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 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.

Recurrent Miscarriage - How to Deal With It?

Vaginismus is a condition characterized by significant pain in the vagina generally during sexual intercourse. This pain occurs on penetration due to the contraction of the vaginal muscles.

Causes

The exact cause of Vaginismus is not exactly known to the doctors. But some researchers suggests that the pain might result from severe anxiety or illogical fears before sex.

Vaginismus can be primary or secondary depending on the concerned woman s previous sexual experiences. Vaginismus can be linked to an earlier sexually painful experience, sexual trauma or psychological factors. In some cases, the pain tends to exist without any direct physical cause. The causes of the pain might vary from women to women and might occur in some cases with only one specific partner and not with others.

Sometimes the pain might stem from underlying infections or any other underlying complications.

The symptoms of Vaginismus are as follows:

Severe pain during intercourse.

Severe pain during insertion of tampons or during any medical check-ups.

The following treatments can be useful to treat Vaginismus:

If the pain arises due to anxiety or fear, counselling sessions can help you to a remedy.

If the pain arises whenever something penetrates the vaginal walls, progressive desensitization can be useful to treat the pain. The process aims to loosen the vaginal muscles so that you don t experience any pain during sexual intercourse.

Kegel exercises (at least 20 of them) can help in the initial stage to relax the vaginal muscles. After you exercise for a few days, you should try inserting one finger inside your vagina while doing the exercises. Try doing it gently and if it still hurts, try doing it with a lubricating jelly. This continuous procedure will help in the contraction of the vaginal muscles which eventually relax.

Vaginismus - Things You Should Be Aware of 

Polycystic Ovarian Syndrome or PCOS is referred to as a condition that leads to an imbalance in the hormonal levels of women between the ages of 18 to 44. Women suffering from the syndrome develop small cysts in the ovaries. These cysts might disrupt the normal functions of the ovaries resulting in hormonal imbalances. If you suffer from PCOS, the secretion of the male hormone androgen (which is present in a small amount in every female) increases abnormally, thereby causing a significant disruption of the ovulation process and the menstruation cycles.
Causes:
Women suffering from obesity or who have a past history of PCOS in their families are at a higher risk of suffering from the syndrome.
Symptoms:
The symptoms that one might experience along with syndrome are as follows:
Appearances of acne along with the development of excess body and facial hair.
Irregular or no periods.
Problems with conception and infertility.
Intense pain in the pelvic area and severe depression.
Homeopathic Treatment for PCOS:
Polycystic Ovarian Syndrome is curable with the Homeopathic mode of treatment. Homeopathic treatment for polycystic ovarian syndrome is very safe and free from any side effect.Which Homeopathic medicine is required to extract the disease from its roots varies from case to case. Both the physical and mental spheres of the patient are thoroughly investigated while prescribing the Homeopathic medicine. The complete cure of PCOS is a time-consuming process and it cannot be expected in a few days. It requires complete observation regarding the change of symptoms in the patient and frequent clinical follow-ups. Some of the most beneficial homeopathic remedies for PCOS are:
Sepia   Useful for the symptoms of severe pain in the lower back and abdominal areas along with abnormal menstrual periods.
Apis Mellifica  This homeopathic preparation is effective in relieving the symptoms of severe pain in the ovarian regions along with tenderness in the abdominal and uterine areas caused by PCOS.
Pulsatilla   This medication is very effective in treating symptoms of PCOS such as late and minimal menstrual periods along with rapid mood swings, irritation and a decreased sensation of thirst.
Sulphur   This homeopathic preparation is very useful if there is a presence of severely itchy and painful acne along with other skin related symptoms of PCOS.
Natrum Muriaticum   This homeopathic preparation is useful if you experience significant problems with conception along with irregularity in menstrual cycles, along with an excessive craving for salt in the regular diet, unwillingness towards sunlight exposure, and intense episodes of crying and uncharacteristic shyness.
Graphites   If you are of a stout build or are overweight and regularly suffer from constipation along with PCOS, graphites are one of the best homeopathic medications to relieve symptoms and treat this condition.
These are just a few of the commonly used Homeopathic remedies and are mentioned only to create awareness about the effectiveness of Homeopathic medicines for PCOS. It is not advisable to resort to self-medication for any disease.


Homeopathy for PCOS 

Endometriosis is a painful condition where the endometrium tissue lining the walls of the uterus, grows as implants outside the womb of the patient. This can lead to a number of painful conditions and is often considered as a common cause behind severe pelvic pain, as far as women are concerned. Here is all you need to know about endometriosis and pelvic pain.

 Painful menstruation: depending on the stage of the condition, the implants could remain on the surface or go deeper into the ovaries which may cause acute and severe problem during ovulation as well as the menstrual cycles. This is one of the symptoms that one must not ignore. If you are having painful cramps that affect the pelvic area and the abdomen, and if these cramps last throughout the duration of the cycle, then there are strong chances that you are experiencing the pain that comes with endometriosis. 
 Pain during and after intercourse: while there are many reasons why women may face pain during intercourse, it may be noted that vaginal and pelvic pain that come during and after intercourse could point towards the presence of endometriosis, which is causing irritation and discomfort due to the implants. 
 Bowel movements and urination: usually, pelvic pain may trickle down to and also get activated by the bowels when there is a motion as well as urination. This is a common problem that can cause pain, which spreads throughout the region if the patient is suffering from endometriosis. 
 Bloating and other symptoms: when the abdomen and nearby regions face bloating due to the implants and their painful spread, the pelvic region as a whole bears the brunt in terms of severe pelvic pain. The bloating and other symptoms like loose motions and constipation can also create pain in the abdomen and pelvic region on a persistence basis. Sharp pains may also shoot up and down the lower back due to such symptoms which should not be ignored if they do not abate within a few days. 
 Misdiagnosis: many times, the bloating and pelvic pain may be linked with pelvic inflammatory disease, which causes pain in the muscles and joints. But if you are having pain in the abdomen as well as problems during your menstrual cycle, then it may be helpful to have the tests for endometriosis done as well. 

In order to diagnose the condition, the doctor must ensure that proper imaging tests like mri and ct scans as well as an ultrasound with lab tests based on blood samples have been conducted. The pelvic pain that comes with this condition can be treated with the help of pain relievers like ibuprofen and aspirin.

Could Your Pelvic Pain be Endometriosis?

Diabetes during pregnancy is known as gestational diabetes. It is interesting to note that the chances of getting gestational diabetes, is one of the most common complication of pregnancy. It has increased by almost 40%. Also, gestational diabetes not only affects the health of the mother, but also the health of the baby. What usually happens with gestational diabetes is that the blood sugar level, of both the mother and the baby go above the normal level. Ayurveda can help treat this disease. Here are the most common Ayurveda remedies for gestational diabetes.

1. Gurmaar
Gurmaar, called "The Sugar Killer" is also known as Gymnema sylvestre in medical jargon. Gurmaar also contains gymnemic acid molecules, which are crucial because they have an anti-diabetic effect. They work by combining with glucose molecules, which are in the blood stream. These stop the glucose from entering the bloodstream. 

2. Karela
Karela is commonly known as bitter gourd and its biological name is Momordica charantia. It has anti-diabetic properties and also contains many other micronutrients, which are crucial in preventing the complications which arise from gestational diabetes.

3. Vizaysaar
Vizaysaar comes from the bark of a tree whose biological name is Pterocarpus marsupium. It is very useful for diabetes. If you immerse the wood of Vizaysaar in water overnight and then drink it, your blood sugar levels are expected to fall.

4. Saptrangi
Saptrangi is biologically known as Salacia oblonga. Just like Vizaysaar, it is a tree whose bark is immersed in water and then drunk by the patient suffering from diabetes. You will know that the water is ready for drinking when it turns brown, which usually happens overnight. It is also being studied in Western herbal schools in addition to Ayurveda nowadays.

5. Tulsi
Tulsi is a holy plant in Hindu mythology and is known as Ocimum sanctum in biological terms. It is worshiped as a holy plant because it has tremendous medicinal properties including treating many types of cancers, cough, cold, sore throat as well as reducing blood sugar.

6. Ashwagandha
The medical name for ashwagandha is Withania somnifera. It is another great remedy for diabetes.

Ayurveda and Gestational Diabetes

Vaginismus is a condition where vaginal contractions and squeezes may be caused due to pain during intercourse or due to the insertion of objects like tampons. This mildly uncomfortable condition is also characterised by spams and other symptoms like the feeling of coming up against a thick wall which can cause pain. This may be due to a variety of reasons starting from infections to anxiety. To a large extent, the treatment of this condition depends on the cause. Following are the various ways in which this condition can be treated.

    Sex Therapy: A sexologist or an expert who specialises in psychosexual medicine can help in treating this condition by conducting a series of counselling sessions where psychoanalysis will help in understanding and unravelling the cause of the condition. This may be followed by CBT or cognitive behavioural therapy. This kind of therapy usually helps in reprogramming the brain after the root cause for the condition is known. 
    Exercises: During sex therapy, the doctor may also teach you various kinds of exercises and vaginal trainers that can help you in strengthening the pelvic floor and relaxing the muscles as well. These vaginal trainers are especially helpful in equipping you suitably so that you can relax your vagina and let the insertion happen. Vaginal trainers consist of four smooth balls of plastic which can be inserted with the help of lubricants to help in stretching the vagina. 
    Relaxation: Getting yourself to relax is also a matter of exploration and touching, which can help you understand the kind of touch and the exact areas that make you tense. During sex therapy, you may be taught a technique known as progressive relaxation. This mode includes tensing and relaxing your muscles as you explore by inserting a finger. 
    Sensate Focus: This is a part of sex therapy and involves your partner. In this method, you will be asked to abstain from sex and touch each other without going to the genitals and other private parts. This will help in better arousal and sexual stimulation.
    Surgery: The last option for treating a very severe form of this condition is to put the patient through surgery which will seek to remove endometriosis, as these growths in the womb's lining can cause a lot of pain during intercourse. Also, vaginal enlargement surgery can be carried out with the help of episiotomy. 

This kind of procedure usually helps in fixing the scar tissue that may have been left from a previous procedure, which can restrict or block the vaginal path. Getting help at the right time for this condition is of great importance so as to have a normal sex life.

How to Treat Vaginismus

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