Pelvic inflammatory disease (PID) refers to the infection that occurs in the female reproductive organs. It happens when sexually transmitted bacteria infect the uterus, ovaries or fallopian tubes on spreading from the vagina. Generally, the cervix plays the role of preventing the bacteria from entering the vagina and infecting the reproductive organs. But when the cervix becomes exposed to an STD, it loses its power to put a stop to the spread of these microorganisms to the reproductive organs.

What causes this condition?
STDs like gonorrhea and chlamydia have been found to be responsible for about 90% of PID cases.

Some of the other causes include
- Abortion
- Childbirth
- Pelvic procedures

The condition is only detected later in life when you face difficulty in getting pregnant or have chronic pelvic pain complaints. If you experience symptoms like vomiting, high fever, pain in the lower abdomen and instances of fainting, you should immediately seek a doctor.

What puts you at risk for PID?
Certain factors may put you at a higher risk for PID and these are:

- Instances of sexually transmitted diseases like Chlamydia (an STD that can occur from anal, oral or vaginal sex) and gonorrhea (a condition that causes discharge from the vagina or urethra) can make you prone to developing PID.

- Douching on a regular basis can increase your risk of PID as it disrupts the equilibrium of good and bad bacteria in your vagina, and may hide the symptoms of the condition as well.

- Even a previous history of PID can increase your chances of having another episode of PID.

- Compared to older women, teenagers who are sexually active are more prone to developing PID.

- Having multiple sexual partners can also put you at a greater risk for PID and STDs.

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Could you be at a risk of pelvic inflammatory disease (PID)?

Pregnancy brings with it a new set of additional responsibilities. The mother has to be extra vigilant about monitoring and caring for her health. This ensures that sufficient nutrition is being provided to the growing infant, at the same time, ensuring no harm comes to you. Listed below are some simple ways to do the same.

1. Prenatal care: As soon as you realize you are pregnant, it is advisable to talk to a doctor or a midwife about proper prenatal care. This could include anything and everything from prenatal vitamins to food habits to exercise to sleeping habits to periodic scanning and a number of other things that your doctor will prescribe.

2. Diet: You need to ensure two things that is you are eating enough for two people and everything is healthy and not harmful for the little one that gets all its nutrition through you. The diet should be healthy, nutritious, wholesome and of course free of junk. Some pointers to a healthy diet include:

a. Include a good amount of fruits and vegetables every day; break it into five small portions.
b. Sufficient amount of carbohydrates should be the basis of each meal.
c. Whole grains are preferred to white grains, which also give good amount of fiber.
d. A good amount of proteins including fish, eggs, meat, nuts, pulses, milk, and other dairy products.
e. Ensure adequate amount of iron, calcium, and other minerals are included in the diet.
f. Avoid eating unpasteurized dairy products, uncooked or undercooked food and smoked seafood.
g. While most vitamin requirements should be met through the diet, in some people, prenatal vitamins which provide the increased demands for folic acid.

3. Weight gain: If your weight was normal for your age and height before pregnancy, expect to add about 12 to 15 kg during your pregnancy. Consult with your doctor on weight changes and nutritional aspects to monitor weight throughout pregnancy. This could change based on if it is twins, your weight before pregnancy, and body type.

4. Exercise: Exercising during pregnancy is being increasingly encouraged for the following reasons:

a. Improved energy levels
b. Controls back pain
c. Improved sleep pattern
d. Improves constipation
e. Improves muscles strength and endurance
There are specific exercises designed to benefit the pregnant women. Whether it is walking or swimming aimed at improving overall health or Kegel exercises aimed at improving vaginal and perineal muscles, your doctor should be able to draw up a routine.

5. Lifestyle changes: With pregnancy setting in, it is time to bid goodbye to smoking and drinking alcohol. Continued smoking after onset of pregnancy has many serious complications, including growth retardation, low birth weight. Alcohol can lead to miscarriage, stillbirth and premature delivery.

These are simple ways to monitor and care for your and of course, the baby's health throughout pregnancy.

5 Ways to Monitor and Care for Your Health During Pregnancy

Use of contraceptives is really important to avoid unwanted pregnancy. Countries like China and India, facing the problem of population explosion lay more stress on the use of contraceptives. However, you must always use or take oral and barrier contraceptives following the advice of a medical practitioner unless it is absolutely necessary to go ahead without consultation. The reason behind medical assistance is your own health. Contraceptive methods do have a vast range of side effects that can result in health hazards. There are various kinds of contraceptives; each having its own set of advantages and disadvantages. Being acquainted with the side effects of some contraceptive methods can help you choose wisely in times of need.

Possible side-effects of using condoms: Some men are allergic to latex. Using condoms can lead to heightened sensitivity. It can also lead to rashes in your genitals. Condoms are not foolproof. They do not provide total protection against sexually transmitted infections, HPV or against Syphilis and Herpes. These diseases can be contracted by coming in contact with genital skin that is not covered by a condom.
Possible side-effects of a Contraceptive Film: A contraceptive film might act as an interruption in your sexual activities if it is not placed properly, that is to say it must come in contact with the cervix to be effective. Using the film nonoxynol- very frequently can make you susceptible to life threatening diseases like HIV and other STIs.
Possible side-effects of a Cervical Cap: A cervical cap has to be inserted by a clinician and requires immense care to be fitted in later. Some of its side - effects can be of serious concern. If it is left inside for more than forty eight hours, it can result in toxic shock syndrome. Toxic shock syndrome is an infection that mars your overall health. It is also known to increase the chances of inflammation of the surface of your cervix.
Possible side-effects of Progestin only pills: Progestin only pills or mini pills can subject you to long- lasting depression. It can make you feel bloated and can actually increase your weight to a great extent if used on a regular basis. Minipills lead to irregularities in your menstrual cycle and might also make bleeding during menstruation scanty.
Possible side-effects of combined oral contraceptives: If this is your first month on combined oral contraceptives, you might feel nauseous and they can give you a terrible headache. Women taking these pills have a higher chance of developing cervical dysplasia. If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.

Side Effects of Different Contraceptive Methods

What is Endometrium?

The uterus is where the fetus grows and develops. It has three linings- the outermost lining, the middle layer and the innermost lining. The innermost layer is called Endometrium. The endometrium is made of mucosal tissues.

How the endometrium changes and what is its function?

Before ovulation, when an egg is released, the functional layer of the endometrium undergoes a change. Vascularization takes place i.e. a buildup of blood vessels and tissues that thickens the endometrium in anticipation of implantation of a fertilized egg. If conception does not take place, the tissues and cells are shed from the endometrium lining. This is when a woman gets her period.

When conception does take place, the fertilized egg attaches itself to the endometrium. The endometrium also supports the placenta, which provides the fetus with oxygen and nutrition.

What is the ideal thickness of the endometrium?

In pre-menopausal women, the thickness of the endometrium should be-

  Between 2-4 millimetres during menstruation,
  5-7 millimetres at the onset of the early proliferative phase
  Around 11 millimetres during the late proliferative phase
  16 millimetres during the secretory phase



What is a poor/thin endometrium?

If the endometrium lining does not meet standard thickness and is not conducive to implantation, it is called a poor endometrium.

Causes behind thin endometrium

There could be many reasons that can lead to a poor endometrial layer-

  Inadequate secretion of estrogen
  Insufficient blood flow
  Prolonged use of birth control pills
  Substandard quality of endometrial tissues
  Presence of fibroids (small uterine tumours)
  Amenorrhea (unnatural periods/ excess bleeding or too little bleeding)
  Intrauterine adhesions (scar tissues form between the layers of the uterus and glue them together)
  Pelvic inflammatory disease
  Use of clomiphene

What are the symptoms of poor endometrium?

  Infertility (inability to conceive)
  miscarriage
  Irregular menstruation
  Painful periods
  Inadequate bleeding during menstruation

Treatment for poor endometrium

  Since the most common cause of poor endometrium is insufficient estrogen, doctors prescribe estrogen pills that can raise estrogen levels.
  If poor endometrium is the result of poor blood flow, an Ultrasonography Test will reveal that. Then doctors prescribe Vitamin E pills and L-arginine amino acid pills to thicken the endometrium layer.
  Regular exercising increases blood flow to the uterus
  Acupuncture is a very effective stress buster. Chronic stress could lead to a shrunk uterine wall. Acupuncture can allay the stress and promote the health of the uterus.
  Intrauterine adhesions can be extracted through surgery.
  Natural remedy (through natural therapy) includes asparagus, royal jelly, cover and they help in thickening the endometrium layer.
  Granulocyte Colony Stimulating Factor if injected into the body raises endometrial thickness and combats infertility.

Only an endometrium of normal thickness can support a pregnancy. If the lining is not thick enough medical intervention may be necessary.

Poor Endometrium - Can It Be Treated?

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

Endometriosis is a condition in which the endometrial cells lining the inside wall of the uterus begin to grow outside the uterus. In a majority of the cases, the growth is on the ovaries, the Fallopian tubes, or the tissues around the uterus. In rare cases, it occurs in other body parts. Normally, women in the age group of 30 to 40 years are prone to developing this condition and genetics is believed to be the reason behind this disorder. It is a serious medical condition if it causes discomfort to the woman.

Signs and Symptoms:  The signs and symptoms of endometriosis include chronic pelvic pain, pain during menstruation, urination, and intercourse, longer periods, bleeding between menstrual cycle, bloody urine or stool, and urinary and bowel problems.

Treatment methods:  In many cases, endometriosis goes undiagnosed and it can only be diagnosed through biopsy. If the biopsy confirms endometriosis, then it can be treated in the following ways:

Hormonal treatment: Hormonal treatment includes birth control pills, placement of the intrauterine device, Gonadotropin-releasing hormone, and Danazol or Medroxyprogesterone (Depo-Provera).
Pain medication: Pain killers with anti-inflammatory properties are prescribed to those who suffer from painful menstruation.
Surgery: This is the last treatment option and only advised to those who did not find relief from medicines and hormonal treatment. Surgeons try to remove the areas affected by endometriosis but in severe cases, the ovaries might need to be removed completely.
Complications: It is important to treat endometriosis on time as delay can lead to complications. The complications arising out of endometriosis include the following:

Infertility: The scarring and distortions caused in the reproductive organs due to endometriosis and the endometriotic cysts can make a woman infertile.
Scarring: The bleeding and the inflammation caused by endometriosis leads to scarring of the tissues of ovaries.
Ovarian cysts: Sometimes, the abnormal growth of endometrial cells outside the uterus spreads to the ovaries and starts growing over there, leading to cysts.
Prevention: As it been mentioned before, in many cases, endometriosis goes undiagnosed but it can be prevented or its symptoms managed effectively if one is cautious. One should do the following:

Exercise regularly: Exercise increases immunity and also reduces the level of estrogens, which slows down the progression of endometriosis. It also provides relief from pain.
Eat nutritious diet: A diet rich in vitamin and minerals ensures good health of the reproductive organs and a fine immune system. This helps to fight the symptom of endometriosis and keeps the disorder in check.
Endometriosis is known to affect a large number of women and since the early symptoms are mild or confusing, most of the time they go undetected. Nevertheless, a woman can avoid it and the complications arising out of it by being mindful of the symptoms. They should also undergo a regular pelvic exam and follow the instructions of their gynecologist. This would ensure timely detection of the disorder and if this is ensured, the management also becomes easy.

Suffering From Endometriosis - What Are Its Treatment Options?

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