Dr. Dipti Jain

While pregnancy is not a pathological condition, it is a happy time that can be marred by various conditions. Debilitating morning or all day sickness, which is usually characterised by nausea, reflux in the Gastroesophageal band, heartburn and acidity.

This can also turn into vomiting and lead to complications if it does not stop. Persistent, almost daily vomiting can be termed as excessive vomiting in pregnancy, and this is known as Hyperemesis Gravidarum in medical terms. Let us find out more about this condition.

• Routine: Hyperemesis Gravidarum usually strikes as a matter of routine at a set time everyday where the patient will either be in unappetising company of acute and painful acidity and nausea, or will also be vomiting.
• Severity: The severity of the condition usually decreases as the patient's pregnancy progresses. Usually, this condition strikes around the fourth or fifth week of pregnancy, before becoming better towards the middle of the second trimester. There are cases, though, where it continues to be just as severe till the very end of the pregnancy.
• When to take action: The patient may have to be hospitalised in case too much vomiting takes place, so as to prevent excess loss of water and salt from the body, and resultant weakness which may affect the growth of the foetus. Also, it is best to call the doctor when you have experienced fainting and dizzy spells.
• Causes: Hyperemesis Gravidarum or excessive vomiting during pregnancy cannot be attributed to any specific or single cause. Usually, it is known to be a genetic condition passed down by mothers to their daughters. But in most cases, doctors believe that the condition is due to hormonal changes, where an increase in the HCG hormone, or Human Chorionic Gonadotropinhormone level during pregnancy may lead to a variety of symptoms such as morning sickness or excessive vomiting. This hormone is known to be at its peak during pregnancy.
• Risk Factors: It has mostly been seen that women who are carrying twins are at risk of suffering from this condition. Also, women who have suffered from chronic motion sickness in the past report excessive vomiting during pregnancy.
• Treatment: The best way to treat this issue is to prevent too much of nausea and vomiting with the help of a bland diet that does not have heavy to digest ingredients. Also, it is best to take small and frequent meals.

Working your way around excessive vomiting during pregnancy is a matter of ensuring that you take rest, fluids and other precautions.

The ovaries are the egg producing organs, an essential part of the female reproductive system, they are responsible for the production of estrogen and release an egg every month. If the egg is fertilized with a sperm it can result in a pregnancy.

Ovarian cysts are quite common among women. Ovarian cysts are known to be small sacs filled with fluid that are situated in the ovaries.

Causes of ovarian cysts: Among ovarian cysts, the most common one is called the 'functional cyst'. This type of cyst is generally formed during the process of ovulation, wherein either the eggs do not successfully release from the sac or the sac (follicle) fails to disintegrate properly after the release of the egg.

Certain factors that can cause ovarian cysts are:

1. Age that is ovarian cysts are more likely to occur in women who have reached menopause
2. Smoking
3. Being overweight or obese
4. Consumption of fertility drugs
5. Hormone replacement therapy
6. Family history of ovarian cysts and cancer
7. Early menstruation, that is, the onset of the period before the age of 11
8. Hypothyroidism

Symptoms related to ovarian cysts: Generally, ovarian cysts show no specific symptoms and are generally located during a physical examination or an ultrasound. But, in case you suffer from large cysts or those that have ruptured, you may experience certain signs like:

1. Pain while having sex. Great discomfort may be felt, particularly when deep penetration is attempted.
2. Pain in the lower abdominal and pelvic region. This pain may be intermittent or persistent. It can also vary from being mild to quite sharp.
3. Irregularity in the menstrual cycle.
4. An uncomfortable pressure in the lower abdominal and pelvic area.
5. Acute pain in the pelvic area and the lower back all throughout the menstrual period.
6. Pain in the pelvic area after a session of vigorous exercise or strenuous physical activity.
7. A feeling of discomfort or pain while urinating or during bowel movements.
8. Nausea, followed by vomiting.
9. Pain in the vaginal area, or light bleeding.
10. Infertility
11. Problems with healthy bowel movements.
12. Bloating

During the natural course of events, a woman's body starts its reproductive phase with menarche and at about 50 years of age, attains menopause. This is when the reproductive function ceases and the ovaries stop producing the hormone estrogen and progesterone. This is medically termed early or premature menopause. 

Menopause that occurs before 40 years of age is termed as Premature Menopause; it is due to primary ovarian insufficiency and occurs in 1% of the women.  If it occurs between 45 to 50 years, it is termed as early menopause.

Causes of premature menopause: Normal ageing, family history, genetic disorders, autoimmune disorders, toxins, and surgery are some reasons that could lead to premature menopause.

Effects: Estrogen and progesterone have a lot of beneficial effects on a woman's body. Reduction in their levels leads to some of the below changes:

• Emotional changes like mood swings, irritability, and in some cases depression, especially in premature menopause.
• Irregular cycles before complete cessation of the menstrual cycles.
• General mucosal dryness leading to vaginal dryness, dry skin, dry eyes.
• There also would be urinary incontinence and reduced sex drive due to reduced hormone levels.
• For women who still would want to have children, infertility would be a big cause for concern. This could lead to other emotional issues, worsening the depression.
• Bones lose their density and get weak and are more prone to fracture. This leads to Osteoporosis.
• Postmenopause, women are more prone to heart attacks and stroke, leading to cardiovascular health issues. Though not fully proven, this is believed to be true as the good role that estrogen plays on blood vessels is negated with menopause.
• Menopause leads to accelerated damage of genetic structures, thereby leading to faster ageing. This also leaves a feeling in the women of being less attractive and less desirable.

There is also a good news, that after menopause women are at lesser risk of cancer especially, breast and ovarian.

However, it is not easy for women to handle premature menopause. The body undergoes some changes much earlier than expected, and it requires a lot of support and caring and comforting to come to terms with it especially, if associated with infertility or chemotherapy for cancer. Emotional issues of not being able to have children and feeling less attractive require frank talks to boost the person's confidence and increase self-worthiness.

It is easier said than done, but one of the key ways to handle premature menopause is an open discussion.

Polycystic Ovarian Disease results from the disorder more commonly known as PCOS or Polycystic Ovary Syndrome. A syndrome is starkly different from a disease, for the former entails a set of symptoms usually occurring in concurrence, while the latter means a particular biological condition with an identifiable reason behind it. 

A syndrome solicits your concern and forethought in order to eliminate or at least control the chances of an underlying disease. Trigger to a syndrome is undetectable and hence fighting it efficiently is fairly problematic. It is rare to find adolescent girls without hormonal problems.
 
Hormonal imbalances are just too common to be a novel topic any further. Polycystic Ovary Syndrome is faced due to imbalances in hormone secretions. It refers to the development of multiple cysts in your ovary. This condition usually affects women falling within the age group of 15 to 50. Eight among ten women, at a given point of time, are reported with PCOS. Symptoms of PCOS, when neglected, can lead to Polycystic Ovarian Disease. If you have been facing similar health issues, it is advisable to undergo a check- up and get diagnosed at the earliest possible. 

Symptoms of Polycystic Ovarian Disease

1. A receding hairline or increased hair fall can lead to thinning of scalp hair. Such a sign should not be taken lightly as it could be indicative of Polycystic Ovarian Disease.
2. Extremely painful menstruation, irregular periods or prolonged periods with heavy bleeding might be reason enough for worrying.  
3. Development of acne could be another sign. Acne is common to girls attaining puberty, but an unprecedented growth should be a matter of concern. 
4. Patchy skin, pigmentation and discoloration of the skin are the other symptoms.
5. PCOS may also result in continual depression and anxiety.
6. Obesity is the most commonly noticed symptom. People suffering from Polycystic Ovarian Disease have lower metabolism and thus, reducing weight is an ordeal. 
7. Many women tend to grow thick facial hair or chest hair. Such a condition discourages the person to go out in public. It leads to social ostracizing which further bears severe effects on one's mental health.
8. PCOS mostly affects women belonging to the childbearing age. As a result of this syndrome, females stop ovulating. Conception becomes extremely difficult as the syndrome may lead to infertility.

Polycystic Ovarian Disease can result in Type 2 diabetes or even cardiovascular problems. If not diagnosed and treated at an early stage, it might lead to ovarian cancer. There is hardly any preventive measure to counter the chances of such a syndrome, but certain alterations in your diet under the guidance of a dietician and regular exercising can improve your health.