ERECTILE DYSFUNCTION DISEASE - LEARN ABOUT CAUSES, POTENCY, DRUGS AND HOW ARE ERECTILE DYSFUNCTION TREATED

Erectile Dysfunction (impotence)

Erectile dysfunction (ED), also known as impotence, is the inability to achieve or sustain an erection for satisfactory sexual activity. Erectile dysfunction is different from other conditions that interfere with male sexual intercourse, such as lack of sexual desire (decreased libido) and problems with ejaculation and orgasm (ejaculatory dysfunction).



Erectile dysfunction (ED, impotence) varies in severity; some men have a total inability to achieve an erection, others have an inconsistent ability to achieve an erection, and still others can sustain only brief erections. The variations in severity of erectile dysfunction make estimating its frequency difficult. Many men also are reluctant to discuss erectile dysfunction with their doctors due to embarrassment, and thus the condition is underdiagnosed.
Nevertheless, experts have estimated that erectile dysfunction affects 30 million men in the United States.

What is an Erection

An erection occurs when blood is pumped into the penis and stays there, making it hard. It generally happens because a guy is thinking about sex, or because his penis is being stimulated - or both.
The result is that signals go down the nerves that lead from his spinal cord to his genitals. They tell the blood vessels which supply the penis to open up. Blood flows in and the organ ‘blows up’ like a balloon. A valve mechanism near the base of the penis keeps the blood from flowing out again – a least, until sex is over.
Nicotine is now known to narrow those vital blood vessels – which is why ED is much commoner in smokers. But often, there is nothing physically wrong with men who develop ED.

Erectile Dysfunction Causes

There are many underlying physical and psychological causes of erectile dysfunction. Reduced blood flow to the penis and nerve damage are the most common physical causes. Underlying conditions associated with erectile dysfunction include the following:

Vascular Disease

Arteriosclerosis, the hardening and narrowing of the arteries, causes a reduction in blood flow throughout the body and can lead to impotence. It is associated with age and accounts for 50% to 60% of impotence in men over 60. Risk factors for arteriosclerosis include:

• High blood pressure
• High cholesterol
• Diabetes mellitus

Smoking, which can lead to any of the above risk factors, is perhaps the most significant risk factor for impotence related to arteriosclerosis.

Hormone Imbalances

Hormone disorders account for fewer than 5% of cases of impotence. Testosterone deficiency, which occurs rarely, can result in a loss of libido (sexual desire) and loss of erection.
Among other conditions, an excess of the hormone prolactin, caused by pituitary gland tumor, reduces levels of testosterone. Hormone imbalances can also result from kidney or liver disease.

Diabetes Mellitus

Chronic high levels of blood sugar associated with diabetes mellitus often damage small blood vessels and nerves throughout the body, which can impair nerve impulses and blood flow necessary for erection. About 60% of men with diabetes experience impotence.

Neurologic Conditions

Spinal cord and brain injuries (e.g., paraplegia, stroke) can cause impotence when they interrupt the transfer of nerve impulses from the brain to the penis. Other nerve disorders, such as multiple sclerosis (MS), Parkinson's disease, and Alzheimer's disease, may also result in impotence.

Drugs

Over 200 commonly prescribed drugs are known to cause or contribute to impotence, including drugs for high blood pressure, heart medications, antidepressants, tranquilizers, and sedatives.

» Learn more: Erectile Dysfunction


Written by Dr David Delvin, GP and family planning specialist

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ARTHRITIS DISEASE - LEARN ABOUT ARTHRITIS CAUSES, SYMPTOMS, TYPES AND HOW ARE ARTHRITIS TREATED

Arthritis

Arthritis simply means a painful condition of the joints. There are different types of the disease - many inflammatory and others more degenerative in nature.
Arthritis is classified as one of the rheumatic diseases. These are conditions that are different individual illnesses, with differing features, treatments, complications, and prognosis. They are similar in that they have a tendency to affect the joints, muscles, ligaments, cartilage, and tendons, and many have the potential to affect internal body areas as well.

Arthritis sufferers include men and women, children and adults. Approximately 350 million people worldwide have arthritis. Over 40 million people in the United States are affected by arthritis, including over a quarter million children! More than half of those with arthritis are under 65 years of age. Nearly 60% of Americans with arthritis are women.
There are many forms of Arthritis (over 100 have been described so far, and the number is growing). The forms range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation as a result of an overactive immune system (such as rheumatoid arthritis). Together, the many forms of arthritis make up the most common chronic illness in the United States.

Arthritis Causes

The causes of arthritis depend on the form of arthritis. Causes include injury (leading to degenerative arthritis), inheritance (such as in osteoarthritis), abnormal metabolism (such as gout and pseudogout), infections (such as in the arthritis of Lyme disease), and an overactive immune system (such as rheumatoid arthritis and systemic lupus erythematosus). Treatment programs, when possible, are often directed toward the precise cause of the arthritis.

Arthritis Symptoms

Symptoms of arthritis include pain and limited function of joints. Inflammation of the joints from arthritis is characterized by joint stiffness, swelling, redness and warmth. Tenderness of the inflamed joint can be present. Loss of range of motion and deformity can result. Certain forms of arthritis can also be associated with pain and inflammation of tendons surrounding joints.
Some forms of arthritis are more of an annoyance than a serious medical problem. However, millions of people suffer daily with pain and disability from arthritis or its complications. Moreover, many of the forms of arthritis, because they are rheumatic diseases, can cause symptoms affecting various organs of the body that do not directly involve the joints. Therefore, symptoms in some patients with certain forms of arthritis can also include fever, gland swelling, weight loss, fatigue, feeling unwell, and even symptoms from abnormalities of organs such as the lungs, heart, or kidneys.

Types of Arthritis

In literal terms, Arthritis can be defined as the swelling of joints. Arthritis comprises of nearly hundred different types and is classified based on the intensity of inflammation, the way the wear and tear occurs, etc.

Rheumatoid Arthiritis

This type of arthritis is chronic and systematic affecting the joints and leading to an inflammation of the synovitis. It also tends to spread to other parts of the body and tissues. It is an autoimmune disease where the body’s immune system by mistake attacks the synovium and causes arthirtis.

» Learn more: Arthritis

Reviewed by Dr Badal Pal, consultant rheumatologist

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ANXIETY DISORDER - LEARN ABOUT ANXIETY SYMPTOMS, TYPES AND HOW ARE ANXIETY DISORDER TREATED

Anxiety Disorder

Anxiety is a normal response to stress or danger. At times it is helpful because it can help prepare the body for action, and it can improve performance in a range of situations. Anxiety becomes a problem when it is experienced intensely and it persistently interferes with a person's daily life.
Depression and anxiety commonly occur together. Not everybody who is anxious is depressed, but most depressed patients have some symptoms of anxiety.

Anxiety Symptoms

Anxiety can be experienced in a number of different ways.

Physical symptoms

• Racing heart beat (palpitations);
• Chest tightness;
• Breathing fast, feeling short of breath or finding it hard to "get breath";
• Dry mouth, butterflies in the stomach, feeling sick. Sweating;
• Tremor;
• An urge to pass urine.

Psychological symptoms

• Inner tension;
• Fear of losing control;
• Agitation;
• Dread that something catastrophic is going to happen, such as a blackout, seizure, heart attack or death;
• Feelings of detachment, as if being trapped in a bubble separate from the world;
• Irritability.

What types of anxiety disorders

There are a number of "types" of anxiety disorders. They tend to overlap considerably and it is not uncommon for people to have features of several of the disorders.

Panic disorder

In panic disorder, repeated panic attacks occur unpredictably and often without obvious causes. The attacks consist of severe anxiety with physical and psychological symptoms.
Psychological symptoms typically include dread (particularly of extreme events such as dying), having a seizure, losing control or "going mad".
Physical symptoms can include any of the general symptoms of anxiety described above and often the hyperventilation syndrome.
To the sufferer, the attacks feel as if they are going on for a long time, but actually they tend to last only a few minutes, and at their longest they last around an hour. Panic disorder is common in depression, GAD or agoraphobia.

» Learn more: Anxiety Disorder

Written by Dr Hamish McAllister-Williams, MRC clinical scientist, senior lecturer and honorary consultant psychiatrist

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ANGINA PECTORIS (CHEST PAIN) DISEASE - LEARN ABOUT ANGINA SYMPTOMS, CAUSES, RISK FACTORS AND HOW ARE ANGINA PECTORIS TREATED

Angina Pectoris (chest pain)

Angina Pectoris (Chest Pain) is chest discomfort that occurs when there is a decreased blood oxygen supply to an area of the heart muscle. In most cases, the lack of blood supply is due to a narrowing of the coronary arteries as a result of arteriosclerosis.

Angina Pectoris Symptoms

Symptoms typically start during physical exertion or emotional stress. They are often worse in cold or windy weather and sometimes after big meals.

• A sense of heaviness or numbness in the arm, shoulder, elbow or hand, usually on the left side.
• Increased shortness of breath on exercise.
• A squeezing or heavy pressing sensation on the chest.
• The discomfort can radiate into both arms, the jaw, teeth, ears, stomach and in rare cases between the shoulder blades.
• A constricting sensation in the throat.

Blood then clots around the rupture, and the clot may be large enough to block the artery and seal off the blood supply. This may cause unstable angina or a heart attack.

Angina Pectoris Causes

In most cases, the cause of angina is coronary atherosclerosis: the thickening of arteries that supply blood, oxygen and nutrients to the heart.
Symptoms may only appear at times when your heart needs more blood supply, such as when you're stressed, exercising or climbing stairs.
This happens when fatty deposits, called plaques or atheroma, narrow the arteries over time and reduce blood flow to the heart.
As your heart tries to pump faster to meet your body's increased demands, the narrowed arteries struggle to keep up. The heart then receives too little oxygen, which causes pain in the heart that is felt as chest pain. In severe cases this can also happen when the heart is at rest.

» Learn more: Angina Pectoris

Reviewed by Dr Neal Uren, consultant cardiologist, Dr Patrick Davey, cardiologist and Dr Stephen Collins, GP

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ALZHEIMER'S DISEASE - LEARN ABOUT ALZHEIMER'S DISEASE AND HOW ARE ALZHEIMER'S DISEASE TREATED

Alzheimer's disease

Alzheimer's disease is the most common type of dementia, affecting over half of all dementia sufferers. Alzheimer's disease is caused by a loss of brain cells, probably related to an imbalance in the chemical messengers (neurotransmitters) in the brain.

How are people affected?

Over time, their mental abilities deteriorate, gradually progressing through forgetting important matters, getting confused about where they are and what day it is, to becoming lethargic and withdrawn and starting to neglect personal hygiene.

The sufferer may tend to dwell in the past and mistake friends and neighbours for long-departed family members. Conversation may become repetitive and the personality may alter as people develop odd or uncharacteristic behaviours.

In the later stages of the illness, sufferers lose insight and may not be aware of their plight, which makes the disease particularly hard for carers to bear.

Who develops Alzheimer's disease

The main risk factor for Alzheimer's disease is increased age. As a population ages, the frequency of Alzheimer's disease continues to increase. Ten percent of people over 65 years of age and 50% of those over 85 years of age have Alzheimer's disease. Unless new treatments are developed to decrease the likelihood of developing Alzheimer's disease, the number of individuals with Alzheimer's disease in the United States is expected to be 14 million by the year 2050.

There are also genetic risk factors for Alzheimer's disease. Most patients develop Alzheimer's disease after age 70. However, 2%-5% of patients develop the disease in the fourth or fifth decade of life (40s or 50s). At least half of these early onset patients have inherited gene mutations associated with their Alzheimer's disease. Moreover, the children of a patient with early onset Alzheimer's disease who has one of these gene mutations has a 50% risk of developing Alzheimer's disease.

There is also a genetic risk for late onset cases. A relatively common form of a gene located on chromosome 19 is associated with late onset Alzheimer's disease. In the majority of Alzheimer's disease cases, however, no specific genetic risks have yet been identified.

Other risk factors for Alzheimer's disease include high blood pressure (hypertension), coronary artery disease, diabetes, and possibly elevated blood cholesterol. Individuals who have completed less than eight years of education also have an increased risk for Alzheimer's disease. These factors increase the risk of Alzheimer's disease, but by no means do they mean that Alzheimer's disease is inevitable in persons with these factors.

All patients with Down syndrome will develop the brain changes of Alzheimer's disease by 40 years of age. This fact was also a clue to the "amyloid hypothesis of Alzheimer's disease"

» Learn more: Alzheimer's disease

Written by Professor Marion McMurdo, honorary consultant in medicine for the elderly

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ALLERGY (FOOD) DISEASE - LEARN ABOUT ALLERGY SYMPTOMS, TYPES AND HOW ARE ALLERGY TREATED

Allergy (Food)

Allergy (Food) it is a reaction by your immune system to a normal amount of a particular food. This reaction happens every time that food is eaten. Although food allergies are rare, they are most common in children under the age of four. The most frequent food allergies are to: milk, fish, eggs, nuts, tomatoes, citrus fruit.

How do food allergies begin?

A hypersensitive reaction towards food is usually a type 1 allergic reaction to something in the diet.
This means your child's immune system produces a class of antibodies called IgE in response to a particular food. These antibodies cause the allergic symptoms.

In fact, only about 3 per cent of children suffer allergic reactions towards food, and most will outgrow them before they reach the age of three.

Almost one third of the population omit certain foods from their diet or their children's diet because they believe they cause an allergic reaction.

Food allergy symptoms

Children with food allergies often have several different symptoms. These include:

• Asthmatic bronchitis or asthma
• Allergic cold (itchy, streaming eyes and nose)
• Severe infantile eczema or skin rash
• Vomiting and diarrhoea for no apparent reason

» Learn more: Allergy (Food)

Written by Dr Dan Rutherford, GP, consultant obstetrician and gynaecologist

tags: food allergies, allergies, food allergy symptoms, allergy symptoms, food allergy network, food allergy testing, allergy testing, food allergies treated

ALCOHOLISM DISEASE - LEARN ABOUT ALCOHOLISM SYMPTOMS, STAGES AND HOW ARE ALCOHOLISM TREATED

Alcoholism

Alcoholism interventions should be carefully planned and developed by professional substance abuse counselors who are experienced in such procedures. The most essential purpose of an alcoholism intervention is to get the alcoholic to seek professional alcohol addiction treatment.

Alcohol. Friend or foe?

High levels of alcohol consumption can lead to physical illness and psychological and social distress. Alcohol has therefore always had an ambivalent position in society.

In moderation, it can be the oil that makes a social occasion go with a bit more flow or helps a shy person overcome their inhibitions.

Small, regular amounts of alcohol also seem to have a positive effect on the heart and circulation. But too much alcohol is often a recipe for disaster.

The increasing use of alcohol, along with other drugs of abuse, is a serious public health problem across all age ranges, but especially so in the young.

What is alcohol dependence?

Alcoholism, or alcohol dependence is a medical term with a deliberately more precise meaning than the problems that can occur, sometimes as one-offs, through an uncharacteristic binge.

In alcohol dependence a number of features come together in the behaviour of the person affected.

• Withdrawal symptoms such as anxiety and tremor develop after a short period without a drink, and are reduced by taking more alcohol.
• Tolerance develops, so it takes more alcohol to produce drunkenness.
• Drinking begins to take priority over other activities. It becomes a compulsion.

Often alcohol dependence remains undetected for years. Both the availability of alcohol and the way it is used (the social patterns) appear to be major factors in influencing the likelihood of a person becoming alcohol dependent.

There may also be a genetic component, because alcohol dependence clusters in some families. However, it’s hard to be sure that this is not because of learned behaviour.

Alcoholism Symptoms - First Stage

The following represents some of the alcoholism symptoms and behaviors in the first stage of alcoholism:

• Increasing tolerance;
• A conscious effort to seek out more drinking opportunities;
• Gross Drinking Behavior - more frequent drinking of greater amounts;
• Boasting and a "big shot" complex;
• An ability to drink great amounts of alcohol without any apparent impairment;
• Lack of recognition by the person that he or she is in the early stages of a progressive illness.

According to the Centers for Disease Control and Prevention (CDC), each year in the United States, between 1,300 and 8,000 babies are born with fetal alcohol syndrome (FAS). Fetal alcohol syndrome is a combination of physical and mental birth defects that affects about 6% of the babies born to women who are alcohol abusers or alcoholics.

» Learn more: Alcoholism

Written by Dr Dan Rutherford, GP

tags: alcoholism, alcohol, alcohol alcoholism, alcohol and alcoholism, symptoms alcoholism, alcoholism effects, alcoholism Revia, alcoholism Antabuse, alcoholic, alcoholism treatment, alcoholism symptoms, alcoholism stages, alcoholism signs, alcoholism drug

ACUTE BRONCHITIS DISEASE - LEARN ABOUT ACUTE BRONCHITIS CAUSES, SYMPTOMS, TYPES AND HOW ARE ACUTE BRONCHITIS TREATED

Acute bronchitis

Acute bronchitis is an infection of the bronchial tree. The bronchial tree is made up of the tubes that carry air into your lungs. When these tubes get infected, they swell and mucus (thick fluid) forms inside them. This makes it hard for you to breathe.

What causes acute bronchitis?

The usual cause is an infection due to a virus. The viruses responsible for acute bronchitis include those that might otherwise only cause a cold, but in bronchitis they spread further down the respiratory tree. The bronchial lining, already damaged by this infection, is then open to secondary attack by bacteria.

People who have underlying lung problems, such as chronic (ie long-standing) bronchitis, are more likely to get acute bronchitis as their lung defence mechanism against infection is lower than normal. Smoking is the commonest reason for this to happen. Although much less common, exposure to irritant fumes and dust can be a cause of acute bronchitis.

What are the symptoms of acute bronchitis?

The symptoms of acute bronchitis can include:

• Sore throat;
• A cough that may bring up yellow or green mucus;
• Fever;
• Chest congestion;
• Wheezing;
• Shortness of breath;
• Chills;
• Body aches.

How does acute bronchitis affect the bronchi?

Viruses or bacteria cause inflammation in the respiratory passages, which results in:

• irritation of the respiratory passages, causing a cough;
• the swelling of the mucous membrane (lining) of the bronchi, along with the increased production of mucus makes the airways narrower, leading to a wheeze;
• an increased production of mucus (phlegm);

The inflammation can lead to fever, fatigue, coloured spit and a general feeling of ill-health.

How do people get acute bronchitis?

The viruses that cause acute bronchitis are sprayed into the air or onto people’s hands when they cough. You can get acute bronchitis if you breathe in these viruses. You can also get it if you touch a hand that is coated with the viruses.

If you smoke or are around damaging fumes (such as those in certain kinds of factories), you are more likely to get acute bronchitis and to have it longer. This is because your bronchial tree is already damaged.

» Learn more: Acute Bronchitis

Reviewed by Dr Dan Rutherford, GP

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ACNE (SPOTS) DISEASE - LEARN ABOUT ACNE SYMPTOMS, TYPES, CAUSES AND HOW ARE ACNE SKIN DISORDERS TREATED

Acne (Spots)

Acne is a very common skin disorder that most young people get in early puberty. It is caused by inflammation of the small oil glands (sebaceous glands) that surround the fine hairs on the face and chest.
The severity of acne increases and, typically, reaches its peak around the ages of 17 to 19. For most people, acne tends to go away by the time they reach their mid-20s; however, very sensitive people may continue to have the disorder until they reach their 40s.

Hormonal changes related to pregnancy or menstrual periods can also cause or contribute to acne. This is also the case with environmental irritants such as pollution, intense heat, humidity or cold.

Acne Symptoms

The first symptoms are small, tender, red spots that later turn into pimples containing degraded fatty acids. The inflammation disappears over a few days or weeks, depending on the severity.

Severe acne can cause scars which will never disappear. Acne can also cause psychological stress and be socially disabling. An early effective treatment is therefore imperative.

What Causes Acne?

During puberty, the production of male sex hormones (androgens) increases in both girls and boys, which can stimulate the sebaceous glands to produce more sebum. In some people, the sebaceous glands are extremely sensitive to androgens. These people, mostly men, get acne so severely that they need medical treatment.

The increased production of sebum makes the openings of the sebaceous glands narrower, which prevents the sebum from getting out. Meanwhile, the sebum production continues regardless.
Pimples are often caused by Propionebacterium acnes, a common bacterium on the skin that feeds on sebum. This bacterium produces waste products and fatty acids that irritate the sebaceous glands and make them inflamed.

» Learn more: Acne (Spots)

Reviewed by Dr Paul Klenerman, consultant physician and infection specialist and Professor James Ferguson, consultant dermatologist

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ACID REFLUX DISEASE - LEARN ABOUT ACID REFLUX SYMPTOMS, CONDITIONS, AND HOW TO PREVENT ACID REFLUX

Acid reflux (Gastro-oesophageal reflux)

Acid reflux (Gastro-oesophageal reflux, GERD, Heartburn) is a condition where the lower oesophageal sphincter (the muscular ring at the lower end of the oesophagus) is abnormally relaxed and allows the stomach's acidic contents to flow back or 'reflux' into the gullet (oesophagus). It can also cause heartburn.
Acid reflux is a common condition and the most frequent cause of indigestion in the US.

What are the symptoms of Acid reflux oesophagitis?

• The acid reflux may reach the pharynx (throat) and mouth. It is sour and may burn.
• A painful or burning sensation in the upper abdomen or chest, sometimes radiating to the back (heartburn).
• Excess belching is common.
• A small number of patients have difficulties breathing and suffer from hoarseness because the refluxed fluid irritates the larynx and respiratory tract.

How does Acid Reflux affect your health?

It is an unpleasant condition that can have a big influence on your lifestyle. Many people feel that their quality of life is lowered by the symptoms.

Prolonged exposure to refluxed acid leads to oesophagitis (inflammation of the oesophagus). Long-standing oesophagitis may be complicated by the formation of scar tissue that contracts and results in a narrowing (stricture) in the affected part of the oesophagus. This can make it difficult or even impossible to swallow. It is a serious condition that requires urgent assessment and treatment, but, fortunately, this complication is relatively rare.

It can cause ulceration leading to bleeding and an iron deficiency that could develop into anaemia due to a chronic blood loss.

When does Acid Reflux occur?

• Reflux symptoms may have no apparent cause.
• Symptoms typically occur after eating a large or fatty meal or drinking alcohol.
• It is made worse by smoking.
• Lying down, bending over or bending and lifting can all cause reflux.
• The frequency with which the symptoms occur varies. For most people, they are rare but weekly and daily episodes of refluxes are not uncommon.

Which conditions can cause Acid Reflux?

In many cases, the disorder cannot be attributed to any specific cause but the following conditions can contribute to the problem.

Constipation

Constipation increases the tendency to reflux by raising pressure inside the stomach cavity.

Foods

Chocolate, peppermint, coffee, fruit juices and alcohol prevent the oesophageal sphincter from working properly.

Hiatus hernia

The stomach pokes through the diaphragm, preventing the muscle fibres of the diaphragm from closing the lower end of the oesophagus. The oesophagus remains wide open which allows stomach acid to get into the oesophagus.

» Learn more: Acid Reflux

Reviewed by Dr Alan Ogilvie, gastroenterologist and Dr Roger Henderson, GP

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ABDOMINAL PAIN (LOWER) IN WOMEN DISEASE - LEARN ABOUT CAUSES, TYPES AND HOW ARE ABDOMINAL PAIN TREATED

Lower Abdominal Pain in Women

Abdominal pain (or stomach ache, menstrual pain) are sharp pains in a woman's lower abdomen that occur when her menstrual period begins and may continue for 2-3 days. Symptoms can range in severity from a mild annoyance to severe pain that interferes with normal activities.

What causes lower abdominal or pelvic pain

All women feel discomfort or pain in the lower abdomen below the navel from time to time, for instance, before or during menstruation.

The most common causes are a urinary disorder such as a bladder or kidney problem, a bowel problem or a condition involving the reproductive system - the uterus, Fallopian tubes and ovaries.

In many cases it can be difficult to identify the cause of the pain, but noting certain features will help you and your doctor come to a likely diagnosis.

Type of pain arising from conditions of the reproductive organs

Pain might originate from the uterus (womb), Fallopian tubes or ovaries. It is usually felt in the middle of the lower abdomen, above the line of pubic hair as far up as the navel. Occasionally, the pain is more to one side, which is more typical of a pain coming from an ovary.

There might be discomfort or even pain during intercourse (called dyspareunia) felt deep within the pelvis.
Pain originating from the uterus is usually worse at the time of a woman's period (dysmenorrhoea).
Examples of conditions of the reproductive organs giving rise to pain include endometriosis, pelvic inflammatory disease, ovarian cysts, fibroids and problems related to the early stages of pregnancy such as miscarriage and ectopic pregnancy.

In any case of sudden, severe, unexplained abdominal pain your doctor should be contacted.

» Learn more: Abdominal Pain

Reviewed by Dr Philip Owen, consultant obstetrician and gynaecologist

tags: abdominal pain, abdominal pain in women, pelvic pain, lower abdominal pain, lower pelvic pain, menstrual pain, menstrual cramps, severe menstrual pain, menstrual pain relief, menstrual pain remedies, how to relieve menstrual pain, menstrual pain reliever