Wednesday, August 6, 2008

Contraceptive Pills (OC Pills)

Combined Oral Contraceptive Pill

The pill works mainly by changing the body's hormone balance so that a woman does not ovulate (do not release an egg each month). In addition, it causes the mucus made by the cervix to thicken. This makes it difficult for sperm to enter the uterus (womb) to fertilize an egg. The pill also makes the lining of the uterus thinner so that fertilized egg does not attach to the womb.

Advantages
- It is over 99% effective if used correctly
- Does not interfere with sex.
- Periods are often lighter, less painful, and more regular.
- May relieve pre-menstrual tension.
- Helps to protect against some benign (non cancerous) breast disease.
- Reduces the risk of developing certain types of cyst in the ovary.
- Reduces the risk of developing cancers of the ovary and uterus (womb).
- Reduces the risk of pelvic infection (as the 'mucus plug' may prevent bacteria as well as sperm getting into the uterus).

Disadvantages/ Side effects

Most women who take the pill do not develop any side effects. For most women the benefits far outweigh the disadvantages, as the risks are small.
Some women develop nausea headaches, or sore breasts. These usually go away within days or weeks of starting the pill.
Uncommon side effects include: tiredness, change in sex drive, skin changes, and mood changes.
Sometimes causes a rise in blood pressure.
Breastfeeding women should not take the pill as it can reduce the amount of milk.
Small increased risk of breast cancer in women who use the pill.
The risk of thrombosis (blood clot in the blood vessel) is more in women in the following situations:
- Previous history of thrombosis
- Severe obesity
- Immobility (e.g. wheelchair bound)
- Severe varicose veins
- Poorly controlled diabetes
- High blood pressure
- Close family member who has had a thrombosis, heart attack, or stroke before the age of 45
- Severe migraine
- Smoking - particularly if woman is over 35

Method of taking pills

There are different brands of pill, which contain varying amounts and types of estrogen and progestogen. The following gives a general guideline.

Brands with 21-day pills
Take the first pill on the first day of next period. A woman will be protected against pregnancy from then on. Take the pill at about the same time each day for the 21 days. Then have a break of seven days before starting next pack. A Woman will usually have some bleeding (like a period) in the seven-day break. Woman will be protected from pregnancy during the seven-day break provided she has taken pills correctly. Start the next pack on time. Start the next pack after the seven-day break whether still bleeding or not. If the pill is taken correctly, first pill of each pack will be on the same day of the week.

Brands with everyday pills (28 day pills)
These contain 21 active and seven 'dummy' pills. Instead of a seven-day break, carry on taking the dummy pills. The idea is to get in a routine of taking a pill everyday. The pills have to be taken in the correct order.

Precautions/ Additional information
- Missing or forgetting to take one or more pills Ovulation (and therefore pregnancy) may occur if the pills are missed, particularly if the missed pills are at the end or beginning of the packet. If unsure the pills are taken correctly, then use other forms of contraception (such as condoms) and seek advice from a doctor.
- Interference of other medicines with the pill
Some medicines may interfere with the pill. In particular, many types of antibiotics can stop the pill from working properly. In short - before taking any other medicines, ask your doctor whether they stop the pill from working properly.
- Vomiting or Diarrhoea
If vomiting occurs within 2-3 hours of taking a pill, the pill will not get absorbed. Take another pill as soon as possible. If vomiting continues even after taking the second pill, then it is the same as 'missing pills'
- Mild diarrhoea does not affect the absorption of the pill. Very severe diarrhoea may do so; consider this as the same as 'missing pills'
- No Period
It is normal to have period like bleeding during the seven-day break between pill packs (or during the dummy pills everyday pills. However, there may not be any bleeding between pill packs. In such a situation start the next pack after the usual seven-day break and continue to take pill as usual. Consult doctor if no bleeding occurs after the next pack (two packs in total). A pregnancy test may be advised.
- Bleeding whilst on the pill (breakthrough bleeding)
During the first few months woman may have some vaginal bleeding in addition to the usual bleeding between packs. This is not serious. It may vary from 'spotting' to a heavier loss like a light period. Do not stop taking pill. This problem settles after the first 2-3 months. If it persists, see your doctor.

Artificial Insemination (AI)

About Artificial Insemination(AI)

Artificial insemination is a simple and inexpensive medical procedure, commonly used in the treatment of infertility. AI is just one of those options that may be considered prior to attempting more involved treatments, such as IVF.It refers to the technique that involves placement of the sperm into the female reproductive tract by artificial means. In majority of the cases, the husband's sperm is used.
Advanced techniques like IVF; ICSI or donor insemination might have to be considered in some cases where the attempts are not fruitful.
The technique has also been used in animals for breeding purposes to improve productivity of milk and beef.

Indications For Artificial Insemination

Male Partner :
1.Inability to ejaculate into the vagina.
2.This can occur in a number of clinical conditions such as diabetes and multiple sclerosis.
3.Trauma or injury to the spinal cord following a road traffic accident.
4.Retrograde ejaculation.
5.A condition where the sperms enter the urinary bladder rather than coming down the male urethra. This can be caused due to diseases like diabetes.
6.It can also result from an operation or surgery that destroys the value that prevents the backflow of sperms into the urethra.
7.Less commonly it can be the result of some drugs used for treatment purposes.
8.Men with sperm count lower than that required for successful fertilization.
9.Men with poor quality sperms that poses difficulties with fertilization.
10.Mechanical difficulties with intercourse (Structural abnormalities of the penis owing to trauma or injury).

Types of Artificial Insemination

1.Intracervical insemination :The sperm is injected into the cervix, located at the opening of the uterus .
2. Intrauterine insemination (IUI):The sperm is injected into the uterus.
3. Intrafollicular insemination:The sperm is injected into the ovarian follicle
4. Intratubal insemination:The sperm is injected into the Fallopian tubes

The type of infertility will determine the site of injection of the sperm into the reproductive tract.

Sunday, April 6, 2008

Loss of Menses

Amenorrhea
Two types - primary and secondary amenorrhea

1. Primary amenorrhea: Period does not start even after attaining the age of 16 years.
2. Secondary amenorrhea: Period starts at normal age but stops afterwards.

Amenorrhea is normal only before puberty, during pregnancy, while breastfeeding, and after menopause.

Causes of primary amenorrhea:

Ø Birth defect in development of uterus or fallopian tubes
Ø Genetic disorder
Ø Problems with one of the three organs - the hypothalamus part of the brain, thyroid gland and pituitary gland
Ø Anorexia nervosa (lack of appetite)
Causes of secondary amenorrhea:

Ø Problems with the hypothalamus, pituitary gland, thyroid gland, adrenal glands, ovaries, or other parts of the reproductive system.
Ø Hormonal abnormalities
Ø Stress induced hormonal imbalance
Ø Heavy exercise
Ø Tumor in the reproductive system
Ø Scars on the inside wall/ lining of the uterus after surgery or any other infection
Secondary symptoms of amenorrhea may exist from time to time. But they are very individualized.

Diagnosis:

Primary amenorrhea – Periods have not started by age of 16
Secondary amenorrhea - No menstruation in adult women for last 3 months except pregnancy, breastfeeding and menopause.

Confirmatory tests:

Hormone levels in the blood
Diagnosis for a pituitary tumor by x-ray
Ultrasonography for possible tumors in the ovary or adrenal glands.

Amenorrhea is an abnormality. It is advisable to visit the doctor at the very beginning so that any other complications do not get aggravated.

Abortion

Abortion or, MTP
MTP stands for Medical Termination of Pregnancy)

Methods used:

Surgical Method (surgical evacuation)
Medical Method (using drugs)

Which method to use depends on length of pregnancy and related complications.

Surgical evacuation of the uterus is the most commonly employed method of abortion (more than 90% of cases).

For 7 – 12 weeks: It is called suction and curettage. A flexible tube is inserted into the uterus by forced opening of the cervix. Using suction pumps and forceps the fetus and the placenta are removed. Mild scraping of the wall of the uterus is the last step.
However, for pregnancies of more than 18 weeks, dilation and evacuation can cause serious complications.

Medical Method (using drugs)
For less than 7 weeks: At this stage suction & curettage can be performed but the chances of continuation of pregnancy increases as the fetus is very small & may be missed during currettage.
Drug M (actual name not disclosed) and Drug P are the two drugs used. They are given orally or vaginally. Drug M blocks progesterone hormone from providing the shield necessary for continuation of pregnancy. Drug P stimulates contraction of the uterus. This combination of drugs causes abortion in about 95% of cases. Drug method is generally used for pregnancy less than 7 weeks old.

For Pregnancies more than 12 Weeks:

This is called second trimester abortion. This requires opinion of two Gynaecologists.

Drug P is used in higher doses. It is given orally or vaginally. Drug P stimulates contraction of the uterus.Once the baby and placenta are out a gentle curettage is done to ensure all the products of conception are removed.


Investigations to be done before MTP:
Hb,Cbc
Blood Group
Urine - Routine & Microscopy
Ultrasonography (to rule out abnormal & ectopic pregnancies)
Complications arising out of an abortion depend on length of the pregnancy and the method used. In general, longer the pregnancy, greater is the risk. In general drug method is riskier than the surgical evacuation. Abortion must be done at authorized clinics and hospitals. This is a very sensitive surgery. It should be done by a qualified Gynaecologist only.

Sunday, March 30, 2008

Exercises in Pregnancy

Yoga Asanas or exercises are ways of moving or holding the body in different positions.
Yoga has several exercises or postures that work wonders on a woman’s health and in pregnancy conditions. Varying widely in application and style, these exercises (postures) gently stretch and explore all parts of your body.
During pregnancy, yoga Asanas are a gentle way to keep active and supple. The remarkable effects of these postures in pregnancy show the power of yoga for ensuring a smooth pregnancy, natural childbirth and restoration of body shape after childbirth.

How Pregnancy Yoga Exercises Can Help?

Relieving edema (fluid retention) and cramping which can be quite common in the last months.
Influencing the position of the baby and turning it in advance if needed. Strengthening and massaging the abdomen which help stimulate bowel action and appetite.
Raising the level of energy while also helping in slowing the metabolism to restore calm and focus.
Helping to reduce nausea, morning sickness and mood swings in combination with pranayamas (yogic breathing).
Focus on relieving tension around the cervix and birth canal.
Focus on opening the pelvis to make labor easier and quicker.

How Yoga Can Help in Post Natal Care ?

Restoring the uterus, abdomen and the pelvic floor.
Relieving upper back tension and breast discomfort.

For Details:
http://jayshreeclinics.googlepages.com/
http://acnetreatment4girls.googlepages.com/

Intimate Hygiene for Girls

As a young girl, you were the centre of your parent’s universe. The growing-up years made you discover yourself –your talents, your likes & dislikes & your friends. Gradually, the pains of growing up made up for the pleasures and praise you received when you did well at something. You were blossoming into a young lady, full of dreams and desire. Life seemed so full of potential.
Along the way, you developed your own beauty and hygiene habits while coping with the emotional, mental and physical stresses that challenged you. But you know being a woman has never really been easy…PMS, the uncomfortable days of the week, the heartbreaks, the disappointments, the cold feet before marriage… and to top it all that feeling of discomfort in the private places of your being… never an answer to decidedly determine the cause for the discomfort.
As today’s women life at home and work keeps you so busy that you tend to neglect your own health and hygiene at times.
Ascribing to the saying fashion cannot be avoided, Hygiene cannot be neglected, a woman should be prudent in tending to her hygiene especially in the intimate area.
I attempt to introduce you to the refreshing concept of Intimate Hygiene, one every women should know & follow for her own comfort, to enhance her own confidence. Only because she is the centre of her family’s universe and her own.
Puberty can be defined as a girl’s journey towards womanhood. She blossoms from being a girl child into a woman. She notices changes inside and outside her body. Puberty can being as early as 10Yrs or as late as 16 Yrs. The average age, however, is 13 Yrs. This is the time when she gains height, develops breasts, internal reproductive organs, body shape, hair growth is seen and there is onset of menstruation.
Important to young girl’s health at this point of time is intimate hygiene and orienting her into its ways.
Cleaning Habits:
The Intimate area of women is extremely delicate and susceptible to infection if proper hygiene is not maintained. Because of the close proximity of the vagina to the rectum there are greater chances of infection as sometimes cleaning the wrong way or with wrong cleansers can do more harm than good.
The golden rule in cleaning your intimate area is front to back. By this we mean that after urination or bowel movement, you should wash & wipe the area from front to back. This prevents bacteria from moving from the rectal area to the vagina.
During Menstruation:
Ø Maintenance of Hygiene is very important during menstruation. Sanitary napkins should ideally be made of cotton lining.
Ø Avoid the nylon lined ones or those that are heavily deodorized. This tends to cause allergies which could lead to rash/swelling/itching.
Ø Change your sanitary napkin as often as required.
Ø Keeping the vulval area clean and dry is very important.
Antiseptic Liquids:
· Washing your intimate area with antiseptic liquids can only irritate the area causing a burning sensation.
· Some women believe that washing undergarments with antiseptic liquids helps in hygiene, little realizing that if the antiseptic is not washed properly, its residue could cause allergy.
Soaps:
· There is a misguided notion that using excessive soap in the intimate area will keep it clean. Instead, soaps are considered harsh for this delicate area, causing dryness and discomfort.
Tissue Paper:
· Many women tend to use wet, fragrance tissue as they feel this will dispel bad odor. Tissue paper either treated with chemicals or strong fragrance if used indiscriminately can cause infection in the perineal area.
Swimming:
· It is common knowledge that swimming pools are treated with chlorine and not cleansed on a regular basis. This makes it very vital that you take shower post swimming and wash the perineal area thoroughly to avert any infection.
Aroma Therapy:
· Many women like to treat themselves to this. But the fact is that unclean massage tables and some aroma oils themselves are breeding grounds for allergy and infections.
Pre & Post intercourse:
· Always wash your intimate area before & after intercourse to avoid infections. It is extremely important for you and your partner.

For details

http://jayshreeclinics.googlepages.com/

http://acnetreatment4girls.googlepages.com/