HPV Vaccination

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accination has proven to be a successful measure in the prevention of multiple infectious diseases and its massive application has achieved the disappearance of many of them. An infectious agent is an indispensable part of the genesis of cervical cancer and the idea of looking for a vaccine against that agent came a long time ago.

Currently, the vaccine is a reality: the infectious agent is human papillomavirus (HPV) of a variety of high oncogenic risks. Human papillomavirus vaccines are a new and effective resource in the strategies of primary prevention of cervical cancer.

Effectiveness of vaccines against cervical cancer precursor lesions:

The preventive effect of the available human papillomavirus vaccines is proven for precursor lesions of cervical cancer.

There are three stages of cervical intraepithelial neoplasia (CIN): CIN 1, CIN 2, and CIN 3. These stages are determined according to the severity of the changes that appear in the cells: slight, moderate, or high.

The tetravalent vaccine protects against CIN 2 produced by human papillomaviruses 16 and 18, in 97 to 100% of women. For cross-protection, it also protects against the same injuries caused by other types of high-risk human papillomaviruses: type 31 (46.2% of protection), type 33 (28.7%), type 45, (7.8%) and type 52 (18.4 % of protection).

The bivalent vaccine protects against CIN 2 produced by human papillomavirus 16 and 18 in around 92.9 and 95.7% of women. For cross-protection, it also protects against injuries caused by types 31 (36.1% of protection), 33 (36.5%), 45 (59.9%) and 52 (31.6%).

Despite their high rates of effectiveness, vaccinated women may develop cervical cancer due to vaccine failure (which is extremely rare) or because it is caused by high-risk human papillomavirus against which it was not offered protection. The need for detection, even among vaccinated women, it’s essential.

Other benefits of human papillomavirus vaccination

The human papillomavirus vaccination offers, at the same time to vaccinated men and women, protection against other types of cancer.

Patients can get a vaccine against HPV at Harley Street Hospital. Book an appointment with us to help prevent this disease.

Heavy Periods

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enstruation is defined as periodic, spontaneous uterine bleeding, which expels the endometrium of an ovulatory cycle. In the normal menstrual period, the average duration of the cycle is 21 to 35 days, the volume of bleeding is 30 to 80 ml and the duration is calculated from 2 to 7 days.

Hypermenorrhea (or menorrhagia) refers to a menstruation at regular intervals that is increased in quantity (more than 80 ml) and does not exceed 7 days.

Reports from the World Health Organization indicate that 18 million women aged 30 to 55 years perceive their menstrual bleeding as excessive. Reports show that only 10% of these patients experience blood loss severe enough to cause anemia or to be clinically defined as menorrhagia.

In practice, the measurement of menstrual blood loss is difficult. Therefore, the diagnosis is usually based on the patient’s history. Excessive bleeding is considered when there is one or two saturated napkins or tampons in a maximum time of 3 hours, a number of used sanitary towels greater than 7 a day, or both.

Menorrhagia should be distinguished clinically from other common gynecological diagnoses. This includes metrorrhagia (flow at irregular intervals), menometrorrhagia (frequent, excessive and prolonged flow), polymenorrhoea (bleeding at shorter intervals than 21 days) and dysfunctional uterine bleeding (abnormal uterine bleeding, without obvious structural or systemic abnormality, usually anovulatory).

So, for menstrual bleeding to be properly controlled, it is necessary that the myometrical contractility is sufficient, the epithelization of the endometrial mucosa has not suffered alterations and blood coagulation occurs normally.

Causes of Heavy Periods

Any process produced by various causes, whether genital or extragenital, or both types at the same time, and that alters any of these mechanisms, can cause hypermenorrhea. However, less than 50% of the cases have an identified cause.

The most common anatomical causes of hypermenorrhea are uterine myomatosis, especially submucosal myomas, and endometrial polyps. In the presence of uterine pathology (myomas / adenomyosis and to a lesser extent endometrial polyps), disturbances in the production and / or release of angiogenic factors (vascular endothelial growth factor [VEGF], fibroblast-derived growth factor [FGF] and factor growth transforming beta [TGF-B]) may be the underlying disorder of the vascular fragility.

At Harley Street Hospital, we have the best doctors who are trained to diagnose and properly treat these conditions. Book a consultation to get a specialist´s opinion.

Female Infertility

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nfertility is a condition that affects 15-20% of couples in their reproductive age. This deficiency can have a negative impact on the development of the individual, producing frustration and weakening the personality, since most couples consider having children as a goal of life.

Causes of Female Infertility

Anovulatory Infertility

Anovulation is defined as the condition in which the development and the follicular rupture are altered and therefore the oocyte is not released from the follicle. Several causes have been identified, including autoimmune genetic factors, and others, such as chemotherapy. The ovarian dysfunction, secondary to gonadotropic regulation is another cause.

Hyperprolactinemia

Hyperprolactinemia (higher-than-normal levels of the hormone prolactin in the blood) alters pulses of secretion of gonadotropin-releasing hormone (GnRH) and based on circulating concentrations of prolactin, clinical manifestations such as an inadequate luteal phase, anovulation and amenorrhea may appear.

Hypogonadotropic Hypogonadism

It is observed in cases with weight disorders and excessive exercise. It can be idiopathic or caused by pituitary or hypothalamic dysfunction.

Hypergonadotropic Hypogonadism

This is the usual situation in patients under 40 years old with premature ovarian insufficiency, women with resistant ovaries, or with genetic disorders.

Polycystic Ovaries

It is the endocrine pathology of major prevalence and the most frequent cause of anovulation.

Women with polycystic ovaries may present a wide range of symptoms and clinical signs; however, anovulation and hyperestrogenism are considered prerequisites in this pathology.

Tubal-Peritoneal Infertility

Tubal-peritoneal factors are responsible for 30% of the causes of infertility. The functions of the fallopian tubes are intimately linked to the integrity of the ciliated epithelium responsible for the uptake of oocytes. Fertilization takes place at the outer end of the ampullary section. The tubes also participate in the early development of the embryo and in its transport to the uterine cavity. Therefore, any anatomical or functional alteration of the tubes is associated with infertility.

Endometriosis

The association between endometriosis and infertility was established long ago. Several situations have been suggested to explain the presence of infertility in patients with endometriosis, among which there are anatomical, anovulation and luteal phase alterations.

Uterine Infertility

There is a wide spectrum of uterine abnormalities, whether congenital or acquired, associated with the presence of infertility or recurrent miscarriages. Examples include congenital alterations, intrauterine exposure to medications, submucosal fibroids, polyps and synechiae.

At Harley Street Hospital, we believe in making a difference to the lives of women. Book a consultation to get our specialist´s opinion.

Chronic Pelvic Pain

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hronic pelvic pain (CPP) is one that is located at the level of the lower abdomen, the pelvis, or intrapelvic structures, persisting for at least six months, which occurs continuously or intermittently.

If it is not acute and the mechanisms of central pain sensitization are well documented, pain is understood as chronic regardless of the elapsed time. In all cases, it is frequently associated with negative consequences in the cognitive, behavioral, sexual, and emotional areas.

Chronic pelvic pain is a complex condition in which symptoms of the reproductive, urological, gastrointestinal, abdominal wall, pelvic floor, and psycho-social factors are frequently intermingled, so an exhaustive clinical history becomes very important.

Multidisciplinary Management of Pain

CPP is a symptomatic complex that can originate from gastrointestinal, urological, reproductive, musculoskeletal, or neurological diseases. When the cause of the pain is evident, the treatment is directed to treat it. However, a subgroup of patients persists with pain despite treatment of the underlying cause.  It is in this context that the multidisciplinary management of CPP, with the planned and interactive participation of different specialists (urologist, gynecologist, gastroenterologist, coloproctologist, pain specialist, psychiatrist, psychologist, kinesiology among others) is very important in both the study and treatment.

Multimodal therapy is redirected to treat the pain and the underlying cause -if it exists- and all those biological, psychological, and environmental factors that are influencing it.

A proper therapy for this condition includes medical treatment (non-steroidal anti-inflammatory drugs, opioids, antidepressants, neuromodulators, muscle relaxants, alpha-blockers), but also psychotherapy, non-pharmacological therapy of the pelvic floor (biofeedback, myofascial massage), pelvic floor pharmacological therapy (injections in points trigger, botulinum toxin), bladder instillations, neuromodulation and surgical interventions (adhesiolysis, uterine neuroablation, presacral neurectomy) when appropriate.

At The Harley Street Hospital, we have the best specialists who can help you to treat chronic pelvic pain effectively. Book a consultation.