Dr. Leelavathi V

Drink plenty of water, ors, coconut water or similar other health drink to combat this scorching heat. Babies less than six month should be on mothers milk only.

Genital herpes is a sexually transmitted disease. One out of every six people in the United States suffers from this disease. It is more common than you think. Like any other STD, it is extremely important to take proper protection (use a condom) while engaging in sexual activities.

Genital Herpes is caused by the herpes simplex virus (HSV). There are two types of herpes simplex virus.

1. HSV-1 is most commonly associated with blisters and ulcers around the mouth known as cold sores.
2. HSV-2 is associated with blistering lesions in genital areas that are exposed during sexual contact.

However, both types of herpes simplex virus can infect the mouth or the genital areas, meaning that genital contact with a cold sore on the mouth can lead to genital herpes. Likewise, kissing someone with a cold sore can spread the herpes simplex virus infection.

After the initial outbreak of herpes, the virus travels through the nerves and resides in nerve tissue within the body.

Most people with genital herpes don’t know they have it. That’s because in most people it produces either no symptoms or very mild ones.

Symptoms of Genital Herpes:

1. The area around your genitalia becomes red and cracked without any pain or itching.
2. Itching around your anal region
3. Blisters around your genitalia can cause immense pains when they break open.
4. Pain in the open sores while urination.
5. Headaches and backaches.
6. Flu and swollen lymph nodes are very common.
7. Fatigue is also felt if you suffer from genital herpes.

Symptoms like these can be mistaken for other infections such as vaginal yeast infections, bacterial infections and bladder infections. So, if you are suffering from such symptoms it is advisable to go in for a health check up followed by a physical exam and a blood test to confirm whether you have genital herpes or not.

How can it get spread?

You can only get Genital Herpes from vaginal intercourse and not anal or oral intercourse. The fluid present in the sore of a genital herpes patient has infected fluid. If the fluid comes in contact with their partner’s sexual organs while having intercourse they can be easily infected.

Can Symptoms Be Treated?

There is no cure for genital herpes. But the symptoms can be lessened and prevented with treatment. Treatment can also reduce the risk of infecting others.

Your healthcare provider may prescribe antiviral medications to help prevent or reduce the pain and discomfort from an outbreak of symptoms. Medication taken on a daily basis to suppress the virus can reduce the number of outbreaks and reduce the risk of infecting others

How to Avoid Getting Genital Herpes:

1. Try to have sex with people who have been tested negative for herpes or any other STDs.
2. Use a latex condom while having sex. It prevents any sort of liquid to pass inside your partner’s genitalia. If you wish to discuss about any specific problem, you can consult a sexologist.

What is recurrent miscarriage?

If you have three or more miscarriages in a row, doctors call it recurrent miscarriage. If you have experienced recurrent miscarriage, your GP or midwife will refer you to a gynaecologist. Your gynaecologist will try to identify the reason for your losses.

Having miscarriage after miscarriage may leave you feeling utterly drained of hope. At times, it may be hard to keep trusting in the future. This experience affects every aspect of a woman’s life from her mental and emotional health to her physical health and social well-being. 

If you can, try to draw comfort from the fact that most women who experience recurrent losses do go on to have a baby. This is especially the case if tests can find no reason for the losses. Six out of 10 women who have had three miscarriages will go on to have a baby in their next pregnancy.

Treatment of Recurrent Pregnancy Loss

Treatment for anatomic abnormalities of the uterus involves surgical restoration through removal of local lesions such as fibroids, scar tissue and endometrial polyps or timely insertion of a cervical cerclage (a stitch placed around the neck of the weakened cervix) or the excision of a uterine septum when indicated.

A thin endometrial lining has been shown to correlate with compromised pregnancy outcome. Often times this will be associated with reduced resistance to blood flow to the endometrium. Such decreased blood flow to the uterus can be improved through treatment with sildenafil (Viagra), Terbutaline and possibly aspirin.

Sildenafil (Viagra) Therapy Viagra has been used successfully to increase uterine blood flow. However, to be effective it must be administered starting as soon as the period stops up until the day of ovulation and it must be administered vaginally (not orally). Viagra in the form of vaginal suppositories given in the dosage of 25 mg four times a day has been shown to increase uterine blood flow as well as thickness of the uterine lining. To date, we have seen significant improvement of the thickness of the uterine lining in about 70% of women treated. Successful pregnancy resulted in 42% of women who responded to the Viagra. It should be remembered that most of these women had previously experienced repeated IVF failures.

Terbutaline this is a medication that relaxes the muscle in the uterine wall and so permits improved hormone delivery to the endometrium. The use of Terbutaline will often cause an increase in heart rate. It should not be prescribed to women who have irregular heart beats (arrhythmias), and women who have decreased cardiac reserve.

Aspirin this is an antiprostaglandin that improves blood flow to the endometrium. It is administered at a dosage of 81mg orally, daily from the beginning of the cycle until ovulation.

Selective Immunotherapy Using Intralipid, heparin, aspirin and corticosteroid

Many causes of pregnancy loss or failure can be treated with immunotherapy comprising combinations of aspirin and heparin and corticosteroids (dexamethasone or prednisone) and Intralipid (IL) to regulate increased level of Natural Killer Cell Activation (NKa). Achievement of optimal success with Intralipid/corticosteroid therapy requires that the treatment be initiated well before ovulation takes place (about 7-14 days prior to anticipated implantation). Given the fact that only 10-15% of natural cycles (with or without the use of insemination and/or fertility drugs) will result in a pregnancy, it follows that repeated administration of Intralipid will be required in most cases before a pregnancy will occur. IVF achieves pregnancy rates that are often 2-3 times higher. This often makes IVF a treatment of choice in cases of immunologic recurrent pregnancy loss.

Role of IVF

Preimplantation genetic diagnosis (PGD) a procedure whereby the embryo can be tested for genetic or structural chromosomal abnormalities requires the use of IVF to select the best embryo(s) for transfer to the uterus. In cases of structural chromosomal (translocations) egg or sperm donation is often another option worth considering.

In those cases where due to intractable anatomical or alloimmune dysfunction IVF repeatedly is unsuccessful or is not an option, Gestational Surrogacy might represent the only recourse other than adoption.
If a couple with Recurrent Pregnancy Loss is open to all of the diagnostic and treatment options referred to above, a live birth rate of 70% – 80% is ultimately achievable.