Gynecologic Disorders
Genital Tract Infections
Menstrual disorders and alteration in the mucus pattern can also
be caused by gynecologic disorders such as anatomical abnormalities,
neoplasia or inflammatory diseases.
The second most frequent cause of fertility disorders are inflammatory
processes, usually secondary to genital tract infections (GTI),
which predominantly have an origin in sexually transmitted diseases.
Microbial mucin degrading enzymes are associated with sexually transmitted
infections and produced by the offending micro organisms. These
enzymes will alter the mutually beneficial cohabitation that normally
exists between commensals such as Lactobacillus, which use glycogen
as an energy source and contribute to normal mucin turnover by the
production of mucin degrading enzymes such as sialidase. Mucin molecules
would be partly or completely degraded by the microbial enzymes.
These molecules dictate the rheological properties which determine
the amount and viscosity of the mucus, so these properties will
change in response to enzymes produced by microbial organisms in
the genital tract (37).
A woman who knows her own mucus pattern in
times of health will be able to early recognize a GTI. These
will usually cause a continuous discharge whose characteristics
will depend upon the etiologic agent causing the infection.
In general, an ovulatory pattern is identifiable, but it is
associated with a creamy, sticky BIP. Symptomatic infections
(itching and a characteristic discharge) are usually caused
by fungi, bacteria or parasites. Chlamydia trachomatis infections,
with an incidence of 13% in infertile couples and often associated
with tubal pathology, (30, 34) will be asymptomatic or present
with continuous moistness and variable degrees of pelvic pain.
This infection may also show a mucopurulent discharge associated
with the mucus discharge. The recognition of this infection
and timely treatment may prevent fertility disorders. |
Human spermatozoa from infected male patient
with Ct |
 |
Continuous discharge: Symptomatic infections caused
by fungi, bacteria
It has been shown that these infections provoke pelvic inflammatory
processes and are associated with spontaneous abortions. Recent
studies (20) have shown that the mesh spacing between mucin fibers
is large enough for small viruses as human papiloma virus (HPV),
associated to cervical neoplasia, to diffuse unhindered through
mucus. Bacterial vaginosis related bacteria, micoplasms, trichomonas
vaginalis, and gardnerella among others, must also be considered
when unusual mucus patterns or menstrual irregularities occur. In
this situation, both members of the couple should be treated in
order to restore the healthy condition.
Continuous discharge: Symptomatic infections caused
by virus(HPV), Chlamydia
Incidence of Chlamydia trachomatis in groups of
males females and couples with or without first trimester spontaneous
abortions
Contraceptive Pill
Fertility disorders may also be iatrogenic, caused by contraceptive
pills or by hormonal therapy. Women coming off the pill may present
cycles with short luteal phases, absence of a well defined mucus
pattern, indicating anovulation, (21) poor mucus response due to
damaged cervical epithelium and a poor menstrual flow due to alterations
of the endometrial lining. Major cycle disturbances lasting for
up to seven cycles (cycle length > 35 days or luteal phase of
< 10 days, monophasic basal body temperature or anovulatory cycles)
occur frequently in women, after discontinuation of the birth control
pills. It has also been shown that in comparison with formerly used
mechanical anti-conception methods; pill users have lower monthly
percentages of conception during the first three months and a somewhat
lower percentage between the fourth and tenth months after discontinuation
of the pill (13, 14, and 16).
Conclusion
Self knowledge acquired by learning the BOM is an invaluable tool
for women willing to achieve a healthy reproductive system state.
Thus, identification of medical and environmental causes of abnormal
menstrual cycle patterns may provide clues to the causes of the
most frequent fertility disorders. Early diagnosis of these alterations,
as can be achieved through self fertility awareness, will not only
improve fertility disorders, but may help in the diagnosis and treatment
of other pathologies such as metabolic conditions, endocrine disorders,
anatomical alterations, pelvic inflammatory diseases or even neoplasia.
Moreover, the menstrual cycle pattern should be taken into consideration
in the clinical decision-making process.
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