Vaginismus is a condition where vaginal contractions and squeezes may be caused due to pain during intercourse or due to the insertion of objects like tampons. This mildly uncomfortable condition is also characterised by spams and other symptoms like the feeling of coming up against a thick wall which can cause pain. This may be due to a variety of reasons starting from infections to anxiety. To a large extent, the treatment of this condition depends on the cause. Following are the various ways in which this condition can be treated.

    Sex Therapy: A sexologist or an expert who specialises in psychosexual medicine can help in treating this condition by conducting a series of counselling sessions where psychoanalysis will help in understanding and unravelling the cause of the condition. This may be followed by CBT or cognitive behavioural therapy. This kind of therapy usually helps in reprogramming the brain after the root cause for the condition is known. 
    Exercises: During sex therapy, the doctor may also teach you various kinds of exercises and vaginal trainers that can help you in strengthening the pelvic floor and relaxing the muscles as well. These vaginal trainers are especially helpful in equipping you suitably so that you can relax your vagina and let the insertion happen. Vaginal trainers consist of four smooth balls of plastic which can be inserted with the help of lubricants to help in stretching the vagina. 
    Relaxation: Getting yourself to relax is also a matter of exploration and touching, which can help you understand the kind of touch and the exact areas that make you tense. During sex therapy, you may be taught a technique known as progressive relaxation. This mode includes tensing and relaxing your muscles as you explore by inserting a finger. 
    Sensate Focus: This is a part of sex therapy and involves your partner. In this method, you will be asked to abstain from sex and touch each other without going to the genitals and other private parts. This will help in better arousal and sexual stimulation.
    Surgery: The last option for treating a very severe form of this condition is to put the patient through surgery which will seek to remove endometriosis, as these growths in the womb's lining can cause a lot of pain during intercourse. Also, vaginal enlargement surgery can be carried out with the help of episiotomy. 

This kind of procedure usually helps in fixing the scar tissue that may have been left from a previous procedure, which can restrict or block the vaginal path. Getting help at the right time for this condition is of great importance so as to have a normal sex life.

How to Treat Vaginismus

What is endometriosis?

Endometriosis is a common condition where cells of the lining of the womb (the endometrium) are found elsewhere, usually in the pelvis and around the womb, ovaries and fallopian tubes. It mainly affects women during their reproductive years. Endometriosis is not an infection and it is not contagious.

What are the symptoms?

The main symptoms of endometriosis are pelvic pain, pain during or after sex and painful, sometimes heavy periods. It may cause problems with getting pregnant. It can affect many areas of a woman s life including her general physical health, emotional wellbeing and daily routine. Many women may have no symptoms. It is a long-term condition. Some women with endometriosis become pregnant easily while others have difficulty getting pregnant.

What causes endometriosis?

Endometriosis occurs when the cells of the lining of the womb are found in other parts of the body, usually the pelvis. Each month this tissue outside the womb thickens and breaks down and bleeds in the same way as the lining of the womb. This internal bleeding into the pelvis, unlike a period, has no way of leaving the body. This causes inflammation, pain and damage to the reproductive organs. Less commonly, endometriosis may occur on the bowel and bladder, or deep within the muscle wall of the uterus (adenomyosis). It can also rarely be found in other parts of the body.

The symptoms of endometriosis are common and could be caused by a number of other conditions such as irritable bowel syndrome (IBS) and pelvic inflammatory disease (PID).

There is no simple test for endometriosis.
Your gynaecologist may examine your pelvic area, this will include an internal examination.
You may be offered a scan. This can identify whether there is an endometriosis cyst in the ovaries. A normal scan does not rule out endometriosis.
For most women, having a laparoscopy is the only way to confirm endometriosis; because of this, it is often referred to as the  gold standard  test. This allows the gynaecologist to see the pelvic organs clearly and look for any endometriosis.
Several factors may influence your decision about treatment. These include:

How you feel about your situation
Your age
Whether your main symptom is pain or problems getting pregnant
What treatment can I get?

The options for treatment may be:

Pain relief

Hormone treatments: There is a range of hormone treatments to stop or reduce ovulation (the release of an egg) to allow the endometriosis to shrink or disappear. The hormonal methods below are contraceptives and will prevent you from becoming pregnant:

The combined oral contraceptive (COC) pill or patch. These contain the hormones estrogen and progestogen and work by preventing ovulation and can make your periods lighter, shorter and less painful.
The intrauterine system (IUS): this is a small T-shaped device which releases the hormone progestogen. This helps to reduce the pain and makes periods lighter. Some women get no periods at all.
The hormonal methods below are non-contraceptive, so contraception will be needed if you do not want to become pregnant:
Use of hormonal progestogens or testosterone derivatives
GnRH agonists are drugs that prevent estrogen being produced by the ovaries and cause a temporary and reversible menopause.
Some women find that recreational exercise improves their wellbeing, which may help to improve some symptoms of endometriosis.

Surgery: Surgery can be used to remove areas of endometriosis. There are different types of surgery, depending on where the endometriosis is and how extensive it is. How successful the surgery is can vary and you may need further surgery.

Laparoscopic surgery: The gynaecologist removes patches of endometriosis by destroying them or cutting them out.
Laparotomy: If the endometriosis is severe and extensive, you may be offered a laparotomy. This is major surgery which involves a cut in the abdomen, usually in the bikini line.
Hysterectomy: Some women have surgery to remove their womb (a hysterectomy) with or without the ovaries. Depending upon your own situation, your doctor should discuss hormone replacement therapy (HRT) with you if you have your ovaries removed.
What if I am having difficulty getting pregnant?

Getting pregnant can be a problem for some women with endometriosis. Your doctor should provide you with full information about your options such as assisted conception. If you become pregnant, endometriosis is unlikely to put your pregnancy at risk.

Endometriosis - Signs & Symptoms That Indicate It!

Once the reality of the positive pregnancy test sets in, dreaming about the yet-to-arrive begins. Curiosity about gender, options for names, ways to manage, shopping ideas, etc., begin to get discussed. And then totally out of the blue the news comes that there is a miscarriage. This is one of the most depressing phases. It is very important for the family to be around and support each other. While the entire family is upset and hurt over the news, the mother needs most care as there is just not emotional but a huge physical component also to the episode. On the other hand, remember that miscarriages are extremely common, and is no indication of a fertility issue.

The first step would be to diagnose and confirm the miscarriage. After that, depending on whether it was complete or incomplete, some medical intervention might be required. In most cases, medications like misoprostol are given to expel the uterine contents. These help by clearing out the contents in about a couple of days' time. In some cases, a D and C might be required if your doctor suspects that medication will not suffice. This also helps identify if there is any issue in the uterus that could have caused the miscarriage.

While the above take care of the physical part, the emotional component also requires cautious management. Needless to say, this is trickier than the earlier one.

Mourn to your heart's content - When you have nursed a life within you and have lost it, it is very normal to cry for its loss. There would be a mix of emotions - shock, denial, confusion, anger, grief, depression, etc. Take some solace from that fact that this is nature's way of removing unhealthy fetuses.

Get someone to talk to - Need not be your husband, but anybody whom you can talk to without having to watch words. A sibling, a good friend, a close relative - your choice. Make sure you don't pick ones who will judge and sympathize with you. More than sympathy, you need someone understanding and knowledgeable.

Socialize more - As you would have kept to yourself post your positive test, use this time to socialize more and meet friends whom you have not regularly been in touch with. Close family members, your children (if you already have), society groups, movie groups, etc., help to a great extent.

Formal medical counseling: If you are not able to cope with your regular circle of family and friends, try seeking professional advice from counseling.

Spirituality - Whether you believe in temple or churches, spend some time there. Involve in some religious activity if you would like, this helps very often.

As much as it is painful and traumatic, it is not very uncommon or unnatural. Get back on your feet, the sooner you do, the better.

Miscarriage - Ways To Recover

Miscarriage is termed as the loss of the fetus in or before 20th week of pregnancy. Medically, miscarriage is known as spontaneous abortion, though the word spontaneous is more of a keyword as it is not an abortion.

Symptoms of Miscarriage 
Miscarriage happens due to weakness, back pain, fever, abdominal pain along with severe cramps and bleeding, which starts from slow to heavy.

Cause of Miscarriage 
Common cause of miscarriage is when the fetus is known to have fatal genetic problems and these are not related with the mother. The other causes are infection, medical problems like thyroid and diabetes, immune system rejection, hormonal imbalance, abnormalities of the uterus, and physical problems of the mother. If a woman is over 35 years of age, has thyroid and diabetes and had an miscarriage earlier then that woman is at a high risk of getting a miscarriage.

Sometimes a miscarriage might take place due to the cervical insufficiency. This is due to the weak cervix, also known as the incompetent cervix, which is unable to hold the pregnancy. A miscarriage in this condition usually occurs in the second trimester. Though there are a very few symptoms in this, but there might be a feeling of sudden pressure that the water is going to break and tissues from the placenta and fetus are released without any pain. This can however, be treated by a stitch in the cervix at 12 weeks. This stitch helps to hold the cervix until the full term is completed. If it is first pregnancy and cervical insufficiency is diagnosed, then also a stitch can be applied, thus resulting in full term and avoiding miscarriage.

Diagnosis of Miscarriage: 
-   The doctor does a pelvic test, an ultrasound and blood tests to confirm a miscarriage
-   Blood tests are done to analyze the pregnancy hormone hCG. This is monitored regularly if miscarriage is suspected
-   Genetic tests, blood tests and medication are important in women who have a history of prior miscarriages
-   Pelvic ultrasound and hysterosalpingography are tests, which are done when there are repeated miscarriages
-   Test like hysteroscopy is also done. In this the doctor observes the inside of the uterus with a device, which is thin telescope like device. This is inserted in the vagina and cervix.
-   If the cervix is dilated, then the woman might be diagnosed with an incompetent cervix and this can be corrected by cerclage, a procedure done to close the cervix.
-   If the blood type of the pregnant woman is Rh negative, she is prescribed a blood product called Rh immune globulin (Rhogam). This prevents from forming, antibodies which could turn to be harmful for the baby.

Bleeding in Early Pregnancy: Diagnosing Miscarriage

Vaginal bleeding is something that most women experience between their periods when they are not due for a menstrual cycle. It is considered as an abnormal occurrence when you bleed before you are expecting your menstrual period, or after you are done with your monthly cycle. It is usually characterised by bouts of spotting where a thick brown reddish discharge may be experienced. Also, this kind of bleeding is considered abnormal if it occurs during pregnancy or menopause.

Here are a few causes of abnormal vaginal bleeding:
1.  Hormones: An imbalance in the hormones like the estrogen and progesterone can lead to abnormal vaginal bleeding. These are the hormones that help in regulation of the monthly menstrual cycles. An imbalance can occur due to side effects caused by birth control pills that may not suit the individual, a contraceptive patch, or even contraceptive implants and injections. Further, an intrauterine device may also be the cause for this kind of bleeding. The hormonal balance can also get affected due to internal ailments like a dysfunctional thyroid gland and ovaries.

2. Pregnancy and Delivery: Some amount of spotting is considered normal in the first trimester of one's pregnancy. Yet, severe bleeding and persistent spotting must be reported to the gynaecologist immediately. Women also bleed for a while after the delivery of the baby, in the postpartum period. This may also happen when an abortion takes place as the uterus may not have come back to its original size and due to remaining foetal tissues within. Complications during the pregnancy like an ectopic pregnancy or a miscarriage can also lead to such kind of bleeding. An ectopic pregnancy is one where the egg gets implanted in the fallopian tube instead of entering and implanting itself in the uterus.

3.  Fibroids: Uterine fibroids are usually considered as non-malignant and non-cancerous growths within the uterus. These are common in many women who have gone through childbirth. These fibroids can also cause some amount of bleeding and spotting.

4. Infections: When there is an infection in the reproductive organs like the ovaries and uterus of the patient, there may be some amount of bleeding. An infection in this area can also cause inflammation, which is one of the primary causes of abnormal bleeding. This can also occur due to a sexually transmitted disease or STD, as well as painful intercourse and sexual abuse which can lead to scarring as well.

5. Cancer: One of the least common causes includes cervical, ovarian and other forms of cancer. 
Stress and diabetes can also cause abnormal vaginal bleeding in rare cases. It is best to see a doctor as soon as such bleeding takes place.

Causes of Abnormal Vaginal Bleeding

Chlamydia is one of the most common STD. It is a bacterial infection, caused by Chlamydia trachomatis. Occurring in both males and females, it can be transmitted via oral, genital, or anal sex. it has been dubbed as silent infection, as the affected person hardly ever presents with symptoms. It is extremely common though about 1 in 20 females in the age group of 15 to 25 can be affected. The disease, if left untreated, can cause severe reproductive issues including infertility in both males and females. Let us look at symptoms in men and women separately.

Men: About 50% of men infected with Chlamydia will go with no symptoms. It may take about 3 weeks for the symptoms to manifest and will include

    Small amounts of discharge from the penis
    Discomfort or pain with urination
    Painful, swollen, and inflamed testicles
    Burning and itching around the tip of the penis

Depending on the mode of transmission, the eyes, throat, and rectum can also be infected and there could be throat infection or conjunctivitis also.

If left untreated, Chlamydia can affect the sperm quality and lead to infertility in men in the long run.

Women: The infection is "silent" even in females and does not manifest itself with a lot of symptoms, only 30% of infected females present symptoms including:

    Abnormal, white or light yellow vaginal discharge
    Painful sex
    Bleeding or spotting in between regular periods
    Sometimes even bleeding during sex
    Burning or itching sensation around the vagina
    Severe abdominal discomfort
    Fever

In females, the infection usually travels up the urinary and reproductive tract. So, from vaginitis, it can lead to urinary tract infection, cervicitis, bartholinitis, and even pelvic inflammatory disease. If it reaches the fallopian tubes and/or the uterus, then the chances of fallopian tubes getting blocked is high. There can be scarring of the tubes and this can lead to infertility or ectopic pregnancy (pregnancy in areas other than the uterus, for example the fallopian tubes). This can be very dangerous and can be life-threatening situation too.

Pelvic inflammatory disease (PID) is a serious bacterial infection of the uterus and the fallopian tubes. Untreated Chlamydia infection often results in PID and requires antibiotics and bed rest.
Chlamydia infections have two negative sides to it, on one hand, it is difficult to detect given the absence of symptoms. On the other hand, there are serious implications leading to even fertility. It is therefore very important to prevent it. It is best to use a condom, especially with unknown partners; and in case of any doubt, one should get themselves tested and treated.

Symptoms of Chlamydia in Men and Women

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