Patient's question:
Is there a relationship between infertility and menstrual disorders? Married for a year without contraceptionDoctor's answer:
(1) Menstrual Disorders:1. Changes in menstrual cycle: Menstruation may come earlier or later than usual.
2. Changes in menstrual flow: Excessive or insufficient bleeding.
3. Prolonged menstrual period: Commonly seen in luteal phase deficiency and endometrial inflammation.
(2) Amenorrhea: No menstruation by the age of 18; or continuous absence of menstruation for more than 6 months after its onset. A significant number of infertility cases are caused by amenorrhea. The latter can be classified as uterine, ovarian, pituitary, or hypothalamic based on the affected site.
(3) Dysmenorrhea: Pain during menstruation may occur in the presence of conditions such as endometriosis, pelvic inflammatory disease, uterine fibroids, uterine malformation, or abnormal uterine position.
(4) Symptoms Before and After Menstruation: Some women experience periodic symptoms such as "breast tenderness before menstruation," "headache during menstruation," "diarrhea during menstruation," "edema during menstruation," "fever during menstruation," "oral candidiasis during menstruation," "facial acne before menstruation," "urticaria during menstruation," and "depression or irritability during menstruation." These symptoms are often caused by endocrine disorders and luteal phase dysfunction, which can lead to infertility.
(5) Abnormal Vaginal Discharge: Increased vaginal discharge, yellow in color, with an odor, resembling curd or watery discharge, may occur in the presence of conditions such as vaginitis, cervicitis (cervical erosion), endometritis, adnexitis, pelvic inflammatory disease, and various sexually transmitted diseases. These conditions can also affect fertility to varying degrees.
(6) Abdominal Pain: Chronic lower abdominal or bilateral flank or lumbosacral pain may occur in the presence of conditions such as pelvic inflammatory disease, uterine myitis, ovarianitis, endometriosis, or tumors of the uterus or ovaries.
(7) Galactorrhea: Milk discharge from the breasts during non-lactation periods, either spontaneously or after manual stimulation, often suggests conditions such as hypothalamic dysfunction, pituitary tumors, prolactinomas, or primary hypothyroidism, chronic renal failure, or the use of birth control pills or antihypertensive drugs like hydralazine. Galactorrhea is often accompanied by amenorrhea, leading to infertility.
Medical Advice: Male infertility can be caused by various factors or conditions, with congenital issues being more significant, while acquired ones are often more manageable. With proper medical treatment, there is still a chance to restore fertility. For example, certain medical conditions such as diabetes and some neurological disorders can cause impotence or reduce sperm production. Tuberculosis-induced orchitis and prostatitis can disrupt sperm transport. Chronic conditions like sinusitis, chronic bronchitis, and bronchiectasis may be associated with asthenozoospermia or cystic fibrosis (causing bilateral vas deferens defects). Mumps after puberty may lead to orchitis, impairing sperm production. Long-term excessive alcohol and tobacco consumption can degrade semen quality. Illicit drug use, such as marijuana and heroin, can also affect male fertility.
If you have had a fever exceeding 38.5°C in the past six months, it can suppress sperm production for up to six months and may also damage sperm DNA. Certain medications can cause temporary or permanent reductions in sperm count, such as hormonal preparations (e.g., male or female hormones, steroids), or drugs for urinary tract infections (e.g., Nitrofurantoin), gout (e.g., colchicine), or ulcerative colitis (e.g., sulfasalazine, a sulfonamide). Women who are pregnant or exposed to female hormones or hormone-like additives may give birth to male infants with genital abnormalities or low sperm production. Taking male hormones to enhance physical appearance can also reduce sperm count. Some chemotherapy drugs used to treat cancer can also affect fertility.