There are two methods by which abortion can be done:

Medical Abortion - Non-surgical abortion in which medicines are used to induce abortion

Surgical Abortion - Use of transcervical procedures for terminating a pregnancy, including vacuum aspiration, and dilatation and evacuation (D and E).

Surgical or Medical Abortion for Unwanted Pregnancy

If pregnancy is lesser than = 7 weeks; medical method with Mifepristone with Misoprostol is favorable as the success rate is as high as 97%.

If pregnancy is between 7-12 weeks; surgical abortion is the only option.

If pregnancy is beyond 12 weeks - 20 weeks, then the woman needs to be hospitalized and will be given either Mifepristone followed by Misoprostol tablet or only Misoprostol tablets and woman will then abort like a miscarriage in the hospital. If any products are remaining, then it will be evacuated surgically.

Surgical abortion is preferred if patient desires concurrent tubal ligation or IUCD (CuT) insertion.

If a woman fulfills the criteria for selecting either method i.e. before 7 weeks, final choice has to be given to the woman.

Summary of choice between Surgical or Medical abortion in India

lesser than = 7 weeks - Medical method or surgical method

7-12 weeks - Surgical abortion

12 - 20 weeks - Medicines with or without surgical procedure in hospital

Advantages of Medical Abortion

Avoid surgery

Controlled by the woman and may take place at home

No need for admission to the hospital

Usually, well tolerated by women, if properly counselled and motivated

No need to take leave from work, as bleeding can be managed with menstrual pads even while in the office or at work.

Disadvantages of medical abortion

Takes time (hours to days) to complete abortion, and the timing may not be predictable. Women experience bleeding and cramping, and potentially some other side-effects (nausea, vomiting, fever, and shivering). May require more clinic visits than surgical abortion.

Advantages of Surgical Abortion

Quick procedure

Complete abortion easily verified by evaluation of aspirated products of conception

Takes place in a hospital so Sterilization or placement of an intrauterine device (IUD) may be performed at the same time as the procedure. It can be performed under local anaesthesia if woman is properly motivated and counselled

Disadvantages of surgical abortion

Requires instrumentation of the uterus

Small risk of uterine or cervical injury

Timing of abortion controlled by the doctor and hospital

Anaesthesia needs to be administered. Most doctors perform this procedure under short general anaesthesia. A woman needs to be in the hospital for at least 6 hours. Effect of sedation will be there throughout the day.

Methods of Abortion for Unwanted Pregnancy

Breast pain, also known as mastalgia, can be termed as any type of discomfort, pain or tenderness in and around the breast or the underarm region. It can also be accompanied by a sharp pain or a burning sensation. 
There are two major types of breast pain
Cyclical Pain: As the name suggests, this type of pain occurs on a cyclic basis and is linked with one s menstrual cycle. It may happen when one is going through her periods and is influenced by hormonal imbalance. This type of pain is generally not a cause of concern.
Non-Cyclical Pain: This is generally not common and its cause can be linked to a variety of reasons; cancer or a malignant tumour in the breast being the most severe consequence.


Causes of Breast Pain
Lumpy breasts along with soreness and pain can be caused due to fibrocystic breast tissue.
Hormonal imbalance can also lead to pain or discomfort in and around the breast region. Abnormal prolactin limits can also be a contributing factor.
Breast cancer can also lead to pain, mostly in the left breast. Along with the pain, it can also induce a dull ache, tightness or heaviness in the chest.


Treatments for Breast pain
The various treatments for cyclical breast pain include:
Making modifications in the diet
Administering Vitamin E and calcium supplements
Including thyroid hormonal supplements in the diet
Reducing sodium intake in your diet
For non-cyclical breast pain, which is often the cause of cancer, a thorough examination is recommended. A clinical biopsy will be advised if the lumpy tissues make the tumour harder to be detected through a mammogram.
If the pain is on account of an injury, then appropriate painkillers will have to be administered to reduce the pain.


Breast Pain - Understanding the Types and Reasons Behind it

Ovarian cysts are fluid-filled sacs that develop on a woman's ovary. A patient might experience abdominal and pelvic pain, abnormal bleeding, menstrual irregularities, pain during intercourse or irregular bowel movements. These symptoms indicate an ovarian cyst developing inside you. Ovarian cysts are common in women and may develop during menstruation. In many cases, symptoms are not observed, and you may get ovarian cysts without knowing. Usually being harmless, ovarian cysts may sometimes lead to severe health conditions.

Here are 7 important things you should know about ovarian cysts:
1. You should know the reason behind the formation of ovarian cysts. When the follicle does not release the egg, it may grow bigger in size and take the form of a follicular cyst. A corpus luteum cyst may also develop, which is a cavity that gets formed after the egg is ruptured and released from the follicle. The cysts may bleed and cause pelvic pain.

2. It is important for you to know if you have an ovarian cyst. Many ovarian cysts do not show symptoms and go away by themselves. Follicular cysts do not change your menstrual cycle, but corpus luteum cysts may cause bleeding.  

3. You should know how to detect an ovarian cyst. You should visit a gynecologist regularly for diagnosis. Bigger cysts can be diagnosed via a pelvic examination. Ultrasound is also used for detection.  

4. You should have an idea about all the symptoms associated with ovarian cysts. These include fever, nausea and vomiting. These symptoms indicate that you have an infection. Sometimes, a cyst might twist an ovary, which may cut off blood supply to the ovary, causing permanent damage.

5. In case you are at a risk of twisting of the ovaries, you have to undergo a surgery. Surgery is also considered when the cyst lasts longer than three menstrual cycles and it is bigger than four inches in size. The cyst may also pose the risk of being a tumor. The common surgical procedures for ovarian cysts are laparoscopy and laparotomy.  

6. You can prevent ovarian cysts be taking birth control pills, which help in suppressing ovulation and prevent the formation of a cyst. Birth control pills may help only if you are not pregnant.

7. Ovarian cysts are more common in premenopausal women. However, these are possible in postmenopausal women as well, especially in the early postmenopausal stage.  

Sometimes, there might be chances of an ovarian cyst being cancerous in nature, which may lead to ovarian cancer. The risk of cancerous ovarian cysts increases with age. It is recommended to consult a gynecologist for the proper diagnosis and treatment of ovarian cysts in women. Pain medications and heating pads are used as alternative treatment methods for less serious ovarian cysts.

7 Things You Should Know About Ovarian Cysts

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?

A collection of symptoms typically occurring between ovulation and menses (discharge of blood and from the uterus) is defined as premenstrual syndrome (PMS). Premenstrual syndrome symptoms can either be physical or emotional.

Physical symptoms and signs include:
i. Muscle or joint pain
ii. Headache
iii. Fatigue
iv. Weight gain due to fluid retention
v. Bloated abdomen
vi. Breast tenderness
vii. Acne breakouts
viii. Diarrhoea or constipation

While other behavioural and emotional symptoms include:
i. Anxiety or tension
ii. Depressed mood
iii. Crying spells
iv. Anger or irritability and mood swings
v. Food cravings and appetite changes
vi. Insomnia
vii. Social withdrawal
viii. Poor concentration

Causes 
The exact cause of PMS is unknown. But there are several contributing factors, such as:
1. Cyclic hormonal changes: The hormones oestrogen and progesterone fluctuate a lot while preparing for a normal menstrual cycle. This fluctuation causes some of the symptoms of PMS.
2. Chemical changes: The fluctuation of serotonin, a kind of neurotransmitter (brain chemical), affects the mood, which causes some of the emotional symptoms of PMS. For instance, insufficient serotonin triggers premenstrual depression, insomnia, food cravings and fatigue.
3. Depression: If the PMS symptoms are severe, depression could be the underlying cause, though it doesn't usually trigger all of the symptoms.

Treatment
There is no permanent cure for PMS, but a few lifestyle changes and home remedies can work very well for you. Some treatment options include:

1. To ease abdominal bloating, drink lots of fluids
2. Eat a balanced diet comprised of plenty of vegetables and fruits. Reduce your alcohol, caffeine, salt and sugar intake.
3. You can take supplements such as magnesium, calcium, vitamin B-6 and folic acid to reduce mood swings and cramps.
4. Take vitamin D supplements to relieve symptoms
5. Sleep for at least eight hours in the night to counter fatigue
6. Exercise to improve your emotional health and reduce bloating
7. Try to reduce your stress as much as you can; read a book or walk to relieve some stress.

Besides, these lifestyle changes, you can take over-the-counter medications such as aspirin and ibuprofen to reduce stomach cramps, muscles aches and headaches. Diuretics (drugs that increase urination) are excellent treatments for bloating and fluid retention. However, consult your doctor before consuming any medication or supplement.

Causes and Treatment of Premenstrual Syndrome

Post pregnancy, you may experience pain due to multiple reasons. However, such pain might subside within a few weeks, but still it is advisable that one should be prepared prepared for all kinds of discomfort post pregnancy, such as the pain you endure while breastfeeding or the epidural pain. If you have undergone surgery, then there may be pain due to surgical incisions as well. One should keep herself hydrated all throughout and be patient while trying to deal with such post pregnancy pain.

Managing pain depends on the type of pain you are experiencing. Below is a summarized account of the different types of pain one might go through and how to come out of it.

    Incisions: In case the delivery occurs by the caesarian procedure, you might have to endure pain from the incisions. The pain generally lasts till all the incisions heal, so you will require pain medications to get relief from the pain.
    Uterine contractions: The uterus needs to return to its normal size after the delivery. The pain from these contractions tends to increase with subsequent pregnancies. Like incisions, pain medications will be administered to help you get relief from the pain.
    Vaginal dryness: A woman s vagina tends to be dry while she is breastfeeding. This can cause pain if you want to indulge in sexual intercourse. In this regard, lubricants (preferably water based) are a good way to treat vaginal dryness.
    Engorgement of the breast: When a woman starts lactating, her breasts tend to become fuller and thus, cause minor but persisting pain. A breast pump (used to extract milk from a woman s breasts), in this case, can relieve you of such pain.
    Back pain: Pregnancy related stress and strain can often lead to back pain. This back pain usually stems from holding the baby and breastfeeding it. If it so happens, you can consider changing your posture while breastfeeding and taking warm baths twice a day to get rid of the backaches.
    Joint pain: There may be pain in your joints such as the one in your wrists, hands and feet. This usually occurs due to all the chemical changes that your body undergoes during pregnancy. Pain medications and stretches can help ease this sort of a pain.
    Pain in the legs: Post pregnancy leg pain is caused because of all the fluids that are administered intravenously. Once the content of fluids in the body reduces, the pain tends to subside. However, any sign or symptom of blood clots or visible redness in the legs might warrant medical attention at the earliest.
    Headaches: This is the most common type of pain that can result from a pregnancy. Headaches are caused due to hormonal imbalances, insomnia and stress that you may experience. It is advisable to not take any pain medication in this regard as painkillers can interfere with your bodily hormones even more, given that headaches are usually not something to worry about. Drink plenty of water and try to get ample rest; this should take care of the pain automatically.

Post Pregnancy Pain - How best to Manage it?

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