Miscarriage is the early loss of foetus within 20 weeks of pregnancy. It is also known as  spontaneous abortion . According to research, about 8-20% of the pregnancies end in miscarriage. Out of the total number of miscarriages, 80% of them end within 12 weeks of pregnancy.

Types of Miscarriages and their Symptoms 

Threatened Miscarriage   As the term suggests, in this condition the process of miscarriage might have begun. This is the initial stage of the process. In threatened miscarriage, there is slight bleeding accompanied by cramps and pain in the lower back, which is usually mild. The cervix (the lower part of the uterus) remains closed. 
Inevitable and Incomplete Miscarriage   In these conditions, there is bleeding along with an open cervix. When there is dilatation and thinning of the cervix, miscarriage is inevitable. In incomplete miscarriage, part of the tissue comes out and a part remains inside the uterus. In inevitable and incomplete abortions, the bleeding and cramps are more severe. 
Complete Miscarriage   Complete miscarriage is when the embryo has completely emptied from the uterus. The pain and bleeding reduce once the foetus is expelled. This can be confirmed through ultrasound. 
Missed Miscarriage   In Missed miscarriage, there is no sign of the life of the embryo and there is no expulsion of the embryo. It can be detected from the absence of heartbeat of the embryo found on ultrasound. 
Recurrent Miscarriage   It happens when there are two or three miscarriages one after the other. It affects about 1% of the pregnancies. 
Risk Factors 

Increased maternal age i.e., women above 35 years. 
Excess or insufficient chromosome in embryo. 
Placenta is the organ which links mother and the baby for blood supply. Problem in the development of placenta can cause miscarriage. 
Excessive smoking and drinking during pregnancy. 
Obese women have higher risk of miscarriage. 
Long-term health conditions like high blood sugar, high blood pressure, liver disease etc.
Infections like rubella, malaria etc. 
Weakened cervix, which is the result of previous injury or surgery, can also result in miscarriage. 
What are the symptoms of a miscarriage? 

Bleeding or spotting can be one of the symptoms of miscarriage. It should be kept in mind that not all pregnant women who suffer from spotting or bleeding, end in miscarriage. 
Lower backache starts before or right after bleeding, which can be persistent or you could have cramps which may be mild or sharp and can feel like more of pelvic pressure. 
Missed miscarriages are detected through ultrasound when the doctor finds that there is no heartbeat of the embryo or when the uterus is not growing. 
What are the treatment options in miscarriage? 

Medical   In most of the cases, there are no specific drugs to stop a miscarriage from occurring. In some cases, certain hormonal preparations help. There is no point in prescribing medicines for prevention of miscarriage if there is heavy bleeding. 
Surgery   Dilatation and evacuation (D&E) is a simple operation which is done under general/local anaesthesia. In this operation, the cervical canal is dilated and contents present in the uterus are evacuated. There is no cutting involved as it happens through the vagina. The process needs only five to ten minutes, but the patient has to stay in the hospital for about 3-4 hours. 
This process is opted when: 

There is heavy bleeding. 
The patient suffers from missed miscarriage. 
What can you do to prevent miscarriage? 

Nothing much can be done to prevent miscarriage in most of the cases. However, following supportive measures may help: 

There should not be overexertion during pregnancy. Moderate amount of physical activity is permissible. 
One should have a well-balanced diet. Studies have shown that a diet loaded with fruits and veggies helps in overall well-being during pregnancy. One should limit the consumption of caffeine. 
Avoid smoking, alcohol and certain drugs to prevent miscarriage. 
Avoid stress and anxiety. 
Report to Doctor (preferably Obstetrician) as soon as any symptom related to miscarriage appears.

Miscarriage - Symptoms, Treatment and Prevention

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

Polycystic ovary disease or PCOD is a kind of hormonal disorder in which a woman produces a surplus of male hormones like testosterone.
High levels of male hormones produce symptoms like irregular ovulation or no ovulation at all. In simple words, women with PCOD or PCOS don t release a mature egg from their ovaries every month resulting in infertility. PCOD affects one in 10 women worldwide.

Women suffering from PCOD suffer from symptoms like heavy vaginal bleeding. This is because, as they don t ovulate and produce the hormone Progesterone like normal women do and have normal periods, the lining of their uteri becomes thick leading to heavy bleeding and sometimes uterine cancer.

The other common symptoms of PCOS are:

Acne
Weight gain
Oily skin
Heart problems
Irregular periods
Migraines
Hirsuitism
Infertility
Mood swings and depression
There is a propensity for developing diabetes as well in PCOS affected, as a number of women with PCOD are resistant to the action of the hormone insulin used for sugar metabolism. This means that it takes larger than normal amounts of insulin to maintain normal blood sugar levels. Though fairly common, PCOD has no surefire cure in mainstream allopathic medicine but Ayurveda can help alleviate PCOD symptoms in a big way.

PCOD - How Ayurveda Can Help?

In Ayurveda, PCOD is caused due to an imbalance of any of the two doshas - Pitta (Fire) and Kapha (Water). Aggravated Pitta causes contamination of the dhatus or tissues like blood and plasma. This causes a buildup of toxins or ama in the body.
In PCOS patients, these toxins get accumulated in the channels of the mind, leading to an imbalance of hormones secreted by the pituitary gland. This results in an imbalance of female hormones and causes the formation of ovarian cysts which is nothing but a collection of fluids within the ovary, anovulatory periods or periods with no ovulation etc.

Ayurvedic herbal remedies for PCOD

Ayurveda works on these problems:
-Correcting hormonal imbalance
-Reducing obesity
- Reducing high cholesterol levels
-Treatment for insulin resistance
Herbs like Ashoka (saraca asoca), Dashamoola are amongst a group of herbs which are used to prepare Sukumara Kashaya like Ashwagandha, Eranda, Shatavari etc for correcting hormonal imbalance.
Other drugs for curing PCOS are-
1. Shatavari or Asparagus racemosus
This helps mainly in promoting normal development of ovarian follicles. It also regulates periods and aids in revitalizing the female reproductive system. Shatavari also helps in controlling high levels of insulin due to PCOS, due to its phytoestrogen or natural plant based estrogen levels.
2. Guduchi
Guduchi is a powerful anti- inflammatory herb. We know that chronic inflammation in body tissues is the root cause for insulin imbalance and ovarian cysts in women. This herb helps in revitalizing body tissues and lowering insulin resistance.
3. Shatapushpa or fennel
Fennel seeds are used as a supplement as the phytoestrogens in them bring down inflammation and control insulin resistance.
4.Triphala
Triphala is rich in vitamin C- a powerful natural antioxidant that helps in reducing inflammation by reducing free radicals. Hence this remedy is excellent for cleansing and detoxifying systems and is therefore best taken prior to taking any other Ayurvedic medicines to improve outcome.
5. Aloe Vera- Kumari (Aloe barbadensis)
Aloe Vera is yet another Ayurvedic herb that is extremely beneficial in treating PCOS as it helps in regularizing menstrual cycles and promote normal menstruation. It also normalizes hormonal imbalance.

PCOD - How Ayurveda Medicines & Treatment Is Beneficial For You?

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

Contraception is not only restricted to married couples in today's world. Most of the young couples refrain from seeking medical advice for contraception may be because of social concerns or simply because they feel hesitant and shy.

There are many contraceptive pills available over the counter which youngsters are tempted to buy and use as it seems to be the easy way out. Frequent and improper use of such emergency pills can lead to a lot of hormonal disturbances and the menstrual cycle goes topsy turvy. Then the dilemma starts. As it becomes difficult to interpret the cycle dates and erratic bleeding which happens is disturbing.

In my practice I have seen many young girls popping in pills randomly every now and then. Sometimes at weekly intervals as they are unable to manage the stress of their relationship getting disturbed. What youngsters should try and understand is there is nothing wrong in having pills for contraception but it should be done with proper guidance and the selection of the right pill for that particular individual is important which can be done easily by getting into consultation with a doctor. Need not necessarily be a gynecologist always.

Emergency pills are ok for once in a blue moon kind of use. But it should not become a habit.


Misuse Of Emergency Contraceptive Pills

It is important that you understand and fulfil the needs of your partner and address issues that concern you both. Sexual intercourse for humans is not only a reproductive act, but is also considered to be an emotional and pleasurable act. However, statistics report that almost 30% of the women experience pain during intercourse. This not only hampers the pleasure, but is also an unhealthy sign since it is indicative of a problem.

Painful intercourse could be a regular occurrence, or a sporadic one. There could be numerous reasons that cause the discomfort and pain. Though it might be an early manifestation of grave diseases such as endometriosis or fibroids, but more often, it is triggered due to conditions such as vaginal dryness, yeast infection, bacterial vaginiosis, which can be easily treated. It is pertinent to understand that it is not the physical infirmity of the entire female anatomy that causes such pain/ discomfort, but the existence of certain conditions that can be treated by a medical practitioner. 

Certain such causal factors associated with painful intercourse and the efficient ways to deal with them are discussed below:

 Vaginal dryness: vaginal dryness is one of the most commonly cited causes for painful intercourse. There are various causal factors of vaginal dryness. These include, but are not limited to, consumption of certain drugs, bathing with hot water, health conditions or even lack of foreplay. Vaginal dryness due to the aforementioned causes is a short-lived condition that can be treated well with the help of a medical practitioner. Usage of lubricants that is suitable for you, as advised by a medical practitioner, could go a long way in aiding the ease of sexual intercourse. The lubricants act as an effective substitute, if the body is unable to naturally secrete vaginal fluids to ease intercourse, thereby greatly reducing the pain that is experienced.
 Improper vaginal expansion: the female anatomy is designed in such a way that it expands normally during intercourse. Proper foreplay enables the woman to get excited, which results in the release of vaginal fluids that aids in sexual intercourse. However, in the event that the female is not excited enough prior to the act, sexual intercourse can become a painful act, since the vagina is unable to expand in the absence of vaginal fluids. In such cases, take things slow and give your body time to comfortably go with the flow.
 Vaginal itching caused by infection: vaginal infections can be caused by antibiotics, prior sexual activity that has resulted in contraction of sexually transmitted diseases etc. This results in an itching or burning sensation while having sex. It is essential to rest your body instead of forcing things and to consult your doctor as soon as possible. The doctor can correctly diagnose the causal factors behind the infection, and prescribe the necessary medicines for it.

However, if your symptoms vary from the common ones mentioned above, or in case you have a different query, it is always advisable to consult the doctor.

How to Make Sex Less Painful for a Woman

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