Type of pelvic floor dysfunctionDescription
Obstructed defecationThis occurs when stool enters the rectum, but the body cannot fully evacuate the bowels.
RectoceleThis involves tissue from the rectum protruding into the vagina. Stool may get caught in this pocket, forming a bulge in the vagina.
Pelvic organ prolapseThis refers to the pelvic floor stretching and the pelvic organs dropping as a result of age, childbirth, or a collagen disorder.
Paradoxical puborectalis contractionThis involves a pelvic floor muscle called the puborectalis contracting. When it happens, trying to pass stool may feel like pushing against a closed door.
Levator syndromeThis involves the pelvic floor muscles spasming after bowel movements. It can cause lasting dull pain or achy pressure high in the rectum.
CoccygodyniaThis refers to pain in the tailbone that worsens during and after bowel movements.
Proctalgia fugaxThis involves painful spasms of the rectum and muscles in the pelvic floor.
Pudendal neuralgiaThis refers to irritation or damage to the pudendal nerves, which help the pelvis function.
UrethroceleThis refers to the urethra pressing into the vagina.
EnteroceleThis involves the small intestine descending and pushing into the vagina, forming a bulge.
CystoceleThis involves the bladder dropping and pushing into the vagina.
Uterine prolapseThis refers to the uterus descending and pushing into the vagina.

Symptoms

Pelvic floor dysfunction can cause a variety of symptoms, and some can interfere with daily life.

Depending on the type of pelvic floor dysfunction, a person may experience:

  • pelvic pain
  • pressure
  • a bulge somewhere in the lower pelvic region
  • stress urinary incontinence, which involves a small amount of urine leaking from the body due to an activity such as coughing
  • involuntary leakage of stool
  • incomplete urination
  • bowel movement dysfunction
  • pain during sexual intercourse

Also, some people who see their doctors about bladder overactivity find that pelvic floor dysfunction is responsible.

Causes

Many issues can cause the structures of the pelvic floor to weaken, including:

  • age
  • systemic diseases
  • lasting health issues that cause increased pressure in the abdomen and pelvis, such as a chronic cough
  • pregnancy
  • trauma during delivery
  • multiple deliveries
  • large babies
  • operative delivery

Research indicates that stress urinary incontinence, pelvic organ prolapse, or both occur in about half of all women who have given birth. These issues are closely associated with birth-related injury to the pelvic floor muscles.

The pelvic floor muscles can also stretch naturally with age. Stress urinary incontinence and pelvic organ prolapse become more common with increasing age in females, for example.

Collagen disorders can also affect the muscles’ ability to support the pelvic organs.

Meanwhile, coccygodynia usually stems from trauma to the tailbone, such as from a fall. That said, in about one-third of people with the condition, the cause of coccygodynia is unknown. The pain can make having a bowel movement difficult.

Exercises

Doctors recommend pelvic floor exercises in various situations.

They may particularly benefit pregnant women because the pelvic floor muscles can stretch and weaken during labor. Strengthening these muscles may help prevent incontinence after the baby is born. Some doctors recommend that women who wish to become pregnant start the exercises ahead of time.

Males can also benefit from pelvic floor exercises, though the dysfunction is more common in females. In males, these exercises can help prevent pelvic organ prolapse and urinary incontinence and improve sexual intercourse.

To exercise these muscles, a person should be sitting comfortably. Then, they should attempt to squeeze their pelvic muscles without holding their breath.

It is important to isolate the correct muscles without tightening those of the stomach, buttocks, or and thighs.

Doctors recommend that females aim to do 10 long squeezes — holding each for 10 seconds — followed by 10 short squeezes. However, initially, it may be a good idea to practice holding a squeeze for a few seconds at a time.

By practicing frequently, a person should be able to add more contractions to their routine week by week. It is important to do this gradually and to avoid overworking the muscles.

Within a few months, a person may notice a reduction in their symptoms. Even if symptoms resolve completely, a person should continue strengthening these muscles.

There are physical therapists who specialize in pelvic floor dysfunction. A person may find that consulting one of these professionals leads to a better outcome.

Treatment

Doctors determine the cause of pelvic floor dysfunction before recommending treatment because different types of dysfunction require different approaches.

The purpose of treatment is to relieve or reduce symptoms and improve the person’s quality of life. For some people, a combination of treatment methods works best.

Doctors may recommend:

  • Dietary changes: For example, eating more fiber, drinking more fluids, and taking certain medications can make bowel movements easier.
  • Laxatives: Taking a daily laxative may help people with pelvic floor dysfunction pass stool, but it is important to consult a healthcare provider first because not all laxatives are equally effective.
  • Pain relief: Some people require injections of pain relief or anti-inflammatory medication to relieve their symptoms.
  • Biofeedback: This involves electrical stimulation, ultrasound therapy, or massage of the pelvic floor muscles to help improve rectal sensation and muscle contraction.
  • Pessary: A doctor or nurse inserts a pessary into the vagina to support prolapsed organs. This type of device can help treat various symptoms of pelvic floor dysfunction, either as an alternative to surgery or while a person awaits surgery.
  • Surgery: When prolapse interferes with daily activities, a doctor may recommend surgery. Large rectoceles also require surgery if the person experiences symptoms.

Stem cell therapies

Researchers behind a 2016 study investigated whether a stem cell-based therapy could resolve pelvic floor dysfunction in rats.

The researchers engineered the stem cells to produce and release elastin and collagen into the pelvic floor and injected them into rats with pelvic floor dysfunction.

The elastin and collagen promoted the repair of pelvic floor structures and decreased signs of stress urinary incontinence.

In a final component of the study, the researchers developed stem cells that blocked a factor that stops the production of elastin. This promoted increased production and release of elastin into the pelvic floor.

With further studies, researchers may find that similar therapies are effective in humans.

When to see a doctor

Anyone who experiences painful bowel movements, difficulty urinating or passing stool, pelvic pain, or pain during sexual intercourse should speak with a doctor.

An unusual bulge in the lower pelvic region may also be a reason to see a doctor, though a bulge alone may not be a cause for concern.

People with pelvic floor dysfunction have plenty of treatment options. While the topic may be uncomfortable to bring up with a doctor, it is important to seek professional advice about these symptoms.

While some family doctors may not be familiar with pelvic floor dysfunction, specialists such as colorectal doctors, urologists, and gynecologists can help diagnose the issue and recommend the best course of action.

Summary

Pelvic floor dysfunction can affect anyone, but pregnant women have the highest risk.

The various types of pelvic floor dysfunction stem from different causes, and a doctor must identify the underlying issue before developing a treatment plan.

Exercises can help some people with pelvic floor dysfunction. Depending on the cause, a doctor may also recommend dietary changes, medication, a pessary, biofeedback, or surgery.

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When faced with an unplanned pregnancy, some women might consider a home abortion. Online sources cite abortion home remedies that they claim are both safe and effective.

For example, some suggest consuming various fruits, herbs, or supplements in excessive quantities. Others recommend intense exercise or inserting implements through the cervix to the uterus to induce abortion.

None of these options is a good idea. Some are merely ineffective, while others are incredibly risky and could potentially lead to disability or death.

In this article, we discuss the risks of home abortions, which range from toxicity to life threatening infection. We also detail the alternative options available to those who wish to end a pregnancy safely.

The risks of home remedies

Some abortion home remedies, such as drinking certain teas, may seem relatively safe.

However, consuming everyday herbs in excessive amounts could potentially lead to toxicity. Some remedies can be fatal.

The World Health Organization (WHO) report that 47,000 women die every year due to unsafe abortions, and an additional 5 million develop a disability as a result.

The WHO state that it is possible to prevent almost all of these deaths and disabilities through accessing safe abortion, sex education, and family planning.

Potential risks of home remedies include:

An incomplete abortion

An incomplete abortion is one that was not fully successful. It occurs when the pregnancy ends, but some of the fetal tissue remains in the body.

It is necessary to seek immediate medical treatment for an incomplete abortion to avoid significant blood loss, severe infection, or death. However, a woman may not know if the abortion is incomplete until they develop severe symptoms, such as bleeding.

Toxicity

Taking herbal remedies or abortion pills purchased from unreputable online sources can have serious consequences.

Even natural remedies can be toxic, especially when people consume them in large amounts.

When people eat toxic amounts of something, the liver comes under pressure to filter the toxins from the body. In severe cases, this results in liver damage or liver failure.

Some websites claim to sell abortions pills online, but many of these pills are not genuine. In some cases, they could be harmful. Products from other countries can contain contaminants from heavy metals. The Food and Drug Administration (FDA) or other authorities do not monitor these products, which means the public is not protected.

Hemorrhaging

Hemorrhaging means major blood loss. While all surgeries, including surgical abortions, carry the risk of heavy bleeding, an abortion by an unqualified person increases that risk significantly.

Internal bleeding is life threatening and may go unnoticed until it is too late to stop it.

Infection and scarring

There is a risk of infection and internal scarring with surgical abortions, but this risk increases dramatically with at-home surgical abortions.

Inserting anything through the cervix to the uterus is extremely dangerous, as it can cause infection and scarring. Both of these outcomes can lead to infertility. Severe infections are life threatening.

At-home medical solutions

There is a safer alternative to home remedies for women who want to terminate their pregnancy at home.

A doctor can prescribe medication for a woman to take at home. This is known as a medical abortion. This option is becoming more common in the United States.

Typically, a medical abortion involves taking two medications, mifepristone and misoprostol, at different times. Mifepristone causes hormonal changes that allow the pregnancy to end, while misoprostol causes the uterus to contract and expel the uterine lining.

Medical abortion has a success rate of up to 99% for early pregnancy termination. Research indicates that it does not increase future pregnancy complications.

Medical abortions are an option for women who are up to 10–12 weeks pregnant or less, depending on local laws.

It is important to note that it is against the law to induce an abortion in many countries.

Surgical abortion

Doctors perform surgical abortions in situations where a medical abortion is not an option.

During a surgical abortion, also known as dilation and curettage (D&C), a surgeon will remove the fetus, using suction and a sharp tool called a curet.

In many areas, surgical abortions are an option for up to 24 weeks of pregnancy. After this time, options for terminating the pregnancy diminish. A doctor will typically only perform a surgical abortion if the pregnancy poses a risk to the life of the woman, or if there are issues with the baby’s development.

Women should talk to their doctor or midwife about how they feel about continuing the pregnancy.

Legal surgical abortions are relatively safe and effective. In rare cases, a D&C can cause scarring of the uterine wall, which is called Asherman’s syndrome.

Asherman’s syndrome may make it more difficult to get pregnant again, or it may increase the risk of miscarriage in future pregnancies.

Where to get help

People who have attempted a home abortion should seek medical help. It is essential that they get urgent attention if they have:

  • excessive bleeding
  • fever or chills
  • jaundice (yellow skin or eyes)
  • loss of consciousness
  • sweaty, cold skin
  • vomiting
  • other severe, persistent, or concerning symptoms

Women must tell their doctor what caused the symptoms. Giving as much information as possible will help the doctor to treat the issue correctly and promptly, as well as offer care and support.

People living in the U.S. who wish to have more information on accessing an abortion or on alternative options can get help from the following organizations:

Outside the United States, people may wish to contact:

Recovery

Recovery from a medical or surgical abortion usually takes a couple of weeks. During this time, a person may experience some cramps and vaginal bleeding. Sometimes, the bleeding can last longer than 2 weeks, and on rare occasions, it can last up to 45 days. Anyone with bright red blood or bleeding that continues longer than 2 weeks must see their doctor.

The medications a woman takes during a medical abortion may cause nausea and other short-term effects.

The anesthetics or sedatives a doctor administers during a surgical abortion may also cause nausea or other side effects.

After either type of abortion, a doctor will advise that women wait until the bleeding ends before having sex to reduce the risk of infection. In the case of complications, some women may need to wait longer.

Do not use tampons for 6 weeks; use only pads.

During the recovery period, women can take ibuprofen to alleviate pain. Heating pads may also be helpful for cramps.

Women should contact their doctor or the clinic if they experience heavy bleeding, smelly discharge, fever, or other signs of infection.

It is also vital to deal with any emotional distress following an abortion. Abortions affect everyone differently — all emotional responses are valid. A doctor or the abortion clinic can provide contact details for therapists who offer postabortion counseling.

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Regular vaginal discharge is a sign of a healthy female reproductive system. Normal vaginal discharge contains a mixture of cervical mucus, vaginal fluid, dead cells, and bacteria.

Females may experience heavy vaginal discharge from arousal or during ovulation. However, excessive vaginal discharge that smells bad or looks unusual can indicate an underlying condition.

This articles discusses why someone may have heavy vaginal discharge and what they can do about it.

1. Arousal

Sexual arousal triggers several physical responses in the body. Arousal increases blood flow in the genitals. As a result, the blood vessels enlarge, which pushes fluid to the surface of the vaginal walls.

Arousal fluid is clear and watery with a slippery texture. This fluid helps lubricate the vagina during sex.

Other signs of female arousal include:

  • increased heart rate and breathing
  • flushing of the face, neck, and chest
  • swelling of the breasts
  • erect nipples

2. Ovulation

Cervical fluid is a gel-like liquid that contains proteins, carbohydrates, and amino acids. The texture and amount of cervical fluid both change throughout a female’s menstrual cycle.

For example, after menstruation, cervical fluid has a thick, mucus-like texture. It can be cloudy, white, or yellow.

Estrogen levels increase closer to ovulation. This causes the cervical fluid to become clear and slippery, similar to that of raw egg whites.

Cervical fluid discharge increases during the days leading up to ovulation and decreases after ovulation. Females may have no discharge for a few days after their period.

3. Hormonal imbalances

Hormonal imbalances related to stress, diet, or underlying medical conditions can cause heavier vaginal discharge.

Polycystic ovary syndrome (PCOS), for example, refers to a set of symptoms that occur as a result of hormonal imbalances. According to the Centers for Disease Control and Prevention (CDC), PCOS affects up to 5 million females in the United States.

Those with PCOS have higher levels of male hormones called androgens. Increased androgen levels can:

  • change the amount or texture of cervical fluid
  • cause irregular periods
  • prevent ovulation

Not everyone with PCOS will have increased vaginal discharge. Paying attention to other PCOS symptoms may help someone identify and seek treatment for the condition faster.

Some other symptoms of PCOS to look out for include:

  • fewer than eight periods in 1 year, or periods that occur every roughly 21 days
  • excess facial and body hair
  • thinning hair or hair loss
  • acne on the face and body
  • weight gain
  • darkening of the skin on the neck, groin, or breasts
  • skin tags on the armpits or neck

Hormonal birth control, such as birth control pills and intrauterine devices, can also cause increased vaginal discharge, especially during the first few months of use.

Excess vaginal discharge and other symptoms, such as spotting and cramping, usually resolve once the body adjusts to the hormonal birth control.

4. Vaginitis

Vaginitis refers to inflammation of the vagina, which can occur from an infection or irritation due to factors such as douches, lubricants, and ill-fitting clothing.

Vaginitis can cause thick vaginal discharge that may be white, gray, yellow, or green.

Other symptoms of vaginitis include:

  • foul vaginal odor
  • an itching or burning sensation in the genital area
  • redness or inflammation of the vagina
  • pain or discomfort when urinating
  • pain during sexual intercourse

5. Bacterial vaginosis

Bacterial vaginosis is a condition that results from an overgrowth of bacteria in the vagina. This vaginal infection is the most common among females aged 15–44 years.

The exact cause of bacterial vaginosis remains unclear. Females can develop bacterial vaginosis after sexual intercourse. However, this condition is not a sexually transmitted infection (STI).

According to the Office on Women’s Health, those who have bacterial vaginosis may notice a milky or gray-colored vaginal discharge. Some also report a strong, fishy vaginal odor, especially after sexual intercourse.

Bacterial vaginosis can also cause:

  • discomfort when urinating
  • painful burning or itching in the vagina
  • irritation of the skin around the vagina

6. Yeast infection

Vaginal yeast infections result from an overgrowth of the Candida fungus. Females of all ages can develop a vaginal yeast infection, and nearly 70% will have a yeast infection at some point in their lives.

The most common symptom of a vaginal yeast infection is an intense itching in the vagina and vulva.

Vaginal yeast infections can also cause an odorless vaginal discharge that looks similar to cottage cheese.

Vaginal yeast infections are treatable at home using over-the-counter antifungal ointments. Symptoms should improve within a few days. However, severe infections can last longer and may require medical treatment.

7. Trichomoniasis

Trichomoniasis is an STI caused by a parasite. Females can develop trichomoniasis after having sex with someone who has the parasite.

Although most people who have trichomoniasis do not experience symptoms, some may have an itching or burning sensation in the genital area.

Trichomoniasis infections can also cause excess vaginal discharge that has a foul or fishy odor and a white, yellow, or green color. It may also be thinner than usual.

What is healthy discharge?

Healthy vaginal discharge varies from person to person. It also changes throughout their menstrual cycle.

In general, healthy vaginal discharge can appear thin and watery or thick and cloudy. Clear, white, or off-white vaginal discharge is also perfectly normal.

Some females may have brown, red, or black vaginal discharge at the end of their menstrual periods if their vaginal discharge still contains blood from the uterus.

Natural hormonal changes during ovulation can cause an increase in vaginal discharge, which should return to normal after ovulation.

When to see a doctor

It is not always necessary to see a doctor about excessive vaginal discharge. However, a female may want to consider seeing their doctor if their vaginal discharge has an abnormal appearance.

Yellow, green, gray, or foul-smelling vaginal discharge could indicate an infection. Other reasons to see a doctor include:

  • itching or burning near the genitals
  • discomfort or pain when urinating
  • discomfort or pain during sexual intercourse

Possible treatment options

Treating excess vaginal discharge depends on the underlying cause.

People can reduce symptoms of vaginitis by avoiding the source of irritation. Doctors can treat bacterial vaginosis and yeast infections using antibiotics or antifungals.

Doctors can also treat trichomoniasis using antibiotics. The CDC recommend that females wait 7–10 days after receiving treatment before having sex.

Treatment for PCOS varies depending on the individual. A doctor may recommend a combination of lifestyle changes and medications to help people manage their symptoms and regulate their hormone levels.

Maintaining a healthy body weight and eating a varied diet low in added sugars may also help improve some symptoms of PCOS. Birth control pills that contain estrogen or progestin can help balance out excess levels of androgens.

Tips for managing heavy vaginal discharge

Even healthy vaginal discharge can cause discomfort at times. Here are some tips for managing heavy vaginal discharge:

  • Wear panty liners. However, be sure not to let them become too moist, as this can increase the risk of urinary tract infections and vaginitis.
  • Choose breathable underwear made from natural fibers such as cotton.
  • Avoid wearing tight pants.
  • Avoid using hygiene products that contain added fragrances, coloring agents, or other harsh chemicals.
  • Keep the genital area clean and dry.
  • Wipe from the front to the back when using the bathroom.

Outlook

Excess vaginal discharge can occur as a result of arousal, ovulation, or infections. Normal vaginal discharge ranges in color from clear or milky to white.

The consistency of vaginal discharge also varies from thin and watery to thick and sticky. Generally, healthy vaginal discharge should be relatively odorless.

A female can speak with a healthcare professional if they notice any symptoms of an infection. Some symptoms to look out for include:

  • yellow, green, or gray vaginal discharge
  • foul-smelling vaginal discharge
  • discharge that looks similar to cottage cheese
  • itching or burning in or near the genitals

Doctors can easily treat most vaginal infections using antimicrobial medications. Depending on the severity of the infection, people may see their symptoms improving within a few days to weeks.

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Lower abdominal pain is pain that occurs below a person’s belly button. Bloating refers to a feeling of pressure or fullness in the abdomen, or a visibly distended abdomen. Sometimes, these symptoms occur together.

Though occasional lower abdominal pain and bloating are common, a person should speak to their doctor if it becomes a regular occurrence. In some cases, this combination of symptoms may indicate an underlying issue that requires medical treatment.

Keep reading for more information on some of the more common causes of abdominal pain and bloating. We also outline various treatment options for this combination of symptoms.

Causes of both abdominal pain and bloating

There are several causes of combined lower abdominal pain (LAP) and bloating. Some relatively harmless, or benign, causes include:

  • consumption of high fat foods
  • swallowing too much air
  • stress

In some cases, LAP and bloating can occur as a result of an underlying medical condition, such as:

  • constipation
  • food intolerances, such as lactose or gluten intolerance
  • gastroesophageal reflux disease (GERD), although this more commonly causes upper abdominal pain-gastroenteritis, which is inflammation of the gastrointestinal (GI) tract that causes vomiting and diarrhoea
  • diverticulitis, which is inflammation or infection of part of the large intestine
  • ileus, which is a condition that slows the function of the small and large intestine
  • delayed stomach emptying, or gastroparesis, which is a complication of diabetes mellitus
  • intestinal obstruction
  • inflammatory bowel disease (Crohn’s disease or ulcerative colitis)

Other conditions that can cause LAP and bloating are specific to females. These include:

  • menstrual pain
  • endometriosis
  • ovarian cysts
  • pelvic inflammatory disease (PID)
  • pregnancy
  • ectopic pregnancy

LAP and bloating can also be due to conditions that do not necessarily affect the stomach, intestines, or reproductive organs. These conditions include;

  • drug allergies
  • side effects of certain medications
  • hernia
  • cystitis, or infection of the urinary tract infection
  • appendicitis, or inflammation of the appendix
  • kidney stones

When to see a doctor

If the cause of LAP and bloating is relatively benign, symptoms should go away within a few hours to days.

A person should see a doctor if:

  • their symptoms last longer than a few days
  • their symptoms begin to interfere with their daily life
  • they are pregnant and are unsure of the cause of LAP and bloating

People should seek immediate medical attention if vomiting or the inability to pass gas occur alongside LAP and bloating.

People who experience LAP and bloating along with one or more of the following symptoms should seek emergency medical attention:

  • sudden worsening of pain
  • fever
  • unusual vaginal discharge
  • bloody stool
  • unexplained weight loss
  • severe nausea and vomiting

Diagnosis

To make a diagnosis, a doctor will begin by carrying out a physical examination. An initial examination will involve applying pressure to the abdomen. This will help the doctor to check the location of pain and to feel for any abnormalities.

A doctor will also make a note of the person’s medical history, and any other symptoms they experience. They may also ask whether there is anything that triggers the pain or makes it worse.

Diagnostic tests, such as urine, blood, or stool tests, may also be necessary. These can help to identify signs of infection or other underlying conditions.

In some cases, a doctor may order one of the following imaging tests to check for abnormalities in the abdomen:

  • ultrasound
  • X-ray
  • CT or MRI

If the imaging tests come back normal, a doctor may perform a colonoscopy for a closer look inside the intestines.

Treatment

The following are some general home treatment options that may help to alleviate symptoms of LAP and bloating:

  • increasing fluid intake
  • exercising to help alleviate gas and bloating
  • taking over-the-counter (OTC) pain medications
  • taking OTC antacids

If home treatments do not work, a person should speak to their doctor about other treatment options. These will vary, depending on the cause of LAP and bloating. However, some examples include:

  • prescription medications to treat pain and bloating
  • antibiotics to help treat a bacterial infection
  • emergency surgery to remove a ruptured appendix

Prevention

There are some steps a person can take to help alleviate LAP and bloating. Two key steps include quitting smoking and avoiding trigger foods.

The following are examples of foods that may cause or contribute to LAP and bloating:

  • high fat foods
  • certain plant-based foods, such as cabbage, lentils, and beans
  • dairy products if a person is lactose intolerant
  • carbonated drinks
  • beer
  • chewing gum
  • hard candy

Also, people may benefit from increasing their intake of high fiber foods such as fruits, vegetables, and whole grains. This will help to prevent constipation and associated bloating.

If an underlying condition is the cause of LAP and bloating, then treating the condition should help to alleviate these symptoms.

Outlook

There are many potential causes of lower abdominal pain and bloating. Some causes are relatively benign and easy to treat, while others may be more serious.

Occasional lower abdominal pain and bloating are usually not a cause for concern. However, people should see a doctor if their symptoms worsen, last more than a few days, or disrupt their daily activities.

People who experience additional symptoms, such as vomiting, fever, or blood in the stool, should seek emergency medical attention.

In some cases, people can prevent lower abdominal pain and bloating by avoiding foods that may trigger these symptoms.

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People may have heard that peeing after sex is beneficial, especially for women. This is because peeing flushes bacteria out of the body, which may help prevent a urinary tract from developing.

Here, we look at how peeing after sex may help to prevent urinary tract infections. We also discuss whether there are any other benefits to peeing after sex.

Benefits of peeing after sex

Sexual intercourse is a risk factor for urinary tract infections (UTIs).

During sex, bacteria can pass from the genitals to the urethra.

The urethra is the tube that connects the bladder to the urethral opening where urine comes out. Bacteria can then make its way from the urethra to the bladder, resulting in a UTI.

Peeing after sex helps to flush bacteria out of the urethra, helping to prevent UTIs.

How can it help prevent UTIs?

Females are up to 30 times more likely to get a UTI than males. This is due to two reasons: Firstly, the female urethra is close to the vagina and anus. This means that bacteria can easily spread from these areas to the urethra. Secondly, the urethra is shorter in females than it is in males. This means that bacteria that enter the urethra can reach the bladder more easily.

In women, peeing after sex can help to flush any bacteria away from the urethra.

For males, peeing after sex is less important. This is because males have a longer urethra. As a result, bacteria from the genital area is less likely to reach the bladder.

Although there is no solid evidence to confirm that peeing after sex can prevent UTIs, there is no harm in following this practice. It may help to reduce the risk of UTIs, especially in women and people who are more prone to UTIs.

Does it prevent pregnancy?

Peeing after sex will not prevent pregnancy. The urethra and vagina are separate parts of the female anatomy. As a result, peeing will not affect any sperm that enter the vagina. Using some form of birth control is the only way to prevent pregnancy during sex.

Does it prevent STIs?

Peeing after sex does not prevent sexually transmitted infections (STIs). People contract STIs by absorbing bacteria through the mucous membranes inside their bodies during sexual intercourse. Peeing after sex will not prevent these bacteria from entering the body.

Using a condom or other form of barrier contraceptives during sex can help to reduce the risk of STIs.

How soon after sex should you pee?

There is no recommended time to pee after having sex, although some anecdotal sources suggest peeing within 30 minutes after sex. In general, the sooner people pee after sex, the sooner they can flush out bacteria before it travels up the urethra.

If people are struggling to pee after sex, drinking a glass or two of water may help. A larger amount of urine will also be more effective in flushing out bacteria.

Other ways to prevent UTIs

The following tips may also help to reduce a person’s risk of getting a UTI:

  • drinking 8-10 glasses of water each day to ensure regular flushing of bacteria out of the urethra
  • peeing whenever the urge arises, rather than holding in urine
  • avoiding going more than 3 or 4 hours without urinating
  • always wiping from front to back after going to the toilet
  • cleaning the genitals with warm water each day
  • avoiding using scented female hygiene products
  • avoiding douching
  • avoiding using spermicides if prone to UTIs
  • wearing loose cotton underwear
  • avoiding tight clothing
  • avoiding staying in wet bathing or workout clothes that can trap moisture and harbor bacteria around the genitals
  • limiting baths to 30 minutes or less, or taking showers
  • drinking cranberry juice or taking cranberry extracts

When to see a doctor

People should see a doctor if they experience the following symptoms of a UTI:

  • painful or burning sensation when urinating
  • feeling the need to urinate often, despite passing only a small amount of urine each time
  • cloudy urine
  • foul-smelling urine
  • blood in the urine
  • pressure or pain in the lower abdomen
  • feeling tired, weak, or shaky
  • confusion

If people have a UTI, a doctor will likely prescribe antibiotics to clear the infection. People will usually start feeling better within a few days.

In some cases, a UTI can make its way up to the kidneys. A kidney infection can be severe and requires immediate medical treatment. Symptoms of a kidney infection include:

  • a fever
  • chills
  • nausea
  • vomiting
  • pain in the lower back

People should also see their doctor if they notice any unusual or painful symptoms during or after sex. These could be symptoms of an STI.

Summary

Peeing after sex may help to flush bacteria out of the urethra, thereby helping to prevent a urinary tract infection (UTI). It may be especially helpful for women, or people who are prone to UTIs.

However, peeing after sex will not prevent pregnancy or sexually transmitted infections (STIs).

People should see a doctor if they experience symptoms of a UTI or STI. Some people may require treatment with antibiotics.

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The testicles, or balls, are oval-shaped glands that form part of the male anatomy. They sit inside a thin sack of skin called the scrotum. As a person ages, the scrotum loses elasticity, and the skin starts to sag. Certain medical conditions can also cause the skin to appear saggy.

Skin loses its elasticity over time as a person gets older, and the effects of gravity start to become more noticeable everywhere on the body, including the testicles.

Some treatments can help keep the scrotum from sagging too much, although there is no way to prevent or treat the issue completely. Sagging testicles, which people often refer to as saggy balls, are usually not a cause for concern. However, if they appear with other symptoms, such as pain on one side of the balls or in the prostate, a person should see a doctor.

In this article, we look at the possible causes of sagging testicles, as well as treatment options and when to see a doctor.

What is normal?

The testicles hang inside the scrotum, or scrotal sac. The looseness of the skin around the testicles varies among individuals, and in many people, it is naturally fairly loose. The scrotum helps protect the testicles and provides some impact resistance.

The scrotum also moves in response to heat to protect the delicate testicles and sperm inside. In doing so, it helps keep the sperm viable by preventing them from becoming too warm or too cold.

In cold weather, the skin tightens up as the cremaster muscle pulls the testicles toward the body to keep them warm. In hot conditions, the skin loosens to prevent the testicles from overheating. The looser skin allows the balls to hang away from the warm body and encourages airflow around the scrotum to keep the area cool.

As such, even in younger people, the testicles will typically sag a bit. A person will generally notice this once they start producing sperm during puberty.

As a person ages, the testicles will generally sag much more. The process may not be noticeable at first, but by the age of 50 years, most people will notice a drastic difference in how much their balls sag.

Causes

Sagging testicles are a completely normal part of the aging process. A study from 2014 verifies the decrease in skin mechanical properties with aging. The skin loses collagen with age, causing the layers of the skin to stretch more.

While this applies to the skin everywhere on the body, it may be more noticeable in certain areas, such as the face and testicles. The scrotum and testicles already hang away from the body, so more stretchy skin and the efforts of gravity can lead to the effect appearing more drastic.

Other times, sagging testicles may be the result of an underlying issue, such as a varicocele. A varicocele occurs when a vein near the testicles swells up. This swelling can cause an increased blood flow to the testicles, which heats them. The body then responds by dropping the testicles lower to prevent them from getting too hot.

According to a study in the Asian Journal of Andrology, varicoceles appear in up to 15% of males and may have an association with infertility.

Varicoceles may make a person feel as though their testicles are moving or squirming, and they may also notice pain in the area. Anyone experiencing these symptoms alongside sagging testicles should see a doctor. Sometimes, a person will not experience any other symptoms and will not notice that they have the issue.

Treatments

Although age-related sagging in the scrotum is normal, some people may be uncomfortable with its appearance or find that it gets in the way of their daily life — for example, by making it easy to sit accidentally on the testicles. Surgery is the only sure way to resolve the issue, but people can also try a range of nonsurgical methods, including those below.

Exercises

There are several different exercises that people claim can prevent or treat sagging testicles, although there is no scientific evidence to prove that they work. Still, many people perform exercises to help them work out the muscles in this area of the body.

Some people say that they feel better when doing these exercises, perhaps because they feel as though they are being proactive. Even if they are ineffective, testicle exercises are unlikely to harm the testicles or make the sagging any worse.

Two exercises that some people use are Kegels and testicular holding:

Kegel exercises

Doing basic Kegels, by finding and activating the pubococcygeal (PC) muscles, may help some people support their penis and testicle health in general. The PC muscles are the muscles that a person uses to hold back their urine stream.

The basic Kegel exercise involves contracting the muscles as though trying to cut off the urine stream. As this exercise activates the PC muscles, it may improve the strength of the pelvic floor and help with some issues in the testicles, prostate, and penis.

Testicular holding

Testicular holding is similar to weight training the testicles. Holding the testicles in one hand and pulling downward activates the PC muscles. Doing this for 5 minutes each day may activate the PC muscles more strongly than simple Kegels.

Keeping the skin healthy

As much of the sagging in the testicles is due to aging skin, it may help to keep the skin as youthful as possible.

The American Academy of Dermatology recommend several ways to protect and care for the skin, including:

  • avoiding sun exposure
  • quitting smoking
  • drinking less alcohol
  • maintaining a healthy weight
  • eating a balanced diet

These tips may help improve skin health in general, which may slow the progress of saggy testicles.

Surgery

Some surgical options are available to treat overly sagging testicles. These are largely for people who dislike how their testicles look. These treatments may also help in cases where the person has problems that arise from their saggy testicles, such as accidentally sitting on their testicles too often.

In these cases, a procedure called a scrotoplasty may help keep the scrotum from hanging down as far. During a scrotoplasty, the surgeon will carefully remove extra skin from the scrotum to let the testicles rest higher up toward the body.

Surgery works to treat saggy balls, but the results are not permanent. The effect is likely to wear off over time as the skin continues to stretch with age.

In the case of a varicocele, a surgical procedure called a varicocelectomy treats the underlying issue by tying off the swollen veins. The symptoms should go away as the area heals, and this may have a positive effect on the sperm.

Other methods

There is no miracle cure for sagging testicles. People may come across other methods — such as only wearing tight briefs and avoiding sex or masturbation — on internet forums and by word of mouth, but these are not effective methods.

Other sources claim that lotions, creams, hormones, or supplements can help. Although they are probably harmless to most people, there is no evidence that these methods will work.

When to see a doctor

People who notice troubling symptoms, such as pain in their groin or prostate, should see a doctor. Anyone who wants to discuss cosmetic surgery should talk to a doctor about a referral to a trusted cosmetic surgeon.

Summary

The majority of the time, sagging testicles are a normal part of the aging process. The testicles naturally sag, even at a young age, to protect the sperm inside and keep them viable.

Anyone worried about saggy balls or other associated symptoms should contact a doctor for a diagnosis. In some cases, there may be an underlying issue to treat. In others, cosmetic surgery may help a person feel better.

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There are many misconceptions about masturbation. A lack of research into its long-term effects may contribute to some of these misapprehensions. Both masturbation and acne relate to hormonal changes, but is there a link between the two?

It is a common myth that masturbation causes acne. While both are common during puberty, this is the only real link between them.

Keep reading to learn more about the relationship between masturbation and acne, the causes of acne, and how to treat it.

Does masturbation cause acne?

Hormonal changes occur during puberty. These hormonal changes cause the body to produce more oil, which may contribute to the development of acne. Many people also start masturbating during puberty, which also has a small effect on hormone levels.

Because acne and masturbation tend to occur around the same time, this could explain the common misconception that masturbation causes acne. However, it is a myth — both masturbation and acne relate to hormonal changes.

Masturbation and hormones

Although masturbation can cause changes in hormone levels, these changes are minimal.

Testosterone levels rise during masturbation and return to normal after ejaculation. The effect is temporary and does not appear to have any long-term health implications.

One study looked at hormonal changes after masturbation following a period of abstinence. The findings indicate that any hormonal changes following masturbation are temporary and minimal. This, however, only looks at the short term effects.

There has been little research into the long-term effects of masturbation on hormone levels.

Causes of acne

Acne is a skin condition that causes whiteheads, blackheads, and pimples to develop.

Pores under the skin connect to glands that produce sebum, which is n oily substance. These glands can become blocked by a buildup of sebum, dead skin, or other debris. Bacteria can accumulate and cause inflammation. This leads to the visible symptoms of acne, such as pimples.

Acne can develop anywhere on the body. It is most common on:

  • the face
  • shoulders
  • back
  • chest
  • arms

While acne can develop at any age, it usually occurs and is most prominent during puberty.

The exact causes of acne are unclear but may relate to:

  • hormonal changes
  • medicines
  • cosmetic use
  • genetics

Poor hygiene does not cause acne, but it can make the symptoms worse in people who already have it.

Acne treatment

There are many different treatments for acne. Choosing the right one will depend on the severity of the condition.

There is a variety of over-the-counter (OTC) medications that are suitable for most types of acne. They are available as gels, creams, soaps, or lotions.

In mild cases, suitable OTC products should contain active ingredients such as:

  • benzoyl peroxide
  • salicylic acid

Some products will contain more than one of these substances.

Doctors recommend that people try combinations of these products when one does not work. Acne can have different causes that require different treatments. Start with one type of treatment and add a second if there is no improvement within 4 to 6 weeks.

In moderate cases, a doctor may prescribe antibiotics to treat the acne if it is due to a bacterial infection. The antibiotics, which can be a cream or a pill, will help fight the bacteria that are causing the inflammation. This may be in addition to OTC medications, such as benzoyl peroxide. Antibiotics may include the following:

  • clindamycin
  • erythromycin

In severe cases, such as cystic acne (nodular acne), a doctor may suggest isotretinoin. This drug comes as a capsule and is highly effective for treating acne. However, isotretinoin can have serious side effects, including:

  • dry skin
  • dry eyes
  • sore throat
  • skin rashes
  • headaches
  • anxiety
  • severe stomach pain
  • bloody diarrhea
  • yellowing skin
  • difficulty urinating

Doctors will only use isotretinoin in the most severe cases because of all these side effects. Anyone taking this medication should keep an eye out for any of these side effects and report them to a doctor if they experience any of them.

While it is difficult to prevent acne from developing, some tips for people who are prone to acne include:

  • avoiding washing more than twice a day
  • washing sweat off the face
  • avoiding scrubbing areas of skin prone to acne
  • using cosmetic products that do not clog pores
  • trying not to touch or pick at the acne
  • keeping bedding and clothing clean
  • spreading acne medication on all acne-prone areas, not just where outbreaks occur

When to see a doctor

Acne is a widespread condition and rarely has any serious health implications.

Most cases of acne do not require a doctor. OTC medications should clear away symptoms without the need for stronger medicine.

If the acne does not improve after 4 to 6 weeks of home treatment, consider seeing a doctor.

Summary

Masturbation does not cause acne.

Hormonal changes may contribute to the development of acne, and masturbation can also cause changes in hormone levels, but these disappear after ejaculation. Furthermore, these hormonal changes are minimal and do not contribute to the development of acne.

People tend to start masturbating and develop acne at around the same time, typically during puberty. This is likely a source of the confusion and the myth that masturbating causes acne.

The exact cause of acne remains unclear.

Acne is a widespread condition with many different treatments. Most cases of acne are mild and do not require a doctor. In more severe cases, a doctor may prescribe antibiotics or stronger forms of medication.

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Many people with uterine fibroids have no symptoms, but others may experience pain and abnormal vaginal bleeding. For some people living with fibroids, the pain is intense enough to interfere with daily life.

Uterine fibroids are noncancerous growths that form inside the uterus. They can grow quite large and cause pain and pressure.

Fibroid pain usually occurs in the lower back or pelvis. Some people also experience stomach discomfort, intense cramps when menstruating, or pain during intercourse.

Easing the pain at home

There is little evidence that home remedies can ease fibroid pain. However, there are a few methods that people can try.

These include:

  • taking over-the-counter (OTC) medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
  • using heating pads
  • practicing yoga or stretching
  • doing gentle exercise
  • eating a healthful diet

Some people may be interested in trying herbal remedies to shrink the fibroids and ease the pain. A 2013 Cochrane review analyzed previous research on the use of common herbal remedies — including Tripterygium wilfordii and Guizhi Fuling — to treat fibroids and their symptoms.

The researchers concluded that the quality of the data in the reviewed studies was insufficient to support the use of these herbal remedies.

Making lifestyle changes may be a more effective way for people to ease their fibroid pain.

Medication

A person can take medication to help ease fibroid pain. However, medication will not cure fibroids, and a person may require surgery later on.

These types of drugs may help ease fibroid symptoms:

  • Birth control pills: These can help reduce period pain. They may also make periods lighter, but they will not shrink fibroids.
  • A hormonal intrauterine device (IUD): This device releases progestin, which can help with painful, heavy periods but will not shrink fibroids.
  • Gonadotropin-releasing hormone (GnRH) agonists: These drugs counteract the effect of the hormones that regulate a person’s period. They can stop monthly bleeding and may help shrink fibroids.

The GnRH agonists may cause side effects, so doctors recommend that people take these for no longer than 6 months. After a person stops taking these drugs, the fibroids typically grow back.

Surgery

When fibroids cause pain, and medication does not work, a person may consider surgery. Doctors may recommend one of the following surgical procedures:

  • Myomectomy: A myomectomy is the removal of the fibroids from the uterus. This procedure does not remove the uterus, so it is still possible for the person to get pregnant afterward.
  • Ablation: This procedure involves using heat to destroy the fibroids. It will not remove the fibroids altogether, but they may shrink.
  • Laparoscopic power morcellation: For this procedure, a surgeon will make a tiny incision and insert a surgical instrument through it to break up fibroids. However, the Food and Drug Administration (FDA) caution that this treatment carries significant risks.
  • Hysterectomy: A hysterectomy removes the uterus. Sometimes, the surgeon will also remove the ovaries.

Other symptoms of fibroids

In addition to pain, some people experience the following symptoms:

  • very heavy bleeding
  • anemia from heavy periods
  • frequent bowel movements or urination
  • swelling or pressure in the stomach

Diagnosis

Many people find out that they have fibroids during a routine pelvic exam. A doctor can often feel the fibroids in the uterus during the exam.

A doctor can also detect fibroids by performing imaging tests, such as:

  • ultrasounds
  • MRIs
  • X-rays
  • CT scans

A doctor may sometimes recommend a hysterosalpingogram, which uses dye to see the uterus during an X-ray, or a sonohysterogram, which uses a saline solution to enhance the view of the uterus during an ultrasound.

Causes

Doctors do not fully understand what causes fibroids, but some possible causes and risk factors include:

  • Genetics: Fibroids may run in families, and certain genetic mutations increase the risk of these growths.
  • Hormones: Estrogen, progesterone, and growth hormones may increase the risk. Therefore, people who take hormonal birth control or have growth hormone injections may be more likely to develop fibroids.
  • Nutritional imbalances: Some research suggests that there is an association between vitamin D deficiency and the development of fibroids.
  • Race and ethnicity: African American women appear to be more likely than white women to develop fibroids.
  • Obesity: People who have overweight or obesity are two to three times more likely to develop fibroids than those with a moderate body weight.

When to see a doctor

It is not possible for a doctor to diagnose fibroids based on a person’s symptoms alone.

Many other conditions, including infections, pregnancy loss, and cancer, may share some of the symptoms of fibroids, so it is important to see a doctor for unusual bleeding or pelvic pain.

A person who already knows that they have fibroids should see a doctor if they experience:

  • sudden worsening of symptoms
  • heavy bleeding
  • pressure or swelling in the abdomen
  • returning fibroid symptoms after fibroid surgery

Summary

Many people develop uterine fibroids without being aware of them. However, some individuals may experience severe pain and need surgery or other treatments.

A person experiencing fibroid pain can stretch, use heat, or take OTC medications, but if the pain does not improve, they should see a doctor.

A doctor can guide treatment decisions by helping a person weigh up the risks and benefits of various symptom management options.

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