Understanding PMS Part -2

Having looked at the causes, symptoms and methods to diagnose PMS, it is now time to consider prevention and treatment.

Prevention

Menstruation is a natural process and the premenstrual syndrome is part of this. There is no way to completely prevent it or reduce the discomfit it causes and the effect it can have on your life. However, by understanding the nature of what you are going through, you will be able to cope with it better. The best way to do this is to talk to your doctor not only about PMS in general but also about any specific issues you may be facing. Your doctor will be able to advise you on the changes, usually minor, that you can make to your lifestyle to reduce the discomfort and find relief. These steps usually consist of nothing more than proper exercise, the right diet and getting enough rest. Over and above, if your condition requires specific treatment or medication, the doctor can prescribe what is best for you. 

Treatment

There is no specific treatment for PMS as such. What is available are ways to relieve the symptoms and make life more comfortable during those difficult days. Besides consulting a specialist about your condition, the following tips can help you to deal with it better.

• Understand your condition. Keep a dairy of your PMS symptoms, including how severe they are and how long they last. These can vary from month to month, but over a period of a few months the diary will allow you to understand how your moods and physical condition, are affected in the days before your period. Once you know that, you will be able to plan your month to minimize those activities that cause you the most distress during the PMS days.  If that does not provide enough relief, your diary will help your doctor to decide if medication can help and if so, what to prescribe.
• A healthy diet can help to control both the physical and also the mental symptoms. Reducing your intake of salt, sugar and caffeine is known to help in reducing the symptoms.  The American College of Obstetrics and Gynecology advises that a diet rich in complex carbohydrates can help in relieving the symptoms. Your doctor may also recommend nutritional supplements like calcium, magnesium, and vitamins B6 and E.
• Proper exercise can help your body to cope with the stress of PMS. The best exercise for PMS related issues is an aerobic style exercise, like walking. Continuing the exercise, perhaps at a lower intensity, during the PMS days can also help your body to cope with the condition.
• There are over the counter medications that can help in controlling the symptoms. Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen can reduce the intensity of cramps, breast tenderness and head and back aches. If depression or anxiety is a serious problem, your doctor may prescribe the use of antidepressants. Diuretics may also be prescribed to reduce fluid retention.

Nontraditional treatments and home remedies can do more harm than good. The best way to deal with PMS and limit the impact it has on your life is to consult your gynecologist. If you do want to try home remedies, discuss them with your doctor before starting the remedies.

Understanding PMS Part – 1

PMS, as defined by the American College of Obstetrics and Gynecology is “The cyclic occurrence of symptoms that are sufficiently severe to interfere with some aspects of life, and that appear with consistent and predictable relationship to the menstrual period." Studies show that about 85% of women of childbearing age experience symptoms of PMS, in varying degrees, although only between 2% to 10% experience severe symptoms. Treated as a topic for sitcom jokes for many years, PMS, or Premenstrual Syndrome to give it its correct name, is now recognized as a genuine medical condition and one that, if the symptoms are severe enough, requires treatment. The symptoms of PMS can be both physical and also psychological and occur just before the beginning of the menstrual period.

The Causes

The exact cause of PMS is still being researched and debated, but the consensus is that the fluctuations in hormone levels that occur just before the onset of your period is a major factor. The fluctuations, especially of estrogen and progesterone are part of the natural preparation of the body to menstruate.

The Symptoms

The symptoms of PMS are many and varied and can occur in a variety of combinations. The types, number and severity of the symptoms differ from woman to woman and also from month to month for each woman. The main, and most common symptoms include:

• Abnormal food cravings and a desire to overeat.
• Aggression and / or bouts of anger.
• Anxiety and / or feelings of depression.
• Bloating / water retention.
• Breast tenderness and increased sensitivity.
• Fatigue and listlessness.
• Headaches and backaches.
• Irritation with things that are normally not a problem.
• Sudden and possibly very strong mood swings that occur without warning and for no apparent reason.
• Tearfulness and a tendency to cry for no real reason.
• Trouble in concentrating or focusing on important matters.

There are other possible symptoms and if you think you have symptoms of PMS, consult your gynecologist to find out if that is the case and if so, what steps you need to take to control the problem.

The Diagnosis

There is no single comprehensive test or set of tests to determine if a woman is suffering from PMS or not. There are some strategies that a health care provider may suggest to help in making a diagnosis, but the problem here is that the type and severity of the symptoms can vary from month to month. That being said, the two most common courses of action are:

• A Thyroid Test: Since the symptoms of thyroid disease are often similar to PMS, a test of this nature will help to reveal if there is a thyroid condition that needs to be treated. If not, then the possibility of PMS is increased.
•  Maintaining a PMS diary: You will be asked to maintain a record of your PMS symptoms, duration and severity over a period of a few months. This will allow your doctor to understand the case better and decide if you are suffering from PMS or not.

In the next part of this blog we will share tips and suggestions on how to manage and overcome PMS.

Understanding Hysterectomies

A hysterectomy is a surgical procedure to remove a woman’s uterus. This could be required for a number of reasons, including:

• Uterine prolapse which is when uterus has slipped from its normal position into the vaginal canal.
• Uterine fibroids that cause a variety of problems, including pain and bleeding.
• Endometriosis which is the development of uterine-lining tissue outside the uterus.
• Adenomyosis which is a thickening of the uterus.
• Abnormal bleeding.
• Chronic pain in the pelvis.
• Cancer of the ovaries, cervix or uterus.

A hysterectomy for problems other than cancer is usually performed only if other treatments have been ineffective.

Types of Hysterectomies

There are 3 basic types of hysterectomies:

• When the surgeon removes only the top section of the uterus, leaving the cervix in place, it is called a Supracervial or Subtotal Hysterectomy.
• When the cervix and uterus are completely removed, it is a Total Hysterectomy.
• When the whole uterus along with the tissue on the sides, the top section of the vagina and the cervixare removed, it is called Radical Hysterectomy. This s normally done when cancer has been detected.

Surgical Options

There are two ways of performing the operation – The more common open surgery which is the traditional method and the minimally invasive procedure (MIP).

In the case of open surgery a 5 to 7 inch long incision is made across the belly through which the organs are removed. The patient typically spends 3 days in the hospital after the procedure and a visible scar will remain.

In the case of an MIP hysterectomy, a number of approaches are available:

• Vaginal hysterectomy
• Laparoscopic hysterectomy
• Laparoscopic-assisted vaginal hysterectomy
• Robot-assisted laparoscopic hysterectomy

Your doctor will tell you about the way each is done and why a particular option may be chosen.

In general the MIP approach results in a faster recovery, a shorter hospital stay, a lower chance of infection and less pain and scarring as compared to open surgery. Typically after a minimally invasive procedure, a woman can return to normal activities after 3 or 4 weeks. While after an open surgery the time to return to normal activities, could be 4 to 6 weeks. Not all women are good candidates for the MIP approach. Your doctor will decide which is right for you.

Life after a Hysterectomy

If the ovaries are removed along with the uterus, menopause will begin. If theovaries are left in place, menopause will occur naturally. Sex is to be avoided for 6 weeksafter the surgery. In almost all cases patients report that the procedure was successful in curing theproblems they were facing such as heavy periods or extreme pain.

A hysterectomy, although it is a major procedure, is not something that you should dread. It is today acommon and safe operation. Your gynecologist will be able to tell you, after studying your medical history and examining you, if you need one, or if an alternative treatment is better. She will walk you through the procedure, the recovery and answer all your questions. As with all surgery, the moreconfidence and trusts you have in your doctor, the easier everything is.

The Importance of Postpartum Care

As a mother, your newborn child’s wellbeing is your first priority. That’s good and natural. But pregnancy and vaginal delivery can cause more changes in your body than you realize. Unless you get the postpartum care you need, you are not going to be able to care for your baby the way you should and the way you want to. A doctor who specializes in obstetrics services will be able to monitor your condition and ensure that you received the care you deserve, not just for yourself but for your baby, too.There are a number of common problems you may face. Here are some of them:

• Vaginal Tearing. This is the result of an episiotomy or tearing during the delivery. Unless properly treated, this can take a long time to heal and in the meanwhile you could experience a variety of painful and uncomfortable symptoms including issues when sitting, urinating, difficultbowel movements and so on.
• Vaginal discharge is normal after delivery. It normally lasts for a few weeks and then slowly tapers off. If it does not and the bleeding continues,has an unpleasant odor or you have a persistent temperature of over 100 degrees, you need to be checked by your doctor. Proper postpartum care will spot these problems early so that treatment is begun immediately.
• Urination problems. Swelling and bruising of the tissue around the bladder and the urethra is common after delivery. This can cause difficulty in urinating or cause it to be very painful. The urine can also cause a sharp stinging sensation if it comes into contact with tender perineal tissue. These problems usually resolve themselves but if the pain or difficulty is excessive to the extent that you are unable to pass urine properly, consult your doctor without delay. Birth related stretching of the tissue at the base of the bladder can affect the nerves and muscles and result in incontinence. This is another problem that will usually correct itself, but if it continues, see your doctor.
• Contractions. Contractions that resemble menstrual cramps are normal for a few days after delivery. These help to compress blood vessels in the uterus and prevent excessive bleeding. However, if there is also fever or the abdomen is tender and painful when touched, it could be a sign of a uterus infection that should be checked by your doctor, immediately.
• Mood swings. The hormonal changes, the body undergoes during childbirth can lead to sudden mood swings that vary in intensity. These are normal and typically subside after a couple of weeks. If talking to loved ones does not help and if the moods swings become worse or darker, contact your doctor without delay. The sooner this is treated the better.

Childbirth is the most natural act – it has been going on literally since the evolution of civilization. That does not mean that there are no unpleasant side effects or discomfort that could arise from it. When modern medical care has ways to reduce or even completely eliminate these problems, taking advantage of it would be to your benefit and the infant’s benefit. Your health and your ability to care for your baby depend on it. Speak to your obstetrician to learn more about postpartum care and why it is so important.

Do You Need The O-Shot?

Recent studies have revealed that about 40% of women suffer from some form of sexual dysfunction. While this figure is, in itself, frightening what is worse is that only 10% of these women are willing to contact a doctor to discuss the problem and seek a solution. There appears to be two apparent reasons for this. One is the intimate nature of the problem and the fact that even today many women are reluctant to discuss sexual issues with their doctors. The other is the besides hormone replacement therapy (HRT), there are few viable evidence based alternative treatments. At least that was the situation until now.

What Is The O-Shot?

To put it very simply the O-Shot uses growth factors, otherwise known as Platelet Rich Plasma (PRP), taken from the patient’s own blood to rejuvenate tissue in the clitoris and vagina. In other words PRP therapy uses the patient’s own tissue to heal the affected parts of the body. PRP is that part of the blood that is retained after the plasma and platelets are separated from the white and red blood cells. These platelets have growth factors that work to repair and rejuvenate the damaged or worn cells of the body. The injection of PRP will also assist in the formation of new blood vessels and collagen. The procedure is a simple one. Blood is drawn from the arm in the same way it is collected for a blood test. The platelets are separated and introduced to a calcium chloride solution that releases the growth factors. A small gauge needle is then used to inject the product into the affected areas.

What Can the O-Shot Do?

Although the O-shot is a new state-of-the-art procedure, there is already a large volume of evidence, gathered from doctors across the country, about its many benefits. Among them are:

• Heightened sexual desire and arousal
• Increased feeling of intimacy and bonding during sex
• Stronger and improved orgasms
• The frequency of orgasms increases
• If any pain was present during intercourse, it decreases significantly
• Better natural vaginal lubrication
• If stress incontinence is a problem, it is almost completely eliminated on over 90% of cases

Recovery and Down Time

Since PRP therapy uses the patient’s own blood, there are very little chances of any contraindications appearing. The reduced risk, minimal trauma and inflammation along with natural looking and long lasting results make it a desirable option. The procedure takes under one hour and is done in the doctor’s office. There is no incision and the patient can resume normal activities after leaving the office.  Side effects, if any, are usually limited to minor spotting for the first 12 hours after the procedure. Results will be noticeable within one to three weeks and the complete benefits will be seen within three months.

The O-Shot is a cost effective and attractive option for women who suffer from sexual dysfunction problems. To learn more and to find out if you are a good candidate for the treatment, discuss your case with a gynecologist who specializes in the O-Shot procedure. If, after studying your case and examining you, the doctor advises that you should do it, you can look forward to a rejuvenated and more pleasurable sexual life.

Correcting Vaginal Laxity

The vagina is made up of 3 layers – soft tissue, smooth muscle and bundles of fiber, all of which works to contract and relax it as required. During childbirth the vaginal canal stretches and when it returns to some extent to its pre-childbirth condition, it will not have its original tone and muscle control. The condition gets worse with each subsequent birth and also with age. This laxity is the reason many women experience a sense of looseness in the vaginal area. The results are lessening of pleasure during intercourse, change in appearance of the labia or vulva majora and often incontinence. Another effect that many women find is that of dryness.

In the past exercises, gels and surgical options were used to cure this condition. There is now a new treatment, ThermiVa, which offers a safe non-surgical and effective remedy.

What is ThermiVa?

ThermiVa is a state of the art hand held device that uses radio frequency to deliver accurate and controlled heat to the areas to be treated. This agitates the collagen causing it to shrink and tighten thereby reducing the laxity. In addition the application of this thermal energy stimulates the production of new collagen which helps the healing process. The new collagen helps to revitalize and thicken the tissue, and by doing so augments the tightening process. The heat that is delivered is controlled between 104 to 113 degrees F, so there is no danger of burning.

The Benefits

• ThermiVa is a safe FDA approved procedure.
• It is non-surgical and non-invasive and can be performed in the doctor’s office.
• The procedure involves 3 treatments that are done 4 to 6 weeks apart.
• The procedure normally takes less than half an hour and the patient is able to resume all normal activities, including sexual intercourse, immediately.
• Minimal discomfort is felt during the procedure.
• It is very effective in treating vaginal laxity.
• The results can be felt immediately after the first treatment and the improvement continues over the next 3 months.
• Unlike some surgical procedures which advise against future pregnancies, there is no restriction on a woman becoming pregnant again after the ThermiVa treatment.
• The device is single use thereby removing the possibilities of infections from it.
• Maintenance treatments are required only once or twice a year.
• It is cost effective when compared to other options.
• ThermiVa can be used on women of all ages and ethnicities.

The Risks

The risks associated with the procedure are minimal. In a few cases a patient may feel slight vaginal irritation for 24 hours after the procedure. If required, the doctor can prescribe medication to deal with this, though it is usually not required. The feeling of warmth during the procedure may, in some cases, cause a slight discomfort but this will disappear after the treatment is over.

While ThermiVa is a safe and effective procedure, only a specialist will be able to advise you if it is the right option for you of if another procedure could offer better results. Talk to a gynecologist about the problems you face to learn if ThermiVa is right for you.

Birth Control with Essure

A woman will try many birth control methods before finding one that suits her and her partner. Once the family is complete, she will usually look for a permanent family planning method that does not require pills, condoms and other things that may fail if not used properly. Once such a method is found, a major stress factor is removed and life can be enjoyed to the fullest without needless anxiety.

Permanent contraception is the most common form of birth control for women over the age of 30 and for those who are not planning to have any more children. Essure is a safe and effective means of permanent birth control. Once done, it lasts for life.

The Procedure

Essure is a nonsurgical means of permanent birth control that does not have any side effects. It works with a woman’s body to create a natural way of stopping pregnancies from occurring. It is FDA approved and in the almost 15 years that it has been available, has been proven to be 99% safe and effective.

The procedure is done in your doctor’s office, without the necessity to be hospitalized. It only takes about 10 minutes after which you can walk out and return to your normal activities. Small inserts are placed in the fallopian tubes via the vagina. These inserts block sperm from reaching the eggs and causing pregnancy. The inserts are designed to be soft and flexible so that they adapt to the shape of the tube structure without any discomfort and also so that they remain firmly in place. Local anesthetic and pain medication is used to avoid any discomfort that may be felt during the procedure. Once the anesthesia wears off, which is normally a few minutes after the procedure is completed, you can go back to your home, office or anywhere else you want.

It is important to remember that there is no such thing as a 100% effective birth control method. That being said, Essure is among the most effective. Also, Essure is only a method of birth control and does not offer protection again sexually transmitted diseases or HIV.

After The Procedure

In a few cases, patients may experience, nausea, vaginal bleeding, cramping, mild pain and back or pelvic discomfort. If this should occur, you doctor will prescribe medication to relieve the symptoms which are normally short lived.

It takes 3 month for the Essure inserts to become fully effective. During this period you will have to use other birth control methods to avoid pregnancy. After the 3 months are over, your doctor will perform a confirmation test to check that the fallopian tubes are fully blocked. In a few cases it may take a little longer for the blockage of the tubes to be complete. If the blockage is not complete after 3 months, another confirmation test will be done after a period decided by your doctor. Once the blockage is confirmed there is no need to use any other form of birth control.

Consult a Specialist 

Essure has been proven to be safe, effective and convenient for birth control, though it is possible that there are women who could be exceptions and this method may not be suitable. Consult a medical specialist who will determine if this is right for you and if it is not,  willtell you what the other options are.