Kamatchi Diabetics & Research Center

Infertility happens when a couple cannot conceive after having regular unprotected sex.While there may be many causes for the same , stress is the major cause.

Infertility is a condition where a couple trying to conceive in a natural way is not able to do so even after one year of trying. It is also a matter of worry for patients who are over the age of 35 years and those who are not able to conceive naturally even after 12 months of trying constantly.

So here are the causes, risks and treatment for this condition.

* Causes

There are many causes of infertility. It may be down to a condition present in one or both partners. As per a medical study, 20% of the cases of infertility are due to males, while 40% to 50% cases are due to problems in the female partner. 30% of the cases suffer from infertility due to problems in both males and females. Ovulation and fertilisation are the main elements of the conception process, and any condition in the female or male can upset either function which can make it difficult to conceive. While abnormal sperm production and transport may be a common condition that leads to infertility in males, other factors like side effects of cancer treatments and too much exposure to toxins and chemicals can also play an important role in this regard.

For females, the causes of infertility may range from ovulation disorders, uterine and fibroid tumours, uterine and cervical anomalies, damage to or blockage of the fallopian tubes, endometriosis, primary ovarian insufficiency and pelvic adhesions. Also, factors like thyroid, cancer and medication leading to temporary infertility may be at play. 

* Risk

There are a number of factors that put a male or a female at risk of infertility. Being in your mid 30s usually has an adverse effect on the ovulation and production of well functioning sperm. Further, smoking and tobacco are among the main causes of infertility in either partner. Excessive alcohol consumption may also lead to this problem. Being overweight or underweight can also make a person infertile. Further, not getting enough exercise and routine activities out of your day, can lead to this condition as well. 

* Treatment

Male patients can go through treatment for any existing infections, hormonal injections and medication, surgical options like vasectomy reversal, and ART or assistive reproductive technology. Female patients can turn to medication that will stimulate ovulation, Intrauterine Insemination, and surgical processes to correct a uterine septum and remove endometrial polyps, or even a hysteroscopy surgery. 

If these methods fail, the patient or the couple can always turn to methods like In Vitro Fertilisation. For other mild reasons, lifestyle changes along with a stress free environment can help in increasing the chances of conception.
 

Unable to conceive even after repeated attempts can be heart-wrenching. Infertility problems in both males and females have been on an unbelievable rise. In females, infertility often results from hormonal imbalance brought about by health conditions such as PCOS, Endometriosis, Hyperandrogenism. Incidences of infertility are also relatively higher in individuals (both males and females) suffering from diabetes, obesity, thyroid problems, stress, anxiety, and related problems.

Unani approach to deal with Infertility
The lifestyle habits (such as sleeping pattern, substance abuse, sedentary life sans any exercise or physical activities) and dietary practices contribute immensely towards the reproductive health of an individual. Leading an unhealthy or sedentary lifestyle or eating unhealthy foods often results in an accelerated built up of toxins in the body which disrupts the balance between the four humors (Dum or blood, Sauda or black bile, Balgham or Phlegm, Safra or yellow bile). More than often, this disruption affects the reproductive health of an individual making it difficult for a woman to conceive. Used since ancient times in India (as early as the 11th century),

Unani has truly been a savior for millions of couples who had given up all hopes of embracing parenthood naturally and safely without any complications or side effects (as often seen in the case of conventional treatment).

1. Ilaj Bil Ghiza (Dietotherapy): Time and again, Unani has stressed the importance of healthy and nutritious eating in dealing with infertility. The food that one eats can play a pivotal role in improving the quantity as well as the quality of the sperms and the eggs. With healthy eating, one also needs to lead a more relaxed and active life. Meditation, mild to moderate exercise and physical activities also work wonders to restore the hormonal balance. In general, walnuts, green leafy vegetables, salmon, oysters, raspberries, blueberries, eggs, bread (whole grain), flax seeds are known to improve the condition of infertility in both the sexes. For men, citrus fruits, garlic, pumpkin seeds, tomatoes, carrots, berries, red peppers contribute significantly to deal with infertility and related problems. For women, the fertility boosting food options include eggs, milk, yam, nuts, and lean meat and poultry. One is also expected to avoid or reduce the intake of coffee, alcohol, processed foods, saturated and trans fats, simple carbohydrates, soy products, tofu, fish with a high mercury content (King Mackerel, swordfish, shark, to name a few). 
2. Ilaj Bil Dawa or Pharmacotherapy: The use of Unani medicines (comprising of herbal concoctions and formulations) have been pathbreaking in dealing with a myriad of fertility problems including low libido, sperm and egg mortality and morphology, enhancing the sperm count. Some of the herbs often used in treating infertility include Withania somnifera, Nigella sativa, Sida cordifolia, Asparagus adscendens, Tribulus terrestris.
3. Ilaj Bil Tadbeer or Regimental Therapy: Elevated levels of toxins in the body can immensely interfere with the fertility in both men and women. Ilaj Bil Tadbeer is a detoxification process that goes a long way to cleanse the body of the harmful toxins.

Do you have an extremely low reading of thyroxine or T4, it means that you are suffering from an under active thyroid disease called hypothyroidism. With this condition, your thyroid glands fail to make sufficient thyroid hormones. The thyroid gland releases hormones, which travel all over your bloodstream and affect all parts of the body. Thyroid controls how the cells of the body use energy from food via the metabolism process, which in turn affects the body’s temperature, heartbeat and burning of calories. Lack of thyroid hormones slows down the body’s functions, reduces your energy and the metabolism is disrupted.

Causes of hypothyroidism
The primary cause of this condition is Hashimoto’s thyroiditis. Thyroiditis refers to an inflammation of your thyroid gland. Hashimoto’s thyroiditis is an autoimmune disorder in which extra antibodies are produced which destroy the thyroid gland. Viral infections may also lead to thyroiditis.

Other causes of the condition are as follows:

1. Radiation therapy to the neck region for the treatment of several cancers like lymphoma may damage the cells present in the thyroid gland. Hence, the gland cannot secrete hormones properly.
2. Radioactive iodine treatment is undertaken by people having an overactive thyroid gland. Radiation destroys the thyroid gland cells and leads to hypothyroidism.
3. Certain medicines used to treat heart problems, cancer and psychiatric diseases may affect the thyroid gland and lead to hypothyroidism.
4. Surgeries undertaken for removing the thyroid also lead to hypothyroidism.
5. Iodine is required by the thyroid gland to produce hormones. A low amount of iodine in your diet and body may lead to hypothyroidism.

Risks factors of hypothyroidism

Usually women, especially older women are more likely to get hypothyroidism than men. The factors which determine if you are at a risk of acquiring the condition are as follows:

1. Race
2. Age
3. Premature graying of hair
4. Autoimmune disorders like type 1 diabetes, rheumatoid arthritis, vitiligo, celiac disease, Addison’s disease and many more.
5. Bipolar disorder
6. Turner’s syndrome
7. Down’s syndrome

The symptoms of hypothyroidism are as follows:

1. Changes in menstrual cycle
2. Constipation
3. Hair loss and dry hair
4. Fatigue and tiredness
5. A slow heart rate
6. Depression
7. An increased sensitivity towards cold
8. Swelling of the thyroid gland or goiter
9. Gaining weight unusually or great difficulty in losing weight
10. Carpal tunnel syndrome

If you observe the symptoms of hypothyroidism, you should consult a doctor who will prescribe several blood tests, such as the thyroid stimulating hormone test and the T4 or thyroxine test. Based on the results, a treatment method is adopted.

type diabetes

Single yoga pose that is haalassan helps to lower sugar levels. This aasan stimulate pancreas to secret insulin.

Diabulimia is a type of eating disorder in which patients of Type 1 diabetes take less amount of insulin purposely, in order to lose weight. These patients have excessive concerns related to body weight and body shape, and a disturbed body image emerges (regarding oneself overweight despite a normal or reduced body weight). These patients attribute too much importance to body weight and body shape and fear of gaining weight. 

Our body requires insulin for moving glucose from the blood to the cells. In type 1 diabetes patients, the pancreas stop producing insulin and glucose gets stored in our bloodstream. Kidney excretes excess glucose leading to increased urination. The body gets devoid of glucose and the calories associated with it and a rapid loss of weight occur.  Once the patient is started on insulin they develop weight gain. Patient with disturbed body image stops insulin in order to lose weight. Patients develop binge eating,  with more emphasis on sugar and carbohydrate enriched foods. The excess sugar gets out of the body by urinating.
Symptoms including excessive thirst, increased water intake, increased urination, and weakness are observed in the early period, irreversible findings including neuropathy, retinopathy, nephropathy, and osteoporosis, which occur in poorly controlled diabetics, are observed in the long term. It has been proven by research that almost 30% of type 1 diabetes patients are the ones who abstain from or avoid using insulin in order to lose weight. This habit leads to the risk of many other fatal diseases which may be permanent in nature.

Prevention

Diabulimia is more common among teenage girls who suffer from type 1 diabetes and are generally obsessed with body image. Proper patient education can help a lot in these patients.  It is advised not to neglect your insulin.
 

Do you have an extremely low reading of thyroxine or T4, it means that you are suffering from an under active thyroid disease called hypothyroidism. With this condition, your thyroid glands fail to make sufficient thyroid hormones. The thyroid gland releases hormones, which travel all over your bloodstream and affect all parts of the body. Thyroid controls how the cells of the body use energy from food via the metabolism process, which in turn affects the body’s temperature, heartbeat and burning of calories. Lack of thyroid hormones slows down the body’s functions, reduces your energy and the metabolism is disrupted.

Causes of hypothyroidism
The primary cause of this condition is Hashimoto’s thyroiditis. Thyroiditis refers to an inflammation of your thyroid gland. Hashimoto’s thyroiditis is an autoimmune disorder which destroy the thyroid gland. Viral infections may also lead to thyroiditis.

Other causes of the condition are as follows:

1. Radiation therapy to the neck region for the treatment of several cancers like lymphoma may damage the cells present in the thyroid gland. Hence, the gland cannot secrete hormones properly.

2. Radioactive iodine treatment is undertaken by people having an overactive thyroid gland. Radiation destroys the thyroid gland cells and leads to hypothyroidism.

3. Certain medicines used to treat heart problems, cancer and psychiatric diseases may affect the thyroid gland and lead to hypothyroidism.

4. Surgeries undertaken for removing the thyroid also lead to hypothyroidism.

5. Iodine is required by the thyroid gland to produce hormones. A low amount of iodine in your diet and body may lead to hypothyroidism.

Risks factors of hypothyroidism
Usually women, especially older women are more likely to get hypothyroidism than men. The factors which determine if you are at a risk of acquiring the condition are as follows:

1. Race

2. Age

3. Autoimmune disorders like type 1 diabetes, rheumatoid arthritis, vitiligo, celiac disease, Addison’s disease and many more.

4. Bipolar disorder

5. Turner’s syndrome

6. Down’s syndrome

The symptoms of hypothyroidism are as follows:

1. Changes in menstrual cycle

2. Constipation

3. Hair loss and dry hair

4. Fatigue and tiredness

5. A slow heart rate

6. Depression

7. An increased sensitivity towards cold

8. Swelling of the thyroid gland or goiter

9. Gaining weight

10. Carpal tunnel syndrome

If you observe the symptoms of hypothyroidism, you should consult a doctor who will prescribe several blood tests, such as the thyroid stimulating hormone test and the T4 or thyroxine test. Based on the results, a treatment method is adopted.

Diabetes is one major silent killer. Depression is another silent killer. According to the studies, a patient with diabetes has higher chances of getting depressed. Lack of social support, staying alone, lower income, the presence of diabetes complications and poorly controlled diabetes increase chances of depression in diabetes patients. Similarly depressed patient is at increased risk of development of diabetes. Thus, depression and diabetes have a cyclic relationship.

Need to break

It is very important to break the vicious cycle as it can affect the sugar control, quality of life and patient care. The depressed patient is less likely to follow diet and exercise. They do not take medicines regularly. The depressed patients will have bad control of sugars and increased complications of diabetes. It affects the quality of life of the patient.

How we can break the cycle?

Speak out

Depression remains underdiagnosed and untreated. One of the reason is the stigma associated with psychiatric illness in the society. Unless and until patient doesn't talk about it they are not going to improve. Hence ADA recommends evaluating for depression in patients with poorly controlled diabetes.

Psychotherapy

Psychotherapy or in particular cognitive behavioral therapy has been proven beneficial towards treating depression.

Regular Exercise

Regular exercise is very beneficial towards treating, both depression and diabetes. Exercise helps regulate blood sugar levels and hence can help control diabetes. It also helps in reducing excess weight, which can enhance your self-image and make you feel happier. Simultaneously, it also releases endorphins or the 'feel good' brain chemical. This can help alleviate depression symptoms.

Antidepressant

These are the medicines given to improve depression. Under the guidance of a psychiatrist, they help a lot. So don't say no to these medicines when prescribed by the psychiatrist.

Diabetic men usually are prone to suffering from erectile dysfunction, i.e., they are unable to maintain an erection while having sex. If you are suffering from diabetes for a long time, your nerves and blood vessel might get damaged. That will cause you to suffer from erectile dysfunction. Almost 35% to 75% diabetic men suffer from erectile dysfunction. This situation becomes more serious with age.

Causes

It involves various factors like impairment in the nerves, blood vessels, and also cause problems in proper muscle functioning. You need healthy blood vessels, nerves, as well as healthy male hormones and sexual desire to get an erection. Diabetes damages the nerves and blood vessels responsible for an erection. So even if you have the required amount of hormones and the desire, you might not be able to get a proper erection.

Treatment

If you are suffering from diabetes, and have a condition of erectile dysfunction, then the most common treatment for you is Sildenafil. Other medications, which you can take are tadalafil, avanafil, and vardenafil. But keep in mind that if you have any heart problems, then you should refrain from taking any of these medicines as they will further complicate situations for you. Consult your doctor in this case to know which will be the best treatment for you to cure erectile dysfunction. Other treatment methods are as follows:

1. Intracavernous injection therapy

2. Vacuum erection devices

3. Venous constriction device

4. Intraurethral therapy

5. Penile prostheses

The dosage of these medicines depends upon weight of the patient as well as presence or absence of other co-morbid conditions like hypertension, dyslipidemia, cardiac problems, kidney/liver diseases, etc. Prescription of these medicines also depends on the other medications that the patient is taking as these ED medicines have a lot of adverse drug-interactions. Hence, one must always consult a doctor before starting these medications.

The Role of Counselling for Treating Erectile Dysfunction

Erectile dysfunction can be caused by psychological factors and once a man experiences erectile dysfunction it can have a major impact on their emotional well-being. A man may feel a loss of manhood, a loss of confidence, low self-esteem, angry and depressed and it may also affect his relationship or sexual encounters. Therefore, counselling is a crucial part of treatment in order to address these issues.
Does psychosexual counselling work?

Psychosexual counselling is most effective when a man's sexual partner is willing to be part of the treatment. Studies have shown that for men with stress-related ED, when the partner is involved in the therapy, the problem is resolved 50%-70% of the time. When the man must go through counselling alone, the results are less successful.

Psychosexual counselling is unlikely to work if a man drops out of treatment after just one or two sessions.

Sometimes, several sessions of psychosexual counselling can be helpful if a man is due to receive medical or surgical treatment for ED. A counsellor can help guide a couple towards agreeing on treatment, or help them improve their sexual communication and lovemaking skills. A man may benefit from counselling on his own regarding how to talk to his partner about penile injections or a vacuum constriction device, which are both treatments for ED.