Women’s Physical Health

Bacterial Vaginosis is one of the most common infections that affect the vagina, a part of the reproductive organs during reproductive years.

It’s caused by the bacterial imbalance in the vagina that naturally contains both good and bad bacteria, both maintain the vaginal pH balanced, but their overgrowth for numerous reasons may lead to pH imbalance which it is crucial to prevent germs and vaginal dryness, eventually that imbalance causes infection.¹

What are the causes of bacterial Vaginosis?

Bacterial Vaginosis isn’t one of the sexually transmitted diseases, scientists yet can’t confirm the real reason behind the infection, but studies concluded that it’s more likely to affect ” sexually active women as well as women with multiple sexual partners “. On the other hand, it’s less likely to affect females with no prior sexual experience.

There are numerous factors that may cause a bacterial imbalance, thus increasing the possibility of infection, such as:

• Stress
• Using vaginal washes frequently without consulting a doctor.
• Using intrauterine devices to prevent pregnancy.
• Some medications like antibiotics are used to treat urinary tract infections and throat infections that may eliminate vaginal flora.
• Vaginal douching may reduce vaginal flora.²

How do you know if you have bacterial Vaginosis?

You will notice many symptoms like:

1. White or gray vaginal discharge with a fishy smell especially after intercourse.
2. Burning sensation during urination.
3. Bleeding after intercourse.
4. Redness and itchiness in the vagina.

A specialized doctor runs many tests for a diagnosis like:

1. Taking medical history from the patient.
2. Asking about daily practices and sexual relations.
3. Clinical examination by taking a swab from the vagina to examine under the microscope and confirm the diagnosis.

What is the treatment?

After confirming the diagnosis, the doctor will prescribe antibiotics whether given orally or applied directly inside the vagina (creams or vaginal suppositories), most prescribed antibiotics are:

• Clindamycin.
• Metronidazole.¹

The patient must take the treatment based on the doctor’s instructions to prevent recurring infections, a common situation that may happen after a few months of treatment which needs treatment with more antibiotics.³

The doctor may look for other possible factors of bacterial Vaginosis like decreased levels of Estrogen that may happen after menopause, then they will prescribe Estrogen vaginal suppositories to restore balance.

How to prevent frequent bacterial Vaginosis?

Bacterial Vaginosis may become a frequent issue for the patient, causing disturbances like burning sensation and pain during intercourse.

This can be prevented by doing some things that will keep the vaginal environment balanced to avoid such infections like:

1. Change wet clothes after swimming or doing sports, moist environment is suitable for bacterial growth.
2. Wipe from front to back after using the toilet, this prevents bacteria spread from the anus to the vagina.
3. Keep the vagina clean by using unscented natural soap that doesn’t contain any chemicals, avoid excessive cleaning so the good bacteria won’t get affected as well.
4. Avoid douching “unless it’s doctor’s instructions.”⁴

Bacterial Vaginosis is a common problem, but treatable problem. Simple measures can be done to prevent bacterial Vaginosis and other vaginal infections. In the end, an ounce of balanced personal hygiene and prevention measures is better than a pound of cure.

Also read:

• Endometriosis
• Polycystic Ovary Syndrome
• Premenstrual Dysphoric Disorder

References:

1. Web Teb
2. MOH
3. NHS
4. Fair View

What is “endometriosis” and how does it affect the daily life of women? What are its symptoms? How can women live with it or prevent it?

‏Pain expresses itself in the human body in different ways, and the intensity of pain varies from one person to another. According to what is known as the “pain threshold”, which in turn depends on the frequency of exposure to pain, in addition to the difference in age and the frequency of the painful stimulus. Whether we are men or women, we suffer pain on different levels. Some women, for example, have a “pain threshold” that makes them more resilient and adaptable to menstrual pain.

‏The woman may suffer severe pain that forces her to take time off from work. However, it should not be surprising if we learned that she suffers from symptoms of what is called “endometriosis”. 

‏Endometriosis and its symptoms

‏During menstruation, when the fetus is not implanted into the uterus, the lining detaches and is excreted from the body via menstrual blood. But in the disease called “endometriosis” there is a tissue similar to the tissue that lines the uterus that grows outside the uterus usually in the abdominal cavity. This tissue out of the uterus responds to the changes in the menstrual cycle just like the real endometrium.¹

‏Endometriosis has symptoms. Most particularly:
‏Pain in the lower back and abdomen, which is extreme during menstruation in a way that prevents women from practicing normal daily activities. In addition to feeling nauseous and vomiting, and bleeding between periods. Women with endometriosis suffer from constipation or diarrhea, and difficulty getting pregnant.

‏What are the causes of endometriosis?

‏There are several possible scientifically unconfirmed theories and hypotheses about the causes of endometriosis. Among the most important of these theories are:

1. ‏Imbalance in the immune system.
2. An imbalance in the secretion of some hormones.
3. ‏Menstrual blood comes out in the opposite direction to its normal course through the fallopian tubes and its descent into the pelvic cavity, especially on the ovaries and behind the uterus.
4. Post-operative cleaning and scraping of the uterine cavity (Curettage ).²

‏There are several factors that increase the risk of developing endometriosis, such as:

• ‏Never having children.
• ‏When the period starts at a young age.
• ‏Delayed menopause.
• ‏Short menstrual cycles; For example, less than 27 days.
• ‏Heavy menstrual bleeding and lengthy periods that last more than 7 days.
• ‏Increased levels of the hormone “estrogen” in the body, or exposure to the hormone “estrogen” for a longer period.
• ‏A low body mass index (BMI).
• ‏One or more female relatives (mother, aunt, or sister) suffer from endometriosis.
• ‏Any pathological conditions impede blood exit from the body during periods.
• ‏Reproductive system disorders.³

‏Endometriosis is a long-lasting disease. All associated treatments aim to control its symptoms and limit its side effects. As women, it is not easy for us to live with persistent pain, which intensifies on certain days a month and prevents us from carrying out our daily activities. However, women who suffer from this disease must follow some treatment methods.

Treatment of endometriosis

‏The disease may be treated with medication or surgery, depending on symptoms, lesions, desired outcome, and patient choice. Steroidal contraceptive pills, non-steroidal anti-inflammatory drugs, and pain relievers are also commonly used treatments for this disease. They should all be accurately prescribed and carefully monitored to avoid potential side effects that could cause problems. ‏Medical treatments for endometriosis focus either on lowering estrogen or raising progesterone. This is in order to alter the hormonal environments that promote endometriosis.⁴

‏As for women who are not able to seek medical treatment, and have been diagnosed with “simple endometriosis”. They can resort to some simple home remedies and help relieve pelvic pain and feel relieved through the following:

• ‏Using heat treatments. Heat pads, hot water bottles, and warm baths are a great ways to relax pelvic muscles and reduce pain.
• ‏Massage the abdomen and pelvis with castor oil, because of its usefulness in relieving cramps and pain.
• ‏Resorting to anti-inflammatory herbs and foods; Turmeric and warm ginger tea have anti-inflammatory properties.
• ‏Likewise, foods with diuretic properties, bone soup, and healthy seeds may help comfort abdominal pain.
• Over-the-counter anti-inflammatory drugs such as ibuprofen and naproxen sodium can also be taken for rapid improvement.

‏If an ounce of prevention is better than an ounce of treatment for women who are susceptible to endometriosis, then prevention is linked to the need for early diagnosis of the disease. Also, it is associated with increasing awareness about it, and paying attention to women’s health to prevent its abnormal development.

‏In conclusion, it should be noted that the various institutions and companies should pay attention to work; Taking care of the general health of its female workers. By providing a safe and comfortable environment at work, and taking into account their emergency health conditions, in accordance with regulations and legislation related to women’s rights at work.

Also read:

• Polycystic Ovary Syndrome (PCOS)
• Postmenopausal Osteoporosis (PO)
• Interstitial Cystitis (IC)

References:

[1] Webteb

[2] Mayo Clinic

[3] WHO

[4] Wikipedia

Postmenopausal Osteoporosis, which can affect the quality of life, is considered the most common disease in women after menopause.¹ The World Health Organization defines “menopause” as the ceasing of menstruation for 12 consecutive months with the absence of etiological reasons. During the transitional period of menopause, women can experience many unpleasant symptoms, such as hot flashes, night sweats, and mood swings.

What is postmenopausal osteoporosis? 

Bone fragility or osteoporosis is a multifactor metabolic disorder that affects the bones. A decrease in the mineral density of the bones and a subtle deterioration of the bone’s tissue structure are observed in osteoporosis, which leads to weakening in the bone’s structure and therefore bone fragility.¹ In this case, the bones are more prone to fractures. 

Osteoporosis is called a “silent disease” because the weakening and loss of bone structure occur initially without any symptoms. Usually, people with osteoporosis don’t realize they have it until their bones are so weak that a sudden strain, bump, or fall leads to a fracture or collapse of one of the vertebrae. Collapsed vertebrae can be felt or noticed in the beginning by severe back pain, loss of height, or spinal deformities such as stooped posture.²

Menopause is the most common cause of osteoporosis. Therefore, osteoporosis is more dangerous and more common in females. Women are more likely to develop osteoporosis after menopause due to the hormonal changes they go through to accommodate the natural changes that occur in the body. The fluctuation of hormones is accompanied by fluctuating estrogen levels, which decrease. Estrogen is a hormone that helps maintain bone health by slowing natural bone deterioration. So when estrogen decreases after menopause, that greatly accelerates bone loss.³

What are the causes of osteoporosis in postmenopausal women? 

after menopause, and over time,  a decrease in the level of certain hormones in the body (such as estradiol) can lead to osteoporosis. This occurs in two phases: 

• The first phase: Begins at the age of menopause, and it occurs due to a lack of estrogen, as we mentioned earlier. Which leads to a disproportionate increase in bone resorption compared to its formation. This stage can be defined as the bone loss associated with menopause. 
• The second phase: It appears after 4-8 years, in which there is a slower continuous loss of many bones in the body. It is mainly due to the decline in bone formation, caused by aging. This phase can be seen in men as well.¹

What are the methods of prevention and treatment of PO? 

It is possible to start taking preventive measures against osteoporosis which affects postmenopausal women, starting from childhood or adolescence. Preventive measures include:

• It is recommended to reduce coffee and soft drinks as they interfere with calcium absorption.
• It is also recommended to reduce alcohol intake because it increases the loss of bone mass.⁴ 
• A balanced diet rich in vitamin D and calcium must also be maintained. 

Certain lifestyle changes may help prevent osteoporosis. Including:

• Sports exercises: Some types of exercise (such as resistance training, balance exercises, and weightlifting) help maintain bone health.
• Exposure to sunlight regularly, as the sunlight helps produce vitamin D, which is important for maintaining bone health.
• Weight management: Preventing obesity helps maintain bone strength. 
• Avoid smoking, as this can help reduce the risk of osteoporosis.³

As for treatment, there are many medications and hormonal treatments to reduce bone loss and stimulate the formation of new bone, including the following: 

• Bisphosphonate: It is used orally and helps reduce osteoporosis. 
• Denosumab: an intravenous drug that reduces the risk of bone fractures. 
• Abaloparatide: A bone-building medicine that is given as an injection. 
• Estrogen therapy: Prevents osteoporosis by reducing bone deterioration.³ 

And many other therapeutic medicines have proven effective in reducing the effects of osteoporosis in women and reducing the risk of fractures resulting from it.

The appropriate medication and dosage are determined by the doctor, so we do not recommend taking any medications without consulting your orthopedist. 

How can someone overcome and deal with osteoporosis? 

If you suffer from osteoporosis, it is very important to avoid any falls that could lead to a fracture. Falls can be avoided indoors by: 

1. Keeping the home floor clean and free of clutter. 
2. Ensure that the lighting is bright enough to enable you to see your surroundings. . 
3. Some walking aids, such as crutches, can also be used. 

Also, to avoid deterioration of the condition, it is important to follow up with the doctor to take the necessary medications, follow the appropriate diet, and practice some sports activities that the doctor may recommend. 

If you live with or know someone who suffers from osteoporosis:

• Ensure that they take the medications prescribed by the doctor.
• Help them do some exercise. 
• Help them keep their house floor clean. Ensure that it is free of any slippery materials or scattered items such as electrical wires and others. 
• Help them with any physical activity that may be difficult for them, such as walking. 
• Finally, and most importantly, provide them psychological assistance and be there for them. 

We, as the Uplifting Syrian Women initiative, encourage everyone, especially women, to take preventive measures to avoid osteoporosis after menopause, as it is a very common disease. We also advise women who are going through menopause to conduct the necessary examinations, such as checking bone density regularly.

Finally, we advise people with osteoporosis to keep in touch with their supervising doctor and to commit to all their instructions and recommendations. We wish everyone well recovery.

Also read:

• Premenstrual Dysphoric Disorder (PMDD)
• Polycystic Ovary Syndrome (PCOS)
• Interstitial Cystitis (IC)

References:

[1] NIH

[2] Web MD

[3] Endocrine

[4] Women’s

Do you experience severe symptoms during menstruation, and feel that these symptoms are so extreme that they affect your life? Are you afraid or ashamed of expressing it? You are not alone. Many of us feel this way.

Most women in our Eastern societies feel fear and shyness when talking about issues related to the menstrual cycle. This is because these communities consider it shameful or disgraceful to talk about this topic. But sometimes it might be necessary; particularly when menstruation is accompanied by physical and mental symptoms that may disrupt the woman’s life, work, and social relations.

What is premenstrual dysphoric disorder?

The premenstrual dysphoric disorder is a condition where the symptoms experienced by a woman during the premenstrual cycle are very severe and serious. So severe that it disrupts her general performance at work and home, and might even develop suicidal tendencies. In this case, the woman is diagnosed with premenstrual dysphoric disorder, or what is known for short as PMDD.¹

What is the difference between premenstrual dysphoric disorder and premenstrual syndrome?

75% of women who menstruate suffer from premenstrual syndrome (PMS), which includes physical and emotional symptoms.²

Physical symptoms may include heart palpitation, breast swelling and tenderness, fatigue and insomnia, headaches, nausea, and vomiting, in addition to skin problems. As for the emotional symptoms, they include bouts of depression, forgetfulness, difficulty concentrating, irritability and easily getting angry, and social withdrawal.

Most of these symptoms may greatly affect a woman’s life and make her miserable. These symptoms disappear during the first days of menstruation and are usually short-lived. Premenstrual dysphoric disorder is a severe form of premenstrual syndrome. As the previously mentioned symptoms are so severe that some women may have suicidal tendencies, and greatly affect social life and work.²

Premenstrual syndrome is usually diagnosed through a doctor’s evaluation. Doctors recommend that women keep a daily record of their symptoms so that they are aware of the physical and emotional symptoms they are experiencing. This helps the doctor to diagnose correctly by identifying the regular symptoms associated with the onset of menstruation. The diagnosis of premenstrual dysphoric disorder is made according to specific guidelines. Doctors cannot diagnose unless a woman records her symptoms during at least two menstrual cycles. These guidelines state that a woman should suffer from 5 symptoms of premenstrual syndrome, in addition to some symptoms of premenstrual dysphoric disorder.²

Doctors differentiate between PMS and PMDD through several factors, the most important of which is when the symptoms go away. If these symptoms disappear with the onset of menstruation, they are often caused by PMDD and PMS.²

Causes and symptoms of PMDD

Recently, it has been proven that some women with a history of postpartum depression or a family history of depression are more likely to develop PMDD. In addition, there is a relationship between low serotonin levels and premenstrual dysphoric disorder. Serotonin plays an important role in regulating mood. Women who suffer from PMS symptoms are often more susceptible to hormonal changes during the menstrual cycle. But scientists still can’t pinpoint why some women develop PMDD or PMS. The matter needs more research and studies.³

In addition to the symptoms of PMS mentioned above, a woman must have one of the following symptoms in order to be diagnosed with PMDD. These are:

Mood swings, feeling stressed, anxious, overwhelmed, depressed, self-conscious, and irritable or angry.

The symptoms must also include at least one of the following: Lack of energy, fatigue, and changes in appetite, difficulty concentrating, decreased interest in usual activities, and sleep problems (insomnia or oversleeping). These symptoms must be severe enough to disrupt daily activities and have occurred within the past 12 months for a diagnosis to be made.¹

What is the treatment for PMDD?

When symptoms of PMDD start, they can be reduced or prevented through one of the following methods:

1. Birth control pills can help relieve symptoms of premenstrual dysphoric disorder or premenstrual syndrome. This is done by taking it for a continuous period without interruption or with short interruptions.
2. Antidepressants that reduce emotional symptoms, extreme fatigue and sleep problems.
3. Taking some nutritional supplements and vitamins such as vitamin B6. Herbal remedies may help reduce symptoms too, but it is necessary to consult with a doctor before consuming anything.
4. Quitting smoking, avoiding alcohol, reducing caffeine, and following a healthy diet. In addition to getting enough sleep and doing mindfulness exercises such as yoga. All of these things can reduce the symptoms of PMDD. Avoiding emotional stimuli and stress-causing sources helps not to increase symptoms.⁴

In all cases, it is preferable to consult a doctor before doing any of the previous treatments in order to discuss the available and most appropriate treatment methods.

In conclusion, you must take into account that what you may suffer from is normal and should not be concealed as if it is forbidden. In the event that the symptoms are hard to control, it is necessary to talk to your loved ones or friends and seek help from them, alongside seeking medical advice. And remember that we at the Uplifting Syrian Women initiative will always be by your side.

Also read:

• Eating disorders

• Polycystic Ovary Syndrome (PCOS)

• Attention Deficit Hyperactivity Disorder

References:

[1] MSD

[2] Nabta Health

[3] Cleveland Clinic

[4] Mayo Clinic

How can one determine if they have interstitial cystitis and how to treat it? Interstitial cystitis is a chronic condition characterized by pelvic pain, pressure, urinary frequency, and urgency, without the presence of infection. This disease primarily affects women and is therefore crucial to understand. This article aims to provide a comprehensive overview of the symptoms, diagnosis, and treatment options for interstitial cystitis.

Interstitial Cystitis in Women

Interstitial cystitis is a chronic condition that affects women predominantly, with 90% of interstitial cystitis patients in the United States being female. This long-term condition can significantly impact the daily life and well-being of those affected, potentially leading to depression in up to 35% of women with IC. The disease can also have a negative impact on sexual relationships due to the pain it causes during sexual activity.¹

Symptoms of IC

The symptoms of interstitial cystitis can vary greatly among individuals, ranging from mild to severe, and can be continuous or intermittent. They may develop gradually over time due to damage to the bladder wall. The most common symptoms include:

1. Pelvic pain or pain between the vagina and anus in women.
2. Pain between the scrotum and anus in men.
3. Urgent and frequent need to urinate.
4. Passing small amounts of urine frequently.
5. Pain or discomfort after urination.
6. Pain during sexual intercourse.²

It is important to note that although the symptoms of IC may resemble those of a chronic urinary tract infection, there is usually no evidence of bacterial infection.

How is this Disease Diagnosed?

Diagnosis of interstitial cystitis involves several methods, including:

1. Urinalysis: This test is performed to assess the presence of blood in the urine or other signs of inflammation that may support the diagnosis.
2. Biopsy: Tissue samples may be taken from the bladder and urethra to rule out the presence of cancer as a cause of pain.
3. Residual urine measurement: This test measures the amount of urine left in the bladder after urination to determine if the bladder is fully emptying.
4. Pelvic and internal organ examination: This examination helps to rule out other potential causes of the symptoms.
5. Cystoscopy: This procedure involves inserting a small endoscopic device through the urethra to reach the bladder and examine it from the inside.

Interstitial Cystitis Treatment

Treatment options for IC may include a combination of dietary modifications, physical activity, pharmacological treatments, and in rare cases, surgical intervention. There is no definitive cure for this condition, and treatment plans may be individualized based on the severity of symptoms and the patient’s response to therapy.³

• Dietary modifications may include avoiding trigger foods and drinks, such as alcohol, caffeine, chocolate, tomatoes, and fruit juices, as some patients report that these items.
• Physical activity, such as walking and practicing yoga, may also be helpful for some patients.
• Pharmacological treatments for interstitial cystitis may include nonsteroidal anti-inflammatory drugs (NSAIDs), tricyclic antidepressants, antihistamines, and other medications aimed at reducing pain and bladder discomfort.
• Surgery is only considered in severe cases after other treatments have been tried without success. Surgical options may include bladder augmentation, bladder cutting, or bladder stenting procedures.

It is important to note that interstitial cystitis remains a poorly understood condition, with no established cure and a high prevalence among women. However, various treatments can be used to alleviate symptoms and allow patients to lead more normal lives free from chronic pain and discomfort.

Also read:

• • Attention Deficit Hyperactivity Disorder.
  • Endometriosis

References:

[1] NCBI

[2] Mayo Clinic

[3] Mayo Clinic

Polycystic ovary syndrome is a major concern for women these days. If you have entered adolescence or teenage years and feel that your hair is falling out profusely, that you have hirsutism in separate areas of your body, or that you experience irregular periods, this article may direct you to the problem you are suffering from, or urges you to go to a specialist for an accurate diagnosis.

What is Polycystic Ovary Syndrome?

It is a hormonal disorder that is common in women, especially during puberty, in which the ovaries grow many groups of small fluid-filled sacs, and fail to produce ova. The reason behind this syndrome is still not completely clear, but there are several important factors, including increased insulin. Or low-grade inflammation, and there is also a role for the genetic factor in its occurrence. [1]

How do you detect symptoms of Polycystic Ovary Syndrome?

These symptoms often appear around the time of the first period during puberty, or they may occur later in response to some predisposing factor such as being overweight. [1]

For the diagnosis of this syndrome, at least two of the following signs must be present: Irregular menstrual cycles, as well as short or long menstrual cycles, are among the most common signs. Hyperandrogenism and subsequent symptoms resulting from high levels of male hormones, such as excessive hirsutism on the face and body, severe acne, or male-pattern baldness. Ovarian cyst, when the ovaries swell and fill with the sacs that surround them, leads to dysfunction.

Does PCOS stop here or are there complications I could have?

Treatment for polycystic ovary syndrome is essential. Because, like other diseases, if neglected, it will lead to other complications [1], including:

• Infertility.
• Spontaneous abortion or obstructed labor.
• Having type-2 diabetes or prediabetes.
• Sleep apnea.
• Depression, anxiety, and eating disorders.
• Endometrial cancer.
• Metabolic syndrome is a group of medical conditions that include high blood pressure, blood sugar, cholesterol, or triglyceride levels in the body, and the resulting increased risk of heart attacks.

How to diagnose PCOS?

There is no confirmed examination for the presence of the syndrome in the patient, but the doctor may start by asking some questions that are indicative of this disorder, first: about periods and weight changes, then follow up with a physical examination that aims to look for signs of excessive hair growth, acne, and insulin resistance. In addition to the following checks:

• Pelvic examination, as examination is done visually and manually to look for any growths or abnormal structures.
• Blood tests, to measure the levels of hormones in the body, and this test is useful in excluding other causes of changes in the menstrual cycle.
• Ultrasound examination, in order to detect the shape of the ovaries and the thickness of the endometrium. [2]

As for the additional tests that tell us about the presence or absence of complications, they are:

• Periodic examinations of blood pressure, glucose tolerance, cholesterol, and triglyceride levels.
• Screening for depression and anxiety.
• Screening for obstructive sleep apnea. [2]

What is the pharmacological treatment protocol for Polycystic Ovary Syndrome?

In the event that the doctor diagnoses the syndrome, a group of medications is prescribed, namely:

1. Combined contraceptive pills, which reduce the production of androgens in the body, regulate the level of estrogen, and thus reduce the appearance of acne and excessive hair growth, as well as reduce the risk of endometrial cancer.
2. Progesterone treatment, which helps regulate the menstrual cycle and reduces the risk of endometrial cancer, when taken for a period ranging between 10-14 days every month or two.
3. The doctor’s recommendations regarding medications that assist in the ovulation process, such as Letrozole, which may play an effective role in stimulating the ovaries, Clomiphene which is taken in the first phase of the menstrual cycle, and Metformin which improves insulin resistance. Additionally,  in the event that the patient has prediabetes, Metformin can reduce the chances of the condition worsening to type 2 diabetes, and it also plays a role in weight loss.
4. Reproductive gonadotropins are given by injection.
5. The importance of lifestyle in addition to drug therapy. [2]
6. Changing the patient’s lifestyle helps to reduce the severity of this syndrome. Some of these changes:

• Maintaining a healthy weight plays an essential role in lowering insulin and androgen levels and restoring ovulation.
• Reducing carbohydrate consumption.
• Increase physical activity, as doing exercise helps lower blood sugar levels. [2]

The high prevalence of this syndrome among women requires us to be more aware of its existence and its symptoms, in order to reach the correct diagnosis and thus avoid many unwanted complications. The Uplifting Syrian Women initiative supports the need to raise health awareness about gynecological diseases and urges women not to neglect any sign or symptom, because it may hide an important problem behind it.

Also read:

• Attention Deficit Hyperactivity Disorder.
• Panic Disorder.
• Insomnia.

References:

[1] Mayo Clinic

[2] Mayo Clinic