Dr. Ramesh Goyal

Diabetes is often considered as deadly as cancer. It is a disease that requires lifestyle changes and diet modifications. It is also a disease that affects almost the entire system of your body. Whether you have Type 1 or Type 2 diabetes, it will do you a world of good to understand the effects of diabetes. Neurovascular damage is one of the most common effects, this means that diabetes will affect the nerves and blood supply of the body.

While Type 1 diabetes makes its presence felt much earlier and is hereditary quite often, Type 2 appears later in life with age and cumulative stress. The effects of diabetes are related to the duration of the disease. Therefore, people with Type 1 diabetes are more likely to have the symptoms early on and need to learn to manage them. Type 2 makes its appearance later, but needs good monitoring for the effects to not surface or prolong the severity of symptoms.

As we all know, all body systems are affected by diabetes, sexual health is no exception. Diabetes decreases blood supply and impacts the nerves in the genitals, thus causing a series of issues right from reduced libido and erectile dysfunction in males to vaginal dryness and painful coitus (perunia) in females.

Listed below are issues diabetic men and women face in terms of sexual health:

In Men:

1. Diabetes reduces testosterone levels, which is directly reflected in reduced libido. Altered nerve function does not provide proper signals to the penis and there is also reduced blood flow to the organ. Both these can diminish the chances of a good erection. Studies have shown that among men who have had diabetes for 10 years, about 50% have experienced erectile dysfunction. Pregnant
2. The affected nerve function also leads to difficulties in reaching a climax. Diabetes in men can additionally cause Peyronie's disease, which leads to a curved penis, and this leads to painful and difficult erections and coitus.

In Women:

1. It leads to reduced sexual desire due to testosterone levels. Vaginal dryness is very common in females with diabetes and therefore, there is a definite decline in the urge.
2. The above mentioned neurovascular damage also prevents women from reaching a good climax, as the nerve supply is affected.
3. Diabetes also increases the predisposition to urinary tract infections, which can lead to painful sexual experience due to additional vaginal dryness and itching.

Finally, as much as it may sound as a cause for concern, it is not. People with diabetes know that making small lifestyle changes can go a long way in terms of onset of symptoms, their severity, and the leading of a normal life. Modifications in diet and lifestyle to include healthy eating, reduced stress, and exercising are very useful. It is also very important to talk to your doctor about how your sexual health has changed with diabetes. It is a sensitive and private topic, but if you are concerned about it, then do not hesitate to seek help. If you wish to discuss any specific problem, you can consult a sexologist.

How to make your menstrual cycles regular?

First, you should know what is meant by the word 'irregular'? In most women period movers at an interval of 28 to 30 days. But it is said to be normal if it happens every 21-35 days. That means you should have periods not more frequently than every 3 weeks or not less frequently than every 5 weeks. But if you had previous cycles at an interval of every 4 weeks but now you are having periods every 5 weeks, that is ABNORMAL, although it is occurring every 35 days. In other words, change in interval up to 7 days is normal, nit beyond that. For example, if you had periods every 30 days previously and for last 2 months it is happening every 33 days or every 25 days, then it's normal. But if it happens at an interval of more than 37 days (30 + 7) or less than 23 days (30- 7) then it's, of course, abnormal.

So what are the things you can do for regular periods?

1. Normal weight
Ideal weight varies according to the height. We express it in terms of BMI (Body Mass Index) that is the weight in Kg divided by the square of the height in centimeters. Ideal BMI should be between 19 to 25. If it's more than 25, reduce weight by diet and exercise. IT can resume normal menstruation without any drugs. IF despite your sincere efforts, you are unable to lose weight or even after normalization of weight menstruation remains irregular, you must consult your gynaecologist for treatment.
On the other hand, very low BMI can also cause irregular menses. Treatment is weight gain. This is often seen in athletes and they are even at the risk of losing bone calcium because if excessive exercise and strict diet control. If gaining weight does not help, you must consult your doctor for having regular periods.

2. Stress, Anxiety, Tension, Depression
These are an inevitable part of modern lifestyle. These may not only cause mental problems but will also cause physical problems by altering the hormone levels. The result is an abnormal menstrual cycle. Try to avoid them by relaxation, counseling and if necessary by taking help of doctors.

3. Thyroid disorders
The problem of the thyroid gland is common in females and causes abnormal weight and changes the action of many hormones. The result is irregular menstruation. So if you feel lethargy, extreme cold, weakness or increased weight, do not forget to check thyroid status after consulting a doctor.

4. Pituitary disorders
The pituitary gland is a gland situated inside the brain that controls hormone of other glands of the body. If there is soMe tumour or soNe abnormalities in its function, there will be high level of prolactin hormone secretion or there will be a deficiency of hormones like FSH and LH. As a result, ovaries cannot produce enough hormones and you will have irregular menstruation. So in the case of abnormal menstruation, please Check your prolactin level.

5. PCOS
Polycystic Ovarian Syndrome is common nowadays. Apart from causing abnormal menstruation, it increases the risk of infertility, high blood pressure, diabetes, heart disease and even cancer. It is diagnosed by clinical features, hor tests and ultrasonography. It may also cause weight gain, male like the growth of hairs in body and oily skin. The treatment is weight control and drugs to regularize menses. This is particularly important in young women teenagers, in whom timely treatment can prevent many serious consequences.

6. Premature Ovarian Failure
In some women, menopause can come earlier and irregular menstruation may be the early indication of this. This may be followed by permanent cessation if periods. So if you are planning for family expansion but have irregular menses, do not delay pregnancy.

7. Problems in uterus
Excessive trauma to the uterus by repeated surgical abortion or infections like STD are tuberculosis can damage the lining of the uterus. The result is irregular menses followed by total cessation of menses. But this problem can be easily treated if you consult your gynecologist in time.

8. Systemic diseases and drugs
Irregular menSes should never be ignored. Sometimes it may be because if so e undiagnosed diseases like diabetes, diseases if heart, liver, kidney, chest etc. Often it may be the side effect if the drugs you are taking- like antacids containing domperidone, psychiatric drugs, Steroids or chemotherapy.

In conclusion, irregular menstruation may sometimes warn you about serious diseases and may be associated with infertility and early menopause. Stay healthy, have healthy diet and lifestyle, maintain a normal weight, get rid of tension and attend your doctor's clinics in time.