Dr. Asha Gavade

Use of contraceptives is really important to avoid unwanted pregnancy. Countries like China and India, facing the problem of population explosion lay more stress on the use of contraceptives. However, you must always use or take oral and barrier contraceptives following the advice of a medical practitioner unless it is absolutely necessary to go ahead without consultation. The reason behind medical assistance is your own health. Contraceptive methods do have a vast range of side effects that can result in health hazards. There are various kinds of contraceptives; each having its own set of advantages and disadvantages. Being acquainted with the side effects of some contraceptive methods can help you choose wisely in times of need.

1. Possible side- effects of using condoms: Some men are allergic to latex. Using condoms can lead to heightened sensitivity. It can also lead to rashes in your genitals. Condoms are not foolproof. They do not provide total protection against sexually transmitted infections, HPV or against Syphilis and Herpes. These diseases can be contracted by coming in contact with genital skin that is not covered by a condom.

2. Possible side- effects of a contraceptive film: A contraceptive film might act as an interruption in your sexual activities if it is not placed properly, that is to say it must come in contact with the cervix to be effective. Using the film x201nonoxynol- 9201d; very frequently can make you susceptible to life threatening diseases like HIV and other STIs.

3. Possible side effects of a cervical cap: A cervical cap has to be inserted by a clinician and requires immense care to be fitted in later. Some of its side - effects can be of serious concern. If it is left inside for more than forty eight hours, it can result in toxic shock syndrome. Toxic shock syndrome is an infection that mars your overall health. It is also known to increase the chances of inflammation of the surface of your cervix.

4. Possible side- effects of progestin only pills: Progestin only pills or mini pills can subject you to long- lasting depression. It can make you feel bloated and can actually increase your weight to a great extent if used on a regular basis. Minipills lead to irregularities in your menstrual cycle and might also make bleeding during menstruation scanty.

5. Possible side- effects of combined oral contraceptives: If this is your first month on combined oral contraceptives, you might feel nauseous and they can give you a terrible headache. Women taking these pills have a higher chance of developing cervical dysplasia. Consult an expert & get answers to your questions!

Vaginal dryness is an uncomfortable and painful condition that usually occurs during or after menopause. The estrogen level in your body gets reduced during this time which eventually leads to vaginal dryness. However, there are other factors that can trigger this condition including certain medications and immune disorders. This is a problem that can affect women at any age but it is visible more frequently in older women.

Here are some common factors that may lead to vaginal dryness:

1. Hormonal changes - A decrease in estrogen level that occurs during menopause is one of the most common causes of vaginal dryness. The decrease in estrogen may also occur during perimenopause, during breastfeeding or after childbirth. Radiation and chemotherapy for cancer treatment may also result in a decrease in vaginal lubrication.

2. Irritants - Chemicals present in soaps, dyes, hygiene products and perfumes may cause allergy in some women. Irritants present in underwear or towels and other allergens like objects and lubricants that are placed in the vagina may also cause vaginal dryness.

3. Insufficient arousal - Low libido or other sexual problems may also lead to vaginal dryness. Poor sexual performance and early ejaculation may also contribute to it.

4. Anxiety - Sexual desire can be affected by emotional and psychological factors such as anxiety and stress that may eventually lead to vaginal dryness. High anxiety level in women results in insufficient flow of blood, causing vaginal dryness.

How can vaginal dryness be treated?

Topical estrogen therapy is a common method of treating vaginal dryness caused by low estrogen level. Topical estrogen helps in inserting some hormone that your body is no longer producing. This controls the vaginal symptoms to a certain extent but it does not replace as much estrogen as oral hormone therapy, in your blood stream. Lubricants and moisturizers may also be applied to reduce vaginal dryness and make sex less painful and uncomfortable.

Word of Caution:

Please get a PAP Smear done before starting local estrogen and keep a follow up with your doctor. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

Both IVF (in vitro fertilisation) and surrogacy are alternative methods of having a baby and can be resorted to when a couple cannot conceive the natural way. The reason behind the inability to conceive can be due various reasons ranging from infertility and low sperm count (in men) to damaged fallopian tubes and early menopause (in women).

You can opt for either surrogacy or IVF if you've been trying to conceive for more than a year without any results. But which of the two should you opt for? well, there are three things you must keep in mind before making a choice.

How does it work?
Surrogacy is opted for when the woman is unable to conceive by natural means, and when there's no possibility of her getting pregnant whatsoever. Surrogacy can be of two types- full surrogacy and partial surrogacy. Full surrogacy involves the implantation of sperms and eggs of the couple into the uterus of the surrogate mother; while partial surrogacy involves the fertilisation of the surrogate mother's egg by the sperm of the intended father. By opting for surrogacy the woman partner is unable to carry the child, a desire that is present in most women.

On the other hand, ivf works towards the treatment of infertility in one or both the partners, enabling the woman partner to conceive the child. Ivf involves the fertilisation of a woman's eggs by the sperm of the intended father in a laboratory dish. The developed embryo (or fertilised egg) is then implanted in the woman's uterus. This is a viable option for couples who want to have a baby on their own.

Chances of a successful pregnancy are usually higher with surrogacy when compared to IVF.

The risks involved
Risks of surrogacy include multiple births, ectopic pregnancy (implantation of the fertilised egg in the fallopian tube instead of the uterus, leading to miscarriage) and birth defects in the child, to name a few. Apart from that, the genes of the surrogate mother can affect the development of the unborn baby; hence, a surrogate mother has to be chosen with utmost care.

As for risks associated with IVF, ovarian hyperstimulation syndrome (swollen and painful ovaries), multiple births, ectopic pregnancy and stress can take place if ivf is opted for.

The legal process
Surrogacy requires the fulfilment of complex legal processes such as determining eligibility, matching profiles of surrogates with intended parents, finding of a potential surrogate and more, which require proper legal counselling. Besides the cost of surrogacy in India is roughly inr 8, 25, 000.

Ivf does not involve any such processes and is easier to carry out. The cost of IVF in India can range between inr 2, 50, 000 to inr 4, 50, 000, making it a much more viable option.

Based on these factors, you can make the choice of a procedure that is best suited for you.

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

Breast cancer is one of the most feared diagnoses in women. When cancerous cells develop in a woman's breast, irregular lumps, changes in the shape or size of the breast and discharge of blood from the nipples may be experienced. There are lots of preventive measures that you can take to avoid breast cancer. It is important to live a healthy life with as less exposure to toxins as possible. Here are some tips and strategies that can lower your risk of breast cancer

Preventive measures:

• Plant based diet - Studies have shown that a high plant based diet, full of vegetables and fruits, is packed with antioxidants, minerals, and nutrients that lower the risk of breast cancer. Eat light, and avoid refined sugar and processed meat. Try to construct a healthy Mediterranean diet plan rich in olive oil and nuts.
• Maintain an appropriate weight - Do not gain extra weight as obesity and excessive weight gain are related to breast cancer. Cut down on fat and exercise regularly to lead an active life.
• Breastfeeding - If you are a new mom, breastfeed your baby as it has numerous health benefits for both you and your child, including lowering the chances of breast cancer in the mother.
• Sleep - It is important to get 8 hours of sleep every night to live a healthy life. Many studies have shown that a short duration of sleep and exposure to light at night that disrupts the circadian rhythm increases the risk of breast cancer.
• Avoid tobacco and alcohol - Do not smoke as it increases the chances of cancer in other organs and also leads to toxin inclusion in the body. Also, be sure to drink in moderation as excess alcohol consumption is cancer causing offender.
• Artificial hormones - Women during Women during menopause often resort to hormone replacement therapy, and the extended use of this therapy can heighten the risk of breast cancer. Therefore, it is recommended to look for other options to smoothen your transition to the menopausal phase. In case you have a concern or query you can always consult an expert & get answers to your questions!

Most people will give you a blatant NO. And they are quite right to do so. But if you have been a habitual offender who can't unwind without their drink, pregnancy is going to be a big problem. So does the rule stand in all cases? What if you drank when you didn't know you were pregnant yet? What if you had a light drink here and there, will it literally spell disaster? Let's find out.

Contradictory advice everywhere: Most doctors will advice you to stay away completely from alcohol as soon as that first positive emerges in your test. Others may give you a little leeway and let you have an occasional drink. There are friends who'll confess to have cheated during their pregnancy and snuck in a beer or two and say that their kids turned out just fine. There are other friends will scorn on you for even thinking such a thing. Same goes for your relatives. Like all things in pregnancy, random advice will just not work.

How much can you drink? Let's assume that you are confident nothing will happen and want to be adventurous and give it a cautious try. Danish researchers have some good news for you. Some studies have shown that low to moderate consumption of alcohol does not harm the baby. In fact, in 2012, Danish researchers released a highly publicized study that found no major problems in children below 5 years whose mothers had consumed 1- 8 alcoholic drinks a week during pregnancy.

Unfortunately, not all research is made equal. With pregnancy, each mother, each child and progression of each pregnancy is different. It really has to be on a case by case basis and nothing can be taken on face value. Most people will still advise you to completely go off alcohol as there is no "safe" amount during pregnancy. Some women have a larger quantity of the enzyme that breaks down alcohol. If a woman with lower levels of this enzyme drinks alcohol, it is more likely to harm her unborn child as the alcohol will remain in her bloodstream longer.

How alcohol can affect your child?
There are a huge number of disorders that can affect your child when in the womb and even after because of alcohol consumption. These disorders are collectively called "Fetal Alcohol Spectrum Disorder". It is characterized by increased risk in miscarriage and stillbirth. It can also result in the baby having low birth weight and increase problems with learning, speech, attention span, language and hyperactivity. Alcohol consumption may also affect a girls and boys differently. While both may turn out to have aggressive and delinquent behaviour, girls are more likely to develop mental health problems too.

If you are unable to give up on alcohol, you need to immediately get professional help to overcome your addiction.

Also note that the term "non-alcoholic" beverage is misleading as they can contain trace amounts of it. Consult a doctor today on which drinks are safe for you.

During the natural course of events, a women's body starts its reproductive phase with menarche and at about 50 years of age, attains menopause. This is when the reproductive function ceases and the ovaries stop producing the hormone estrogen and progesterone. In some cases, for various reasons including medical, the ovaries stop functioning earlier, and this is medically termed early or premature menopause. Menopause that occurs before 40 years of age is termed premature menopause; it is due to primary ovarian insufficiency and occurs in 1% of the women.  If it occurs between 45 to 50 years, it is termed early menopause.
Causes: Normal ageing, family history, genetic disorders, autoimmune disorders, toxins, and surgery are some reasons that could lead to premature menopause.
Effects: Estrogen and progesterone have a lot of beneficial effects on a women's body. Reduction in their levels leads to some of the below changes:
- Emotional changes like mood swings, irritability, and in some cases depression, especially in premature menopause.
- Irregular cycles before complete cessation of the menstrual cycles.
- General mucosal dryness leading to vaginal dryness, dry skin, dry eyes.
- There also would be urinary incontinence and reduced sex drive due to reduced hormone levels.
- For women who still would want to have children, infertility would be a big cause for concern. This could lead to other emotional issues, worsening the depression.

- Osteoporosis - Bones lose their density and get weak and are more prone to fracture.
- Cardiovascular health - Post menopause, women are more prone to heart attacks and stroke. Though not fully proven, this is believed to be true as the good role that estrogen plays on blood vessels is negated with menopause.
- Accelerated ageing - Menopause leads to accelerated damage of genetic structures, thereby leading to faster ageing. This also leaves a feeling in the women of being less attractive and less desirable.
There is also a good news, that after menopause women are at lesser risk of cancer - especially breast and ovarian. 
It is not easy for women to handle premature menopause. The body undergoes some changes much earlier than expected, and it requires a lot of support and caring and comforting to come to terms with it - especially if associated with infertility or chemotherapy for cancer. Emotional issues of not being able to have children and feeling less attractive require frank talks to boost the person's confidence and increase self-worthiness.
It is easier said than done, but one of the key ways to handle premature menopause is an open discussion. In case you have a concern or query you can always consult an expert & get answers to your questions!

Opting for an abortion can often be immensely emotionally exhausting on your part. The emotional stress, guilt and confusion might become over bearing. To make this decision something you don’t regret, equip yourself with all the knowledge and help available.

Here are 5 of the top tips before choosing to terminate the life growing inside you:

1. Being certain about your pregnancy: It is critical to know that you are actually pregnant before proceeding with a surgical or medical abortion. Getting a test done from a reputed hospital is way more accurate than home tests which might not always be able to give you a correct reading. A sonogram is the best way to confirm your pregnancy.

2. Get an accurate idea: 1 out of every 5 pregnancies results in a miscarriage. Thus, getting all the information possible from a doctor helps you make an informed choice. You should be aware of all the consequences. At the same time, get facts, such as whether the foetus has a heartbeat, right. An ultrasound helps in determining this as well as whether the foetus is located in the uterus.

3. Know about your health: You should get yourself checked up thoroughly, primarily for any STD’s. Knowing whether or not you have an STD is important as abortion in a person with an STD increases the likelihood of complications and infection.

4. Legality: In India, abortion is illegal, as one of the main reasons for doing so is sex selective abortion wherein, the male child is preferred over the female. Certain provisions however, allow the termination of a foetus. If the pregnancy is up to 20 weeks and the birth would result in serious mental trauma or health complications for either mother or the unborn child, then an abortion is permissible. A trained government professional will be able to answer all your questions in regard to your choice of terminating the foetus. Sex determination of the foetus is illegal in India.

5. Get informed about the risks involved: Getting an abortion can be quite strenuous both physically and emotionally. It is a medical procedure that is irreversible in nature. There are multiple abortion options based on how far your pregnancy has progressed. Each of these procedures has side effects and medical risks involved. Often a counsellor or a psychologist is needed to provide support as women might become fragile or emotionally unstable after opting for an abortion. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

Infertility is a condition that refers to the inability to conceive, even after regularly having unprotected sex for a period of 6 months at least. In most cases, infertility may also refer to the biological inability of a person to contribute to the process of conception; or to a woman who is incapable of carrying a pregnancy to its full term.

There are several causes behind infertility; but taking the current lifestyle of the people into account, stress and a sedentary lifestyle are emerging as major factors behind this condition.

How do stress and sedentary lifestyle cause infertility?

1. Stress: Stress is turning into a major cause of infertility, esp. in women. A research carried out by Emory University observed 16 women between their mid 20s-30s, with normal weights for a period of 6 months to come to this conclusion. It found out that each of these women did not get their periods for the 6 months under observation due to high amounts of cortisol (stress hormone) in their body. Each of these women had really hectic work lifestyles, which indicated that women with stressful jobs are at a higher risk of experiencing infertility due to stress.

In fact, both the partners, when going through a period of stress, are unable to conceive. However, during periods when they felt good, their chances of having a baby increased dramatically.

2. A Sedentary Lifestyle: Again, more of a risk factor for women than men.
Amongst women, a sedentary lifestyle during teenage causes hormonal imbalance and anovulatory cycles more commonly seen in PCOD (polycystic ovarian disorder - the development of multiple small cysts in the ovary) patients, which is a major cause for infertility.

As for men, those with a sedentary lifestyle generally tend to be overweight or obese, which can lead to low sperm quality. This, in turn, can significantly reduce a couple’s chances of conceiving.

What can do you to prevent infertility?

1. Stay Active: Acupressure, regular exercising, daily brisk walking, practicing yoga and meditation are some of the ways by which you can alleviate the problem of infertility. Each of these activities help in improving the flow of blood to your reproductive organs, which helps in the release of toxins from the body. They also help in enhancing the movement of the pelvic region and in reducing any type of inflammation and pain in the area, thereby increasing your chances of conceiving. The added benefit of practicing these is a significant reduction in your stress levels.

2. Eat Right: Diet too plays a major role. Certain foods are known to boost your fertility, while maintaining proper hormonal balance and reducing the chances of miscarriage. Foods like cold water fish, raw dairy, eggs, tomatoes and dark leafy greens among others should be a part of your daily diet.

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

Surrogacy is the method that is used for reproduction in which a woman other than the woman, who wants to have the baby, agrees to undertake pregnancy and give birth to a child for the couple that appoints her. A couple can opt for surrogacy in the following conditions.

- Infertility
In the case of females who cannot reproduce due to infertility or some other medical conditions that make the process risky for both the mother and the childlike heart diseases, liver infirmities and high blood pressure, surrogacy can opt for so that the couple can experience the bliss of becoming parents.

- If you are a single parent
A single parent can opt for surrogacy in order to fulfil his/her dream of having a child to live for.

- Other factors
There are several other factors when a couple might want to opt for surrogacy. For instance, in couples, where the female is too busy building a stable career for herself and she cannot take the risk of opting for pregnancy, surrogacy can come to their rescue. Also, repeated miscarriages, pelvic disorder, hysterectomy, an impaired uterus or the absence of uterus can act as reasons to opt for surrogacy.

There are a few factors that need to be considered before opting for surrogacy. They are listed below.

Type of surrogacy

Traditional surrogacy and gestational surrogacy are the two options available. In traditional surrogacy, the surrogate mother not only carries the embryo in her womb until childbirth but also donates the egg. However in gestational surrogacy, the egg is taken from the biological mother and impregnated in the womb of the surrogate mother through in vitro fertilization techniques. The intended parents need to take a decision regarding the type of surrogacy that they wish to opt for.

Surrogacy laws

The intended parents must be aware of the surrogacy laws prevalent in their country so as to make sure that they can go through the entire process smoothly. For instance, in India, it is mandatory that the surrogate child should be biologically related to one of the two parents.

Cost of surrogacy

Another important factor that needs to be considered while opting for surrogacy is the cost of the undertaking. It can involve high costs due to the unpredictability of the situations surrounding the process, so the financial stability of the intended parents should be kept in mind. Also, choose the right agency or even if you choose an independent candidate to become the surrogate mother for your child, make a wise choice. If you wish to discuss about any specific problem, you can consult a Gynaecologist.