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

It has been espoused in common knowledge that when you have inttercourse with your partner, it makes both of you feel happier, satisfied and contented. This helps bring you closer to each other and results in a stronger and better relationship. Sexual activities have a direct connection to your psychological well-being. However, the number of times you have sex isn t as important as the quality of the time you spend with your partner.

Stressed out on sex!
Due to modern lifestyle and stress, young couples are increasingly finding it difficult to hit the bed together, thus putting sex on the backburner. Research states most young couples now consider sex as secondary, mechanical and monotonous, which can be kept for a later time. But that is not the sign of normalcy. You don t need to do it daily, but 2 or 3 times a week is beneficial for a healthy body, mind, and relationship.

Some of the benefits of having regular sex

    Sex releases endorphins hormone which reduces stress and also lets you experience euphoria. This makes you feel satisfied and happy during the act and in general with your life.
    It is directly related to promoting attractiveness. During sexual intercourse, the body releases pheromones which make you look more attractive to other people.
    If you experience orgasms during the activity, you are most likely to have an enhanced life span due to the promotion of better circulation within the body.
    Sex acts as an excellent pain reliever due to the release of endorphins.
    Sex also helps you to have better control of your bladder by working out the muscles during an orgasm.
    It has also been shown to lower the risk of prostate cancer in men.

How much is too much?
These are just a few of the reasons sexologists and health care experts advise you to have intercourse often, at least twice weekly. You don t need to do it regularly, as over indulgence will have negative effects too. It could also signal the start of problems with sexual addiction. Some of the negative effects of too much sex could be:

    It will lead to a detrimental effect on your sexual activity. You will find it difficult to get aroused often.
    You experience cramps on your body.
    You can experience difficulties in your bowel and urinary functions.
    You would be constantly distracted by the thoughts of sex which could lead to sex addiction.

It is best to stay within a limit, have fun with your partner twice or thrice a week and enjoy the health and psychological benefits of this natural marvel.

How Frequently Should You be Having Sex?

Diabetes is a chronic metabolic disorder that results in higher level of blood sugar in the body. It is assuming epidemic proportions and India has become the new diabetic capital with more than 50 million diabetic people. The main problem with diabetes is that it does not completely go away and there is a whole myriad of issues that it brings along with it. Heart attack, stroke, eyesight problems, delayed wound healing, nerve damage and impotence. Therefore, diabetes and by that we mainly mean blood sugar level has to be managed so that there is a delay in onset of the associated conditions and/or reduced in severity.

Ayurveda refers to diabetes as Prameha (excessive urination) and Madhumeha (sugary urine) and has identified close to 20 forms of the disease. According to Ayurvedic belief, each disease is caused due to imbalance in kapha, pitta, and vata doshas and diabetes is caused by all these, predominantly by kapha. With any stream of medicine, management of diabetes involves two tracks   one is lifestyle changes and the second is medications.

Lifestyle changes include the following:

    Diet: Reduce the amount of rice, sugar, potato, sweet fruits, maida, deep fried foods, and red meat. Protein-rich foods like lentils, soya, green leafy vegetables and fish should be increased. Diet plan should change to small, frequent meals instead of binge eating.

    Exercise: Include 30 minutes of regular exercise into your daily routine if you have a diabetic predisposition.

    Others: Avoid smoking and alcohol, ensure sufficient sleep, avoid sleeping during day time, improved foot and eye care, periodically check sugar levels and manage stress levels.

Medication

Ayurveda has a whole lot of home remedies which have proven to be very effective against diabetes:

    Jambhul: Eugenia Jambolana whether eaten raw or juice extract has been shown to have beneficial effects in managing sugar levels and cholesterol.

    Gymnema sylvestre: Used to manage diabetes for over 2000 years, it reduces sugar cravings and is being touted as the future for diabetes treatment.

    Bitter gourd (Momordica charantia): It has 3 components that give it strong antidiabetic properties. The charantin reduces blood sugar levels; the polypeptide has insulin-like effects; and lectin that again has hypoglycemic effects.

    Bel (Aegle marmelos): Also known as wood apple, leaves of the plant are shown to have antidiabetic properties. 5 to 10 leaves can be chewed on a daily basis to help control blood sugar levels.

    Fenugreek (Trigonella foenum graecum): Consuming 10 g of fenugreek seeds soaked in water increases the amount of insulin produced, thereby increasing sugar breakdown.

    Neem: Chewing about 4 to 5 leaves in the morning on an empty stomach helps to control blood sugar levels. Alternately, neem leaves powder is available which can be dissolved in water and consumed.


Diabetes - 6 Natural Remedies that Will Help You Manage it

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

Caesarean section or C-section is fairly common today and most mothers do not realize that once their incision has healed completely, the scar tissue problems can still occur. Unfortunately, there are no instructions for how to heal and care for C-section scars after they go home. The general post-operative instructions from hospital include a list of activities to avoid like lifting heavy articles and driving.

Caesarean scars can cause pain well after they've healed. This happen at the site of incision, but in other areas as well. It's important to remember that the scar you see on a mother's lower abdomen is just one spot that scar tissue has formed. There are also internal scars which can spread throughout the body over a time period. This scar tissue can cause lingering pain and dysfunction well after delivery.

When our body tissue gets damaged, scar tissue forms. After a C-section, scar tissue forms along the abdomen and uterus as part of the natural healing process. Caesarean scars can be painful and mothers feel pain or tightness in their scars when they are reaching, leaning, lifting or standing up straight. The scar can cause muscle, connective tissue, and nerve damage in areas adjacent to scarred area. Over time this can lead to pelvic pain, bowel problems like constipation and irritable bowel syndrome and painful sex.

C-section scars are typically located in an area where they can entrap nerves. This can cause pain and also create an urgency or frequency to urinate. The best thing for a new mother is rest and recovery and doing too much, too soon, after a caesarean is a health risk. It is important that to keep incision clean, eat well and avoid lifting heavy articles to support healing. It is recommended that mothers have lymphatic and myofascial massage two days prior to surgery and as soon as possible post-surgery. Lymphatic massage is a light massage assisting in drainage and allows the collagen to align with the incision.

At three months post-caesarean mothers can begin scar tissue release therapy that involves massaging of the scar tissue so it becomes softer and more flexible like the surrounding skin and internal tissues. It needs to be done with three dimensional focus, slowly and gently separating the adhered tissues in all directions. The scar tissue release therapy painful with a burning sensation for some mothers, while some only feel mild discomfort or no pain at all.

Regardless of the age of the scar, one could get benefits from scar tissue release therapy from injuries to burns to surgical scars. Surface and internal scarring from surgeries could be contributing to many of the issues. Sometimes scarring is just a piece of the puzzle of your pain and so a pelvic floor physiotherapy in addition to scar tissue release therapy is recommended. The scar tissue release therapy reduces the appearance of C-section scars. It softens tissues and increases circulation, which all lead to a lightening in colour of the C-Section scar.

Tips to Deal with Caesarean Section Stiches

What are the factors that make a woman fertile? + The most effective way to address infertility

Infertility is the inability to get pregnant after a year of unprotected intercourse. Both men and women can be infertile.

In about one-third of cases, the cause of infertility involves only the male.

In about one-third of cases, the cause of infertility involves only the female.

In the remaining cases, the cause of infertility involves both the male and female or no cause can be identified.

Women are born with a finite number of eggs. Thus, as the reproductive years progress, the number and quality of the eggs diminish. The chances of having a baby decrease by 3% to 5% per year after the age of 30 and this reduction is noted to a much greater extent after age 40.

Female infertility can also be caused by a number of factors including:

1. Damage to fallopian tubes

Damage to the fallopian tubes can prevent contact between the egg and sperm. Pelvic infections, endometriosis, and pelvic surgeries can lead to fallopian tube damage.

2. Hormonal causes

This can lead to ovulation disorders which prevent the ovaries from releasing eggs such as in polycystic ovary syndrome ,  hyperprolactinemia or disorders of the thyroid gland - hyperthyroidism / hypothyroidism, can interrupt the menstrual cycle and cause infertility.

3. Cervical causes

A small group of women may have a problem in which the sperm cannot pass through the cervical canal. Whatever the reason is , this problem may be treated with intrauterine inseminations.

4. Uterine causes

Abnormal anatomy and distortion of the uterine cavity due to the presence of polyps and fibroids or problem with the endometrial lining can lead to failed implantation of the embryo.

Endometriosis occurs when endometrial tissue grows outside the uterus - often affecting the function of the ovaries, uterus, and fallopian tubes.

5. Primary Ovarian Insufficiency:

Also called as Premature Menopause, when the ovaries stop working prematurely before the age of 40. Certain conditions are associated with early menopause like immune system diseases, radiation or chemotherapy and smoking.

Causes of male infertility may include:

1. Abnormal sperm production or function due to various problems, such as undescended testicles, genetic defects, health problems including diabetes, prior infections such as mumps, trauma or prior surgeries on the testicles or inguinal region.

2. Problems with the delivery of sperm, due to sexual problems, such as premature or retrograde ejaculation, certain genetic diseases, such as cystic fibrosis, structural problems, such as blockage of the epididymis, or damage to the reproductive organs.

3. Overexposure to certain chemicals and toxins, such as pesticides, radiation, tobacco smoke, alcohol, frequent exposure to heat can elevate the testicular temperature, impairing sperm production.

4. Damage related to cancer and its treatment, including radiation or chemotherapy for which timely cryopreservation can be done for future use.

5. Unexplained infertility, In approximately 20% of couples the cause cannot be determined using the currently available methods of investigation.

Why is IVF the best way to treat infertility in women?

Conception is a complicated process that depends on upon many factors:

On the production of healthy sperm by the man and healthy eggs by the woman

The sperm's ability to fertilize the egg when they meet.

The ability of the fertilized egg (embryo) to become implanted in the woman's uterus

IVF (or in-vitro fertilization) is a lab procedure where the sperm and the egg are combined in a dish (where fertilization takes place) and is followed by transferring the embryo (the fertilized egg) into the uterus. It is increasingly being used as a method to conceive as it has been established as a safe procedure that helps bypass a number of complications women may face while conceiving such as ovulation problems and issues with the fallopian tube.

Even women who face issues such as PCOS, endometriosis, and premature ovarian failure can conceive through this process. Moreover, IVF has been in practice since 1978 and has a safe track record. The success rates of IVF are high as well, making it a preferred procedure for couples who suffer from fertility problems. Unexplained infertility can also be treated with the help of this procedure.



What factors that  make a woman fertile? + The most effective way to address infertility

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