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Amenorrhea is when you don”t have menstrual periods. There are two types of amenorrhea. Primary amenorrhea is when you haven”t ever had a period and you are 16 years of age or older. Secondary amenorrhea is when you have had normal periods but then you don”t have one for 3 or more months in a row. Causes & Risk Factors   Primary amenorrhea can be caused by the following:   Problems with the hypothalamus, which is an area in your brain that interacts with your pituitary gland to regulate your menstrual cycle Abnormal chromosomes Pituitary disease, which affects the pituitary gland. The pituitary gland is located just under the brain and helps regulate your menstrual cycle. An obstruction of the vagina, such as a membrane that is blocking menstrual flow You may develop secondary amenorrhea due to: Pregnancy Use of oral or injected contraceptives, such as birth control pills or Depo-Provera Stress Certain types of medicine, such as antidepressants, chemotherapy medicine and antipsychotics Extremely low body weight A problem with the thyroid, which is another gland that produces hormones that have an effect on menstruation Regular strenuous exercise, like long distance running, especially if body fat is low Treatment   You should see your doctor if you think you have amenorrhea. The following things may help you and your doctor figure out the cause of your amenorrhea: If you could be pregnant, take a home pregnancy test. If your periods aren”t the same every month, write down when they start and how long they last. Then give this information to your doctor. Find out if you have any family members with similar menstrual problems. Remember that it is still possible to get pregnant even if you aren”t having regular periods every month. Treatment depends on what is causing your amenorrhea. It may be as simple as changing your diet and exercise program to help you maintain a healthy weight. You may need medicine. Rarely, surgery is needed

Acne is a skin problem that occurs when the hair follicles of your skin are blocked by a mix of dead skin cells and sebum (oil). When this happens, bacteria can grow in the plugged hair follicles and cause more skin irritation.   Acne can occur anywhere on skin, but is most common on the face, neck, chest, and back. It usually starts in the early teen years, when the oil glands in the body start making more sebum, but can last into or begin in adulthood, too Causes & Risk Factors   Acne occurs when a mix of dead skin cells and sebum block the hair follicles of your skin. There are a few different types of acne:   When the hair follicle becomes plugged with oil and skin cells, a “whitehead” forms in the hair follicle. If the follicle is plugged near the surface of the skin and air touches the plug, it turns black and is called a “blackhead.” A blackhead isn”t caused by dirt. If the wall of a plugged hair follicle breaks, the area swells and turns into a red bump. If the hair follicle wall breaks near the skin surface, the bump usually becomes a pimple. If the follicle wall breaks deep in the skin, acne nodules or cysts can form. This is called “cystic acne.” Who gets acne more often between boys and girls Both boys and girls get acne. But it may be worse in boys because they have more skin oils. For many people, acne symptoms fade by the age of 25, but they can continue well into the adult years.   Family history also plays a role. If your mother and father had bad acne, you may have it, too.   Your immune system plays a role too. Some people are extra sensitive to the bacteria that get trapped in their hair follicles. Things that often make acne worse Hormonal changes, especially during puberty, before your monthly period (in women), or during pregnancy Certain medications Certain cosmetics, such as oil-based makeup, suntan oil, and hair products Stress Squeezing or picking at skin blemishes Hard scrubbing of the skin Treatment How can acne be treated Many treatments are available for acne, including over-the-counter and prescription medicines.   Benzoyl peroxide and salicylic acid are the most common and most effective over-the-counter medicines for acne. These medicines kill bacteria, dry up skin oil, and make your skin peel off. They are available in many forms, such as gels, lotions, creams, soaps, or pads. Keep in mind that it can take up to 8 weeks before you notice an improvement in the appearance of your skin. If an over-the-counter acne product doesn”t seem to help after 2 months, talk to your doctor. In some people, over-the-counter acne medications may cause side effects such as skin irritation, burning, or redness. Tell your doctor if you have side effects that are severe or that don”t go away over time. Prescription medicines If over-the-counter medicines are not effective, your doctor may prescribe one or more of the following medicines:   A retinoid cream or gel: Retinoids, such as tretinoin and adapalene, are usually applied to the skin once a day. Be sure not to get them near your eyes, mouth, and the area under your nose. If you use a retinoid, you must avoid the sun or use a strong sunscreen because this medicine increases your risk of sunburn. Women who are pregnant or may become pregnant should not use a retinoid called tazarotene because it can cause birth defects. Antibiotics: If your acne is severe, your doctor may prescribe an antibiotic to treat it. Antibiotics such as minocycline, doxycycline, and tetracycline reduce bacteria and inflammation, and can be used in combination with other treatments for acne, such as benzoyl peroxide. Antibiotics can be taken by mouth or used on the skin as a lotion, cream, or gel. Erythromycin and clindamycin are 2 antibiotics used in topical lotions and gels for acne. Isotretinoin: Isotretinoin is a strong medicine used to treat very bad acne. This medicine can cause serious side effects. You will need to carefully follow your doctor’s instructions for taking the medicine, and your doctor will monitor you closely. Learn more about isotretinoin. Birth control pills: Birth control pills can help treat acne in women. Talk to your doctor about the pros and cons of taking birth control pills for acne. other treatments? In addition to or in combination with medicines, cosmetic procedures such as peels, skin abrasion (dermabrasion or microderm abrasion), and laser or light treatments may help treat acne. These treatments may also help reduce acne scars. Individual large acne cysts often respond dramatically to small injections of steroid medication by your family doctor or a dermatologist. Lifestyle changes such as healthy diet and regular exercise may also help treat or prevent acne. Complications   Acne, especially cystic acne, can cause scars in some people. You can help reduce scarring by not squeezing or picking at blemishes. Also, avoid scrubbing your skin. If you do get scars, treatments to help reduce scarring are available

Infertility means that couples have been trying to get pregnant with frequent intercourse for at least a year with no success. Female infertility, male infertility or a combination of the two affects millions of couples in the around the world. An estimated 10 to 15 percent of couples have trouble getting pregnant or getting to a successful delivery.   Infertility results from female infertility factors about one-third of the time and male infertility factors about one-third of the time. In the rest, the cause is either unknown or a combination of male and female factors. The cause of female infertility can be difficult to diagnose, but many treatments are available. Treatment options depend on the underlying problem. Treatment isn’t always necessary , many infertile couples will go on to conceive a child spontaneously.     SYMPTOMS The main symptom of infertility is the inability of a couple to get pregnant. A menstrual cycle that’s too long (35 days or more), too short (less than 21 days), irregular or absent can be a sign of lack of ovulation, which can be associated with female infertility. There may be no other outward signs or symptoms.   When to see a doctor When to seek help depends, in part, on your age. If you’re in your early 30s or younger, most doctors recommend trying to get pregnant for at least a year before having any testing or treatment. If you’re between 35 and 40, discuss your concerns with your doctor after six months of trying. If you’re older than 40, your doctor may want to begin testing or treatment right away. Your doctor also may want to begin testing or treatment right away if you or your partner has known fertility problems, or if you have a history of irregular or painful periods, pelvic inflammatory disease, repeated miscarriages, prior cancer treatment, or endometriosis.   CAUSES To become pregnant, each of these factors is essential : You need to ovulate. Achieving pregnancy requires that your ovaries produce and release an egg, a process known as ovulation. Your doctor can help evaluate your menstrual cycles and confirm ovulation. Your partner needs sperm. For most couples, this isn’t a problem unless your partner has a history of illness or surgery. Your doctor can run some simple tests to evaluate the health of your partner’s sperm. You need to have regular intercourse. You need to have regular sexual intercourse during your fertile time. Your doctor can help you better understand when you’re most fertile during your cycle. You need to have open fallopian tubes and a normal uterus. The egg and sperm meet in the fallopian tubes, and the pregnancy needs a healthy place to grow. For pregnancy to occur, every part of the complex human reproduction process has to take place just right. The steps in this process are as follows: * One of the two ovaries releases a mature egg.               * The egg is picked up by the fallopian tube.               * Sperm swim up the cervix, through the uterus and into the fallopian tube to reach the egg    for fertilization.              * The fertilized egg travels down the fallopian tube to the uterus.              * The fertilized egg implants and grows in the uterus. N.B – In women, a number of factors can disrupt this process at any step. Female infertility is caused by one or more of these factors. Ovulation disorders Ovulation disorders, meaning you ovulate infrequently or not at all, account for infertility in about 25 percent of infertile couples. These can be caused by flaws in the regulation of reproductive hormones by the hypothalamus or the pituitary gland, or by problems in the ovary itself. Polycystic ovary syndrome (PCOS). In PCOS, complex changes occur in the hypothalamus, pituitary gland and ovaries, resulting in a hormone imbalance, which affects ovulation. PCOS is associated with insulin resistance and obesity, abnormal hair growth on the face or body, and acne. It’s the most common cause of female infertility. Hypothalamic dysfunction. The two hormones responsible for stimulating ovulation each month , follicle-stimulating hormone (FSH) and luteinizing hormone (LH) ,are produced by the pituitary gland in a specific pattern during the menstrual cycle. Excess physical or emotional stress, a very high or very low body weight, or a recent substantial weight gain or loss can disrupt this pattern and affect ovulation. The main sign of this problem is irregular or absent periods. Premature ovarian insufficiency. This disorder is usually caused by an autoimmune response where your body mistakenly attacks ovarian tissues or by premature loss of eggs from your ovary due to genetic problems or environmental insults such as chemotherapy. It results in the loss of the ability to produce eggs by the ovary, as well as a decreased estrogen production under the age of 40. Too much prolactin. Less commonly, the pituitary gland can cause excess production of prolactin (hyperprolactinemia), which reduces estrogen production and may cause infertility. Most commonly this is due to a problem in the pituitary gland, but it can also be related to medications you’re taking for another disease. Damage to fallopian tubes (tubal infertility) When fallopian tubes become damaged or blocked, they keep sperm from getting to the egg or block the passage of the fertilized egg into the uterus. Causes of fallopian tube damage or blockage can include :   * Pelvic inflammatory disease, an infection of the uterus and fallopian tubes due to chlamydia, gonorrhea or other sexually transmitted infections * Previous surgery in the abdomen or pelvis, including surgery for ectopic pregnancy, in which a fertilized egg becomes implanted and starts to develop in a fallopian tube instead of the uterus * Pelvic tuberculosis, a major cause of tubal infertility worldwide. * Endometriosis Endometriosis occurs when tissue that normally grows in the uterus implants and grows in other locations. This extra tissue growth  and the surgical removal of it  can cause scarring, which may obstruct the tube and keep the egg and sperm from uniting.

Acne is a skin problem that occurs when the hair follicles of your skin are blocked by a mix of dead skin cells and sebum (oil). When this happens, bacteria can grow in the plugged hair follicles and cause more skin irritation.   Acne can occur anywhere on skin, but is most common on the face, neck, chest, and back. It usually starts in the early teen years, when the oil glands in the body start making more sebum, but can last into or begin in adulthood, too. Causes & Risk Factors   Acne occurs when a mix of dead skin cells and sebum block the hair follicles of your skin. There are a few different types of acne:   When the hair follicle becomes plugged with oil and skin cells, a “whitehead” forms in the hair follicle. If the follicle is plugged near the surface of the skin and air touches the plug, it turns black and is called a “blackhead.” A blackhead isn”t caused by dirt. If the wall of a plugged hair follicle breaks, the area swells and turns into a red bump. If the hair follicle wall breaks near the skin surface, the bump usually becomes a pimple. If the follicle wall breaks deep in the skin, acne nodules or cysts can form. This is called “cystic acne.” Who gets acne most between boys and girls? Both boys and girls get acne. But it may be worse in boys because they have more skin oils. For many people, acne symptoms fade by the age of 25, but they can continue well into the adult years.   Family history also plays a role. If your mother and father had bad acne, you may have it, too.   Your immune system plays a role too. Some people are extra sensitive to the bacteria that get trapped in their hair follicles   Things that often make acne worse Hormonal changes, especially during puberty, before your monthly period (in women), or during pregnancy Certain medications Certain cosmetics, such as oil-based makeup, suntan oil, and hair products Stress Squeezing or picking at skin blemishes Hard scrubbing of the skin Treatment How can acne be treated Many treatments are available for acne, including over-the-counter and prescription medicines. Over-the-counter treatments are : Benzoyl peroxide and salicylic acid are the most common and most effective over-the-counter medicines for acne. These medicines kill bacteria, dry up skin oil, and make your skin peel off. They are available in many forms, such as gels, lotions, creams, soaps, or pads. Keep in mind that it can take up to 8 weeks before you notice an improvement in the appearance of your skin. If an over-the-counter acne product doesn”t seem to help after 2 months, talk to your doctor. In some people, over-the-counter acne medications may cause side effects such as skin irritation, burning, or redness. Tell your doctor if you have side effects that are severe or that don”t go away over time Prescription medicines If over-the-counter medicines are not effective, your doctor may prescribe one or more of the following medicines:   A retinoid cream or gel: Retinoids, such as tretinoin and adapalene, are usually applied to the skin once a day. Be sure not to get them near your eyes, mouth, and the area under your nose. If you use a retinoid, you must avoid the sun or use a strong sunscreen because this medicine increases your risk of sunburn. Women who are pregnant or may become pregnant should not use a retinoid called tazarotene because it can cause birth defects. Antibiotics: If your acne is severe, your doctor may prescribe an antibiotic to treat it. Antibiotics such as minocycline, doxycycline, and tetracycline reduce bacteria and inflammation, and can be used in combination with other treatments for acne, such as benzoyl peroxide. Antibiotics can be taken by mouth or used on the skin as a lotion, cream, or gel. Erythromycin and clindamycin are 2 antibiotics used in topical lotions and gels for acne. Isotretinoin: Isotretinoin is a strong medicine used to treat very bad acne. This medicine can cause serious side effects. You will need to carefully follow your doctor’s instructions for taking the medicine, and your doctor will monitor you closely. Learn more about isotretinoin. Birth control pills: Birth control pills can help treat acne in women. Talk to your doctor about the pros Other treatments In addition to or in combination with medicines, cosmetic procedures such as peels, skin abrasion (dermabrasion or microderm abrasion), and laser or light treatments may help treat acne. These treatments may also help reduce acne scars. Individual large acne cysts often respond dramatically to small injections of steroid medication by your family doctor or a dermatologist. Lifestyle changes such as healthy diet and regular exercise may also help treat or prevent acne. Complications   Acne, especially cystic acne, can cause scars in some people. You can help reduce scarring by not squeezing or picking at blemishes. Also, avoid scrubbing your skin. If you do get scars, treatments to help reduce scarring are available.