Monday, April 4, 2022

Congenital Anomalies of the Female Reproductive System

Congenital anomalies occur for a number of reasons. Approximately every 1 in 33 babies is born with some form of birth defect, ranging from mild and asymptomatic to life-threatening, and they can be either preventable (i.e. influenced by the mother and her environment) or heritable (i.e. genetic). The female reproductive system isn't spared from this possible outcome during fetal development, and there are several types of congenital anomalies that are seen in this biological system.

Birth defects

The differences between birth defects in males and females are most discernible in regards to the external genitalia by which we designate the baby's sex. Female is defined genetically based on the presence of two X chromosomes (genotype 46XX as opposed to male, 46XY), but the absence of male genitalia is considered an indicator of a female at birth. However, abnormal levels of male sex hormones during fetal development due to congenital adrenal hyperplasia, maternal treatment with progesterone, or a maternal hormone-producing tumor can caused alterations to occur in the external female genitalia (e.g., enlarged clitoris). Truly ambiguous external genitalia is referred to as pseudohemaphroditism or virilization. The physical condition is often corrected by surgery after genetic confirmation of sex.

Mullerian duct development. CC By-SA 4.0 Devinka98. Source

Mullerian anomalies

Defects of the vagina and uterus are called Mullerian anomalies based on their embryonic development from the Mullerian duct. The defects are usually not detected until puberty, when they cause pelvic pain, irregular menstruation, or other reproductive issues, because the ovaries and external genitalia are not affected. The most common defects are agenesis and hypoplasia, in which the tract or part of the tract (such as the vagina) does not form. Whether fertility is affected depends on the exact type and extent of the defect. Some can be surgically remedied to alleviate painful menstruation.

  • Unicornuate uterus: only half the uterus forms (banana-shaped). The condition is rare and often accompanied by kidney agenesis.
  • Uterus didelphys: double uterus, potentially including duplication of the vagina and cervix.
  • Bicornuate uterus: misshaped womb.
  • Septate uterus: a wall of tissue divides the uterus.
  • Diethylstilbestrol (DES)-related uterus: T-shaped uterus in the child due to maternal exposure to the drug DES; also increases risk of vaginal cancer.
  • Arcuate uterus: slight variation in the shape of the uterus, considered simply as a variation of the norm.

Other female reproductive tract defects

  • Cloacal abnormalities: The cloaca is the initial tube from which the rectum, urinary tract, and vagina form. Persisting late into development can result in a lack of the appropriate orifices, resulting in severe pain and gastrointestinal disruption, as well as the appearance of male genitalia.
  • Imperforate hymen: The vaginal opening is completely blocked, which is discovered when menstruation begins.
  • Abnormal ovaries: An extra ovary or extra tissue on the ovaries can occur, as well as ovotestes (presence of both male and female tissues).

Chromosomal abnormalities

When a baby is born with only one sex chromosome it is known as monosomy. X monosomy is referred to as Turner syndrome, or gonadal dysgenesis, and occurs in an estimated 1 of every 2000 live births. Sometimes the second X chromosome is only partially missing. Children born with this condition have swollen hands and feet, and sometimes a wide webbed neck. Puberty doesn't occur and the adolescent lacks secondary sex characteristics unless treated with estrogen. Children may also have a short stature unless treated with growth hormone. Menstruation is absent and an adult with Turner’s is infertile. The condition has a number of complications, including heart defects, autoimmune disorders (e.g., hashimoto’s thyroiditis and diabetes), arthritis, and cataracts.

 

Saturday, March 12, 2022

Heart and Cardiovascular Learning Guides

Human heart. Gray's Anatomy, 1918

 

Here is an outline and links to the current heart and cardiovascular system-related learning guides currently available at Just Facts-Long-lasting Curriculum.

 

The basics on the circulatory system are in this other post.

Saturday, February 26, 2022

Medical Exams You Should Schedule Now

 

Photo by Mockup Graphics on Unsplash

There are a number of medical conditions we'll all face as we age - arthritis, malnutrition, heart disease, cancer, cognitive and balance difficulties, depression - so it's important to stay up to date on your condition by visiting a doctor for regular exams. But there are also different tests and screenings you should remember to ask about.

  • Cholesterol and blood sugar checks

  • Cancer screenings

  • Dental exams

  • Eye exams

  • Prostate and breast exams

  • Gynecological exams 

Read more about these exams and why they're important on Maeflowers at Medium

You should also occasionally go over your prescription medications with your doctor to ensure they are doing what you need them to do. For example, if you've changed your diet, quit smoking, quit drinking, and lost weight, you may find it possible to decrease or discontinue prescriptions for lipids or hypertension. (Only do this under advisement from your doctor based on exam and blood results.)

Another question to ask your doctor is whether you're up to date on vaccinations. Most offices follow the CDC schedule. In particular, tetanus is repeated every 10 years, influenza every year, and the hepatitis series is new in the last 10-20 years. In addition, according to the CDC< all adults over a certain age should be tested for HepC at least once.

Screening allows early treatment, which results in better outcomes!

Saturday, November 6, 2021

What We Got Wrong with the U.S. COVID Response

Photo by CDC from Pexels
 

I have held an unpopular opinion since early in the coronavirus pandemic — the United States should have locked down completely. I have added more unpopular opinions on top of that in the past year and a half in criticism of the health agencies, both American and international. Though whether it’s unpopular really depends on the audience, as I know a lot of scientific and medical professionals would agree with me. 

With bad public messaging, unmitigated viral spread, lack of testing and quarantines, and inherent issues in the health care system, read my commentary at Medium on what the U.S. got wrong about COVID-19

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Thursday, September 30, 2021

Hyper-responsibility Syndrome and Anxiety

A man disturbed from sleep by visions caused by guilt. Etching by Brocas. Credit: Wellcome Collection. Public Domain Mark
 

 

I often feel responsible for others’ actions when I play no role in what they've done. Even if they’re only working off information I provided, my brain latches on to how I played a role and have to take responsibility. But I'm not alone in this. It's a phenomenon called hyper-responsibility syndrome. I wrote about the psychology and neurology underlying inflated responsibility and guilt elsewhere. In this post, I talk about the personal aspects of this mental health issue.

Friday, September 24, 2021

Morbid about mortality

You'll notice a new link over in the sidebar. I now have a publication at Medium that collates my health type articles that aren't in other publications. The most recent stories there have been about death. 

The past almost 2 years have been a very introspective time for me. Partly because in my editing job, I've been knee-deep in depressing data. Another part is my own health and the health of those close to me. It would have been a hard time period even without the pandemic.

I took part in the Medium Writers' Challenge last month and, though I hadn't originally planned on it, ended up writing on the topic of death. Specifically, that we need to Respect Death as a Natural Phenomenon. Even if we don't like it, the truth of the matter is that it's going to happen. To everyone. 

To get my mind off that morbid topic I delved into a bookcase in my house and pulled out a random book to read. About the plague. Because of course I did. 

Turns out, the Black Death has a lot in common with the COVID-19 pandemic. We haven't learned much from history, probably because we don't actually learn history. We just hear the parts people want to remember.

 


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You can also subscribe to a newsletter for all my stories (here), or after becoming a member you can follow just the Maeflowers publication.

Sunday, November 8, 2020

A little help with fact-checking

Now is a good time to direct you to an article I wrote a few months ago - Just in case you're having trouble with deciding which "news" to trust.

How to Tell Truth from Fiction: Fact-checking 101

1. Check your biases

2. Check for sources

3. Consider the messenger (i.e., check their biases)

4. Look for independent confirmation


Photo by Joanna Kosinska on Unsplash