During the natural course of events, a woman's body starts its reproductive phase with menarche and at about 50 years of age, attains menopause. This is when the reproductive function ceases and the ovaries stop producing the hormone estrogen and progesterone. This is medically termed early or premature menopause. 

Menopause that occurs before 40 years of age is termed as Premature Menopause; it is due to primary ovarian insufficiency and occurs in 1% of the women.  If it occurs between 45 to 50 years, it is termed as early menopause.

Causes of premature menopause
Normal ageing, family history, genetic disorders, autoimmune disorders, toxins, and surgery are some reasons that could lead to premature menopause.

Effects:
Estrogen and progesterone have a lot of beneficial effects on a woman's body. Reduction in their levels leads to some of the below changes:

-    Emotional changes like mood swings, irritability, and in some cases depression, especially in       premature menopause.
-   Irregular cycles before complete cessation of the menstrual cycles.
-   General mucosal dryness leading to vaginal dryness, dry skin, dry eyes.
-   There also would be urinary incontinence and reduced sex drive due to reduced hormone levels.
-   For women who still would want to have children, infertility would be a big cause for concern. This could lead to other emotional issues, worsening the depression.
-   Bones lose their density and get weak and are more prone to fracture. This leads to Osteoporosis.
-   Postmenopause, women are more prone to heart attacks and stroke, leading to cardiovascular health issues. Though not fully proven, this is believed to be true as the good role that estrogen plays on blood vessels is negated with menopause.
-   Menopause leads to accelerated damage of genetic structures, thereby leading to faster ageing. This also leaves a feeling in the women of being less attractive and less desirable.

There is also a good news, that after menopause women are at lesser risk of cancer especially, breast and ovarian. 
However, it is not easy for women to handle premature menopause. The body undergoes some changes much earlier than expected, and it requires a lot of support and caring and comforting to come to terms with it especially, if associated with infertility or chemotherapy for cancer. Emotional issues of not being able to have children and feeling less attractive require frank talks to boost the person's confidence and increase self-worthiness.

It is easier said than done, but one of the key ways to handle premature menopause is an open discussion.

Premature Menopause - How Your Body Is Affected?

C-section or Caesarean section is a surgery performed to deliver a baby. The baby is taken out from the abdomen through an incision in the abdominal wall. This surgery is performed when there is some sort of physical difficulty in natural childbirth through the vagina. Other reasons for performing a C-section are when the mother is carrying more than one baby, or the health of the baby is in danger. It could also be because of an undesirable fetal position, or when the mother is physically unable to push the baby out of the uterus. 


Procedure followed in C- Section
The procedure is most often done when the mother is in her senses and awake. However, epidural or spinal anaesthesia is provided to numb the body from chest to the feet, before the surgery is performed.


An incision is made on the lower abdomen, above the pubic area. A cut is made through the uterus and amniotic sac. The baby is pulled out from this opening. The umbilical cord is cut and cleaned. The fluids are cleaned from the baby s mouth and nose. The infant s breathing rate, heart rate and other vitals are kept under observation. 


Recovery from a C-section can take several weeks. The stitch wounds need to heal, including the recovery of pelvic muscles. It is important to walk around and do some very light exercises to boost the healing procedure. Doctors may prescribe painkillers in some cases and advice on effective post-operative care. Though the surgical procedure is quite safe now, with the use of highly advanced technology, there are risks that cannot be entirely ignored. 


Risks associated with C-section
Infections: Any surgery has some risk of infection associated to it. In the case of a C-section, an infection can occur around the site of incision that may rapidly spread in the uterine wall and other internal pelvic organs.
Haemorrhage: Blood refuses to clot and dangerously high quantity of blood is lost in the process. In such a case, it requires immediate transfusion and intensive care.
Injuries: The mother or the baby, both have a risk of getting injured during the surgery. Although these are rare, but the infant may suffer nicks and cuts while being manually pulled out from the womb. Other organs of the mother located near the pelvis may suffer minor or major wounds.


After the C-section, the mother and child will be retained in the hospital for 2 to 3 days, under intense care and constant monitoring. It is important to exercise and take the medications as advised by the physician to prevent any complication. 

C- Section - Understanding the Procedure and Risks

When tissues that usually grow inside the uterus, start growing outside the organ, it is called endometriosis. Painful periods, pain during sex, pain while urinating or bowel movements, extreme bleeding, fatigue, infertility, diarrhea, bloating and nausea are some of the symptoms of endometriosis.

Treating endometriosis usually depends on the following factors

Age
Severity of symptoms
Severity of the disease
Future plans for children
Depending on these the doctor might opt for any of the following treatments

Medication for Pain: If the symptoms are mild, then the doctor will prescribe some pain killers like Nonsteroidal anti-inflammatory drugs. 
Hormone Therapy: Hormone therapy is effective, but once you stop them, your symptoms may come back. Some of the hormone therapies include: 
Hormonal Contraceptives: Birth control pills, vaginal rings and patches are useful in controlling the hormones that are responsible for tissue build-up outside the uterine cavity. 
Medroxyprogesterone: This drug stops menstruation, which in turn stops the tissue build-up and put an end to all the symptoms. But on the other hand, gaining weight, low bone production and depression are some of the common effects of this drug. 
Gonadotropin-releasing hormone (Gn-RH) antagonists and agonists: Hormones that stimulate ovaries are blocked by these. They bring down oestrogen levels and hence prevent menstruation. 
Danazol: This drug prevents menstruation and symptoms of endometriosis by blocking the hormones that stimulate the ovaries. However, Danazol may not be a favourable option because of its side effects. The drug should be avoided during pregnancy.
Conservative Surgery: If you are trying to get pregnant, but you already suffer from endometriosis, then removing endometriosis surgically is a viable solution. Your uterus and ovaries will be preserved, which might increase your chances of becoming pregnant. Even suffering from severe pain might find relief from conservative surgery. 
Hysterectomy: In extreme cases, the only way to deal with the symptoms is to completely remove the uterus, ovaries and cervix. Since a hysterectomy means you cannot have children, it is kept as the last option for women in their reproductive age.

Management of Endometriosis

Missing out on your periods or irregular periods once in a while is common. However, the problem arises when irregular periods become every month s story. The irregularity can be an amalgamation of a host of factors. Ignoring the same for long will only complicate things further. For women of reproductive age, the problem can give rise to deleterious consequences, including difficulties in conceiving. In this article, we will discuss some of the common triggers that result in irregular periods and when to seek medical help.

What causes Irregular Periods?
The hormonal balance plays a significant role in the proper functioning of the vital organs of the body. More than often, irregular periods are found to be a manifestation of hormonal imbalance. Some of the conditions that trigger the hormonal imbalance include

PCO is a common medical condition that affects women of reproductive age. PCOS is characterized by the formation of cysts in the ovary (one or both) that affects the ovulation process. In PCOS, there is an increased production of Androgen, especially Testosterone that can cause irregular periods, hair fall, facial hair, weight gain etc.

Time and again doctors and health professionals emphasize the importance of leading a stress-free life. Research suggests stress and anxiety often interfere with the functioning of the Hypothalamus. As a result, the pituitary glands that control and regulate the activities of the ovaries, adrenal glands, and thyroid glands may be affected. These can also trigger a hormonal imbalance giving rise to menstrual problems such as Irregular periods. In case of extreme stress, there may be a short-term cessation of periods (Secondary Amenorrhea).

The hormonal imbalance and irregular periods can also be an outcome of other medical conditions such as endometriosis, a cancer affecting the reproductive organs, fibroids, obesity, diabetes, hyperprolactinemia (characterized by elevated level of prolactin) or even thyroid disorders.

Women who indulge in strict dieting can also suffer from irregular periods. Strict dieting (especially the ones that are without a proper nutritional guidance) can rob the body of the essential nutrients disrupting the hormonal balance.

Irregular periods are normal in women who are nearing their menopause.

When to seek medical assistance?
Irregular periods can be indicative of a severe health problem. Consult a gynecologist

If your regular cycles get delayed by more than 7 days.

There is spotting or bleeding in between the periods.

Your periods last for more than ten days or less than two days.

There is excruciating pain during periods.

The gap between two successive menstrual cycles is more than 35 days or less than 21 days.

Your periods are heavy and unmanageable, affecting your daily routine.

Irregular Periods - When To See A Gynaecologist?

Recurrent pregnancy loss refers to the situation when three consecutive pregnancy loss takes place. A pregnancy loss is a clinically defined pregnancy which ends before twenty weeks.

Causes of recurrent pregnancy loss

Major cases of pregnancy loss occur due to genetic abnormalities and chromosomal abnormalities. The abnormality may occur from the sperm, egg or the early developed embryo.
Recurrent pregnancy loss may occur in a woman due to ascending maternal age. This happens because of poor quality of the egg, which further leads to chromosomal abnormalities. In some cases, the pregnant mother or the father can have some gene irregularities. In such cases, the would-be-born infant is affected, and this causes pregnancy loss or miscarriage.
Uterus abnormalities also lead to recurrent pregnancy loss. This may happen because of poor supply of blood to the uterus. Abnormalities in the uterus are in-born in some women and in others these may develop over time.
Women having a poor immune system are likely to suffer pregnancy loss. Abnormalities in hormone secretion like thyroid or diabetes may also cause pregnancy loss in women.
If a woman suffers from abnormalities in blood clotting, the chances of miscarriage are enhanced.
Testing for recurrent pregnancy loss
Several tests and examinations should be carried out for detection of pregnancy loss. 

Karyotype analysis of the woman and her male partner has to be conducted. Karyotype refers to the genetic or chromosomal constituents of an individual and this test is carried out to detect abnormalities in genes and chromosomes of the parents, which cause miscarriage when passed on to the developing infant.
Another test includes the evaluation of the uterus and the uterine cavity. This is done by ultrasound, saline ultrasound, MRI, hysterosalpingogram X  ray or by hysteroscopy. These tests help to get information on the uterus shape, about fibroid presence, detect abnormalities within the uterus and observe the opening and closing of the tubes. Tests to detect the functioning of hormones are also carried out.
Treatment
The treatment for women with recurrent pregnancy loss depends upon the underlying causes of the pregnancy loss.

In case of patients with karyotypic abnormalities, genetic counselling is recommended, where a specialist is consulted to know about chromosomal abnormalities.
Prenatal genetic studies are carried out by some couples to know about the offspring s genetic make-up. This is done with chorionic villus sampling or with amniocentesis. A process known as in vitro fertilization can be carried out.
In case of uterine abnormalities, a surgery may be performed and medications for reducing blood clot are used if antiphospolipid syndrome is detected.
Recurrent pregnancy loss may happen due to various reasons and proper tests, and treatment procedures should be carried out for curing pregnancy loss. This phenomenon affects a woman and her partner deeply.

Recurrent Pregnancy Loss - Know the Reasons Behind it!

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

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