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Here in Bangladesh OCPs come in two main types: combined estrogen–progestin pills and progestin-only “mini-pills”. Common generic formulations widely marketed include: • Combined pills - Ethinyl estradiol + levonorgestrel - Ethinyl estradiol + desogestrel (0.02 mg / 0.03 mg) - Ethinyl estradiol + drRead more
Here in Bangladesh OCPs come in two main types: combined estrogen–progestin pills and progestin-only “mini-pills”.
Common generic formulations widely marketed include:
• Combined pills
– Ethinyl estradiol + levonorgestrel
– Ethinyl estradiol + desogestrel (0.02 mg / 0.03 mg)
– Ethinyl estradiol + drospirenone (0.02 mg / 0.03 mg)
– Ethinyl estradiol + gestodene
– Cyproterone acetate + ethinyl estradiol (also used for acne/hirsutism)
– Ethinyl estradiol + lynestrenol (0.0375 mg / 0.05 mg)
– Ethinyl estradiol + levonorgestrel + ferrous fumarate (with added iron)
• Progestin-only pills
– Desogestrel 75 µg
– Norethisterone acetate
– Levonorgestrel (also used as emergency contraceptive)
– Lynestrenol
You can get these through public-sector clinics (MoHFW-subsidized), NGOs (Marie Stopes, BAPSA) and private pharmacies nationwide.
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Diagnosis of Chronic Cervicitis 1. Clinical evaluation - Pelvic exam with speculum: inspect the cervix for erythema, friability and discharge; bimanual palpation to assess adnexal tenderness or masses. - Symptom assessment: chronic vaginal discharge (often scanty or mucopurulent), postcoital bleedinRead more
Diagnosis of Chronic Cervicitis
1. Clinical evaluation
– Pelvic exam with speculum: inspect the cervix for erythema, friability and discharge; bimanual palpation to assess adnexal tenderness or masses.
– Symptom assessment: chronic vaginal discharge (often scanty or mucopurulent), postcoital bleeding, pelvic discomfort, or may be asymptomatic.
2. Cytology and microbiology
– Pap smear–style sampling: collect endocervical cells and discharge with a swab or cytobrush for cytology and culture.
– Laboratory testing:
• Nucleic acid amplification tests (NAAT) for Neisseria gonorrhoeae and Chlamydia trachomatis—the most sensitive and specific diagnostics for STI-related cervicitis.
• Wet mount, Gram stain and culture (Thayer-Martin agar) if trichomoniasis, bacterial vaginosis or other bacteria are suspected.
• Urinalysis/urine NAAT if urinary symptoms coexist.
– Pregnancy test: to exclude gestational causes of bleeding.
3. Rule out noninfectious irritants
– Review use of intravaginal devices (caps, IUDs), douches, spermicides, lubricants or latex condoms that can provoke chronic irritation.
Treatment of Chronic Cervicitis
1. Address infectious causes
– Empiric antibiotic therapy (when STI suspected or high-risk):
• Azithromycin 1 g orally once plus ceftriaxone 500 mg IM once (dual therapy for chlamydia and gonorrhea).
• Metronidazole or tinidazole if bacterial vaginosis/trichomoniasis is identified.
– Antiviral therapy for HSV-associated cases: e.g., acyclovir 400 mg orally TID for 7–10 days; no cure but reduces symptom duration.
– Treat sexual partners simultaneously and advise abstinence until therapy is complete.
2. Remove or modify irritants
– Discontinue offending products (douches, spermicides, latex barriers).
– If an IUD or cervical cap is implicated, consider temporary removal.
3. Symptomatic relief and follow-up
– Topical estrogen cream for atrophic cervicitis in postmenopausal women.
– Analgesics for pelvic discomfort.
– Repeat testing in 3–6 months to confirm resolution; chronic cases may recur without adequate removal of causes and partner treatment.
Below is a classical homeopathic framework for chronic cervicitis. Please note this is informational only and not a substitute for professional medical care.
1. Individualized Constitutional Assessment
• Gather a full symptom picture: character of discharge (color, odor, quantity), pain (burning, cutting), bleeding patterns, associated urinary or backache, plus mental/emotional state, appetite, thermals and modalities.
• Note any aggravating factors—sex, cold drafts, stress—and relieving factors—warmth, rest, Sitz baths.
2. First-line Homeopathic Remedies
Select based on the chief local symptomatology plus constitutional background:
• Kreosote (Kreosotum)
– Indicated for yellowish-white, extremely putrid, acrid discharge that burns and itches after scratching.
• Alumina
– For transparent, profuse, corrosive leucorrhea with intense burning in the genitals; relief from cold water applications.
• Natrum muriaticum
– When discharge is thick, white, and itching is worst at night, often with emotional oversensitivity and periodic headaches or backache.
• Hydrastis canadensis
– Yellowish, tenacious discharge with soreness and drawing pain; glandular swelling in the vulvar region may accompany it.
• Sepia officinalis
– Chronic, recurrent cervicitis in women with bearing-down sensation, irregular menses, irritability or indifference to loved ones; useful for atrophic mucosa and post-partum or menopausal cases.
3. Supportive “Chronic” Remedies
For deeper constitutional support and recurring flares, consider:
• Belladonna
– Sudden onset of burning, throbbing pain, bright-red mucosa, with feverishness, flushed face and sensitivity to light/noise.
• Pulsatilla
– In women with mild, bland, yellowish-green discharge that is changeable in quantity, weepy mood, better in open air; hormonal lability is prominent.
4. Potency & Dosage Guidelines
• Begin with 30C potency: 1 dose (3–5 pellets) once daily for one week.
• Reassess local and constitutional signs; if improvement plateaus, repeat the same remedy in 200C weekly, or shift to a new indicated remedy.
• Chronic cases may require alternating remedies every 2–4 weeks based on evolving symptom picture.
5. Adjunctive Care
• Sitz baths with chamomile or calendula to soothe local inflammation.
• Dietary support: anti-inflammatory foods, probiotics to rebalance vaginal flora.
• Avoid irritants: douches, scented soaps, tight synthetic clothing.
6. Monitoring & Referral
• Track symptom changes (discharge, pain, bleeding) every 2–4 weeks.
• If there’s no response after 6–8 weeks or if systemic signs (fever, pelvic mass) arise, refer for gynecological evaluation and microbiologic testing.
With targeted diagnostics and cause-specific therapy, most women achieve symptom resolution, though recurrence is possible if risk factors persist.
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