CAUSES OF HOT FLUSHES AND NIGHT SWEATS

Most women in their life time experience hot flushes and sweating at night or even during the day. When peri menopausal, menopausal and post menopausal; it is estimated that this happens in about 15% of women throughout their lives. This can be very uncomfortable and very embarrassing depending on where you are and what you are doing at the time. The simple answer is to wear light clothing, give up smoking if you are a smoker, try HRT if it is ok for you, or natural remedies.

There are many other endocrine conditions which cause hot flushes and sweating, overactive Thyroid (this controls our body function and is located in the neck). If the hot flushes are not controlled by menopausal treatment, have your thyroid tested. It is common to have thyroid disorders during menopausal years, and the treatments are simple.

There are few other endocrine causes which can cause these symptoms, these are 1) Pheochromocytoma, this is a tumour of the Adrenal gland, 2) Carcinoid syndrome, is a complex syndrome arising from the appendix. This can occur at any age and will have many other symptoms associated with it. Often if someone is diabetic and is on insulin or diabetic drugs, sweating can happen due to low blood sugar, this is a serious problem and can be life threatening. Treatment is simple, sugar drinks or a glass of fruit juice with some food.

Various infections also cause sweating; some of these are very serious, such as Tuberculosis, Osteomylitis (bone infection), Endocarditis (infection of heart valves), HIV, Abscesses formation, Malaria and other infections.

Cancer also causes sweating and fever. Lymphomas are more common to do so.

Certain drugs particularly antidepressants are known to cause sweating.

Stroke and Heart Attacks can cause severe sweating.

Many disorders of the nervous system also cause sweating

My idea of giving women this list is to make them aware of the many causes of sweating. Most of these can happen suddenly and at different age groups, along with many other symptoms, so take notice and do not ignore them.

URINARY TRACT INFECTIONS IN FEMALES

Urinary tract infections (UTI’s) are a very common problem in women and young female children. What is a urinary tract in humans? It consists of two kidneys on either side of our spine in our abdomen. Two tubes called the ureters run one from each kidney into a bag called the urinary bladder. In the female a small tube called the urethra opens to the outside from where females pass urine. In men it is different, it is long and on the way it is connected to other tubes. 

Of all the urinary tract infections that happen 80% happen in women. According to one study almost 50% of women have had at least one UTI in their lives by the time they are 50. UTI’s when simple are confined to the urinary bladder  this is called cystitis.  In some women and children it happens repeatedly than it becomes more significant. It can even travel to the kidney, and it is called pyelonephritis, it can become more serious. In even more neglected cases it can cause serious infection in parts of the body, so do not ignore UTI’s or simple bladder infections. What causes UTI’s so commonly in women. It is because our urethra is small, it is close to the rectum, and bacteria easily travel to the urethra and causes infection. It is also possible that local hygiene is not so good. Women often need a catheter after an operation, during labour, or other times if they are unable to pass urine. Other causes can be obesity, unprotected sex with an infected person. Some diseases such as Diabetes, Multiple Sclerosis, Parkinson’s Disease and some local abdominal diseases such as  Fibroids (a benign uterine tumour ), Endometriosis, Ovarian Cysts, Vaginal Infections, Kidney or Bladder Stones and using local contraceptives such as Vaginal Foam and a Diaphragm. Menopausal and post menopausal women are also very prone to UTI’s due to lack of protection from Oestrogens. Chemotherapy and commercial personal hygiene products. Malformations of the UT may be a cause of UTI’s. This will show in childhood and often recurrent.

What are the symptoms of UTI’S?

Rarely there are any symptoms, mostly women have frequent moments of passing urine and it is painful to do so. There is back ache (where kidneys are located), pain in the stomach and on the side of the abdomen. There can be nausea, vomiting, fever and even diarrhoea. The urine can be smelly and may contain blood. A young child will have all these problems. She may refuse to eat. The best thing is to go to the doctor. They can do a dip test with a strip in urine to confirm  infection and send a urine sample collected after wiping the vagina called the mid stream urine, for culture and appropriate antibiotics are started immediately. The symptoms improve within two days. If this does not happen the ABS are changed as the urine culture report will tell the doctor about the infecting bacteria and the suitable Antibiotic. A urine culture is also done after treatment to ensure that the infection has cleared. If a woman or children have recurrent infections, many other tests are done. These are an ultrasound, tests for STD’s,  a Cystoscopy meaning there by looking with a telescopic light inside the urinary bladder. Also make sure that the child is not being molested by anyone. Children sometimes have a problem that when they pass urine some urine goes back into their ureter. (The tube connecting kidney to the bladder) This requires surgical treatment. If this is not done the kidneys maybe damaged.

Women and girls who get repeated UTI’s should address their life style factors. Drink plenty of water, do not wear tight clothing, and do not wear anybody else’s clothes. Avoid grapefruit and cranberry juice that is recommended on social media for UTI’s. Use correct and safe contraceptives. Always have safe sex. Keep good hygiene for external parts of the body, when wiping bottom, wipe from top to the bottom.

         For women who get recurrent UTI’s meaning they have 2 episodes in 6 months or 3 in a year, Prophylactic treatments are required; with Postcoital Antibiotics, Continuous Low Dose Antibiotics and treatment for any voiding problems such as prolapse management of serious infections such as Aids, Antibiotics with UT instrumentation such as catheters.   

        

         Pregnancy and UTI’S

         In pregnancy UTI’s are important. In fact in all pregnant mothers a urine test is done and if there is bacteria even in absence of infection this is treated. UTI’s in pregnancy an cause premature  labour and due to  abdominal pressure, the infection can quickly go into the kidney causing pylonephritis. The women become very sick, symptoms become more severe, they are given intravenous antibiotics. They need to be hospitalized. If UTI’s happen again during pregnancy a woman is given prophylactic ABS for the rest of her pregnancy.

In UTI’s in addition to ABS we use urinary antiseptics they help and prevent bacteria, if the infection is simple and in the bladder alone for prophylaxis. In these situations we need to watch the sensitivity of bacteria so that the resistance bacteria do not develop,which will be impossible to treat. This is one big disadvantage of using prophylaxis.

Besides UTI’s there are a few other common problems with URINARY TRACT which are not strictly infection. One of them is called Interstitial Cystitis (IC) or Bladder Pressure Pain. This is a painful condition without infection. It is poorly understood, difficult to diagnose and treat. It is believed that there is some defect in the bladder lining which is irritated by food, sex and some vulval hygiene products. Diagnosis is made by using a cystoscopy in which they use a potassium solution for bladder wash this causes pain in women with IC. Treat is not very effective, women need a lot of psychological help, nonsteroidal anti inflammatory tablets, antihistamines and tricyclic anti depressants. In USA, FDI has allowed one oral drug Pontosan polysulfate to a maximum of six months. Change of life style factor is also recommended. Other urinary problem often in the elderly is over sensitive bladder when you need to go to the toilet frequently but there is no UTI. For this, one has to do pelvic floor exercises, bladder training, scheduled toilet trips, absorbent pads or underwear. Local oestrogen cream may help and intermittent catheterisation which in itself can be risky.  Usually the bacteria in UTI’s is ECOLI, which comes from our bowel but in unusual circumstances and in nursing homes they can be more serious and  difficult to treat, these are Proteus , Pseudomonas , Klebsella and bacteria from STD’s

Urinary tract system in our body is very important, as it gets rid of all the waste products from our body. If kidneys fail humans are on death bed. Special attention should be paid to all our Urinary tract problems particularly in children, women, pregnancy and the elderly. Never ignore blood in the urine, rarely can it be due to UTI’s but it can be a sign of cancer. Women do die from UT cancers.