The menopause can take three very different routes for women. There are those who sail through it with very few symptoms or problems and don't even notice that their ovaries have stopped producing the hormone. Then there are those for whom it is a matter of a few hot flushes and a couple of night sweats, doesn't last long and not really a bother. This usually marks a relief from the periods. But for some it is abject misery accompanied with crippling fatigue, absolute exhaustion, hot flushes, vaginal drying, mood swings along with low desire or lack of sexual feelings. These symptoms might persist for more than 7 years.
Hormone Replacement Therapy (HRT) is considered to be an effective treatment for menopausal symptoms. The other problems linked with menopause can also be influenced by HRT in a positive manner.

HRT is indicated in:
1. Treatment of symptoms of menopause and the risk benefit ratio is apt for the women and they have been informed about the same
2. For women who are around 51 years and are reaching menopause even though they are asymptomatic
3. In women who are at the risk of osteoporotic fractures and are under 60 years and the non-estrogen treatments cannot be given
4. HRT is not recommended in women who are above 60 years

Benefits of HRT:
The benefits of HRT usually are more than the risk if done in a woman who is under 60 years of age. 
These include:
1. Improvement in quality of life by relieving muscle pains and improving sleep
2. The mood swings are controlled and low moods are usually alleviated by HRT. Low moods usually arise due to menopause.
3. It reduces the vasomotor symptoms, usually within four months of the treatment with maximum benefit in three months
4. HRT improves the urogenital symptoms by lowering the vaginal dryness, vaginal atrophy, urinary frequency and symptoms. 
5. HRT reduces the risk of osteoporosis. HRT is believed to preserve the bone mass density of the skeletal sites thus reducing the chances of vertebral and nonvertebral fractures.
6. HRT also reduces the risk of colorectal cancer and cardiovascular diseases

Risks of HRT
The main risks of HRT are stroke, endometrial and breast cancer, thromboembolic disease, pulmonary embolism and gallbladder disease. Though other risks are:
1. It increases the risk of ischemic stroke
2. There is a small risk associated with breast cancer and the risk increases more, if the woman is underweight or overweight, alcohol user, smoker and stops HRT suddenly
3. Estrogen only HRTs can increase the risk of endometrial cancer. If cyclical progestogen is used for 10 days for 28 cycles then the risk is eliminated.

The Efficacy of Hormone Therapy in Early Menopause

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?

As we all know that IVF stands for In vitro fertilisation. It is a method of stimulating the ovaries in a female body, to release an ovum (egg), which is taken out of the body and fertilised artificially in the laboratory with the help of a sperm. After this, the embryo is transferred back to the uterus where it grows and develops naturally.

Understanding the Procedure

The doctor attempts to have complete control over your menstrual and ovulation cycles, so as to know the correct time of the month when you ovulate. This includes, charting basal body temperatures, hormonal therapy drugs etc.
Frequent blood tests, ultrasound will be required to map the progress of ovulation.
Injections, drugs will be prescribed in required dosage to stimulate the ovaries.
During this time, the doctors will monitor the growth of oocytes (eggs).
After a suitable growth of the oocytes follicles, the eggs are retrieved for artificial insemination. (Fertilisation with the use of sperm cells in the laboratory).
After the successful fertilisation, the embryo is transferred back to the uterus.
Can IVF have side effects?

As a side effect it has a major chance of multiple pregnancies. People intending to have just one child, may not be mentally or economically prepared to take the responsibility of more than one child.
The drugs and medicines used throughout the IVF procedure may create hormonal complications in the long run. It bears a risk of ovarian hyperstimulation syndrome, if the mother has to go through the cycle multiple times.
But it offers a number of benefits too...

IVF increases the chance of pregnancy by a large percentage. It is one of the most successful methods of boosting fertility and pregnancy.
Couples, who have repeatedly failed to bear children naturally, can opt for this treatment to produce their own offspring.
In case the couples are completely infertile, donor eggs or sperms may be used in the process. However, in that case, the offspring will not bear the DNA of both parents.
IVF can greatly reduce the chance of surgery on the fallopian tubes.
IVF also provides an opportunity to choose the healthiest embryos before implanting it back in the uterus. A procedure, known as the pre-implantation genetic diagnosis, determines the presence of any abnormal genes or other chromosomal absurdity.
The procedure of IVF has a very high success rate and with technological advancements in the field of medicine, it has also become much safer.
IVF allows women, who go into premature menopause, to be able to bear a child. This treatment is mostly for women who decide to experience motherhood at a slightly older age.
IVF allows same sex partners and single women to bear an offspring.
It is extremely helpful for women who have their fallopian tubes damaged, blocked or surgically removed.

IVF - 9 Benefits You Must Know!

Are you pregnant and planning on having a natural childbirth? There are several things to keep in mind when considering a natural childbirth. Natural birth involves no interventions and drugs and you need to prepare well for it. Here are some important tips you should follow, if you want to have a natural childbirth:

Choose a birth environment of your choice: You should choose a safe place for giving birth. Many women feel more secure at home and prefer it as the place for giving birth, while some choose a hospital.
Choose a care provider you trust: It is important for you to choose a trustworthy care provider, who will make you feel at ease and will pay respect to your wishes. In the case of giving birth in a hospital, you can opt for hiring a doula.
Prepare your body: It is important to prepare your body physically before natural childbirth. Pregnancy is quite exhausting and makes you want to refrain from activities, but you should walk for some time every day to keep fit. Keeping your body in good shape will help you with stamina during delivery.
Ice Game: You can play the ice game with your partner. It is a game designed to give you a glimpse of how to handle labor pain. This is more of an assessment, meant for giving you an idea about coping with pain of contractions. This method is also ideal for learning to deal with pain.
Educate yourself: It is important for you to read a lot about pregnancy. You should read from the Internet and also from books and stories related to natural childbirth.
Be positive: It is very important for you to maintain a positive state of mind, prior to your natural childbirth. You need to be determined and strong and reiterate to yourself that you are strong and will be able to cope with the process.
Coping strategies: Learn about various coping strategies. Keeping your jaw relaxed, horse lips, and low moaning are some strategies you can try.
Avoid cervical checks: Try avoiding cervical checks as much as possible, as they are not always a progressive measure. You do not have to be too much focused on dilation numbers.
Prepare your partner: Your partner also has to play an important role during your childbirth. You should make him learn all the major facts regarding natural childbirth and let him know about your expectations and hopes for labor.
Change positions during labor: You should try different positions during labor, and not think of being silly.
It is also important for you to get rid of preconceived ideas of natural childbirth from your mind. The process is different in different women, and you must embrace it.

Want Natural Delivery? 10 Things You Must Prepare for!

The female reproductive organ is an area of the human body where many microbial organisms inhabit together and it is a necessary requirement for its health. These organisms may include fungi and bacteria and play important roles individually in maintaining the pH levels (the acidic and alkaline balance) levels of the vagina. However, when one of these, especially the fungi go out of balance and begin to propagate, it results in a vaginal yeast infection.

Symptoms
A yeast infection or vaginal candidiasis is a fungal infection that causes extreme itchiness of the vulva (which is the opening of the vagina) and the further insides of the vagina as well. It may result in a white discharge from time to time and causes vaginal inflammation. Some of the other symptoms are:

Pain in the vagina akin to a burning sensation while urinating or when having sex
Rashes in the vagina
General soreness and pain
White odorless discharge, which is thick in consistency
Colorless watery discharges can occur as well
Swelling and redness near the vulva or the vagina in general
Causes
The type of fungi that causes vaginal yeast infections is the  candida fungus . Usually, this fungus is present within the vagina, but is kept in check by the Lactobacillus bacteria. These are bacteria naturally present within the vagina and secrete acids, which keep the fungi in check. However, when the levels of bacteria are reduced, it will cause the levels of fungi to increase causing a yeast infection.

Risk Factors
The below mentioned factors can aggravate the risks of this disease:

Problems brought on by diabetes
A compromised immune system
Pregnancy may also disturb the balance
Starting to use or stopping the use of oral contraceptive pills
Hormone therapy
Usage of antibiotics that may kill off lactobacillus bacteria within the vagina
Generally, yeast infections are not considered to be sexually transmitted, although yeast infection could be spread through sexual contact as well.

The primary treatment includes a course of anti fungal oral medication to lessen the levels of the fungi within your vagina. It could be supplemented with vaginal creams, which may reduce the itching and the inflammation. If you have recurrent infection multiple times within a year, then you may have to go for a longer course of treatment and correct the underlying conditions that may be causing it.

Vaginal Yeast Infection - 6 Signs You are Suffering from it

How to know if you're pregnant

There are two main ways of finding out if you are pregnant - getting your blood tested, and doing home pregnancy urine test. In order for these tests to give you a clear picture, you need to wait until the right time i.e. until you've missed your period. However, there are several early signs of pregnancy that can give you an indication that you might be expecting.

1. Shortness of breath - Do you find yourself losing your breath on the stairs or when you walk for a long period of time, more than you usually do? This could be a sign of pregnancy since the fetus needs oxygen, leaving you feeling a little breathless even when you mildly exert yourself.

2. Sore breasts - If your breasts suddenly start feeling a little heavy or you feel like they have grown and your areolas seem slightly darker, it could be one of the first signs that you are pregnant.

3. Fatigue - The increase in hormones in your body during a pregnancy could lead to you feeling a lot more tired. If you end up exhausted after a normal day this could be because women tend to feel extreme tiredness during their first trimester of pregnancy.

4. Nausea - Around 6 weeks into a pregnancy (sometimes earlier), women tend to feel nauseous. This usually subsides as you enter into your second trimester. Feeling nauseous could be a sign of pregnancy. You can treat it by eating things that help settle your stomach like crackers and soda.

5. Frequent Urination - If you notice yourself needing to urinate more than usual, it could be a sign of pregnancy. This happens because your body is now producing extra fluids that cause your bladder to work extra.

6. Headaches - An early sign of pregnancy is experiencing frequent headaches. This happens because your body is now suddenly dealing with a lot of excessive hormones. To deal with the headaches make sure you take a pregnancy safe painkiller instead of a normal one.

Everybody has a way of expressing itself if only we take the time out to listen. If we really pay attention to these tiny reactions, detecting a pregnancy early, that is even before you skip that period is possible



How to know if you're pregnant

Don't wait any longer, manage your Gynaecological Endoscopy online with a Lybrate doctor today

Consult for Gynaecological Endoscopy - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES