hypercellularity

Your adrenal glands are two small organs that sit on top of each kidney. The adrenal glands make different types of hormones you need to stay alive and healthy. Hormones are chemicals that travel in your bloodstream and control how different parts of your body work.

The adrenal glands make the hormones cortisol, aldosterone, adrenaline, and noradrenaline. They also make hormones that your body uses to make sex hormones (estrogen and testosterone). All of these hormones do many important jobs, including:

• Turning food into energy and managing blood sugar levels
• Balancing salt and water
• Keeping blood pressure normal
• Responding to illness and stress (your "fight or flight" response)
• Timing when and how fast a child develops sexually
• Supporting pregnancy

When you have an adrenal gland disorder, your body makes too much or too little of one or more hormones. The symptoms depend on the type of problem you have and how much it affects the hormone levels in your body.

There are many types of adrenal gland disorders, including:

• Addison Disease - a condition in which the adrenal glands don't make enough cortisol
• Cushing Syndrome - a condition caused by too much cortisol in the body, often from taking steroid medicines for a long time
• Aldosterone-producing adenoma - a benign tumor (not cancer) that makes too much aldosterone and may cause serious high blood pressure
• Hereditary paraganglioma-pheochromocytoma - an inherited condition causing different types of tumors that make adrenaline and other hormones. Some tumors may become cancerous.
• Adrenal gland cancer - cancerous tumors, including adrenocortical carcinoma and neuroblastoma
• Congenital Adrenal Hyperplasia (CAH) - a group of inherited disorders in which the adrenal glands don't make enough cortisol. The most common type is 21-hydroxylase deficiency (also called CAH1). In the United States, newborn babies get a blood test to see if they have CAH. People born with CAH may not have symptoms until childhood or later in life.

The cause of adrenal gland disorders depends on the type of disorder you have. Causes can include:

• Medicines such as steroids.
• A problem in another gland, such as the pituitary gland. The pituitary gland releases hormones that affect how the adrenal glands work.
• Changes in genes (mutations). These changes can cause the adrenal glands to make too much or too little of one or more hormones.
• Infections.

In many cases the cause of the problem isn't clear.

Health care providers use different tests to check for adrenal disorders depending on your symptoms and health history. For example, you may have tests of your blood, urine (pee), or saliva (spit). These tests check your hormone levels. Your provider may order x-rays, CT scans, or MRI scans to look for tumors.

Different types of adrenal gland disorders have different treatments. They include medicines and surgery. Radiation therapy is sometimes a treatment for tumors. There are treatments to cure certain adrenal gland disorders. For other disorders, treatments can manage your symptoms.

NIH: National Institute of Child Health and Human Development

The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.

An enlarged prostate is when your prostate gland becomes larger than normal. It's also called benign prostatic hyperplasia or BPH for short. Benign means not cancer. And hyperplasia means too much cell growth. BPH isn't cancer and it doesn't increase your risk of getting prostate cancer.

Usually, the prostate gland continues to grow during adult life. That's why BPH is the most common prostate condition in people over age 50. As the prostate gets bigger, it may press against the bladder and pinch the urethra. This can slow or block the flow of urine out of your bladder.

Over time, the bladder muscle may become weak from trying to pass urine through a narrow urethra. When this happens, your bladder may not empty completely when you urinate. A narrowed urethra and weak bladder cause many of the urinary problems you may have with BPH.

Researchers aren't sure why the prostate keeps growing. Some researchers think changes in hormones with aging may cause the prostate to get bigger.

You're more likely to develop BPH if you:

• Are age 40 or older. The chance of getting BPH increases as you get older.
• Have family members who have had BPH.
• Have certain health conditions such as:
  • Obesity.
  • Heart disease and problems with blood circulation.
  • Type 2 diabetes.
  • Erectile dysfunction.
• Don't get enough physical activity.

Symptoms of BPH include:

• Having a frequent or urgent need to urinate
• Waking up many times to urinate
• Having problems with urine flow, such as:
  • Trouble starting to urinate
  • A stream that's weak, slow, or stops and starts
  • Dribbling after urination
  • Urinary incontinence
  • Feeling that you can't completely empty your bladder
• Pain after ejaculation or during urination
• Urine with an unusual color or smell

It's important to see your health care provider if you have any of these symptoms because they could be from a more serious health problem.

You should get medical help right away if you:

• Can't urinate at all
• Have fever and chills with urination that's painful, frequent, and urgent
• Have blood in your urine
• Have pain in your lower abdomen (belly) and urinary tract

For most people, BPH doesn't cause other problems. But BPH increases your chance of developing serious conditions, including:

• Acute urinary retention. With this condition, you suddenly can't urinate at all. This a medical emergency. Acute urinary retention is common in older males and the chance of having it increases with age. It may be triggered by:
  • Taking certain over-the-counter cold or allergy medicines
  • Drinking alcohol
  • Cold temperatures
  • Not moving enough over a long period of time
• Urinary tract infections (UTIs)
• Bladder damage and bladder stones
• Kidney damage

To find out if you have BPH, your provider will:

• Ask about your medical history. Be sure to tell your provider about all the medicines you take, because certain medicines can make BPH symptoms worse.
• Ask about your family health history.
• Examine you. The exam may include a digital rectal exam (DRE) of your prostate. In a DRE, your provider inserts a gloved finger into your rectum to check if your prostate is large, tender, or irregular in any other way.
• Order medical tests, if needed, such as:
  • Urine tests.
  • A PSA blood test (prostate-specific antigen test).
  • Urodynamic testing to see how well you can hold and release urine.
  • Cystoscopy to look inside your urethra and bladder.
  • Ultrasound pictures of your prostate and urinary tract.
  • A prostate biopsy to diagnose or rule out prostate cancer.

Not everyone needs treatment for BPH. Treatment options depend on how much your symptoms bother you, your health, age, and the size of your prostate:

• Lifestyle changes may improve mild symptoms. They include:

  • Drinking less before bedtime or going out
  • Avoiding or cutting back on beverages with caffeine and alcohol
  • Bladder training and exercising the muscles that control urine flow
  • Preventing or treating constipation

• Medicines can help mild to moderate symptoms by:

  • Stopping the prostate from growing
  • Shrinking the prostate
  • Relaxing muscles to improve urine flow

  Sometimes combining 2 types of medicine helps more than taking just one type of medicine.

• Medical procedures can help improve moderate to severe BPH symptoms when medicines don't help enough. There are several different types of procedures. They all use an instrument inserted into the urethra to either:

  • Widen the urethra
  • Destroy part of the prostate with heat

• Surgery may be helpful when symptoms are severe, other treatments haven't helped, or you have another problem, such as bladder damage. Different types of surgery are used to:

  • Remove part or all of the prostate
  • Make cuts in the prostate to take pressure off the urethra

  Most BPH surgery is done with tools inserted into the urethra.

Your provider can explain the possible benefits and side effects of your treatment options so you can decide what's best for you.

Researchers haven't found ways to prevent BPH. You can take care of your prostate health by:

• Talking with your provider about your risk for developing an enlarged prostate
• Getting regular checkups
• Paying attention to your symptoms so you can get treatment early if you see signs of BPH

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.

There are many types of prostate diseases:

• Prostatitis is inflammation (swelling and pain) in the prostate gland. It's the most common type of prostate problem in people under than age 50. There are different types:
  • Chronic prostatitis is also called chronic pelvic pain syndrome. It's the most common type of prostatitis.
  • Acute bacterial prostatitis starts suddenly from a bacterial infection and is treated with antibiotics. It is not common.
  • Chronic bacterial prostatitis happens when a bacterial infection keeps coming back. The symptoms usually start slowly. It may take longer to treat than acute bacterial prostatitis.
  • Asymptomatic prostatitis has no symptoms and usually doesn't need treatment. You may learn you have it after having tests for other health problems.
• Enlarged prostate is also called benign prostatic hyperplasia (BPH). The prostate gland tends to grow larger with age. That's why enlarged prostate is very common in older people and rare in those who are under age 40. When the prostate grows larger, it may press on your urethra and cause problems with urination.
• Prostate cancer happens when cancer cells form in the prostate gland. Prostate cancer is a common type of cancer in those aged 50 and older. Most prostate cancers grow slowly and may never cause health problems. But certain prostate cancers are serious.

Anyone with a prostate can develop prostate problems. But some people are at higher risk.

You may be more likely to develop prostatitis if you have:

• A lower urinary tract infection, also called a UTI. An infection in your lower urinary tract (bladder and urethra) may lead to acute or chronic bacterial prostatitis.
• Nerve damage in your lower urinary tract from surgery or an injury. This may lead to chronic prostatitis.
• Emotional stress, which can lead to chronic prostatitis.

You may be more likely to develop an enlarged prostate (BPH) if you:

• Are age 40 or older.
• Have family members who have had BPH.
• Have certain health conditions such as:
  • Obesity.
  • Heart disease and problems with blood circulation.
  • Type 2 diabetes.
• Don't get enough physical activity.

You may be more likely to develop prostate cancer if you:

• Are older than age 50.
• Have a parent, sibling, or child who has or had prostate cancer.
• Are African American.

The symptoms of prostate problems include:

• Needing to urinate a lot.
• Needing to rush to the bathroom, but not being able to urinate or only going a little.
• Leaking or dribbling urine.
• Having a weak urine stream.

Other symptoms depend on the type of prostate problem you have and may include:

• Not being able to urinate at all. This is a medical emergency.
• Any problems, starting or controlling urine flow.
• Waking up often to urinate.
• Blood in your urine or urine that has an unusual smell or color.
• Fever, chills, or body aches.
• Great discomfort or pain:
  • While urinating or after ejaculation.
  • In your abdomen (belly), between your scrotum and anus, or in your scrotum or penis.

Contact your provider if you have any of these symptoms.

To find out if you have a prostate problem, your provider will:

• Ask about your medical history and symptoms.
• Ask about your family health history.
• Do a physical exam. The exam may include a digital rectal exam (DRE) of your prostate. In a DRE, your provider inserts a gloved finger into your rectum to feel the general size and condition of your prostate.
• Order tests, if needed. Tests may include:
  • Blood and urine tests to look for infection.
  • Urodynamic testing to see how well you can hold and release urine.
  • Cystoscopy to look inside your urethra and bladder.
  • Ultrasound pictures of your prostate and urinary tract.
  • A PSA blood test (prostate-specific antigen test).
  • Prostate biopsy to diagnose or rule out cancer.

Treatment depends on what prostate disease you have and which symptoms bother you most.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

The uterus, or womb, is the place where a fetus grows during pregnancy. Uterine diseases are conditions that affect the uterus. These diseases can be benign (not cancer) or malignant (cancerous). They may affect your menstrual periods, your ability to get pregnant, or the health of your reproductive organs.

Some types of uterine diseases include:

• Adenomyosis. Tissue that usually lines the uterus grows on the outside walls.
• Cervicitis. Swelling or inflamed tissue of the cervix. The cervix is the lower part of the uterus.
• Endometrial hyperplasia. An overgrowth of normal cells inside the uterus.
• Endometriosis. Tissue like the lining of the uterus grows in other places in your body.
• Uterine prolapse. The uterus drops in to the vagina due to weakened pelvic muscles. This can happen after a few vaginal births, menopause, or because of obesity.

Various factors can cause uterine diseases. These can include hormonal imbalances, thyroid problems, fibroids, polyps, cancer, infection, or pregnancy.

Your symptoms will depend on the type of uterine condition you have. The first sign of a problem with the uterus may be abnormal bleeding. Bleeding could occur between periods, be very heavy, or last much longer than usual. Other symptoms may include bleeding after sex or pelvic pain.

To find out the cause of your symptoms, your health care provider may:

• Ask about your symptoms and medical history
• Do a pelvic exam
• Order blood tests or imaging tests
• Do a biopsy

Treatment depends on the cause. It may include pain medicine, hormone therapy, or surgery. Your provider will work with you to choose the best treatment.

Breast diseases include various conditions and changes in your breast. Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges of fluids that are not breast milk.

Although many women fear cancer, most breast changes are benign, meaning they are not cancer. These breast changes are known as benign breast disease. See your health care provider if you have a breast lump, pain, discharge, or skin irritation. Minor and serious breast problems often have similar symptoms and may need treatment.

Common breast changes and conditions can include:

• Fibrocystic breast changes can include lumpiness, thickening, and swelling, often just before your period. Your breasts may feel painful, swollen, or tender.
• Cysts are fluid-filled lumps that may be tender.
• Fibroadenomas are solid, round, rubbery lumps that easily move when pushed, occurring most in younger women.
• Intraductal papillomas are wart-like benign tumors that grow in the milk duct of the breast.
• Blocked milk ducts.
• Milk production when you're not breastfeeding.

Symptoms depend on the type of breast disease. Benign breast diseases may not have any symptoms, or they could include:

• A lump or firm feeling in your breast or under your arm
• A change in the size or shape of your breast
• Nipple discharge
• Skin changes such as itching, redness or darkening, dimples, scaling, or puckering on your breast or nipple
• Painful, swollen, or tender breasts

See your provider if you're noticing any of these symptoms or other unusual changes. Some symptoms may be warning signs or symptoms of breast cancer.

Some breast changes may be felt or seen. You may notice a change in your breast, or your provider may notice it during a clinical breast exam. Other breast changes may only be found during a screening mammogram or other imaging tests such as an MRI or ultrasound. Your provider may also recommend a breast biopsy to check a suspicious change in your breast.

Some benign breast changes may increase your risk of breast cancer in the future and may need treatment now. Treatment depends on the type of breast disease that you have. Some breast changes may go away without treatment, while others may require monitoring, biopsy, or surgery.

NIH: National Cancer Institute

The lymphatic system is a network of tissues and organs. It is made up of:

• Lymph - a fluid that contains white blood cells that defend against germs
• Lymph vessels - vessels that carry lymph throughout your body. They are different from blood vessels.
• Lymph nodes - glands found throughout the lymph vessels. Along with your spleen, these nodes are where white blood cells fight infection.

Your bone marrow and thymus produce the cells in lymph. They are part of the system, too.

The lymphatic system clears away infection and keeps your body fluids in balance. If it's not working properly, fluid builds in your tissues and causes swelling, called lymphedema. Other lymphatic system problems can include infections, blockage, and cancer.

Your newborn infant has screening tests before leaving the hospital. There may be different tests depending on the state where you live. They include:

• Tests on a few drops of blood from pricking the baby's heel. The tests look for inherited disorders. All states test for at least 30 of these conditions.
• A hearing test that measures the baby's response to sound
• A skin test that measures the level of oxygen in the blood. This can tell if the baby has a congenital heart defect.

These tests look for serious medical conditions. If not treated, some of these conditions can cause lifelong health problems. Others can cause early death. With early diagnosis, treatment can begin right away, before serious problems can occur or become permanent.

If a screening shows that your baby might have a condition, the health care provider or the state health department will call you. It is important to follow up quickly. Further testing can verify whether your baby has the condition. If so, treatment should start right away.

NIH: National Institute of Child Health and Human Development

Most people have four pea-sized glands, called parathyroid glands, on the thyroid gland in the neck. Though their names are similar, the thyroid and parathyroid glands are completely different. The parathyroid glands make parathyroid hormone (PTH), which helps your body keep the right balance of calcium and phosphorous.

If your parathyroid glands make too much or too little hormone, it disrupts this balance. If they secrete extra PTH, you have hyperparathyroidism, and your blood calcium rises. In many cases, a benign tumor on a parathyroid gland makes it overactive. Or, the extra hormones can come from enlarged parathyroid glands. Very rarely, the cause is cancer.

If you do not have enough PTH, you have hypoparathyroidism. Your blood will have too little calcium and too much phosphorous. Causes include injury to the glands, endocrine disorders, or genetic conditions. Treatment is aimed at restoring the balance of calcium and phosphorous.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Polycystic ovary syndrome (PCOS), also known as polyendocrine metabolic ovary syndrome (PMOS), is the name of a hormonal disorder. PCOS affects the ovaries, as well as many other parts of the body.

If you have PCOS, you usually have at least two of these problems:

• Not ovulating. Normally, your ovaries make the egg that is released each month as part of a healthy menstrual cycle. This is called ovulation. But with PCOS, the egg may not develop as it should, or it may not be released during ovulation. Your periods may be irregular, or you may not have them at all.
• High levels of androgens. Androgens are hormones that are important for normal male sexual development. Women normally make smaller amounts of androgens. Having higher levels of androgens can cause you to have extra body or facial hair (called hirsutism).
• Growths in one or both ovaries. These growths are often clumps of ovarian follicles that have stopped developing. They may appear as cysts, which are small fluid-filled sacs

Although it's less common, you may not have growths in your ovaries. You may only have symptoms of PCOS, not ovulate, and have high levels of androgens.

The exact cause of PCOS is unknown. Research has shown that different factors may play a role, including:

• Genetics. PCOS tends to run in families.
• Imbalances in androgen levels.
• Insulin resistance. This is a condition in which your body can't use insulin properly. Insulin is a hormone that helps move blood glucose (also called blood sugar) into your cells to give them energy. Insulin resistance can lead to high blood glucose levels.

PCOS often develops as young as age 11 or 12, around the time of your first period. But you can develop it later.

The symptoms can vary from person to person. Some women have few or even no symptoms. They may not realize they have PCOS until they have trouble getting pregnant. Other women may have more severe symptoms.

The symptoms of PCOS may include:

• Irregular or missed menstrual periods.
• Too much hair on the face, chest, stomach, or thighs.
• Obesity, weight gain, or trouble losing weight.
• Severe acne which may be hard to treat.
• Oily skin.
• Patches of thickened dark skin (called acanthosis nigricans).
• Infertility. PCOS is one of the most common causes of infertility. But many women with PCOS can still get pregnant.

PCOS is linked to many other health problems, including:

• Insulin resistance, which can lead to prediabetes and type 2 diabetes.
• Heart disease. Having PCOS increases your risk, and this risk goes up as you age.
• High blood pressure.
• High LDL ("bad") cholesterol and low HDL ("good") cholesterol. This increases your risk of heart disease.
• Endometrial hyperplasia, a condition in which the lining of your uterus, or womb, becomes too thick. This can increase your risk for endometrial cancer, also called uterine cancer.
• Sleep apnea, a disorder that causes you to repeatedly stop breathing during sleep.
• Depression and anxiety.

Although there are links between PCOS and these conditions, researchers do not know whether:

• PCOS causes some of these problems
• Some of these problems cause PCOS, OR
• There are other conditions that cause both PCOS and these other health problems

Not everyone who has PCOS will have all these problems. However, you and your health care provider may want to monitor your health for signs of them, so they can be treated early.

There is no specific test for PCOS. To find out if you have PCOS, your provider:

• Will do a physical exam, which will include looking for the physical signs of PCOS.
• Will ask about your medical history and family health history.
• May do a pelvic exam to check for signs of extra male hormones and to see if your ovaries are enlarged or swollen.
• May order a pelvic ultrasound to look for growths on your ovaries and check the thickness of your endometrium (the lining of your uterus, or womb).
• May order blood tests, including tests to check your hormone levels.

Treatments for PCOS can help you manage your symptoms. The treatments may include:

• Lifestyle changes, which can help reduce many symptoms. They can also lower your risk for or help manage related health problems. These changes include:
  • Maintaining a healthy weight
  • Getting regular physical activity
  • Eating healthy foods
• Medicines:
  • Hormonal birth control, such as pills, shots, and IUDs, can make your period more regular. They may also help remove acne and extra facial and body hair. But it's only an option if you're not currently trying to get pregnant.
  • Anti-androgen medicines, which block the effect of androgens. This can help reduce hair loss on your head, the growth of facial and body hair, and acne. Providers do use them to help with these symptoms, but anti-androgen medicines are not approved by the U.S. Food and Drug Administration (FDA) to treat PCOS. These medicines can cause problems during pregnancy. Your provider may have you take them with birth control (to prevent pregnancy).
  • Insulin-sensitizing medicines, which are medicines that are used to treat type 2 diabetes. They improve insulin resistance and keep your blood glucose levels steady. They may also lower your androgen levels. They are not approved by the FDA to treat PCOS. But they may help with your symptoms.
  • Medicines for acne. These medicines come in pills, creams, or gels.
• Treatments for hair removal, such as facial hair removal creams, laser hair removal, and electrolysis.
• Fertility treatments if you are having trouble getting pregnant. They include medicines and procedures such as in vitro fertilization (IVF).

Cancer is a disease when the cells of the body grow out of control. Cancer screening is having tests to look for signs of cancer before you have any symptoms. By the time cancer causes symptoms, it may have already spread to other parts of your body. A screening test may help find cancer early, when it may be easier to treat.

Cancer screening only tells you whether you might have cancer. It doesn't diagnose cancer. If a screening test shows signs of cancer, you'll need to have other tests to find out if you do have cancer and how serious it may be.

Prostate cancer screening looks for signs of cancer in the prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.

Prostate cancer is most common in people over age 50. It usually grows slowly and doesn't cause health problems. In fact, it's possible to live a long life with prostate cancer and never know you have it. But in certain cases, prostate cancer may spread to other parts of the body and can be very serious.

The goal of prostate cancer screening is to find prostate cancers that may be more likely to spread so they can be treated early.

Two tests are commonly used to screen for prostate cancer:

• A prostate-specific antigen test, also called a PSA blood test. PSA is a protein made by your prostate. A high level of PSA in your blood may mean you have prostate cancer, but it's not proof of cancer. That's because many other things may cause high PSA levels, including:
  • Having an enlarged prostate (benign prostatic hyperplasia or BPH)
  • Having other common prostate problems
  • Taking certain medicines
  In general, the higher your PSA, the more likely it is that you have cancer. But a low PSA blood level isn't a guarantee that you don't have cancer.
• Digital Rectal Examination (DRE). The DRE is a prostate exam. In this exam, your health care provider inserts a lubricated, gloved finger into your rectum to feel your prostate for lumps or anything unusual. A DRE can check only one side of the prostate.

A PSA test or a DRE may be able to detect prostate cancer at an early stage. But it is not clear whether early detection and treatment lower the risk of dying from prostate cancer. You should talk with your provider about the benefits and harms of prostate cancer screening.

The possible benefits of prostate cancer screening include:

• Finding and treating prostate cancer early before it spreads
• Getting a better sense of your prostate cancer risk (based on your PSA test)
• Peace of mind if your screening shows you're unlikely to have prostate cancer now
• The option to choose further testing and closely monitor your prostate if your screening shows you may have cancer

The possible harms of prostate cancer screening include:

• Getting a false positive result. This means that your PSA test shows you may have prostate cancer when you really don't. A false positive may lead to:
  • Worry while you have more tests to look for signs of cancer.
  • A prostate biopsy. In a biopsy, a doctor removes tissue from your prostate so it can be studied under a microscope to look for cancer cells. This is the only way to diagnose cancer. The possible harms of a prostate biopsy include:
    • Fever
    • Pain
    • Blood in semen
    • Urinary tract infection
• Having prostate cancer treatment that you may not have needed. Prostate cancer screening may lead to a cancer diagnosis, but it's not always clear whether the cancer is likely to grow and spread. You could have unnecessary treatment for cancer that would never have caused any health problems. And the common prostate cancer treatments may have serious, permanent complications, such as:
  • Urinary incontinence
  • Erectile dysfunction
  • Problems controlling your bowel movements (BMs)

Since there are benefits and risks to prostate screening, you should talk with your provider to decide if screening is right for you. You and your provider should consider:

• Your age. The risk of prostate cancer increases after age 50.
• Your family health history. If members of your family have had prostate cancer, your risk may be higher.
• Your race. Prostate cancer is more common in African Americans. They also have a higher risk of developing prostate cancer at a younger age and having more serious disease.
• Your general health. Are you well enough to have treatment for prostate cancer if it's found?
• What you prefer. How do you feel about the possible benefits and harms of screening, diagnosis, and treatment?

NIH: National Cancer Institute