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

Do you know that the future health of your baby is decided  before you even conceive? Your preconception health is very important. Planning a baby is a demanding task, but if you plan it well you will have a healthier and easier pregnancy. 

These are a few tips which can do wonders

1. Relaxation at Work and Household Backup - Plan out your work schedule. You might need to change your work hours or may be change the job profile. You will also need someone to help you out with the household chores around this time.

2. Finances - Get your finances settled and insurance plan changed accordingly.

3. Lifestyle Modification - Eat healthy. Stop the intake of alcohol and stop smoking. Set aside a time for regular exercise if possible. Try to lose that extra flab and stay very active.

4. Reduce Stress - Create a support system for yourself. Engage in activities that uplift your mood.

5. Take Folic Acid -Take 400 mcg of folic acid tablet daily. It helps prevent birth defects of brain and spine in the baby.

6. Avoid Exposure to - Harmful chemicals, metals and toxic substances at workplace and home. Protect yourself from infections. Stay away from cats.

7. Up-to-Date Vaccination - Make sure your vaccination is complete. Vaccination against rubella and flu are very important. It is also important to maintain a gap of at least one month between your rubella shot and pregnancy planning.

8. Optimize your Medical Condition - If you have Hypertension, Diabetes, Asthma, Epilepsy or any other medical condition you must take complete advice from the physician. Blood pressure and sugar levels have to be under full control. The type and dose of the drug may need modifications.

9. Check Family History - Ask your parents, grandparents, brothers, sisters, aunts and cousins about any health problems in the family like genetic problems, mental retardation or malformations in babies. This can help your Gynaecologist to determine which problems to look for and how to prevent it. 

10. Visit your Doctor - Carry a record of your medical conditions, family history and a checklist of your queries. Get tested for Li Blood Group, Thalassemia, HIV, Thyroid Levels, and Blood Sugars.



Why Your Baby's Health is Decided Much Before You Even Conceive

Dealing with Dysmenorrhoea (Painful Periods)

Dysmenorrhoea is a medical condition where a woman has extremely painful periods. While menstruation is normal, it is very painful. This is caused by disorders like fibroids, pelvic inflammatory disease, adenomyosis, endometrial polyps, use of intrauterine contraceptive device or endometriosis. Many women assume that pain is normal and must be tolerated.

Few ways to deal with dysmenorrhoea are:

1. It’s Ok To Take Pain Relievers: To relieve the pain, simple analgesics like paracetamol and aspirin can be taken.

2. Anti-inflammatory Drugs Can Taken: Non-steroidal anti-inflammatory drugs are also prescribed to deal with dysmenorrhoea and most women are known to feel relief from the pain.

3. Fish Oils Capsules: Fish oil capsules which contain Omega 3 fatty Acids are also a good option to use when troubled with severe menstrual pain.

4. Prefer Light Diet: A few minor dietary changes can also help. Eating low fat vegetarian food especially on the days of the periods can prove to be helpful.

5. Avoid Sedentary Lifestyle: It is said that exercise can reduce the pain of dysmenorrhoea. Sedentary lifestyle is not good for the uterus region and it is advisable to indulge in regular exercises.

6. Use Heat Therapy: Heat therapy is a common and effective way to deal with dysmenorrhoea. Keeping a hot water bag on the region of the pain is known to soothe the pain and help relax the muscles.  

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

From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over WhatsApp, Facebook and other media.

Why Do Some Girls Have Extremely Painful Periods?

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

Chlamydia is one of the most common STD. It is a bacterial infection, caused by Chlamydia trachomatis. Occurring in both males and females, it can be transmitted via oral, genital, or anal sex. it has been dubbed as silent infection, as the affected person hardly ever presents with symptoms. It is extremely common though about 1 in 20 females in the age group of 15 to 25 can be affected. The disease, if left untreated, can cause severe reproductive issues including infertility in both males and females. Let us look at symptoms in men and women separately.

Men: About 50% of men infected with Chlamydia will go with no symptoms. It may take about 3 weeks for the symptoms to manifest and will include

    Small amounts of discharge from the penis
    Discomfort or pain with urination
    Painful, swollen, and inflamed testicles
    Burning and itching around the tip of the penis

Depending on the mode of transmission, the eyes, throat, and rectum can also be infected and there could be throat infection or conjunctivitis also.

If left untreated, Chlamydia can affect the sperm quality and lead to infertility in men in the long run.

Women: The infection is "silent" even in females and does not manifest itself with a lot of symptoms, only 30% of infected females present symptoms including:

    Abnormal, white or light yellow vaginal discharge
    Painful sex
    Bleeding or spotting in between regular periods
    Sometimes even bleeding during sex
    Burning or itching sensation around the vagina
    Severe abdominal discomfort
    Fever

In females, the infection usually travels up the urinary and reproductive tract. So, from vaginitis, it can lead to urinary tract infection, cervicitis, bartholinitis, and even pelvic inflammatory disease. If it reaches the fallopian tubes and/or the uterus, then the chances of fallopian tubes getting blocked is high. There can be scarring of the tubes and this can lead to infertility or ectopic pregnancy (pregnancy in areas other than the uterus, for example the fallopian tubes). This can be very dangerous and can be life-threatening situation too.

Pelvic inflammatory disease (PID) is a serious bacterial infection of the uterus and the fallopian tubes. Untreated Chlamydia infection often results in PID and requires antibiotics and bed rest.
Chlamydia infections have two negative sides to it, on one hand, it is difficult to detect given the absence of symptoms. On the other hand, there are serious implications leading to even fertility. It is therefore very important to prevent it. It is best to use a condom, especially with unknown partners; and in case of any doubt, one should get themselves tested and treated.

Symptoms of Chlamydia in Men and Women

Alchol can it affect your intimacy level with your partner, yes! But with this you might be wondering how can that be possible when you actually sustain yourself for long, maybe longer than you should be. It is probably the  whiskey penis . Alcohol may give you a sense of elation at one point of time, but it is essentially a nervous depressant. The over consumption of alcohol mainly has a reduced effect on sensitivity for both men and women.

How alcohol affects sex life in men: The effect of alcohol on the sex life of men is immense. In most cases, chronic and acute cases of alcohol consumption have shown to reduce the production of testosterone in men. Since testosterone is the hormone that results in the increase in libido in men, the effects of alcohol really reduce the performance in men. It has shown to reduce pleasurability and it can also reduce the intensity of orgasms. Sometimes, it can cause difficulty in ejaculation or delayed ejaculation.

How alcohol affects sex life in women: Alcohol can have a very mixed effect on women in general. While it can increase sexual arousal and desire, it can also result in low sensitivity. Women have a higher percentage of fat as compared to water in their bodies, this means that alcohol has a more profound effect on their bodies as compared to that in men. Their bodies also take longer to process and eliminate the alcohol. While some women report a heightened sense of sexual arousal and an increase in the duration of the orgasm, a large number of women also complain of lesser lubrication.

Alcohol also has a psychological effect; that is the loss of inhibition that may help in developing carnal instincts when intoxicated. This psychological effect may have a more profound effect than the physiological effects as a result of which women might claim that alcohol does indeed help in better sex.

Alcohol - How it Affects Your Sex Life?

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