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

Roti vs. Rice- What should you have your meals with?

The nutritional conflict between rice and roti is age-old, as primary staples of every Indian cuisine.  White rice and wheat chapattis are both infused with considerable amounts of protein, calorie, fat as well as fibre. This overlap makes it tougher to choose just one as an accompaniment with your meals.
The health-conscious can take a sigh of relief with this list of effective benefits of the two. Let’s pit them against each other!

#1: If you opt for a lighter meal…Choose rice!
Boiled white rice is easier to chew and digest as it is low in fibres. For those with issues of diarrhoea, colitis, an upset stomach or morning sickness, rice is a favourable choice. If you are suffering from chronic gastrointestinal distress, rice is recommended for you.
Tip- You can consume a bowl of steamed rice with sautéed vegetables for a wholesome meal!

#2: If you are looking for muscle growth…Choose roti!
Rotis is the best food accompaniment for vegan and vegetarian bodybuilders. At home, you can mix variants of whole grains to harness the benefits of calcium and other minerals. Wheat chapattis made of whole grain consist of complex carbohydrates that boost your energy.
Tip- For reducing your portions, have two servings of roti (without ghee) with a large bowl of home-cooked yellow dal.

#3: If you have a heart condition… Choose rice!
For you to keep your heart healthy, the consumption of rice is vital. Brown as well as white rice is full of fibres and high in magnesium, niacin, phosphorus that can prevent heart problems.  Rice helps you in lowering bad cholesterol levels.
Tip- Substitute your regular white rice in the khichdi or biryani recipe with brown rice. (Contains fibrous bran and germ layer)

#4: If you want to feel fuller… Choose roti!
For weight watchers, who want the feeling of satiety for longer period should include rotis in their meal. Wheat rotis take longer to digest which helps in maintaining blood sugar levels. This quality also makes it a good alternative for diabetic individuals. Wheat rotis are nutritious and contain vitamins B1, B2, B3, B6 and B9 that help in keeping you strong.
Tip- While kneading the wheat dough for the rotis, you can add soya powder to increase its protein content.
To escape the dilemma of choosing between these two healthy and tasty staple sides, try switching to whole-wheat rotis and brown rice. Savour both, guilt-free!

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

 Roti vs. Rice- What should you have your meals with?

Infections of the vagina, cervix and uterus

Vaginal problems are very common and a little awareness can enable women to take care of this delicate region of their body. Vaginal infections are the most irritable and hurtful and lack of education on the same makes it difficult to prevent them; from burning and itching to unpleasant odour, most women have faced these infections at some point of their lives.

Here are few points you must know about to stay clear of these infections.

1. Vaginal infections: vagina contains bacteria and yeast which are good and maintain the health of the area. However, things like change in levels of hormones, poor hygiene, pregnancy, sexual contact, antibiotics, disturb the balance of health, thus causing infections. Most common types of vaginal infections are: bacterial infections, yeast infections, trichomonas vaginitis. While there exist over-the-counter cure for these infections, it is best to visit your gynecologist and get the infections diagnosed &amp; treated.

2. Cervix inflammation: infection or inflammation in the cervix is called cervicitis. It is pretty common and is influenced by a number of factors like allergies, infections or irritations - it is important to know the cause of cervicitis because in the long run, it could pose a problem with fertility. Symptoms of cervicitis include foul smelling vaginal discharge, pain during passing urine, pelvic pain, abnormal bleeding like bleeding after sexual contact or between periods. Cervicitis is treated with the help of anti-fungal medications, antibiotics and anti-viral medications depending upon the evaluation of the underlying cause.

3. Pelvic and uterine infection: infection in the uterus and pelvis is also a matter which should not be left untreated. It can present with pain lower abdomen, pain during intercourse, frequent and painful urination. The infection can be caused by various organisms which can lead to pelvic inflammatory disease which in turn can spread to the uterus, ovaries and the fallopian tubes.

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

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Infections Of The Vagina, Cervix and Uterus: Facts You Must Know.

Miscarriage is termed as the loss of the fetus in or before 20th week of pregnancy. Medically, miscarriage is known as spontaneous abortion, though the word spontaneous is more of a keyword as it is not an abortion.

Symptoms of Miscarriage 
Miscarriage happens due to weakness, back pain, fever, abdominal pain along with severe cramps and bleeding, which starts from slow to heavy.

Cause of Miscarriage 
Common cause of miscarriage is when the fetus is known to have fatal genetic problems and these are not related with the mother. The other causes are infection, medical problems like thyroid and diabetes, immune system rejection, hormonal imbalance, abnormalities of the uterus, and physical problems of the mother. If a woman is over 35 years of age, has thyroid and diabetes and had an miscarriage earlier then that woman is at a high risk of getting a miscarriage.

Sometimes a miscarriage might take place due to the cervical insufficiency. This is due to the weak cervix, also known as the incompetent cervix, which is unable to hold the pregnancy. A miscarriage in this condition usually occurs in the second trimester. Though there are a very few symptoms in this, but there might be a feeling of sudden pressure that the water is going to break and tissues from the placenta and fetus are released without any pain. This can however, be treated by a stitch in the cervix at 12 weeks. This stitch helps to hold the cervix until the full term is completed. If it is first pregnancy and cervical insufficiency is diagnosed, then also a stitch can be applied, thus resulting in full term and avoiding miscarriage.

Diagnosis of Miscarriage: 
-   The doctor does a pelvic test, an ultrasound and blood tests to confirm a miscarriage
-   Blood tests are done to analyze the pregnancy hormone hCG. This is monitored regularly if miscarriage is suspected
-   Genetic tests, blood tests and medication are important in women who have a history of prior miscarriages
-   Pelvic ultrasound and hysterosalpingography are tests, which are done when there are repeated miscarriages
-   Test like hysteroscopy is also done. In this the doctor observes the inside of the uterus with a device, which is thin telescope like device. This is inserted in the vagina and cervix.
-   If the cervix is dilated, then the woman might be diagnosed with an incompetent cervix and this can be corrected by cerclage, a procedure done to close the cervix.
-   If the blood type of the pregnant woman is Rh negative, she is prescribed a blood product called Rh immune globulin (Rhogam). This prevents from forming, antibodies which could turn to be harmful for the baby.

Bleeding in Early Pregnancy: Diagnosing Miscarriage

An often painful condition usually involving the bowel, ovaries or the tissue lining the pelvis, endometriosis is characterized by the abnormal growth of the endometrial tissue beyond the premises of your uterus or your pelvic region. The endometrium, in fact, functions perfectly normal with each menstrual cycle, but because of it being displaced, it cannot exit the body and consequently gets trapped.

Besides causing severe pain and distress, endometriosis can also adversely affect fertility. When the ovaries get involved, certain cysts known as endometriomas tend to develop which often result in the formation of scar tissues and adhesions.

Complications associated with it

Infertility: Impaired fertility is the most common kind of complication arising from endometriosis, with approximately one-third to one-half women having problems with pregnancy. During endometriosis, the fallopian tube gets obstructed, thereby restricting the union of the egg and sperm.
Ovarian cancer: Women with endometriosis are more likely to suffer from ovarian cancer. Moreover, they are also more susceptible to acquiring endometriosis related adenocarcinoma, which is another variant of cancer, but a comparatively rarer phenomenon.
How best to treat it?

Depending upon how severe your symptoms are, endometriosis can be treated via the use of medications or through the advent of surgery.

Pain medications: Certain medications, including pain relievers and anti-inflammatory drugs, are particularly useful in providing relief to painful menstrual cramps.
Hormone therapy: Undergoing hormonal therapy can help ward off or reduce the pain of endometriosis, but it should be kept in mind that it is only a temporary fix and that symptoms might reoccur. Hormonal therapies include:
Hormonal contraceptives
Medroxyprogesterone
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists
Danazol
Conservative surgery: This can either be done through laparoscopy or, in more extensive cases, through traditional abdominal surgery.
Assisted reproductive techniques: These include in-vitro fertilization, and are sometimes more preferable over conservative surgery.
Hysterectomy: This is usually done in more severe cases of endometriosis whereby ovaries are also removed with uterus and cervix

Complications and Treatment of Endometriosis

When endometrial tissue that usually grows inside the uterus, starts growing outside uterus, it is called Endometriosis. Pain during or before periods, pain during intercourse, pain while urinating or bowel movements, heavy bleeding, infertility are some of the symptoms of endometriosis.

Treatment of endometriosis usually depends on the following factors:

Age of female
Severity of symptoms
Duration of the symptoms
Future plans for children/ fertility
Associated pathologies
Accordingly the doctor might choose any of the treatment options like:

Medication for Pain: If the symptoms are mild, then the doctor will prescribe some pain  relieving medications like Nonsteroidal anti-inflammatory drugs (e.g. Diclofenac) or anti-spasmodics(e.g.drotaverine)
Hormone Therapy: Hormone therapy is effective, but once you stop them, your symptoms may recur. Some of the hormone therapies include: 
Hormonal Contraceptive pills: Useful in controlling the hormones that are responsible for endometrial tissue growing outside the uterine cavity.
Medroxyprogesterone: This helps to counter effect estrogen hormone which is responsible for endometrial tissue growth.
Gonadotropin-releasing hormone (GnRH) agonists: Gonadotropin hormones that stimulate ovaries are blocked by these. They bring down oestrogen levels and hence symptoms. It can cause absence of menstruation in some females which is reversible.
Danazol: It is synthetic androgen, suppresses growth of endometrial tissue temporarily.  However, Danazol may not be a favourable option because of its side effects. Females should avoid pregnancy while on this drug.
Dienogest: This newer progesterone molecule, which does not have major side effects and is apporved for use in endometriosis.
Other medications like selective progesterone receptor modulators, immunomodulators, anti angiogenic factors are being evaluated.
Conservative surgery: If you are trying to conceive, then surgical excision or ablation of endometrial tissue is one treatment option.Suboptimal surgery with conservation of maximum ovarian tissue is considered suitable in such cases.
Hysterectomy: In severe endometriosis cases where female has completed her family, hysterectomy is offered wherein the uterus, cervix & if required ovaries can be removed.

Endometriosis - Ways To Manage It Well!

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