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Health Problems & Solutions

Not to Get Pregnant

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I have done something wrong,” said the young woman. No, it was not theft or murder she was confessing to but unprotected sex. An unguarded passionate moment with her boyfriend had made her pregnant. She was terrified of the stigma — the boyfriend was still a student, there was no way they could get married right away.
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This is quite a common scenario in urban as well as rural India. Women increasingly face the problems of unplanned and unwanted pregnancies. It’s most important that they know how to take care of themselves, married or single.

First, women need to be in control of their bodies, especially when it comes to sexual intercourse, pregnancy and childbirth. Many safe women-oriented contraceptive methods are available.

Women become pregnant only on certain days of the month. The ovum or egg of a fertile woman is released 14 days before her next period. The egg survives 12 to 24 hours after release and the sperm for up to 72 hours. Couples may refrain from intercourse on these days if they wish to avoid pregnancy. This method, however, is not reliable as many women do not menstruate with clockwork precision.

Women may use contraceptive creams containing nonoxynol-9 in the vagina. These substances increase the effectiveness of the safe period. They are effective for about an hour. But they do not suit everyone and may cause vaginal irritation or allergic reactions. They are available in pharmacies without a prescription.

Diaphragms can be inserted prior to intercourse. These come in various sizes and need to be combined with a spermicide. An initial medical examination is needed to confirm the size. The device has to be left in the vagina for eight to 12 hours after intercourse but should be removed within 24 hours.

Women can also opt for an intrauterine contraceptive device (IUCD), popularly known as a “copper T”. These need to be inserted by a medical professional. They can work for three, five or 10 years, depending on the type and manufacturer’s recommendations. Imported devices can be purchased from the pharmacy. Also, free IUCDs are distributed by the government.

“Depo” injections of long-acting progesterone are available
. A woman needs to have an injection every 12 weeks. They can cause weight gain, irregular cycles, breakthrough bleeding or spotting. The irregular periods can raise the spectre of an unwanted pregnancy.

Oral contraceptive pills (OCP) prevent pregnancy if taken regularly.
There are combination pills containing estrogen and progesterone with different trade names. They are also provided free by the government (Mala D). The active ingredient is given for 21 days. Then there is a pill-free interval of seven days after which the next lot needs to be started. Sometimes placebo pills are administered during the pill-free period. They prevent pregnancy as well as regularise the cycle. They do not increase the risk of cancer.

Breast feeding women can opt for “progesterone only” pills. These are taken without a pill-free interval.

There’s a new contraceptive in the market — a plastic ring impregnated with estrogen and progesterone. The ring needs to be inserted in the vagina and left there for three weeks followed by a one week ring-free interval. A woman can purchase and insert the ring herself. An advantage of this over the pill is that the question of forgetting the latter does not arise.

Condoms can be used by the male partner. These have to be used from the beginning to the end of intercourse, and can be combined with a spermicidal cream.

Casual sex and multiple partners can result in sexually transmitted diseases. Some like Hepatitis B and HIV can eventually be fatal. Only condoms can prevent these diseases.

Even if you have had unplanned and unprotected sex, you can use emergency contraception (morning after) pills. Although theoretically these pills should be dispensed only by prescription, in many places they are available over the counter (OTC). The tablet should be taken after intercourse as soon as possible. It is 80 per cent effective if taken within 72 hours.

The morning after pill contains either progesterone or a combination of estrogen and progesterone in higher doses than in the 21 or 28-day packs of OCPs. An alternative is to take four low-dose or two “standard-dose” OCPs, and then take an equal dose 12 hours later.

If an unwanted pregnancy occurs, do not buy medicine OTC or rush to an unqualified quack out of shame or fear. Medical abortion pills are available and effective. They work up to the 49th day after the last period.

The last two are stopgap emergency measures. They are not to be considered regular methods of contraception. They are detrimental to health if repeatedly used.

Source : The Teleghraph ( Kolkata, India)

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Health Problems & Solutions

Some Health Quaries & Answers

Storm in a teacup

Q: I have a ceramic mug that I bought from a street vendor. When I drink tea out of it I get a taste of clay

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A: Try drinking the beverage through a straw. If you can still taste the ceramic, discard the mug. Hot liquids can dissolve some of the clay and glaze. Some of these may be contaminated with dangerous heavy metals like lead. This is particularly true of poor quality stuff.

Breast-feeding & contraception

Q: I am breast feeding my four-month baby and want to use some safe and reliable form of contraception. I do not like the idea of an intrauterine contraceptive device.

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A: You could ask your husband to use condoms from the beginning to the end of intercourse. If this does not appeal to both of you, or is not feasible, you can opt for progesterone injections. They are sold under the trade name Depo Provera. The injection has to be given every 12 weeks under medical supervision. Another option is “progesterone only” pills, the trade name of which is Cerazette. Unlike conventional oral contraceptive pills, these have to be taken every day. Both the injections and tablets can cause irregular menstruation. After one year (when you stop breast-feeding), you can switch to oral contraceptive pills.

Frequent itching

Q: I have recurrent itching in my vagina and it has been diagnosed as a yeast infection. Despite repeated treatment it comes back.

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A: Recurrent infection is likely to occur if the normal vaginal Ph changes. This occurs if the normal bacterial flora of the vagina changes. This can occur during pregnancy, diabetes, urinary tract infection, with the use of oral contraceptive pills or antibiotics. Vaginal douching or washing with too much soap can also cause a similar problem. Treatment is with medications like fluconazole (tablet) or clotrimazole (vaginal pessaries and creams).

Relapses are common as the organism is now becoming increasingly resistant to the common medication. Unless the underlying cause is treated, relapses will occur. Relapses can also occur if your partner has diabetes which is not very well controlled.

Sleepless nights

Q: I am 64 years old and have difficulty sleeping at night. I started taking alprazolam 0.25 mg at night. Now I find that even with 0.5 mg I do not get any sleep.

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A: Alprazolam can be addictive if used as an over-the-counter (OTC) drug without medical supervision. Eventually higher doses may be needed for the same quality of sleep. It can also cause dizziness and loss of balance, particularly if you suddenly get up in the night. Other less addictive prescription medicines are available. Your doctor will be able to prescribe medication to help you sleep that will not react with any of the other medication that you might be taking for other illnesses like diabetes or hypertension. It is better to avoid “sleeping pills” altogether as far as possible. Try —

· Not sleeping in the daytime

· Exercising in the morning and evening

· Drinking a glass of warm milk at night.

Heat boils

Q: I have developed boils on my legs. They are painful and pus comes out if I squeeze them. I have this problem every summer. I am not diabetic.

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A: Our skin has a number of harmless commensal bacteria living on it. If small cuts and breaks occur in the skin as a result of scratching, these bacteria can enter the body and produce superficial boils. You need to keep your skin clean by bathing twice a day. Use a germicidal soap like Neko which is bactericidal. Apply the soap using a loofah or plastic scrubber. Avoid using talcum powder. Apply an antiseptic skin ointment (without steroids) like Neosporin or Soframycin on the boils after a bath. Do not break or squeeze the boils. If you develop fever consult a physician.

Lower testes

Q: My right testes appears to be larger than the left one.

A: The two halves of the body are not same. There may even be differences between your right hand and the left one. In most people the right testicle not only hangs lower but may also be larger. As long as there are no lumps or pain, you can leave it alone. If you are really worried, do an ultrasound scan to make sure there is no hernia or hydrocoele.

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Nan or Lactogen?

Q: My son is nine months old. Should I give him Nan or Lactogen?

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A: Children should be weaned on to solid foods after six months. Substituting tinned milk for breast milk is not the answer. They can be started on soft home-cooked solids such as cooked rice, dal and vegetables like potato. Eventually, by the age of one, they should be on the same diet as the family. Tinned precooked cereals and biscuits should be avoided.

 

Source: The Telegraph (Kolkata,India)

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