Treatment of Mirena (Hormonal Iud)
Pap Smear Procedure
Dilatation And Curettage (D C) Procedure
Proton Therapy Treatment
Preimplantation Genetic Diagnosis (Pgd)
Pregnant Women Counseling
Prenatal And Birth Care
Musculoskeletal Pain Management
Ovarian Ablation Procedure
Treatment Of Female Sexual Problems
Egg Donation Procedure
Treatment Of Menstrual Problems
Treatment Of Menopause Related Issues
Treatment of Polycystic Ovary Syndrome In Adolesce
Pre And Post Delivery Care
Child deliveries during pregnancies are of two types. If you are pregnant or have someone in your family who is then you can either go for caesarean section (or C-section) delivery or normal delivery, which is also known as vaginal delivery. In some case C-section delivery is chosen by your doctor as it may be a safer option in case you have some health complications. Diabetes, high blood pressure or herpes can cause complication that may in advance let you know whether the delivery procedure would be C-section or the normal one. Here are the pro and cons of both the procedure.
Natural Delivery: Benefits and Disadvantages
- Shorter stay in the hospital and time for recovery can help you in case of normal delivery.
- It may be physically painful but at the end of the day as it is a natural delivery method and you will experience less postpartum pain.
- There would be lesser chances of respiratory problems in your baby.
- Normal delivery may cause fear and anxiety which may lead to huge complications. Even your baby may face the risk of being deprived of oxygen from cord compression.
- It is also more painful and unpredictable.
- There may be increased chances of pelvic organ prolapses in normal section deliveries.
C-section: Benefits and Disadvantages
- You will be well in advance told about the delivery date by your doctor and hence planning is made easy. 2. If you have any infection like herpes chances of your baby being is reduced by c section delivery.
- There will be lesser risk of pelvic floor injury and few cases of urinary continence.
- There will be no risk of birth related trauma like bruises and swelling.
- There are surgical risks of anesthesia which can cause severe adverse side effects like headache, nausea and vomiting.
- There are also chances of heart attacks and blood clotting in veins. You may also have chances of postpartum infection in c section delivery.
- Numbness around the area of operation and bleeding may require a hysterectomy which is a surgery to remove the uterus.
There are many other pro and cons of the two methods of delivery and you should always consult your doctor and follow proper medications for better delivery of the newborn.
Treatment for Repeated Miscarriages and IVF Failure
Infertility is a condition where a couple, trying to conceive in a natural way is not able to do so even after one year of trying. So here are the causes and risks for this condition.
Causes: There are many causes of infertility. It may be due to a condition present in one or both partners. As per a medical study, 20% of the cases of infertility are due to males, while 40% to 50% cases are due to problems in the female partner. 30% of the cases suffer from infertility due to problems in both males and females. Ovulation and fertilisation are the main elements of the conception process and any condition in the female or male can upset either function, which can make it difficult to conceive.
While abnormal sperm production and transport may be a common condition that leads to infertility in males, other factors like side effects of cancer treatments and too much exposure to toxins and chemicals can also play an important role in this regard. For females, the causes of infertility may range from ovulation disorders, uterine and fibroid tumours, uterine and cervical anomalies
Risks: There are a number of factors that put a male or a female at risk of infertility. Being in your mid 30s usually has an adverse effect on the ovulation and production of well functioning sperm. Further, smoking and tobacco are among the main causes of infertility in either partner.
Excessive alcohol consumption may also lead to this problem. Being overweight or underweight can also make a person infertile. Further, not getting enough exercise and routine activities out of your day, can lead to this condition as well.
A collection of symptoms typically occurring between ovulation and menses (discharge of blood and from the uterus) is defined as premenstrual syndrome (PMS). Premenstrual syndrome symptoms can either be physical or emotional.
Physical symptoms and signs include:
- Muscle or joint pain
- Weight gain due to fluid retention
- Bloated abdomen
- Breast tenderness
- Acne breakouts
- Diarrhoea or constipation
While other behavioural and emotional symptoms include:
- Anxiety or tension
- Depressed mood
- Crying spells
- Anger or irritability and mood swings
- Food cravings and appetite changes
- Social withdrawal
- Poor concentration
Causes: The exact cause of PMS is unknown. But there are several contributing factors, such as:
- Cyclic hormonal changes: The hormones oestrogen and progesterone fluctuate a lot while preparing for a normal menstrual cycle. This fluctuation causes some of the symptoms of PMS.
- Chemical changes: The fluctuation of serotonin, a kind of neurotransmitter (brain chemical), affects the mood, which causes some of the emotional symptoms of PMS. For instance, insufficient serotonin triggers premenstrual depression, insomnia, food cravings and fatigue.
- Depression: If the PMS symptoms are severe, depression could be the underlying cause, though it doesn't usually trigger all of the symptoms.
Treatment: There is no permanent cure for PMS, but a few lifestyle changes and home remedies can work very well for you. Some treatment options include:
- To ease abdominal bloating, drink lots of fluids
- Eat a balanced diet comprised of plenty of vegetables and fruits. Reduce your alcohol, caffeine, salt and sugar intake.
- You can take supplements such as magnesium, calcium, vitamin B-6 and folic acid to reduce mood swings and cramps.
- Take vitamin D supplements to relieve symptoms
- Sleep for at least eight hours in the night to counter fatigue
- Exercise to improve your emotional health and reduce bloating
- Try to reduce your stress as much as you can; read a book or walk to relieve some stress.
Besides, these lifestyle changes, you can take over-the-counter medications such as aspirin and ibuprofen to reduce stomach cramps, muscles aches and headaches. Diuretics (drugs that increase urination) are excellent treatments for bloating and fluid retention. However, consult your doctor before consuming any medication or supplement. If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.
Cancer that originates in the uterus is termed as Endometrial Cancers. The cancer is known to originate in the endometrium i.e. lining as well as the cells of the uterus. Abnormal vaginal bleeding causes the cancer to be detected early and a consultation with the doctor should be done immediately. When other cancers originating from the uterus are considered, endometrial cancer is found to be the most common.
Causes: The exact cause for endometrial cancer is not known clearly. The cells in the endometrium tend to become abnormal due to the occurrence of a genetic mutation, which causes rapid multiplication of cells that ultimately lead to the formation of a tumour like mass. They begin to spread to other parts and proceed to affect the tissues in the surrounding areas.
The typical symptoms of endometrial cancer include:
- 1. Irregular bleeding in between periods
- 2. A watery discharge from the vagina
- 3. Bleeding from the vagina postmenopausal
- 4. Pain in the pelvic floor muscles
Risk factors that might increase the chances of being affected by endometrial cancer include:
- 1. Aging increases the chances of this disease, especially post menopause.
- 2. Obesity can cause hormonal imbalance.
- 3. Certain drugs used in hormone therapy
- 4. Early onset of menstruation, especially before 12 years of age
Treatment for Endometrial Cancer Includes:
- Radiation therapy: This treatment procedure involves using radiations, such as X-rays to target and destroy the cancer cells. The two forms of radiation therapy are external radiation therapy (external machine is used to direct radiation on the cancer cells) and internal radiation therapy (radioactive substance enclosed within small and consumable items is placed near to or directly at the spot of cancer).
- Hormone therapy: Medications are administered to eliminate imbalances in hormone levels and prohibit the growth of cancer cells in the body. This remedy is preferred if the cancer progresses to an advanced stage.
- Chemotherapy: This form of treatment uses oral administration or injection of chemicals into the veins so that the growth of cancerous cells is curbed, either by elimination of the cells or by prohibiting cell division.
- Surgery: In this surgery, the areas affected by cancer are surgically removed; i.e. the uterus in this case. The surgical procedures that might be used include total hysterectomy (total removal of uterus), radical hysterectomy (removal of the cervix, uterus and part of the vagina) and Bilateral salpingo-oophorectomy (removal of both the ovaries and the fallopian tubes)
Water birth, as revolutionary as it might sound, is not a bad idea. Common in the European countries like Australia and New Zealand, many birth centres in the United States have also started installing water birth tubs. It is the process of giving birth in a warm water tub, which is said to ease the process. The logic behind this goes that since the baby stays in the mother's womb for nine months in a water sac, therefore, birthing in a similar environment is better for the baby and less complex. Many obstetricians believe that this also prevents any kind of foetal complications.
There are both benefits and risk of water birth. They are as follows:
Benefits of water birth:
Water labour and water birth has the following advantages for the mother and the baby.
For the mother:
- The warm water provides mobility and comfort to the mother. The mother is also at a spontaneous position in water to change her location and deliver the baby.
- Pressure on the abdomen is decreased. Buoyancy helps in the efficient contraction of the uterine walls and it improves blood circulation, which again gives better supply of oxygen to the uterine muscles. The baby is provided with sufficient amount of oxygen while the mother endures lesser pain.
- Birthing in water helps in conservation of energy on part of the mother. The immersion helps to reduce collision with gravity and gives support to the mother's weight. This energy produced helps in coping with the uterine muscle contractions.
- The process of labour becomes more productive as it gives relaxation to the mother. While the mother calms down in the water, her hormones start working better and in turn the process is accelerated. The water also helps in soothing the pelvic muscles.
- The immersion helps in lowering the level of blood pressure and in reducing anxiety.
- Stress is hugely reduced as the mother is at ease and this helps in producing endorphins that serve as pain inhibitors.
For the baby:
- The baby gets a similar environment as the amniotic sac which helps in the birthing process gets added support.
- The stress of birth is greatly reduced.
Risks of water birth:
- There remains a risk of water embolism that is when the water enters into the mother's bloodstream.
- If the mother has herpes, this practice should not be followed as herpes spreads in water faster.
- This should be avoided in case of excessive bleeding and any kind of maternal infection.
Pregnancy is a welcome change in a woman's life. She is full of hope and happiness while awaiting the birth of her bundle of joy. However, it is almost inevitable to bring up the topic of conception and leave out a host of bodily alterations or disadvantages it entails. You might eagerly wait for months in a row to conceive and once you do the signs of health issues show. Most noticeable of all other problems are the ones affecting your skin. Skin problems can be immensely predominant and widespread in a pregnant mother; so much so that her psychological disposition might vary considerably.
Commonly observed symptoms of the skin that may affect you during pregnancy:
- Your eyes may look puffy and withdrawn: While the news of a baby lighting up your life in a few months' time makes you very happy, it also subjects your body to exhaustion. It is natural for expecting mothers to feel tired and wasted. Acute iron deficiency and poor blood circulation could result in fatigue that further surfaces as dark circles and puffy bags under your eyes.
- Your face could develop acne suddenly: Acne is caused mainly because of excess sebum secretions from the oil glands present in your body. Excess oil tends to choke the open pores of your skin preventing it from breathing. Increased levels of progesterone are maintained by the human body for a strong uterine lining that is again required for the healthy development of a child; progesterone kicks off oil secretions.
- Spider like marks could spot your skin: Hormonal imbalances, sudden increase in weight, and heightened pressure in the veins may cause the blood vessels in your face to redden and grow big; the veins then look like the web of a spider. This condition is often referred to as Spider Angiomas.
- Big dark patches can also be seen: During pregnancy, your body has an excess of both oestrogen and progesterone. These hormones incite the impact of melanocytes, thus resulting in big dark patches on your skin. The condition is more prevalently known as Melasma.
Miscarriage refers to the spontaneous loss of the fetus before one completes the 20th week of pregnancy, taking into account the period from the conception to gestation. It usually happens in the first trimester of the pregnancy; that is within the seventh and the twelfth week of conception. Recurrent miscarriage is when one suffers from multiple miscarriages in a row.
- Abnormally-shaped Uterus: Some miscarriages, particularly late ones, are thought to happen because the uterus (womb) has an abnormal shape.
- Polycystic Ovary Syndrome (PCOS): Women with this condition have many small cysts in their ovaries.They also tend to have hormonal problems, including high levels of insulin and male hormone in the blood, which can lead to recurrent miscarriage.
- Infection: Some serious infections can cause or increase the risk of single miscarriages. These include toxoplasmosis, rubella, listeria and genital infection. But it is not clear whether infection plays a role in recurrent miscarriage.
- Diabetes and Thyroid Problems: Uncontrolled diabetes and untreated thyroid problems can cause miscarriage. But well-controlled diabetes and treated thyroid problems do not cause recurrent miscarriage.
Your risk of recurrent miscarriage is higher if:
- you and your partner are older; the risk is highest if you are over 35 and your partner over 40;
- you are very overweight. Being very underweight may also increase your risk.
Each new pregnancy loss increases the risk of a further miscarriage. But even after three miscarriages, most couples will have a live baby next time.
Testing After Recurrent Miscarriage:
If you have had three miscarriages in a row, you should be offered tests to try to find the cause. This should happen whether or not you already have one or more children. Testing is not usually offered after one or two early miscarriages (up to 14 weeks) because these are often due to chance. But you might be offered tests after two early miscarriages if you are in your late 30s or 40s or if it has taken you a long time to conceive.
If you had a late (second trimester) miscarriage, where your baby died after 14 weeks of pregnancy, you should be offered tests after this loss.
- You can opt for blood tests to check for sticky blood syndrome or APS. Tests would look for antibodies that would help treat the condition. Antibodies are chemicals produced by the body to combat infections.
- Get an examination done should the doctor suspect chromosomal abnormalities and in case it is diagnosed, both of you can consult a clinical genetics specialist for genetics counseling.
- Your doctor will recommend an ultrasound scan to trace any type of abnormality that may make a pregnancy futile, for instance, a short or a fragile cervix.
It is natural to pin your hopes on testing as the answer to your problems. But there are three reasons why it may not be the answer you’re looking for:
- A cause may not be found; when this happens your miscarriages are called ‘unexplained’
- Even if a cause is found, it may not be treatable;
- Treatment may not lead to a successful pregnancy. This can happen if a pregnancy miscarriages for a different reason than the one being treated. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
Infertility is a condition wherein a woman does not get pregnant in spite of having unprotected intercourse over a period of a year or even more. An abnormal menstrual cycle that is either too short or too long, irregular or even scanty can be an indication of a lack of ovulation, which in turn, is another factor behind female infertility.
Ovulation disorders are characterized by either a lack of ovulation or irregular and infrequent ovulation. These are a major cause of infertility. This may be due to defects in the regulation of the reproductive hormones by the pituitary gland or the hypothalamus (brain center responsible for producing some of the most essential hormones required by the body). Malfunctioning of the ovary is another cause in itself. Polycystic Ovarian Syndrome, premature failure of the ovaries (a condition wherein a woman’s ovaries fail to function properly even before she is 40 years old), hypothalamic dysfunction (a dysfunction of the hypothalamus) and excessive production of prolactin (a hormone that stimulates milk production among women after childbirth) by the pituitary gland are some of the factors responsible for the occurrence of such a disorder.
Damaged fallopian tubes do not allow the sperms to fuse properly with the egg. They might also prevent the fertilized egg from entering into the uterus. This condition may be caused due to pelvic inflammatory diseases (a group of infections of the reproductive organs in women), an infection in the fallopian tubes or the uterus caused due to various Sexually Transmitted Diseases, any abdominal surgery or surgery of the pelvic region and pelvic tuberculosis.
Endometriosis, wherein the tissue that usually grows in the uterus, starts growing outside it, is another factor responsible for infertility.
Several cervical or uterine disorders, such as tumors, inflammation within the uterus, uterine abnormalities, a cervical narrowing or the inability of the cervix to produce mucous for the sperm to travel to the uterus, are likely to impact fertility by obstructing implantation or enhancing the chances of miscarriage.
Fertility drugs can be used to regulate and induce ovulation. But they carry with them certain risks and therefore you should consult your physician prior to consumption. Few examples of these drugs are Clomiphene Citrate, Gonadotropins, Metformin, Letrozole and Bromocriptine.
Surgical procedures can be recommended to correct reproductive abnormalities and restore fertility. A laparoscopic surgery or a tubal ligation reversal surgery (a surgery that unites one’s fallopian tubes again in order to enable the woman to have a baby) can be advised by the doctor.
- Reproductive assistance by Intrauterine insemination (a process that involves putting sperms inside a woman’s uterus in order to help her conceive) and Assisted reproductive technology (consisting of IVF and surrogacy).
Birth control is a method by which unwanted pregnancy is prevented. Partners can plan their childbearing in a better way using the increased levels of awareness about birth control.
Methods of birth control:
- Intrauterine devices (IDUs): These are most effective methods of birth control. The intrauterine device (IUD) is a long-acting and reversible form of contraception for women. It is of two types: Copper IUD (contains copper) and Hormone-releasing IUDs (progestin hormone is released into the womb slowly). It is a small device that is fitted inside the womb and it provides contraception by preventing fertilization of the egg.
- Sterilization: This is a process of birth control that renders a woman incapable of conception or a man incapable of sperm delivery. The process is conducted with the consent of the individual and can be done using either surgical or non-surgical methods. In both the cases, tubes carrying sperms (in males) and fallopian tubes (females) are either cut or blocked.
- Condoms: These are the most commonly used measures for birth control. Male and female condoms act as barriers and prevent the sperm from reaching the uterus.
- Oral contraceptive pills: These pills are the most popular measures of birth control used by women across the world. This is the most convenient way of postponing pregnancy. However, it is very important that the side effects of the contraceptive pills be noted. The side effects cause changes in the body, such as irregular bleeding, increase in the breast's size increased levels of blood pressure as well as eventual infertility.
- Contraceptive Injections: In this method, one hormone injection is administered, the effects of which last inside the body for a time period of 8 to 12 weeks i.e. 2-3 months. The contraceptive injection has the similar effects as that of contraceptive pills on birth control. Evidently, the shot is irreversible, which makes the woman infertile for a period of three months. However, similar to the pill, protection from STDs is not offered by contraceptive injections. But these injections can guarantee 99% safety and surety on being used.
- Natural Family Planning: Even though it is not any external pill or device, Natural Family Planning is also a method of birth control. It relies on the knowledge of timings of the menstrual cycle (periods) so that the couple can avoid sex during the time period when the woman is fertile. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
Your body goes through drastic changes when you are pregnant. Your body makes more blood during pregnancy; for instance, prior to pregnancy, your body made approximately 5 litres of blood, but now it produces 7 to 8 litres of it.
Producing excess red blood cells requires haemoglobin, which in turn requires plenty of folate, iron and vitamin B12. If there is a deficiency in any of these requirements, you might develop anaemia.
Anaemia is a condition, which is characterized by a lack of red blood cells in the body. The risks of becoming anaemic during pregnancy include:
- Being extremely fatigued
- Miscarriages, premature birth, or low birth-weight
- The baby can inherit anaemia from the mother
- The child can have certain developmental delays
- Postpartum depression (post-childbirth depression)
How it can be prevented?
To prevent such risks, it is important to implement the proper diet. Here are some dietary tips to prevent anaemia during pregnancy:
1. Consume iron-rich foods: Foods that provide you with the best source of iron are
- Poultry and eggs
- Dark green and leafy vegetables (for example: spinach, broccoli and kale)
- Seeds and nuts
- Beans and lentils
- Ripe bananas
2. Don't forget the supplements: Foods are great sources of the nutrients you require, but they may be lacking at times. Ask your doctor for supplements like vitamin, folic acid and iron supplements mostly. Consuming supplements before pregnancy can go a long way in preventing anaemia.
3. Folic acid is important: Folic acid is very important for pregnant women. You must consume 400 milligrams of it to prevent anaemia and birth defects in babies. Foods that are rich in folic acid include:
- Brussel sprouts
4. Vitamins are crucial: Vitamin C helps in iron absorption which boosts haemoglobin production. Some foods rich in vitamin C include
- Citrus fruits
- Bell peppers
5. Be vigilant while cooking: Sometimes while cooking foods, the wrong method can strip them of their iron content. So be careful not to fry, boil or stew such foods too much. Certain foods are best consumed raw; read the labels properly if in doubt.
6. Abstain from certain habits: Alcohol, tea, cigarette and coffee hinder iron absorption. So stop consuming them if you are trying to conceive or have conceived.
Vulvar cancer is an invasive and cancerous growth, which occurs in the vulva (the external vaginal or reproductive tract opening in females). The main types of vulvar cancer include:
- Squamous cell carcinoma: This condition gives rise to abnormal growths that generally originate from the most common forms of skin cells known as squamous cells. They are characterized by open sores, scaly red patches, elevated growths with a depression in the centre or warts which might crust or bleed. They can cause disfiguring and sometimes can prove to be fatal if their growth is allowed.
- Melanoma: This is a form of cancer that is known to develop cells that contain pigment called melanocytes. It is one of the most dangerous forms of cancer and is more commonly found in women.
- Basal cell carcinoma: Basal cell carcinoma contributes to around 1- 2% of vulvar cancer. This form of cancer tends to be slow-growing lesions on the labia majora (external large vulvar folds), but is capable of occurring anywhere else on the vulva. The behaviour bears resemblance to basal cell cancers that occur in other locations. Their growth is local and the risk of deep invasion or metastasis (spreading of cancer) is low. Treatment of basal cell carcinoma involves excision. However, these types of lesions tend to recur if they are not removed completely.
Symptoms of vulvar cancer include:
- Itching, bleeding or burning sensation on the vulva that is not relieved.
- Occurrence of skin changes such as rashes or warts, on the vulva.
- Pain in pelvis, particularly during sex or urination.
- Changes in skin colour of the vulva (abnormally red or white).
- Lumps, ulcers or sores that occur on the vulva which does not subside
Treatment options of vulvar cancer include:
1. Surgery: This is the most common form of treatment wherein, the cancer is removed without affecting the sexual function of the woman. Some of the surgical procedures include:
- Laser Surgery
- Wide local excision (small portion of the cancerous tissue)
- Radical local excision (removing a major portion of benign tissues as well)
- Ultrasonic surgical aspiration (tumour is broken into small pieces using fine vibrations)
- Vulvectomy (removal of all or part of vulva)
2. Radiation Therapy: This treatment procedure involves using radiations such as X-rays to target and destroy the cancer cells. The two forms of radiation therapy are external radiation therapy and internal radiation therapy.
3. Chemotherapy: This form of treatment uses oral administration or injection of chemicals into the veins so that the growth of cancerous cells is stopped, either by elimination of the cells or by prohibiting cell division.
In a normal pregnancy, the egg that the ovaries release enters the fallopian tube. If a sperm fertilises it, the fertilised egg attaches itself inside the uterus. However, sometimes the fertilised egg can attach itself outside the uterus. This condition is called ectopic pregnancy.
Ectopic pregnancy can be detected in the first few weeks of the pregnancy itself. If your doctor does discover ectopic pregnancy, you would need immediate medical attention. Ectopic pregnancies can be sad and scary. The survival rate of the baby is extremely low, and you may need some time to get over your loss. Fortunately, one ectopic pregnancy doesn't mean you can never conceive again. Many women who lost their first baby to ectopic pregnancy have been able to have a healthy and normal pregnancy the second time around.
The causes of ectopic pregnancy include:
- An inflammation or infection of the fallopian tube can lead it to become entirely or partially blocked.
- Scar tissue from a surgery or an infection of the fallopian tube may also hinder the movement of the fertilised egg.
- Surgery in the tubes or pelvic areas in the past might cause adhesions.
- Birth defects or abnormal growths can cause anomalies in the shape of the tube.
These causes are usually followed by certain risk factors, such as:
- Age (The age group of 35-44 especially)
- An ectopic pregnancy in the past
- Previous abdominal or pelvic surgery
- Pelvic inflammatory disease
- Several prompted abortions
- Conceiving with an intrauterine device in place
- Endometriosis (growth of uterus lining tissues outside the uterus).
- Fertility treatments.
The signs and symptoms of ectopic pregnancy include:
- Minimal vaginal bleeding
- Vomiting and nausea with pain
- Pain in the lower abdomen
- Sharp cramps in the abdomen
- Localised pain (Pain concentrated on one side of your body)
- Pain in your neck, rectum or shoulder
- Rupture of the fallopian tubes can cause fainting due to the bleeding and pain
The treatment of ectopic pregnancy can be any one of the following:
- If the pregnancy has not progressed too far, methotrexate will be administered. This absorbs the pregnancy tissue and can save the fallopian tubes.
- The tubes may be removed if they have ruptured or stretched, and have started bleeding.
- Laparoscopic surgery (operations performed by making minor incisions) may be performed to remove or repair the tubes and recover the ectopic pregnancy.
The menopause can take three very different routes for women. There are those who sail through it with very few symptoms or problems and don't even notice that their ovaries have stopped producing the hormone. Then there are those for whom it is a matter of a few hot flushes and a couple of night sweats, doesn't last long and not really a bother. This usually marks a relief from the periods. But for some it is abject misery accompanied with crippling fatigue, absolute exhaustion, hot flushes, vaginal drying, mood swings along with low desire or lack of sexual feelings. These symptoms might persist for more than 7 years.
Hormone Replacement Therapy (HRT) is considered to be an effective treatment for menopausal symptoms. The other problems linked with menopause can also be influenced by HRT in a positive manner.
HRT is indicated in:
- Treatment of symptoms of menopause and the risk benefit ratio is apt for the women and they have been informed about the same
- For women who are around 51 years and are reaching menopause even though they are asymptomatic
- In women who are at the risk of osteoporotic fractures and are under 60 years and the non-estrogen treatments cannot be given
- HRT is not recommended in women who are above 60 years
Benefits of HRT:
The benefits of HRT usually are more than the risk if done in a woman who is under 60 years of age.
- Improvement in quality of life by relieving muscle pains and improving sleep
- The mood swings are controlled and low moods are usually alleviated by HRT. Low moods usually arise due to menopause.
- It reduces the vasomotor symptoms, usually within four months of the treatment with maximum benefit in three months
- HRT improves the urogenital symptoms by lowering the vaginal dryness, vaginal atrophy, urinary frequency and symptoms.
- HRT reduces the risk of osteoporosis. HRT is believed to preserve the bone mass density of the skeletal sites thus reducing the chances of vertebral and nonvertebral fractures.
- HRT also reduces the risk of colorectal cancer and cardiovascular diseases
Risks of HRT:
The main risks of HRT are stroke, endometrial and breast cancer, thromboembolic disease, pulmonary embolism and gallbladder disease. Though other risks are:
- It increases the risk of ischemic stroke
- There is a small risk associated with breast cancer and the risk increases more, if the woman is underweight or overweight, alcohol user, smoker and stops HRT suddenly
- Estrogen only HRTs can increase the risk of endometrial cancer. If cyclical progestogen is used for 10 days for 28 cycles then the risk is eliminated.
My friend was pregnant 2 month ago. She took a mtp kit and few hours later she had a heavy flow of blood and some gilts of blood but one month later her periods are not coming and she again took a mtp kit .but periods are not coming. What do she?
Vitamin D and pregnancy go hand in hand. Expecting mothers need to ensure they get the recommended amounts of vitamin D during pregnancy for the healthy development of the baby as well as their own well-being.
Vitamin D is a fat-soluble vitamin obtained mostly from consuming fortified milk or juice, fish oils and dietary supplements. It also is produced in the skin by exposure to sunlight. Vitamin D, which is ingested or produced in the skin must undergo hydroxylation in the liver and kidney to promote absorption of calcium from the gut to enable normal bone mineralization and growth. Severe maternal vitamin D deficiency has been associated with congenital rickets and disordered skeletal homeostasis coupled with fractures in the newborn during pregnancy. Vitamin D is necessary for the metabolism and absorption of phosphorus and calcium. Many studies are finding a connection between low serum vitamin D levels and an increased risk of certain types of autoimmune disease, cancers, insulin resistance, neurological disease and cardiovascular disease.
Latest studies have shown that vitamin D deficiency is common during pregnancy especially among women residing in northern latitudes, living in cold climates or wear sun and winter protective clothing and ethnic minorities, especially those with darker skin. As the vitamin D level of newborn is largely dependent on maternal vitamin D status, the infants of mothers with vitamin D deficiency are also at risk of vitamin D deficiency. Inadequate level of vitamin D can lead to abnormal bone growth, fractures, or rickets in newborns. Deficiency of vitamin D leads to a higher risk of pregnancy complications like gestational diabetes, premature birth and low birth weight.
The symptoms of a vitamin D deficiency include aching muscles, bone pain, and softened bones leading to fractures. Fish liver oil, fatty fish, and eggs are excellent food source for Vitamin D. It is difficult to get sufficient vitamin D from food, which makes it necessary to have vitamin D supplements. Since the skin uses the sun's rays to produce vitamin D, limited sun exposure is recommended. Exposure to the sun's ultraviolet rays intensifies the pigment changes causing skin darkening in pregnant women. Thus, most doctors endorse that pregnant women protect themselves from the sun and get their vitamin D from supplements. The average prenatal vitamin contains 400 IU of vitamin D, which makes it imperative that additional supplements should be taken. The significant compounds for human development are D2 and D3. The best way to really ensure adequate vitamin D is through simple supplementation. Ergocalciferol is the vegetarian form of vitamin D, whereas cholecalciferol is the animal-sourced form, derived from fish liver oil or lanolin from sheep.
Hypertension during pregnancy can be a problem for both baby and the mother. Thus it is of utmost importance that during pregnancy a good health should be maintained along with controlled blood pressure and cholesterol levels. With an increase in multiple births and women of older age the risk of hypertension during pregnancy has increased. But if proper care is taken it can be avoided.
Types of Pregnancy Hypertension:
There are three prominent forms of hypertension that can be seen during pregnancy. The pregnant ladies should be aware of the same. These are:
- Preeclampsia: This is the most common and serious hypertension during pregnancy. This hypertension can only be controlled by delivering the fetus, which usually involves complications like death of the mother or child. This occurs 20 weeks after pregnancy.
- Gestational Hypertension: This form is only prevalent during pregnancy and is not a problem for the mother or baby after delivery. This usually occurs in the last leg of the pregnancy
- Chronic Hypertension: This form forms either prior to the pregnancy or before 20 weeks of the pregnancy.
Management of Pregnancy Hypertension:
Hypertension during pregnancy can be handled by the following:
- In case of severe hypertension, blood pressure medication should be continued during pregnancy.
- If you are on ACE inhibitor type medication, then the medication is changed to one that is even safe for the baby.
- Your doctor might like to monitor you daily and can advise hospitalization for a few days
- If medication is missed, it might lead to uncontrolled life threatening hypertension. Thus the medication should not be missed at any time.
- In case of mild hypertension and absence of other diseases like diabetes and kidney disorders, the doctor might stop the medication or reduce the dose. Also, being off medicine does not cause any problem in mild hypertension.
- Irrespective of the hypertension being mild or severe, the prenatal appointments should not be missed, so that the doctor can monitor you and the baby. So that problems, like rise in blood pressure, poor fetal growth, and signs of preeclampsia can be spotted and steps can be taken for the same.
- In case there is some form of hypertension present the prenatal visits and lab tests will be more.
- Apart from the usual second trimester ultrasound, there will be periodic ultrasounds in the third trimester to monitor the baby's growth and the amniotic fluid.
- Also regular fetal tests and Doppler ultrasounds will be done to track the baby's growth.
- Lifestyle changes should be made. Salt intake should be limited, fresh food instead of processed food should be consumed.
- If blood pressure is high then doctor might ask you to avoid exercise especially if you never did before pregnancy.
Miscarriage is termed as the loss of the fetus in or before 20th week of pregnancy. Medically, miscarriage is known as spontaneous abortion, though the word spontaneous is more of a keyword as it is not an abortion.
Symptoms of Miscarriage
Miscarriage happens due to weakness, back pain, fever, abdominal pain along with severe cramps and bleeding, which starts from slow to heavy.
Cause of Miscarriage
Common cause of miscarriage is when the fetus is known to have fatal genetic problems and these are not related with the mother. The other causes are infection, medical problems like thyroid and diabetes, immune system rejection, hormonal imbalance, abnormalities of the uterus, and physical problems of the mother. If a woman is over 35 years of age, has thyroid and diabetes and had an miscarriage earlier then that woman is at a high risk of getting a miscarriage.
Sometimes a miscarriage might take place due to the cervical insufficiency. This is due to the weak cervix, also known as the incompetent cervix, which is unable to hold the pregnancy. A miscarriage in this condition usually occurs in the second trimester. Though there are a very few symptoms in this, but there might be a feeling of sudden pressure that the water is going to break and tissues from the placenta and fetus are released without any pain. This can however, be treated by a stitch in the cervix at 12 weeks. This stitch helps to hold the cervix until the full term is completed. If it is first pregnancy and cervical insufficiency is diagnosed, then also a stitch can be applied, thus resulting in full term and avoiding miscarriage.
Diagnosis of Miscarriage:
- The doctor does a pelvic test, an ultrasound and blood tests to confirm a miscarriage
- Blood tests are done to analyze the pregnancy hormone hCG. This is monitored regularly if miscarriage is suspected
- Genetic tests, blood tests and medication are important in women who have a history of prior miscarriages
- Pelvic ultrasound and hysterosalpingography are tests, which are done when there are repeated miscarriages
- Test like hysteroscopy is also done. In this the doctor observes the inside of the uterus with a device, which is thin telescope like device. This is inserted in the vagina and cervix.
- If the cervix is dilated, then the woman might be diagnosed with an incompetent cervix and this can be corrected by cerclage, a procedure done to close the cervix.
- If the blood type of the pregnant woman is Rh negative, she is prescribed a blood product called Rh immune globulin (Rhogam). This prevents from forming, antibodies which could turn to be harmful for the baby.
Pregnancy is that period of time in a woman's life when she is excited about giving birth to her baby. She is not only responsible to keep herself healthy, but her baby is also her responsibility. What she eats, how she lives and her daily routine will affect the baby. Thus, to have a healthy pregnancy it is necessary that you exercise regularly and eat well. You should also avoid those things that may hurt your baby.
Take care of what you eat:
During pregnancy it is important to get proper nutrition so that you and your baby are healthy. For slow and gradual weight gain, it is necessary to pay close attention to the folic acid, calcium and iron intake. However, if you are obese, then your weight gain regime will be different from others.
The diet during pregnancy should include:
- Intake of fruit and vegetables is important as they are good sources of vitamins, minerals and even fiber. They are good for digestion and also help in preventing constipation. Eat fresh fruits and vegetables daily.
- During pregnancy carbohydrates are also important as they act as an important source of energy. Different food items that are rich in carbohydrates are potatoes, bread, breakfast cereals, pasta, rice, noodles, millet, maize, oats, yams, sweet potatoes, and corn meal. It is better to eat whole grains and potato with the skin on as they are rich in fiber.
- Intake of protein is very important during pregnancy, and thus you should take lean meat, pulses, beans, nuts, fish, and eggs. All these items should be cooked well so that you do not face any problem in digestion during pregnancy.
- It is also necessary to eat dairy products like milk, cheese, butter and yoghurt during pregnancy. They are important because they contain the calcium and nutrients that are necessary for the growth of the baby.
What to avoid?
Just as you should eat certain food items to be healthy, there are certain foods that must be avoided to be fit and healthy. Avoid the following during pregnancy
- Drugs and alcohol
- Medicines that are not prescribed by your physician
- Smoking tobacco
- Fried and oily food
- Fishes those are rich in mercury like shark, tilefish, swordfish and those fishes that are caught in local waters are not considered safe.
- Too much intake of caffeine is also hazardous for a pregnant lady.
Thus, by following the above-mentioned diet tips you can keep your baby and yourself healthy. Always get advice from your physician for any decision that you take during pregnancy.