Use of contraceptives is really important to avoid unwanted pregnancy. Countries like China and India, facing the problem of population explosion lay more stress on the use of contraceptives. However, you must always use or take oral and barrier contraceptives following the advice of a medical practitioner unless it is absolutely necessary to go ahead without consultation. The reason behind medical assistance is your own health. Contraceptive methods do have a vast range of side effects that can result in health hazards. There are various kinds of contraceptives; each having its own set of advantages and disadvantages. Being acquainted with the side effects of some contraceptive methods can help you choose wisely in times of need.

Possible side-effects of using condoms: Some men are allergic to latex. Using condoms can lead to heightened sensitivity. It can also lead to rashes in your genitals. Condoms are not foolproof. They do not provide total protection against sexually transmitted infections, HPV or against Syphilis and Herpes. These diseases can be contracted by coming in contact with genital skin that is not covered by a condom.
Possible side-effects of a Contraceptive Film: A contraceptive film might act as an interruption in your sexual activities if it is not placed properly, that is to say it must come in contact with the cervix to be effective. Using the film nonoxynol- very frequently can make you susceptible to life threatening diseases like HIV and other STIs.
Possible side-effects of a Cervical Cap: A cervical cap has to be inserted by a clinician and requires immense care to be fitted in later. Some of its side - effects can be of serious concern. If it is left inside for more than forty eight hours, it can result in toxic shock syndrome. Toxic shock syndrome is an infection that mars your overall health. It is also known to increase the chances of inflammation of the surface of your cervix.
Possible side-effects of Progestin only pills: Progestin only pills or mini pills can subject you to long- lasting depression. It can make you feel bloated and can actually increase your weight to a great extent if used on a regular basis. Minipills lead to irregularities in your menstrual cycle and might also make bleeding during menstruation scanty.
Possible side-effects of combined oral contraceptives: If this is your first month on combined oral contraceptives, you might feel nauseous and they can give you a terrible headache. Women taking these pills have a higher chance of developing cervical dysplasia. If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.

Side Effects of Different Contraceptive Methods

If you lose a baby before 24 weeks of pregnancy, it is called a miscarriage. If this happens in the first 3 months of pregnancy, it is known as an early miscarriage. Unfortunately, early miscarriages are common, with 10 20 in 100 (10 20%) pregnancies ending this way. Late miscarriages, after 3 months of pregnancy but before 24 weeks, are less common: 1 2 in 100 (1 2%) pregnancies end in a late miscarriage. When a miscarriage happens three or more times in a row, it is called recurrent miscarriage. Recurrent miscarriage affects 1 in 100 (1%) couples trying to have a baby.

Why does recurrent miscarriage and late miscarriage happen?

Sometimes there is a reason found for recurrent and late miscarriage. In other cases, no underlying problem can be found. Most couples are likely to have a successful pregnancy in the future, particularly if test results are normal.

There are a number of factors that may play a part in causing recurrent and late miscarriage:

Age, the older you are, the greater your risk of having a miscarriage. If the woman is aged over 40, more than 1 in 2 pregnancies end in a miscarriage. Miscarriages may also be more common if the father is older.
Antiphospholipid syndrome (APS- a syndrome that makes your blood more likely to clot) is uncommon but is a cause of recurrent miscarriage and late miscarriage.
Thrombophilia (an inherited condition that means that your blood may be more likely to clot) may cause recurrent miscarriage and in particular late miscarriages.
Genetic factors, about 2 5 in 100 couples (2 5%) with recurrent miscarriage, one partner will have an abnormality on one of their chromosomes (the genetic structures within our cells that contain our DNA and the features we inherit from our parents). Although this may not affect the parent, it can sometimes cause a miscarriage
Weak cervix is known to be a cause of miscarriage from 14 to 23 weeks of pregnancy. This can be difficult to diagnose when you are not pregnant. It may be suspected if in a previous pregnancy your waters broke early, or if the neck of the womb opened without any pain.
Developmental problems of the baby may lead to a miscarriage but are unlikely to be the cause of recurrent miscarriage.
Infection that makes you very unwell can cause a miscarriage. Milder infections that affect the baby can also cause a miscarriage. The role of infections in recurrent miscarriage is unclear.
An abnormally shaped uterus may contributes to recurrent miscarriage or late miscarriages. However, minor variations do not appear to cause miscarriage.
Diabetes and thyroid problems can be factors in miscarriages. They do not cause recurrent miscarriage, as long as they are treated and kept under control.
It has been suggested that some women miscarry because their immune system does not respond to the baby in the usual way. This is known as an alloimmune reaction. There is no clear evidence to support this theory at present. Further research is needed.
Are there any other risk factors?

Being overweight increases the risk of miscarriage. Smoking and too much caffeine may also increase the risk. Excessive alcohol is known to be harmful to a developing baby and drinking five or more units a week may increase the risk of miscarriage.

The chance of a further miscarriage increases slightly with each miscarriage. Women with three miscarriages in a row have a 4 in 10 chance of having another one. This means that 6 out of 10 women (60%) in this situation will go on to have a baby next time. 

Why are investigations helpful?

Finding out whether there is a cause for your recurrent miscarriage or late miscarriage is important as your doctor will be able to give you an idea about your likelihood of having a successful pregnancy. In a small number of cases there may be treatment available to help you.

What investigations might be offered?

Blood tests:

For APS- APS is diagnosed if you test positive on two occasions 12 weeks apart, before you become pregnant again.
For thrombophilia- If you have had a late miscarriage you should be offered blood tests for certain inherited thrombophilias.
To check you and your partner s chromosomes for abnormalities. You may be offered this test if your baby has been shown to have abnormal chromosome
Tests for abnormalities in the baby You should be offered tests to check for abnormalities in your baby s chromosomes. This is not always possible but may help to determine your chance of miscarrying again. If you have had a late miscarriage you may also be offered a postmortem examination of your baby. This will not happen without your consent and you will have the opportunity to discuss this with your health team beforehand.

Tests for abnormalities in the shape of your uterus. You should be offered a pelvic ultrasound scan to check for any abnormalities in the shape of your uterus. If an abnormality is suspected, further investigations may include a hysteroscopy (a procedure to examine the uterus through a small telescope which is passed through the vagina and cervix) or a laparoscopy (a procedure in which a surgeon uses a fine telescope to look inside the abdomen and pelvis).

Tests for infection. If you have had a late miscarriage, tests such as blood samples and vaginal swabs may be taken at the time to look for any source of infection.




What are my treatment options?

Treatment for APS

If you have APS and have had recurrent miscarriage or a late miscarriage, treatment with low-dose aspirin tablets and heparin injections in pregnancy increases your chance of having a baby. Aspirin and heparin make your blood less likely to clot and are safe to take in pregnancy.

Having APS means you are at increased risk of complications during pregnancy such as pre-eclampsia, problems with your baby s growth and premature birth. You should be carefully monitored so that you can be offered treatment for any problems that arise.

Treatment for thrombophilia

If you have an inherited tendency to blood clotting (thrombophilia) and have had a miscarriage between 12 and 24 weeks of pregnancy, you should be offered treatment with heparin. At present there is not enough evidence to say whether heparin will reduce your chance of miscarriage if you have had early miscarriages (up to 12 weeks of pregnancy). However, you may be still offered the treatment to reduce the risk of a blood clot during pregnancy.

Your doctor will discuss what would be recommended in your particular case.

Referral for genetic counselling

If either you or your partner has a chromosome abnormality, you should be offered the chance to see a specialist called a clinical geneticist. They will discuss with you what your chances are for future pregnancies and will explain what your choices are. This is known as genetic counselling.

Monitoring and treatment for a weak cervix

If you have had a miscarriage between 14 and 24 weeks and have a diagnosis of a weak cervix, you may be offered an operation to put a stitch in your cervix. This is usually done through the vagina at 13 or 14 weeks of pregnancy under a general or spinal anaesthetic. Your doctor should discuss the surgery with you.

If it is unclear whether your late miscarriage was caused by a weak cervix, you may be offered vaginal ultrasound scans during your pregnancy to measure the length of your cervix. This may give information on how likely you are to miscarry. If your cervix is shorter than it should be before 24 weeks of pregnancy, you may be offered an operation to put a stitch in your cervix.

Surgery to the uterus

If an abnormality is found in your uterus, you may be offered an operation to correct this.

Hormone treatment

Taking progesterone or human chorionic gonadotrophin hormones early in pregnancy has been tried to prevent recurrent miscarriage. More evidence is needed to show whether this works.

Immunotherapy

Treatment to prevent or change the response of the immune system (known as immunotherapy) is not recommended for women with recurrent miscarriage. It has not been proven to work, does not improve the chances of a live birth and may carry serious risks (including transfusion reaction, allergic shock and hepatitis).

What if no cause is found?

Where there does not appear to be a cause for recurrent miscarriage or late miscarriage, there is currently no evidence that heparin and aspirin treatment reduces the chance of a further miscarriage. For that reason this treatment is not recommended in these circumstances.

What does this mean for us in the future?

You and your partner should be seen together by a specialist health professional. Your doctor will talk to you both about your particular situation and your likelihood of having a further miscarriage and a successful pregnancy. If a cause has been found, possible treatment options will be offered to you to improve your chance of a successful pregnancy.

For couples where no cause for recurrent miscarriage has been found, 75 in 100 (75%) will have a successful pregnancy with this care. It is worth remembering that the majority of couples will have a successful pregnancy the next time even after three miscarriages in a row.

Recurrent And Late Miscarriage - Tests & Treatment For Couples!

Breastfeeding is best for the baby and its benefits extend well beyond the paradigm of basic nutrition. Breast milk contains all the vital vitamins and nutrients, which a baby needs in the first six months of life. It is fully loaded with disease fighting substances, which protect baby from illness. Many international paediatric organisation recommend exclusive breastfeeding for the first six months and recent research reports have proven that breastfeeding is good for both mother and the baby.

Breastfeeding protects the baby from a long list of illnesses, such as ear infections, lower respiratory illnesses, stomach disorder and meningitis and are less severe when they do happen. Breast milk adapts as the baby grows to meet the changing needs. Breastfeeding builds a strong emotional bond between the mother and the baby and it has long term benefits lasting right into adulthood.

The first milk of the mother contains high concentrations of secretory immunoglobulin A (IgA), which guards against invading germs by forming a protective layer on the mucous membranes in baby's intestines, nose, and throat. Mother's body responds to pathogens (virus and bacteria) that are in her body and makes secretory IgA, which is specific to those pathogens, creating protection for the baby based on to whatever mother is exposed. 

The antibodies in breast milk gives a baby's immune system a boost and also helps children avoid type 1 and type 2 diabetes, high cholesterol and inflammatory bowel disease that strike later in life. Babies who were not breastfed run the risk of developing Crohn's disease and ulcerative colitis.

Breastfeeding boosts child's intelligence. Surveys have shown that premature infants with extremely low birth weight who receive breast milk shortly after birth improved their scores of mental development at eighteen months when compared with premature infants who weren't given breast milk. The emotional bonding happening during breastfeeding contributes to some of the brainpower benefits. Breastfeeding lowers the risk of sudden infant death syndrome (SIDS). It reduces a child's risk of becoming obese as a teen or adult as the breast milk contains less insulin, which stimulates creation of fat. The high content of leptin in the milk regulates appetite and fat.

Breastfeeding triggers the release of the hormone oxytocin that promotes relaxation and nurturing. Oxytocin released while nursing also helps your uterus contract after birth, resulting in less postpartum bleeding. It reduces stress level and the risk of postpartum depression. Research studies show that breastfeeding results in changes in breast tissue and lactation reduces the production of oestrogen, which reduces the risk of breast and ovarian cancer. It also reduces the risk of osteoporosis and cardiovascular disease.

Benefits of Breastfeeding for Baby & Mother

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?

Are you experiencing high blood sugar during pregnancy? This condition is known as gestational diabetes. It is associated with hormonal changes, which occur in your body during pregnancy. Women who are overweight, above the age of 25, and have a family history of diabetes are more likely to experience gestational diabetes. In most cases, the blood sugar levels return to normal after giving birth, and proper management enables you to keep away from any complications during pregnancy as well. 

Here are ways by which you can control your sugar levels during pregnancy:

Develop an ideal diet plan. You should consult a registered dietitian for framing a diet, which is specific to your condition. Your overall health, age, and other health conditions, if present, are taken into consideration while shaping your diet plan.
Cut down your consumption of sugary food items and drinks. Avoid having candies, soda, cakes, cookies, and all food products, which contain simple sugar in large amounts. This can boost your blood sugar levels rapidly and worsen gestational diabetes.
Have three to four small meals regularly, and also eat snacks in between. Eating frequently prevents the crashing of your blood sugar levels between meals.
Reduce your amount of carbohydrate intake. Instead, consume a lot of food rich in fiber like fruits, vegetables, and whole grain.
Drink a lot of water every day. Sufficient hydration of your body is important for stabilizing your blood sugar levels to keep away from complications during pregnancy.
Undertake regular, light activity after your doctor s approval. Activities like walking and swimming help in keeping your blood sugar under control. Exercising during pregnancy is also important for weight loss after giving birth.
Buy a glucose meter and get your blood sugar levels checked frequently. Most common meters require you to prick your finger with a needle and drop your blood on a strip for testing. You can make changes in your diet and medication for preventing a hypoglycemic episode, based on your regular results.
If your doctor recommends it, you should test your urine ketones. Ketones occur in your urine, while your body burns fat to produce energy. These are harmful for your growing baby.
Apart from these, you should take insulin strictly according to your doctor s instructions. Your doctor will instruct you in detail about how and when to administer insulin. You will also be provided with information on storing insulin at a safe place.


High Sugar During Pregnancy - Tips To Help You Control It!

Impact of drinking water in plastic bottles

We store water in all sorts of plastic bottles, jugs or containers. It can be low grade or high grade, but plastic is plastic! This is a very harmful daily practice as plastic containers carry lot of chemicals and bacteria. 

Let s see the harmful effects of drinking water in plastic bottles:

1. Harmful substances: Apart from harmful chemicals in plastic, water when get stored in plastic bottles also produces harmful substances like fluoride, arsenic and aluminium which can be poison for human body. So, drinking water from plastic bottles would mean drinking slow poison that will slowly and steadily deteriorate your health.

2. Dioxin production: Plastic does melt in hot environment. And we, often store water in plastic bottles while driving and so many times leave it in the car where it is in the direct exposure of sun. Such heating releases a toxin called Dioxin which when consumed can accelerate breast cancer.

3. BPA generation: Biphenyl A is an estrogen-mimicking chemical which can lead to lot of health problems like diabetes, obesity, fertility problems, behavioural problems and early puberty in girls. It s better not to store and drink water from a plastic bottle.

4. Liver cancer and reduced sperm count: Because of presence of a chemical called phthalates in plastic, drinking water from plastic bottles can also lead to liver cancer and reduction in sperm count.

5. Vitamin based bottled water: Nowadays, we get water mostly in plastic bottles and to increase its health content, manufacturers make it vitamin-enriched to attract buyers. But this is even more harmful as it carries health-harming additives like food dyes and high fructose corn syrup.

6. Impact on immune system: Our immune system is immensely affected when we drink water in plastic bottles. The chemicals from plastic bottles are ingested and tend to  disturb our body s immune system.

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

Nothing s more dangerous than drinking water in plastic bottles!

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