Vaginitis also known as vaginal infection or vulvovaginitis, it is a situation in which the vagina gets sore and irritated. It is a common occurrence in females. Though it is not a very serious disorder yet it can be a cause of severe discomfort and irritation. Common side effects that are prevalent in the case of vaginitis include either abnormal discharge or vulvovaginal irritation or both. The discharge may also tend to have an unpleasant odor. In ayurveda, vaginitis is often seen as an amalgamation of yoni dahan and yoni kandu, the two different disorders that affects vagina.

The most common causes of vaginitis include: 
1.Infections
2. Deficiency of estrogen
3. Skin irritants like perfumed soaps and vaginal sprays
4. Allergies 
5. Sexual activity, etc.

Diabetes, usage of steroids or tight clothing is also among some of the causes of vaginitis. Ayurveda aims to treat vaginitis naturally, by using precise combinations of certain herbs in addition to a paste for local application.The following are some ayurvedic home remedies that can be used to treat vaginitis:

1. To relieve the burning sensation: Add water to triphala herb powder; mix the ingredients. Wash your vagina with this solution to lessen the burning sensation.
2. To eliminate toxins from the body: Make a beverage of dried cartilaginous tube herb in boiling water and consume it. The herb is known to aid the body in eliminating harmful toxins.
3. To cure inflammation: Garlic and turmeric are known to cure inflammation. You can use this treatment to cure infection. Turmeric can also be consumed to fight away internal infections.
4. To cure infection: Margosa also known as neem is an effective natural remedy for curing inflammation. It destroys microorganisms effectively. You can use neem powder to cure the infected area.
5. To combat the growth of harmful bacterium: Citrus juices are known to aid the canal to regain its acidity and prevent the multiplication of unhealthy bacteria
6. To avoid infection: Yogurt is one amongst the foremost common home remedies for duct infection. If you apply yogurt on the inflamed areas and additionally eat a bowl of yoghurt on a regular basis your infections will disappear.
7. To reduce swelling and redness: Soak a clean cloth in cool water and place it on the inflamed space. The cool sensation will compress the blood vessels and reduce the burning sensation, redness, swelling and irritation.

Ayurveda Way to Treat Vaginitis Infection 

Diabetes during pregnancy is known as gestational diabetes. It is interesting to note that the chances of getting gestational diabetes, is one of the most common complication of pregnancy. It has increased by almost 40%. Also, gestational diabetes not only affects the health of the mother, but also the health of the baby. What usually happens with gestational diabetes is that the blood sugar level, of both the mother and the baby go above the normal level. Ayurveda can help treat this disease. Here are the most common Ayurveda remedies for gestational diabetes.

1. Gurmaar
Gurmaar, called "The Sugar Killer" is also known as Gymnema sylvestre in medical jargon. Gurmaar also contains gymnemic acid molecules, which are crucial because they have an anti-diabetic effect. They work by combining with glucose molecules, which are in the blood stream. These stop the glucose from entering the bloodstream. 

2. Karela
Karela is commonly known as bitter gourd and its biological name is Momordica charantia. It has anti-diabetic properties and also contains many other micronutrients, which are crucial in preventing the complications which arise from gestational diabetes.

3. Vizaysaar
Vizaysaar comes from the bark of a tree whose biological name is Pterocarpus marsupium. It is very useful for diabetes. If you immerse the wood of Vizaysaar in water overnight and then drink it, your blood sugar levels are expected to fall.

4. Saptrangi
Saptrangi is biologically known as Salacia oblonga. Just like Vizaysaar, it is a tree whose bark is immersed in water and then drunk by the patient suffering from diabetes. You will know that the water is ready for drinking when it turns brown, which usually happens overnight. It is also being studied in Western herbal schools in addition to Ayurveda nowadays.

5. Tulsi
Tulsi is a holy plant in Hindu mythology and is known as Ocimum sanctum in biological terms. It is worshiped as a holy plant because it has tremendous medicinal properties including treating many types of cancers, cough, cold, sore throat as well as reducing blood sugar.

6. Ashwagandha
The medical name for ashwagandha is Withania somnifera. It is another great remedy for diabetes.

Ayurveda and Gestational Diabetes

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!

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)

4 Types of Contraception for Birth Control

There are a number of contraceptives available but which method of birth control suits you depends on your sexual life, preferences and your lifestyle as a whole. Professional medical help should be sought in order to understand what method of contraception sis ideal for you.

Here is a list of 4 types of contraceptives for birth control.

1. Barrier methods

Barrier methods are designed to prevent the sperm from entering the uterus. They constitute-

- Diaphragms: It is a shallow and flexible cup that is made of either latex or soft rubber. It is inserted into the vagina before the sexual intercourse where it prevents the sperm from entering the uterus.
- Cervical caps: It is a thin cup of silicone whose function is same as the diaphragm, only it is smaller in size, so less noticeable and more rigid as well.
- Contraceptive sponges: These are soft foam sponges that are filled with spermicide and are disposable. They are also inserted into the vagina before sexual intercourse in order to prevent pregnancy by killing the sperm cells or preventing them from entering the vagina.
- Spermicides: These are chemicals that can kill the sperm and hence assist in birth control.

Other methods include male condoms and female condoms.

2. Hormonal methods

Hormonal methods use hormones in order to either stop or regulate ovulation so as to prevent pregnancy. There are various methods through which hormones can be injected into the body. Some of them are-

- Contraceptive patch: It is a thin patch made of plastic that sticks to the skin and is responsible for releasing hormones into the bloodstream through the skin.
- Vaginal rings: A thin, flexible ring that is inserted into the vagina where it stays for 3 weeks and is removed after that, only to be re-inserted in the 5th week.
- Implantable rods: They are inserted under the skin of the upper arm of women where they release progestin.

Other methods include contraceptive pills and progestin-only pills.

3. Intrauterine methods of contraception

The intrauterine device is a small device, T-shaped that is inserted into the uterus in order to prevent pregnancy. The good thing about intrauterine devices is that they can remain functioning for many years at a stretch. IUDs are two types-

- Hormonal IUD(Intrauterine Device)
- Copper IUD

4. Sterilization

Sterilization is the most reliable contraceptive for birth control as it is permanent. It either prevents the release of sperm or the fertilization of the egg. Sterilization methods can either be surgical or non-surgical. Some of the sterilization techniques are-

- Tubal ligation: It is the surgical technique used in females.
- Vasectomy: It is the surgical technique of male contraception.

Other methods include sterilization implants.



4 Types of Contraception for Birth Control

The presence of blood in urine is known as Haematuria. It is categorized under 2 types:

    Macroscopic haematuria, which means the patient has seen blood.
    Microscopic dipstick haematuria, which means blood is identified by urine microscopy or by dipstick testing either in association with other urological symptoms (symptomatic microscopic haematuria) or during a routine medical examination. It has been variably defined as 3 or more , 5 or more or 10 or more Red Blood Cells (RBCs) per high - power field.

Urological and other Causes of Hematuria

    Cancer: Bladder, Kidney and Prostate Cancer
    Stones: Kidney, Ureteric
    Bladder Infections: Bacterial tuberculosis, infective urethritis Inflammation
    Interstitial Cystitis Trauma : Kidney, bladder, urethra, pelvic fracture causing urethral rupture
    Renal cystic disease: (e.g. medullary sponge kidney)
    Other urological causes: Benign prostatic hyperplasia, vascular malformations
    Other medical causes of haematuria: anticoagulation therapy (e.g. asprin, anti platelet therapy) Nephrological Causes: more likely in children and young adults, proteinuria; red blood cell casts.
    Urological investigations: Urine culture, urine cytology, cystoscopy, renal ultrasonography and intravenous Urography and CT Urography.

Management of haematuria depends on the cause as determined by the urologist.

Causes and Treatment for Hematuria

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