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  1. Infertility can be defined as the inability to achieve pregnancy after regular unprotected sexual activity (Khizroeva et al., 2019).
  2. The pathophysiology of infertility includes hormonal imbalance, polycystic ovary syndrome, hypothyroidism, hyperprolactinaemia, obesity and diabetes mellitus.
  3. The symptoms of infertility in females includes abnormal menstruation cycle associated with pain and cramps, irregular menstrual cycle varying every month and skipped menstrual cycles (Morgante et al., 2018).
  4. Certain blood test can diagnose infertility like Thyroid profile, Presence of follicle stimulating hormone, luteinizing hormone, and prolactin in blood.
  5. Differential diagnosis for infertility in women is ultrasound of ovary and uterus, ovarian reserve testing and hysterosalpingography.
  6. The non-pharmacological treatment of infertility includes reducing body weight, intake of healthy diet, and regular exercise.
  7. The pharmacological treatment for infertility among women includes certain fertility drugs like gonadotropins, clomiphene citrate, metformin, bromocriptine and letrozole.
  8. In the present world, infertility is one of the most common diseases among people that is mainly observed in women. It denotes an unnatural state of an adult in which the person is unable to become pregnant. There are certain causes that lead to infertility including delayed puberty, genetics, environmental factors and lifestyle factor.
  9. The woman must visit fertility expert for the treatment and regular follow up must be done for treatment purpose (He et al., 2018).
  1. Dysmenorrhoea is a term used for menstrual cramps associated with severe pain (Armour et al., 2019).
  2. The abnormal and increased level of prostanoid and eicosanoid secretion might cause dysmenorrhoea.
  3. The symptoms of dysmenorrhoea include cramps in lower abdomen during menstruation, pain in lower abdomen, nausea, vomiting, fatigue and back pain.
  4. Secondary dysmenorrhoea can be diagnosed by hysterosalpingography, Laparoscopy and Transvaginal ultrasonography.
  5. The three differential diagnosis of menstrual cramps or dysmenorrhoea includes Ultrasound of uterus, fallopian tubes, ovaries and cervix, MRI of ovaries and hysteroscopy (Barcikowska et al., 2020).
  6. Non-pharmacological treatment for dysmenorrhoea includes use of hot bag in the lower abdomen, reducing body weight, healthy diet and regular exercise.
  7. The pharmacological treatment of dysmenorrhoea includes surgery, pain relievers and hormonal birth control pills.
  8. Dysmenorrhoea, which is commonly known as menstrual cramps are pain in lower abdomen before or during menstruation cycle. It is common among women who suffer from heavy menstrual bleeding, irregular menstrual cycle and polycystic ovary syndrome. It is classified either as primary or as secondary based upon certain conditions.
  9. A woman with dysmenorrhoea might visit a gynaecologist for treatment of the same.
  10. Frequent follow-ups must be done with the time interval of not more than three months (Woo et al., 2018).
  1. Uterine fibroids, which are also called uterine leiomyomas are the benign smooth muscle tumours in uterus (Pavone et al., 2018).
  2. It is one of the main causes of the abnormal uterine bleeding in women and is developed during reproductive years. Its growth is dependent on ovarian steroid hormones like progesterone and oestrodiol.
  3. Symptoms of uterine fibroids include heavy menstrual bleeding, pelvic pain, constipation, longer menstrual cycle, frequent urination, back pain and difficulty during urination (Manyonda et al., 2020).
  4. Laboratory test of uterine fibroids includes Ultrasound of uterus and magnetic resonance imaging.
  5. The three differential diagnoses of uterine fibroids are hysterosalpingography, hysterosonography and hysteroscopy.
  6. Non-pharmacological treatment for uterine fibroids includes uterine artery embolization, radio-frequency ablation, laparoscopic myomectomy, hysteroscopic myomectomy and many more (Manyonda et al., 2020).
  7. Pharmacological treatment includes gonadotropin-releasing hormone agonists, progestin releasing intrauterine device tranexamic acid and non-steroidal anti-inflammatory drugs.
  8. Most of the patient does not have any symptoms; however, few women have heavy menstruation associated with pain. It Causes pain during sex and if the size becomes large it pushes the bladder which cause frequent urination. However, after menopause, the size eventually decreases and it is a common cause for uterus removal in women.
  9. Although it is not severe disease but in few cases the woman might visit the physician.
  10. Long-term follow up is required after the treatment (Li et al., 2020).
  1. Polycystic ovarian syndrome is one of the most common endocrine disorder among women (Patel, 2018).
  2. The pathophysiology of polycystic ovarian syndrome includes interaction of epigenetic and genetic changes, Alteration of neuroendocrine system; primary ovarian abnormalities end metabolic modifiers.
  3. The symptoms of polycystic ovary syndrome include polycystic ovaries, irregular menstruation cycles and excessive androgen.  
  4. Pelvic ultrasound is one of the common methods for diagnosing polycystic ovary syndrome (Paris et al., 2020).
  5. The differential diagnosis of polycystic ovary syndrome includes hypothyroidism, hyperprolactinaemia and congenital adrenal hyperplasia.
  6. The non-pharmacological treatment of polycystic ovarian syndrome is the modification of lifestyle, reducing weight, restriction on calorie intake and maintenance of healthy body weight.
  7. The pharmacological treatment includes progestin therapy, combination birth control pills, metformin, gonadotropins, letrozole and clomiphene.
  8. Polycystic ovary syndrome may cause problem for conceiving and is caused by Hormonal changes in the body. The ovary is filled with cysts, which are the immature follicles, which appears as a “string of flowers” during ultrasound exam.
  9. Polycystic ovary syndrome may cause infertility in women and so proper treatment must be done with frequent follow up for improving the condition (Kazemi et al., 2020).
  1. Endometriosis is the disease associated with the female reproductive system (Bulun et al., 2019).
  2. Histopathological and epidemiological studies indicated that the endometriotic tissue is considered as the origin of ovarian cell carcinoma and ovarian endometrioid carcinomas that are collectively called Endometriosis associated cancer.
  3. The symptoms of endometriosis include dysmenorrhoea, Painful intercourse, infertility, pain with the bowel movement and urination, excessive bleeding and fatigue.
  4. The laboratory diagnosis of endometriosis includes pelvic examination.
  5. The differential diagnosis of endometriosis is ultrasound, laparoscopy and magnetic resonance imaging (Agarwal et al., 2019).
  6. The non-pharmacological treatment of endometriosis includes Acupuncture and physiotherapeutic therapy.
  7. The pharmacological treatment includes Medications for pain, hormonal therapy, fertility treatment and conservative surgery.
  8. In endometriosis, cells that are similar to those in endometrium grow inside and outside of the uterus. The cells usually covered the ovaries, fallopian tubes and the tissues surrounding the uterus and ovary. It is another factor, that leads to infertility among women and are associated with pelvic pain, heavy menstrual bleeding and pain during bowel movement.
  9. Clinical intervention is important with frequent and long-term follow up by the physician (Li et al., 2019).

References

Agarwal, S. K., Chapron, C., Giudice, L. C., Laufer, M. R., Leyland, N., Missmer, S. A., ... & Taylor, H. S. (2019). Clinical diagnosis of endometriosis: a call to action. American journal of obstetrics and gynecology, 220(4), 354-e1. https://www.sciencedirect.com/science/article/pii/S000293781930002X

Armour, M., Parry, K., Manohar, N., Holmes, K., Ferfolja, T., Curry, C., ... & Smith, C. A. (2019). The prevalence and academic impact of dysmenorrhoea in 21,573 young women: a systematic review and meta-analysis. Journal of women's health, 28(8), 1161-1171. https://www.liebertpub.com/doi/full/10.1089/jwh.2018.7615

Barcikowska, Z., Rajkowska-Labon, E., Grzybowska, M. E., Hansdorfer-Korzon, R., & Zorena, K. (2020). Inflammatory markers in dysmenorrhoea and therapeutic options. International journal of environmental research and public health, 17(4), 1191. https://www.mdpi.com/1660-4601/17/4/1191

Bulun, S. E., Yilmaz, B. D., Sison, C., Miyazaki, K., Bernardi, L., Liu, S., ... & Wei, J. (2019). Endometriosis. Endocrine reviews, 40(4), 1048-1080. https://go.gale.com/ps/i.do?id=GALE%7CA615911742&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=0163769X&p=HRCA&sw=w&userGroupName=anon%7Ed67fa7ee

He, Y., Tian, J., Oddy, W. H., Dwyer, T., & Venn, A. J. (2018). Association of childhood obesity with female infertility in adulthood: a 25-year follow-up study. Fertility and sterility, 110(4), 596-604. https://doi.org/10.1016/j.fertnstert.2018.05.011

Kazemi, M., Pierson, R. A., McBreairty, L. E., Chilibeck, P. D., Zello, G. A., & Chizen, D. R. (2020). A randomized controlled trial of a lifestyle intervention with longitudinal follow?up on ovarian dysmorphology in women with polycystic ovary syndrome. Clinical endocrinology, 92(6), 525-535. https://onlinelibrary.wiley.com/doi/abs/10.1111/cen.14179

Khizroeva, J., Nalli, C., Bitsadze, V., Lojacono, A., Zatti, S., Andreoli, L., ... & Makatsariya, A. (2019). Infertility in women with systemic autoimmune diseases. Best Practice & Research Clinical Endocrinology & Metabolism, 33(6), 101369. https://doi.org/10.1016/j.beem.2019.101369

Li, W., Jiang, Z., Deng, X., & Xu, D. (2020). Long-term follow-up outcome and reintervention analysis of ultrasound-guided high intensity focused ultrasound treatment for uterine fibroids. International Journal of Hyperthermia, 37(1), 1046-1051. https://www.tandfonline.com/doi/full/10.1080/02656736.2020.1807617

Li, X. Y., Chao, X. P., Leng, J. H., Zhang, W., Zhang, J. J., Dai, Y., ... & Wu, Y. S. (2019). Risk factors for postoperative recurrence of ovarian endometriosis: long-term follow-up of 358 women. Journal of ovarian research, 12(1), 1-10. https://link.springer.com/article/10.1186/s13048-019-0552-y

Manyonda, I., Belli, A. M., Lumsden, M. A., Moss, J., McKinnon, W., Middleton, L. J., ... & McPherson, K. (2020). Uterine-artery embolization or myomectomy for uterine fibroids. New England Journal of Medicine, 383(5), 440-451. https://www.nejm.org/doi/full/10.1056/NEJMoa1914735

Morgante, G., Massaro, M. G., Di Sabatino, A., Cappelli, V., & De Leo, V. (2018). Therapeutic approach for metabolic disorders and infertility in women with PCOS. Gynecological Endocrinology, 34(1), 4-9. https://www.tandfonline.com/doi/abs/10.1080/09513590.2017.1370644

Paris, V. R., Solon-Biet, S. M., Senior, A. M., Edwards, M. C., Desai, R., Tedla, N., ... & Walters, K. A. (2020). Defining the impact of dietary macronutrient balance on PCOS traits. Nature communications, 11(1), 1-15. https://www.nature.com/articles/s41467-020-19003-5

Patel, S. (2018). Polycystic ovary syndrome (PCOS), an inflammatory, systemic, lifestyle endocrinopathy. The Journal of steroid biochemistry and molecular biology, 182, 27-36. https://doi.org/10.1016/j.jsbmb.2018.04.008

Pavone, D., Clemenza, S., Sorbi, F., Fambrini, M., & Petraglia, F. (2018). Epidemiology and risk factors of uterine fibroids. Best Practice & Research Clinical Obstetrics & Gynaecology, 46, 3-11. https://www.sciencedirect.com/science/article/abs/pii/S1521693417301372

Woo, H. L., Ji, H. R., Pak, Y. K., Lee, H., Heo, S. J., Lee, J. M., & Park, K. S. (2018). The efficacy and safety of acupuncture in women with primary dysmenorrhoea: a systematic review and meta-analysis. Medicine, 97(23). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5999465/

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