During the natural course of events, a woman's body starts its reproductive phase with menarche and at about 50 years of age, attains menopause. This is when the reproductive function ceases and the ovaries stop producing the hormone estrogen and progesterone. This is medically termed early or premature menopause. 

Menopause that occurs before 40 years of age is termed as Premature Menopause; it is due to primary ovarian insufficiency and occurs in 1% of the women.  If it occurs between 45 to 50 years, it is termed as early menopause.

Causes of premature menopause
Normal ageing, family history, genetic disorders, autoimmune disorders, toxins, and surgery are some reasons that could lead to premature menopause.

Effects:
Estrogen and progesterone have a lot of beneficial effects on a woman's body. Reduction in their levels leads to some of the below changes:

-    Emotional changes like mood swings, irritability, and in some cases depression, especially in       premature menopause.
-   Irregular cycles before complete cessation of the menstrual cycles.
-   General mucosal dryness leading to vaginal dryness, dry skin, dry eyes.
-   There also would be urinary incontinence and reduced sex drive due to reduced hormone levels.
-   For women who still would want to have children, infertility would be a big cause for concern. This could lead to other emotional issues, worsening the depression.
-   Bones lose their density and get weak and are more prone to fracture. This leads to Osteoporosis.
-   Postmenopause, women are more prone to heart attacks and stroke, leading to cardiovascular health issues. Though not fully proven, this is believed to be true as the good role that estrogen plays on blood vessels is negated with menopause.
-   Menopause leads to accelerated damage of genetic structures, thereby leading to faster ageing. This also leaves a feeling in the women of being less attractive and less desirable.

There is also a good news, that after menopause women are at lesser risk of cancer especially, breast and ovarian. 
However, it is not easy for women to handle premature menopause. The body undergoes some changes much earlier than expected, and it requires a lot of support and caring and comforting to come to terms with it especially, if associated with infertility or chemotherapy for cancer. Emotional issues of not being able to have children and feeling less attractive require frank talks to boost the person's confidence and increase self-worthiness.

It is easier said than done, but one of the key ways to handle premature menopause is an open discussion.

Premature Menopause - How Your Body Is Affected?

What is endometriosis?

Endometriosis is a common condition where cells of the lining of the womb (the endometrium) are found elsewhere, usually in the pelvis and around the womb, ovaries and fallopian tubes. It mainly affects women during their reproductive years. Endometriosis is not an infection and it is not contagious.

What are the symptoms?

The main symptoms of endometriosis are pelvic pain, pain during or after sex and painful, sometimes heavy periods. It may cause problems with getting pregnant. It can affect many areas of a woman s life including her general physical health, emotional wellbeing and daily routine. Many women may have no symptoms. It is a long-term condition. Some women with endometriosis become pregnant easily while others have difficulty getting pregnant.

What causes endometriosis?

Endometriosis occurs when the cells of the lining of the womb are found in other parts of the body, usually the pelvis. Each month this tissue outside the womb thickens and breaks down and bleeds in the same way as the lining of the womb. This internal bleeding into the pelvis, unlike a period, has no way of leaving the body. This causes inflammation, pain and damage to the reproductive organs. Less commonly, endometriosis may occur on the bowel and bladder, or deep within the muscle wall of the uterus (adenomyosis). It can also rarely be found in other parts of the body.

The symptoms of endometriosis are common and could be caused by a number of other conditions such as irritable bowel syndrome (IBS) and pelvic inflammatory disease (PID).

There is no simple test for endometriosis.
Your gynaecologist may examine your pelvic area, this will include an internal examination.
You may be offered a scan. This can identify whether there is an endometriosis cyst in the ovaries. A normal scan does not rule out endometriosis.
For most women, having a laparoscopy is the only way to confirm endometriosis; because of this, it is often referred to as the  gold standard  test. This allows the gynaecologist to see the pelvic organs clearly and look for any endometriosis.
Several factors may influence your decision about treatment. These include:

How you feel about your situation
Your age
Whether your main symptom is pain or problems getting pregnant
What treatment can I get?

The options for treatment may be:

Pain relief

Hormone treatments: There is a range of hormone treatments to stop or reduce ovulation (the release of an egg) to allow the endometriosis to shrink or disappear. The hormonal methods below are contraceptives and will prevent you from becoming pregnant:

The combined oral contraceptive (COC) pill or patch. These contain the hormones estrogen and progestogen and work by preventing ovulation and can make your periods lighter, shorter and less painful.
The intrauterine system (IUS): this is a small T-shaped device which releases the hormone progestogen. This helps to reduce the pain and makes periods lighter. Some women get no periods at all.
The hormonal methods below are non-contraceptive, so contraception will be needed if you do not want to become pregnant:
Use of hormonal progestogens or testosterone derivatives
GnRH agonists are drugs that prevent estrogen being produced by the ovaries and cause a temporary and reversible menopause.
Some women find that recreational exercise improves their wellbeing, which may help to improve some symptoms of endometriosis.

Surgery: Surgery can be used to remove areas of endometriosis. There are different types of surgery, depending on where the endometriosis is and how extensive it is. How successful the surgery is can vary and you may need further surgery.

Laparoscopic surgery: The gynaecologist removes patches of endometriosis by destroying them or cutting them out.
Laparotomy: If the endometriosis is severe and extensive, you may be offered a laparotomy. This is major surgery which involves a cut in the abdomen, usually in the bikini line.
Hysterectomy: Some women have surgery to remove their womb (a hysterectomy) with or without the ovaries. Depending upon your own situation, your doctor should discuss hormone replacement therapy (HRT) with you if you have your ovaries removed.
What if I am having difficulty getting pregnant?

Getting pregnant can be a problem for some women with endometriosis. Your doctor should provide you with full information about your options such as assisted conception. If you become pregnant, endometriosis is unlikely to put your pregnancy at risk.

Endometriosis - Signs & Symptoms That Indicate It!

4 Things that Cause Vaginal Dryness

Vaginal dryness is an uncomfortable and painful condition that usually occurs during or after menopause. The estrogen level in your body gets reduced during this time which eventually leads to vaginal dryness. However, there are other factors that can trigger this condition including certain medications and immune disorders. This is a problem that can affect women at any age but it is visible more frequently in older women.

Here are some common factors that may lead to vaginal dryness:

1. Hormonal changes - A decrease in estrogen level that occurs during menopause is one of the most common causes of vaginal dryness. The decrease in estrogen may also occur during perimenopause, during breastfeeding or after childbirth. Radiation and chemotherapy for cancer treatment may also result in a decrease in vaginal lubrication.

2. Irritants - Chemicals present in soaps, dyes, hygiene products and perfumes may cause allergy in some women. Irritants present in underwear or towels and other allergens like objects and lubricants that are placed in the vagina may also cause vaginal dryness.

3. Insufficient arousal - Low libido or other sexual problems may also lead to vaginal dryness. Poor sexual performance and early ejaculation may also contribute to it.

4. Anxiety - Sexual desire can be affected by emotional and psychological factors such as anxiety and stress that may eventually lead to vaginal dryness. High anxiety level in women results in insufficient flow of blood, causing vaginal dryness.

How can vaginal dryness be treated?

Topical estrogen therapy is a common method of treating vaginal dryness caused by low estrogen level. Topical estrogen helps in inserting some hormone that your body is no longer producing. This controls the vaginal symptoms to a certain extent but it does not replace as much estrogen as oral hormone therapy, in your blood stream. Lubricants and moisturizers may also be applied to reduce vaginal dryness and make sex less painful and uncomfortable.

Word of Caution

Please get a PAP Smear done before starting local estrogen and keep a follow up with your doctor.



4 Things that Cause Vaginal Dryness

The abnormal growth of the endometrium tissue outside the uterus is known as endometriosis. Ideally, the abnormal tissue is supposed to break down and exit the body. However, in this condition, the tissue is unable to pass out of the body. As a result, the surrounding tissue tends to get irritated and leads to the formation of scar tissues.

The various causes of endometriosis include:

Immune system disorder: Complications in the immune system might render it incapable of destroying the endometrial tissue that grows outside the uterus.
Surgical scar implantation: Certain surgeries such as a C-section may result in the attachment of endometrial cells to the incision area.
Embryonic cell transport: These cells may be transported to other parts of the body by the blood vessels which may lead to endometriosis.
Retrograde menstruation: Instead of passing out of the body, under this condition, the blood flows back into the pelvic region via the fallopian tubes. When these cells attach themselves to the pelvic cavity, it causes endometriosis.
Symptoms
1. Pain during sexual intercourse
2. Pain during periods including pelvic pain, especially during periods, lower back pain and abdominal pain.
3. Excessive bleeding during periods
4. Fatigue
5. Constipation
6. Bloating

The major complication that results is fertility problems. Endometriosis may prevent the combination of the egg and the sperm and thus, impairs your ability to conceive. It is recommended not to delay pregnancy if you have endometriosis. This disorder also tends to increase the risk of ovarian cancer in some women.

How can it be treated?

Endometriosis is usually done using surgery or medications. 

Medication: It usually involves painkillers.
Hormone therapy: Some of the hormonal therapies include:
Hormonal contraceptives
Progestin therapy
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists
Conservative surgery: If a patient wants to become pregnant, surgery is done as much as possible without harming the uterus and ovaries. Suggested procedures include laparoscopy and traditional abdominal surgery.
Assisted reproductive technologies: An example of this form of treatment is In Vitro Fertilization.
Hysterectomy: Under severe circumstances, total hysterectomy is conducted in order to facilitate the removal of cervix and uterus. If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.

Endometriosis - 4 Reasons Behind it!

Endometriosis is a condition in which the endometrial cells lining the inside wall of the uterus begin to grow outside the uterus. In a majority of the cases, the growth is on the ovaries, the Fallopian tubes, or the tissues around the uterus. In rare cases, it occurs in other body parts. Normally, women in the age group of 30 to 40 years are prone to developing this condition and genetics is believed to be the reason behind this disorder. It is a serious medical condition if it causes discomfort to the woman.

Signs and Symptoms:  The signs and symptoms of endometriosis include chronic pelvic pain, pain during menstruation, urination, and intercourse, longer periods, bleeding between menstrual cycle, bloody urine or stool, and urinary and bowel problems.

Treatment methods:  In many cases, endometriosis goes undiagnosed and it can only be diagnosed through biopsy. If the biopsy confirms endometriosis, then it can be treated in the following ways:

Hormonal treatment: Hormonal treatment includes birth control pills, placement of the intrauterine device, Gonadotropin-releasing hormone, and Danazol or Medroxyprogesterone (Depo-Provera).
Pain medication: Pain killers with anti-inflammatory properties are prescribed to those who suffer from painful menstruation.
Surgery: This is the last treatment option and only advised to those who did not find relief from medicines and hormonal treatment. Surgeons try to remove the areas affected by endometriosis but in severe cases, the ovaries might need to be removed completely.
Complications: It is important to treat endometriosis on time as delay can lead to complications. The complications arising out of endometriosis include the following:

Infertility: The scarring and distortions caused in the reproductive organs due to endometriosis and the endometriotic cysts can make a woman infertile.
Scarring: The bleeding and the inflammation caused by endometriosis leads to scarring of the tissues of ovaries.
Ovarian cysts: Sometimes, the abnormal growth of endometrial cells outside the uterus spreads to the ovaries and starts growing over there, leading to cysts.
Prevention: As it been mentioned before, in many cases, endometriosis goes undiagnosed but it can be prevented or its symptoms managed effectively if one is cautious. One should do the following:

Exercise regularly: Exercise increases immunity and also reduces the level of estrogens, which slows down the progression of endometriosis. It also provides relief from pain.
Eat nutritious diet: A diet rich in vitamin and minerals ensures good health of the reproductive organs and a fine immune system. This helps to fight the symptom of endometriosis and keeps the disorder in check.
Endometriosis is known to affect a large number of women and since the early symptoms are mild or confusing, most of the time they go undetected. Nevertheless, a woman can avoid it and the complications arising out of it by being mindful of the symptoms. They should also undergo a regular pelvic exam and follow the instructions of their gynecologist. This would ensure timely detection of the disorder and if this is ensured, the management also becomes easy.

Suffering From Endometriosis - What Are Its Treatment Options?

What is vaginal dryness and how can it affect you?
Vaginal dryness is often a result of menopause and it is capable of affecting women of any age. Although it feels like a minor irritation, it can have a huge impact on a person's sex life. Normally, the vaginal walls are lubricated with a layer of clear fluid. The 'oestrogen' hormone is used to maintain this thin layer of fluid, thus keeping the vaginal lining thick, elastic and healthy. However, menopause brings about a condition known as vaginal atrophy, which is a drop in the levels of oestrogen and this greatly reduces the level of vaginal moisture that is available. Improper lubrication of the vagina can result in painful sex which in turn affects libido, arousal and desire.

Treatment 
The most common treatment for this condition resulting from low levels of oestrogen is Topical oestrogen therapy. In this, hormones which are no longer secreted by the body are replaced by the topical oestrogen. Even though Topical Oestrogen Therapy is helpful in relieving the symptoms of vaginal dryness, the treatment pales in comparison to oral oestrogen hormone therapy (HT).

Usually, women mostly use one of the three types of vaginal oestrogen listed below:
1. Vaginal oestrogen tablet: A tablet is inserted into the vagina using a disposable applicator. The procedure is carried out once daily during the initial two weeks of treatment, after which it can be inserted twice a week.

2. Vaginal oestrogen ring: A soft and flexible ring is inserted inside the vagina, either by the patient or the doctor. Oestrogen, in the form of a steady stream, is then released directly to the vaginal tissues by this ring. Replacement of this ring is done every three months.

3. Vaginal oestrogen cream: An applicator is used to apply cream to the vagina daily. The frequency of application can be reduced as per doctor's advice.

Side effects and aftercare 
Side effects such as breast pain and vaginal bleeding are common when any form of oestrogen product is used. Vaginal moisturisers should be used to keep the vagina lubricated. Use of water-based lubricants during sex can make it more enjoyable. Use of bubble baths, scented soaps, douches and lotions around the sensitive area of the vagina should be avoided as these products can worsen the problem.

Modes of Treatment for a Dry Vagina

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