Why every 1 in 5 Women in India suffers from PCOS? (And what they need to know)

Polycystic ovarian syndrome (PCOS) is a medical condition related to a woman’s endocrine system. Generally, this disorder is characterised by an imbalance of the sex hormones (oestrogen and progesterone), which leads to the development of multiple small cysts in the ovaries. Symptoms of PCOS include acne, irregular menstrual cycle and depression to name a few.
The causes of PCOS have not been accurately identified so far, but researchers suggest that the following factors might contribute to the onset of the condition.

1. Increased amount of insulin secretion- Women suffering from insulin resistance may get PCOS as their body is not able to effectively use this insulin, which results in increased insulin secretion by the pancreas. This, in turn, triggers more androgen (male sex hormone) production in the ovaries, making it difficult for the ovaries to ovulate.

2. Lower inflammation levels- The white blood cells present in your body form resistance against infections through a response termed as inflammation. Women with lower inflammation levels are likelier to get PCOS as the decreased levels stimulate polycystic ovaries, thereby producing more androgens.

3. Genetic factor-  If you have a family history of PCOS, it’s highly probable that you may also get it as the disease is linked with your genes.

How To  Live with PCOS

PCOS comes with numerous side effects like acne, obesity, infertility, excessive facial or body hair among others. There are certain lifestyle changes, which you may consider to manage PCOS and minimise its side effects.

1. Change your diet - Opt for a low carbohydrate, low sugar diet to keep your insulin levels in control, as insulin is responsible for increasing the severity of PCOS symptoms. 

2. Try to maintain an ideal body weight - Obesity is known for worsening insulin resistance, and you can prevent this by regularly keeping your weight in check. You can practice some easy at-home exercise to reduce weight besides having a balanced diet.

3. Get yourself checked regularly - Visit a doctor and get yourself checked regularly for potential health risks as PCOS is often associated with increased chances of diabetes, heart diseases, certain forms of cancer, hypertension, and high LDL (bad) cholesterol levels.

4. Join a support group - Joining a PCOS support group will help you cope with your emotional difficulties, while helping you to live a better life by cultivating an optimistic outlook.

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

Every 1 in 5 Women in India suffers from PCOS! Why? (And what they need to know)

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!

Recurrent pregnancy losses happen to a very small fraction of the population. Only 1% of couples are affected by it. Nevertheless, it is a very difficult and serious process to deal with due to the sensitivity of the issue. A woman is said to have recurrent pregnancy losses if she has lost 3 or more of her pregnancies. Although the exact reason for recurrent pregnancy losses are not known, there are several suggested reasons.

Reasons why it may happen 

Anomalies in the uterine lining such as polyps (abnormal tissue growth, usually in the cervix), or fibroid tumors can result in miscarriages if left untreated.
Hormonal factors such as thyroid malfunctions or pituitary problems can cause an imbalance in the luteinizing hormone (a hormone which triggers ovulation) resulting in miscarriage.
Age is also an issue one must keep in mind while addressing pregnancy losses. Women over the age of 35 are more likely to experience recurrent pregnancy losses. As women get closer to menopause, their bodies produce reduced levels of hormones and eggs which cater to a pregnancy. Therefore, due to the reduced levels of hormones, an older woman is susceptible to losing a baby as they have elevated levels of hormones and therefore are more fertile.
Lifestyle factors also have been linked to recurrent pregnancy losses. Constant exposure to toxic chemicals can result in pregnancy problems. Along with that, constant drug use, smoking and excessive consumption of alcohol are some of the lifestyle choices that can cause recurrent pregnancy losses.
Infections such as syphilis, malaria, measles, herpes simplex etc. can cause recurrent pregnancy symptoms if left untreated as they can obstruct and complicate the growth of the baby, resulting in premature development or pregnancy loss.
Management of Pregnancy Loss

Polyps and fibroid tumors are complicated disorders which should be given immediate medical attention. Although surgical methods are available, the best way to treat polyps and fibroid tumors is through the intake of progestin hormone pills which shrink the size of the polyps/cysts.
Eating a healthy diet to ensure the prevention of diabetes is highly recommended. Fruits, leafy green vegetables and whole grain cereals are a prerequisite for the complete growth of the baby as well as arming the body with the necessary strength it needs for pregnancy transitions as well as a stronger immune system.
A regular workout routine is also advised for pregnant women as it ensures a healthier and stronger immune system.
Although recurrent pregnancy loss is very emotionally debilitating for a woman and her partner, there are several means and measures to overcome this tragedy. One should not be disheartened by such an occurrence and get the required help needed.


Recurrent Pregnancy Loss - Possible Reasons Behind It!

While it is widely felt that men commit all sex related mistakes, women are equally at the erring end with respect to sex.

Here are 6 mistakes women frequenty make without realising it- 

1) Not Initiating Sex: It is a myth that women are not interested in sex as much as men. Neither should men have to be the traditional intiators. In fact, because most guys feel that they are always the initiators, it tends to set up disequilibrium on the passion levels in the relationship. Women must show interest by taking the first step every now and then. Your partner will really appreciate it, and it will also be very satisfying for you.

2) Not Guiding Him: It might be awkward for a woman to directly talk about what she wants, but it is the only way to lead your man to understand what works for you. If you let your man know what you like and what you do not, it is easier for him and makes for a good experience for both.

3) Bothering About Your Looks: Accept and appreciate your body. Concerns about how you look, during intercourse stops you from enjoying yourself and ruins your chances of achieving an orgasm. Men want their partners to abandon themselves during the act. All they really care about is your enthusiasm, energy, interest and flexibity.

4) Assuming Men Are Casual About It: It is a myth that men are not romantic or take sex casually. It is important for them. Both men and women find sexual intimacy in the context of a committed relationship to be much more satisfying.

5) Assuming He Should Be Up For It Always: There are many aspects of life that men, just like you, deal with daily. The pressures of daily rouitne -- work, family, bills – sometimes affects a man’s libido. Women tend to be surprised by this and often take a man’s lack of interest in sex personally. Give your man space to be and accept things naturally.

6) Getting Upset When He Suggests Something New: Men like to experiement. And if he suggests something new that you cannot appreciate, try to convey it in a very subtle manner. Do not get upset. Always talk about your comfort level and discuss openly about moral grounds.

Have any further questions on your sexual health and relationships? Click on consult privately to ask me.

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6 Sex Mistakes Women Make

Female genital sores are painful eruptions that bear a red appearance which may cause severe itching and pain. These lumps and sores may be caused due to sexually transmitted diseases and other ailments like allergic reactions, dermatitis, and other irritants. These lesions are usually found in the vaginal area and may also be caused to a number of skin disorders which all affect this region. Let us find out how to treat this painful condition.

Recognising the sores and lumps: 

Many of these cases go unreported because the patient may feel embarrassed or ashamed to come up with the problem. But one must recognise the symptoms and the appearance of such sores so that the doctor may take a look at the earliest signs of eruption, so as to avoid a flare up and increase in the severity of the condition. The symptoms include pain and itchiness in the area as well as burning and bleeding along with pain in the pelvic area and discomfort during sexual intercourse and urination.

Causes: 

There are many reasons for these eruptions. Sexually transmitted diseases or stds remain the top causes. Genital warts, genital herpes and chancroid which is a bacterial disease, can also cause this condition. Further, syphilis and molluscum contagiosum is a viral infection with pearl shaped nodules, which can also cause such eruptions and lumps in the genital area. Apart from stds, other chronic conditions like inflammation of the vulva known as vulvovaginitis, and contact dermatitis as well as atopic dermatitis, can cause this condition.

Diagnosis: 

The diagnosis will usually be done with a pelvic examination as well as urine culture to show the presence of bacteria. Also, other blood tests may be done to detect the presence of cysts. The patient's medical history will also be taken into account, for such cases.

Treatment: 

The doctor will prescribe a host of medicines including antibiotics and anti-viral medicines along with corticosteroids and pain relievers to help in treating these sores. Also, anti-itching ointments and medicines will be prescribed to make the condition less painful. These sores may also have to be removed with a minor surgical procedure at the doctor's clinic, in case they are too bothersome or painful.

Home remedies: 

The best way to take care of these sores is by taking a sitz bath with warm water and wearing clothes that will not brush against the area, which can cause further abrasions and discomfort.

One can prevent this condition by practicing safe sex with one partner at a time. Using condoms is strongly recommended along with routine testing and check-ups. All sexual contact should be avoided until the condition is cured completely.

Ways to Treat Sores and Lumps on Genitals

Child nutrition from age 6 months to 5 years growth and development of a child depends on the nourishment received by the child right from birth. Healthy diet and proper eating habits are essential to be inculcated in a child as early as possible. A balanced diet given to the child at the earliest provides all nutrients required for adequate growth and development. Nutritional value of every food item introduced in the child s diet should be gauged prior and then given to the child.

Nutritional requirement of children varies in accordance to the age group. It is necessary that the parents should have knowledge about the age-specific requirements of the diet, which will benefit the child in their growing years.

Following is the ideal child nutrition ranging from the age group of 6 months to 5 years.

1. 6 months to 12 months

A. Right from the birth of a newborn child, it is necessary to begin breastfeeding for the baby. It should begin within an hour of the child s birth. It is the ideal way of providing proper nutrition to the child.

B. Breastfeeding is beneficial by providing nourishment and also by improving the immunity of the baby.

C. From birth to 6 months, only breastfeeding is advised. It is a critical source of nutrition for the child even during illness.

D. After the baby turns 6 months old, solid food can be introduced in the child s diet.

E. Breastfeeding can be continued and supplemented with other food items.

F. Usually, fruit juices are introduced first in the diet.

G. Feeding bottle should be avoided and the child should be fed with a spoon and cup. Proper hygiene and good handling of the food is required.

H. It is necessary to wipe the gums and developing teeth clean with a wet gauge to prevent any decay that can be caused by sticking of the food on the teeth surfaces fed to the child.

2. 1 year to 3 years

A. Children in this age group can tell when they feel full after feeding. It is necessary to listen to their demand for food and also avoid overfeeding children.

B. This age group requires children to eat all types of nutrients, so parents should focus on providing a variety of food items to replenish their child s nutritional requirements.

C. Children in this age group require fat-rich foods and should be given dairy products for calcium requirements.

D. Processed foods should not be given to children at this age. Calories intake should be monitored to the optimum level.

E. Since children at this age are involved in activities like walking, running around and playing it is essential to keep feeding them at regular intervals to maintain the energy levels of their bodies.

3. 3 years to 5 years.

A. Children belonging to this age group require to eat a well-balanced, nutrient rich diet.

B. Grains should be included on a routine basis. They provide the child with carbohydrates, fibres and minerals. All these nutrients provide energy to the child s body.

C. Inclusion of whole wheat grains provides fibres in adequate quantity.

D. Refined foods should be avoided, whole grain bread should be included in the diet.

E. Fruit intake should be increased, as they are an important source of various vitamins. Fresh fruit should always be preferred over juices for growing children.

F. Sugar intake should be kept to a minimum quantity since refined sugars do more harm to the child s health than any good.

G. Vegetables should form a considerably greater part of the child s daily diet, with the inclusion of a variety of vegetables.

H. Protein sources of food include meat, poultry, pulses, beans and nuts. Along with protein, these food items also provide iron, zinc and minerals to the body.

Apart from the above specified food items, daily intake of milk is necessary for children of growing age. It provides the body with sufficient calcium to facilitate bone growth in growing children. Also, nuts like walnuts, almonds, cashews are advised to be given to the children daily.

In case you have a concern or query you can always consult a specialist & get answers to your questions!

Nutrition Tips For Children From Age 6 Months To 5 Years!

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