Congenital Adrenal Hyperplasia (CAH) Tips

Excess facial hair growth in a woman results from a condition known as hirsutism. The growth in hair pattern is exactly similar to that of an adult male. Areas, where abnormal hair growth is visible, are chest, above the lips, etc. These hairs are dark, but fine in nature. They are more commonly known as peach fuzz. 

What Causes Excessive Facial Hair Growth in Females?

Here we try to find out the main cause of these facial hair growths, how various treatment and home remedies can be helpful to prevent excessive growth of hair on the face.

1. Genetic reasons: Women from the Indian sub-continent or Mediterranean region are more likely to have facial hair as compared to their American, European, and East-Asian counterparts. One of the common reasons for facial hair growth is genetics. It is a trend that runs in the family, it is more likely that a woman will get it. There is not much that can be done in this case except managing the hair growth effectively.
2. Imbalance of the hormone: Abnormal hormone production can lead to hirsutism. In many cases, there are conditions where female starts producing male hormones leading to abnormal hair growth in the face. One of the most common causes of facial hair growth is a polycystic ovarian syndrome (POS). This again is a hormonal imbalance leading to facial hair growth. Even adrenal gland related disorders such as Cushing’s syndrome, Adrenal cancer and congenital adrenal hyperplasia can lead to excess hair.
3. Medications: Certain medications can lead to excess hair growth in the face. For instance, certain steroids such as anabolic can lead to excess hair growth. Minoxidil is also known to cause hirsutism if taken in excess of 1 ml per day. Other medication-related to testosterone and cyclosporine can lead to excess facial hair in females. It is advised to follow the doctor’s advice before consuming any of these medicines.
4. Androgens: Although androgen is a male hormone, it is present in minute quantities in women too. Facial hair increase is nothing, but the sudden increased production of androgen in a female. Even birth control pills can lead to increased production of androgen in the body. In these cases, it is very important to seek medical advice.

Treatment and Remedies for Facial Hair Growth

One should get medical help at the earliest if one of these conditions matches their symptoms:

• The hair growth is sudden and abrupt.
• One witness male features such as increases muscle, acne, and reduced breast size.
• Certain medication has led to hair growth.

Home Remedies for Facial Hair Growth

• Usage of shaving, plucking and depilatory cream
• Laser hair reduction procedure shows immediate results in stopping and countering any further hair growth.
• Electrolysis can be tried to permanently damage the follicles.
• Weight loss is another good solution to excess hair growth. If you wish to discuss any specific problem, you can consult a doctor and ask a free question.

Update From Lybrate: Just like the face, we need to take care of our intimate areas too. Buy Intimate Hygiene Care Products from Lybrate and keep yourself healthy and infection-free.

In case you have a concern or query regarding skincare consult doctor online, you can always consult the best dermatologist online & get the answers to your questions.

It is normal for a woman to have fine and light facial and body hair. The problem arises when the facial hair is thick and are present in excess (more like males), especially in the sideburns, chin, upper and lower lip area. It leaves them highly embarrassed, shattering their self-confidence like never before. While threading or waxing do help, but it is a temporary solution. Sooner or later the problem resurfaces leaving them helpless and distressed. In fact, many, if not all, females have to face bullying, harassment, and humiliation only because they have facial hair. At times, the situation goes to such an extent that the person starts avoiding functions and get-togethers. For such women, laser therapy comes as a blessing aiding in effective facial hair reduction and removal.

What triggers excessive facial hair in females?
Hormonal imbalance (especially, increased level of testosterone or androgen) is one of the prime factors that results in thick and unwanted facial hair in females. This hormonal imbalance and the resulting appearance of facial hair can be brought about by medical conditions such as

1. PCOS (Polycystic Ovarian Syndrome), characterized by the presence of cysts in one or both the ovaries
2. Congenital Adrenal Hyperplasia (an inheritable autosomal recessive disorder which interferes with the ability of the adrenal glands to produce the sex hormones
3. Menopause
4. An ovarian tumor can play an instrumental role in the appearance of excessive facial hair in females
5. Obesity
6. Cushing's Syndrome

Laser Therapy for Facial Hair Reduction
The Laser Therapy can work wonders, reducing the facial hair with elan and without any hassle. In Laser therapy, a high-intensity light beam (laser) is focussed on the target area (in this case, the facial hair). The light is being absorbed by the pigment present in the hair follicles thereby destroying the targeted hair.

Steps involved in the laser-assisted facial hair reduction
Before carrying out the laser hair removal, the facial hair undergoes trimming (usually just a few mm above the surface of the facial skin).

1. For proper penetration of the laser beam and also to keep the epidermal skin layer safeguarded, a cooling gel or a cooling device is used during the procedure. Preventive measures should also be implemented for the safety of the eye.
2. The laser beam is then focussed on the target skin to be treated. It is also important to monitor the treated area closely to ward off any complications that may result from the treatment.
3. Finally, the dermatologist uses ice packs, anti-inflammatory lotions (cold water can also be used) to cool the treated skin area.
4. The time interval between two sessions depends upon the body part that is being treated.

Benefits

1. The effect of laser facial hair removal is more precise and long-lasting.
2. It enhances your overall appearance doing your confidence a world of good.
3. With experienced dermatologists, chances of major complications are almost negligible.

Excess facial hair growth in a woman results from a condition known as the hirsutism. The growth in hair pattern is exactly similar to that of an adult male. Areas, where abnormal hair growth is visible, are chest, above the lips, etc. These hairs are dark, but fine in nature. They are more commonly known as peach fuzz.

There could be a number of reasons for excess facial hair in a woman:

1. Genetic reasons: Women from the Indian sub-continent or Mediterranean region are more likely to have facial hair as compared to their American, European and East-Asian counterparts. One of the common reasons for facial hair growth is genetics. It is a trend that runs in the family, it is more likely that a woman will get it. There is not much that can be done in this case except managing the hair growth effectively.
2. Imbalance of the hormone: Abnormal hormone production can lead to hirsutism. In many cases, there are conditions where female starts producing male hormones leading to abnormal hair growth in the face. One of the most common causes of facial hair growth is polycystic ovarian syndrome (PCOS). This again is a hormonal imbalance leading to facial hair growth. Even adrenal gland related disorders such as cushing's syndrome, Adrenal cancer and congenital adrenal hyperplasia can lead to excess hair.
3. Medications: Certain medication can lead to excess hair growth in the face. For instance, the certain steroid such as anabolic can lead to excess hair growth. Minoxidil is also known to cause hirsutism if taken in excess of 1 ml per day. Other medication related to testosterone and cyclosporine can lead to excess facial hair in females. It is advised to follow the doctor’s advice before consuming any of these medicines.
4. Androgens: Although androgen is a male hormone, it is present in minute quantities in women too. Facial hair increase is nothing, but the sudden increased production of androgen in a female. Even birth control pills can lead to an increased production of androgen in the body. In these cases, it is very important to seek medical advice.

Treatment and remedies:
Medical help:
One should get medical help at the earliest if one of these conditions matches their symptoms:

• The hair growth is sudden and abrupt.
• One witness male features such as increases muscle, acne and reduced breast size.
• Certain medication has led to the hair growth.

Home Remedies:

• Usage of shaving, plucking and depilatory cream
• Laser hair reduction procedure shows immediate results in stopping and countering any further hair growth.
• Electrolysis can be tried to permanently damage the follicles.
• Weight loss is another good solution to excess hair growth. If you wish to discuss about any specific problem, you can consult a dermatologist.
• A hair transplant procedure is a surgical procedure in which hair is moved from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'. The procedure is performed to restore hair growth and is typically done on the scalp, but can also be performed on other areas of the body.

It is normal for a woman to have fine and light facial and body hair. The problem arises when the facial hair is thick and are present in excess (more like males), especially in the sideburns, chin, upper and lower lip area. It leaves them highly embarrassed, shattering their self-confidence like never before. While threading or waxing do help, but it is a temporary solution. Sooner or later the problem resurfaces leaving them helpless and distressed. In fact, many, if not all, females have to face bullying, harassment, and humiliation only because they have facial hair. At times, the situation goes to such an extent that the person starts avoiding functions and get-togethers. For such women, laser therapy comes as a blessing aiding in effective facial hair reduction and removal.

What triggers excessive facial hair in females?
Hormonal imbalance (especially, increased level of testosterone or androgen) is one of the prime factors that results in thick and unwanted facial hair in females. This hormonal imbalance and the resulting appearance of facial hair can be brought about by medical conditions such as

1. PCOS (Polycystic Ovarian Syndrome), characterized by the presence of cysts in one or both the ovaries
2. Congenital Adrenal Hyperplasia (an inheritable autosomal recessive disorder which interferes with the ability of the adrenal glands to produce the sex hormones
3. Menopause
4. An ovarian tumor can play an instrumental role in the appearance of excessive facial hair in females
5. Obesity
6. Cushing's Syndrome

Laser Therapy for Facial Hair Reduction
The Laser Therapy can work wonders, reducing the facial hair with elan and without any hassle. In Laser therapy, a high-intensity light beam (laser) is focussed on the target area (in this case, the facial hair). The light is being absorbed by the pigment present in the hair follicles thereby destroying the targeted hair.

Steps involved in the laser-assisted facial hair reduction
Before carrying out the laser hair removal, the facial hair undergoes trimming (usually just a few mm above the surface of the facial skin).

1. For proper penetration of the laser beam and also to keep the epidermal skin layer safeguarded, a cooling gel or a cooling device is used during the procedure. Preventive measures should also be implemented for the safety of the eye.
2. The laser beam is then focussed on the target skin to be treated. It is also important to monitor the treated area closely to ward off any complications that may result from the treatment.
3. Finally, the dermatologist uses ice packs, anti-inflammatory lotions (cold water can also be used) to cool the treated skin area.
4. The time interval between two sessions depend upon the body part that is being treated.

Benefits

1. The effect of laser facial hair removal is more precise and long-lasting.
2. It enhances your overall appearance doing your confidence a world of good.
3. With experienced dermatologists, chances of major complications are almost negligible.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Approximately 15 percent of couples are infertile. This means they aren't able to conceive a child even though they've had frequent, unprotected sexual intercourse for a year or longer. In about half of these couples, male infertility plays a role.

Male infertility is due to low sperm production, misshapen or immobile sperm, or blockages that prevent the delivery of sperm. Illnesses, injuries, chronic health problems, lifestyle choices and other factors can play a role in causing male infertility.

Not being able to conceive a child can be stressful and frustrating, but a number of male infertility treatments are available

The Causes of Male Infertility

Male infertility has many causes - from hormonal imbalances, to physical problems, to psychological and/or behavioral problems.  Moreover, fertility reflects a man’s “overall” health.  Men who live a healthy lifestyle are more likely to produce healthy sperm.  The following list highlights some lifestyle choices that negatively impact male fertility - it is not all-inclusive:

· Smoking significantly decreases both sperm count and sperm cell motility. 
· Prolonged use of marijuana and other recreational drugs. 
· Chronic alcohol abuse. 
· Anabolic steroid use causes testicular shrinkage and infertility. 
· Overly intense exercise produces high levels of adrenal steroid hormones which cause a testosterone deficiency resulting in infertility. 
· Inadequate vitamin C and Zinc in the diet. 
· Tight underwear increases scrotal temperature which results in decreased sperm production. 
· Exposure to environmental hazards and toxins such as pesticides, lead, paint, radiation, radioactive substances, mercury,  benzene, boron, and heavy metals 
· Malnutrition and anemia. 
· Excessive stress! 

Modifying these behaviors can improve a man’s fertility and should be considered when a couple is trying to achieve pregnancy.

Hormonal Problems:

A small percentage of male infertility is caused by hormonal problems.  The hypothalamus-pituitary endocrine system regulates the chain of hormonal events that enables testes to produce and effectively disseminate sperm.  Several things can go wrong with the hypothalamus-pituitary endocrine system: 

· The brain can fail to release gonadotrophic-releasing hormone (GnRH) properly.  GnRH stimulates the hormonal pathway that causes testosterone synthesis and sperm production. A disruption in GnRH release leads to a lack of testosterone and a cessation in sperm production.

· The pituitary can fail to produce enough lutenizing hormone (LH) and follicle stimulating hormone (FSH) to stimulate the testes and testosterone/sperm production.  LH and FSH are intermediates in the hormonal pathway responsible for testosterone and sperm production.

· The testes' Leydig cells may not produce testosterone in response to LH stimulation. 

· A male may produce other hormones and chemical compounds which interfere with the sex-hormone balance.

The following is a list of hormonal disorders which can disrupt male infertility:

Hyperprolactinemia: 
Elevated prolactin, a hormone associated with nursing mothers, is found in 10 to 40 percent of infertile males.  Mild elevation of prolactin levels produces no symptoms, but greater elevations of the hormone reduces sperm production, reduces libido and may cause impotence.  This condition responds well to the drug Parlodel (bromocriptine).

Hypothyroidism: 
Low thyroid hormone levels can cause poor semen quality, poor testicular function and may disturb libido.  May be caused by a diet high in iodine.  Reducing iodine intake or beginning thyroid hormone replacement therapy can elevate sperm count.  This condition is found in only 1 percent of infertile men.

Congenital Adrenal Hyperplasia: 
Occurs when the pituitary is suppressed by increased levels of adrenal androgens.  Symptoms include low sperm count, an increased number of immature sperm cells, and low sperm cell motility.  Is treated with cortisone replacement therapy.  This condition is found in only 1 percent of infertile men.

Hypogonadotropic Hypopituitarism: 
Low pituitary gland output of LH and FSH.  This condition arrests sperm development and causes the progressive loss of germ cells from the testes and causes the seminiferous tubules and Leydig (testosterone producing) cells to deteriorate.  May be treated with the drug Serophene.  However, if all germ cells are destroyed before treatment commences, the male may be permanently infertile.

Panhypopituitafism: 
Complete pituitary gland failure lowers growth hormone, thyroid-stimulating hormone, and LH and FSH levels.  Symptoms include:  lethargy, impotence, decreased libido, loss of secondary sex characteristics, and normal or undersized testicles.  Supplementing the missing pituitary hormones may restore vigor and a hormone called hCG may stimulate testosterone and sperm production.

Symptoms

The main sign of male infertility is the inability to conceive a child. There may be no other obvious signs or symptoms. In some cases, however, an underlying problem such as an inherited disorder, hormonal imbalance or a condition that blocks the passage of sperm may cause signs and symptoms. Male infertility signs and symptoms may include:

1. The inability to conceive a child
2. Problems with sexual function - for example, difficulty with ejaculation or difficulty maintaining an erection (erectile dysfunction)
3. Pain, swelling or a lump in the testicle area
4. Decreased facial or body hair or other signs of a chromosomal or hormonal abnormality
5. Having a lower than normal sperm count (fewer than 15 million sperm per milliliter of semen or a total sperm count of less than 39 million per ejaculate)

Tests and diagnosis

Many infertile couples have more than one cause of infertility, so it's likely you will both need to see a doctor. It may take a number of tests to determine the cause of infertility. In some cases, a cause is never identified. Infertility tests can be expensive and may not be covered by insurance — find out what your medical plan covers ahead of time.

Diagnosing male infertility problems usually involves:

1. General physical examination and medical history. This includes examining your genitals and questions about any inherited conditions, chronic health problems, illnesses, injuries or surgeries that could affect fertility. Your doctor may also ask about your sexual habits and about your sexual development during puberty.
2. Semen analysis. Semen is generally obtained by masturbating and ejaculating into a special container at the doctor's office. Your semen is then sent to a laboratory to measure the number of sperm present and look for any abnormalities in the shape (morphology) and movement (motility) of the sperm. The lab will also check your semen for signs of problems such as infections. Often sperm counts fluctuate from one specimen to the next. In most cases, several semen analysis tests are done over a period of time to ensure accurate results. If your sperm analysis is normal, your doctor will likely recommend thorough testing of your female partner before conducting any more male infertility tests.

Your doctor may recommend additional tests to help identify the cause of your infertility. These can include:

1. Scrotal ultrasound. This test uses high-frequency sound waves to produce images inside your body. A scrotal ultrasound can help your doctor see obstructions or other problems in the testicles and supporting structures.
2. Transrectal ultrasound. A small, lubricated wand is inserted into your rectum. It allows your doctor to check your prostate, and look for blockages of the tubes that carry semen (ejaculatory ducts and seminal vesicles).
3. Hormone testing. Hormones produced by the pituitary, hypothalamus and testicles play a key role in sexual development and sperm production. Abnormalities in other hormonal or organ systems may also contribute to infertility. A blood test measures the level of testosterone and other hormones.
4. Post-ejaculation urinalysis. Sperm in your urine can indicate your sperm are traveling backward into the bladder instead of out your penis during ejaculation (retrograde ejaculation).
5. Genetic tests. When sperm concentration is extremely low, genetic causes could be involved. A blood test can reveal whether there are subtle changes in the Y chromosome — signs of a genetic abnormality. Genetic testing may also be ordered to diagnose various congenital or inherited syndromes.
6. Testicular biopsy. This test involves removing samples from the testicle with a needle. The results of the testicular biopsy will tell if sperm production is normal. If it is, your problem is likely caused by a blockage or another problem with sperm transport.
7. Anti-sperm antibody tests. These tests are used to check for immune cells (antibodies) that attack sperm. You are especially likely to have anti-sperm antibodies if you've had a vasectomy reversal.

Specialized sperm function tests. A number of tests can be used to check how well your sperm survive after ejaculation, how well they can penetrate an egg, and whether there's any problem attaching to the egg. If you do have a low sperm count, having healthy sperm can be an important factor in male fertility.

I had a case of PCOD few years before which made me concentrate on this disease. By studying more and more in-depth and understanding such cases I came to a conclusion that this disease can be related with some emotional disturbances and that side can be cured by homeopathic remedies. Since last 3 to 4 years, I had various cases of PCOD and PCOS, girls and married women who were in a depressed state of mind due to PCOD or PCOS. They wanted to know about the disease in a language that they can understand what actually was going on in the body.

Here I am trying to explain what actually happens inside the body that results in polycystic ovarian disease or syndrome. It is the most common endocrine disorder among girls and married woman between age 18 to 45 years. It is one of the leading cause of poor fertility. In early puberty, most of the girls and their parents neglect the symptoms like delayed menses which could be due to pcod.

What is PCOD or PCOS?

PCOD is Polycystic Ovarian Disease where: 

• Females suffer from irregular or no ovulation or can be said irregular or absent menstrual periods without any known reason like pregnancy.
• Increased serum androgen levels, which can be diagnosed by a blood test.
• On ultrasound sonographic studies of the ovaries with multiple cysts can be seen which confirms the diagnosis.

The set of symptoms produced by this cystic disease of an ovary is called as Polycystic Ovarian Syndrome (PCOS). Those signs and symptoms are

1. Oligomenorrhea - Less than 8 cycles in a year.
2. Amenorrhea - No menstrual periods for 3 or more consecutive months.
3. Infertility - This is due to lack of ovulation, as we know without ovum pregnancy is impossible.
4. Hyperandrogenism - Androgen is a male sex hormone but it is present in a female in very low concentration. This level of androgen increases in patients of PCOD and hence few signs like acne, hirsutism (male pattern of hair growths such as on chin and chest), a bit masculine body like a male. Male pattern baldness can also be seen which is called as androgenic alopecia.
5. Obesity - Tendency towards central obesity can be seen in such patients.

These signs and symptoms may also occur due to other diseases like

1. Hypothyroidism - This is a case of under-functioning of the thyroid gland 
2. Congenital adrenal hyperplasia - That is an excessive or deficient production of sex steroids and can alter the development of primary or secondary sex characteristics in some affected infants, children, or adults
3. Cushing's syndrome 
4. Hyperprolactinemia - That is increased secretion of hormone prolactin by the pituitary gland
5. Androgen secreting neoplasm - Tumours secreting male sex steroids (androgens) that arise in women and are associated with the development of male physical characteristics, a process called virilization. Such tumours can develop either in the ovary or, more rarely, in the adrenal gland.

What actually happens in this disease

Polycystic ovaries develop when the ovaries are stimulated to produce an excessive amount of androgenic hormones, especially testosterone, by either one or a combination combined with genetic susceptibility.

• The release of an excessive luteinizing hormone (LH) by the anterior pituitary gland
• Through high levels of insulin in the blood (hyperinsulinemia) in women whose ovaries are sensitive to this stimulus. 

The syndrome acquired its most widely used name due to the common sign on ultrasound examination of multiple (poly) ovarian cysts. These "cysts" are actually immature follicles not cysts. The follicles have developed from primordial follicles, but the development has stopped ("arrested") at an early antral stage due to the disturbed ovarian function.

A majority of women with PCOS have insulin resistance and/or are obese. Their elevated insulin levels contribute to or cause the abnormalities seen in the hypothalamic-pituitary-ovarian axis that lead to PCOS. Increased insulin levels increase the rate of releasing gonadotropin-releasing hormone and the ratio of luteinizing hormone and follicle stimulating hormone disturbs which leads to an increase in ovarian androgen production, decreased follicular maturation and decreased sex hormone binding.

Management of PCOD / PCOS

The primary treatment for PCOS includes - lifestyle changes, medications.

The aim of treatment may be considered under four categories:

1. Lowering of insulin resistance levels
2. Restoration of fertility
3. Treatment of hirsutism or acne
4. Restoration of regular menstruation, and prevention of endometrial hyperplasia and endometrial cancer.

As PCOS appears to cause significant emotional distress, appropriate support may be useful.

Diet - Where PCOS is associated with overweight or obesity, successful weight loss is the most effective method of restoring normal ovulation/menstruation, but many women find it very difficult to achieve and sustain significant weight loss. A balanced vegetarian diet is advised.

Homeopathic Treatment

Homeopathy is the safest way to treat any human being with any type of disease. In Homeopathy we approach the problem of the patient holistically i.e. we treat the person as a whole and not just disease. Mental and emotional symptoms are prime important for us. We believe that every person is different from another and so are his thoughts and mind. It is important to understand what is the mental state of the patient, how he or she reacts in his disease state, how he or she performs his routine work instead of his sufferings, all such reactions are very important to reach the perfect dosage of medicine to cure a patient. 

In most gental, rapid and permanent way. Every patient can be treated with the same medicine but cannot be cured with the same medicine. That’s why we individualize every patient and try our best to know more about the patient so as to assure that the treatment is perfect to cure the patient.

A fistula is an abnormal connection between two hollow spaces (epithelial surfaces), such as blood vessels, intestines, or other hollow organs. Fistulas are usually caused by injuries or surgeries resulting in infection or inflammation. Also sometimes fistulae are created for therapeutic purpose.

Types of fistulas include:

1. Blind - with only one open end. Also known as sinus tracts
2. Complete - with both external and internal openings
3. Incomplete - a fistula with an external skin opening, which does not connect to any internal organ

Location:

1. Eye, adnexa, ear, and mastoid process: Lacrimal fistula, carotid cavernous fistula, mastoid fistula, craniosinus fistula, labyrinthine fistula, perilymph fistula, and preauricular fistula
2. Circulatory system: Coronary arteriovenous fistula, arteriovenous fistula of pulmonary vessels, pulmonary arteriovenous fistula, cerebral arteriovenous fistula, arteriovenous fistula, and fistula of the artery
3. Respiratory system: Pyothorax with fistula and tracheoesophageal fistula
4. Digestive system: Duodeno biliary fistula, salivary gland fistula, fistula of stomach and duodenum,  gastrocolic fistula, gastrojejunocolic fistula, enterocutaneous fistula, gastric fistula, fistula of appendix, anal and rectal fissures and fistulas, anal fistula, anorectal fistula, fistula of intestine, enteroentral fistula, fistula of gallbladder, biliary fistula, and pancreatic fistula
5. Musculoskeletal system and connective tissue: Fistula of joint
6. Urogenital system: Vesicointestinal fistula, urethral fistula, vesicovaginal fistula, cervical fistula, enterovaginal fistula, and rectovaginal
7. Congenital malformations, deformations and chromosomal abnormalities: Congenital preauricular fistula, Portal vein-hepatic artery fistula, congenital fistula of lip, Congenital fistula of salivary gland, congenital absence, atresia and stenosis of the rectum with fistula, congenital fistula of rectum and anus, congenital fistulae between uterus and digestive tract, and congenital rectovaginal fistula

Causes:

1. Inflammatory bowel disease causes of anorectal, enteroenteral, and enterocutaneous fistulas.
2. Complications from gallbladder surgery can lead to biliary fistula.
3. Radiation therapy, obstructed labor can lead to vesicovaginal and rectovaginal fistulas. Also, vesicovaginal and rectovaginal fistulas may also be caused by rape with foreign objects.
4. Obstetric fistula develops when the blood supply to the tissues of the vagina, bladder (and/or rectum) is cut off during prolonged obstructed labor.
5. Head trauma can lead to perilymph fistulas.
6. Trauma to other parts of the body can cause arteriovenous fistulas.
7. External causes include traumatic arteriovenous fistula and persistent postoperative fistula.

Physical examination: to determine the extent and pathway of the fistula

Treatment:

1. Treatment for fistula depends on the cause and extent of the fistula.
2. Surgery is often required to assure adequate drainage of the fistula. The surgical intervention combined with antibiotic therapy is usually required
3. In some cases, fistula is temporarily covered e.g. cleft palate fistula is treated with a palatal obturator to delay the need for surgery to a more appropriate age.
4. Surgical procedures commonly used are fistulotomy, placement of a seton (a cord that is passed through the path of the fistula to keep it open for draining)
5. Filling the fistula with fibrin glue

What is Endocrine Disorders?

Endocrine disorders are medical conditions that affect the body's endocrine system.

Many symptoms, including exhaustion, weight gain, and changes in mood or appetite, might be brought on by them.

Endocrine disorders may be caused by a number of factors, including genetics, environmental exposure, and other medical conditions.

Types of Endocrine disorder:

• Diabetes Mellitus: It is a chronic disorder that causes the body to be less able to make or react to insulin, which raises blood sugar levels.
• Hypothyroidism: This disorder causes slower biological activities because the thyroid gland does not generate enough of several hormones.
• Hyperthyroidism: A disorder when the thyroid gland overproduces certain hormones, causing the body to operate quickly.
• Cushing's Syndrome: A disorder that can result in weight gain and other symptoms due to excessive amounts of the hormone cortisol, which is generated by the adrenal glands.
• Addison's Disease: It is an autoimmune condition that damages the adrenal glands and causes inadequate cortisol and other hormone synthesis.
• Acromegaly: A disorder caused by excess growth hormone production, resulting in enlarged hands and feet, facial features, and other physical changes.
• Polycystic Ovarian Syndrome (PCOS): A hormone disorder that affects female reproductive health, leading to irregular menstrual cycles and infertility issues

What are the signs and symptoms of Endocrine Disorders?

• Diabetes: The signs and symptoms of this condition include an increase in thirst, frequent urination, exhaustion, loss of weight, blurry vision, and a slowing of wound healing.
• Hypothyroidism: It is characterised by a variety of symptoms, such as an increase in body weight, constipation, weariness, dry skin and hair, and depression.
• Hyperthyroidism: Symptoms include sudden weight loss, nervousness or irritability, rapid heartbeat, sweating profusely and bulging eyes (exophthalmos).
• Cushing’s Syndrome: This disorder is caused by an overproduction of cortisol from the adrenal glands which can lead to a variety of signs or symptoms such as weight gain in the face and trunk area as well as thinning arms and legs; thinning skin; pink or purple stretch marks on abdomen; high blood pressure; muscle weakness; fatigue; and increased risk for infections due to impaired immune system function.
• Addison’s Disease: This endocrine disorder occurs when the adrenal glands don't produce enough hormones such as cortisol and aldosterone leading to symptoms like fatigue, muscle weakness, loss of appetite, nausea/vomiting, low blood pressure (hypotension), darkening of skin in certain areas (hyperpigmentation), salt cravings along with depression and anxiety.

What are possible complications of Endocrine Disorders?

• Diabetes can lead to a variety of complications, such as heart disease and stroke, kidney damage, vision loss, nerve damage, and amputation.
• Hypothyroidism can cause a variety of physical and mental symptoms, such as fatigue, depression, dry skin and hair loss. It can also lead to an increased risk of heart disease and high cholesterol.
• Hyperthyroidism can cause a wide range of symptoms including weight loss, increased appetite, increased sweating, palpitations (a feeling like your heart is racing), difficulty sleeping and irritability. It can also lead to an increased risk of osteoporosis.
• Cushing's Syndrome symptoms include weight gain in the face and upper body region, thinning skin, stretch marks on the skin, acne and other skin problems, excessive facial hair growth in women and weakened muscles or bones.
• Addison's Disease is caused by an underproduction of hormones from the adrenal gland leading to fatigue, low blood pressure (hypotension), salt craving and darkening patches on the skin (hyperpigmentation).
• Other endocrine disorders such as polycystic ovary syndrome (PCOS) or adrenal insufficiency can also lead to various complications including infertility or an increased risk for diabetes or cardiovascular disease.

Benefits of Natural Treatments

• Non-invasive, safe and low-risk: Natural treatments are generally non-invasive, safe and low-risk. This can lead to greater acceptance by patients as well as lower healthcare costs.
• Empowerment: Natural treatments can help patients feel more in control of their health by taking an active role in their own healing process.
• Improved quality of life: Natural treatments are known to improve overall quality of life, reduce fatigue and stress levels, and improve mood and energy levels.

Holistic Ways to Manage Symptoms

• Eat a nutrient-dense diet: focus on fresh, whole, and unprocessed foods.
• Exercise regularly: aim for at least 30 minutes of moderate exercise per day.
• Reduce stress: practice relaxation techniques such as yoga, meditation, and deep breathing.
• Get adequate sleep: aim for 7-8 hours per night.
• Supplement carefully: nutritional supplements may help to manage endocrine disease symptoms when used correctly.
• Avoid toxins: limit your exposure to environmental pollutants and toxic chemicals in processed foods and personal care products.

Diet and Exercise Changes for treating Endocrine Diseases

For endocrine diseases, diet and exercise changes may include reducing the amount of processed foods consumed, increasing intake of fruits and vegetables, reducing caffeine and alcohol intake, exercising regularly, and monitoring blood sugar levels.

Mindfulness Practices for endocrine disease

• Deep Breathing: The practice of taking long, calm breaths while concentrating on the breath might be beneficial for lowering stress and restoring hormone balance.
• Body Scanning: Scanning your body and noticing any sensations or emotions can help to bring awareness to areas of tension that may be contributing to endocrine disease.
• Guided Imagery: Guided imagery can help create a relaxed state, reduce stress levels, and promote healing.
• Meditation: Meditation can help to reduce stress and balance hormones that are out of balance due to endocrine disease.
• Gratitude Practice: Practising gratitude can help shift focus away from worries and negative thoughts, allowing for a more positive outlook on life which can in turn help improve endocrine health.

Home remedies and tips for Endocrine Disorders

• Ashwagandha (Withania somnifera): Ashwagandha is an Ayurvedic herb used for centuries to help balance hormones, reduce inflammation and stress, improve circulation, and support a healthy immune system.
• Fenugreek (Trigonella foenum-graecum): Fenugreek is an Ayurvedic herb that helps to regulate the endocrine system and its hormones. It has been shown to help lower cortisol levels, regulate blood sugar levels and promote a healthy metabolism.
• Shatavari (Asparagus racemosus): Shatavari has been traditionally used in Ayurveda to balance hormones, boost fertility and increase libido. It can also help reduce anxiety and stress levels that can affect hormone balance.
• Guggul (Commiphora mukul): Guggul is a resin derived from the mukul tree that has been used in Ayurveda for centuries to treat endocrine disorders such as diabetes, thyroid problems, low libido and obesity.
• Brahmi (Bacopa monnieri): Brahmi is an Ayurvedic herb that helps to reduce stress and anxiety which can lead to better hormonal balance in the body.
• Amalaki (Emblica officinalis): Amalaki is an ancient Ayurvedic herb used to boost energy levels and balance hormones naturally by stimulating the pituitary gland located at the base of the brain responsible for releasing important hormones in the body like serotonin, dopamine and melatonin which are linked to overall well being..
• Licorice root (Glycyrrhiza glabra): Licorice root is an adaptogenic herb with many health benefits including balancing hormones naturally by increasing progesterone levels while decreasing cortisol production in the body which can be beneficial for those with endocrine disorders like PCOS or infertility..
• Bitter melon (Momordica charantia): Bitter melon has long been used in traditional medicine as a natural remedy for diabetes due to its ability to lower blood sugar levels while also helping with other endocrine disorders like hypothyroidism due to its high content of antioxidants, vitamins, minerals and other nutrients..
• Shilajit (Asphaltum punjabinum): Shilajit is a mineral-rich resin found in mountain ranges across India that has been used for centuries as an Ayurvedic tonic for treating endocrine disorders like diabetes due its high content of trace minerals including calcium, magnesium, iron and zinc as well as plant based compounds like fulvic acid which help regulate hormones naturally..

 What are the surgical treatments for Endocrine Disorders?

• Endoscopic Thyroidectomy: The thyroid gland may be completely or partially removed with this operation, which involves just a little amount of incision work.The procedure is used to treat various thyroid disorders such as hyperthyroidism, nodules, goitres, and cancer of the thyroid gland.
• Adrenalectomy: During this procedure, the adrenal glands, which are important for manufacturing hormones that govern metabolism and other physiological processes, may have all or a portion of their tissue removed. It is used to treat conditions such as Cushing's syndrome, congenital adrenal hyperplasia (CAH), aldosteronism, and pheochromocytoma.
• Parathyroidectomy: This procedure involves removing one or more of the parathyroid glands located in the neck near the thyroid gland. It is used to treat conditions such as hyperparathyroidism, which can lead to high levels of calcium in the blood and increased risk for kidney stones and bone loss.
• Pancreatectomy: This procedure involves removing some or all of the pancreas, an organ located behind the stomach that helps with digestion and produces hormones to regulate blood sugar levels. It can be used to treat pancreatic cancer, pancreatitis, and other conditions affecting the pancreas.

Best doctors to consult for Endocrine Disorders?

• Endocrinologists: Endocrinologists specialise in the diagnosis and treatment of endocrine disorders, such as diabetes, thyroid disease, and reproductive disorders. They are able to provide comprehensive care for endocrine-related conditions, from diagnosis to treatment.
• Primary Care Physicians: Primary care physicians are general practitioners who can provide basic care for endocrine disorders. They may be able to diagnose and treat simple conditions or refer patients to an endocrinologist when needed.
• Paediatricians: Paediatricians specialising in the health and medical care of infants, children, and adolescents. They can diagnose and treat endocrine disorders that affect children and provide ongoing care for these conditions as they age.
• Nurse Practitioners: Nurse practitioners (NPs) are advanced practice nurses who can provide primary care services including diagnosis, treatment, and management of endocrine disorders in both adults and children.