Till now no one can answer this question accurately but there are a lot of theories but you can’t find enough evidence to support one single theory so we can say according to many studies that there are multiple factors contributing to the disease.

Fibromyalgia Hereditary and genetic Theory

It has been found that People who have a family member with fibromyalgia are more likely to develop Fibromyalgia.
So doctors suspect genetic predisposition in Fibromyalgia mainly because they find families in which more than one person has the conditions. Also, other factors that seem to trigger fibromyalgia don’t cause the disease in most people.
So most probably there are certain genetic mutations that may make you more susceptible to developing the disorder but these gene mutations are still hidden.

Triggering factors for fibromyalgia

In many people the beginning of their fibromyalgia symptoms usually comes after exposure to certain events. These events may be medical illness like the flu, an injury or surgery, or emotional trauma and stress. Post traumatic stress disorder has been linked to fibromyalgia

Central sensitization theory

people with fibromyalgia have a lower threshold for pain because of increased sensitivity in the brain to pain signals as repeated nerve stimulation causes the brains of fibromyalgia patients to have abnormal increase in levels of certain neurotransmitters that signal pain and the brain’s pain receptors develop a sort of memory of the pain and become more sensitive, and then they can overreact to pain signals.

Hormonal and chemical abnormalities

Abnormalities in the levels of serotonin, melatonin, substance P and cortisol levels have been linked to fibromyalgia.

So we can state that Fibromyalgia is a hereditary disease need genetic susceptibility may be initiated by a certain event like emotional trauma or illness as flu or surgery which together lead to chemical  disturbance of the body hormones or nerve cell chemicals.

All women over 20 years old should advised to do breast examination monthly , one week after the menstrual period.

Steps of examination are as follow

First inspection in front of the mirror to look for lump or skin dimpling, or recent nipple retraction and she sholud report that to her surgeon or physician.

Second palpate the breast and axilla and the supra clavicular regions for also prescence of lump, that done in systematic manner during standing position , and repeated in lying down position.

Breast Mammography

In western countries , female regulary run on both breast self examination and breast mamography , the frequency of mamgraph examination every one , two , or even three years depending on each country.

Finding of variable dots of calcification are suspicious and in that case biopsy is indicated.

Skin signs of breast cancer

The overlying skin of the breast become dimpled and also may show puckering and that due to fixation of the cancer , beside contracture of cooper ligament , another sign is nipple retraction and deviation of it main site , and that also due to fixation of mass . Peau d’orange is another sign and that sign occur due to obliteration of breast lymphatics , also breast skin may show dilated veins , ulceration and fungation and may have bad odor and that occur in last stages , also in last stages the skin may be hard , thick , have metalic brown in color .

Lymphatic signs

The lymph node may be also affected , and it can be at first axillary lymph node and then ascend to other lymph node groups , but these groups cant be seen , finally it  supra clavicular lymph node is the last station of lymph node may be affected , when the lymph node affected , it start to be enlarged , then it become mobile and then fixed , showing the character of breast mass.

Other signs of breast cancer are umbilical nodule , and chest affection , pathological fracture , jaundice .

Breast mass is the main symptom of local breast cancer , but if the cancer grow and begin to metastasize first to adjacent tissue , the patient in that time complains of dimpling sensation in her breast , but if the cancer metastasize to distant organs , according to the organ affected , the female has it complain , if the cancer affect respiratory system , the female complains of chest pain , productive cough which may be bloody , dyspnea , if it metastasize to the brain the female in that time complains of projectile vomiting , headache , and that metastasis is very rare , and the final two organs are liver and the female will complain of abdominal pain and may be associated with jaundice , the bone may be also affected , the patient will complain of bone ache , and pathological fracture.

There are multiple staging techniques , but the most simple and most practicl is TNM staging , which classify cancer according two three variables , as T refer to tumor size , and that “T” subdivided into T1, in which the tumor size les than 2 cm , and T2 , tumor become from 2-5 cm , T3 ,the tumor progress up to 5 cm and finally T4 and in that case the tumor may have any size but with direct extension to the chest wall or even to chest skin.

“N ” that letter refer to lymph node , as when the cancer progress , it can involve the draining lymph nodes for the breast , that lymph nodes also subdivided into:

N0 : in that case no lymph nodes are involved

N1: lymph nodes are involved , but the axillary one and it is mobile

N2 : lymph nodes become fixed

N3 : in that case the supraclavicular  lymph nodes are involved.

Finally “M” refer to Metastasis and it only have two options ,

M0 and in that case there is no metastasis ,and M1: there is metastasis .

Formulating the above three letter in main four stages , which are:

Stage 1: T1,N0,M0

Stage 2 : T1, N0 ,M0  or T2 ,N0/N1 , M0

Stage 3 : subdivided into

• Stage 3 A: T1/T2/T3 , N2 ,M0 or T3 , N0/N1/N2 , M0
• Stage 3 B: any T with N3 with M0 , or T4 with any N also with M0

Stage 4 : any M or any N but with M1.

Breast from the histological view , consist of epithial tissue , ducts and covered by skin .

Cancer when develop it can a rise in epithial tissue and in that case it called lobular carcinoma , when it arise in ducts it called ductal carcinoma , and finally arising in the skin it called paget’s disease and as it mainly seen in breast nipple , it finally called paget’s disease of the nipple .

Lobular carcinoma , at first that carcinoma arise as amass seen mainly by radiographic diagnosis or “mammography ”, and it can not diagnosed clinically and the females in that stage does not has any complains, also  that type is easily treated and that make clear why screening is very important  , but when that mass grow to extent it can be paplpated by pare hand , in that time it may be non –invasive type and it may progress more and be invasive and difference between both by clinical and radiological and laboratory investigation .

Ductal carcinoma , also have the same pathway , at first it can be mainly diagnosed by mammography and then it progress to be non –invasive ,and finally invasive , but both non-invasive and invasive have sub types or histological subtypes , as non-invasive have papillary type and cemedo type , and invasive carcinoma have scirrhous , atrophic scirrhous , encephaloid and mucinious types , all of these types only from histological views.

Finally paget’s disease of the nipple , it mainly seen as an erosion of the nipple which extent to the areola and that erosion may be followed by breast tissue cancer by about one to two years, females with paget’s disease mainly are old , and that cancer commonly seen in one breast not in both . Paget’s disease consider to have good prognosis , if it alone and it mainly treated by radical mastectomy.

Genetic factors play very important rule , as about from 5-10 % of females with breast cancer , occur due to mutation in suppressor genes , these genes are mainly BRACA1 which lie in chromosome number 17 , and BRACA 2 which lie in chromosome number 13 , breast cancer with positive of one of  these genes , characterize mainly by arising   in young age and cancer seen bilaterally ( in both breasts ) .

Family history or positive family history is another important factor as the risk increase in female with positive mother or sister breast cancer history by two or even three times , and if female have both mother and sister history it arise up to 14 times!

Females who exposed to long time of estrogen which not opposed by progesterone which seen in female with early menarche and late menopause , seen also in nullipara , or even mutlipara but not lactating , also seen in female running on oral contraceptive pills , as that long time of estrogen exposure lead to over growth of breast tissue , which later transform into malignancy.

Fat females or who eat high fat diet are also at risk , as the fat inside fat cells converse into estriol , which is estrogen sub type characterize by being weak , but long acting hormone , so it has the same effect of unopposed estrogen.

Race also play a rule as records show , breast cancer affecting mainly white females more than Asian or African one.

Females with previous history of benign tumors also are in great risk , also females with previous cancer are at risk  , also who have previous history of radiation therapy to chest , all these increase risk for breast cancer.

There are other risks , such as alcohol in take , decrease physical activity and increase in weight.

Generally females should screen regularly for breast cancer , but those who have positive risk factors should not forget to check up for their breast

Although breast cancer seen mainly in females, but also it  affect males , and when it develop in male breast , it become more dangerous and severe than affecting females !

Breast for females considered to be very vital organ in her body , and it account very important physical , psychological and  also sign of beauty for any female young or even old.

Giving short note about the normal anatomy and physiology of that vital organ , we can say that , Breast is not an organ , it is modified sweat gland , which called “Mammary gland” , and it is lie in the chest wall , extend from the 2^nd rib of chest  down wards to the 6^th rib and also extend from the sternum to the axillary line , the breast have a tail which consider prolongation of the breast itself and it extend to the axillary fat .

Second the main function of the female breast is formation and ejection of milk , that job done by special epithial tissue and ducts of the breast and it controlled by higher centers in the brain.

Breast cancer when arise it affect one of two parts of the breast , that is epithial tissue or the duct system , also it can be local , that mean only arise in breast tissue and that stage consider an early stage , or it may be metastatic to various organ , and in that stage it consider to some extent hopeless and only palliative treatment is the only choice.

Early screening and diagnosis of breast cancer , differ dramatically in breast cancer prognosis and also in ways of treatment .

So for any female , she should screen regularly for breast cancer .

Women with vaginal dryness usually experience vaginal itching associated with burning sensation ,that lead to uncomfortable or painful sexual course , also it may affect urinary system, as some women may complain of urinary urgency and frequency , that beside pressure and discomfort sensation.

Vaginal dryness results from , In normal female  body  the vaginal walls covered  with a thin layer of moisture. This moisture layer is made of a clear fluid excreted through the blood vessel walls around the vagina. When a woman is sexually aroused, these blood vessels receive more blood flow, stimulating the secretion of fluids, thus increasing vaginal lubrication , but with Lack of estrogen  lead to decrease of vaginal lining blood supply resulting in vaginal dryness and vaginal atrophy vaginal dryness which may predispose to Vaginal infection and Uncomfortable sex. There are other causes of vaginal dryness

such as  Health disorders like in surgical removal of the ovaries , immune disorders , sjogern disease and vaginal infection , also as a result of life style disorder  which mainly seen in  smoking , excessive caffeine and alcohol consumption , stress and anxiety , finally some medication may also lead to vaginal dryness mainly as side effects of antidepressant , antihistaminic and anti estrogenic drugs.

Vaginal dryness treatment , are same like of menopause treatment , but females can use Vaginal lubricant and in late cases some doctors prefer surgical options .

Menopause Night sweets causes

Like hot flashes, night sweats has not completely explained mechanism, but its main cause is the lack of estrogen. That lack of estrogen shifts the set point in the thermo regulation center leading to increase body temperature , and so increase sweating as away for heat loss , there also other night sweets causes like Infection , mainly due to Tuberculosis, Other bacterial infections which lead to pus formation (streptococcal or non streptococcal), endocarditis, Osteomylitis, pus under tension or HIV infection may also lead to night sweats. Malignant tumors (cancers), most common malignant tumors cause night sweats is Lymphoma. Specially if associated with weight loss and unexplained fever. Medical drugs , Some drugs can lead to night sweats as a side effect of the drug like Antidepressant drugs ,as it cause hot flashes and so it  can be associated with  night sweats or cause night sweats only  in range about 8 to 22 % , Also antipyretics which are used for lowering body temperature will lead to night sweats
Other medications include ( Anti estrogenic drugs, Niacin, Hydralazin and nitroglycerin).

Night sweats treatment

Treatment of night sweats and also other menopause symptoms include two main aspects , Natural remedies which in turn  include two main vital approaches, and if these steps carried correctly , you can get rid of night sweats completely , these approaches are

1. Life style modification

These simple modifications , can make you get free of night sweats , beside it does not have any side effects or even expensive like medication, by simple changes in your life, you can enjoy your night without annoying night sweats .
These steps are
1. Avoid stress, and anxiety also try to do relaxing and breathing exercises , they have a lot of benefits .
2. Avoid hot rooms and bedding , and take cool showers especially before going to sleep , also you can cool the surrounding environment by putting air conditioners or even fans , also you can put ice water tanks beside your hand, it also may be useful
3. Avoid alcohol , smoking diet pills and spicy food .

2. Natural herbs for night sweats treatment

• Phytoestrogenic herbs(e.g. black cohosh)
• Non estrogenic herbs (e.g. macafem)

The second approach is medical treatment  which mainly is Hormone replacement therapy.