Patient Review Highlights
I found the answers provided by the Dr. Jyoti Kapoor to be knowledgeable, well-reasoned, sensible, practical and professional. Thank you doctor for being patient and helpful with me
I found the answers provided by the Dr. Manish Mannan to be very helpful. Dr manish manan my baby chekup very Good and i am satisfied dr manish excellent Docter for children
Bad experience with lybrate bcoz Dr. Rajnish monga was not available at that time given by you. So will not use this lybrate app or process in future
I found the answers provided by the Dr. Rajnish Monga to be very helpful, knowledgeable, well-reasoned, caring and inspiring. Above expectations
It was a false appointment. Dr. Sanjay Sharma had no OPD yesterday still my appointment was booked. It was a waste of effort for me. Poor service.
Dr. Vineet Kumar Surana provides answers that are very helpful. Its really v helpful and informative to me. Thank u
Rajesh Kumar M
Dr. Priyanka Prakash provides answers that are knowledgeable, well-reasoned and saved my life.
Dr. Aruna Kalra provides answers that are very helpful. Thnx .....
Sexual problems might mean you have a broken heart, literally. The most common sexual problem in men is erectile dysfunction (ED). Erectile dysfunction affects >30% of men between 40 and 70 years of age. There are several different causes of ED, including depression, low testosterone, neurological problems, and some medications, such as beta blocker but the most common cause is a problem with the blood vessels called atherosclerosis.
Erectile dysfunction is frequently a sign of atherosclerosis, that can be the first clue to heart disease in men. It usually comes 3 to 5 years before a heart attack, so after ED is diagnosed, there is time to treat atherosclerosis and prevent a heart attack.
Sexual Activity and Cardiovascular Disease
Decreased sexual activity and function are common in patients with CVD and are often interrelated to anxiety and depression. In fact research has proved that there is a strong link between erectile dysfunction and heart disease. Studies have shown that if a man has ED, he has a greater risk of having heart disease. For instance, in one study, 57% of men who had bypass surgery and 64% of men hospitalized for a heart attack had had ED.
Several having ED can predict that a man will probably have heart disease symptoms within five years. In fact, having ED is as much a risk factor for heart disease as a history of smoking or a family history of coronary artery disease.
The Stockholm Heart Epidemiology Programme (SHEEP) study of post-MI patients (50% women) found that those who were sedentary had a higher risk of MI with sexual activity (relative risk 4.4) than did those who were physically active (relative risk 0.7).
How is the Heart and ED Related?
Deposition of cholesterol in the arteries causing atherosclerosis is taken as the most important reason for ED as the plaque formation reduces the blood flow in the penis, thereby affecting the erection process. However the latest studies show that ED is also due to the dysfunction of the inner lining of the blood vessels (endothelium) and smooth muscle. This causes inadequate blood supply to the heart and the penis which also aids in arthrosclerosis. Hence ED and heart disease are found to be inter related.
What to do?
If you are suffering from ED or heart disease , it is best to discuss your concerns with a specialist - for the heart a cardiologist and for the ED a urologist
Various studies and researches have been able to prove that women outlive men. In fact they are expected to live at least 7 years more than men. More men are living with and dying of Coronary Heart Disease (CHD) than women and have more hospital discharges for Cardiovascular disease (CVD) and CHD. The prevalence of CHD is higher in men within each age stratum until after 75 years of age, which may contribute to the perception that heart disease is a man's disease.
The classic risk factors for CVD are the same in women and men, but there are gender differences in the prevalence of risk factors. Dr Bernadine Healy first introduced the concept of the Yentl syndrome in 1991, suggesting gender bias in the management of CHD.
HEART DISEASE AND SEX DIFFERENCES
Reasons for Cardiovascular Disease:
There are a number of risk factors that affect the men more than women. The following are few aspects that are reasons for the rising incidences of heart disease in men:
High blood pressure
High cholesterol level
Sedentary life style
Unhealthy food habit
Lack of exercise
It is important that men take control of their health. Opt for regular cardiac screenings tests, yoga, stress management and ensure that they live a heart healthy life.
Even after putting her best in her family, Radha's husband was shouting at her again, her children were again complaining about the food, her mother-in-law about her joint pains and even when she had a million issues on her mind, the one bothering her most was her board presentation scheduled tomorrow in office.
Tired, exhausted and challenged she smiled remembering her mother's words-
'They say it's difficult to be a woman! You need to think like a man, act like a lady, and look like a girl and work like a horse.'
From an amoeba to higher species four aspects are common-Nutrition, Reproduction, Excretion and the fourth one is Stress. Working professional or a home maker, a woman's plate is always full with multiple projects and a huge list of things to do. Cooking, washing, cleaning, picking & dropping kids, homework, spouse attention, extended family, social obligations, and dependency on maids, over demanding workplace, sometimes obnoxious co-workers, and long commuting hours are facets that bother every woman today.
All these activities and stressing situations are disturbing. The human mind is not conditioned to handle so much. The result is emotional disturbance- anxiety, energy drain and undue stress.
We need to understand that we have the power to be happy, stress free, peaceful and only we can help ourselves. Hence it's important to take charge of situations causing stress. We should try to go easy on ourselves and accept the following:
We are not Durga or an Octopus with multiple hands: We need to understand our limitations and should not stretch ourselves. We can always ask for help from others. Sometimes people around us are just unaware about our needs. We should ask our family, friends, co-workers for help bluntly, rather expecting them to read our mind.
Don't try to control the uncontrollable: We should not get tense unnecessarily when something happens unplanned and hampers your schedule. We need to accept facts -we can't change the weather, situations, how others behave. The best way is to relax and accept situations and re-plan your day.
Don't be a perfectionist: Expecting perfection from others adds on to our stress. Not everyone can be organised like you. Your maid might not be able keep your home spotless, your daughter's hand writing could be as poor as the girl you hated in your class, and your co-worker might not be good in MS Excel. A perfectionist cannot delegate work. Be easy on yourself and on others. Most importantly don't nag people about issues; it can make them feel suffocated.
Self-compassion: Be compassionate with yourself too. Don't feel pressure to perform every time. Don't try to put extra efforts beyond your limit to please others. Give some room to others to make mistakes- after all people learn from them.
Stay on schedule: An organised approach to handle tasks always gives a pleasure of accomplishment and it's very important to design a balanced routine and stick to it. A 'Me Time' is very important when you budget your day.
Simplicity reduces stress: Keeping less stuff helps us to manage and organise things better. Don't buy or store things you don't need.
Take care of your health: Our mind, body and soul are inseparable. Taking care of your health, practicing yoga, and exercising, eating a healthy diet is important to fuel better emotional well-being.
Tears are not sign of weakness! Don't feel guilty: Yeah! Shedding tears does not make you weak. Don't feel miserable for being sensitive. Express yourself openly!
Be assertive in communication style: We can always put across our points assertively without sounding irritated, frustrated or angry. It's important to put your thoughts and difference of opinion constructively.
We look around at our friends' marriage and often conclude that their marriage is better than ours. No wonder we turn to self-pity mode for not being to lucky to have a happier and exciting relationship. Who knew the love shall fade away! Where is the harmony and intimacy we always dreamt of ??
Why does romance not last? When we need someone to love and more importantly to be loved. All success, a seven digit salary, and big cars, nothing. nothing lets us feel content unless we have someone to share it with. Probably you have been married for years and have lost the romantic spark you had. And you look back and start analysing, where, what, when and how things went wrong?
And blame game starts; you curse circumstances and try to justify your actions
Ritikaa and Mehul fell in love at first sight. Despite family resistance they married. After a few months, they were arguing for small things and wondering why did they have married. Dr Radhakrishnan is a scientist married to a pathologist; he is looking from separation from his wife after 26 years, though he is not seeing anyone else.
Suchitra and Prakash married ten years ago, they divorced after two years of their marriage. They don't have kids. There were no obligations but they reunited four years back and divorced again, but still the relationship is not broken.
Do happy couples exist??? Heartbroken Alok who is just 32 yrs old, asked me with teary eyes - I earn 4 crores a year, but I feel lonely, unloved and dejected!
Every day I listen to stories of heartache! And my belief in the power of love and affection is growing many folds.
Marriage is more than being a room partner! Not only marriage but any relationship is like a plant, we need to nurture it to blossom. Every marriage faces its own challenges at different time and for different reasons. We need to consciously work on it but with ease.
No marriage is boring or perfect! It's about how do we respond to our marriage.
Every couple has to face common issues related with adjusting with new families, career balance, baby plans (in some cases), spending, eating, hygiene (bathroom etiquettes) habits of spouse, interest and hobbies, gender specific responsibilities and of course money matters.
Let it be anything . .Assertiveness is key to success.
Watch your own actions:
Are you imposing thoughts and actions on your spouse: you have imagined a world, and are trying to move things as per our own wish?
Are you expecting without explaining to her/ him: you might be soul-mates, but don't forget that no two people can be the same. Explain your expectations but don't put conditions to get it accomplished. Allow your spouse to take her or his call.
Are you respecting differences in opinion- disagreement is not disrespect for your views and opinions. It's about perspectives (based on pre conceived notions)
Are you reading your spouse's mind and assuming? Stop assuming, ask but be assertive, use appropriate words, tone and pitch.
Are you giving some room for mistakes? Give people some space to make mistakes, forgive them and self too. Communicate if something bothers you a lot.
Are you judging by actions not understanding intentions? Relax! Before you make opinions and decide you can't take it anymore. Sometimes your spouse is completely clueless and unaware about your mind.
Are you trying to bridge the gap between your spouse and your parents? Relationships are very one-to-one. Never try to bridge the gap between them, you shall end up being a sandwich and will spoil your relations too. Let them grow their own relationship.
Communicate clearly and explain your expectations about money matters - involve your spouse in your financial planning, it's a way to generate trust between you and spouse and it helps to work on budgets and spending habits.
Express clearly about sexual needs and desire. Physical intimacy plays a very important role in marriage. Seek professional help to sort things out before you think you are incompatible.
Make a choice not a sacrifice (otherwise you shall expect your spouse to repay it in the way you want).
Mood swings bother you and everyone around you!
Everyone experiences disappointment or sadness in life. When the "down" times last a long time or interfere with your ability to function, you may be suffering from a common medical illness called depression. According to research, women experience twice the rate of depression as men, regardless of race or ethnic background. An estimated 1 in 8 women will face major depression in their lifetimes. Despite high prevalence rates people are reluctant to acknowledge clinical depression as a disorder that should be evaluated and treated.
Researchers suspect that, rather than a single cause, many factors unique to women's lives play a role in developing depression. These factors include - genetic and biological, reproductive, hormonal, abuse and oppression, interpersonal and certain psychological and personality characteristics. However the stages in a woman's life can also subject her to depression- menstruation, pregnancy, child birth and menopause. Given below are some of the signs and symptoms that you may be experiencing related to your life stage.
Premenstrual Dysphonic Disorder - This affects around 3-8% of the women. In this behavioral changes are observed in women 5 days prior to the commencement of their menstrual cycle. The common symptoms are:
Lack of interest in common activities, such as hobbies
Moderate to severe feelings of tension or anxiety with low energy
Mood Swings , such as feeling overly sensitive
Moderate to severe feelings of hopelessness or depression, feeling overwhelmed
Physical symptoms, such as weight gain, joint or muscle pain, or a headache
Changes in sleeping patterns, such as sleeping too much or too little
Changes in eating habits or food cravings
Problems focusing or concentrating
Unusual irritability or anger
Management: Be calm and relaxed. Keep a check and monitor your cycle and emotional outbursts. If you notice some continuity it's important that you consult a specialist. Ignoring the issues can have an effect on your relationships. Be open and talk to your family and your partner about the same.
Pregnancy and Post Partum Mood Disorders- Pregnancy is a stage in which a woman's body is going through a number of hormonal changes. These changes can have a major effect on the mood and can increase the risk of developing depression. Even post pregnancy the risk doesn't end. The following are a list of symptoms. Be informed if you are pregnant or have just delivered a child.
Lifestyle or work changes resulting in relationship problems
Episodes of depression and irritability
Feeling of lack of social support and lost feeling
Mixed feelings about being pregnant
Feeling that pregnancy has pulled you down
Please note that a woman can feel depressed during pregnancy and the feeling can become worse post child birth. It affects 10-25% of women in India. It's important to understand that it's not just you but your body that is going through change. Hormonal fluctuations, psychological pressures and social support all attribute to the same. Be open and consult specialists. Also talk to your family and your spouse.
Peri Menopause and Menopause Depression- Risk of depression may increase during the transition to menopause, a stage called Peri menopause, when hormone levels may fluctuate erratically. Depression risk also may rise during early menopause or after menopause - both times when estrogen levels are significantly reduced.
Women need to aware that they are vulnerable to develop depression and need professional help to avoid it from causing personal and functional impairment.
Be informed and consult a Psychiatrist if you are experiencing any of the above.
Stress in mechanics is a load, pull or force or a system of forces producing a strain. In life, any event or situation that produces a strain therefore induces a physiological strain.
At work place, a system of forces work to produce desired results which more often than not produce a state of strain or makes an individual's life stressful. But the consequences of chronic stress are not just on individual health and well being but on the organizations as well. This affects the productivity and competitiveness. When an organisation faces a challenge, the flight or fright reaction ensues leading to increased threat perception, alertness and activity. In short term, it can improve productivity, but in case a state of threat is perpetually present like in case of a team led by an anxious or high strung individual, it produces chronic stress leading to lowering of performance. More often, sources of stress at work place are poor communication, unclear roles, discrepancies in expectations and skills, insecurity and sudden and significant change in work structure , to list a few.
Sources of Organisational Stress
Unclear role / objectives
Role conflict (project management)
Over / under promotion
Lack of training
Social or physical isolation
Unrealistic deadlines / targets
Lack of control over decisions
Lack of feedback on good performance
Work overload / underload
Long working hours
The nervous system of an individual facing work stress due to any factor will react by producing a flight or fight response with ensuing physiological and/or psychological changes. These changes produce behavioural effects which if prolonged can be identified as signs of stress. While physical effects of stress lead to higher sick leaves, accident and absenteeism, psychological effects cause high anxiety and irritability leading to lower performance, disturbances in interpersonal relationship and more mistakes and miscalculations due to disturbance in concentration and self confidence .
Signs of rising stress:
Loss of pleasure in things once enjoyed
Irritability and impatience
Tiredness, lack of energy
Inability of concentrate, meet deadlines or make decisions
Increasing cynicism or loss of trust
Anxiety / panic attacks
Sense of losing control over events
Concerns over the effects of organizational stress on productivity, absenteeism and health related problems and consumption have substantially increased over past few decades. Employee health and well being are important assets to organizations and businesses. The Human Resource Department thus needs to watch for signs of stress in the employees and create an environment where the effects of stress can be mitigated. It requires understanding individual skills and deficiencies, clear and adequate communication, promoting an environment where deficiencies can be worked on without lowering self esteem or producing insecurity, encouraging support among team/staff members etc. On a personal level, individuals need to reduce stress by prioritizing their goals and following time management and self -fulfilment activities.
Ways to control stress
Participate in decisions
Ensure travel commitments are reasonable
Make time for yourself
Allocate 'self' time
Pursue a hobby
Look after yourself
Access support (Manager, Occupational Health / HR, Local agencies)
An in house counsellor who can maintain confidentiality and acts a bridge between the organization leaders and teams goes a long way in ensuring adequate stress management.
According to recent statistics only 40% of Indian women opt for preventive health check. Majority resort to self medication and ignore the signs and symptoms of a major illness. Ignorance and neglect leads to complications and fatality. It is important that every woman understands the importance of her health and prevention. Given below are some aspects that ever women needs to consider and implement:
- Physical examination every 2 to 3 years.
- Breast check- to identify early signs of breast cancer. Mammography- every 1 to 2 years after the age of 40 years.
- Screening for thyroid should be done at regular intervals.
- Screening for diabetes- every 3 years after the age of 45 years.
- Screening for cholesterol and blood pressure - every 5 years after the age of 35 years to reduce the risk of heart diseases.
- Women should undergo screening for osteoporosis. Bone mineral density test helps to identify problems early and treatment should be started to prevent fractures.
- Eye examination is essential after every 1 year to prevent eye related problems.
- PAP Smear test - Women at the age of 21 to 30 should undergo a pap smear test every 3 years. This is an essential test for checking cervical cancer. After the age of 30 years. PAP smear+ HPV test should be done every 5 years.
- Screening for ovarian cancer- a vaginal ultrasound is recommended to patients with a family history of cancer in ovary or any pelvic pain should undergo this test.
Consult for any abnormality:
Most importantly if you detect any abnormality in your body it is essential that you consult a doctor immediately. Ignoring or neglecting the signs and symptoms can complicate matters.
Have you been trying to have kids for a long time? Is inability and delay giving you sleepless nights? It is important to know that Stress alone is a major factor for infertility.
Can Stress Have an Effect on Your Fertility?
If your mind and body is under stress your body is signaled to release a hormone - Adrenalin. This is a stress relieving hormone and gives your body the rush to face the stress. This hormone inhibits the utilization of the hormone Progesterone, which is essential for fertility. Also during stress Prolactin, another hormone, is relapsed which also interferes with infertility. Hence to conceive its essential that your anxiety levels are under control.
Chronic Stress also decreases libido:
Chronic stress may cause lack of libido as well as a decrease in general fertility. This has become such a common issue that they have created a name for it Stress Induced Reproductive Dysfunction. These facts are very important to consider if you have been trying to conceive with no results. It also shows that stress relief should be a part of every couple's conception plan even if they are going through IVF.
Ways to reduce stress & improve fertility:
If you are having difficulty to conceive, it's imperative that you get fertility tests done and also evaluate your life. Look out for the stress points that may be hindering a relationship. Remember defeating the stress may be the solution to your worries.
Reduce stress in your life: The issues in your life may be work or result related. You need to learn to balance your personal and professional life. The sooner you do it the better; after all you are preparing yourself to welcome a new born in your life.
Change your reactions: Get a hang of the situation and react accordingly. Over reaction to a situation can harm your body and mind. Stop bothering so much about the future.
Let few things be the way they are: Stop getting bothered about people. Remember by nature everything will fall in place. Let few things be the way they are.
Make it your habit to reduce stress: Call it an obsession or a practice, train your mind to choose options where there is less stress.
Sleep well: A good rest is essential for a healthy mind and body. Meditate, do yoga or seek counseling. Go for facials if it sooths you.
Please note that if your fertility reports are normal, then it's just a matter of time. Give you, your partner and your body time. There are certain medical complications or disorders that can also be responsible for infertility. Be calm and composed so that you are able to face the rough waters clearly with your partner.
Hirsutism is a condition of unwanted hair growth in certain areas of a women's face and body, such as upper lip, beard area, chest and abdomen, that creates a "male pattern" of hair growth. It affects around 5-10% of the women and is a common presenting complaint among females for cosmetic reasons.
Hirsutism is attributed either to increased production or increased sensitivity of the hair follicles to the male hormone- testosterone. Polycystic ovary syndrome (PCOS), which causes irregular menstrual cycles, is the main cause of the same. However in some cases the reasons for the same can be unknown as all reports may seem normal. Such a type is called Idiopathic Hirsutism. It is important for women to not feel shy and embarrassed about the situation. Often resorting to excessive bleaching and razers can harm the skin and the self image of a woman. You should come forward and talk to either a Gyneacologist or an Endocrinologist. The doctors after taking the complete history would advice certain tests that would measure the amount of certain hormones in the blood. If the androgen levels are elevated, doctor may recommend an ultrasound or a CT scan to check ovaries and adrenal glands for tumors or cysts.
The main causes of Hirsutism are:
- Polycystic Ovary Syndrome: In 70% of the cases PCOS is the cause of Hirsutism. Women with PCOS often have hirsutism in combination with acne, balding near the front of the head, and menstrual irregularities. PCOS is also accompanied by infertility (due to menstrual irregularity), obesity, diabetes , High cholesterol and possible heart disease.
- Idiopathic Hirsutism: Idiopathic hirsutism refers to hirsutism that has no identifiable cause. It is usually a mild variation of PCOS. A gradual increased growth of coarse body hair is typically the only symptom in women with this condition. Menstrual cycles are normal in women with idiopathic hirsutism.
- Drug Induced: Certain drugs and steroids taken the past can trigger a hormonal imbalance and cause hirsutism
- Adrenal or tumour causes: These are rare and are related to tumours or abnormal functioning of the adrenal gland.
Since Hirsutism can be a combination of medical issues self medication is not recommended. There are a variety of ways through which the same can be managed or cured. The treatment options are:
- Medical Management: The doctors can recommend a combination of drugs such as oral contraceptives (contain estrogen & progestin that inhibits the male hormone), anti-androgens and insulin sensitive drugs.
- Cosmetic Hair Removal: Electrolysis and the modern day safe Laser therapy are sought after cosmetic ways for removal of unwanted hair. The procedures destroy the hair follicles and prevent the hair from growing.
- Surgical Therapy: Only in specific cases Laparoscopic ovarian drilling or removal of ovarian & adrenal tumours can help treat Hirsutism.
It is important to understand that this problem is medical and can be treated, managed and cured with expert advice & guidance. Women usually get depressed and have image issues. One should not get distressed; it may be a possibility that the reason may be just a little imbalance in your hormones. Eating healthy, weight loss and exercise are tried and tested natural ways to keep your body fit & balanced.
Stress is very common now a day's and it is affecting all age groups - Be it school going children, young adults or working professionals. No one is immune to stress in the present fast and competitive world.
So, what is stress? Stress is the body's response to any kind of physical or emotional demand or threat. Body releases certain stress hormones under these pressure conditions. On long term basis , stress can lead to many chronic conditions affecting the heart and can cause mental disorders like depression, sleep disorders or affect the social well being also.
Women and Stress:
Women deal with stress differently than men. Women are generally soft, caring and gentle. They have to manage their personal and professional life and generally get less support at both fronts.They generally spend their life taking care of others and give least attention to their own needs( emotional and physical). As women progress through different life stages her emotional balance also changes affecting her emotionally making her vulnerable to stress and depression.
Ways to handle Stress:
Relax - don't take each and every situation seriously , take a deep breath, not all emergencies are a do or die situation.
Learn yoga, meditation or other relaxing techniques. Go for a massage , listen to music or talk to a good friend.
Make time for yourself - love yourself and take care or yourself and then you can love and care for others as well. Take out time to do things which you like.
Sleeping is a great way to help both your body and mind. Try to get atleast 8 hours of sleep.
Get a hobby and immerse yourself in doing something creative and constructive.
Do regular exercise- it is the best way to bust stress in a healthy way.
Make new friends or travel to new places. Explore the unknown and spend time with people.
Focus on one thing at a time.
How to manage stress:
Don't let stress make you sick . Often people are not aware of the stress levels and how they are affecting them. One should pay attention to themselves and focus on their emotional and physical needs. Take a break, go on holiday, eat what you like, go out with friends and relax. Live life, love yourself, listen to your body.
Side effects of Stress on Women:
Menstrual problems: Stress can cause delay in periods or sometimes short cycles.
Infertility : Stress can affect the hormonal levels leading to an ovulation and infertility.
Hair loss : Many women complain if losing hair and biting their nails in stress.
Eating disorders : Either women end up binging on healthy food items or completely refuse to eat anything. In stress the best is to out ant divert your attention to something constructive.
Skin ailments: Stress can lead to pimples, break outs and even itching and rashes.
Sleep disorders: Trouble in falling asleep is common in women under stress.
Heart disease: High blood pressure., stroke and heart attack are common ailments caused due to stress. This is because women take stress to heart and are more susceptible to go through heart disease due to stressful situations.
Depression : Women can go into a shell and suffer from acute depression. If you are getting self loathing or helpless thoughts, reach out to your loved ones and talk. If talking and reaching out also doesn't resolve the situation, consult a specialist. Medical expertise can ensure that stress doesn't affect your health.
Weight gain : Women stop going out, start eating unhealthily and restrict their interaction with people in depression and stress. The result is that they start to gain weight. It is best that you keep a check on the scales and opt for a strict diet.
Decreased libido: Stress affects the sex life the most. A decrease in libido can affect relationships and create distances. Talk to your partner and of needed opt for medical advice.
Pregnancy and motherhood are the beautiful yet crucial phases of a woman's life. When to become pregnant or start family is merely personal and the decision may vary from woman to woman. Now days, women are becoming more independent financially and socially as well. Their priorities are also changing. Before getting pregnant and starting family what they want is the best for their babies from all point of view and therefore most of the women have their first pregnancy after 35 years of age.
The science of the right age to get pregnant:
But what is the scientific approach regarding the right age for conception? According to the American College of Obstetrics & Gynecology (ACOG), the chances of conceiving are highest in 20 - 30 years of age. After 32 years of age the fertility in the women starts decreasing as they have fixed number of eggs in the ovary and the number of eggs decreases with advanced age. The eggs are also not that much fertile as compared to younger women. Problems that can affect the fertility becomes more common with increasing age as well. The older women are more likely to have pre-existing health problems as compared to younger ones. There is increased risk of miscarriages, different complications and birth defects in older age. According to ACOG, the risk for miscarriage for women aged 20 to 30 years is between nine and 17 percent; this rate increases sharply from 20 percent at age 35 years to 40 percent at age 40 years and 80 percent at age 45 years.In between 20 -30 years of age, the fertility rate is high among this age group. The chances of complications, chromosomal abnormality, preterm deliveries and birth defects are minimal. Pregnancy is often physically easier for women in their 20s because there's a lower risk of health complications.
The most important aspect in pregnancy is - YOU
Whatever may be the age of the women during pregnancy, the thing which matters most is the health of the baby and the mother. In advanced age also, mothers need to stay fit and healthy by optimum exercise, healthy nutritional diet and positive approach.
Painful menstrual cramps is a condition during periods in which a woman or girl has crampy lower abdominal pain, sharp or aching pain that comes and goes, or the pains which radiates to lower back and thighs. In some women or girl the cramps are associated with nausea, loose stools, headache and dizziness. Many women or girls have painful menstrual cycles.
During menstrual cycles, the uterus tries to expel out its lining and a hormone called progesterone is responsible for the uterine muscle contraction. The more the prostaglandin level, more painful the cramps.
Sometimes the pains are moderate to severe making it hard to do normal household work, job, or school-related activities during each menstrual cycle. Painful periods or menstruation is the leading cause of absence from school and work among women in their teens and 20s.
In medical terms it is called as 'Dysmenorrhea.'
There are two categories of Dysmenorrhea.
Primary Dysmenorrhea is menstrual pain that occurs around the time that menstrual periods first begin in healthy young women. In most cases, it is not related to a specific problem with the uterus or other pelvic organs.
Secondary Dysmenorrhea is menstrual pain that develops later in women who have had normal periods. It is often related to problems in the uterus or other pelvic organs, like
Intrauterine device (IUD)
Pelvic inflammatory disease
Premenstrual syndrome (PMS)
Sexually transmitted infection
Stress and anxiety
Home remedies to manage the Menstrual Cramps-
Take a hot water bag and give hot fermentation to lower abdomen, lower back or thighs
Do light circular massage with your fingertips around your lower belly area.
Eat light but frequent meals.
Healthy nutritional diet is a great help
Side lying position with knee folded helps to relieve the pain
Practice relaxation techniques such as meditation or yoga
Take warm showers or baths.
Walk or exercise regularly, including pelvic rocking exercises
Loose weight if overweight
When to consult a doctor?
Severe pain associated with nausea/ vomiting
Increased or foul-smelling vaginal discharge
Fever and pelvic pain
Sudden or severe pain, especially if your period is more than one week late and if sexually active
No relief with routine medications
If intrauterine device (IUD) is inserted
Heavy bleeding with clots
Pain occurs at times other than menstruation, begins more than 5 days before period, or continues after period is over.
Do you feel extremely tired many times in a day? Are you experiencing sudden weight gain, chills at night and hair loss? Is your neck a bit bloated up? If you are experiencing any of the mentioned symptoms, it might be that your body regulator- Thyroid- is unbalanced. Quick 3 tests can help you detect any abnormality - TSH, T3 and T4. Women were three times more likely to be affected by thyroid dysfunction than men. 1 in 10 adults in India suffers from hypothyroidism, with 50 per cent being women.
What is the thyroid gland?
The thyroid is a butterfly shaped gland in the front of the neck. It produces hormones that control the speed of your metabolism - the system that helps the body use energy. Thyroid disorders can slow down or rev up your metabolism by disrupting the production of thyroid hormones. When hormone levels become too low or too high, you may experience a wide range of symptoms.
What are the Symptoms?
Thyroid can be of 2 types - Hyper (Overactive) and Hypo (Underactive) Thyroid.
|High and Overactive Thyroid|
|Dry Skin & Hair||Tremors - Hand Shaking|
|Brittle Hair||Hair loss or thinning hair|
|Low Pulse||High Pulse|
|Weight Gain||Weight loss without trying|
|Intolerance to cold temperature||Intolerance to hot temperature|
|Swelling in lower part of neck||Swelling in lower part of neck|
The swelling in the neck is a major and most significant feature. Hence one should always do the Self Neck Test.
Who should be tested?
Women aged 35 and above or those with symptoms/risk factors/family history are the right candidates for screening. It has been estimated that 75% of the people suffering from thyroid are undiagnosed.
Diagnosing thyroid disorders - A simple blood test can provide an answer. TSH (Thyroid Stimulating Hormone) levels determine thyroid hypo and hyper function as it regulates the work of thyroid gland. Rarely an imaging study or biopsy is needed. Two additional tests may be required - T3 and T4.
What happens if Thyroid remains undetected?
As Thyroid disorders are hormonal imbalances, undetection can lead to a number of secondary complications:
- High Cholesterol and Hypertension
- Hair Fall
- Heart Disease
- Complications in pregnancy
Are you facing troubles, such as unwanted facial hair, excessive weight gain, irregular periods, and acne on face or sudden hair loss? If you are experiencing any two symptoms, you might be suffering from Poly Cystic Ovarian Disorder / Syndrome. Affecting at least 1 in 10 Indian women it is the most common issue facing us today. It is also a leading cause of infertility. Many women ignore the signs and symptoms and fail to consult specialists. PCOS can manifest in many ways- it can have a single symptom or it can be associated with many aspects.
The common signs and symptoms are:
- Irregular or absent menstrual periods.
- Heavy vaginal bleeding: As the cycle gets delayed in PCOS, the uterus lining becomes thicker (a condition known as hyperplasia). When a woman starts her periods after a long time, she can experience heavy and prolonged bleeding.
- Oily skin and acne on face and back.
- Darkening and thickening of certain areas of the skin, especially in skin folds of the neck, armpits, and groin.
- Excessive hair growth on the face, chest, abdomen, or thighs.
- Thinning of hair on the crown of the head.
- Type 2 Diabetes
- Cardiovascular problems, including high cholesterol
- Multiple tiny ovarian cysts; some women with PCOS have a large number of tiny follicle cysts (visible by ultrasound) on their ovaries.
The cause of PCOS is not fully understood, but genetics may be a factor. It seems to run in families, so your chance of having it is higher if other women in your family have it or have irregular periods or diabetes.
If you are experiencing any of the given symptoms, it is advisable that you consult a Gynecologist or an Endocrinologist.
PCOS on the rise in adolescents:
Adolescent PCOS is on the rise these days due to change in lifestyle, academic load and lack of physical exercise. In many girls the symptoms commence with irregular periods and weight gain, followed by hair loss and acne. It is imperative that PCOS be diagnosed early so that its secondary issues - insulin resistance, type 2 diabetes, high cholesterol, high blood pressure, and heart disease can be controlled medically.
How PCOS is diagnosed:
It can easily be diagnosed through a physical examination, simple inexpensive blood tests and most importantly an ultrasound. You should consult a Gynecologist or an Endocrinologist.
How can PCOS be prevented or controlled:
PCOS cannot be prevented but weight control is the key to prevention of metabolic syndrome at a young age. Early diagnosis and treatment can help manage the symptoms and prevent long-term problems.
Even post diagnoses exercise, diet control and adherence to medication are essential. One should also document their menstruation cycles dates for clinical aspects.
In some older women who wish to conceive surgical treatment known as laparoscopic drilling of the cysts can be done.
Pregnancy is a beautiful period in every woman's life. Lots of physical, mental and emotional changes occur during pregnancy and the best way to cope up with them is exercise, also known as pregnancy yoga or antenatal exercise. Working out when you are expecting is great for you and your baby.
Benefits for mother and baby of Pregnancy Yoga:
- Increased sense of well being,
- Improves body muscle tone and relieves tension
- Ensures healthy weight gain,
- Cardiovascular and respiratory fitness
- Maintain a stable body position
- Decrease in pregnancy related muscle problems, joint pains, constipation, abdominal bloating,
- Reduces fatigue and helps manage stress
- Increases endurance and strengthening muscles
- Help relieve back pressure
- Improve posture and balance
- Improve circulation and lowers blood pressure
- Helps prepare for the strain of labor
- Increased chances of natural labor and childbirth
- Improves self-image
- Regains figure faster
- Prepare for immediate postnatal period
- Stretches for lower back
- Upper back stretch
- Pelvic Tilts
Guidelines for exercise:
- Exercise at least three times per week
- Avoid exercise in supine position after first trimester and prolonged motionless standing
- Modify exercises according to maternal symptoms and fatigue levels
- Avoid exercises that could cause loss of balance or falling (ballistic exercises)
- Have adequate diet
- Hydration before, during and after exercise
Things to know while doing exercise or pregnancy yoga:
- Consult your doctor first
- Start after 12-14 weeks
- Wear loose, comfortable clothes
- Keep at least 3-4 hrs gap between meal and exercise
- Early morning is the best time
- Avoid becoming too hot or overheated
- Be gentle- avoid stretching or straining muscles/joints.
- Medical problem- consult doctor- do under strict supervision
- Listen to your body
- Never exercise till exhaustion or breathlessness
- Heart rate should not > 140/min
- Take frequent breaks during exercise
- Keep yourself hydrated
- Eat healthy diet- plenty of fruits, vegetables
Discontinue exercise if:
- Light headiness
- Excessive dryness of mouth
- Abdominal cramps
- Severe pain/ uneasiness
- History of vaginal bleeding
Becoming a parent is the most cherishing moment in a couple's life, hence it is important to ensure that both the mother and the baby are healthy. In today's world lot of factors like environmental, socio-economic, lifestyle associated, and addictions such as smoking and alcohol affect the health of both men and women. If the parents have ill health or unhealthy lifestyle practices, the same can complicate matters and also cause infertility.
Today's life, especially in the metro cities, is fast and becoming more stressful. Pregnancy is a period when the health of the baby is directly dependent on the health of the mother and father. Also during the early phase of pregnancy the development of a baby inside the womb is very rapid and is the base for its future. Preconception counseling helps parents to understand and identify the different factors affecting the growth of the baby along with the modifications or complete illumination of these factors (if possible) to maintain the healthy development of the baby and the health of the mother as well.
Hence preconception counseling is a good initiative towards a healthy outcome. It not only guides the parent about the healthy lifestyle but also helps to find out the genetic factors causing any malformation or medical conditions, affecting the baby- the mother- the whole family through an emotional, psychological, social and economic point of view. It helps the parents to understand the condition, its future consequences so that they are able to take informed decisions.
Planning a baby 1
The Prenatal Counseling Guides About:
- The right height and weight as per the BMI. This highlights the right attributes needed for conception
- Blood pressure to check any abnormality
- Medical history - whether they have had any medical treatment for any particular disease. If yes, then what are the medications? They check whether these are safe medications for pregnancy or not. The doctors then alter them accordingly to avoid any harmful effect on pregnancy.
- Abdominal & pelvic examination to rule out any abnormality
- Rubella screening- It is important to have a vaccine. As Rubella causes abortions or congenital birth defects in baby.
- Varicella screening to assess any chances of future abnormalities
- Depression screening as its medication are harmful for the baby & also if mother is not prepared for pregnancy then the outcome is usually affected.
- Blood tests like urine analysis, complete blood count, sugar, blood group & tests for -STDS (HIV, VDRL), Hepatitis B, thyroid dysfunction
- The importance of well-balanced nutritional diet and how to opt it
- The change or modification in the lifestyle to reduce stress
- Exercise and its benefits
- Any family history of any disease like Haemophilia and the steps towards it
- Quitting alcohol and smoking as they have adverse effects on the growth and development of baby
- Any kind of drug addiction having ill effect on the health of both mother and baby
Thus prenatal counseling in planning a baby is a step towards ensuring a healthy outcome.
Headache is a very common medical problem. Nearly 25% of females and 8% of males in general suffer from headaches at some point in their life.
More than 90% of headaches are due to migraine. However headaches are also caused due to tensions and due to wrong lifestyle practices. If headaches are not treated and managed at the right time they can also complicate into - brain like hemorrhage, meningitis, brain tumors, etc.
Any new onset headache should be taken seriously as it could be because of a serious brain illness.
Common myths associated with Headaches:
- It's because of Acidity - Headaches are not caused due to acidity or 'Gas' , as popularly highlighted.
- Headaches could only be because of sleepless nights - They could be because of any strain on your body. Eyesight, tension, nasal issues, flu are few reasons.
- Headaches are only because of tension - They could be because of a number of reasons, tension could be just one factor.
- Headaches can be cured by self medication - Persistent headaches need to be addressed by specialists. Ignoring the signs and symptoms can lead to complications.
Common symptoms of migraine are:
- One sided or whole head pain
- Head pain accompanied with nausea or vomiting
- Irritation with loud noise and bright lights.
- Increase in headache with even slight movement of head.
Reasons of Headaches:
- Migraine or headache episodes can be triggered due to the following reasons:
- Irregular meal timings
- Improper sleep
- Excessive mental stress
- Excessive alcohol intake
- Due to intake of certain food items like red wine, chocolates, cheese, preservatives
- Change of weather season
- Excessive heat or cold
If headaches occur more than 1 or 2 times in a month, then medical attention becomes important. Headaches take away precious working hours from our routine, reduce your efficiency and can make you vulnerable to excessive consumption of pain killers. At a certain point of time even pain killers stops working. It is essential that you consult a specialist for medical advice and a holistic lifestyle management. Ignoring the same can lead to complications such as loss of vision & paralysis of the body- After all your body's health, balance and maintenance is in your hands!
Diabetes is so common that it has become a part of our daily life. Almost every 7th person on this earth is affected with this dreaded disease. Therefore, it is not uncommon to find someone in our family affected with Diabetes. Let us see what can we do to keep our affected dear ones healthy, free from complications and lead a productive life, along with preventing others in the family from becoming Diabetic.
Changes Required in Family:
- Diet: Diabetes is basically a lifestyle disease. Changes in our daily routine can help to modify the disease. Remember the so called diabetic diet is not something very special but a very healthy combination of foods. If we incorporate such kind of diet in our daily routine we can always keep our dear ones healthy and can prevent ourselves from becoming diabetic. So ultimately it benefits both. Recent data shows that if one of the spouse is diabetic it increases chances of developing Diabetes in the other partner. This reflects on the bad lifestyle habit of the whole family.
- Diabetes and family Exercise: Second important aspect required is regular exercise and believe me it's just not possible for a common person to go for exercise with the rest of family sitting at home. It requires a combined effort and hence if one person is diabetic it is always good to change your family lifestyle and start exercising as a whole family.
- How to Prevent Diabetes in other Family Members: If one person in the family is diabetic there are always more chances of developing Diabetes in other members of the family. It involves preventing obesity by incorporating good dietary habits, regular exercising.
Anyone in family with a history of Diabetes should get there blood glucose checked yearly after the age of 40 and if one has a hectic lifestyle then they should opt for the tests after the age of 30. These involve testing your blood glucose fasting as well as postprandial and also getting your HbA1c checked. If you find any report abnormal, consult your Endocrinologist.
What is the prevalence of obesity?
Obesity is rapidly becoming a common problem. According to the World Health Organization (WHO), there were about 1.6 billion overweight adults aged 15 years and above and at least 400 million adults are obese worldwide. It is a serious public health problem that is growing in countries with low or middle income. According to IOTF (International Obesity Task Force), it was estimated that the prevalence rate of obesity could reach 45% to 50% in the USA, 30% to 40% in Australia, England and Mauritius and more than 20% in Brazil by 2025. Of note, many developing countries like India, face the double burden paradox of obesity and under nutrition. What is Obesity?
Obesity is basically the mother of most chronic diseases. It is measured as excess weight as compared to height of individual and usually measured in terms of BMI (Body Mass Index). Obesity is defined as BMI more than 30 as per western population is concerned and more than 28 as per Asian population is concerned. However even a BMI of more than 23 for Asian population and more than 25 for western population is considered as abnormal and defined as overweight which is considered as a harmful state. Other methods to measure obesity is waist circumference and waist to height ratio. Waist circumference of more than 80 in women and more than 90 in men is consider abnormal irrespective of BMI.
What if I am obese?
Obesity is not a single disorder but is a starting point of various disorders. In the long run it can lead to increase chances of Diabetes, hypertension, PCOS in women, infertility issues in women, heart disease, sleep difficulty. It also causes osteoarthritis especially of knee joint, breathing difficulty and many other diseases with increased chances of certain cancers in the long run. Overall being obese can be a costly affair.
Headaches are one of the most common ailments that afflict mankind regardless of age and gender. Headaches are pains and can occur in any region of the head, they can occur on both sides or on one side. The main aspects that are experienced are throbbing, nausea in the head which can occur gradually or suddenly. Headaches may last for days, hours or even less than an hour. It is important that we understand the symptoms and consult specialists if the symptoms persist.
The WHO reports that around 47% of the world's adult population will have experienced a headache within the last year. The global burden of headache is high as the same leads to disability and loss of working hours. Headache disorders are rated among the world top 10 causes of disability worldwide.
Half to three-fourth of the adults between 18 to 65 years of age in the world have had headaches in the last one year and among those more than 10 % have reported migraine. In the global burden of diseases study, migraine alone accounted for 1.3% of years lost due to disability.
Headaches are categorized into primary and secondary headaches:
- Primary headaches are illnesses caused directly by over activity or problems with pain sensitive structures in the head. This includes muscle nerves and blood vessels in the head and neck. They also include the chemical activity inside the brain.
- The common primary headaches are migraine, TTH and cluster headaches.
- Secondary headaches are because of some other condition affecting the pain sensitivity structures ranging from brain tumor or any other complication.
Causes of Headache:
Headaches can be caused because of various simple reasons that are mostly undetected and undiagnosed. Headaches are mainly caused by
- Hormonal changes
- Too much or too little sleep
- Exercising rigorously
- Straining eyes
- Excess of caffeine intake
- Not eating on time
The causes of headaches may be due to sinusitis, glaucoma, overuse of medication , ice cream headaches etc. Headaches are not perceived by the public as serious since they are mostly episodic and do not cause death. Majority take over the counter medications to relieve this headache. Repeated headache and the constant fear of the next one damages family life, social life and can cause unemployment.
There are more than 200 types of headaches, out of which majority of them are harmless and few are life threatening. It is important that you understand the symptoms and consult specialists if they persist.