A 32 year old G2P1 (1011) presented with amenorrhea of 2 years duration. Both sister and grandfather were diagnosed with Pulmonary Tuberculosis 10 years ago and adequately treated for 9 months with quadruple anti-Koch`s medications. Patient presented with no sign nor symptoms highly suspicious for tuberculosis. Physical and Pelvic examinations, complete endocrinologic investigations, chest X-ray and transvaginal ultrasound all revealed normal results. Progesterone challenge test failed to elicit withdrawal bleeding. Hyteroscopy showed a globularly fibrotic endometrial cavity, while endometrial biopsy revealed chronic granulomatous inflammation with Langhan`s giant cell typical of genital tuberculosis. She was subsequently started on anti-Koch`s medications for 6 months, with prompt resumption of menses after treatment. Second-look hysteroscopy on readmission showed normal, healthy-looking endometrium with no areas of fibrosis. Repeat endomentrial biopsy revealed benign secretory phase endometrium, with absolutely no evidence of chronic granulomatous inflammation. This paper aimed to underscore the value of hysteroscopy as a vital tool in the work-up amenorrhea, and to demonstrate, using second look hysteroscopy, the efficacy of anti-tuberculosis treatment on the uterine cavity in an amenorrheic woman diagnosed with genital tuberculosis.
Human ; Female ; Adult ; TUBERCULOSIS, FEMALE GENITAL ; AMENORRHEA ; HYSTEROSCOPY

Sexual function is an important aspect of an individual's well being. The inability to have sexual intercourse for any reason, when one chooses to, is a concern that will cause distress. It's the kind that does not only affect the individual who is unable to, but also the partner who is able to. Dyspareunia is one reason for this. The pain during coitus may be severe enough, and thus cause frustration everytime it is attempted. Reported here is a 31 year old nulligravid who has an incomplete form of congenital atresia of the outer third of the vagina on which a modified Fenton's procedure was done. The Fenton's surgical technique was originally conceptualized to "widen a tight vagina" in patients with postpartum dyspareunia caused by scar tissue formation and contacture after an episiorrapy. The above mentioned congenital defect, its incidence, embryogenesis, presentation and management are discussed in this case report. The innovation in surgical intervention is also described.
Human ; Female ; Adult ; ABNORMALITIES

Background: Life expectancy of women already increased up to 75 years old, and so women will live 1/3 of their lives during the menopausal period. Medical intervention at this point of life should be regarded as an opportunity to provide and reinforce programs of preventive health care to prepare women to this stage, and so it is important to address perceptions of women regarding menopause and HRT. Objective: To explore the knowledge, attitude and practices of Filipino women towards menopause and hormone replacement therapy Methods: A clinical descriptive cross-sectional study was conducted from May to November 2018 among a random 250 employees and patients from Philippine General Hospital. Respondents were asked to answer a validated questionnaire regarding their knowledge, attitude and practices towards menopause and hormone replacement therapy (HRT). Results: The average age of menopause is 48 years old. The top most common symptoms perceived were easy fatigability, mood swings, hot flushes, loss of capacity in engaging in sexual activities, and loss of sexual desire. Half of them (53%) have fair self-rating knowledge on menopause, only 30% have knowledge on HRT and more than half (131=52%) of them have no knowledge at all about HRT. Forty percent answered that they learned it from their doctors. Among the menopause patients, only 9 have taken HRT, and mostly given by a specialist in a public hospital. At least 7 in ten respondents had correct knowledge on menopause but only 14-33% had correct answer on HRT. Almost 70% of the respondents were “undecided” with the statements regarding their perception on HRT, which is consistent with the fact that they don’t even know what HRT means. When asked on practices on menopause, 81% agreed that consulting a doctor for menopause is necessary, and 78% agreed that if HRT was prescribed, they would comply with it. However, only 60% had actually seen a doctor for menopausal symptoms. Only less than half of the respondents would use HRT even if it would cause them relief of symptoms and good health outcome. This is also consistent with the fact that they are not familiar with HRT and the benefits they would get from it. Conclusion Majority of women have fair knowledge on menopause but almost none on HRT. Women are not familiar with the benefits they would get from HRT, but there’s a high percentage of women (78%) who will take HRT if prescribed by their doctors. There is a need to strengthen menopausal programs in the country to be able to fill in the gap towards knowledge on menopause and especially HRT.
Menopause ; Hormone Replacement Therapy