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Management of Abortion
Caesarean Section Procedure
Treatment Of Female Sexual Problems
Termination Of Pregnancy Procedure
Treatment Of Pregnancy Problems
Well Woman Healthcheck
Treatment Of Female Sexual Problems
Treatment Of Medical Diseases In Pregnancy
Treatment Of Menstrual Problems
Intra-Uterine Insemination (IUI) Treatment
Medical Termination Of Pregnancy (Mtp) Procedure
Gynecology Laparoscopy Procedures
Pap Smear Procedure
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- Chances are you've never heard of vaginismus (or, as it is now known, genito pelvic pain penetration disorder) before. Why? Because it's the disorder nobody wants to talk about, least of all those whom it most affects - women. Vaginismus is musculature of the outer third of the vagina, which interferes with coitus and causes distress and interpersonal difficulty.
- Among the male factor infertility, erectile dysfunction was found to be the top ranking cause accounting for 79.37% followed by premature ejaculation 12.01%, Lack of sexual desire 3.92%, homosexual orientation 2.79%, sexual aversion disorder 1.31% and disorders of sexual preference 0.61%.
- Vaginismus is believed to be a psycho-physiologic disorder due to fear from actual or imagined negative experiences with penetration and/or organic pathology. Women with vaginismus have also been noted to have a lack of sex education. Vaginismus was the 63.9% , ed 11.9% , PME 8.3% , low male sexual desire 2.7%, low sexual desire in female 13.9% dysfunctional underlying non consummation of marriage is largely treatable. Adaptation to the situation usually occurs and associated factors add to the primary cause. Treatment of the underlying dysfunction can challenge the relationship.
- Sexual dysfunction is a common problem which leads to inter-personal problems and marital discord. defined as recurrent or persistent involuntary spasm of the with coitus and causes distress and interpersonal difficulty.
Treating vaginismus merits a two-front approach which includes behavioral sex therapy techniques and relational intervention. When appropriate, the behavioral intervention consists of prescribing dilators (from smallest to largest) that the wife is to use in the privacy of her own home to gradually desensitize herself to penetration (the fourth and usually largest dilator is roughly the size of a penis). While the husband may be called upon to help his wife insert the dilators (depending on his wife's comfort level), for the most part his job is to ease off the pressure for her to perform, be supportive, and try to understand his role in the marital dynamic (usually an enabling one) and the associated symptom.
Ascribing to a psychodynamic model of treatment, is helpful for a couple to understand where their symptom came from, but I'll admit this is not always necessary for them to achieve a positive outcome. Nevertheless, employing the psychodynamic systems approach to uncover any conflicts that might be behind or exacerbating the vaginismus. These underlying causes may include prior sexual abuse, chronic control struggles experienced in the family of origin, negative messages or beliefs about sex emanating from the family of origin, religious values that conflict with sexual pleasure, to name a few. I also pay close attention to the couple's interactional style in order to assess whether it, too, is a contributing factor.
What causes it?
- "Both [primary and secondary conditions] are psychologically based. "It's a physical condition, but it's a psychological condition as well.
- "To treat it correctly, you need to treat both the physical and psychological aspects."
- while there are many hypotheses on possible causes, its actual etiology is unknown, probably in part due to the fact sufferers are so reluctant to come forward.
- "It's a really complex thing, And while it is influenced by many things -- there are lots of hypotheses -- the big link, for primary vaginismus anyway, seems to be strong correlation between being raised in a religious environment.
- "This may be due to several factors including lack of information, insufficient premarital education, a cultural context strongly proscribing sexual behavior, and the expectation that intercourse take place immediately after the wedding, necessitating a radical shift from sexual abstinence to sexual intercourse.
- Often the anxiety resulting from repeated attempts at intercourse contributes to the sexual dysfunction. One or both partners may be anxious that penetration will be painful, that there will be bleeding, or that the woman will get pregnant. While a certain amount of anxiety surrounding sexual activity is normal, when one or both partners are overly anxious, sexual function can be affected in the following ways: The male partner may have difficulty maintaining an erection strong enough to allow penetration or he may lose his erection just prior to intercourse. Anxiety may contribute to premature ejaculation, also just prior to reaching penetration. Anxiety may prevent the woman from relaxing enough to allow penetration. She may close her legs or contract her vaginal muscles. This presentation is referred to as vaginismus, defined as the persistent or recurrent difficulty of a woman to allow vaginal entry of a penis, a finger, and/or any object, despite her expressed wish to do so. While anxiety may indeed be a factor contributing to and perpetuating many sexual problems, there are many components to sexual problems, including physiological ones. Therefore, each partner in a couple presenting with an unconsummated marriage should undergo a physical exam.
- Physical presentations of the female partner that might prevent intercourse can include sexual pain disorders such as localized vulvodynia, also known as vulvar vestibulitis syndrome. This fairly common condition is characterized by pain with touch at the entry to the vagina, which can prevent intercourse. A woman's hymen may be a barrier to intercourse. Some women have a very thick hymen, or a septate hymen, which is a thin piece of membrane running vertically which separates the vagina in to two sides. While most of these conditions can be addressed with sexual counseling and physical therapy, including use of vaginal dilators, in most cases a septate hymen needs to be repaired surgically.
- Frequently, lack of knowledge about sexual anatomy and physiology may contribute to a situation whereby attempting intercourse feels awkward and un-natural. Often all that is needed is some basic anatomical information and positioning advice. For example, a couple may report that the woman's vagina feels dry and excess friction prevents intercourse. In this case, the couple may be advised to ensure that intercourse take place when the woman is sufficiently aroused after plenty of exciting foreplay. Over the counter lubricants may be very helpful. While some people are physically active, very aware of their bodies, and comfortable with movement, other people are less so and may simply have not figured out how their bodies move in order to comfortably find a position for intercourse. One or both of the partners may have mobility problems or difficulty getting in to or maintaining a position. A woman may have difficulty keeping her legs open or a man may not be able to hold his weight up on his arms. In these cases as well, consultation with a physical therapist may be helpful in providing exercises and positioning advice.
- While behavioral solutions may be found for many couples, it is important to note that couples in unconsummated relationships, particularly of long standing duration, may benefit from couples therapy directed by a competent Sexologist. A doctor working with such a couple may wish to gain understanding in how the couple presents and organizes around the problem: How is the presenting problem perceived by each partner? Is there attribution of blame? What is the significance of the dysfunction itself and how is that perceived by the couple? Who is aware of this situation and in what way is outside intervention (community, parents, and religious leader) perceived in assisting or perpetuating this condition? Identifying the various factors contributing to the condition and dealing with them with physical, psychosexual, and couples therapy, may be the key to consummation and the commencement of a satisfying intimate life.
"So we are talking about people who are raised in conservative faith, who may not have looked at their anatomy in the mirror," Small continued. "They haven't touched themselves, they haven't looked at themselves -- they may view the entire thing as being dirty."
"In terms of the secondary form, this is a result of some kind of trauma or sexual issue, and can be triggered by something later on.
"Women don't talk about it. They learn to live with it. I've seen cases where women have been married or in relationship for up to 12 years and only present when they want to have children."
- Women don't talk about it. They learn to live with it. I've seen cases where women have been married or in relationship for up to 12 years and only present when they want to have children.
How to treat it
- Most women who experience vaginismus choose to live with it rather than come forward and have it treated. Even those in long-term relationships may try to conceal what is happening from their partner or forgo sexual relations all together.
- "If they don't do that, they cut that part of intimacy out of their relationship altogether and choose to shut down any intimate feelings they might have. They end up having a very different kind of relationship.
- "What is important to say is there is a cure and they can be helped. That's the message that needs to get out there. Treatment for vaginismus have included systematic desensitization along with insertion of graded dilators/fingers11, drugs like anxiolytics, botulinum toxin injection,12
- and sex therapy. An In the Indian scenario where the talk about sex is taboo and limited among partners it becomes very essential to first improve their communication so as to improve the sex related issues. eclectic approach involving education, graded insertion of fingers, Kegel's exercises and usage of anaesthesia with vaginal containment was tried.
- As Small previously mentioned, the best approach in terms of a cure is to seek both psychological and physical treatment.
- For the psychological side of things, she recommends seeking out a competent female sexologist.
- Physically, many women are taught how to use vaginal dilators in conjunction with relaxation techniques.
- "With vaginal dilators, basically how they work is you start off very very small, and then, using relaxation techniques, slowly work your way up in terms of size.
- "It's imperative these women have a gentle introduction and remember they are in control of the situation.
- "There is also something called saturation therapy which is often undertaken with their partner. Using dilators, they are able to discuss their mental state and what their thoughts are at any stage. There has actually been incredible results with that. Something like 90 percent of participants report sexual success afterward." there has been some preliminary research done into the effectiveness of Botox, but states at this stage, the research is still too new to offer any kind of conclusive evidence.
Steps to take
- If you think you or your partner might have vaginismus, it's extremely important to understand treatment is available, and, better yet, comes with a high level of success rates.
- "The first step is to see a competent female sexologist. "It is one of those things that, when it presents, it is pretty obvious it is on a psychological basis.
- "A sexologist may double-check everything is okay, but typically what they will find is anatomically they are fine and everything is in order and working -- the cause stems from a psychological basis.
- "The big thing about it is it's treatable, and it is possible to lead a really fulfilled life.
I am 31 years female. Marriage and ttc since 1 yr. Husband semen, tube tests and all other tests are also normal. This month I did follicular monitoring and in my left ovary the egg got ruptured. Now again am getting cramps and periods are about to come. please suggest me, why am bot able to conceive.
My I have baby. 5 yrs complete my marriage, my & my hubby all reports is good, Doctors told me! why not conceive baby.
What is breast reduction?
Breast reduction, or reduction mammaplasty, is a procedure performed to reduce the size of overly large breast. This is done by removing excess breast fat, glandular tissue, and skin to create breast that are more proportionate to your body.
Who is a good candidate for breast reduction?
The best candidates for breast reduction have large breast which interfere with activities of daily living. Also if your breasts cause neck, shoulder, and back pain or if your breasts cause skin irritations beneath the breast crease you may be a good candidate.
Where is the scar from breast reduction surgery?
The scar for breast reduction usually is a circular shape around the areola with a vertical line extending from the areola to the crease and a horizontal line in the crease (or an anchor pattern.)
What are the possible risks of a breast reduction?
Potential risks include bleeding, infection, seroma, pain, scarring, numbness, asymmetry, loss of sensation in the nipple, partial or total loss of nipple or areola, potential inability to breastfeed, fat necrosis, and need for additional surgery.
How long is breast reduction surgery?
Breast reduction surgery is usually 3-4 hours depending on the size of your breast.
What is the typical recovery time for breast reduction surgery?
This procedure can be done as an outpatient or as an overnight stay. You will be sent home on pain medicine and antibiotics. You will have surgical drains in place on each breast. You will be placed in a surgical bra that will need to be worn for 4-6 weeks following your procedure. You will need to be off work for 2-3 weeks dependent on the type of work you perform. You should not do any strenuous activity for 4-6 weeks following this procedure.
How long before I can return to work?
Most patients are able to return to work in 2-3 weeks depending on the work requirements.
How long before I can return to normal activity?
Most activities of daily living can be resumed within a couple of days. You will be given 5 kg lifting restrictions for the first few weeks following surgery. It is important to get up and move around within a day of surgery to help decrease the chance of developing a blood clot. Strenuous activities should be avoided for about 4-6 weeks or until.
Recently I had laparoscopy for removal of ovarian cyst (endometriosis, can I conceive after this, I want baby.
What to expect from a c section? What things to be kept in mind during and after c section for proper healing of incision?
In an incredibly fast paced and unhealthy lifestyle of the modern world, irregular menses aren’t exactly an unusual situation. The length of a monthly cycle may either last longer than usual or end earlier than usual, only to begin in a short while again, accompanied by greater abdominal pain and blood loss. Irregular cycles may vary from 8 to 21 days or more. The variation of 21 days or more is considered highly irregular and abnormal. A woman may face some menstrual irregularities at both ends of menstrual life, (onset- menarche and end of cycle- menopause) which is normal and in most of the cases, it is self-establishing.
Causes of Irregular Menstrual Cycle:
The cause of irregularities in menstrual cycle is basically hormone imbalance. The altered levels in the body lead to irregular cycles. There are many factors in routine life which affect hormonal balance. Some of them are:
- Poor diet or wrong dietary habits
- Stress and anxiety, thoughts and emotions
- Lifestyle: Lack of physical activity and exercise, too much physical exertion, stress and strain during menses.
- Illness: Long-term illness like fever, tuberculosis, thyroid problem etc.
- Medication: Certain medicine if taken for a long time, like oral contraceptive pills, hormonal therapy etc., alters hormonal balance.
- Imbalance of Tridosha (vatta, pitta and kapha) in body, leads to irregularities of reproductive system.
As per Ayurveda, Vatta is the main culprit in menstrual irregularities.
How To Deal With Menstrual Irregularities:
With the sudden acceptance of eastern concepts of yoga and organic and indigenous medicines around the world, Ayurveda has gained importance in treating irregular menses, gynecological and obstetric problems.
- Lifestyle and Food- There is no alternative for lifestyle and food habits correction. Eating healthy and nutritious food, regular exercise, yoga, physical activity, outdoor games lead to good physical health.
- Meditation and Breathing: Exercise is good for taming hormones. It keeps a person physical and mentally healthy.
- Avoid heavy physical work during menses.
- A good oil massage over body keeps Vatta in balance (one of the important tridoshas of body: vatta, pitta and kapha).
Ayurveda has proven to be much helpful in regulating the menstrual cycles. According to certain studies, Ayurveda came in rather handy while tackling PCOS, a disease distressing 1 in 3 women today. It is certain that Ayurveda medicines work better in certain scenarios and definitely have fewer risks in comparison to allopathic medicines and surgeries. Over a period of time, they have proven much more beneficial in overcoming the irregular menses and the irritation along with the accompanying pain and PMS symptoms. Ayurvedic medicines use herbs and roots and almost everything found in nature to discover a rather organic cure for diseases. Certain plants like Shatavari are used to reduce the much spoken about mood swings or PMS symptoms during periods which can only worsen in case of an irregularity. The bark of the Ashoka tree has proven to be quite helpful in relieving menstrual pain and excessive bleeding. Other plants and their parts like the Lodhra, Guggul, Guduchi and Amlaki, Jatamansi etc. are useful in regulating periods and reducing the stress and irritation accompanied by it.
Panchkarma- Basti therapy (Enema- administration of medicines through rectal route). In this treatment, decoction of different herbs and medicated oils are used for giving enema. Basti has proven its efficacy since centuries, for treating Vatta. A course of 5, 8, 15, 30 or 60 basti, as per person’s requirement can be given for menstrual problems. Irregular periods, although are faced by a large chunk of women, pose different symptoms for different people and hence individualized treatment is advised. If you wish to discuss about any specific problem, you can consult an ayurveda and ask a free question.