the breast of a woman who is BREASTFEEDINGan
infant and cracks or breaks in the SKIN, usually
around the nipple, that allow BACTERIAto enter the
milk duct. Mastitis due to infection is less common
in women who are not breastfeeding. Mastitis
may also occur as a result of viral infection or
become chronic for reasons the doctor cannot
identify though are likely hormonal.
Bacterial MastitisThe symptoms of bacterial mastitis include PAIN,
redness on the skin above the area of the infec-
tion, and swelling or hardness at the site of the
infection. Many women also have FEVER, chills,
bodywide MUSCLEaches, and fatigue. It is impor-
tant for breastfeeding women to continue breast-
feeding, as the infant’s sucking helps massage the
blockage from the duct. Warm compresses or a
heating pad to the breast also may help.
A course of treatment with an antibiotic med-
ication generally results in rapid improvement of
bacterial mastitis. The small amount of the antibi-
otic that enters the breast milk is not enough to
affect the infant. The doctor may recommend an
analgesic medication to relieve pain and fever. A
complication of bacterial mastitis is breast ABSCESS,
in which the infection forms a pocket within the
breast tissue that requires minor surgery to open
and drain, as well as a more extended course of
antibiotics, so HEALINGcan take place.
ANTIBIOTIC MEDICATIONS
TO TREAT BACTERIAL MASTITIS
amoxicillin-clavulanic acid cephalexin
ciprofloxacin clindamycin
cloxacillin flucloxacillin
Nonbacterial Mastitis
Mastitis may also result from viral infection, most
commonly as a result of the MUMPS VIRUS. Nonspe-
cific chronic mastitis sometimes occurs in a pat-
tern that follows a woman’s MENSTRUAL CYCLE,
suggesting it is hormonal in nature. The diagnostic
path for nonbacterial mastitis often includes MAM-
MOGRAM (X-RAY of the breasts) and sometimes
biopsy of an area of inflammation to rule out
BREAST CANCERor other causes for the symptoms.
When such findings are negative, treatment is
generally NONSTEROIDAL ANTI-INFLAMMATORY DRUGS
(NSAIDS) to relieve inflammation and pain. NSAIDs
also influence the production and release of
PROSTAGLANDINS, hormonelike substances that fluc-
tuate in the BLOODcirculation during the men-
strual cycle. Chronic mastitis is a common
symptom of FIBROCYSTIC BREAST DISEASE.
See alsoANALGESIC MEDICATIONS; ANTIBIOTIC MED-
ICATIONS; HORMONE; MASTALGIA.masturbation Touching one’s own body, and in
particular the genitals, for sexual pleasure and
typically to reach ORGASM. Masturbation is a nor-
mal behavior most common among adolescents
and young adults. Masturbation does not cause
adverse health effects, either of the genitals or
health in general. For several centuries myths
have persisted that masturbation causes blindness,
mental illness or insanity, HAIR growth on the
palms of the hands, INFERTILITY, and other prob-
lems. These myths arise from social and cultural
attitudes toward masturbation, not from medical
science. Excessive masturbation may indicate
underlying psychologic or emotional conditions.
Inappropriate masturbation (notably public mas-
turbation) is often an indication of serious mental
illness, DEMENTIA, or BRAINdamage (such as due to
STROKEor trauma), conditions that disturb the nor-
mal inhibitory mechanisms of conscious behavior.
See also SEXUAL DYSFUNCTION; SEXUAL INTER-
COURSE.menarche A woman’s first menstrual period, the
start of MENSTRUATIONand the beginning of FERTIL-
ITY. The average age of menarche varies among
cultures and countries throughout the world and
largely correlates with nutritional well-being. In
the United States the average age of menarche is
121 ⁄ 2 ; in rural regions of South Africa the average
age of menarche is near age 14. The age of menar-
che has declined worldwide by nearly a year over
the past century, which health experts believe
reflects improved nutrition and overall health sta-
tus. Many cultures celebrate menarche as a rite of
passage that ushers a girl into womanhood.
See also AMENORRHEA; MENOPAUSE; MENSTRUAL
CYCLE.menopause A woman’s last menstrual period,
the end of MENSTRUATION and the closure of a300 The Reproductive System