Dr. Pooja Choudhary

There are usually challenges faced by pregnant women , especially during the first and last trimester of their journey to motherhood. While these are normal and bound to happen , still expecting mothers do have lot of doubts in their mind related to health and diet issues and the same need to be addressed on time to avoid any complications.

Chlamydia is one of the more common STDs among both the genders. It spreads through physical intimate contact; it can develop irrespective of one’s age, however, is most commonly observed among young women. In women, the symptoms include yellow or green colored odorous vaginal discharge, painful urination and a burning sensation or itching around the vagina, lower abdominal ache, painful menstruation or bleeding during sexual intercourse. Now if the infection reaches up to the fallopian tubes, it causes a disease known as Pelvic Inflammatory Disease (PID). In case of unprotected oral sex, the bacteria causing this disorder, ‘Chlamydia Trachomatis’ might infect the throat as well.

Reasons Behind Chlamydia in Women:

1. Being a sexually transmitted disease, Chlamydia gets passed on from one person to another through unprotected sex or through the contact with the genitals of an infected person.

2. In some cases, infants are likely to inherit the disease from their mothers during birth, if she is already affected with it. Hence pre-natal checkups are essential for detection.

3. Although very rare, this infection can affect the eyes as well via oral or genital contact.

How To Treat Chlamydia?

1. The infection can be resolved within a couple of weeks with the use of antibiotics. Once it is diagnosed, the treatment course should start immediately. The widely used antibiotics for curing chlamydia are azithromycin and doxycycline. If you are breastfeeding or pregnant or suffering from any allergy, your doctor might prescribe erythromycin or amoxicillin. For severe complications, a longer course is administered. The treatment may induce mild side-effects in the form of vaginal thrush, sickness, diarrhea and tummy pain.

2. Try and avoid any sort of sexual activity (intercourse or other activities) till the treatment is completely done and none of you show any other sign of the infection.

One of the major milestones in a woman’s life is the entry into motherhood. For most women, when this does not happen in the natural logical sequence of things, there is anxiety and lot of pressure from family and friends. However, with advancements now, there are options like intrauterine insemination and in vitro fertilisation (IUI and IVF) available, which can help increase the chance of conception and pregnancy.

IVF is where the egg is retrieved from the woman’s womb, fertilised externally and then transplanted back into the uterus where it grows to full term. However, there are always unanswered questions like how long to wait before going for IVF, is it the right procedure for me, etc.

Read on to find answers to some of these questions.

1. Maternal age: As a woman reaches 35 and a man reaches 40, the fertility rates drop significantly. The chances that a woman at 35 will conceive is about 20%, which goes down to 5% if the woman is 40. However, this rate can be significantly increased by using IVF, moving it up to about 80%. The quality of the egg would gradually deteriorate, and so if a woman is nearing 40, it is better to consider IVF as the ovarian reserve would be optimal with IVF.
2. Failed intrauterine insemination: In couples who have problems with the sperm reaching the uterus, intrauterine insemination (IUI) is first attempted. However, if 3 or more attempts of fail, it is time to consider IVF.
3. Duration of inability to conceive: While some couples conceive quite promptly in a month or two, most take about 6 to 8 months of unprotected sex to conceive. Therefore, IVF can be an option if you are failing to conceive even after a year. Less than a year, don’t fret. Take it easy and it might just do the trick.
4. Medical health: Both the partner’s medical health should be taken into account. Lifestyle changes like smoking, alcohol abuse, drug abuse should be considered, which can account for poor sexual performance and therefore lead to an inability to conceive. Health conditions like diabetes and heart disease can also lead to infertility. Hypothyroidism in women is another thing that must be ruled out, as it often leads to an inability to conceive.
5. Sexual problems with the partner: One of the first things to do before going for IVF is to check that the male does not have any issues. Be it erection issues or ejaculation issues or sperm issues, they need to be ruled out. Sperm quality, quantity, and motility have to be analysed, and if they are optimal, IVF can be considered.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Celiac disease is a condition in which the small intestine becomes sensitive and reactive to gluten, leading to difficulty in digesting food. Gluten is a kind of a protein found in wheat or barley. In reality, if either of the partners is suffering from celiac disease then you are prone to fertility related issues.

Impact of Celiac disease

As compared to men, this disease is more common among women in general. Women suffering from the disease are generally more prone to infertility and other genealogical problems like preterm births and miscarriages. In the case of men, the disease causes the infertility problems including sperm abnormalities such as low count, abnormal shape, reduced function and such others. Additionally, men with the untreated celiac disease might also have reduced levels to testosterone.

Infertility and Celiac disease

Infertility is one of the lesser known effects of the celiac disease, which is relatively uncommon amongst people. The disease causes infertility by affecting the menstrual cycle among women either in a direct or indirect manner. Some of the infertility related problems caused due the disease are listed below.

• Delayed occurrence of menstruation
• Early menopause
• Secondary amenorrhea (a medical condition associated with sudden cessation of menstruation for 6 months or more)
• Hormonal disruptions and abnormal changes

Diagnosis

Celiac disease is usually diagnosed by its own set of underlying symptoms such as chronic fatigue syndrome, irritable bowel syndrome (IBS), iron-deficiency anemia, and such others. Additionally, the condition can be diagnosed if a person is having repeated miscarriages or inability to conceive for unidentified causes.

What can you do about it?

If you experience symptoms of Celiac disease, consult your doctor at the earliest and follow the treatments and preventative measures suggested. Additionally, you can also consult a dietician who will help you to move on to a low grain or no grain diet that would help you further to avoid the disease. In case you have a concern or query you can always consult an expert & get answers to your questions!

The vagina is a muscular, tubular structure of the female genital tract extending from the vulva to the cervix (the opening of the urethra). Sexual activity affects vaginal health in a number of different ways during intercourse and in the long term.

A few of the varying effects and the factors responsible for these effects are listed below:

1. Changing size of the vagina: The vagina is designed to be elastic and adjustable. So, no permanent change in size is possible but it does undergo temporary changes in sizes as effects of sex. The inner walls of the vagina enlarge during sexual intercourse and during childbirth. Tissues in the clitoris puff out and harden, this also causes an expansion in size. It takes a while to get back to its normal size.
2. Vaginal secretion: When you are aroused during sex, the blood vessels supplying the vagina expand immediately. The blood flow increases to lubricate the vaginal walls (rugae). The rugae unfold and the space increases. These secretions are important because, women who are sexually inactive for a long time at a stretch, experience dryness that leads to urinating difficulties and rashes.
3. Unusual discharge: Apart from natural lubricants, vagina secretes some fluids, the process being termed as 'female ejaculation'. A tiny amount of white fluid made of prostate plasma cells, is produced just before you climax and discharged with some quantity of urine. Sometimes, prostatic specific antigen (PSA) and prostatic acid phosphatase (usually found in semen) are also found in the secretion.
4. Infections in the urinary tract: The friction caused by sexual intercourse may cause small cuts which enable bacteria to pass from the vagina to the urinary bladder through the urethra. This causes infection in the bladder, the urinary tract and the vagina. These can be avoided by using a condom or by urinating before and after having sex.
5. Vaginal pain: A lot of women report the experience of pain and discomfort inside or around the vagina during and immediately after sex. The pain can result from repeated sex within a short period of time or reduced secretion of natural lubricants. If the pain is too severe, you should see a doctor because yeast infections or chronic vulvodynia can also be responsible for the pain sensation.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Urine incontinence is a condition that can be caused by one's everyday habits, side effects to medication, or any other long-term physical ailments. A thorough check-up by your doctor can help in getting to the root cause of this condition.

Certain beverages, medicines and foods can act as diuretics. This leads to bloating in your bladder and an increase in the volume of your urine. They include the following:

1. Liquor
2. Caffeine
3. Decaffeinated tea or coffee
4. Aerated drinks
5. Artificial sweeteners
6. Corn syrup
7. Drinks that contain high doses of artificial flavours, sugar or acid, particularly citrus based beverages
8. Heart medicines, narcotics, and muscle relaxants
9. Extensive intake of vitamins B or C
10. Urinary tract infection (UIT)
11. Constipation

Other causes:

Urinary incontinence can also be caused by the following:

1. Pregnancy: Hormonal changes and increasedweight of the uterus can cause stress incontinence.
2. Childbirth: Delivery can weaken the muscles required for bladder control. It damages the bladder nerves and steady tissue. With prolapse, the uterus, bladder, or the intestine can be pushed down from their usual position and might even protrude into the vagina.
3. Changes developed with age: Maturing of the bladder muscle can weaken the bladder's ability to store urine.
4. Menopause: After menopause,women deliver less estrogen. Disintegration of these tissues can cause incontinence.
5. Hysterectomy: In women, the same muscles and tendons support the bladder and uterus. Any surgery that removes the uterus may harm the supporting muscles, which can prompt incontinence.
6. Expanded prostate: Particularly in older men, incontinence usually occurs from growth of the prostate organ, a condition known as considerate prostatic hyperplasia.
7. Prostate cancer: In men, stress incontinence or urge incontinence can be connected with an untreated prostate disease. Incontinence is a reaction to medicines prescribed for prostate growth.
8. Obstruction: A tumour in your urinary tract can disrupt the typical stream of urine, prompting flood incontinence. Urinary stones at times cause leakage of urine.
9. Neurological disorders: Various sclerosis, Parkinson's illness, stroke, a mind tumour or a spinal damage can meddle with the nerve signals. These are important in keeping control of the bladder.

Your specialist may suggest the following:

1. Bladder control: You may begin by attempting to hold off for 10 minutes each time you feel a desire to urinate. The objective is to extend the time between visits to the toilet until you start urinating in two to three hour intervals.
2. Two-fold voiding: Twofold voiding implies urinating, then holding it for a couple of minutes and attempting once more. This exercise can help in leveraging better control in the long run.
3. Fixed toilet time: You may attempt to urinate every two to four hours instead of sitting tight when the need arises.
4. Liquid intake and diet: You may need to stay away from liquor, caffeine or acidic foods. Also, the fluid intake may have to be reduced in such cases.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Gestational diabetes is a form of diabetes where the blood sugar levels of the body increase during pregnancy. When you are expecting, your body is more repellent to insulin so that a larger amount of glucose is manufactured for the baby’s nourishment. However, this excess blood glucose can build up within the body which causes gestational diabetes. This can lead to health problems for both the mother and the baby. At the end of the gestational period i.e. once the baby is delivered, blood sugar reduces to normal.

When are you at a risk for gestational diabetes?

1. Gestational diabetes can also be hereditary. If a family member or a relative has diabetes, you are more likely to develop gestational diabetes.

2. If you are overweight, you are more susceptible to developing gestational diabetes.

What causes gestational diabetes?

During pregnancy, the placenta connects your baby to the blood supply. This produces other hormones which reduce the levels of insulin. This increases the level of blood sugar in your blood. As your baby develops, your body manufactures more of such hormones which block your insulin levels leading to gestational diabetes. This usually occurs from the 20th week of your pregnancy.

Complications:

1. Increase in Birth Weight – Extra glucose crosses through the placenta which instigates the baby’s pancreas to manufacture more insulin. This can make your baby very large. Sometimes, it becomes difficult for the baby to pass through the birth canal during childbirth as a result.

2. Premature Birth and Respiratory Diseases – High blood sugar may increase the risk of an early labor. It may make the baby due before the 37th week of pregnancy. This also makes the baby more susceptible to respiratory disorders.

3. High Blood Pressure – Gestational diabetes also raises your risks for high blood pressure. This can be fatal for you as well as your baby’s health.

Treatment:

1. Follow a healthy eating schedule. Limit the amount of carbohydrates and ensure you have a healthy and balanced meal.

2. Do light exercises regularly during pregnancy. This helps you to control your blood sugar level. Physical activities which require low levels of energy utilization such as swimming and walking will control your blood sugar level without exerting you too much.

3. Taking insulin shots and medicine for diabetes will also control your blood sugar levels if you have a pre-existing condition.

In case you have a concern or query you can always consult an expert & get answers to your questions!

In case you have a diseased uterus, which makes you infertile, you can undergo a procedure known as uterus transplant or uterine transplant to get pregnant. In the process of sexual reproduction, a diseased uterus does not allow embryonic implantation. This factor is referred to as uterine factor infertility or UFI. As a result, you will not be able to get pregnant.

Who requires a uterus transplant?
This procedure involves women who have UFI and women who had their uterus removed by hysterectomy. Women who have a damaged uterus on account of an injury or infection, which does not function anymore, can also undergo a uterus transplant procedure. Women from the age of 21 to 45 are eligible for this procedure. Many women are born without having a uterus. This condition is called Mayer-Rokitansky-Küster-Hauser syndrome.

Procedure
Uterus transplantation begins with undertaking a uterus retrieval surgery on the uterus donor. The uterus, which is recovered has to be stored and transported to the location of the patient undergoing the transplant. An ischemic tolerance may last over 24 hours. Three major surgeries have to be carried out with the recipient. Firstly, a transplantation surgery is required in which the donor’s uterus gets transplanted. In case pregnancy develops, a Cesarean Section (C-Section) surgery has to be performed. The patient is given immune suppressive therapy. After childbirth, a hysterectomy is done in order to terminate the immune suppressive therapy.

Will the women be able to get pregnant after having sex?
Women receiving a uterus transplant will not be capable of becoming pregnant without undergoing fertility treatments. The transplanted uterus is not connected with the fallopian tubes, which is the location of the normal fertilisation process. The women will require to carry out IVF or in-vitro fertilisation to become pregnant after a uterus transplant. IVF is a process in which the eggs are removed from the ovaries and get fertilised in a laboratory. Then, they are implanted in the uterus. After undergoing the uterus transplant procedure, a woman has to wait for a period of one year. The uterus requires time for healing and after recovery, the embryo may be implanted for pregnancy. After giving birth successfully, a woman will be able to keep the transplanted uterus.

She has the option to get pregnant again. However, after giving birth twice, a hysterectomy must be carried out for the removal of the uterus. This is done so that the woman can stop using the immune suppressant drugs, which are associated with major risks. Uterus transplant is a relatively new technology. In October 2014, the first healthy baby was born to a woman who had undergone a uterus transplant. This surgery is kind of experimental in nature and is usually the last option for getting pregnant. Consult an expert & get answers to your questions!

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 through you. Listed below are some simple ways to do the same.

1. Prenatal care: As soon as you realize that 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 – the whole hog.
2. Diet: You need to ensure two things: that you are eating enough for two people, and also that 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:
   • Include a good amount of fruits and vegetables every day; break it into five small portions.
   • Sufficient amount of carbohydrates should be the basis of each meal.
   • Whole grains are preferred to white grains, which also give good amount of fiber.
   • A good amount of proteins including fish, eggs, meat, nuts, pulses, milk, and other dairy products.
   • Ensure adequate amount of iron, calcium, and other minerals are included in the diet.
   • Avoid eating non-pasteurized dairy products, uncooked or undercooked food, and smoked seafood.
   • Folic acid is compulsory for the first trimester as it helps to protect your unborn baby from developing neural tube defects such as spina bifida. Also, it helps to prevent other birth defects, such as a cleft palate . 
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: 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. Exercising while pregnancy is being increasingly encouraged for the following reasons:
   • Improved energy levels
   • Controls back pain
   • Improved sleep pattern
   • Improves constipation
   • Improves muscles strength and endurance
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. If you wish to discuss about any specific problem, you can consult a Gynaecologist.