Dr. Jagadish

Pregnancy is definitely a new and beautiful phase in a woman’s life. During this time, the woman’s body goes through multiple changes during the nine months and post-delivery, extra care is needed for the body to get back to its pre-pregnancy state. The following are some tips to care for your post-partum body immediately after delivery and through the first six weeks after childbirth.

1. Perineal soreness: The area between the vagina and the anus stretches a lot during labour and can be sore for quite a while. In some women, this area may even be cut to enable easy passing of the baby (episiotomy). This would be more painful and can be managed with topical creams, ice packs, Kegel exercises and warm baths.
2. Uterine shrinkage: The uterus enlarges to accommodate the developing baby shrinks back to its original stage after delivery. This causes severe cramps, especially during the first six weeks and if required, pain medications can be taken for the cramps.
3. Breast fullness: The breasts fill with milk after birth to enable feeding, and the woman feels engorged. This is relieved with feeding, but if the baby is not on mother’s milk, warm soaks on the breasts and a supportive bra can help. It will stop once the breasts stop making milk.
4. Constipation: This is common post pregnancy, and so foods rich in fibre should be consumed. Lots of vegetables, fruits and whole grains should be included in the diet. If required, stool softeners can be used.
5. Body swelling: In preparation for the delivery, the hands and feet swell due to fluid accumulation. This naturally subsides over the first week to 10 days. Lying on the left side and keeping the feet elevated can help.
6. Urination problem: Experiencing a burning sensation or pain while urinating and inability to start or stop a stream of urine are common urination problems, especially immediately after childbirth, which will subside in a couple of weeks. Drinking lots of water, Kegel exercises and warm baths are helpful measures that can be undertaken.
7. Fatigue: Taking care of the newborn can leave you drained. Get adjusted to the baby’s routine and try to sleep with your baby. Get friends and family to help you take care of your child so that you don’t feel the entire strain.
8. Emotional health: Changes in the hormone levels again affects your emotional health, so try and stay positive. Post-partum depression is very common in women, as they feel overwhelmed with caring for the newborn.

It is important to realise that while pregnancy is an important phase, it is a natural process. The body will adapt to these short-lived changes and allow you to bond with your baby by staying close to your child, responding to its needs, spending time together, and taking care of your newborn. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

Do you feel disinterested in getting physically close to your partner? If yes, then it can be a sign of HSDD, that is Hypoactive sexual desire disorder. It is a sex disorder marked by disgust and disinterest towards sex. This disorder affects both men and women.

Men with Hypoactive Sexual Desire Disorder
Men are generally perceived as highly sexual beings, but in reality, 1 out of 5 men may be suffering from HSDD.

Some possible causes of male HSDD include:

1. Psychological issues: Anxiety and stress due to the strain of family or relationship problems, rigours of daily life or mental disorders such as depression are some of the factors that influence sexual desire.
2. Medical causes: Diseases (for example: diabetes), conditions (such as high cholesterol, high blood pressure and obesity) and drugs (such as hair loss medications) have adverse effects on sexual desire.
3. Hormonal problems: Low levels of testosterone usually lead to low sexual desire. Other hormones, such as the thyroid hormone or prolactin (hormone that governs the development of breast milk) can also contribute to the cause.
4. Low levels of dopamine: Dopamine is a neurotransmitter, which is responsible for the pleasure perception in your brain. Low levels of dopamine usually signify low sexual desire.

How it can be treated ?
If the cause is psychological, then sex therapy (psychological counselling based on sexual issues) is used to treat HSDD. But if it is hormonal, testosterone supplements are used.

Women with Hypoactive Sexual Desire Disorder
Female HSDD is more complicated and is difficult to diagnose. HSDD can affect women across all ages.

In women, this disorder can have a wider spectrum of causes, which include:

1. Interpersonal relationship problems: Certain problems such as the partner’s performance issues, loss of emotional gratification with relationships, childbirth and becoming nothing, but only a loved one’s caregiver can all lead to low sexual desire.
2. Sociocultural influences: Media’s portrayal of sexuality, peer pressure and job stress have negative influences on sexual desire.
3. Low testosterone: Women produce testosterone as well, and similar to men, low levels of this sex hormone cause a significant dip in sexual desire.
4. Medical problems: Mental illnesses such as depression or medical problems, such as fibroids or endometriosis (a disorder characterized by the growth of uterine tissues outside the organ) affect women, physically and mentally, thus making ‘hypoactive sexual desire disorder’ a possibility.
5. Medications: Excessive use of antidepressants, oral contraceptives and blood pressure drugs can lower sexual desire.
6. Age: The androgen (sex hormone) levels lower drastically as a woman ages, thus negatively impacting her sexual desires.

Treatment

Sex therapy (therapy that concerns itself with counselling and addressing one’s physical or psychological hindrances to sex) medication changes, diagnosing underlying medical problems, vaginal estrogens and testosterone therapy (therapy that helps in managing the effects of low levels of testosterone) are mostly used to increase sexual desire in women. If you wish to discuss about any specific problem, you can consult a Psychiatrist.

A regular menstrual period is when you bleed for 5-6 days every month. A normal cycle is 11-13 menstrual periods every year. An irregular menstrual period is when there are less than 10 or more than 14 menstrual periods in a year.

Initially, when a teenage girl reaches puberty, the menstrual cycles are a little irregular. It takes a few months to a couple of years before the hormones are balanced and the cycles come in regular intervals.

Peri-menopausal women have extremely irregular periods, ranging from mere spotting in some months to severe bleeding and muscular cramps in the next few months. As a woman approaches menopause, there are wide fluctuations in hormones that cause the irregularity.

Other Causes Of Menstrual Irregularities-

1. Excessive weight gain or weight loss. Obesity has been found to cause menstrual irregularities.

2. Emotional stress and anxiety.

3. Persistent physical exhaustion.

4. Illness.

5. Increase in exercise. Heavy exercise and endurance regimes are known to cause missed or irregular periods.

6. Travelling, differences in temperature and weather conditions can affect periods.

7. Contraceptive pills and other birth control medications.

8. Polycystic ovarian syndrome.

9. Other medical issues with the pelvic organs.

10. Inadequate rest and sleep.

11. Indulging in too much of processed or fried food.

12. Breastfeeding can cause menstrual irregularities and regain normalcy after it has been stopped completely.

13. Eating disorders such as anorexia nervosa or bulimia has been known to cause menstrual irregularities.

Treatments-

1. A balanced diet which includes enough proteins, calcium and vitamins.

2. Abstinence from caffeine and alcohol.

3. Light but regular exercising.

4. Take some medication after due consultation with a doctor.

5. Abstain from smoking or consuming tobacco in any form.

6. Take vitamin and folic acid supplements.

7. Get yourself checked for blood sugar or cholesterol.

8. Maintain an optimum body weight.

9. In case of missed periods for over 2 months, do a home pregnancy check up or visit the gynaecologist.

10. Stay away from situations that stress you and attempt to control your anxiety. Cultivate an activity that you enjoy, be optimistic and enjoy life.

    If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.