Dear Readers,
B. Writes Lifeline from Mocho, Clarendon. She is a 46-year-old woman with a number of female complaints that Lifeline will attempt to address. B is using the three-monthly depo provera injection for birth control and is currently not seeing any regular monthly period at all. Two conditions are of significant concern to her. She is experiencing breast tenderness regularly. Her physician has told her that there is no abnormality, it is just tender breast tissue. She is also experiencing vaginal bleeding after sexual intercourse. She says that after sex she bleeds on and off for two to three days and this worries her a lot, as she doesn't think it's normal. She is also experiencing cramping pain under her 'belly bottom'.
Breast tenderness can occur due to a range of disorders which would include:
❏ Fibrocystic breast disease
❏ Hormonal fluctuations
❏ Pre-menstrual syndrome
❏ Breast cancer
Fibrocystic breast disease
Fibrocystic breast disease and hormonal imbalance occur commonly in women. Fibrocystic breast disease is associated with lumps in the breast which are firm, mobile and tender, in fact, increasingly so nearing menstruation.
Especially in women over age 40 the breast discomfort may come and go and the breasts may be hypersensitive. In some women the breast tissue exhibits increased sensitivity to changes in oestrogen and progesterone levels during the normal menstrual cycle, resulting in breast tenderness, although no lumps can be detected. Use of both oral contraceptives and the injectable contraceptives, including the depo provera injection can also be associated with breast tenderness and, in addition, spotting and light bleeding.
Masses
When breast tenderness persists, an experienced physician should manually examine the breasts for the presence of masses. A mammogram, in older women, and a breast ultrasound, in younger women, are excellent investigative tools to help confirm a diagnosis as to the cause of breast pain. If a lump or mass is discovered, excision biopsy may be required for a firm diagnosis - normally, non steroidal anti-inflammatory analgesics (NSAIDS) such as Brufen, Advil, Aleve, Motrin, Cataglam, Voltaren, Piroxicam, etc., help to significantly reduce breast tenderness. Bathing the breasts with warm water is also useful. If the breast pain is severe, a physician may prescribe an androgenic hormone, like danazol, for a limited time to improve symptoms. It would also be helpful to avoid chocolate- and caffeine-containing food or beverages.
❏ Avoid eating meat
❏ Avoid saturated animal fats.
❏ Take Vitamin C and E supplements, which are known to reduce tissue inflammation and breast tenderness.
Spotting
As mentioned before, some women using the depo provera injection for birth control can experience abnormal vaginal spotting and even heavy, irregular vaginal bleeding. Sexual intercourse tends to aggravate this situation when the uterine endomentrium is unstable and spotting after sex can be due to the injectable contraceptive. However, bleeding after sex is never to be taken lightly and must always be thoroughly investigated by pelvic examination, pap smear, uterine examination, uterine ultra sound and even sampling by curettage. Infections are common and require treatment and uterine and cervical cancers must also be excluded. As B is also experiencing low abdominal cramping pain, she may in fact have a womb infection which needs treatment. B needs to have a thorough breast and pelvic examination by her family physician or a gynaecologist as soon as possible.
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Lifeline
PO Box 1731
Kgn 8
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