There are two methods by which abortion can be done:

Medical Abortion - Non-surgical abortion in which medicines are used to induce abortion

Surgical Abortion - Use of transcervical procedures for terminating a pregnancy, including vacuum aspiration, and dilatation and evacuation (D and E).

Surgical or Medical Abortion for Unwanted Pregnancy

If pregnancy is lesser than = 7 weeks; medical method with Mifepristone with Misoprostol is favorable as the success rate is as high as 97%.

If pregnancy is between 7-12 weeks; surgical abortion is the only option.

If pregnancy is beyond 12 weeks - 20 weeks, then the woman needs to be hospitalized and will be given either Mifepristone followed by Misoprostol tablet or only Misoprostol tablets and woman will then abort like a miscarriage in the hospital. If any products are remaining, then it will be evacuated surgically.

Surgical abortion is preferred if patient desires concurrent tubal ligation or IUCD (CuT) insertion.

If a woman fulfills the criteria for selecting either method i.e. before 7 weeks, final choice has to be given to the woman.

Summary of choice between Surgical or Medical abortion in India

lesser than = 7 weeks - Medical method or surgical method

7-12 weeks - Surgical abortion

12 - 20 weeks - Medicines with or without surgical procedure in hospital

Advantages of Medical Abortion

Avoid surgery

Controlled by the woman and may take place at home

No need for admission to the hospital

Usually, well tolerated by women, if properly counselled and motivated

No need to take leave from work, as bleeding can be managed with menstrual pads even while in the office or at work.

Disadvantages of medical abortion

Takes time (hours to days) to complete abortion, and the timing may not be predictable. Women experience bleeding and cramping, and potentially some other side-effects (nausea, vomiting, fever, and shivering). May require more clinic visits than surgical abortion.

Advantages of Surgical Abortion

Quick procedure

Complete abortion easily verified by evaluation of aspirated products of conception

Takes place in a hospital so Sterilization or placement of an intrauterine device (IUD) may be performed at the same time as the procedure. It can be performed under local anaesthesia if woman is properly motivated and counselled

Disadvantages of surgical abortion

Requires instrumentation of the uterus

Small risk of uterine or cervical injury

Timing of abortion controlled by the doctor and hospital

Anaesthesia needs to be administered. Most doctors perform this procedure under short general anaesthesia. A woman needs to be in the hospital for at least 6 hours. Effect of sedation will be there throughout the day.

Methods of Abortion for Unwanted Pregnancy

Menopause is characterized by the absence of menstrual periods for 12 months. It is the time in a woman s life when the ovaries stop functioning. The periods then stop forever. The normal period of menopause is 51 years of age, however, menopause may happen as ahead of schedule as the 30s or as late as the 60s. There is no solid lab test to determine when a lady will encounter menopause. Early menopause usually starts between the ages of 40 and 45. Untimely menopause begins significantly earlier, before the age of 40. Nevertheless, premature or early menopause is not that common with only about one percent of the women going through early menopause before the age of 40.

The signs and symptoms of early menopause are like the usual menopause. Some basic side effects include:

Irregular periods (amenorrhea)
Hot flashes
Night sweats
Vaginal dryness
Mood shifts
Mental fogginess
Diminished sex drive
Your specialist will suggest a treatment depending on your individual circumstances. Some common ways to deal with premature or early menopause are as follows:

Hormone Replacement Therapy
Supplements containing estrogen and progestin can help and replace some of your reproductive hormones in the body that can no longer make it all alone. They are frequently taken until the normal period of menopause (around 50) to help avoid bone loss. This treatment is not suggested for all ladies since it expands the danger of:

Heart issues
Stroke
Blood clots
Breast cancer
Supplemental Calcium and Vitamin D
Supplementary calcium and vitamin D can help in preventing osteoporosis in case you are not getting enough of these supplements from your normal diet. Women between ages 19 to 50 need to consume 1,000 milligrams of calcium for each day through food or supplements. Ladies over age 51 need to consume 1,200 milligrams for each day. A prescribed day-to-day measure of vitamin D has not yet been built up. For grown-up females, most specialists prescribe 600 to 800 global units through food or supplements. One should get a prescription from a doctor before ingesting the medication.

Other strategies to deal with Infertility
A few ladies with untimely menopause can at present get pregnant with no treatment. Ladies who want to have children, however, tend to become infertile after early or untimely menopause, need to consider in-vitro treatment, fertilization or even adoption.

Talk Therapy
Numerous ladies discover that having a conversation with a therapist can be supportive to adapt to their anxiety. It helps them release their pent up emotions and gives the clarity and satisfaction about their problems. Talk therapies like cognitive behavioral therapy are always beneficial since they help in addressing the symptoms and side effects that a woman may be going through emotionally when it comes to early menopause.

Early Menopause - How to Treat it?

Polycystic ovarian syndrome or PCOS is a condition in which a woman experiences fluctuation of hormone levels, estrogen, and progesterone which causes cysts in her ovaries, dysfunctional menstrual cycle, cardiac problem, fertility and changes in appearance. Hormones are chemical messengers that can trigger a number of issues in the body. Long term problems due to PCOS can be avoided with an early diagnosis and a proper treatment.

Causes
- Genetics and hormonal imbalance have been identified as the main causes of PCOS although the exact reason has not been discovered.
- Overproduction of androgen, a male hormone in a woman can cause small lumps in the ovaries, irregular development of eggs and abnormal insulin level.

Symptoms
The severity of the symptoms depends on the constitution of the person but the most common one is irregular periods. PCOS occurs when there is a decrease in sex hormones which can lead to the development of certain male features like:

- Deeper voice
- Growth of hair on face, toes, stomach, chest and back
- Reduction in breast size
- Loss and thinning of hair

There are other symptoms as well which can help one to determine the syndrome including:
- Oily skin leading to acne
- Irregular egg formation causing fertility problems and miscarriages
- Depression, anxiety and mood swings
- Hyperinsulinemia, that refers to the presence of too much insulin in the body which can cause obesity
- Difficulty in breathing while sleeping

The severity of the symptoms varies but if you are experiencing any of these problems, it is advisable to seek a professional consultation. A healthy lifestyle, regular exercise, nutritious diets are some of the preventive measures you can take. There are hormone regulating medicines and treatments that attempt to curb the condition but there is no permanent cure.

What is Polycystic Ovarian Syndrome?

The contraceptive pill, or simply 'the pill', is a type of hormonal contraception taken by women to prevent pregnancy. Now, even though the birth control pill is extremely effective in preventing unplanned pregnancy, it is not without some side effects. The common side effects of birth control pill include:

1. Intermenstrual spotting: Some women experience intermenstrual spotting or bleeding in the time between their menstrual cycles. This is very common in the first three months of you taking the pill. Most of the times, intermenstrual bleeding resolves itself.

2. Nausea: Some women might experience mild nausea when they take the pill for the first time. The nausea will resolve on its own after some time, but if it gets critical or persists, seek medical help. Taking your pill at bedtime or with food can aid in countering the nausea.

3. Breast tenderness: Breasts can become tender or enlarge as a result of birth control pills. Reducing salt and caffeine intake, and wearing a support bra can be beneficial.

4. Headaches: The development of migraines and headaches are the effects of the sex hormones. Different pills with varied doses and types of hormones may lead to different symptoms of headaches. Studies suggest that pills with low hormone doses are usually linked with headaches.

5. Weight gain: There is no logical link between weight fluctuations and contraceptive pills, but fluid retention (specifically in the hip and breast areas) and enlarged fat cells are common side-effects.

6. Mood changes: Women who may have suffered from depression should consult their doctors when taking the pill. A study discovered that taking pills usually leads to the thickening of the cortexes (outermost layers of the brain involved with analysing incoming stimuli and reward response). However, there is more research pending on this issue.

7. Missed periods: Skipping or missing a period is very common when you are on the pill. Factors such as stress, travel, illness and thyroid or hormonal abnormalities can influence this.

8. Decreased libido: The pills contain hormones that can lower your sex drive or libido.

9. Vaginal discharge: Some women experience differences in their vaginal discharge when they are on the pill. Vaginal lubrication can dip, which causes discomfort during sex.

10. Visual changes: Fluid retention is a side-effect of the pill, which even ends up affecting the cornea; they change shape or swell up.

Birth Control Pills - 10 Common Side Effects!

What is vaginal dryness and how can it affect you?
Vaginal dryness is often a result of menopause and it is capable of affecting women of any age. Although it feels like a minor irritation, it can have a huge impact on a person's sex life. Normally, the vaginal walls are lubricated with a layer of clear fluid. The 'oestrogen' hormone is used to maintain this thin layer of fluid, thus keeping the vaginal lining thick, elastic and healthy. However, menopause brings about a condition known as vaginal atrophy, which is a drop in the levels of oestrogen and this greatly reduces the level of vaginal moisture that is available. Improper lubrication of the vagina can result in painful sex which in turn affects libido, arousal and desire.

Treatment 
The most common treatment for this condition resulting from low levels of oestrogen is Topical oestrogen therapy. In this, hormones which are no longer secreted by the body are replaced by the topical oestrogen. Even though Topical Oestrogen Therapy is helpful in relieving the symptoms of vaginal dryness, the treatment pales in comparison to oral oestrogen hormone therapy (HT).

Usually, women mostly use one of the three types of vaginal oestrogen listed below:
1. Vaginal oestrogen tablet: A tablet is inserted into the vagina using a disposable applicator. The procedure is carried out once daily during the initial two weeks of treatment, after which it can be inserted twice a week.

2. Vaginal oestrogen ring: A soft and flexible ring is inserted inside the vagina, either by the patient or the doctor. Oestrogen, in the form of a steady stream, is then released directly to the vaginal tissues by this ring. Replacement of this ring is done every three months.

3. Vaginal oestrogen cream: An applicator is used to apply cream to the vagina daily. The frequency of application can be reduced as per doctor's advice.

Side effects and aftercare 
Side effects such as breast pain and vaginal bleeding are common when any form of oestrogen product is used. Vaginal moisturisers should be used to keep the vagina lubricated. Use of water-based lubricants during sex can make it more enjoyable. Use of bubble baths, scented soaps, douches and lotions around the sensitive area of the vagina should be avoided as these products can worsen the problem.

Modes of Treatment for a Dry Vagina

Keeping track of your cycle probably doesn't sound that interesting or important, but you can benefit a lot by doing that. There are changes that your body goes through and there are specific times when you are ovulating; knowing all these would make your life a lot easier, which is only possible by tracking your period.

1.   Know about your body: Getting your period every 28 days has always been considered normal but only 15% of women get their periods on the clock. Many factors such as stress, illness, exercise, etc. can cause delay in  your period. This is where tracking your cycle can help you find the pattern that is specific to your body condition. During your cycle there are lots of changes happening in your body. The hormones cause a change in the fluid produced from your cervix and also lead the basal temperature of your body to increase. Monitoring these changes through tracking your cycle is known as the symptothermal method. By this way you know about how fascinatingly your body works.

2.   Desire to get pregnant: Tracking your cycle will help you get pregnant. During your cycle, there is a specific time which heightens the possibility of conceiving. The fluid production from the cervix due to hormonal change is the cause of such possibility. Knowing your cycle can take out the stress from trying to get pregnant and it can also help determine any abnormalities that are preventing your pregnancy.

3. Avoid pregnancy: If you know the time when you are most likely to get pregnant through tracking, you obviously know when not to have sex, if you are trying to avoid pregnancy. Using symptothermal method for the purpose of birth control has proven to be 99.6% effective, which is higher than birth control medications.

4. Health benefits: You can reap a lot of health benefits by tracking your cycle. Conditions like fibroids, polycystic ovarian syndrome and endometriosis are quite common in women, which can be detected by tracking your period. If anything is wrong in your reproductive system, the cycle will indicate it.

4 Reasons To Keep Track Of Your Periods

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