The year 2014 has seen a massive increase in the number of patients affected by Gonorrhoea. The most infected age group is between 15 and 24. This is mainly due to lack of knowledge in this age group about the disease. Here are some facts about Gonorrhoea that one must know.

Gonorrhoea Transmission
Gonorrhoea, also known as drip, is transmitted when a normal person comes in contact sexually with an infected person. Infected fluid of a mother can also pass to her newborn infant during delivery. The disease can affect both the genders.

Cause of Gonorrhoea
Neisseria gonorrhoeae bacteria cause the disease. The bacteria grow in mucus membranes and usually grow in the warm and moist areas of humans' reproductive tracts such as uterus and fallopian tube of women. These can also grow in anus, mouth as well as throat. As a matter of fact, the infection can be passed even via oral or anal sex.

Symptoms of Gonorrhoea
An infected person will develop symptoms of the disease in 2 to 14 days. Men may feel burning or painful sensation while urinating. Other symptoms are as follows:

1. Swollen and painful testicles
2. Swollen or redness at the tip of the penis
3. Penis may have a drip or discharge
4. Frequent urination
5. Recurrent soreness of throat

Females have milder symptoms of the infection. This makes it difficult to diagnose, and is sometimes misinterpreted as common vaginal yeast or other bacterial infection.

Following are a few symptoms of the disease in women:

1. Burning or painful urination
2. Frequent urination
3. Vaginal discharge
4. Soreness in throat
5. Fever
6. Lower abdominal pain
7. Pain while sexual intercourse

If the disease is not treated, infection spreads in blood stream leading to rashes, fever and even pain in the joints. Such unnoticeable symptoms make it difficult to treat.

Testing Methods of Gonorrhoea
One method is that penile or vaginal discharge samples are taken from patients and examined under a microscope by adding reactive stain. However, this is not an accurate assessment.
Another test is conducted where exposing samples are incubated. In case of infection, colony of gonorrhoea shows growth. Preliminary test may take 24 hours. Final assessment may take around three days. Samples can be from the patient's anus, joint fluid, blood, throat, vagina or tip of the penis.

Treatment
The disease is treatable under proper medical supervision. However, the bacterial resistance to Azithromycin drug has made it more difficult for treatment.

Protection
It is highly recommended to have a protected intercourse. Women of age group less than 25 need to have STI evaluation once a year.

Know All About Gonorrhoea

While some couples conceive with ease, conceiving a child can be extremely difficult for others. In cases where a woman is not able to get pregnant despite having regular intercourse in tune with her biological cycle, infertility tests may be suggested to investigate the reason behind this. In most cases, these tests are suggested if a year has gone by without intercourse resulting in a pregnancy. Women may also be said to be infertile, if they cannot carry a foetus to full term. 

Infertility can affect both men and women and can be triggered by a number of different reasons. In some cases, it is treatable while in others, alternative ways of having a family may need to be discussed. Hence, it is very important to understand the different types and triggers for infertility and to undergo complete infertility investigations. Some of the common types of infertility investigations are as given below.

Blood tests: A blood test of both partners is used to assess the general health of the couple and to identify any health factors that may be impeding fertility.
Tests for women: 
Hysterosalpingogram: This is an X ray that can identify if a blockage or any other issue in the fallopian tubes are the cause for infertility.
Pelvic ultrasound: This is used to have a look at the anatomy of the female reproductive system and to check for fibroids.
Laparoscopy / hysteroscopy: This is used to get a clearer picture of the ovaries, uterus and other parts of the reproductive system.
Tracking cycle: Ovulation and the thickness of the uterus lining may also affect infertility, This can be diagnosed by tracking and assessing the menstrual cycle.
Tests for men
Semen analysis:This test is used to get an idea of sperm concentration, motility and the appearance of sperm in a man s semen. In some cases, the semen may not include any sperm cells. In such cases, a follow up investigation may be required to assess if sperm cells are being created in the testicles. This is known as testicular sperm aspiration or a testicular biopsy.
Sperm DNA: The DNA in sperm also plays an important role in fertility. This test is used to assess the sperm DNA integrity and to see how it may affect embryo development and chances of an on-going pregnancy.
Infertility treatment depends on the cause identified by the above tests and hence it is important for both partners to undergo complete testing.

Complete Infertility Investigation - Why is It Important?

Sex, which gives pleasure to most, can be painful for some. Many women, mostly in their menopausal or post-menopausal phase find intercourse and penetration extremely painful. Menopause results in hormonal imbalance, with a significant drop in the estrogen level. The reduced estrogen level results in Vulvovaginal Atrophy (dryness of the vagina and thinning and weakening of the vaginal tissues). In such cases, women experience irritation, Vaginismus (vaginal tightness) and soreness after sex.
 
One can also experience a burning sensation during urination. There may be inflammation of the vaginal tissues. If untreated, the inflammation can cause infection and other complications. "Dyspareunia" or pain during intercourse is very common in postmenopausal women. The pain experienced during sex can be due to "Vulvodynia" as well. Vulvodynia is a condition whereby a women experiences chronic pain in the external genitals or vulva. A number of other factors can also contribute to the pain during sex. A thorough and detailed investigation is thus very important.
 
Treatment
Many women find it extremely embarrassing to discuss menopausal problems with their partners and doctors. The key to effective treatment lies in timely diagnosis and medication. There is nothing to be embarrassed about. The postmenopausal changes can vary from person to person. Thus it is very important to discuss every minute detail with your physician.

Many options are available to make intercourse a less painful experience:

Keep dryness at bay: In most cases, painful intercourse results from dryness of the vagina. Use of a lubricant can ease the pain to a great extend. A water-based lubricant is highly recommendable. Regular use of vaginal moisturizers is also effective to deal with vaginal dryness.

Vaginal care and hygiene: It is very important to keep the vagina clean. Avoid using soaps, bath oils and shower gels. They do more harm than good to the vagina. It is advisable to wash the vagina with warm to lukewarm water. Undergarments should be changed twice daily.

More is good: Having sex at regular intervals is a healthy practice. It not only enhances and improves the blood flow, but also helps to overcome vaginal dryness.

The Pelvic Floor Therapy: It is immensely beneficial. In this therapy, a gentle pressure is exerted in the pelvic region to relax the stiffened and tightened muscles. One can also massage the area to relax the muscles.

Squat: It is a very effective exercise to strengthen the buttocks and hip muscles. Exercises to strengthen the pelvic floor muscles are also very helpful.
Other therapies: One can also opt for Local Estrogen therapy and Systematic Estrogen Therapy.

Menopause should not affect your conjugal and sexual life. Visit here to know more and forget painful intercourse forever.

Pain With Intercourse In The Postmenopausal Woman

According to a report by WHO, every hour about five women die in India during childbirth. Giving birth is one of the most challenging bodily functions that a woman has to perform in their life.

When it comes to the mode of delivery, there are a number of delivery options:

Normal or Vaginal Birth
C-Section or also known as Cesarean
Water Birth
Vacuum Extraction
Of the few mentioned above the most common delivery options are natural birth and C-section. The mode of delivery will be decided only after factoring in the woman s health condition, ability to endure pain etc.

Also, when it comes to deliveries, there is a lot of half-baked information floating around. The internet is one of the biggest contributor in this regard. Here are some of the most common myths -

Myths on Normal Delivery:

Myth 1: It s More Superior
Many women consider or think that being able to bring a life into the world without the aid of any painkillers or any other external interventions gives them a sense of empowerment.

Myth 2: It is Riskier
There is no definite statistic to prove that a natural birth is more risky than other delivery options.

Myth 3: A Process that comes naturally to a Woman
Another commonly held fallacy about normal delivery is that a woman s body knows exactly how to respond to a normal delivery. The common reason given is that women have been undergoing natural childbirth process since time immemorial without external interventions or assistance. Not only is a normal delivery fraught with misconceptions but so is a C-section surgery.

Myths on C-Section:

Myth 1: A C-Section is more convenient compared to a vaginal Birth
A C-Section is an invasive surgery method that comes with its own set of risks like any surgery. Doctors generally advise women to opt for a natural birth if possible.

Myth 2: You cannot undergo too many C-Sections
There is no limitation on the number of C-sections you can have in your lifetime. However, the risks of complications increase with every subsequent C-section.

It is advised that you plan the delivery option based on your health condition weeks before your due date. In some cases, C-section surgery is resorted to during the course of a vaginal birth when complications arise. 

Consult your doctor if you have queries regarding your choice.

Myths On Normal Delivery And C-Section Debunked!

Does watching porn together help you have a better sex life?

It is often said that the couples who do most day-to-day activities together are more committed towards each other. But does the same stand true when it comes to watching sexual content or pornography? Well, research certainly seems to indicate that, with a whopping 96% couples watch pornography together. Here are some pros and cons of viewing porn with your partner.

PROs-

1.  It may help you both in discovering your sexual preferences
It is important for both you and your partner to be on the same page when it comes to discovering your sexuality and figuring out each other’s sexual preferences. Just like adolescent sex education, pornography too educates you about the mechanics of sexual play. It is a useful tool that brings out the kinky side in you and makes you more open to discussions on things that pique your curiosity in the bedroom. As and when you see such visual imagery, it may appeal to you enough to try it out with your partner. Discuss such desires with your partner. This may help you in discovering what really turns you and your partner on.

2. It may help you in maintaining sexual fidelity in your relationship
Watching porn together with your partner can potentially increase the intensity of physical attraction between the two of you.This, as a result, leads to greater gratification for both of you, and if you are sexually satisfied by your partner, you are less likely to look for pleasure outside your relationship. Also, it is way healthier to indulge in it as a team rather than discovering your partner watching porn alone.

3. It may help both of you to pick up newer positions
Porn has the ability to expose you to new and exciting positions you never knew. About 58% of couples who viewed pornography claimed that the shared activity had a positive effect on their sex lives. New moves and unique positions are known to spice up sex lives. Men can surprise their women (or vice versa) with an exotic move or two. Porn may also help in decreasing shyness and in opening up your minds so that you can pick up and practice new moves.

CONs-

Although porn viewing may consist of potential benefits, it may also affect your relationship adversely. When watched in excess, porn may cause certain problems in your relationship, which are-

1. It might set up wrong expectations in reality
Porn movies give you a warped view of what beauty is. It may cause you to have unrealistically higher expectations from your partner, whereas the reality may not match your imaginative hopes and standards. As a result, it may also lead to frustration, aggression and infidelity.

2. It may lead to pornography addiction
 The visual and physical appeal of porn may impact a person’s mental or social well-being. Increased porn viewing may hint at a person’s social isolation, loss of interest in career and other activities etc. It may also make you highly dependent on it, as it allows immediate sexual gratification. As a result the usage may go out of control and relate directly to compulsive behaviour.

3. It may affect your sexual drive and libido
Making love to your partner in real-life may become a foreign concept, as porn can decrease your physical drive with the possibility of making you sexually lazy. Porn may also have certain side effects including probable loss of libido and even difficulty in lasting longer. It may also make regular intercourse seem boring as it may not have the same sensual and visual appeal as pornography.
After realising its various pros and cons if you want to use porn, it is advisable to not use it as replacement but as an accessory for better sexual well-being.

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

Does Watching Porn Together Really Help You Have a Better Sex Life?

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?

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