Emergency is helpful in preventing pregnancies post unprotected sexual activity. It can be used in case of contraceptive failure, in case of sexual assault, incorrect use of contraceptives and unprotected sex.

Emergency contraception can be done by three methods. These are emergency contraceptive pills, combined oral contraceptive pills and copper intrauterine devices.



The copper IUD is considered to be one of the most effective forms of emergency contraception, when it is inserted within 5 days of unprotected sexual activity.

However, the emergency contraceptive pill regimen as per WHO is:

1 dose of levonorgestrel 1.5 mg, or 1 dose of ulipristal 30 mg, taken within 5 days (120 hours) of unprotected intercourse

The Yuzpe regimen which consists of 2 doses of combined oral contraceptive pills

What is Emergency Contraception?

Emergency contraception is usually referred to as the contraception which is used to prevent a pregnancy within the first 5 days after an unprotected sexual activity. It is used post failures of contraception, coerced unprotected sex, rape or misuse of contraception.

Emergency contraception is only effective in the first few days after an intercourse and before the egg has released from the ovary, and before there is fertilization between the egg and the sperm. The emergency contraception can do no harm to an interrupted pregnancy and a developing embryo.

Who needs emergency contraception?

Any girl or woman who is at her reproductive age might need an emergency contraception in case of an unprotected sexual intercourse.

Uses
1 Breakage , slippage or displacement of barrier methods 
2. Three or more missed OCPills for more than 12 hours 
3. Missed Mini pill for more than 3 hours 
4. Missed Desoestrel pills for more than 12 hours 
5. DMPA injections taken more than 2 weeks late 
6. Miscalculated dates of last period and present ovulation side effects 
These are meant only for emergency contraception and NOT AS A REGULAR CONTRACEPTIVE. It involves pumping of a hormone inside your body at levels which are 5 times higher than normal. hence excessive and unnecessary use may cause irregularity in the period cycles and an adverse effect on the menstrual health over a period of time. Ideally it should be taken under guided medical supervision.


In what situations should emergency contraception be used?

Emergency contraception can be used after a sexual intercourse. These include:

In case of no use of contraceptives

If it is a case of rape or coerced sex, where the woman was not protected

When there is a contraceptive failure, like

breakage

incorrect use or slippage

OCPILLS,

mini pills

DMPA

3 or more missed combined oral contraceptives, progestogen-only pill (minipill) taken more than 3 hours late, desogestrel-containing pill 12 hours or more, norethisterone enanthate (NET-EN) progestogen-only injection taken more than 2 weeks late

Delay in placing or dislodgement or early removal of the skin patch or the hormonal ring

Breaking, dislodgement, tearing or early removal of cervical cap or diaphragm

Failure of withdrawal that is ejaculation the external genitalia or vagina

The spermicide tablet failure

Miscalculating the periods, failure from using a barrier on the fertile days

Expulsion of an intrauterine contraceptive device (IUD)

Methods of Emergency Contraception:

There are three emergency contraception methods:

Copper-bearing intrauterine devices (IUDs)

Emergency contraception pills (ECPs)

Combined oral contraceptive pills or the Yuzpe method



Safety of Emergency Contraception

Infertility is a very common problem among both men and women and it refers to the inability to conceive even after regular unprotected sex. The causes of this can be varied and some of the most prominent ones are:

Causes in Women:

1. Polycystic ovarian syndrome

PCOS is a medical condition in women in which they do not ovulate. It is a major cause of infertility in most women. It can often result in irregular menstruation and an increase in the release of male hormones in the female body. This causes male symptoms like the growth of a beard, hoarse voice etc. in females. The probable causes of this condition comprise being over or under weight, thyroid imbalance etc. It is possible to treat this condition with medical aid and weight management can also prove to be helpful.

2. Lack of sufficient healthy eggs

As you grow in age, the number and health of your eggs decline significantly. This could be a possible reason for your infertility. In this condition, optimizing egg health by maintaining a healthy weight and quitting alcohol and cigarettes can help you get rid of your infertility.

3. Blockage of the fallopian tubes

Blockage of or damage to the fallopian tubes causes the tubal factor that is responsible for infertility in women. The tubal factor can also be a result of endometriosis or any sexually transmitted disease like Chlamydia etc.

Causes in Men:

1. Ejaculatory disorders

Retrograde ejaculation, premature ejaculation, and other issues associated with ejaculation may cause infertility in men. In retrograde ejaculation, the semen enters the bladder instead of emerging out of the penis during orgasm. In premature ejaculation, the ejaculation occurs before the vagina is prepared to receive the semen.

2. Chromosome defects

Disorders like Klinefelter's syndrome can cause abnormal growth of the male reproductive organs resulting in infertility. Other such syndromes include Kallmann's syndrome, Karatagener's syndrome, cystic fibrosis etc. These conditions are mostly genetic.

3. Hormonal imbalance

Male infertility can also be a result of hormonal imbalances like hypogonadism (low testosterone levels), disorders of the testicles, abnormal functioning of the pituitary, thyroid, adrenal and the other glands as well.

6 Common Causes of Infertility That are also Curable

An STD or sexually transmitted disease is usually an infection which spreads from one person to another during sexual contact. Some STDs can also be transferred through touch, since they spread by skin contact. People hardly like to talk or discuss about STDs, but it is very important to rule out the possibilities of STD. Whether one likes it or not, if STD testing is ignored, then it can lead to long term consequences.

Why STD Testing is Important

Often STDs have no signs and symptoms, and the only way to know that are you suffering from an STD is to get tested for it. So it is a good idea to get yourself tested, as you never know if you might have STD even though you don't show symptoms. Also, when STDs are diagnosed, most of them can be cured.

Consequences of Not Getting Tested

If one has STD and is not getting tested for the same, then it could lead to health problems which can cause permanent damages or might prove to be fatal. Some of the problems are:

1. Undiagnosed and untreated STDs can lead to damaged reproductive system, leading to sterile men and women. 
2. Chlamydia, if untreated can lead to epididymitis and shrinkage of testicles and infertility in men. It also leads to pelvic inflammatory disease. But good news is, it can be treated easily.
3. Syphillis can make a person blind and deaf, and can also be passed on to babies. 
4. Gonorrhea, which can also be treated easily with antibiotics, can lead to infertility or death if untreated. 
5. Even HIV/AIDS if diagnosed in early stages can enable the patient to lead a normal life and does not mean only death, contrary to conventional perceptions.  

Symptoms of STD

While, gonorrhea, chlamydia and human papilloma virus (HPV) have no symptoms, the common symptoms of STDs might vary. 

1. In women, the common symptoms are pain and burning sensation during urination, blood in vaginal discharge as also abnormal vaginal discharge, abdominal pain, blisters, warts, and swollen glands. 
2. Men often experience inflammation of the testicles, prostate, sores, fever, urethral discharge and pain during urination.

If these symptoms are observed, it is vital to get tested for STDs. Also the best way to protect your partner is not to practice unsafe sex and to refrain from the same until diagnosed and treatment is complete.
 
Getting yourself tested for STD is also beneficial, as it can prevent against complications like cancers and infertility. The standard STD panel of tests consists of Herpes IgG antibody and HIV antibody blood tests, along with a blood test for syphilis antibody and DNA urine test for gonorrhea and Chlamydia.

The Dangers of Putting Off STD Testing

Genital warts refer to small (sometimes invisible), cauliflower shaped bumps, which form around the genital region and severely affect the moist tissues around the concerned region. Genital warts are more common in sexually active people and are one of the most commonly transmitted sexual diseases. The virus responsible for the disease, Human Papillomavirus can also cause other serious disorders such as genital cancers.

Genital warts can occur in both the genders. The virus generally spreads through sexual intercourse. In men, warts appear around the scrotum, the tip of the penis or the anus. In women, warts might form around the vaginal walls, the cervix or around the anal canal. If you had any form of oral contact with the genitals of an already infected person, genital warts can form around your throat or mouth.

The symptoms of genital warts are as follows:
1. Severe itchy sensation and discomfort around the genital areas.
2. Bleeding during sexual intercourse
3. Formation of numerous small, grey bumps around the genital region
Genital warts are caused by genital HPV s, which are transmitted, primarily through sexual contact. In most of the cases, the immune system is able to combat the virus and makes you less susceptible to this disorder.

However, you might be at an increased risk of developing genital warts because of the following reasons:
1. Engaging in unprotected sex, that too with different partners.
2. Past history of other sexually transmitted infection
3. Being sexually active from an early age
4. Having unprotected sexual intercourse without being aware of one s medical history

The treatment for genital warts depends on the severity of the condition. If the warts are causing significant pain and discomfort for you, your doctor might opt for one of the following procedures to get rid of the same:
1. Application of Imiquimod creams around the affected area might help treat the condition.
2. A regulated application of  Trichloroacetic  acid on the affected areas might help to burn off the genital warts.
3. Application of a solution of  Podophyllin  on the affected areas might help destroying the soft tissues around the genital areas.
4. If your warts are significantly large in size or do not respond well to medications, you can also opt for surgical excision or laser therapies to get rid of them

What Can be the Possible Reasons of Gential Warts

Masturbation is considered as a good way of pleasuring oneself and leading to a more qualitative sex life. Masturbation is a sexual activity that is at par with sexual intercourse that will create a basis for an improved sex life. This will ensure that the need for sex is one that is based on respect and love, rather than a mere bodily function. Let us find out how it helps in having a better sex life:

Awareness: masturbating is also a great way to know more about your own sexual preferences and what you like in terms of sexual activities. This awareness helps in better understanding and channelling ones sexual appetite for even better gratification during intercourse.

Staying healthy: masturbating can help in releasing even more dopamine and oxytoxin, both of which have a favourable effect on your brain and mood. These hormones can also help in improving your immune system in the long run.

Knowing your partner: masturbating alone and with your partner can help in knowing your partner and his or her sexual preferences. This can help in pleasuring your partner in a better way which will further fortify the relationship.

Excessive masturbation is strongly recommended as it has its long-term side-effects:

1. The use of sex toys and other accessories can further your satisfaction level. For instance, realistic vaginas can prove to be pretty handy in maximizing your sexual potency. Other credible sex toys are also available which are as helpful. Another effective technique of masturbating better is via porn or r-rated movies. By simultaneously watching movies while masturbating, your imagination gets fueled up with all kinds of sexual fantasies, providing you with more immediate satisfaction than usual.

2. A change in position is also pretty effective in heightening your senses and providing a better feel whilst masturbating. Keeping your hand still and only moving your body is such a way. While doing this, you can masturbate while kneeling or standing or sitting or even swapping hands. The more the variety, the better. Moreover, interchanging positions in between has also been proved to be very effective.

Masturbation: For A Better Sex Life

Spread of HIV infection from a woman who has transmits HIV to her child during pregnancy, childbirth (labor and delivery), or breastfeeding (breast milk) is called as  Mother to child  transmission (MTCT) of HIV. It is also termed as the perinatal transmission of the HIV infection or  vertical  transmission. In the absence of medical intervention, perinatal transmission rates are very high, between 20-45% in different parts of the world. In various regions of the African subcontinent a large number of HIV infected children are present. It is a major cause of deaths in teens and adolescents in that region. 

Almost 90% of all HIV infected children live in the sub-Saharan Africa. In some districts of AP, Karnataka, Maharashtra and TN that were highly HIV-prone, we have several HIV infected children and adolescents. The virus replicates in the body and affects the immune system. Due to decreased immunity, various opportunistic infections enter the body and cause AIDS related symptoms. Prevention of HIV infection in infants and young children is now a high priority and has been the rallying point for enhanced prevention efforts. MTCT HIV infection can be prevented with adequate measures by way of Anti-retroviral treatment (ART). All expecting mothers who are HIV infected should have access to the preventive medical services throughout the gestation period, during labor and also during breastfeeding. 



Proper provision of resources with skilled staff and awareness programs can help in avoiding new infection cases. Breastfeeding is the primary source of transmission of infection from mother to child. Basically, once ART is started in an HIV infected pregnant woman that should continue forever. With proper ART course, chances of MTCT are near Zero. At the Unison Medicare & Research Centre; which is India s first fully comprehensive clinic for HIV Care and infectious Diseases, during last decade, not a single MTCT has occurred after treating more than 160 such HIV infected mothers. Even prior to that MTCT rate was lower than 1%. Our motto has been making the mothers virally suppressed commensurate with the global principle of  Undetectable = Untransmittable ! In fact now more and more HIV infected couples have been coming forward for an elective pregnancy. Even HIV un-infected children orphaned by AIDS or living with sick caregivers are at the great risk of emotional and physical abuse, which in turn increases the child s vulnerability to HIV infection. 

Reduction of risks to these vulnerable children is of great importance and various programs are being implemented for the welfare of orphans and vulnerable children. Various risk factors that are implicated in the transmission of HIV infection from mother to child are as follows: 

Increased viral load 
Genital tract viral load 
Reduced CD4 cell count 
Unprotected sexual intercourse with infected partner 
Smoking, Substance and drug abuse 
Deficiency of Vitamin A and other essential nutrients 
Presence of other Sexually transmitted diseases (STDs) 
Pre-term delivery 
Placental disruption 
Invasive monitoring of the fetus 
Breast feeding In most cases, HIV will not cross through the placenta from mother to baby. 
In an otherwise healthy mother, risk of child getting infected is low. Prenatal visits shouldn t be increased until a complication arises. The physician should observe symptoms of AIDS and pregnancy-related complications on a regular basis. HIV may be the direct cause or a marker of a complex interaction of related medical and social conditions that affect pregnancy. Most HIV positive women are usually asymptomatic and have no major obstetrical problems during their gestation period. They should receive similar obstetric antenatal care as the HIV-negative women, unless indicated by the need to provide specific treatment for HIV related conditions. There is no evidence of a need to increase the number of antenatal visits, provided there are no complications of the HIV infection, although additional counseling sessions may be required to reassure the mother and family. 

Care of the HIV positive woman during pregnancy should include ongoing counseling and support as an integral part of the management. Invasive diagnostic procedures, such as chorionic villus sampling, amniocentesis or cordo-centesis should be avoided wherever possible, due to a possible risk of infection of the fetus. In case you have a concern or query you can always consult an expert & get answers to your questions!

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