The news of pregnancy can be one of the best news in a couple s lifetime. However, where this news does not arrive, it can turn very stressful. Whatever the reasons, if a couple has been trying to have a baby and are not able to, it can be very strenuous. However, statistics reveal that most couples take four to six months to conceive. Some couples even take up to two years.

Lifestyles are changing and there are a lot of factors, which determine the ability of a couple to conceive. There could be issues with either of the couple, and sometimes it might not even be an actual issue, but only psychological barriers hampering the health of the relationship.

Some common conditions that can contribute to the couple not conceiving include endometriosis, ovarian issues, polycystic ovaries, hormonal imbalances, medical illnesses, etc. A few common remedies can be tried first, before reaching out for professional help.

Using lubricants without spermicide topical agents may be used, but some of them could contain chemicals, which are spermicides and reduce the sperm count. This needs to be ruled out before investigating the cause for infertility.
Vitamin B6 helps in the luteal phase, which is from the time of ovulation to menstruation. Zinc also plays a vital role in pregnancy and conception, and so it is advisable to take these supplements when trying to get pregnant.
Weight management, quit smoking, improved hydration, general detoxification, dietary changes, adequate hours of sleep are some changes that can immensely benefit.
An ovulation predictor kit and trying to conceive around that time also increases chances of conception.
For a woman who is 35 years or younger, conception should happen in about four to six months  time. If not, it is time to see a doctor to see what is preventing pregnancy.
Some of the other conditions, which would require a visit to the doctor are as follows:

Consumption of regular asthma medications
Diabetic patients
Epilepsy patients
Chronic smoker
Underweight or overweight women
Diagnosed endometriosis
History of polycystic ovaries
Fibroids
History of irregular periods or other menstrual disorders
History of thyroid disease, especially hypothyroidism, which is one of the main contributing reasons for infertility. Quite often, treating the thyroid levels can lead to pregnancy
History of sexually transmitted disease like chlamydia
History of sexual hormonal imbalance
History of prolonged use of birth control pills
If there is no underlying medical issue, it will happen, don t be anxious.

Struggling to Get Pregnant - What's the Right Time to Visit Your Doctor?

4 Types of Contraception for Birth Control

There are a number of contraceptives available but which method of birth control suits you depends on your sexual life, preferences and your lifestyle as a whole. Professional medical help should be sought in order to understand what method of contraception sis ideal for you.

Here is a list of 4 types of contraceptives for birth control.

1. Barrier methods

Barrier methods are designed to prevent the sperm from entering the uterus. They constitute-

- Diaphragms: It is a shallow and flexible cup that is made of either latex or soft rubber. It is inserted into the vagina before the sexual intercourse where it prevents the sperm from entering the uterus.
- Cervical caps: It is a thin cup of silicone whose function is same as the diaphragm, only it is smaller in size, so less noticeable and more rigid as well.
- Contraceptive sponges: These are soft foam sponges that are filled with spermicide and are disposable. They are also inserted into the vagina before sexual intercourse in order to prevent pregnancy by killing the sperm cells or preventing them from entering the vagina.
- Spermicides: These are chemicals that can kill the sperm and hence assist in birth control.

Other methods include male condoms and female condoms.

2. Hormonal methods

Hormonal methods use hormones in order to either stop or regulate ovulation so as to prevent pregnancy. There are various methods through which hormones can be injected into the body. Some of them are-

- Contraceptive patch: It is a thin patch made of plastic that sticks to the skin and is responsible for releasing hormones into the bloodstream through the skin.
- Vaginal rings: A thin, flexible ring that is inserted into the vagina where it stays for 3 weeks and is removed after that, only to be re-inserted in the 5th week.
- Implantable rods: They are inserted under the skin of the upper arm of women where they release progestin.

Other methods include contraceptive pills and progestin-only pills.

3. Intrauterine methods of contraception

The intrauterine device is a small device, T-shaped that is inserted into the uterus in order to prevent pregnancy. The good thing about intrauterine devices is that they can remain functioning for many years at a stretch. IUDs are two types-

- Hormonal IUD(Intrauterine Device)
- Copper IUD

4. Sterilization

Sterilization is the most reliable contraceptive for birth control as it is permanent. It either prevents the release of sperm or the fertilization of the egg. Sterilization methods can either be surgical or non-surgical. Some of the sterilization techniques are-

- Tubal ligation: It is the surgical technique used in females.
- Vasectomy: It is the surgical technique of male contraception.

Other methods include sterilization implants.



4 Types of Contraception for Birth Control

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

'Congratulations! You're pregnant!' Almost all women long to hear these words and nothing should come in the way, even diabetes. So, if you are a Type 1 or Type 2 diabetic, here are a few things you should keep in mind to have a healthy baby.

1. Your blood sugar must be monitored regularly-
The most important thing you can do to have a healthy baby is to keep your blood sugar as close to normal before and during your pregnancy. Testing is recommended a minimum of four times a day. Glucose passes through the mother's blood to the fetus and hence if your blood sugar fluctuates, so will your baby's. High blood sugar levels are especially harmful during the first 8 weeks of pregnancy when the baby's brain, heart, kidneys and lungs are formed.

2. Your pregnancy is considered high risk-
High blood sugar levels can increase the risk of a miscarriage as well as the risks of your baby being born with birth defects. Diabetes can also increase the risk of developing preeclampsia during the second half of your pregnancy. This could result in a C section or premature birth. Thus, maintain regular checkups and keep your doctor in the loop of all your activities.

3. You should watch out for signs of ketosis-
When you have low blood sugar, the body produces ketones that can be passed on from you to your baby. This production of ketones is a result of the body's burning of fat instead of glucose to provide energy and can develop a condition called ketosis. Symptoms you should watch out for are stomach aches, nausea, fatigue, muscle stiffness, frequent urination and fruity breath.

4. You need Vitamins and Supplements-
Most women require vitamin and mineral supplements at the time of pregnancy. Of these, folic acid, iron, calcium and vitamin D are the most important. These supplements help in the healthy growth of the baby.

5. You should exercise regularly-
Maintaining a regular physical activity routine is very important for diabetics who are expecting a baby. This will help you regularize your blood sugar, relieve stress and strengthen your heart. Avoid activities that increase your risk of falling and aim for at least thirty minutes of daily exercise such as walking, swimming or yoga.

6. Check your medication-
Some medication can be detrimental during pregnancy such as cholesterol and blood pressure medication. Consult your doctor to find a suitable alternative if needed. You may also need to change the kind of insulin you take and its frequency and amount. As you get closer to the delivery date, your insulin requirement may even double or triple.

The key to preventing complications during pregnancy is controlling your diabetes. So take your insulin regularly, maintain regular checkups and eat healthy. You need to be seen by your obstetrician more frequently. Your pregnancy will be monitored closely by more frequent ultrasounds and NST. If your sugar level remains under control and pregnancy is advancing well, a natural onset of pains is aimed for and normal delivery is expected.

Diabetes - How To Handle It While Pregnancy?

8 Foods To Never Eat Before Bedtime
    
Hunger before bedtime is common esp. when you are used to staying up late. The craving to eat something before going to bed makes a person consume anything that is available. Bedtime hunger is not wrong, but there certainly are foods that shouldn't be consumed before going to sleep as they can create health issues. 

Avoid these 8 foods before going to bed.

1. Dairy fat - Having calorie rich cheese or butter for dinner or even before bedtime ensures that your digestive system is going to have a hard time at the night, thus disrupting your sleep.
2. Caffeine - Caffeine from the coffee doesn't let you sleep. It is used to kick our sleepiness so it should never be consumed before bedtime.
3. Spiced/Oily foods- Spices cause flatulence and oils lead to indigestion, ensuring incomplete and disturbed sleep.
4. Red meat - Dinner should always be the lightest meal of the day. If you make your digestive system work heavily overnight, it’s difficult for you to get sound sleep! Red meat being a very heavy, must be avoided to ensure a good night’s sleep.
5. Beans- Beans before bed simply fastens the process of flatulence! Avoid it to have a trouble free night.
6. Sugars- Sugars give you instant energy. That’s exactly what you don’t need before a good night’s sleep so avoid it before bedtime.
7. Aerated drinks- These drinks have acidic content with a lot of sugar and caffeine. Drinking them can destroy you sleep for the whole night so keeping it for the day is wiser!
8. Alcohol- Alcohol makes you drowsy and in a way bogs you down. But that’s really not the kind of sleep you’d like to have. Avoid alcohol to invite the perfect sleep!

If you would like to consult with me privately, please click on 'Consult'.

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8 Foods To Never Eat Before Bedtime

Although most women experience menopause between the age of 45 and 55, but when women experience the menopause before they reach 40, it is termed a premature or early menopause. It is also known as premature ovarian failure.
This may be due to primary ovarian insufficiency in which there is decreased activity in ovaries and the periods spontaneously stops. It may be result of chemotherapy treatment for cancer or it can be surgically induced menopause when the ovaries are removed. Premature menopause can also be caused by treatments for cancer or other conditions that involve chemotherapy or radiation therapy for the pelvis. These treatments can damage the ovaries and result in ovarian failure. The chances of premature menopause depend on the type and amount of chemotherapy as well as the age of the patient

Removal of both ovaries by surgery causes menopause right away. Menstruation stops after this surgery, but the hormones of women facing such condition drop quickly. They experience strong menopausal symptoms such as hot flashes and diminished sexual desire.

Chromosome defects like Turner s syndrome can lead to premature menopause. In this condition, the female is partly or completely missing an X chromosome due to which the ovaries does not form normally leading to early menopause. Women with a family history of premature menopause are more likely to have the same themselves. Autoimmune diseases like Thyroid disease and rheumatoid arthritis that attack the body's immune system may mistakenly effect the ovaries thus preventing them from making hormones.

One should visit agynaecologist, if the period stops or changes before the age of 40. Menopause is confirmed when a woman does not have her period for 12 months in a row. Blood tests for measurement of oestrogen and related hormones, like follicle-stimulating hormone determines if one has reached premature menopause

Women have premature menopause can be observed as physical problems, emotional disturbances or problems associated with sexual functioning. Women experience sudden waves of mild or intense body heat commonly known as hot flashes and can also experience profuse sweating called as night sweats and have difficulty in sleeping. They experience vaginal dryness and the sexual drive or the libido also decreases. The bone density decreases leading to osteoporosis and fractures. In addition to physical symptoms, there are emotional symptoms like anxiety, mood swings, loss of focus and difficulty in concentration. Women who want to conceive and go through premature menopause may feel extremely upset. The sexual symptoms include dryness and thinning of walls of vagina, thus causing pain or discomfort during sexual intercourse.

Premature Menopause - Signs and Causes

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