INFERTILITY

Infertility – difficulty in conceiving a pregnancy. A couple is said to have infertility if the women is not able to conceive for a year without using any birth control methods. 15- 20% of couples will not conceive despite a year of trying. However, this does not mean that these couples won’t conceive later on. Some experts and physicians believe that a time period of 2 years without conception is a better indicator for infertility and they should seek assistance.

Sterility- When an individual has no chance to conceive even with treatment (for example: a female does not ovulate or has two blocked fallopian tubes).

 

WHEN IS THE WOMAN MOST FERTILE??

• A women most fertile period is during ovulation. Ovulation typically occurs on day 11 through day 21 of woman’s cycle.

There are many questions which arise in couples mind when they discover that one of the partner or both are infertile and cannot conceive. Some of them are:

1. 1.       Is infertility a male or a female problem?

–          In early days people used to believe that only females are responsible for a couple being infertile. But recent studies show that it is equally seen both in females and males. 40% of males and 40% of females are seen to be infertile. Other 10% both the partners are infertile and rest of the 10% no cause is known even after testing. So it is always important to test man and woman rather than just blaming one of the partners. No matter what the cause is, these treatments require the active participation of both the partners.

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1. 2.       Is secondary infertility more common than primary?

–          Yes, secondary infertility means if a couple gets a baby for the first time there is a possibility that they face difficulty conceiving the second time. The reason could be infection, damage to the reproductive organs while giving birth to the first child. Sometimes the aging process also is to be blamed at when it comes to second baby though they dint face any trouble in their first baby. Secondary infertility is much more common than primary infertility. Overall, treatment in females with secondary infertility is to work much better than primary infertility.

 

CAUSES OF INFERTILITY:

1 FEMALE INFERTILITY: It involves conditions like:

• Endometriosis (uterine lining which is shed every month grows outside the uterus and forms major cause of infertility in woman.

Symptoms: painful menstrual periods, irregular or heavy bleeding, repeated miscarriages. Solution: laparoscopic surgeries and assisted conception treatment

• Ovulation problems:

Symptoms: absent or irregular bleeding and excessively heavy or light bleeding.

Solution: ovulation stimulating drugs

• Poor egg quality:

No symptoms

 Solution: surrogacy

• Polycystic ovary syndrome:

Symptoms: irregular menstrual periods, excessive hair growth, weight gain

 Solution: ovulation stimulating drugs

• Female tube blockages:

No symptoms

Solution: laparoscopic surgeries or in vitro fertilization (IVF).

 

1. 2.       MALE INFERTILITY: It involves conditions like:

 

•   Male tube blockages: caused by Sexually Transmitted Diseases and cause infection like Chlamydia or Gonorrhea, varicocele (varicose veins in the testicles), any obstruction in the vas deferens (the tubes that transport fertile sperm).

Solution: Surgery to repair varicocele

• Sperm problems: Low or no sperm count, poor motility of sperm, abnormal shaped sperm cell

Solution: Fertility drugs, artificial insemination

• Sperm allergy: about 10% of infertile men and women have immune reactions to sperm which cause them to produce antibodies that kills the sperm cells. In men, this is most commonly seen after vasectomy (removal of vas deferens).

Solution: Sperm washing and intrauterine insemination and assisted contraception methods.

 

1. 3.       UNEXPLAINED INFERTILITY:

 

Some experts believe that being overweight, underweight, exercising excessively and also environmental toxins are responsible for an unexplained infertility but no direct links have been confirmed.

Solution: Fertility drugs and IVF

 

1. 4.       COMBINATION INFERTILITY:

 

Both male and female infertility and when one of the partners is more infertile than the other.

 

 

HOW COMMON IS INFERTILITY???

• Infertility is a growing issue for many couples. It affects around 10% of the American couples of childbearing age.
• The current increase in infertility might be the result of women choosing to delay in starting a family
• The increase of STD’s such as Chlamydia can lead to female tube blockages preventing pregnancy to occur.

 

WHAT INCREASES A MAN’S RISK OF INFERTILITY??

A man’s sperm can be changed by his overall lifestyle. Some things that may actually reduce or affect the sperm count.

1. Heavy alcohol use
2. Drugs
3. Excessive smoking
4. Age
5. Environment toxins like pesticides and even lead
6. Health problems like kidney diseases, mumps
7. Radiation treatment and chemotherapy for cancer.

WHAT INCREASES A WOMAN’S RISK OF INFERTILITY??

1. Age
2. Smoking
3. Excessive alcohol use
4. Stress
5. Poor diet
6. Being overweight or underweight
7. Sexually transmitted infections
8. Athletic training
9. Hormonal problems like polycystic ovary syndrome and primary ovarian insufficiency.

WHEN SHOULD ONE SEEK DOCTOR??

–          Lots of pain during your menstrual period or intercourse

–          Abnormal menstrual cycle ( less than 21 days or more than 35 days from the first day of one cycle to the first day of the next)

–          Troubled by acne, excessive facial hair growth and weight gain

–          Have had fallopian tube infection

–          Have had surgery of reproductive organs

–          Have had more than one miscarriage

–          Your partner has an abnormal sperm analysis

TREATMENT:

–          Fertility treatments can increase the likelihood of getting pregnant

–          Treatments would include lifestyle changes, supplements, medications, surgery, or assisted reproduction

–          Many treatments come under assisted reproduction like Invitrofertilization (IVF), Gameteintrafallopian transfer (GIFT) and Zygote intrafallopian tube transfer (ZIFT). All these procedures involve harvesting a number of eggs in the hope of fertilizing 1 egg, and then insert the fertilized egg into the uterus.

I would elaborate on the treatments as my next topic….

 

 

 

 

 

ANEMIA- STOP FOLLOWING ME!!!!!

Most of the population in this world believes that vegetarians are among the anemic ones. So I would like to correct my friends that it’s not about being a vegetarian or non vegetarian but its about the diet one follows. A vegetarian person equally takes those nutrients like cheese, milk, spinach, soya but the only difference is that they don’t eat meat. It’s always better to take precautions when it becomes to illness, so as vegetarians have higher susceptibility for developing anemia then they should improve their diet and if required additional supplements.

Anemia- a much known blood condition especially among females. Anemia is basically decrease in number of red blood cells (RBC’s) or less than the normal quantity of hemoglobin in the blood. Hemoglobin is a protein (metalloprotein) found inside RBC’s that contains iron and transports oxygen.  Normally hemoglobin (found inside RBC’s) carries oxygen from the lungs to the capillaries but in the case of anemia hemoglobin lacks oxygen (hypoxia) in organs. Since all human cells are dependent on oxygen for survival, varying degrees of anemia can have different clinical consequences. The most common symptom of anemia like fatigue occurs because the organs don’t receive enough oxygen to function.

Anemia is the most common blood condition in the U.S. Approximately 3.5 million Americans are affected with it. Women and people with chronic diseases are at greater risk of anemia.

 

CAUSES OF ANEMIA: Broadly classified into three groups

1. Anemia caused by blood loss: usually after a chronic (long term) bleeding. The patient gradually loses blood which means loss of RBC’s and hemoglobin. It can also occur with acute bleeding. Most common examples of chronic bleeding are:

–          Stomach ulcers ( break or discontinuity in the skin)

–          Hemorrhoids / piles

–          Gastritis (inflammation of the stomach)

–          Some medications like NSAID’s ( pain killers) taken over long period of time

–          Childbirth

–          Menorrhagia ( heavy periods in case of women) have a higher risk of developing anemia

–          Surgery

–          Trauma

–          Blood donations

 

1. Anemia caused by faulty or decreased RBC production: RBC’s lifespan is usually 120 days and then breaks down and is removed by spleen. Some conditions cause RBC’s to die too early. When this happens the bone marrow has to make more RBC’s than normal. If bone marrow fails in doing so caused by their early deaths, then the RBC count will start to fall leading RBC destruction (hemolysis). Following can cause hemolysis.

–      Immune reactions

–      Infections

–      Some medications

–      Poisons

 

1. Anemia caused by destruction of RBC’s: In this type of anemia either body doesn’t produce enough RBC’s or they may not work properly. Examples are:

–          Sickle cell anemia- An inherited disorder which makes the red cells crescent shaped.

–          Iron deficiency anemia- lack of iron is generally due to poor diet, blood loss or inability to absorb sufficient iron from blood. This type of anemia is most common in females of all age group (teenage girls, pregnant women).

–          Vitamin B12 deficiency- caused by poor diet. Seen mainly in old age women who don’t take sufficient vitamin B12, Vitamin C, folate, protein and red meat.

–          Bone marrow problems: like leukemia, rheumatoid arthritis

–          Some conditions like HIV,Crohn’s diseases and also malaria

 

SYMTOMS:

      Some common ones:

–          Fatigue (tiredness) a physical state

–          Lethargy (feeling of laziness, apathy) a mental state

–          Malaise

–          Dyspnea- shortness of breath

–          Poor concentration

–          Palpitations- irregular heart breathing

–          Sensitivity to cold temperatures

    Some rare ones but can occur:

–          Tinnitus (ringing in ears)

–          Sense of taste is effected

–          Headache

–          Dry and flaky nails

–          Ulcers in the corner of mouth

–          Pallor ( very pale looking)

–          Restless leg syndrome- more common among patients with iron deficiency anemia

 

DIAGNOSIS:

Your doctor will do the following:

–          Take your medical history

–          Perform physical examination

–          Blood tests: These will not only confirm the diagnosis of anemia but also give the underlying cause to it. Blood tests would include:

• Full blood count (FBC)
• Blood iron level and serum ferritin level
• Vitamin B12 and Folic acid level
• Special blood tests to detect rare causes of anemia

 

TREATMENT:

1. With iron deficiency anemia your doctor would recommend you to increase iron rich food in your diet and also start you on iron supplements which contains the ferrous form of iron which is easily absorbed by your body. While taking iron be cautious at certain times like:

–          Always consult your doctor before starting iron supplements. Because Iron overload can cause vomiting, diarrhea, headache fatigue, irritability and joint problems

–          Iron poisoning is the commonest poisoning seen in children so always to be kept away from children

–          Taking iron supplements along with food will prevent side effects like constipation, diarrhea, nausea and stomach pain.

–          Remember iron tablets change your stool color blackish brown.

1. Treat the underlying cause
2. With Vitamin B12 deficiency you should take enough supplements which contain Vitamin B12 like meat, liver, kidney, fish, milk, cheese, eggs. And if the deficiency is very much severe than vitamin b12 injections would help.

 

HOW TO PREVENT BEING ANEMIC???

–          If you are a vegetarian meet your doctor for a proper diet and also additional supplements to be considered

–          Ask your doctor if you should take vitamin C. Vitamin C makes your stomach more acidic and increases the absorption of iron

–          Decrease consumption of caffeinated products as these decrease the absorption of iron

–          Select iron fortified cereals and breads

 

 

 

 

 

Phobias – Lets Face IT!!!!!

Do you avoid taking a ride in elevators or highway roads?? Are you scared to go in public?? If you are suffering from any irrational fear because of an object or situation then you are probably suffering from phobia. Phobia is a kind of anxiety disorder in which the sufferer dreads of a situation, living creature, place or a thing. For some people even thinking of their phobia is immensely distressing.

A phobia develops when a person continuously avoids facing their object of fear. It is more serious than a simple fear. There are many kinds of phobias. But some phobias make an individual’s life difficult like agoraphobia (scared of public and going in social) and few phobias which don’t affect a individuals life like phobia of snakes. This phobia won’t do any harm to their daily life.

Sometimes the word phobia is mistaken as discrimination or prejudice rather than fear. Like homophobia, it is not an uncontrollable fear of homosexuals but a discrimination against them. Many old age people don’t like teenagers and youth which are called as ephebiphobia.

NORMAL FEAR AND PHOBIA?? IS IT ANY DIFFERENT??

It is a very natural to experience fear in dangerous dark situations. Fear is a human adaptive response activating the automatic flight or fight response.

  But with the phobias the whole thing is very much exaggerated. Like it is very normal to be afraid of a snarling Doberman but it is irrational to be afraid of a friendly cute poodle if you experiencing a dog phobia.

HOW COMMON ARE PHOBIAS???

In Industrial nations, phobias are the most common anxiety disorder. Over 50 million people in the US and 10 million people in the UK are thought to live with a phobia. They can affect people of any age, sex and socio economic status.

A much higher percentages of females suffer from phobia compared to males

Simple phobias generally start in early childhood and fade away by teens. Complex phobias generally start later on.

 

CAUSE OF PHOBIA:

Simple phobia usually develops in early childhood like 4 and 8 years of age. In few cases it might be due to an experience early in life. The trigger must be an unpleasant fearful experience which over the time developed into claustrophobia.

If one of the parents is phobic about any object then his kid is more likely to be phobic because they are learned fears from parents and it is not genetically inherited.

 

 COMMON TYPES OF PHOBIAS: Simple and Complex phobia

      These are the types of simple phobias:

1. Animal phobias: this includes fear of snakes (opidiophobia), fear of dogs (cynophobia), and fear of birds (ornithophobia).
2. Natural environment phobias: this includes fear of heights, fear of water, fear of dark and fear of storms
3. Situational phobias (triggered by a specific situation): this includes fear of flying, fear of enclosed spaces (claustrophobia), fear of tunnels, fear of driving
4. Blood Injection Injury phobia: This includes fear of blood, fear of injection, and fear of an injury.

Complex phobias:

These affect patients in a much more severe way compared to the simple phobias. Those who suffer from for example agoraphobia may have many other associated phobias as well like monophobia (fear of being left alone) or claustrophobia (fear of being trapped).

 

SOCIAL PHOBIA AND FEAR OF PUBLIC SPEAKING:

Social phobia also called as social anxiety disorder is a fear of social situations. This makes a person very self conscious of themselves and it is experienced by people who are afraid of humiliating themselves in front of others. Anxiety can be of how you look, how you present and how you talk with others.

This kind of phobia makes it difficult for the person to talk or present themselves in a huge crowd. Other fears associated with social phobia are taking exams, mingling with strangers, drinking in public and to be called on in class.

AGORAPHOBIA (fear of open spaces):

Basically it is a fear of an open space but now it is understood as a complication of panic attacks. These people try to avoid crowded places like shopping malls, conferences, gathering which makes a difficult escape.

SIGNS AND SYMPTOMS OF PHOBIA:

 

Typically the more you run away from fear, the more fearful you will tend to be. Your fear will also be higher if getting away is difficult.

Physical signs and symptoms of Phobia:

–          Difficulty breathing (breathlessness)

–          Pounding heart (palpitations)

–          Chest pain or tightness (angina)

–          Trembling or shaking

–          Feeling dizzy

–          Sweating

–          Hot or cold flashes

Emotional signs and symptoms of Phobia:

–          Feeling of anxiety

–          Fear of losing control or going crazy

–          Feeling like you are going to die

–          Feeling an intense need of help

 

WHEN TO CONSIDER TREATMENT??

–          It causes intense and disabling fear, anxiety and panic

–          You recognize that your fear is unreasonable and excessive

–          You avoid many situations and places because of phobia

–          You have had the phobia for more than 6 months

–          Your avoidance might cause significant distress in your daily life.

TIPS FOR PHOBIA TREATMENT:

TIP 1: Face your fears, one step at a time

TIP 2: Learn relaxation techniques like simple deep breathing exercises

TIP 3: Challenge negative thoughts

 

 

 

 

 

 

Premenstrual syndrome (PMS)- real or exaggerated????

Waking up every month with a cranky, depressed mood for nothing in particular. Premenstrual syndrome (PMS) is a collection of emotional symptoms with or without physical symptoms related to a women’s menstrual cycle. The specific emotional symptoms vary from woman to woman. There are variety of symptoms but the three most common ones are irritability, tension and dysphoria   (unhappiness). Other emotional and non specific symptoms include insomnia, stress, anxiety, headache, fatigue, mood swings, increased emotional sensitivity and changes in libido (sex drive).

Women also experience physical symptoms like bloating, abdominal cramps, constipation, tenderness of breasts, cyclic acne and muscle pain. No matter how disruptive the pain is it cannot be considered PMS until and unless it is associated with emotional symptoms. These symptoms are not necessarily to change in every cycle. Sometimes these symptoms don’t take part at all and many a times all of them take part.

Under typical definitions these symptoms usually occur within 10 days period prior to menses and must not be present for at least 1 week between the onset of menses and ovulation. Getting uncomfortable with these symptoms is not going to help you in any way.  It affects your normal routine and the people around you.” Indulging in comfort foods like gooey chocolate, bars, gulping down coffee/tea, skipping meals because of feeling bloated is certainly not going to help.” Says Dr. Loveleena Nadir, Sr. Consultant Obstetrician and Gynecologist, Fortis La Femme.

Risk factors:

–          High caffeine intake

–          Stress may precipitate condition

–          Increasing age

–          History of depression

–          Family history

Top 5 cures for PMS:

1. Magnesium: It is a great element of choice to be added during these symptoms as it contains serotonin. Serotonin which in simple terms mean a mood balancer of the brain. It is a brain chemical which plays role in mood fluctuation and sensitivity. Magnesium reduces bloating and breast tenderness.

Foods rich in magnesium: Brown rice, lentils, whole grain bread, spinach, beans, cashews

 

1. Vitamin B: cure your crankiness and satisfy your food cravings by increasing vitamin B supplement.

Foods rich in Vitamin B: Stay happy by munching a handful of nuts, bananas, chicken breast, sweet potato, whole grains and beans

 

1. Healthy fat> unhealthy fat: Try cutting down on unhealthy fat atleast 2 weeks prior to your menses.

Foods rich in healthy fat: Pumpkin seeds, salmon, walnuts, tuna

1. Potassium: A must for mood swings

Foods rich in potassium: Fresh fruit salads including oranges and apples.

 

1. Increase your fluid/ water intake: Water is drained out of body in the way of sweat and urine hence it’s important to drink water at this time more than the usual quantity. Alternatively you can switch over lemonade or coconut water for more potassium.

 ADVICE:

• Avoid skipping meals during periods
• Avoid taking medications like pain killers instead go for the above nutrients to be included in your diet.

 

DO MEN GET PMS??

Yes, it is real just that in males it is known with a different name. It’s called as irritable male syndrome (IMS). Dr Aimee Aube luck of the University of Derby, who carried out the study, said: “We asked 50 men and 50 women lots of questions about symptoms normally associated with PMS and we found men actually scored higher than women in everything apart from water retention.” The men admitted to feeling antisocial, irritable, suffering poor concentration, and depression, lack of arousal, hot flushes, headache, and back pain. The researchers feel the pain threshold is different for males and females but just that females don’t give it much of an attention.

• It is a topic of discussion as some believe that men do get PMS and some believe they don’t. PMS basically occurs in females due to imbalance of female hormones prior to 1 or 2 weeks of their menses. But these hormonal imbalances don’t take in males at an early age but it does take place at a old age as ageing leads to decrease in testosterone level.
• Males experience mood swings and irritability due to the poor diet which is full of refined sugar and unhealthy fats, too much alcohol and caffeine, and not enough fiber, minerals and vitamins. This is similarly seen in females as well.
• Some other factors which affect men’s moods are social stresses including work and financial pressures and the emotional suppression.

As with the strong evidence above I feel men do suffer from IMS though it’s not proved but researchers have done their part and made it evident that men do suffer from mood swings in a larger way.

WHAT CAN A GUY DO ABOUT IRRITIBILITY AND MOOD SWINGS??

–          Blood sugar balance food plan

–          Regular exercise

–          Plenty of fruits and vegetables

–          Proper micronutrients

–          Healthy emotional balance