Once the reality of the positive pregnancy test sets in, dreaming about the yet-to-arrive begins. Curiosity about gender, options for names, ways to manage, shopping ideas, etc., begin to get discussed. And then totally out of the blue the news comes that there is a miscarriage. This is one of the most depressing phases. It is very important for the family to be around and support each other. While the entire family is upset and hurt over the news, the mother needs most care as there is just not emotional but a huge physical component also to the episode. On the other hand, remember that miscarriages are extremely common, and is no indication of a fertility issue.

The first step would be to diagnose and confirm the miscarriage. After that, depending on whether it was complete or incomplete, some medical intervention might be required. In most cases, medications like misoprostol are given to expel the uterine contents. These help by clearing out the contents in about a couple of days' time. In some cases, a D and C might be required if your doctor suspects that medication will not suffice. This also helps identify if there is any issue in the uterus that could have caused the miscarriage.

While the above take care of the physical part, the emotional component also requires cautious management. Needless to say, this is trickier than the earlier one.

Mourn to your heart's content - When you have nursed a life within you and have lost it, it is very normal to cry for its loss. There would be a mix of emotions - shock, denial, confusion, anger, grief, depression, etc. Take some solace from that fact that this is nature's way of removing unhealthy fetuses.

Get someone to talk to - Need not be your husband, but anybody whom you can talk to without having to watch words. A sibling, a good friend, a close relative - your choice. Make sure you don't pick ones who will judge and sympathize with you. More than sympathy, you need someone understanding and knowledgeable.

Socialize more - As you would have kept to yourself post your positive test, use this time to socialize more and meet friends whom you have not regularly been in touch with. Close family members, your children (if you already have), society groups, movie groups, etc., help to a great extent.

Formal medical counseling: If you are not able to cope with your regular circle of family and friends, try seeking professional advice from counseling.

Spirituality - Whether you believe in temple or churches, spend some time there. Involve in some religious activity if you would like, this helps very often.

As much as it is painful and traumatic, it is not very uncommon or unnatural. Get back on your feet, the sooner you do, the better.

Miscarriage - Ways To Recover

Although most women experience menopause between the age of 45 and 55, but when women experience the menopause before they reach 40, it is termed a premature or early menopause. It is also known as premature ovarian failure.
This may be due to primary ovarian insufficiency in which there is decreased activity in ovaries and the periods spontaneously stops. It may be result of chemotherapy treatment for cancer or it can be surgically induced menopause when the ovaries are removed. Premature menopause can also be caused by treatments for cancer or other conditions that involve chemotherapy or radiation therapy for the pelvis. These treatments can damage the ovaries and result in ovarian failure. The chances of premature menopause depend on the type and amount of chemotherapy as well as the age of the patient

Removal of both ovaries by surgery causes menopause right away. Menstruation stops after this surgery, but the hormones of women facing such condition drop quickly. They experience strong menopausal symptoms such as hot flashes and diminished sexual desire.

Chromosome defects like Turner s syndrome can lead to premature menopause. In this condition, the female is partly or completely missing an X chromosome due to which the ovaries does not form normally leading to early menopause. Women with a family history of premature menopause are more likely to have the same themselves. Autoimmune diseases like Thyroid disease and rheumatoid arthritis that attack the body's immune system may mistakenly effect the ovaries thus preventing them from making hormones.

One should visit agynaecologist, if the period stops or changes before the age of 40. Menopause is confirmed when a woman does not have her period for 12 months in a row. Blood tests for measurement of oestrogen and related hormones, like follicle-stimulating hormone determines if one has reached premature menopause

Women have premature menopause can be observed as physical problems, emotional disturbances or problems associated with sexual functioning. Women experience sudden waves of mild or intense body heat commonly known as hot flashes and can also experience profuse sweating called as night sweats and have difficulty in sleeping. They experience vaginal dryness and the sexual drive or the libido also decreases. The bone density decreases leading to osteoporosis and fractures. In addition to physical symptoms, there are emotional symptoms like anxiety, mood swings, loss of focus and difficulty in concentration. Women who want to conceive and go through premature menopause may feel extremely upset. The sexual symptoms include dryness and thinning of walls of vagina, thus causing pain or discomfort during sexual intercourse.

Premature Menopause - Signs and Causes

PCOS (Polycystic Ovary Syndrome) is a common disease of the endocrine system among women who have attained the reproductive age. Women with this condition generally have ovaries larger in size than the usual, containing small pockets of fluids, also termed follicles. These 'follicles' develop in each of the ovaries as diagnosed with the help of an ultrasound exam. Abnormal or extended menstrual cycles, unusual growth of hair and obesity are some of the common accompanying conditions associated with PCOS. This disorder can interfere with a woman's menstrual cycles, thus making pregnancy difficult. More so, this condition can also impact the way you look and if left untreated for long, can lead to underlying disorders such as diabetes and other cardio vascular diseases.

Causes of PCOS
1. Excessive Insulin secretion: Insulin is a hormone secreted by the pancreas, which allows the body cells to utilize the sugar; the most important energy store of your body. If you suffer from insulin resistance, your body's ability to utilize the insulin gets affected adversely. This forces the pancreas to secrete more insulin in order to keep up with the body's energy supply. This excess insulin might result in an increase in the production of androgen, which in turn, might interfere with the ovulation ability of the ovaries.
2. Low- level inflammation: Inflammation is the process by which your body's white blood cells fight infections. Studies reveal that women suffering from PCOS have a low level inflammation which acts as a catalyst in the production of androgens.
3. Can be hereditary: If you have someone in your family suffering from this syndrome, you might automatically be at a higher risk of developing this disorder.

Symptoms accompanying PCOS
1. Abnormal menstrual is the most commonly observed symptom. Women suffering from PCOS may have less than nine periods in an entire year and in some cases, even none. 
2. Excess secretion of male hormone, which is related to excess androgen production may result in symptoms, such as abnormal body and facial hair, acne and baldness, which is identical to that in men.
3. Unexplained increase in weight and difficulty losing it as well.
4. Another fairly noticeable symptom is depression.
5. Infertility

PCOS- Causes and Symptoms

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?

One of the most severe forms of pain is the pain that a woman experiences during the process of childbirth. On a scale of 1 to 10, with 10 being the most severe, it is believed to be 8 to 10. In the earlier days, a number of women would die during childbirth and survival was considered as a second lease of life. This belief has however, changed with the advancements in medical science. The delivery has now become an almost painless procedure.

How it works: The pelvis and the lower limbs receive nerve supply through the nerves coming out of the spinal cord. A strong anesthetic is injected into the lower back to numb the pelvis and down below. This ensures that the mother is comfortable and awake during the whole procedure and is able to see the child being delivered but has reduced pain in the lower half of the body.

What are its benefits?

The mother has a painless delivery and is conscious and able to see the process of delivery.
Significant relief from the painful experience of childbirth. The pain induces secretion of stress hormones in the mother, which adversely affects both the mother and the child.
Blood pressure is better controlled using this procedure.
Additional instruments can be used during the delivery if required without the need for additional anesthesia.
If required, the procedure can be converted to a cesarean section too, by adding an epidural catheter.
The duration of childbirth has been significantly decreased.
Suitable for patients who have preeclampsia and heart disease
It has some disadvantages too

There are minor complications, including:

This can develop after the painless delivery and the onset and intensity vary from one individual to another
Post-procedure headache
Pain at the site of injection
Difficulty during urination
The normal pushing effect by the woman is reduced due to the numbness and so vacuum may be used or delivery may have to be converted to a cesarean one.
In rare cases, there could also be a sudden drop in the blood pressure
Certain indications

In the following cases, the doctor would advise the mother to go for a painless delivery

Medical conditions like preeclampsia, high BP, or other heart conditions
Subsequent births after having had a cesarean section (VBAC   vaginal birth after cesarean)
People who have previously had prolonged or complicated labor, a painless delivery is easy on both the mother and the child
When it should be best avoided

In some cases, like the ones listed below, the painless delivery should be avoided

Women with bleeding disorders.
Women who are on blood thinners like aspirin, heparin, etc.
Women who have had prior low back surgeries
Women with neurological conditions
A detailed discussion with your gynecologist is the best way to identify, if this would work for you.

Painless Normal Delivery - Is it Possible?

PMS is one of the worst food sensitive diseases. Symptoms include moodiness, bloating and headache. All it takes is one symptom to crop up for the whole body to go down. While environmental changes and preventive measures play a crucial role in dealing with this condition, careful choice of food goes a long way in keeping PMS under control. Here is a list of some best and worst food for PMS:

Foods that are Good During PMS:

Brussels sprouts, Artichokes and Broccoli: These veggies with high fibre content are known to ease bloating. Furthermore, the high water content of these veggies effectively deals with gas, discomfort, and puffiness. The idea is to refrain from foods with high sodium content that only contributes to the suffering.
Quinoa, what berry and popcorn: These foods help to deal with a short temper which is a very common occurring of PMS. Some other good effects of a high carb diet such as these include fighting anxiousness, depression and maintain composure. Consuming whole grain on a daily basis also helps to keep the mood cheerful. This happens because of the added secretion of the feel good factor hormone called serotonin.
Banana: Many women tend to face sleep disturbances before the period sets in. A recent study at the John Hopkins University found that less sleep before the period makes a woman susceptible to cramps and discomfort. Banana contains melatonin. The latter helps the body maintain its natural rhythm.
Eggs: The cravings during PMs can be very difficult to handle. It is therefore very important to start the day a very healthy breakfast. The right amount of protein and healthy fat present in an egg helps to keep the body energised throughout the day. Scrambled egg and an ounce of chicken is a perfect answer to PMs craving.
Some foods to avoid during PMS:

Processed fats: Processed fat contains a lot of processed fats, sodium and salt. Processed fats make a woman puffy and increment bloating. Processed foods contain very high protein content that becomes very difficult for the body to process during PMS.
Sugary foods: Craving for sugary food is pretty normal during PMS. However, too much sugar consumption during PMS fluctuate the blood sugar level. They also aggravate tension and mood swings. The latest study has found that refined sugar can disturb the immune system and creates a lot of fatigue in a woman.
Caffeine: Restricting caffeine during the period can help prevent the cramps and bloating. Certain caffeine such as coffee, cigarettes and chocolate can aggravate breast tenderness, anxiety, and depression. What's more, they systematically create a craving for sweet and other caffeine-related stuff. A better alternative to caffeine during PMs is herbal and green tea, water and fruit juice.

PMS - Foods You Must Have or Avoid During It!

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