Almost every man and woman craves to have a child they can call their own. This makes an inability to procreate one of the most dreaded situations. Infertility can be defined as the inability to conceive a child within 12 months of biologically appropriately timed intercourse. Infertility exacts a huge psychological toll on the person.

Infertility often triggers depression in a person. This may be acute and result from specific events such as the holidays, family celebrations of the news of a someone else having conceived a child or could be cyclic and coincide with phases of their fertility cycle. This depression could lead to problems at work and communication with the spouse.

Infertility can also make a person feel helpless and affect their self esteem. Infertility accompanied by depression can trigger the feeling of having lost control over one s life and can make people withdraw into themselves.

An infertile person may also often feel guilty and make them blame themselves and their prior actions for the condition. This leads them to question their worthiness of being a good spouse and potential parent. A woman who has suffered from an STD earlier or has undergone an abortion earlier can become obsessed with blaming herself for being infertile. 

This affects their daily lives and ability to work. An infertile person may also feel guilty for having robbed their partner of the chance to become a parent. This can put a strain on their relationship and in many cases lead to a broken marriage.

When they find themselves unable to conceive a child, a couple may try to time their intercourse with ovulation tools, such as an ovulation thermometer etc. and may try different positions, some of which may be fairly uncomfortable. They may also end up having intercourse more often than desired. In order to prevent sperm from leaking out of the vagina, a woman may also find herself lying in an awkward supine position after intercourse. A combination of all these factors makes the act a chore and with time can lead to a loss of libido.

Infertility can also trigger anger against life for having been treated unfairly or towards other parents. This may also be displaced towards their family and friends leading to situations where they feel ostracized and unsupported.

When dealing with infertility, it is important to understand that neither partner is to blame. Infertility is a physiological condition and can be treated in most cases. It is important for both partners to support each other during this process and if need be consult a counselor.

Infertility - Its Impact on a Person's Mental Health

Most medications are used because of their one particular therapeutic effect. However, invariably, they affect other organs or systems and produce some good and some adverse effects. The same happens with birth control pills (BCPs), which are the most commonly used method of contraception. It is also the most effective method. It contains the female hormones estrogen and progesterone in various combinations and these have an effect on various body functions, so it should come as a surprise that regular use of BCPs leads to a number of side effects.

Read on to know more

Intermenstrual bleeding: This is the most common side effect and occurs in about 90% of the women, but usually subsides within 3 months. They experience bleeding between their regular periods. While mere spotting can be ignored, bleeding for more than 4 to 5 days needs a visit to the doctor.
Missed period: It is very essential to take the pill at the same time daily. Sometimes, a period might be missed or may be very light and this should be reported.
Effect on libido: While some report a decrease in libido, there are others who experience an increased sex drive. This depends on the individual and not consistent.
Vaginal discharge: The amount and type of discharge can change when on the pill. Decreased lubrication may lead to a reduced sex drive, as it might be painful. If the discharge is foul-smelling or looks suspicious for an infection, then a doctor should be consulted.
Mood changes: Changes in mood and prominent mood swings are very common in women using contraceptives, with many feeling depressed often.
Effects on breasts: While it is not yet proven if they increase the risk of breast cancer, most women experience breast enlargement, tenderness, and sometimes pain. This is more common in between their periods.
Headaches and migraine: BCPs are also proven to have worsening effects on migraine and headaches.
Circulatory effects: Oral contraceptives increase the chances of heart attack and stroke, especially in women who are over 35 and are smokers. Most women experience a slight increase in blood pressure and are more prone to form blood clots. It is essential that contraceptives are used under medical guidance only.
Digestive effects: Oral contraceptives can cause loss of appetite, changes in body weight, diarrhea, and nausea. The weight gain is also attributed to increased fluid retention, especially in the hip and breast areas.
Skin: Some women may experience skin rashes and acne and sometimes hair loss due to the increased level of hormones in circulation.
It is very important that the pill is taken at the same time for best results. Any suspicious symptom should be immediately reported to the doctor.

10 Side Effects of Birth Control Pills

Female infertility is considered as the inability of conceiving. As per WHO it is described as the inability to be pregnant, maintain and carry forward a pregnancy to its full term. It is often of two types:

    Primary Infertility: This is the inability to give birth to a baby either due to the inability to become pregnant or maintain a pregnancy, which includes stillborn and miscarriage.
    Secondary Infertility: This refers to the inability to give birth when there is already a live birth or the woman was pregnant.

The causes of infertility can vary from being acquired or genetic. However, following factors are largely responsible for infertility:

    Genetic: Some genes can lead to mutation leading to infertility like, in case of BMP15 gene there is a hypergonadotrophic ovarian failure which causes infertility.
    Acquired: This is caused by factors like age, smoking, sexually transmitted diseases, obesity, body weight, eating disorders, diseases like diabetes, thrombophilia and also radiation and chemotherapy.

The treatment for infertility usually depends on the cause, age, duration of time for which a person has been infertile and preference of the patient. Infertility is believed to be a complex disorder and the treatment involves a huge amount of physical, financial and psychological commitments. All this also requires a lot of time. Some women might need just a minimum of two therapies to attain fertility while others might require different treatment before they can conceive.

Treatment is largely aimed to restore the fertility either by means of medication and surgery or help in reproduction with the help of some procedures.

Fertility Restoration through medication

This is the main treatment for women who are infertile because of ovulation disorders. These drugs include:

    Gonadotropins: These are injected to stimulate the ovaries. Drugs like Menopur, Repronex, Follistim AQ, Gonal-F, Bravelle restore the production of eggs, while Ovidrel and Pregnyl are used for maturing the eggs and for their release.
    Clomiphene citrate: This is taken orally and stimulates ovulation by releasing more Follicle Stimulating Hormone and Luteinizing Hormone from the pituitary gland.
    Metformin: This is used in females who have PCOS and also when insulin resistance plays a major role in infertility.
    Bromocriptine: Used when the infertility is caused due to excess prolactin production.
    Letrozole: This also induces ovulation

Fertility Restoration through surgery

Surgical procedures can amend the problem of infertility. However, these treatments are very rare these days owing to the success of other fertility treatments. These include:

    Tubal ligation reversal surgery: In case a tubal ligation has been performed it can be reversed by reconnecting the tubes again through surgery.
    Hysteroscopic surgery: This corrects or removes the abnormalities that cause infertility. This surgery can correct the shape of the uterus, remove endometrial polyps and improve chance of getting pregnant.
    Tubal surgeries: In case of blocked fallopian tubes laproscopic surgery can be performed to dilate the tubes, removed blockages or create a new opening.

Assistance in Reproduction through techniques

The most common used techniques for reproduction assistance are:

    Intrauterine insemination or IUI: In this about million healthy sperms are put in the uterus at the time of ovulation.
    Assisted reproductive technology: In this mature eggs are retrieved from a woman and this is then fertilized with sperms in a dish in the lab. Once the fertilization is done the embryo is placed in the uterus for further development. IVF is the most common and effective assisted reproductive technology. This procedure takes place over weeks with several blood tests and hormone injections.

Dealing with infertility is not easy and can be emotionally and physically draining. To cope with the various tests and treatments of infertility one should be fully prepared, eat a healthy diet, exercise reach out for help and support of family and friends and look for other options like a donor egg, adoption or no children.

Treatments of Infertility

In today's time there are various factors, which affects our relation with our partner and among such factors is low libido. Low libido or a decreased sexual activity can affect a relationship in a big way. In some extreme cases, the impact is such that it leads to irreconcilable marital discords. Time and again, an individual, irrespective of their age, sex or occupation can go through periods of low libido. Decreased sexual desire over a longer period of time needs thorough investigation. It could be an indication of something big and serious lying ahead. 
7 critical factors that attribute to low libido: 

1. Hormonal imbalance: women, mostly menopausal and postmenopausal, experience low libido. This is because during menopause, there is a significant drop in the oestrogen level. Reduced oestrogen level can have a huge impact on sexual desires and performance. It can also make the vagina dry, resulting in painful penetration and intercourse. Hormonal imbalance or changes during pregnancy can also result in low libido in females. In males, low libido has been found to be associated with decreased levels of testosterone. 

2. Stress: an individual's mental and emotional state is greatly reflected in their sexual performance. A sound mental health can enhance a performance thousand folds. On the contrary, factors like depression, anxiety and stress, lowers the sexual desires in a person. To enjoy a healthy and normal sexual life, it is important to keep stress and chronically blue moods at bay.

3. Sound sleep to the rescue: the benefits of a sound sleep are beyond imagination. A good 6 - 8 hours of sleep can do your sexual desires or libido a world of good. A sleep deprived soul will be agitated and cranky, both on and off the bed. Continuous sleep deprivation can also lower the testosterone level, resulting in low libido.

4. Medical condition: medical conditions like diabetes, cardiac problems, high blood pressure, or ailments of the coronary artery can rupture an individual's sexual life immensely. Improper functioning of the thyroid glands is another factor contributing to low libido. In such cases, it is best to consult a physician at the earliest. Rest legs syndrome can also contribute to low libido. It is a condition whereby, a male experience an uncontrollable urge to move his legs.

5. Smoking: a killer habit, which affects a person's sexual activity is smoking. Drug abuse and drinking (to some extent) can be equally responsible for a low libido.

6. Change in weight: a sudden change in body weight (gain or loss) can play a significant role in low libido. Take pride in your body structure. There is nothing to be ashamed of.

7. Take a break: boredom can mask your sexual life greatly. Break the monotony, take short breaks, go on vacations and low libido will be a thing of the past.

7 Things That Might Be Causing Your Low Libido

Chlamydia is a very common STI caused by bacteria. Those patients who are suffering from chlamydia usually don't see the side effects in the early stages, which makes it that much more difficult to diagnose it. Chlamydia can bring about a lot of severe problems in the later stages. These include not being able to get pregnant later or causing dangers in pregnancies. This disease is often easily spread since it shows no noticeable symptoms and can be passed on the partner very easily. 75% of the infection in women and 50% of the infections in men cannot be noticed and are without any symptoms.

Symptoms: Since the side-effects are not always visible, when they do happen, they are normally recognizable within one to three weeks of contacting and include the following:

In women these are:

    Vaginal discharge with strong odour
    Abnormal bleeding during periods
    Excruciating periods
    Stomach pain with fever
    Pain while engaging in sexual activities
    Burning around the vagina
    Pain during urination

In men:

    Cloudy discharge from the tip of the penis
    Excruciating pain while urinating
    Burning around the opening of the penis
    Swelling and pain in the testicles

Treatment: Chlamydia is easily treatable. Since it is bacterial in nature, it's treated with anti-infection agents. Following are some of the most common treatments for chlamydia in men as well as women:

1. Azithromycin is an anti-infection generally recommended in large dosage, yet the dosage may be spread out more than 5 days.

2. Doxycycline is an anti-microbial that must be taken twice every day for around one week. Your specialist may recommend different anti-infection agents.

Regardless of which antibiotic you are given, you should follow the dosage guidelines properly to ensure the infection is cured completely. This can take up to two weeks, even with the single-dosage medications.

Try not to engage in sexual relations while your treatment is going on. Unfortunately, you can get chlamydia again in case you're uncovered, regardless of the fact that you've had it and it was treated.

Women with extreme chlamydia infection may require hospitalisation, intravenous anti-microbial and painkillers. Your doctor might use a few tests to diagnose chlamydia. He or she will probably take samples from your urethra and cervix and then send it for further analysis. There are also other tests that include urine samples for presence of bacteria. Sometimes, even blood tests are taken depending upon your symptoms or in case the doctor is not able to diagnose it with previous methods and tests.

After taking the medication, individuals should get a follow-up on the treatment after three months to make certain that the disease is cured. This is highly important in case you are not sure whether your partner has been treated or not.

How to Treat Chlamydia in Men and Women?

Knowing premature ejaculation - part 3: management and techniques (non-medical methods)

As shared in part 1and 2 of this series, because of premature ejaculation (pe), both the partners may end up experiencing highly unsatisfactory sex. In fact, it can increase anxiety, which may deteriorate the problem. 
Remember there is not a single magical drug or medicine in the chemist shop which can solve your problem overnight especially if you have chronic pe. Before seeking any medical treatment for pe, it is appropriate to consider the varied options for solving this issue. These include counseling with a sexual therapist, non- medical treatments like various exercises/ techniques and medical treatments including both modern and alternative medicine.

A. Counseling from an expert - sexual therapist or sexual medicine practitioner:
It is well understood that sex is in the mind. However, repeated pe/ failures can lead to lot of stress and disappointments. Anxiety due to pe itself is a big issue and can lead to recurrence of pe.
Reassurance from sexual therapist / counselor that pe is not a disease and can be easily treatable is relaxing for men who are facing this problem. So please share your detailed history and sexual habits with the expert. This may help the expert to guide you well.

B. Behavioral changes:

Some basic things may also help you to deal with the problem. 

1. Some men attempt to treat themselves for premature ejaculation by distracting themselves by thinking nonsexual thoughts (such as naming cricket players and records) to avoid getting excited too fast when approaching their partners. This helps them to focus their attention away from the sexual stimulation.

2. It is also suggested to men that they should relieve themselves of the sexual tension by ejaculating with self masturbation 1-2 hours before attempting sexual intercourse with their partner.

3. Using condoms is known to help in premature ejaculation in some men by decreasing sensation.

4. Women on top position usually helps to delay orgasm in men

 
C. Exercises &amp; techniques:

There are several exercise and techniques you can try sitting in your home.

1. The" stop and start" method:
This technique involves sexually stimulating the man by self until he feels like he is about to reach orgasm. Then he needs to stop the stimulation for about 20-30 seconds and then start it again. Repeat this pattern until the man wants to ejaculate. This can be continued for 10-15 minutes. At the end of say, 10th or 15th minute, continue stimulation until the man reaches orgasm and ejaculates.
2. The" squeeze" method:
 This technique involves sexually stimulating the man by self or by his partner until he recognizes that he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glans penis meets the shaft) for at least 15 seconds. Stop sexual stimulation for about 60 seconds, and then start it again. The person or couple may repeat this pattern for at least 10-15 minutes. At the end of say, 10th or 15th minute, continue stimulation until the man reaches orgasm and ejaculates.
3. Practice breathing exercises 

Deep breathing can greatly help in controlling the arousal and tension that cause early ejaculation. Men must avoid shallow breathing as it can trigger premature ejaculation. Instead, what you should do is spend 5 seconds taking in a long deep breath; then hold it for 3 seconds and then exhale for the next 5 seconds. If you can do this for 5 minutes in the bedroom without pause then you can control premature ejaculation.

If you would like to consult with me privately, please click on'consult.

Knowing Premature Ejaculation - PART 3: Management and Techniques (Non-medical methods)

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