Birth Control -- FAQs About Hormonal Methods

Which methods of birth control contain hormones?

Contain Estrogen & Progestin	Contain Progestin Only
Combined Oral Contraceptives (The Pill) The Patch (Ortho Evra) The Vaginal Ring (Nuva Ring)	Progestin-Only Pills (Mini-Pill) Depo-Provera Injection (DMPA) Mirena and Progestasert IUDs Norplant Contraceptive Implant

What's the difference between the types of hormones?

Methods containing higher levels of hormones are more effective but have more side-effects. Methods that contain estrogen have more serious side-effects and health hazards than methods with only progestin. Estrogen-free contraceptives are less effective than combined hormonal contraceptives.

How do birth control chemicals work to prevent pregnancy?

Birth control chemicals containing estrogen and/or progestin have several major mechanisms of action. Contraceptive mechanisms prevent fertilization; when these fail, additional mechanisms prevent implantation.

Major Pre-Fertilization Mechanisms

· Prevents ovulation. Changes cervical mucus to provide a barrier to sperm (probably only a minor contraceptive mechanism)

· Major Post-Fertilization Mechanisms. Changes the lining of the uterus to block implantation of the embryo

Do I need to use a backup birth control method in addition to my hormonal contraceptive?

If you start the Pill, Norplant, or Depo-Provera on the first day of your period, it is considered effective right away. It takes up to seven days for the hormones to become fully effective. However, the first seven days of a woman's cycle are already infertile, so no additional protection is required. If you start the method on any other day than the first day of your period, you need to use a backup plan for up to seven days. For the minipill, you may need a backup method for 28 days. Ask your doctor to be sure. For the Pill, some doctors recommend using a backup method for the first 30 days. This is mainly to be sure that a pregnancy does not occur while you are still getting in the habit of taking a pill every day.

I have just stopped my method because I want to have children. How long should I wait before trying to get pregnant?

It is recommended that you wait until you have had 2-3 normal menstrual cycles before trying to get pregnant. This is because it may take several months before your cycles return to normal after discontinuing a hormonal method. Doctors use the first day of your last menstrual period to determine your due date; if your periods are irregular this may result in an inaccurate date. Also, there is some evidence that birth control drugs may exert a prolonged effect on the endometrium, making it more difficult to become pregnant.

I have stopped using birth control. Why am I unable to conceive?

Because of the prolonged effect of the birth control drugs on your body, you may be infertile for some time. For combined oral contraceptives, the average length of infertility is 2-3 months, but some women will remain infertile for 6 months or more. For Depo-Provera users, infertility typically lasts from 6 to 12 months. You may not have any periods during this time.

Why have my periods stopped? Should I take a pregnancy test?

For users of combined oral-contraceptives, missing a period is not uncommon. If you have not missed a pill you are probably not pregnant, but a pregnancy test may not be a bad idea. If you miss two periods in a row OR if you miss your period and you did miss one of your pills, you could be pregnant. Contact your local pregnancy center immediately for a pregnancy test.

For users of progestin-only methods, lack of periods is common. It probably means that you are not ovulating. However, if you are experiencing pregnancy symptoms (nausea, fatigue, sore breasts, frequent urination, etc.) contact your local pregnancy center for a pregnancy test right away.

Half of all Depo-Provera users have no periods at all during the first year of use. And pregnancy symptoms such as weight gain, mild headaches and breast tenderness are also common side effects of the drug. This can be alarming for Depo-Provera users, but usually the pregnancy-like symptoms disappear. Even after using Depo-Provera, it takes on average 10 months from the time of the last injection for normal periods and fertility to return. If you have stopped using your method, it may take time for your periods to return to normal.

I'm on combined OCs and didn't get my period. How can I tell if I'm pregnant?

If your period does not start during the last few days on the "reminder" pills or during the first 3 days of the pill-free interval, take your temperature with a Basal Body Temperature (BBT) thermometer in the morning before you get out of bed. (You can get a BBT thermometer from most drug stores.) If your temperature is 98 degrees F for 3 days in a row during the pill-free week, you are probably not pregnant. You can also take a home pregnancy test, which are usually accurate by the time you miss your period, or visit a local pregnancy resource center for a free, accurate test.

What if I forget to take a pill?

Combined OCs It is recommended that you take that pill as soon as you remember, and take your next pill at the regular time, even if it means you take two pills in one day. You will probably not get pregnant, but just to be sure, you might use a back-up method for 7 days. If you have missed any of pills 15-21, ask your doctor or pharmacist for special instructions. S/he may ask you to continue taking your pills, but to start a new pack instead of taking the reminder pills.

Progestin-Only OCs It is recommended that you take that pill as soon as you remember, and take your next pill at the regular time, even if it means you take two pills in one day. You will need to use a back-up method for the next 2 days.

What if I forget to take two or more pills?

Contact your doctor or pharmacist for instructions. You may need to start a new pack or double up on pills for a while depending on what type of pill you were taking.

What if I get sick and vomit after taking the pill?

If you took a combined oral contraceptive pill two hours or more before you vomited, then you do not need to take it again. If the vomiting ocurred within two hours, you will need a replacement pill.

Can I use oral contraceptives to change the date my period comes?

Yes, but you will need to talk to your doctor or pharmacist for details. This practice can compromise the effectiveness of the pill. You might also ask your doctor about a new type of combined OC pill where women get their periods only four times a year. It works by reducing the number of pill-free intervals which trigger menstruation.

Why am I having irregular bleeding?

Mid-cycle spotting is not uncommon for users of the pill, especially during the first few months of use. When this happens, typically doctors prescribe a stronger formulation of the pill. Spotting is an indication of decreased pill effectiveness, so some doctors recommend using a back-up method should spotting occur. However, spotting could also be a symptom of the STD chlamydia, so you should be tested if you are at risk.

Users of Norplant and Depo-Provera can expect irregular menstrual patterns. No periods, light periods, and even prolonged or heavy bleeding are all potential side-effects. If you have prolonged or heavy bleeding, you should contact your doctor.

If I take my pill every day can I still get pregnant?

Yes. All methods of birth control can fail, even if you use them perfectly. If you miss a pill, take a mini-pill only a few hours late, or take antibiotics that will increase the likelihood of contraceptive failure. One in ten pill users get pregnant every year.

I took the pill before I knew I was pregnant. Can the hormones hurt my baby?

There is no conclusive evidence that a brief exposure to birth control chemicals will cause any sort of birth defect in the unborn child. However, you should avoid taking if these drugs if you think you might be pregnant.

Who should not use hormonal methods of birth control?

• Women who are pregnant (known or suspected)
• Women who are breastfeeding and fewer than 6­8 weeks postpartum
• Women with unexplained vaginal bleeding
• Women with active liver disease (viral hepatitis) or a history of liver tumors
• Women over age 35 who smoke
• Women with a history of heart disease, stroke or high blood pressure
• Women with a history of blood clotting problems or diabetes
• Women with breast cancer or a history of breast cancer
• Women with cancer or a history of cancer in any reproductive organs
• Women with migraines and focal neurologic symptoms
• Women with moral objections to this type of birth control

Do birth control chemicals have unpleasant side-effects or health hazards?

Combined OCs

• · Common Side-Effects (not comprehensive)
• · Weight gain
• · Acne or dark-colored areas on face
• · Nausea/Vomiting (especially at the beginning)
• · Dizziness
• · Headache
• · Depression
• · Acne and/or oily skin
• · Weight gain
• · Vaginal infections
• · High blood pressure
• · Less Common Serious Health Hazards
• · Blood clots in lung or brain
• · Stroke
• · Liver tumors
• · Heart attacks
• · Gallbladder disease
• · Cancer

Progestin-Only Methods

• · Common Side-Effects (not comprehensive)
• · Untimely bleeding or spotting between periods
• · Prolonged menstrual bleeding (8 days or more)
• · No bleeding at all (amenorrhea) for several months or over a year
• · Headache (very common)
• · Nervousness/anxiety
• · Lower abdominal pain
• · Dizziness
• · Loss of sex drive (libido)
• · Depression
• · Acne and/or oily skin
• · Change of appetite
• · Weight gain
• · Breast tenderness (mastalgia)
• · Increased facial or body hair growth (hirsutism) or hair loss
• · Whitish vaginal discharge (leukorrhea)
• · Excessive growth of body/facial hair or hair loss
• · Infection the implants site for Norplant
• · A brief period of pain or itching
• · Enlarged ovarian follicles
• · Bone density loss
• · Less Common Serious Health Hazards
• · Ectopic pregnancy
• · Cancer

What happened to my sex drive (libido)?

One of the most common complains we hear from women is that after starting hormonal contraceptives they just don't feel like having sex any more. Doctors frequently dismiss women's concerns about sex drive while partners are left sulking. Until recently, few studies have examined this issue, other than those conducted by pharmaceutical companies (which tend to be invested in not finding problems). Earlier studies found conflicting results. The most recent research has found that loss of libido is a common problem and may not be reversible.

Will I gain weight if I start the Pill or other hormonal method, and if so how much?

There is no one answer to this question. Weight gain is a very common side effect in response to hormonal birth control and varies on an individual basis. For most women, extra female hormones make fat deposition easier and increase the appetite. Conversely, weight loss usually becomes easier when hormonal birth control is discontinued. For Depo-Provera the average weight gain is 5.4 lbs the first year, 8.1 lbs after two years, and 13.8 lbs after four years. But this is an average, and for many women weight gain can be extreme as this drug can increase the appetite. The average weight gain while on Norplant is only about a pound a year.

Will hormonal methods protect me from sexually transmitted disease?

No. In fact, women who use Depo-Provera may double their risk of acquiring STDs, such as chlamydia, gonorrhea, and HIV. Other hormonal contraceptives seem to also increase the risk of getting an STD. This is because these drugs cause dryness in the genital tract, which facilitates small tears and abrasions, making it easier for infections to enter the body. Also hormonal contraceptives may supresses the immune system, which makes it easier for infections to proliferate.

Source: http://www.contracept.info/

Safe Sex VS Safer Sex

For a time, the use of condoms and other contraceptives was often referred to as "safe sex". It was thought that, as long as you used condoms along with another method of birth control, you were virtually immune from sexually transmitted diseases (STDs) and pregnancy. Nowadays, the only type of safe sex is no sex at all.

What is Safe Sex?

When people speak of "safe sex" today, they are referring to abstinence. Abstaining from sex and sexual play is the only sure method to avoid catching an STD and to prevent an unplanned pregnancy. Although it may not prevent a pregnancy, having sex within a committed, monogamous, long-term relationship with someone who has tested free of any STDs is also generally considered to be safe sex.

So why isn’t using condoms along with other forms of birth control known as "safe sex" anymore but as "safer sex" instead? Because contraceptives can fail, resulting in pregnancy, and condoms cannot provide protection against all forms of STDs. However, condoms are still the only and best protection we have against most STDs. Therefore, it is important to use them every time you have sex.

What’s the Big Deal About STDs Anyway?

While some sexually transmitted diseases, like chlamydia, can be cured, others cannot. HIV is one of the most serious STDs out there and women are one of the fastest growing groups being infected. Moreover, according to UNICEF, half of all new HIV cases worldwide occur in people between the ages of 15 and 24. So if you’re young and sexually active, you’re automatically at a higher risk of being infected with HIV. Although it can be managed through medication, the HIV virus does eventually develop into AIDS leading to death. Other incurable STDs include human papillomavirus (HPV), which is the cause of genital warts and can lead to cervical cancer and even death,hepatitis B and herpes.

Sexually transmitted diseases are dangerous for anyone but they can have especially severe consequences in women. Many STDs can seriously damage your reproductive organs causing you to be infertile. Some, like HPV, have been linked to an increased risk of cervical cancer, a type of cancer that men do not need to worry about. Additionally, if you have an STD while you are pregnant, it is possible to pass the infection on to your baby causing her to become sick or possibly even die.

If you are sexually active, it is imperative that you use condoms each and every time you have sex even though they cannot protect you from every STD. Latex or polyurethane condoms are the most effective at protecting against STDs. However, they cannot provide protection against infections that are transmitted through skin-to-skin contact. Additionally, condoms can break or fall off during sex, putting you at risk of catching an STD. While it was once thought that condoms treated with spermicide helped to kill off STD infections and viruses, current research suggests that spermicides have no such effect. In fact, using spermicides multiple times throughout the day has actually been shown to increase your risk of STDs because the chemicals can irritate your vaginal lining thereby making it easier for an infection to get into your system.

Talking with Your Partner

When you are considering becoming sexually active with someone, talk to them about their sexual history. Remember, when you have sex with someone, you are having sex with every person they have ever had sex with. It is a good idea for both of you to go get tested for STDs so that you can be sure you are both free of any infections. However, some STDs can take as long as six months before they begin to affect you. If your partner has had sex with someone else in the last six months, it is a good idea to either put off having sex or use condoms until he can be retested.

If your partner refuses to get tested or has no desire to talk about his sexual history, you may want to reconsider your choice to have intercourse with him. Never feel guilty for asking about his sexual past. Your health, as well as his, is on the line and you both have a right to know what you’re getting into. Never allow yourself to be pressured, coerced or bullied into a sexual relationship. Do not hesitate to say no. If a your partner forces you to have sex after you’ve said no, that is rape and should be reported to the authorities.

Signs of an STD
If you notice any of the following symptoms, make an appointment with your doctor or gynecologist right away to be tested for STDs:

• Vaginal itching
• Burning sensation when you urinate
• Unusual vaginal discharge
• Blisters around the genital area
• General pain in the pelvic area

Source: http://www.epigee.org/

Condoms -- FAQs

Are condoms effective at preventing pregnancy?
Although condoms do provide protection against getting pregnant, they also carry a 15% failure rate. Depending on your age and how consistently you use condoms, the chances of becoming pregnant could be higher. To increase your protection against pregnancy, use condoms along with another form of birth control, like the sponge. It is important to note, though, that condoms containing spermicide have not been found to be any more effective at preventing pregnancy than non-spermicidal condoms.

Will condoms protect against sexually transmitted diseases?
Condoms made out of latex or polyurethane will help reduce your chances of contracting sexually transmitted diseases (STDs) that are passed through bodily fluids, such as HIV and gonorrhea. They can also offer some protection against other STDs including herpes, trichomoniasis and Chlamydia, although not as effectively. Condoms do not offer much protection against STDs that can be transmitted through skin-to-skin contact, though, such as genital warts. Condoms made out of animal tissue do not offer any protection against STDs.

Are condoms a good way to avoid being infected with HIV?
Condoms can reduce your risk of contracting an HIV infection. However, if your partner has HIV or AIDS, there is still a chance that you could acquire the virus even if you use condoms. A 1993 study found that, of 171 women whose male partner had HIV, two of the women became infected with HIV despite consistently and properly using condoms when they had sex. However, of those women who did not use condoms consistently with their male partner who had HIV, 8 out of 10 women became infected with HIV. Abstinence from vaginal, anal and oral sex is the only way to completely avoid the risk of HIV infection.

Will using condoms with spermicide that contains nonoxynol-9 lower my chances of HIV infection?
Originally, nonoxynol-9 was believed to aid in reducing the risk of HIV infection along with infection of other STDs. However, recent studies have shown this to not be true. In fact, nonoxynol-9 may actually increase a person risk of contracting HIV, especially if it is used frequently. This is because the chemical can irritate the vaginal and rectal lining, thereby make a person more susceptible to infection. For this reason, spermicides are no longer recommended as protection against HIV and STDs. Additionally, more condom manufacturers are no longer producing spermicidal condoms while those who still do are using less spermicide.

Are condoms the best way to practice "safe sex"?
Although it was once a popular term, most experts nowadays recognize that there is no such thing as "safe sex", only "safer sex." While condoms can help to reduce your chances of pregnancy and STDs, they can also break and when they do, both you and your partner are put at risk even though you have done everything right. To be truly "safe" from pregnancy and STDs, it is necessary to practice abstinence. Sex in a monogamous, long-term relationship with an uninfected partner is also consdiered to be "safe" from STDs, although you can still get pregnant. To be "safer" from pregnancy and STDs, it is necessary to use condoms as well as some other form of contraception each and every time you have sex.

How often do condoms break?
Of the three different condom types, latex condoms are the most durable. However, anywhere from 2% to 6% of condoms will fall off or break during sex.

If the condom breaks, what should I do?
Depending on when you notice the break, you have a few different options.

• When you notice the breakage before ejaculation, quickly pull out, remove the broken condom and put a new one on.
• If ejaculation has already occurred, then wash away any semen that has leaked out with soap and warm water. This may also help to reduce your chances of STD infection. If you have any spermicidal foam, insert two applications into the vagina. Do not douche.
• Regardless of when you noticed the break, contact your health care provider or a pregnancy resource center to discuss the possibility of pregnancy, what your options are and to take an STD test.

I always use a condom and they have never broken. Could I still get pregnant?
Although pregnancy is unlikely, it is still possible. If you think you might be pregnant, take a pregnancy test.

Are there any side effects or health risks associated with condoms?
The most common complaint associated with condoms is irritation. This is usually caused by latex condoms and is due to a person having a latex allergy. Spermicidal condoms can also cause irritation and may worsen the allergenic properties of latex condoms. Spermicidal condoms may also increase a woman’s risk of urinary tract infection. However, condoms are a fairly safe method of birth control and have few side effects when compared to methods like the Pill and IUD.

Source: http://www.epigee.org

Issues around Hydrosols or Hydrolats

Hydrosols or hydrolats are the isolated distillation condensate waters, either intentionally produced or produced as a by-product to essential oil production, where aromatic materials are steam or hydro- distilled. Hydrosols are used by aromatherapists, and are used in nebulisers, cosmetics & shampoos and to a limited extent in foodstuffs.

Popular hydrosols include lavender water, orange flower water, kewda water etc. In India for example, kewda water (produced from male spadices of Pandanus odoratissmus flowers) is used for flavouring syrups, soft drinks & Moghlai cuisine. Little chemical data exists on the chemical make-up of many hydrosols, but an interesting paper by Platto A. & Roberts D. (2001) "The Aroma Quality of Lavender Water: a Comparative Study" Perf. & Flav. 26(3), 44-64 compared lavender waters from several different origins & determined amongst other things) that genuine lavender water distillation condensate could be differentiated from reconstituted water (diluted essential oil in water) by the absence of acetate esters.

Customers of hydrosols should always demand a "Certificate of Naturalness" from the supplier. This will have a section showing the total percentage of the natural involved, and a listing of the percentages and identification of each additive, if any. If the product is truly 100% botanically derived from the named source by a purely physical process (i.e. steam distillation) then it will indicate this fact - If the supplier is unable to do this, change to someone more professional [a template of a typical Naturalness certificate is available from Cropwatch on demand].

Production

The production of hydrosols varies enormously depending on distillation techniques and countries of origin. For example, in the large production units such as in Turkey and Egypt, the plant material is distilled in closed equipment. The hydrosols never sees the light of day and atmospheric contamination is unlikely. In addition, the heat of distillation will pasteurise the water making its immediate use safe.

With small scale 'on-the farm' production, the hydrosols can become contaminated by the atmosphere or by the unhygienic conditions in which many stills are located. It is common to see barrels being filled in the open air that previously were stored over filthy drainage channels or in dirty barns.

With essential oils contamination is unlikely to be a problem due to their general inability to support most bacterial or fungal growth. However, with distillation waters this is another matter as hydrosols make an ideal growth medium for bacteria and fungi.

Saferty and Toxicity Issues

Subsequent bottling can turn a contaminated hydrosol into a safe one. For example they can be pasteurised in the same way as drinks or milk, or they can be finely filtered to remove organisms and other contaminants. This is all fine if the hydrosol is kept in a sealed bottle, but once opened they can quickly become contaminated again and the greatest care must be taken to avoid this. To prevent this contamination causing a health problem, larger commercial suppliers will add a preservative. The preservatives are often the same as those commonly used in foods. This idea goes against those who say they "must have a 100% natural product", but in reality, many hydrosols do contain a preservative without it being declared. Thank goodness they do as 'natural' does not equal safe.

There are other methods used to produce what is called a hydrosol or distillation water, but which are not genuine. They can be home-produced simply by making an infusion of the herb, filtering it and selling it as a hydrosol. They can be produced from freeze dried herbal extracts reconstituted with water (common). This may even be done in the country of origin making detection difficult. They can be made by dissolving some essential oil in water by using a surfactant to permit the oils emulsification. Finally, in some cases, they can be a synthetic perfume compound added to water. This is not uncommon with rosewater sold in pharmacies, or beauty shops.

Toxicity

Several people have raised the issue of toxicological effects of hydrosols. This really is unrealistic because many of the herbs from which hydrosols are made are permitted food additives. With most of the commonly available hydrosols one would need to drink the stuff by the gallon for days to even come anywhere near a toxic dose. That even holds good for animals who might lick it off their coats. If hydrosols were toxic then so is a cup of tea or coffee, most canned fruit drinks and many human and animals foods that contain herbs and essential oils. Also, many herbs that hydrosols are made from, have known toxicology from tests done on mice and rats by food safety advisors such as the World Health Organisation.

Microbial Contamination

The biggest hazard from using hydrosols is their potential bacterial contamination. When the product is just used on the skin, this may not cause problems as long as the bacteria can't get into the mouth. However, some dangerously incompetent authors and therapists advocate their internal consumption. If the product being used has not been properly preserved or processed then this represents a significant health hazard.

For those who wish to check the hazards associated with bottled waters below is some essential reading.

http://www.nrdc.org/water/drinking/bw/bwinx.asp

http://www.pacificro.com/Bottled3.htm

The above reports contain information on the contamination that has been found in ordinary bottled waters. In one survey of 103 brands up to a third of samples were contaminated. Cryptosporidium, Giardia and other cysts have been found and these led to 4000 people being hospitalised. Dateline NBC, September, 1994. The NRDC'S study of water found many different kinds of bacteria capable of causing illness.

You may be thinking "what has this got to do with hydrosols"? Well most hydrosols are mainly water with minute traces of a variety of plant chemicals. Rarely are those plant chemicals occurring at a high enough level to inhibit bacterial or fungal growth, despite the hype you will see written on this.

The Law

Most products intended for retail sale for human or animal consumption come under food safety laws and veterinary medicine laws. Hydrosols seem to be slipping through this safety net which would not matter if they were just being used as cosmetic products. However, increasingly people are being advised by quack practitioners to drink them for medical conditions, or being advised to give them orally to animals

Strongly advise any aromatherapist to check their insurance position on this. Many aromatherapy policies do not permit the therapist to practice herbal medicine. If you advise someone in a professional setting to consume a hydrosol for a medical reason, then you are practising as a herbalist. In some countries that would also classify you as an "unlicensed medical practitioner".

How Do I Know If what I’m Buying Is Safe?

The only way you can hope to find out is to ask the supplier pertinent questions (as follows), and do not believe woolly or misleading marketing hype.

1. Does this hydrosol contain a preservative? If the answer is a categorical "no" then see next.

2. Do you have any evidence that this product has been tested for microbial contamination?

3. Can I see copies of test results?

4. Where is the product bottled, i.e. by the distiller or later in the supply chain?

5. Do you repack the hydrosol from bulk barrels or other bulk storage?

6. Do you produce it yourself? If so how is it stored and how do you ensure it is not contaminated?

7. If you advocate its consumption have you been certified as a food preparation premises?

What To Be Wary of

Some hydrosols can be very useful for a limited range of ailments. For example, rose, chamomile, lavender, neroli, and a few others can make wonderfully cooling applications for a variety of skin problems. Indeed in some cases they are better than the same plants essential oil. However, unlike with essential oils, there is hardly any research base behind such uses. It is mainly traditional information and how accurate that information is depends on the depth of knowledge of the person advocating its use. Herbalists in the past rarely used hydrosols because they preferred to use herbal teas or decoctions which (when freshly prepared) were not contaminated by microbes. Therefore, there is very little information to be found on hydrosols in good books on herbal medicine. When in certain societies they did use hydrosols, you should always remember they used the fresh product. They did not use it from a bottle that had been shipped round the world with the time and conditions suitable for microbial growth (unless a preservative is used).

Beware of hydrosols made from plants on which there is no safety data on their essential oils. For example, verbenone type rosemary, ravensara, thyme chemotypes, etc. Also beware of hydrosols made from plants with known dangers, for example the sensitisation reactions associated with fresh Verbena and Yarrow. These hydrosols may be safe on the skin but I am not aware of any formal testing having been done.

Traditional healers rarely used hydrosols because they did not generally undertake distillation, although there are a few exceptions. So one has to ask where all this information entering the market in recent years has come from? The simple answer is a typical one for aromatherapy: The suggested uses are frequently based on how teas and suchlike were and still are used by herbalists. Also, in many cases, the uses have simply been invented by certain aromatherapy authors.

I have to add something very important here. Please never forget that very few aromatherapists are trained in physical diagnosis, in the medical sciences or in herbal medicine. Therefore, the aromatherapists advocating the use of hydrosols can make some enormous blunders on what they write about and teach. Some of the claims on web sites are outrageously misleading and are often illegal under their countries own laws. Canada is particularly bad in this respect.

Beware of those who make references to uses based on the books of certain French aromatherapy authors. With one book in particular, the information is not properly referenced and it is known some of the text was not written by the claimed authors, but rather by editors. Therefore, medicinal claims made in such a book should be viewed with the utmost scepticism. One web site in Canada is using information from this book and the site owner is being promoted as "a world leader on the subject", in reality far from the truth.

Hype and Lies Designed to Mislead

Never accept the following statements without any evidence of their truthfulness. What follows and other answers are just hype and lies designed to mislead.

• " I have been selling this for 20 years and never had a problem".

• "I am a leading authority on the use of hydrosols",

• "such and such teacher says",

• "I am working with 4 chemists around the world",

Other hype:
"They are like homeopathic essential oils".
No, this is complete hogwash. Anyone that says this must be totally ignorant of homeopathy. To be homeopathic the preparation MUST be manufactured in a specific manner and hydrosols are not done like that.

"Homeopathic flower remedies use alcohol as a preservative"
Yes, they do, but the alcohol is around 60% and thus an effective preservative. Also, one only gives a few drops at a time, and see below.

"Adding a little grain alcohol acts as a preservative".
Again hogwash. Such a statement proves the person saying it has absolutely no knowledge of what is required of a preservative. It takes at least 25% alcohol by volume to inhibit most (but not all) micro-organisms. Therefore, if you add a couple of teaspoons of alcohol to a pint of hydrolate all it will do is make the bugs merry!

So Are Hydrosols of Any Use at All?

Yes, they can be if they are properly treated to ensure no contamination. They can be very good for treating most kinds of skin inflammation. Rosewater in particular is wonderful for that. They can be excellent cosmetic agents for treating things like overactive sebum production. Some can be great for subduing the inflammation of acne and similar conditions. Some are the ideal solution to sore eyes or minor convunctival infections. They can be an ideal cooling application for nipple soreness from early breastfeeding, as they can for soothing external vaginal damage from childbirth. There are many other examples involving damaged skin that they are ideal for, but only if the product can be proven to be bug free.

Should I Drink Them?

No You should not. If you wanted a herbal preparation you would rather make a fresh herbal tea which contains far more of the herbs active constituents than most hydrosols.

Myths Organic Food

Myth: Organic food tastes like cardboard.

Fact: This may have been true of processed foods at one time—take crackers or pretzels for example—but this stereotype is as outdated as the hippie connotations that follow it. Today many organic snack foods taste the same as their conventional counterparts, while most people agree that fresh, locally grown organic produce does not compare to the alternative. Even organic produce that is not in season and has been shipped thousands of miles to reach our grocer’s shelves cannot compare to the produce found in our own back yard or at farmers markets. Taste is certainly an individual matter, what you think!Try baking a couple batches of cookies or prepare a couple of bowls of fruit or vegetable salad; use organic ingredients in one and conventional ingredients in the other.Which tastes better?

Myth: Organic food is too expensive.

Fact: In general, organic food costs more than conventional food because of the laborious and time-intensive systems used by the typically smaller organic farms. You may find that the benefits of organic agriculture off-set this additional cost. At the same time, there are ways to purchase organic while sticking to your budget. Consider the following when questioning the price of organic:
• Organic farmers don’t receive federal subsidies like conventional farmers do. Therefore, the price of organic food reflects the true cost of growing.
• The price of conventional food does not reflect the cost of environmental cleanups that we pay for through our tax dollars.
• Organic farming is more labor and management intensive.

Myth: Eating organic food is the same as eating natural food.

Fact: Natural foods do not contain additives or preservatives, but they may contain ingredients that have been grown with pesticides or are genetically modified. In other words, the ingredients in the ingredient panel will look familiar, but they have not been produced organically. Natural foods are not regulated and do not meet the same criteria that organic foods do.

Myth : Organic foods are no healthier than non-organic foods.

Fact: Wrong. Food produced organically contains fewer contaminants. Some scientific studies have shown that there are more nutrients in organically produced food.

Myth: Organic farming increases the risk of food poisoning.

Fact: False. Organic farming can actually reduce the risk.

Myth: Organic farming uses pesticides that damage the environment.

Fact: Untrue. Organic farming systems rely upon prevention rather than cure, minimising the need for pesticides.

Myth: Consumers are paying too much for organic food.

Fact: Not so. crop rotations, organic animal feed and welfare standards, the use of good husbandry instead of agri-chemicals, and the preservation of natural habitats all result in organic food costing more to produce. Non-organic food appears to be cheaper but in fact consumers pay for it three times over – first over the counter, second via taxation (to fund agricultural subsidies) and third to remedy the environmental pollution (or disasters like BSE) caused by intensive farming practices.

Myth: Organic food cannot feed a hungry world.

Fact: False. Intensive farming destroys the fertility of the land and is unsustainable. Organic methods help labour-rich but cash-poor communities to produce food sustainably.

Myth: Organic farming is unkind to animals.

Fact: Far from it. Animal welfare and the freedom to behave naturally is central to organic livestock standards.

Myth: Organic food is 100 percent pesticide-free.

Fact: Truth. While organic farmers don't apply environmentally harmful chemicals to crops, they are permitted to use safer pesticides where necessary. The organic designation never really meant 100 percent pesticide- or chemical-free, despite public perception. The designation actually describes a method of farming that is as ecologically sound as possible. Also, chemical pesticides are now so widespread that they appear regularly in the rainwater that drenches all crops, conventional and organic alike. These chemicals can also drift through the air onto organic fields from conventional fields located miles away.

Myths, Reality and Research around Organic Food

The Myth and Reality Report examines some of the key issues around organic food and its production. It takes up the challenge of answering the critics – who range from public relations companies defending agri-business, through to the heads of national food authorities and some academics. It exposes the misleading and erroneous statements made against organic food, and provides the facts that prove them wrong.

The myths which damage the organic movement are not conjured out of thin air and they do not arrive in the newspapers by chance. The myths are generated by organisations with particular interests to defend, and they are presented as press releases and prepared articles for publication in the media.

Between 1990 and 2000 the organic market in Europe grew at average of 25 per cent a year to reach an annual turnover of £6 billion by April 2000. Growth within the UK has been particularly strong in recent years with a five-fold increase in market value in only 5 years. There is a growing shift in consumer purchasing towards organic food. This trend has developed for a number of reasons :

• Loss of trust in non-organic food products after a long line of food scares.
• Desire to avoid pesticide residues in food.
• Desire to eat food produced without the use of Genetically Modified Organisms (GMOs).
• Demand for the highest possible standards of animal welfare.
• Demand for environmental protection and enhancement.
• Desire to protect the environment from GMO contamination.
• Confidence in the external inspection programme and legal standards for production covering all organic production and processing.
• Health and safety of farm and food workers worldwide.

Policy makers have recognised the potential for organic farming as a means of food production that meets the demands of nature and the marketplace. The benefits of organic management are reflected by government support for conversion, and post-conversion organic management, in all European countries except the UK.

However, the progress and objectives of organic farming have not been welcomed by all. Organic production aims to avoid external inputs in order to achieve sustainability. This conflicts with non-organic agriculture which relies heavily on external inputs to increase yields (particularly pesticides and fertilisers). As a consequence pesticide sales globally are now estimated to be worth over £15 billion a year.

There is clearly a strong commercial interest in maintaining this market. It is therefore no surprise that organic farming has its critics, who are attempting to influence the buying habits of consumers with anti-organic allegations. It is important that these allegations or myths are engaged and refuted rather than ignored and allowed to gain credibility. The myth and reality initiative was launched by the Soil Association and Sustain to provide a well referenced and robust response to these myths. This report aims to educate critics, provide information for the organic sector and the media, and to raise awareness amongst the general public.

However, emerging research is already beginning to show the benefits of organic production. The results of a major six-year study recently reviewed in Nature magazine comparing organic, integrated and conventional apple systems revealed that an organic apple production system has similar yields to conventional and integrated production methods. Importantly, it also has higher soil quality, is better for the environment, produces sweeter and less tart apples, has higher profitability, and achieves greater economic sustainability.
With confident that more research will yield more evidence that organic food and farming is good for people and good for the planet.

source: http://www.biblelife.org/organic.htm

Eating for Optimal Health -- Putting Ideas into Action

• This day starts with a serving from almost every food group to fill you with fiber, vitamins and minerals. Not into breakfast foods? A turkey sandwich, an orange and a glass of milk gives you the same benefits as the more traditional breakfast fare.

• Not only is eating every meal important, snacks help prevent over-hunger which leads to over-eating. This sample day includes 2 snacks. When you eat them depends on your mealtimes. For example, if you have an early breakfast and late lunch, a mid-morning snack is for you. Not crazy about nuts and dried fruit? How about an apple with peanut butter or cheese and crackers. Both give you the needed protein/carb mix to satisfy you and tide you over until mealtime.


• Each of these meals provides a balanced mix of protein and carbs, as well as meats, starches and veggies/fruit. But there's many ways to achieve those goals. Try a slice of pizza and a salad on the side, with some yogurt mixed with a half cup of blueberries. Or, a cup of tuna noodle casserole with steamed carrots and a glass of milk.

Eating for Optimal Health -- Nutrition Basics

Eat Breakfast

Certainly every meal is important, but the first meal after a long night's rest is crucial in many ways. It's the first shot of energy to rev you up and get your day started. It's a great opportunity to eat your first servings of calcium-rich dairy foods, fruits, and whole grains--common ingredients in morning meals. A good breakfast also helps you steer clear of high fat/sugar vending machine fillers.

Don't Skip Meals

Missing meals on a regular basis is a bad idea no matter what your reason. No time? Make time. Trying to lose weight? This won't work. Skipping meals leads to overeating later in the day. In addition, the body becomes very efficient to prevent starvation. Translation: your metabolism slows down and stores more fat. Finally, without the continuous energy food supplies, you become run down and more susceptible to sickness. The solution: During the day try to eat every 3 to 4 hours. That means breakfast, perhaps a snack, lunch, a snack, and dinner.

Eat Protein With Your Carbs

No need to avoid carbs altogether, just don't over do it. Pairing protein-rich foods with your carbs makes this task easier. Carbohydrates provide much-needed energy to your body; however they are digested quickly leaving you feeling hungry soon after eating. Bagels and muffins for breakfast, candy bar snacks and large portions of pasta and rice at lunch and dinner become an unending cycle resulting in hunger pangs and the need for a pick-me-up. Proteins digest more slowly therefore you feel satisfied longer. The solution: Enjoy complex carbs in moderate amounts and along with low-fat protein. Instead of a bagel and cream cheese, try an English muffin with peanut butter. Instead of a candy bar, how about dried cranberries and almonds. Instead of a big bowl of pasta, dish out three-quarters a cup of pasta along with a grilled chicken breast.

Break Down Your Dish

Chances are your dinner (or lunch) plate looks a bit like this: a pile of meat, chicken, or fish and a pile of rice, potatoes, or pasta and on a good day maybe a smidgen of veggies or a salad on the side. Well its time to put your math skills to work. Divide your plate into three parts. One quarter is for the protein of the meal--meat, chicken, beans, etc.--three ounces or about the size of the palm of your hand. One quarter is for the starchy foods--rice, potato, corn, etc.--about a half cup. And the remaining half should be loaded up with fruits and veggies. With the exception of the starchy vegetables like corn, peas, and potatoes, veggies can be eaten as often as and as much as you want. They help fill you up but contribute few calories.

Source: http://health.ivillage.com/

Male Infertility -- 4 Main Types

Male infertility can be classified into four main types:

• No sperm (azoospermia) accounts for 3-4% of male infertility.
• Quantity or quality. This subgroup may account for about 90% of male infertility:
• Quantity: Poor sperm quantity (oligospermia)
  
• Quality :
• low motility (asthenozoospermia)
  
• a high percentage of abnormal sperm (teratozoospermia)
• Antisperm antibodies, etc.
• Sperm dysfunctional, where there is a normal semen analysis, but the sperm lack or have a defective fertilizing capacity, resulting in complete failure of fertilization or poor fertilization of the eggs in IVF. This accounts for 3-6% of male infertility.
• Inability to ejaculate into the vagina. This accounts for 4-6% of male infertility.

Abnormal Sperm -- Causes of Abnormal Low Sperm Counts

There are many biologic and environmental factors that can lead to male infertility. The leading causes are low sperm count, low sperm motility, bad quality sperms, lack of semen. Most cases of male infertility are due to low sperm count.

Smoking

Low sperm count and low sperm motility have an adverse effect due to toxins in cigarettes and also on their lifespan. Studies show that men who smoked also had far less sex drive than their non-smoking peers.

Diet

Male fertility affects by Chemicals such as dibromochloropropane (DBCP), chlordecone, carbaryl and ethylene dibromide. The best advice is to eat healthily, and, if possible, to eat organic. Organically produced crops don’t contain chemicals which destroy sperm and are also a much healthier diet for men who are trying to raise their sperm levels.

Alcohol

With alcohol consumption at an all time high, excessive and ongoing alcohol consumption can have an adverse effect on sperm production and quality. However, drinking in excess of the recommended daily units can decrease healthy sperm and damage developing sperm.

Sexually Transmitted Diseases (STD’s)

Sexually transmitted diseases are one of the main factors relating to drops in sperm counts and sperm motility. One of the most dangerous STD’s harmful to sperm production is Chlamydia. The infection of this disease is often not detectable in men as there are no visible symptoms. Antibodies produced by the disease (called trachomatis IgG antibodies) inevitably have a negative effect on sperm production, thus lessening the chances of conception. Statistics show that the chance of achieving a pregnancy was reduced by 33% if the man was IgG positive.

Testicular Overheating

Exposure to excess heat can have an adverse effect on sperm development. Raised temperatures created by the use of laptops and wearing tight fitting underwear can raise scrotal temperature, slowing down the rate of sperm production. Laptop heat insulators and loose fitting garments such as boxer shorts are recommended to allow air to circulate and keep the testicles cool. Working in conditions that involve a lot of heat (welding for example) may impair fertility on a more permanent basis. Men in these types of professions are recommended to have a tepid bath each evening to bring testicular temperatures down.

Environmental Damages

There are many different environmental effects that can be harmful to sperm production. Whether a result of a direct or indirect attack on the system, pollutants such as toxins, chemicals, pesticides and oxygen-free radicals can all reduce sperm counts. Those at greatest risk will be in trades such as fruit or flower harvesting, contracting, livestock treatment, gardening and poultry and dairy farming. Exposure to metals such as lead, cadmium and arsenic can also lead to trace amounts of these products being found in the semen and thus sperm production is often lowered.

Vigorous Exercise

Certain types of exercise can have a damaging effect on male sperm production. One of the worst forms of exercise for this is cycling or mountain biking. Mountain bikers have been proven to register less then half the sperm count and sperm movement than non-cyclists. The semen alterations are thought to be caused by impounding damage to both the testes and the scrotum, the repeated trauma is considered to be the main reason for the vascular damage and the subsequent effects on sperm motility.

Driving

For many of us, driving is a necessary evil. But spending long hours behind the wheel can have a damaging effect on your sperm. Scrotal temperatures are proven to rise significantly when a man is seated for long periods of time, and statistics show that couples whose partner was employed as a HGV driver or sales rep, (or any occupation that involved spending a great number of hours driving)found that they took longer to conceive. Results also show that sperm counts of professional drivers were lower and that the sperm itself contained more abnormalities.

Misuse of Substances

There are a number of banned substances that can have potentially lethal effects on sperm production. Taking anabolic steroids, for example, to increase performance in sports such as weight lifting, can dramatically alter both the motility and the health of the spermatozoa. Other banned substances, such as cocaine, marijuana and heroin can reduce sperm production by up to 50%, and in cases of ongoing use, may make a man infertile.

Genetic causes

Cystic fibrosis patients who suffer from CF often have missing or obstructed vas deferens (the tubes that carry perm).Naturally, this prevents the sperm from developing correctly. Klinefelter syndrome patients carry two X and one Y chromosomes (the norm is one X and one Y), which lead to the destruction of the lining of the seminiferous tubules in the testicles during puberty, although most other male physical attributes are unimpaired.

Kartagener syndrome a rare disorder that is associated with a reversed position of the major organs, also includes immotile cilia (hair-like cells in lungs and sinuses that have a structure similar to the tails of sperm). Germ cells may also be affected by this condition.

Varicocele
A varicocele is a varicose vein in the cord that connects to the testicle. (A varicose vein is one that is abnormally enlarged and twisted.) Varicoceles are found in 15% to 20% of all men and in 25% to 40% of infertile men. It is not clear how they affect fertility, or even if they do at all. Some theories for their effect include the following:

Varicoceles may partially obstruct the passages through which sperm pass.

• Varicocele may elevate temperature in the testes.
• Varicoceles may produce higher levels of nitric oxide, a substance that has
• Certain damaging effects that might injure sperm.
• Varicoceles may block oxygen to the sperm.
• Varicoceles have been associated with abnormalities in cellular material in the sperm. One study suggested that some men might have genetic abnormalities that cause both varicoceles and impaired sperm, rather than varicocele itself causing infertility.

Radiation Treatment

Radiation treatments and x-rays affect any rapidly dividing cell, so cells that produce sperm are quite sensitive to radiation damage. Cells exposed to significant levels of radiation may take up to two years to resume normal sperm production, and, in severe circumstances, may never recover.

Malnutrition and Lack of Supplements

Deficiencies in certain nutrients, such as vitamin C, selenium, zinc, and folate, may be particular risk factors for infertility in such cases. Those men trying to conceive are recommended to take vitamin C to prevent sperm from agglutinating (i.e. sticking together). This is especially beneficial to smokers. Vitamin B12 and Vitamin E supplements should also be taken to increase sperm activity and production.

Source: http://www.spermtest.com/

Abnormal Sperm -- Do Vasectomies Create Abnormal Sperm?

According to fertility expert Professor Nares Sukcharoen, of the Chulalongkorn University in Bangkok, on 22 Jun 2006, a vasectomy can be reversed and men have fathered children afterwards, but such men may have an increased risk of damaged sperm.

As many as 40,000 vasectomies are carried out in Britain each year, and around 2,500 men later want the surgery reversed often because they wish to have a family with a new partner.

Vasectomy is a quick and minor surgical procedure which is done under local anaesthetic and involves sealing the tubes, or vas deferens, that carry sperm. As a rule it does not affect a man's sex drive or performance. In reversal surgery the tubes are rejoined but the operation is not always successful.

Professor Sukcharoen and his team carried out a small study of men who had a vasectomy reversal and found that they had a 10 times higher number of chromosome abnormalities in their sperm than men who had not had the surgery.

The researchers tested 21 sperm samples from 18 men and found that 3.3% of their sperm had genetic defects, including abnormally high rates of chromosomal defects called sexual aneuploidies, where sperm had an extra X or Y chromosome which cause a number of medical conditions in children, such as Klinefelter syndrome, in which boys are born with an extra X chromosome and often develop abnormally proportioned bodies and experience learning difficulties.

Another rarer condition found called Triple X syndrome, affects around one in 2,000 girls, and is caused by sperm carrying two X chromosomes instead of the usual one.

It can lead to women developing symptoms including seizures and infertility.

Professor Sukchareon who led the study, says he believes a pressure build-up in the vas deferens disrupts the normal production of sperm in men who have had vasectomies and says the study shows that a vasectomy can cause abnormalities in sperm. He says if a couple conceive naturally after the man has had a vasectomy reversal, the woman's body might select only the best sperm.

However if the sperm were used in artificial fertilisation, the genetic defects might be passed on to the child. Sukcharoen says more research and larger studies are needed to confirm his results and to answer other questions regarding reversal surgery and the related problems.

Source: http://www.news-medical.net/

Infertility -- The Basic Infertility Evaluation

Once a couple presents an infertility problem, an organized cost considerate rapid evaluation that makes no major assumptions about cause should be recommended.

Assumptions are common, but should be discouraged. When the couple first identifies an infertility problem there often is a tendency to guess at the cause for the problem. I often hear: "(s)he is the problem," "it must be me since my spouse has had children in another marriage," or "I know I'm normal since I've never been sick a day in my life." Assumptions are usually counterproductive.

The basic infertility evaluation should always include an evaluation of

• Female:
• Ovulation
• The pelvic factor. Pelvic factor infertility as discussed here will include

1. vaginal abnormalities
2. cervical mucus abnormalities
3. defects in the uterine cavity
4. proximal fallopian tube occlusion
5. distal blockage of the fallopian tube
6. endometriosis
7. barriers to implantation

• Male:
  
• Movement of the testes into the scrotum
• The testicular cells and their functions
• Puberty and the full maturation of sperm
• The course of movement for sperm upon ejaculation
• Ejaculation
• Necessary postejaculatory changes in sperm

In addition, it is usually adviseable to confirm that there are no other major barriers to fertility. This might include looking at the periovulatory cervical mucus for the presence of progressively motile sperm several hours following intercourse (postcoital test). This might also include examining the pelvis for the presence of abnormalities, such as endometriosis or adhesions (laparoscopy and possibly hysteroscopy).

If the couple has experienced multiple consecutive miscarriages, the evaluation that I recommend includes

1. Demonstration of a normally shaped uterine cavity,
2. Evaluation for a hormonal deficiency in progesterone production,
3. Analysis of both the maternal (wife's) and paternal (husband's) chromosomes,
4. Laboratory testing for immunologic causes of pregnancy loss, and
5. Taking a history for maternal disease states or environmental toxin exposure

The components of the basic infetility evaluation are discussed in detail. The components of the basic recurrent pregnancy loss evaluation will be the subject of another project (currently in progress).

Source: http://www.drdaiter.com/

Infertility

Reproduction is a normal physiologic event that is absolutely necessary for the survival of the human race. Therefore, infertility is a "real" medical problem that is the result of real pathology.

Infertility is not uncommon, affecting about 10-15% of reproductive age couples (roughly 1 in 7). The remarkable advances in In Vitro Fertilization (IVF) and the Assisted Reproductive Technologies (ARTs) have resulted in the birth of several thousand "miracle babies" over the past few decades. There is also a growing desire for pregnancy in women over 35 years of age, many of whom have postponed their childbearing until they have acheived career stability. For these reasons, the number of couples seeking medical attention for infertility related problems has rapidly grown and the medical community has responded with rapidly developing technology.

The causes of infertility for a specific couple are not always easily recognized. However, if the couple decides to undergo a series of basic diagnostic tests then specific treatable abnormalities associated with infertility may be discovered. Following a full basic evaluation only 5-10% of couples will still have "unexplained infertility."

Treating infertility can also be difficult. There are frequently several accepted alternative treatments for any given abnormality that is discovered. The "optimal" treatment is often controversial since there is usually little reliable scientific data to support one treatment plan over another. Therefore, the physician must use his (her) own experience with the available treatment options for guidance. Relying on the advise of a seasoned and well trained professional is therefore very important.

When to Go for Invertility Care?

Infertility is generally defined as the inability to achieve a pregnancy after one year of regular intercourse without contraception.

Despite this general definition, an evaluation may be appropriate before a full year has passed. This decision depends on the couple's situation. For example, if the woman is older than 35 or 40 it may be prudent to check a basic evaluation soon after deciding to have a baby. If the husband has had a vasectomy, or the wife a tubal ligation, then consultation and consideration of treatment options does not need to be delayed. If the woman desiring fertility has very irregular or no menstrual cycles then immediate consideration of diagnostic tests and treatment is appropriate.

Recurrent pregnancy losses (miscarriages) are sometimes considered a part of infertility since the couple is not able to carry a pregnancy to viability. Once a couple has had two or three consecutive pregnancy losses, it is appropriate to consider a thorough evaluation.

Who is Available to Help Care?

A couple decides early on who will be chosen to help them with their infertility. This selection dramatically effects the treatment plan that is developed. Therefore, careful consideration of the alternatives is advisable.

Not everyone turns to medicine for help. Some couples choose a relative, like a mother or a grandmother. This is generally someone who has a large family with clear success in terms of their own reproduction. Others may turn to religious figures and entrust their fertility to a higher being or guidelines set by an organized religion. I beleive that physicians also have an important role in the care of these couples. Infertility usually involves medical conditions that are now treatable and professional advice is generally available.

Differences in training among the available physicians will be the focus of this section. All physicians treating infertile couples should share certain basic characteristics, including:

Compassion and the willingness to listen.

These are important qualities in an infertility doctor. As you discuss your situation with your doctor, you should be able to identify a willingness to listen to your concerns.

Recent dramatic changes in health care have essentially limited the time that is spent with patients by rewarding the number or "volume" of patients seen rather than giving "the personal touch." Infertility patients may come to resent their doctor if (s)he doesn't address their unique needs or they may change doctors frequently in an attempt to find one who will "hear their concerns." This can be frustrating for both the doctors and the couples.

Expertise in the rapidly changing field of infertility.

Book knowledge coupled with insights gained from extensive clinical experience is a powerful combination.

• The doctors. All doctors are persons skilled in the healing arts who have completed a defined rigorous course of study (typically 4 years). Doctors have been duly licensed by the State's Board of Medical Examiners to practice within the profession. Therefore, many couples believe that "any doctor" will be expert in the treatment of their fertility issues. This may not be so. Most graduates of medical school will have delivered (or helped deliver) a baby and helped to perform (or watched) a hysterectomy. However, many doctors have had no exposure to infertile couples undergoing evaluation. Nevertheless, in many areas of the USA the family doctor (either a family practitioner or internist) is the initial contact for the infertile couple. This physician will then consider whether (s)he is comfortable with ordering the basic infertility evaluation and when to refer the couple for care with an infertility specialist.
  

• The Obstetrician Gynecologist. The obstetrician gynecologist is a doctor who has completed medical school as well as an additional defined training program (typically 4 years) in Obstetrics and Gynecology (Ob-Gyn). To become board certified in Ob-Gyn, the "American Board of Obstetricians and Gynecologists" requires candidates to pass a written exam as well as an oral exam. The oral exam is given by recognized authorities in the field and covers all areas of Ob-Gyn including infertility. Therefore, Ob-Gyns are well trained in the theory of infertility and many will have significant clinical training and experience as well. When the obstetrician gynecologist is the initial contact for an infertile couple there is usually an organized approach that has been established. At some point in the infertility care, the Ob-Gyn may suggest referral to an infertility specialist.
  

• Infertility specialists. Infertility specialists are doctors who should have completed medical school, a residency training program in Obstetrics and Gynecology, and an additional training fellowship (typically 2-3 years) in Reproductive Endocrinology (male and female hormones) and Infertility. This subspecialty fellowship can provide an intense clinical exposure to infertility care that dramatically redefines the physician's approach to the infertile couple. The infertility specialist's approach typically complements the Ob-Gyn's care.
  

Source: http://www.drdaiter.com/

Bronchopneumonia

What is Bronchopneumonia ?

Bronchopneumonia is a illness of lung which is caused by different organism like bacteria, viruses, and fungi and characterized by acute inflammation of the walls of the bronchioles. It is also known as pneumonia. It is common in women and causes to the 6% deaths.

Bronchopneumonia (Lobular pneumonia) - is one of two types of bacterial pneumonia as classified by gross anatomic distribution of consolidation (solidification). In bacterial pneumonia, invasion of the lung parenchyma by bacteria produces an inflammatory immune response. This response leads to a filling of the alveolar sacs with exudate. The loss of air space and its replacement with fluid is called consolidation. In bronchopneumonia, or lobular pneumonia, there are multiple foci of isolated, acute consolidation, affecting one or more pulmonary lobes.

It should be noted that although these two patterns of pneumonia, lobar and lobular, are the classic anatomic categories of bacterial pneumonia, in clinical practice the types are difficult to apply, as the patterns usually overlap. Bronchopneumonia (lobular) often leads to lobar pneumonia as the infection progresses. The same organism may cause one type of pneumonia in one patient, and another in a different patient. From the clinical standpoint, far more important than distinguishing the anatomical subtype of pneumonia, is identifying its causative agent and accurately assessing the extent of the disease.

What are Causes of Bronchopneumonia ?

Bacterial pneumonias tend to be the most serious and, in adults, the most common cause of pneumonia. Streptococcus pneumoniae (pneumococcus) and Mycoplasma pneumoniae both are the common bacterium which which causes bronchopneumonia in the adults and children. The most common pneumonia-causing bacterium in adults is Streptococcus pneumoniae (pneumococcus).

Pathology

• Inhalation of organisms.
• Scarring if alveoli destroyed.

Multiple foci of consolidation are present in the basal lobes, often bilateral. These lesions are 2-4 cm in diameter, grey-yellow, dry, often centered by a bronchia, are poorly delimited and have the tendency to confluence, especially in children.

A focus of inflammatory condensation is centered by a bronchiola with acute bronchiolitis (suppurative exudate - pus - in the lumen and parietal inflammation). Alveolar lumens surrounding the bronchia are filled with neutrophils ("leukocytic alveolitis"). Massive congestion is present. Inflammatory foci are separated by normal, aerated parenchyma.

What are the Symptoms ?

• Cough with greenish or yellow mucus
• Fever
• chest pain
• Rapid, shallow breathing
• Shortness of breath
• Headache
• Loss of appetite
• Fatigue
• Blood-streaked sputum
• Chills
• Signs of pulmonary congestion

Comparison of Bronchopneumonia vs. Lobar Pneumonia

	Bronchopneumonia	Lobar Pneumonia
Location	1. often bilateral 2. basal (i.e. lower lobes)	large area, even whole lobe involvement
Route of infection	spreads from bronchioles to nearby alveoli	both alveoli and bronchioles
Spread of infection	consolidation is patchy	Whole lobe becomes consolidated
Susceptible group	infants, elderly	Adults especially alcoholics and vagrants.
Causing Organism	Dependent on circumstances predisposing to infection(i.e. nosocomial or community acquired)	Often caused by Pneumococcus or Klebsiella.
Recovery	If treated, recovery usually involves focal organisation of lung by fibrosis.	If treated promptly, many recover with lungs returning to normal structure and functioning by resolution. In other cases the exudate in alveoli is organised, leading to lung scarring and permanent lung dysfunction.
Notes	Patients who are immobile develop retention of secretions; thus, most commonly involves the lower lobes.	Patient are severely ill and usually associated bacteriemia.

Treatment of bronchopneumonia

If the cause is bacterial, the goal is to cure the infection with antibiotics. If the cause is viral, antibiotics will nbot e effective. In some cases it is difficult to distinguish between viral and bacterial pneumonia, so antibiotics may be prescribed. Pneumococcal vaccinations are recommended for individuals in high-risk groups and provide up to 80 percent effectiveness in staving off pneumococcal pneumonia. Influenza vaccinations are also frequently of use in decreasing one’s susceptibility to pneumonia, since the flu precedes pneumonia development in many cases.