No Baby Blues

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It’s difficult to believe but true that despite our 1.2 billion  population in India, many of our young adults have difficulty in producing children. They may be called “sterile, infertile or sub fertile”. But before a couple is labelled “infertile”, they should have had at least 12 months of regular contraception-free intercourse.

Worldwide, infertility affects 7-10 per cent of the population. Although women actually produce the babies, if the reasons for the infertility are investigated the woman is at fault in a third of the cases; in a third it is the man and in the remainder either both are responsible or no real cause can be found.

Before embarking on a planned pregnancy, the woman should have had immunisations for measles, mumps rubella (MMR) and hepatitis B (3 doses). She should also start folic acid supplements (5mg/day). Children born with physical or mental defects because these basic facts were forgotten are a human tragedy. Both partners need to keep their body mass index (BMI, or weight in kilograms divided by height in metre squared) at around 23 and be physically active for around 40 minutes a day. They also need to treat any existing underlying disease like diabetes, high blood pressure or thyroid problems.

Studies show that caffeine (found in tea, coffee and cola drinks) affects fertility. Women who drink alcohol can produce babies with “foetal alcohol syndrome”. It also reduces the sperm count in men. Smoking affects the quality of the sperms and inhaled passive smoke is bad for the growing baby. Sperm counts may be reduced by inhaling hazardous chemicals in the work place or by working in high temperatures.

Women ovulate cyclically and the egg is released 14 days before the next period. For a woman to conceive, intercourse must take place around this time and the sperm count must be optimal. Initially, if a menstrual calendar is maintained, the fertile days can be calculated. A semen analysis for sperm count is a non-invasive simple test. Also, after intercourse lie down, don’t douche, and avoid lubricants and cleansing agents.

If these simple methods fail in a couple where the woman menstruates regularly and the man has a normal sperm count, a visit to a reproductive medical unit is warranted. Further investigations to establish the patency of the tubes and quality of the sperm may be needed. Depending on the problem, medication or surgical correction of a specific defect may be needed.

Conservative medical treatments are usually tried for periods varying from 6 months to a year. If they fail, assisted reproductive technology (ART) techniques are started.

In IUI (intrauterine insemination) the woman is scanned during her most fertile period to determine ovulation. Healthy treated sperms from her partner are then inserted into the uterus. The technique is used when the sperm count is low, the motility unsatisfactory or if donor sperm is being used.

In GIFT (gamete intra-fallopian transfer), eggs and sperms are collected, mixed and then placed in the woman’s fallopian tube. Fertilisation takes place naturally in the body.

In IVF (in vitro fertilisation) the eggs are harvested and fertilised with sperm in the laboratory. The resulting embryos are then placed in the uterus. This is used in cases where the fallopian tubes are blocked, the fertility unexplained or when several attempts with the other forms of ART have failed. It can result in multiple pregnancies. Some clinics offer “natural cycle IVF”. This involves collecting and fertilising the one egg released during the normal monthly cycle. It avoids the side effects of fertility drugs and multiple pregnancies are less likely.

In ICSI (intracytoplasmic sperm injection) a single sperm is injected into the centre of an egg. This is used when the male partner has a very low sperm count or if other problems with the sperm have been identified.

Donor eggs from other women can be used if the woman has no eggs of her own, or if she is over 40 and the eggs are of poor quality. Sperm from donors can be used if the husband has a low count (oligospermia) or no sperms (azoospermia). Surrogate mothers can be hired to carry the baby to term.

There is no right time to seek medical help, but if sexual intercourse at least three times a week without contraception for a year has been unsuccessful, it is probably time for proactive action. If, however, the woman has periods at intervals less than 21 days or more than 90 days, the flow is unpredictable (if it starts it does not stop and if it stops it does not start) or if there has been pelvic infection in the past, an evaluation should be done at the earliest. In men, if the testes are not felt in the scrotum, or there is a hydrocoele (swelling) or a past prostate infection, investigation and treatment should be started sooner.

Sources:The Telegraph (Kolkata,India)

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Ailmemts & Remedies

Breast Pain

Breast pain is an extremely common problem. In most women, the pain is cyclical, varying in severity in response to the hormonal changes of the menstrual cycle. This cyclical pain is usually most severe before menstrual periods and tends to affect both breasts.

Breast pain (mastalgia) is a common type of discomfort among women  affecting 70 percent of women at some point in their lives.

Breast pain occurs more frequently in younger, premenopausal women, although women who are postmenopausal can experience breast pain, too. About one in 10 women experiences moderate to severe breast pain more than five days a month. In some cases, women have severe breast pain that lasts throughout their entire menstrual cycles. This can have a major impact on daily activities, such as work, family relations and sexual relationships.

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Breast pain alone rarely signifies breast cancer. Still, if you have unexplained breast pain that’s causing you to worry about breast cancer or otherwise disrupting your life, get checked by your doctor.

Cyclical breast pain affects as many as 1 in 2 women and is commonly a chronic problem. In some women, the pain is severe. Women who experience cyclical breast pain often also have generalized breast lumpiness, Which tends to become worse before a menstrual period. The pain may be aggravated by stress and by caffeine in certain drinks.

In some women, breast pain is not related to menstruation. muscle strain may result in noncyclical breast pain. rarely, pain is caused by a breast cyst or breast cancer. Breast pain may also be due to an acute problem, such as an infection that causes inflammation of the breast tissue or engorgement of the breast with milk after childbirth. sometimes, the cause of breast pain is not known. If you have large breasts, you are more likely to suffer from both cyclical and noncyclical breast pain.

What might the doctor do?
Your doctor will ask you about your breast pain to see if there is a pattern. He or she will examine your breasts to look for an underlying cause, such as a breast cyst or any tender areas in the surrounding muscles. If it is apparent from the consultation and examination that you do not have an underlying disorder, your doctor may ask you to keep a record of when you experience breast pain to help confirm that the pain is cyclical. If your doctor suspects that an underlying disorder may be causing the pain, he or she will probably arrange for mammography or ultrasound scanning in order to detect abnormalities in the breast.

Mild cyclical pain does not normally require treatment. however, in about 1 in 10 women, the pain is so severe that it can interfere with everyday life. Taking large doses of evening primrose oil has been reported to reduce the response of the breast tissue to female sex hormones. however, if this treatment is ineffective or the pain is severe, your doctor may prescribe danazol, a drug that reduces the effects of female sex hormones acting on the breast. Although this drug is effective in relieving pain, it may have side effects such as acne and weight gain. cyclical breast pain tends to ease after menopause. if you take hormone replacement therapy, the pain may continue after menopause, but it often improves after a few months.

If your breast pain is non- cyclical, the cause will be treated if necessary. Cysts are usually drained and antibiotics can be used to treat infection. Nonsteroidal anti-inflammatory drugs may help relieve muscle pain.

What can be done?
Breast pain may be eased by wearing a bra that supports your breasts properly. If your breasts are heavy and the pain is severe, you may need to wear a bra at night. Cyclical pain may be relieved by cutting down on caffeine, practicing relaxation exercises to help control stress, and trying to lose weight to reduce the size of the breasts. Some women find that taking vitamin e supplements is also helpful, but this effect is not supported by scientific studies.

How the breast pain is normally treated?
There are different treatments for breast pain depending on what is causing it. You and your doctor can talk about these treatments and choose one or more that might work for you. Here are some possible treatments for breast pain:
*Wearing a support bra
*Taking an over-the-counter pain medicine
*Taking danazol (brand name: Danocrine) — for severe pain
Other treatments for breast pain are sometimes used. However, there is no proof that these treatments work:
*Avoiding caffeine
*Using less salt
*Taking vitamin E or vitamin B6
*Taking a “water-pill” (a diuretic)
*Most of the time, breast pain goes away on its own after a few months.

Click to learn more about Breast Pain

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.