PCOS / PCOD/ Cyst / Fibroid ফাইব্রয়েড / টিউমার বা সিস্ট

1.    Dysmenorrhea (Painful menses) পিরিয়ড বা মাসিকের সময়ের ব্যথা

Dysmenorrhea refers to painful menstruation, which is commonly experienced as cramps during a woman’s menstrual cycle. It can range from mild discomfort to severe pain and is typically classified into two types:

1. Primary Dysmenorrhea

This type is not associated with any underlying medical condition and is generally a result of natural hormonal fluctuations. It usually begins within a few years of a woman’s first period and can persist until the late 20s or early 30s. Primary dysmenorrhea is most common in younger women, especially those who have never had children.

• Causes: The pain is due to the release of prostaglandins, which are hormone-like substances that trigger uterine contractions. High levels of prostaglandins can lead to stronger contractions, reducing blood flow to the uterus, and causing pain.
• Symptoms: Cramp-like pain in the lower abdomen that usually starts a day or two before menstruation begins and may last for 2–3 days. The pain can be accompanied by nausea, vomiting, fatigue, diarrhea, or headaches.

2. Secondary Dysmenorrhea

This form of dysmenorrhea is usually caused by an underlying medical condition such as endometriosis, fibroids, pelvic inflammatory disease (PID), or adenomyosis. Unlike primary dysmenorrhea, secondary dysmenorrhea typically begins later in life (often after 30) and tends to be more severe.

• Causes: Conditions like endometriosis (where tissue similar to the uterine lining grows outside the uterus) or fibroids (benign growths in the uterus) can cause chronic pain during menstruation. These conditions may also cause irregular or heavy periods.
• Symptoms: Pain can be more constant, may start earlier in the menstrual cycle, and can be more intense than primary dysmenorrhea. The pain may not be confined to the lower abdomen; it can radiate to the lower back or thighs.

2.    Endometriosis এন্ডোমেট্রিওসিস

Endometriosis is a medical condition in which tissue similar to the lining of the uterus (called the endometrium) grows outside the uterus, causing pain, inflammation, and often affecting fertility. This tissue behaves like normal endometrial tissue: it thickens, breaks down, and bleeds during the menstrual cycle. However, because it’s outside the uterus, it has no way to exit the body, which can lead to inflammation, scar tissue, adhesions, and pain.

Symptoms of Endometriosis

The symptoms of endometriosis can vary greatly between individuals, but common signs include:

1. Pelvic Pain:

1. • The most common symptom of endometriosis is pelvic pain, often associated with menstruation. However, this pain is typically much more severe than normal menstrual cramps.
   • The pain may begin a few days before your period and continue throughout your period or even after your period ends.
   • Pain during or after sex is also a frequent complaint.

2. Heavy Menstrual Bleeding:

1. • You may experience menorrhagia (heavy menstrual bleeding) or bleeding between periods.

3. Pain with Urination or Bowel Movements:

1. • This usually occurs during menstruation. It may feel like a sharp or crampy pain, especially if the endometrial-like tissue is near the bladder or bowel.

4. Infertility:

1. • Endometriosis can contribute to fertility problems, and it is estimated that 30-50% of women with endometriosis may experience infertility.
   • Endometriosis can interfere with the normal function of the ovaries, fallopian tubes, and uterus, making it more difficult for women to conceive.

5. Other Symptoms:

1. • Fatigue, bloating, nausea, diarrhea, constipation, and even headaches can occur, especially during menstruation.

Causes of Endometriosis

The exact cause of endometriosis is not fully understood, but several theories exist:

1. Retrograde Menstruation:

1. • One of the most widely accepted theories is that retrograde menstruation occurs. This is when menstrual blood flows backward through the fallopian tubes into the pelvic cavity, carrying endometrial cells that implant on other pelvic organs.

2. Genetics:

1. • Endometriosis tends to run in families. If a close family member (mother, sister, aunt) has it, you may have a higher risk of developing the condition.

3. Immune System Dysfunction:

1. • Some researchers suggest that an issue with the immune system might be a contributing factor. Normally, the immune system would destroy any displaced endometrial tissue, but in those with endometriosis, it may fail to do so.

4. Embryonic Cell Transformation:

1. • It’s possible that certain embryonic cells in the pelvic cavity transform into endometrial-like cells, though this is less well understood.

5. Hormonal Influence:

1. • Estrogen plays a significant role in the growth of endometrial tissue. High levels of estrogen may encourage the growth of endometriosis lesions.

3.    Fibroadenoma স্তন টিউমার/ফাইব্রোএডেনোমা

fibroadenoma is a common, benign (non-cancerous) breast tumor that consists of both glandular and fibrous (connective) tissue. It is typically smooth, round, and mobile under the skin, and most often occurs in women during their reproductive years (usually in their teens to 30s). Fibroadenomas are one of the most common types of benign breast lumps, but they are usually harmless.

Characteristics of Fibroadenomas:

• Shape and Consistency: They are usually round or oval in shape, firm, and feel like a rubbery lump that is easily movable when you press on it. They can vary in size from very small (a few millimeters) to larger masses (up to several centimeters).
• Pain: They are typically painless, although some women may experience discomfort, especially during the menstrual cycle due to hormonal fluctuations.
• Location: Most fibroadenomas are found in the upper, outer quadrant of the breast, but they can occur anywhere in the breast tissue.
• Age Group: Fibroadenomas are most common in women aged 15-35, though they can develop at any age.

Types of Fibroadenomas:

There are a few subtypes of fibroadenomas, based on their appearance under a microscope:

1. Simple Fibroadenoma: This is the most common type, with a well-defined border, smooth texture, and minimal growth. It usually does not require treatment unless it causes discomfort.
2. Complex Fibroadenoma: This type may have cysts, calcifications, or other features and is slightly more likely to be associated with a small increased risk of breast cancer.
3. Phyllodes Tumor: This is a rarer type of fibroadenoma that can grow very large and may have a more complex structure. Phyllodes tumors are also benign but require more careful monitoring, as some may become malignant (cancerous).

Symptoms of Fibroadenoma:

• Lump or Mass: A firm, mobile lump in the breast that may or may not be painful. It is usually easy to feel and is distinct from surrounding tissue.
• Size Changes: The size of the fibroadenoma may fluctuate with the menstrual cycle due to hormone levels (it might swell before menstruation and shrink after), but it typically remains stable over time.
• Breast Changes: In rare cases, a fibroadenoma may cause slight changes in the shape or contour of the breast.

Causes and Risk Factors:

The exact cause of fibroadenomas is not well understood, but several factors may increase the likelihood of developing one:

1. Hormonal Factors: Estrogen plays a key role in the growth of fibroadenomas, which is why they often occur in younger women who are still menstruating. They tend to shrink after menopause, especially if a woman is not on hormone replacement therapy.
2. Family History: A family history of fibroadenomas or breast cancer may increase the risk.
3. Hormonal Birth Control: Some studies suggest that the use of hormonal contraceptives might be linked to an increased risk of developing fibroadenomas, although this relationship is not fully understood.
4. Pregnancy: Pregnant women may experience changes in fibroadenomas due to hormonal fluctuations, but fibroadenomas typically don’t affect pregnancy.