Breast Cancer in Women

Introduction 

 

The breasts

The breasts are made up of fat, connective tissue and thousands of tiny glands called lobules, which produce milk. When a woman has a baby, the milk is delivered to the nipple through tiny tubes called ducts, which allow her to breastfeed.
The body is made up of billions of tiny cells, which usually grow and multiply in an orderly way. New cells are only produced when and where they're needed. In cancer, this orderly process goes wrong and cells begin to grow and multiply uncontrollably.
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Symptoms of breast cancer

Breast cancer can have a number of symptoms, but the first noticeable symptom is usually a lump or area of thickened breast tissue.
Most breast lumps aren't cancerous, but it's always best to have them checked by your doctor.
Signs and symptoms of breast cancer may include:

• Bloody discharge from the nipple
• Change in the size, shape or appearance of a breast
• Changes to the skin over the breast, such as dimpling
• A newly inverted nipple
• Peeling, scaling or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
• Redness or pitting of the skin over your breast, like the skin of an orange

 

 

Risk factors of breast cancer

A breast cancer risk factor is anything that makes it more likely you'll get breast cancer. But having one or even several breast cancer risk factors doesn't necessarily mean you'll develop breast cancer. Many women who develop breast cancer have no known risk factors other than simply being women.
Factors that are associated with an increased risk of breast cancer include:

• Being female. Women are much more likely than men are to develop breast cancer.
• Increasing age. Your risk of breast cancer increases as you age.
• A personal history of breast cancer. If you've had breast cancer in one breast, you have an increased risk of developing cancer in the other breast.
• A family history of breast cancer. If your mother, sister or daughter was diagnosed with breast cancer, particularly at a young age, your risk of breast cancer is increased. Still, the majority of people diagnosed with breast cancer have no family history of the disease.
• Inherited genes that increase cancer risk. Certain gene mutations that increase the risk of breast cancer can be passed from parents to children. The most common gene mutations are referred to as BRCA1 and BRCA2. These genes can greatly increase your risk of breast cancer and other cancers, but they don't make cancer inevitable.
• Radiation exposure. If you received radiation treatments to your chest as a child or young adult, your risk of breast cancer is increased.
• Obesity. Being obese increases your risk of breast cancer.
• Beginning your period at a younger age. Beginning your period before age 12 increases your risk of breast cancer.
• Beginning menopause at an older age. If you began menopause at an older age, you're more likely to develop breast cancer.
• Having your first child at an older age. Women who give birth to their first child after age 35 may have an increased risk of breast cancer.
• Having never been pregnant. Women who have never been pregnant have a greater risk of breast cancer than do women who have had one or more pregnancies.
• Postmenopausal hormone therapy. Women who take hormone therapy medications that combine estrogen and progesterone to treat the signs and symptoms of menopause have an increased risk of breast cancer. The risk of breast cancer decreases when women stop taking these medications.
• Drinking alcohol. Drinking alcohol increases the risk of breast cancer.

 

 

Types of breast cancer

There are several different types of breast cancer, which can develop in different parts of the breast. Breast cancer is often divided into non-invasive and invasive types.

 

Non-invasive breast cancer

Non-invasive breast cancer is also known as cancer or carcinoma in situ. This cancer is found in the ducts of the breast and hasn't developed the ability to spread outside the breast.
This form of cancer rarely shows as a lump in the breast that can be felt, and is usually found on a mammogram (see below).The most common type of non-invasive cancer is ductal carcinoma in situ (DCIS).

 

Invasive breast cancer

Invasive cancer has the ability to spread outside the breast, although this doesn't necessarily mean it has spread.
The most common form of breast cancer is invasive ductal breast cancer, which develops in the cells that line the breast ducts. Invasive ductal breast cancer accounts for about 80% of all breast cancer cases.

 

 

Other types of breast cancer

Other less common types of breast cancer include invasive lobular breast cancer, which develops in the cells that line the milk-producing lobules, inflammatory breast cancer and Paget's disease of the breast.
It's possible for breast cancer to spread to other parts of the body, usually through the lymph nodes (small glands that filter bacteria from the body) or the bloodstream. If this happens, it's known as "secondary" or "metastatic" breast cancer.

 

 Tests and diagnosis of breast cancer

Tests and procedures used to diagnose breast cancer include:

• Breast exam. Your doctor will check both of your breasts and lymph nodes in the armpit, feeling for any lumps or other abnormalities.Women with a higher-than-average risk of developing breast cancer may be offered screening and genetic testing for the condition.
  As the risk of breast cancer increases with age, all women who are 50-70 years old are invited for breast cancer screening every three years.
  Women over 70 are also entitled to screening and can arrange an appointment through their GP or local screening unit.
• Mammogram. A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a screening mammogram, your doctor may recommend a diagnostic mammogram to further evaluate that abnormality. However, you should be aware that a mammogram might fail to detect some breast cancers.
• Breast ultrasound. Ultrasound uses sound waves to produce images of structures deep within the body. Ultrasound may help distinguish between a solid mass and a fluid-filled cyst. An ultrasound is often obtained as part of the examination of a new lump.
• Removing a sample of breast cells for testing (biopsy). Biopsy samples are sent to a laboratory for analysis where experts determine whether the cells are cancerous. A biopsy sample is also analyzed to determine the type of cells involved in the breast cancer, the aggressiveness (grade) of the cancer, and whether the cancer cells have hormone receptors or other receptors that may influence your treatment options.
• Breast magnetic resonance imaging (MRI). An MRI machine uses a magnet and radio waves to create pictures of the interior of your breast. Before a breast MRI, you receive an injection of dye.

Other tests and procedures may be used depending on your situation.

 

 

  Treating breast cancer

If cancer is detected at an early stage, it can be treated before it spreads to nearby parts of the body.
Breast cancer is treated using a combination of surgery, chemotherapy and radiotherapy. Surgery is usually the first type of treatment you'll have, followed by chemotherapy or radiotherapy or, in some cases, hormone or biological treatments.
The type of surgery and the treatment you have afterwards will depend on the type of breast cancer you have.

 

 Breast cancer surgery

Operations used to treat breast cancer include:

• Removing the breast cancer (lumpectomy). During lumpectomy, which may be referred to as breast-sparing surgery or wide local excision, the surgeon removes the tumor and a small margin of surrounding healthy tissue. Lumpectomy is typically reserved for smaller tumors.
• Removing the entire breast (mastectomy). Mastectomy is surgery to remove all of your breast tissue. Most mastectomy procedures remove all of the breast tissue — the lobules, ducts, fatty tissue and some skin, including the nipple and areola (simple mastectomy).
  In a skin-sparing mastectomy, the skin over the breast is left intact to improve reconstruction and appearance. Depending on the location and size of the tumor, the nipple may also be spared.
  
• Removing a limited number of lymph nodes (sentinel node biopsy). To determine whether cancer has spread to your lymph nodes, your surgeon will discuss with you the role of removing the lymph nodes that are the first to receive the lymph drainage from your tumor.
  If no cancer is found in those lymph nodes, the chance of finding cancer in any of the remaining lymph nodes is small and no other nodes need to be removed.
  
• Removing several lymph nodes (axillary lymph node dissection). If cancer is found in the sentinel node, your surgeon will discuss with you the role of removing additional lymph nodes in your armpit.
• Removing both breasts. Some women with cancer in one breast may choose to have their other (healthy) breast removed (contralateral prophylactic mastectomy) if they have a very increased risk of cancer in the other breast because of a genetic predisposition or strong family history.
  Most women with breast cancer in one breast will never develop cancer in the other breast. Discuss your breast cancer risk with your doctor, along with the benefits and risks of this procedure.
  

Complications of breast cancer surgery depend on the procedures you choose. Surgery carries a risk of bleeding and infection.
Some women choose to have breast reconstruction after surgery. Discuss your options and preferences with your surgeon.
Consider a referral to a plastic surgeon before your breast cancer surgery. Your options may include reconstruction with a breast implant (silicone or water-filled) or reconstruction using your own tissue. These operations can be performed at the time of your mastectomy or at a later date.

Preventing breast cancer

As the causes of breast cancer aren't fully understood, it's not possible to know if it can be prevented altogether.
If you're at increased risk of developing the condition, some treatments are available to reduce the risk.
Studies have looked at the link between breast cancer and diet and, although there are no definite conclusions, there are benefits for women who maintain a healthy weight, exercise regularly and who have a low intake of saturated fat and alcohol.
It's been suggested that regular exercise can reduce your risk of breast cancer by as much as a third. If you've been through the menopause, it's particularly important that you're not overweight or obese. This is because being overweight or obese causes more oestrogen to be produced, which can increase the risk of breast cancer.

 

  Living with breast cancer

Being diagnosed with breast cancer can affect daily life in many ways, depending on what stage it's at and what treatment you're having.
How women cope with their diagnosis and treatment varies from person to person. You can be reassured that there are several forms of support available, if you need it. For example:

• your family and friends can be a powerful support system
• you can communicate with other people in the same situation
• find out as much as possible about your condition
• don't try to do too much or overexert yourself
• make time for yourself                                                                                                                   
 

When to see a doctor

If you find a lump or other change in your breast — even if a recent mammogram was normal — make an appointment with your doctor for prompt evaluation.

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UTERINE FIBROIDS...Understand Your Body.

  A uterine fibroid (fibromyoma,leiomyoma) is a benign tumor that forms from the smooth muscle tissue of the uterus (myometrium).A single cell divides repeatedly, eventually creating a firm, rubbery mass dif different from the adjacent tissue. Growth patterns vary,some grow slowly some rapidly and other may remain the same size. Some fibroids go through growth spurts, and some may shrink on their own. Many fibroids that have been present during pregnancy shrink or disappear after pregnancy, as the uterus goes back to a normal size.

Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. They can be single or multiple, in extreme cases expanding the uterus so much that it reaches the rib cage.

• Uterine fibroids are most common among women of reproductive-aged
• Large fibroids can cause severe symptoms like secondary infertility
• Uterine fibroids usually remain benign and have a low risk of becoming malignant

Illustrated picture of multiple uterine fibroids.

 

Cause of Uterine Fibroids

Doctors do not know the cause of uterine fibroids, but research and clinical experience point to these factors as the major cause of uterine fibroids:

• Genetic changes – are oftenly hereditary with a distinct familial predisposition confirmed by genetic testing which reveals hereditary mutations in some of the genes.
• Hormonal changes - Lining of the uterus is very sensitive to hormonal changes. Histological analysis of fibroids indicates a large amount of oestrogen and progesterone receptors than in a healthy myometrium (mid layer of the uterus).

 

Symptoms of Uterine Fibroids

 Initial developmental stages of fibroids are usually asymptomatic( have no clinical signs) and are discovered incidentally during a pelvic exam or prenatal ultrasound of the uterus. These are some of the most common symptoms of a uterine fibroids:

• Heavy menstrual bleeding
• Prolonged menstrual periods — seven days or more of menstrual bleeding
• Pelvic pressure or pain
• Frequent urination
• Difficulty emptying your bladder
• Constipation
• Backache or leg pains
• Severe iron-deficiency anemia - as a result of the heavy bleeding
• Large fibroids may cause infertility by obstructing the connection of the fallopian tubes to the uterus or by interfering with the fetus implantation in the uterus
• Miscarriages may be caused by fibroids

Rarely, a fibroid can cause acute pain when it outgrows its blood supply. Deprived of nutrients, the fibroid begins to die. Byproducts from a degenerating fibroid can seep into surrounding tissue, causing pain and, rarely, fever. A fibroid that hangs by a stalk inside or outside the uterus (pedunculated fibroid) can trigger pain by twisting on its stalk and cutting off its blood supply.
Fibroid location, size and number influence signs and symptoms:

• Submucosal fibroids. Fibroids that grow into the inner cavity of the uterus (submucosal fibroids) are more likely to cause prolonged, heavy menstrual bleeding and are sometimes a problem for women attempting pregnancy.
• Subserosal fibroids. Fibroids that project to the outside of the uterus (subserosal fibroids) can sometimes press on your bladder, causing you to experience urinary symptoms. If fibroids bulge from the back of your uterus, they occasionally can press either on your rectum, causing a pressure sensation, or on your spinal nerves, causing backache.
• Intramural fibroids. Some fibroids grow within the muscular uterine wall (intramural fibroids). If large enough, they can distort the shape of the uterus and cause prolonged, heavy periods, as well as pain and pressure.

 

 Uterine Fibroids Diagnosis

Specialists use the following methods for diagnosing uterine fibroids:

• Abdominal or transvaginal ultrasound of the uterus
• X-ray methods - hysterosalpingography with contrast and a CT scan of the pelvic organs
• MRI of the pelvis organs
• Hysteroscopy - endoscopic visualization of the uterus
• Laboratory tests: Hormones and coagulation factors
• Biopsy of the fibroid to ensure it’s benign. The procedure is performed during the hysteroscopy

 

Treatment of Uterine Fibroids

 There are a variety of treatment options for fibroids, ranging from medical management of symptoms to definitive surgical management.Fibroids cannot be eliminated by medications but symptoms can be managed with certain medications.In some cases, hormonal treatment is enough to block the effect of progesterone and estrogen on the fibroid’s receptors. Hormonal intrauterine devices are also an option and have proven to effectively shrink existing fibroids:

• Combined oral contraceptive pills The birth control pill contains both estrogen and progesterone hormones, which can help decrease bleeding symptoms. Some studies show that they can slow the growth of fibroids, but cannot decrease the size of the fibroid
• Progesterone Releasing IUD (intrauterine device) This device is inserted into the uterus and contains a small amount of progesterone hormone. This can decrease bleeding symptoms. It has no effect on the fibroid itself.
• Progestin pills These pills contain progesterone hormone, which will decrease bleeding side effects. These pills have no effect on the fibroid itself.
• Gonadotropin Releasing Hormone (GnRH) agonists These medications (Lupron, Zoladex, Synarel, etc.) suppress the release of natural estrogen and progesterone production, which then causes shrinkage of fibroids and decrease in bleeding symptoms. These medications cause a temporary menopausal state and are often associated with hot flashes. Typically, your doctor will put you on this medication to correct anemia from heavy bleeding and shrink the size of the fibroid prior to surgical management. GnRH agonists are not a long-term management option.
• NSAIDs (nonsteroidal anti-inflammatory drugs) These are non narcotic pain relieving drugs that may help with the painful symptoms of fibroids but will not effect the fibroid or any bleeding symptoms.

 

 Minimally Invasive Treatment of Uterine Fibroids 

The main goal of minimally invasive treatment methods is to preserve the uterus and its reproductive function, which is essential to young women. Reproductive Health specialists use the following methods:

• Embolization of the uterine arteries and their branches in order to cut off the blood supply to the fibroid. The fibroid then stops growing and eventually its cells die.
•  Myolysis - the fibroid is destroyed by a medical laser, cryotherapy or high-frequency ablation laparascopically.
• Hysteroscopic myomectomy – a minimally invasive endoscopic procedure that allows the removal of fibroid mass from the submucosal layer of the uterus.
• Endometrial ablation and submucosal resection – fruitfully reduces the clinical symptoms of submucosal fibroids, which include heavy bleeding during the menstrual cycle.

 

Surgical treatment of Uterine Fibroids 

In cases where the above mentioned methods are undesired for the patient, either of the following surgical treatment options can be used:

• Hysterectomy – complete removal of the uterus. The procedure can be performed through both laparoscopic and open surgery. It is operative in cases of multiple fibroids which are accompanied by severe clinical symptoms. In most cases uterine fibroids do not require removal of the ovaries or postoperative hormonal treatment.
• Myomectomy – organ-sparing method, which involves only the removal of the fibroids and without affecting the patient’s fertility. This surgery is suitable in cases of several fibroids.

The vast majority of gynecological surgeries are performed laparascopically. This method does not require a large abdominal incision, thereby significantly reducing both the risk of complications and the hospitalization period.

 Preparing for an appointment

Your first appointment will likely be with either your primary care provider or a gynecologist. Because appointments can be brief, it's a good idea to prepare in advance for your appointment.

 

What you can do

• Make a list of any symptoms you're experiencing. Include all of your symptoms, even if you don't think they're related.
• List any medications, herbs and vitamin supplements you take. Include doses and how often you take them.
• Have a family member or close friend accompany you, if possible. You may be given a lot of information at your visit, and it can be difficult to remember everything.
• Take a notebook or electronic device with you. Use it to note important information during your visit.
• Prepare a list of questions to ask your doctor. List your most important questions first, in case time runs out.

For uterine fibroids, some basic questions to ask include:

• How many fibroids do I have? How big are they?
• Are the fibroids located on the inside or outside of my uterus?
• What kinds of tests might I need?
• What medications are available to treat uterine fibroids or my symptoms?
• What side effects can I expect from medication use?
• Under what circumstances do you recommend surgery?
• Will I need a medication before or after surgery?
• Will my uterine fibroids affect my ability to become pregnant?
• Can treatment of uterine fibroids improve my fertility?
• What other alternative treatments might I try?

Make sure that you understand everything your doctor tells you. Don't hesitate to ask your doctor to repeat information or to ask follow-up questions.

 

 

What to expect from your doctor

Some questions your doctor might ask include:

• How often do you experience these symptoms?
• How long have you been experiencing symptoms?
• How severe are your symptoms?
• Do your symptoms seem to be related to your menstrual cycle?
• Does anything improve your symptoms?
• Does anything make your symptoms worse?
• Do you have a family history of uterine fibroids?

Prevention

Although researchers continue to study the causes of fibroid tumors, little scientific evidence is available on how to prevent them. Preventing uterine fibroids may not be possible, but only a small percentage of these tumors require treatment.


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Cervical Cancer Can Be Prevented.

Cervical cancer treatment is based on the results obtained by a diagnosis and the individual wishes of the patient. 

Cancer of the cervix (cervical cancer) is a cancer that begins in the cervix. A common cause of the disease is an infection with the human papilloma virus (HPV), which is sexually transmitted. Thus, one way of prevention is to receive HPV vaccines capable of protecting against this type of viruses.

Cervical Cancer Symptoms

Cervical cancer at its early stages is characterized by asymptomatic(lack of ) clinical signs.
As the disease processes becomes progressive, signs and symptoms of cervical cancer starts manifesting as listed below:

• Profuse vaginal discharge with an unpleasant odor, in some
• cases accompanied by bloody impurity
• Vaginal bleeding after intercourse or arising after the cessation of menses (after menopause)
• Discomfort in the pelvic area
• Appearance of an unpleasant and painful sensations during coitus

A victim should make an appointment with a reproductive Health specialist (gynecologist) if one or all of the symptoms mentioned above are present

Cervical Cancer Diagnosis 

Early detection of cervical cancer has a positive result on the success of the therapy.
Doctors believe that the study of cervical cancer and precancerous changes should begin with a Pap test.During the procedure, smear is extracted from the cervix for further examination under a microscope for the presence of abnormal cells and dysplasia.
DNA testing for HPV is used as a follow-up to abnormal changes traced with a Pap smear.
The DNA test shows the carrier types of HPV that can cause the development of cervical cancer.
If clinical signs and the presence of abnormal cells in the course of screening is appointed, additional checks are required for an accurate diagnosis.

Cervical cancer diagnosis includes:

• Colposcopy. During colposcopy doctors examines the vagina and cervix with an optical device. If needed, during the procedure a biopsy is conducted.
• Cervical conization. The doctor removes a small cone-shaped portion of the mucosa for a subsequent histological examination and a detection of precancerous or cancerous changes.
• On detecting cervical cancer, the patient goes under further diagnostic tests to determine the stage of cancer , such as: X-ray, CT and MRI.
• Additional tests may be required such as cystoscopy and proctoscopy.

Methods of Cervical Cancer Treatment

The plan of treatment of cervical cancer is based on the stage of the cancer, the presence of chronic diseases in the client and her choice. Treatment of cervical cancer is complex often involving three triage,usually includes surgery, chemotherapy and radiotherapy.
A radical method of treatment of this disease is surgery during which a full or partial excision of the uterus (hysterectomy) is undertaken.
The application of hysterectomy in the first stages of the development of cervical cancer is  highly reliable therapy, capable of preventing the recurrence of the disease.

Cervical Cancer Radiation therapy (radiotherapy)

Radiotheratherapy cancer by ionizing radiation through high beams aimed at destruction of the cancerous cells. Internal radiotherapy (brachytherapy) is carried out by placing the device sending radio waves near the cervix.
Sometimes both methods are used at the same time. Radiotherapy may be administered either alone or together with a neoadjuvant chemotherapy regimen served to reduce the size of the pathological tumor before or after surgery, to destroy the remaining abnormal cells. After radiotherapy patients may develop premature menopause.

Cervical Cancer Chemotherapy

For effective treatment, different combinations of chemotherapy drugs (cytostatic) are usually given intravenously. These types of drugs are capable of destroying and slowing the growth of abnormal cells.
According to the modern treatment regimen, chemotherapy is often combined with radiotherapy; this approach has proven itself as highly efficient.
Some side effects of chemotherapy drugs may be developed by patients are like infertility and early menopause.
Cervical Cancer treatment centres creates ideal conditions for the diagnosis and treatment of all cervical cancer disease and be able to boast successful recovery rates due to presence of professional oncologists working in a modern environment.
Now you are aware,do not worry. Seek medical attention.
Post your queries and comments on cervical cancer and wait for the replies.

7 Common Reasons Your ‪‎Vagina Is Itchy Beyond Belief‬.

1. BACTERIA VAGINOSIS
(Commonly abbreviated as BV) is the most common reason for vaginal itching and is caused by an
imbalance in healthy bacteria and a change in vaginal pH. It feels similar to a yeast infection, but in this case, the discharge is more watery and usually has an odor, you’ll have to VISIT your doctor
for treatment .

2.YEAST INFECTION
Like BV, a yeast infection is frequently the result of vaginal pH being out of whack.They can occur at random or following antibiotic use, sex,stress, or a change in diet (and women with diabetes have a higher risk). In addition to itchiness, you may also notice curdled, white, or thick discharge.
The good news is that you can go ahead and use an OTC remedy, like Monistat, which should take care of the symptoms within a day or so. To avoid recurrent infections,We recommends taking a probiotic with a high bacteria count of acidophilus, which will help keep yeast in check.

3.CONTACT DERMATITIS
This skin irritation is caused by allergies to certain products. You can get it from anything with perfumes or additives, including condoms and lubricants, and on top of itching, you may also notice redness, swelling,and skin thickening. It can also be the result of shaving. If you know that you’re susceptible to vaginal irritation, use hypoallergenic hygiene products, like shampoo, fabric softeners,
and laundry detergents,making sure to avoid chemicals, soaps, and irritating lubricants.
Even toilet paper with scents or colors can be troublemakers. Plus, you should definitely avoid shaving if you're sensitive—and never, ever douche. The vagina is self-cleaning, so you don't need to put anything on or in it.

4.ECZEMA/PSORIASIS
Genetic skin disorders like these two can cause redness and itching in the genital region, along with a patchy or rash-like appearance. If you’re diagnosed with either,a mild steroid like hydrocortisone and taking oatmeal baths can help alleviate the discomfort. If you don’t feel relief within a week, ask your doctor about other treatment options.

5.SEXUALLY TRANSMITTED DISEASES

We shouldn’t have to tell you this again, but unprotected sex can lead to an STD (which is why you always, always need to use protection). And a bunch of them can make your genital parts itch, including chlamydia, herpes, trichomoniasis, and gonorrhea. Crabs, or pubic lice, can also appear in women with hair down there.
With any of these, the itching (or tingling sensation) can progress to pain and burning. If you experience itching along with any other common STD symptoms like burning while you pee, foul-smelling discharge, sores on your genitals, and pain during sex, you should book it to
your gynaecologist to get tested as soon as possible. If you do test positive for an STD, your doctor will give you either injectable or oral antibiotics, or an antiviral medication in the case of herpes.

6.LICHEN SCHLEROSIS
This serious condition and cause of vulvar itching appears as white spots on the skin. While it can come out of nowhere,some medical professionals think hormones or an overactive immune system may have something to do with it. Lichen sclerosus needs to be diagnosed by a gynecologist and treated with prescription medication.

7.HORMONES

Anytime your hormones levels change or fluctuate (like during your period,pregnancy, menopause, or while you're taking birth control), you may experience vaginal itching. Dryness is another indicator that hormones could be to to blame for your pain. When it comes to your period, the products you use during that time of the month (like pads and panty liners) often contain fragrances or colors that can add to the discomfort. If this happens to you often, consider trying a menstrual cup or organic cotton products, which may be less irritating. However, it may be difficult to pinpoint if your birth control prescription is what's causing you to itch down there (sometimes the only way to know if this is the culprit is to stop or start hormonal contraceptives). With any of these hormonal changes, your doctor might prescribe a hormonal cream to apply topically and you can also ask about switching pills if the itch continues to be a persistent problem.
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