Contraception is a way to prevent pregnancy and there are many different method and types to prevent pregnancy.

Choice of contraception may vary depending on age, health and the status of relationship. Although different contraceptive methods work in different ways, contraception usually prevents sperm from reaching and fertilising an egg which is how a pregnancy starts.

METHODS OF CONTRACEPTION

Long – Acting Reversible Contraception (LARC)

Intrauterine device (IUD) – For five or more years

The main way an IUD works is by preventing fertilisation of the egg. An IUD is a small device that fits inside your womb. Copper and Mirena IUDs are at least 99% effective in preventing pregnancy.

  • Copper IUD – This contains copper
  • Mirena – This has a progestogen hormone which is slowly released into womb.

Hormonal Contraceptives

“The Pill” is one of the most popular contraceptive method. They are over 99% effective at preventing pregnancy when taken correctly. The Pill comes in two forms.

  • Combined Oral Contraceptive Pill (COC) – COC pill contains the hormones oestrogen and progestogen which stop the eggs developing, so there is no egg released from the ovary.
  • Progestogen Only pill (POP) : POP contains one hormone – progestogen. It mainly thickens the mucus in the cervix so that sperm can’t t
  • Depo Provera injection For three months
  • Vaginal ring – For one month

Barrier Methods

Barrier methods stop sperm from entering the vagina. Condoms protect against sexually transmissible infections (STIs) as well. There are two main barrier methods of contraception:

  • Male condoms – a form of contraception for men
  • Female condoms – a form of contraception for women

If used correctly every time during sex, condoms provide very good protection from pregnancy and infection.

Emergency Contraception

Two options for emergency contraception –

  • Emergency Contraceptive Pill (ECP) – The ECP is taken after unprotected sex to prevent pregnancy. It prevents the sperm from fertilising an egg by changing the way the sperm moves in your body.
  • Copper IUD – The copper from the IUD stops the sperm moving through the womb towards the egg and implantation of fertilised ovum.

Permanent Contraception

Permanent contraception is sterilisation that permanently prevents pregnancy.

  • Vasectomy – It is a procedure for men, a simple operation. After a vasectomy there are no sperm in men’s semen, testicles still make sperm but they are absorbed by the body.
  • Tubal ligation : It is a procedure for sterilisation of women. This procedure is to close both fallopian tubes.

Fertility Awareness

Fertility awareness is a method to plan or avoid a pregnancy by recognising the signs of fertility in a woman’s menstrual cycle.

Menstruation, also called menses, is a normal part of being a healthy female of reproductive age. In a woman who is not pregnant, the menstrual cycle occurs approximately every 28 days, however it may vary. There is huge discrepancy among women in the length and duration of their menstrual cycle and whether they bleed a lot or a little.

Many different reasons can cause menstrual disorders, such as hormone imbalances, genetic aspects, clotting disorders, and pelvic diseases or it can be for unknown reasons.

There are many different types of disorders.

Dysmenorrhoea (Painful Menses)

Dysmenorrhea is the medical word for pain with menses.

Dysmenorrhea (also called Menstrual cramps) are pains in the lowest part of the pelvis a few days before, during, or after a menstrual period, which can sometimes extent to lower back and legs.

  • Primary Dysmenorrhea

Cramping pain which is due to contractions of uterus, with no identifiable cause.

  • Secondary Dysmenorrhea

Menstruation pain that accompanies a medical condition. This is mainly caused by endometriosis, fibroid, adenomyosis. Other causes can be pelvic inflammatory disease, ovarian cysts, ectopic pregnancy, intrauterine device (IUD) contraceptive.

Menorrhagia (Heavy bleeding)

Menorrhagia is the medical word for considerably heavier menses. Menses are considered heavy if there is sufficient blood to soak a pad or tampon each hour for many hours. Menorrhagia is a kind of abnormal uterine bleeding. Metrorrhagia, Menometrorrhagia, Dysfunctional uterine bleeding (DUB)

Women can check for any of the below symptoms are seen:

  • Changing pads or tampons during night
  • Large blood clots
  • Menses continues longer than 10 days

Cause of heavy menstrual bleeding.

  • Hormone imbalance
  • Ovulation problems
  • Uterine fibroids or polyps
  • Endometriosis and adenomyosis
  • Medications and contraceptives
  • Complications of pregnancy
  • Cancer, infection, bleeding disorders

Menorrhagia is frequently accompanied by dysmenorrhea as passing large clots can origin painful cramping. Unnoticed Menorrhagia can lead to anaemia and lot of pain suffering.

Hypomenorrhea (Scanty Menses)

Mostly Hypomenorrhea is not a serious medical disorder. Some common causes can be

  • Hormonal Imbalance
  • Hereditary
  • Prolonged use of contraceptives
  • Nutritional deficiencies
  • Uterine problems
  • Others – Excessive exercise, low body weight, stress, sorrow

Sometimes scanty menses makes achieve pregnancy difficult.

DIAGNOSIS 

To determine if a woman has a menstrual disorder, gynaecologist will take a medical history and ask questions about woman’s menstrual cycle. Gynaecologist need to know what has changed from past normal periods. A pelvic exam may also be needed with blood tests also may be used to measure the levels of hormones in the body.

TREATMENT

Treatment for menstrual disorders may include:

  • Medical treatmentThis may include hormonal therapies, pain relievers, iron supplements.
  • Surgical treatmentMenstrual disorders can be caused by endometrial polyps, fibroids, and adenomyosis.  Doctor may recommend surgery to treat these conditions. This may require a vaginal procedure called hysteroscopy, or a laparoscopic procedure including removal of fibroids or hysterectomy.

Polycystic ovary syndrome is a problem which can cause problem in a woman’s menstrual cycle (monthly period) and getting pregnant due to imbalance of hormones like estrogen and progesterone in body.

Women who suffer from PCOS develop several small cysts on their ovaries, which can be seen during an ultrasound exam. That is why it is called polycystic ovary syndrome. The cysts are not harmful but lead to hormone imbalances.

PCOS can cause problems with a women’s menstrual cycle, fertility, and appearance (excessive hair growth, acne). If it isn’t treated, over time it can lead to serious health problems, such as diabetes and heart disease.

CAUSES

The cause of PCOS is not fully understood, but genetics may be a factor. Recent research suggests that PCOS is related to insulin resistance and the development of diabetes, especially in women who are overweight.

Excess insulin may cause high androgen levels. Overproduction of the hormone androgen (male hormone) which women also produce may be another contributing factor for PCOS.

SYMPTOMS

There are a number of signs and symptoms women with PCOS can have. However, not every woman with PCOS will have every symptom, and each woman will be quite individual in her experience. Symptoms of PCOS typically start soon after a woman begins to menstruate, which includes

  • Irregular periods.
  • Excess facial and body hair
  • Acne
  • Weight gain
  • Anxiety or Depression
  • Polycystic ovaries

DIAGNOSIS

There is no definitive test for PCOS. PCOS is usually diagnosed based on the woman’s history and a physical and pelvic examination to look for signs of PCOS. It may be confirmed by ultrasound and by measuring hormone levels in the blood.

TREATMENT

The treatment will vary from woman to woman, depending on specific symptoms. It generally focuses on management of individual’s main concerns, such as infertility, hirsutism, acne or obesity.

Gynaecologist will firstly suggest lifestyle change with the motive of weight reduction, which can help improving one’s condition. Medications will be targeted on regulating menstrual cycle or aiming fertility or reducing hair growth

Menopausal Disorders are disorders relating to menopause – a natural transition where women go from having normal menstrual periods to no periods at all. Menopause is the time in a woman’s life when the function of the ovaries stops and she can no longer become pregnant.

CAUSES

Menopause can result from:

  • Natural decline of reproductive hormones

In late 30s, ovaries start making less hormones that regulate menstruation (estrogen and progesterone), which gradually decrease periods and  by age 51 there may be no more periods.

  • Total hysterectomy and bilateral oophorectomy

This removes both uterus and ovaries does cause menopause.

  • Cancer Therapy

This includes Chemotherapy and radiation therapy, which can induce menopause though may not be permanent.

  • Genetic factors or autoimmune disease

It can lead to primary ovarian insufficiency in which ovaries fail to produce normal levels of reproductive hormones.

It is believed that the hormone changes (estrogen and progesterone) are responsible for menopausal disorders.

SYMPTOMS

Menopause affects every woman differently. Some women may experience few or no symptoms of menopause, while others experience multiple physical and psychological symptoms. Symptoms that might start in the years around menopause include:

  • Hot flashes
  • Irregular vaginal bleeding
  • Trouble sleeping
  • Vaginal and urinary problems
  • Mood changes
  • Diminished interest in sex
  • Osteoporosis
  • Irritability,  Depression, Fatigue, Dizziness, Headaches, Numbness

In some cases the symptoms might interfere with routine in such cases treatment may become crucial.

TREATMENT

For treatment general diet and lifestyle changes are sufficient in most cases. If that doesn’t completely relieve the symptoms, treatments may include:

  • Hormone therapy (HT) / Hormone replacement therapy (HRT) / Postmenopausal Hormone Therapy (PHT)

Estrogen and progesterone therapy are used to control the symptoms of menopause related to declining estrogen levels such as hot flashes and vaginal dryness.

  • Oral contraceptive pills

Oral contraceptive pills are another form of hormone therapy often prescribed for women in perimenopause to treat irregular vaginal bleeding.

  • Local (vaginal) hormone and Non – hormone treatments:

Local hormonal treatments are available for the symptoms of vaginal hormonal deficiency. Local and oral estrogen treatments are sometimes combined for the same.

Vaginal moisturizing agents as well as the use of lubricants are non-hormonal options for managing the discomfort of vaginal dryness.

  • Antidepressant medications

Effective in controlling the symptoms of hot flashes in most of the of the women.

  • Medications

Depending on individual needs, medication are used to prevent or treat osteoporosis. Several medications are available that help reduce bone loss and risk of fractures.

Treatments for Menopause mainly focus on relieving symptoms and preventing or managing chronic conditions that may occur with ageing like heart and blood vessel disease, osteoporosis, urinary incontinence and weight gain.

Your uterus (or womb) is normally held in place inside your pelvis with various muscles, tissue, and ligaments. Because of pregnancy, childbirth or difficult labor and delivery, in some women these muscles weaken. Also, as a woman ages and with a natural loss of the hormone estrogen, her uterus can drop into the vaginal canal, causing the condition known as a prolapsed uterus.

Muscle weakness or relaxation may allow your uterus to sag or come completely out of your body in various stages :

First degree : The cervixdrops into the vagina.
Second degree : The cervix drops to the level just inside the opening of the vagina.
Third degree : The cervix is outside the vagina.
Fourth degree : The entire uterus is outside the vagina. This condition is also called procidentia. This is caused by weakness in all of the supporting muscles.

Other conditions are usually associated with prolapsed uterus. They weaken the muscles that hold the uterus in place :

Cystocele : A herniation (or bulging) of the upper front vaginal wall where a part of the bladder bulges into the vagina. This may lead to urinary frequency, urgency, retention, and incontinence (loss of urine).

Enterocele : The herniation of the upper rear vaginal wall where a small bowel portion bulges into the vagina. Standing leads to a pulling sensation and backache that is relieved when you lie down.

Rectocele : The herniation of the lower rear vaginal wall where the rectum bulges into the vagina. This makes bowel movements difficult, to the point that you may need to push on the inside of your vagina to empty your bowel.

Prolapsed Uterus Causes

The following conditions can cause a prolapsed uterus :

  • Pregnancy/childbirths with normal or complicated delivery through the vagina
  • Weakness in the pelvic muscles with advancing age
  • Weakening and loss of tissue tone after menopause and loss of natural estrogen
  • Conditions leading to increased pressure in the abdomen such as chronic cough (with bronchitis and asthma), straining (with constipation), pelvic tumors (rare), or an accumulation of fluid in the abdomen
  • Being overweight or obese with its additional strain on pelvic muscles
  • Major surgery in the pelvic area leading to loss of external support
  • Smoking

Other risk factors include :

  • Excess weight lifting
  • Being Caucasian
  • Family history

Prolapsed Uterus Symptoms

Symptoms of a prolapsed uterus include :

  • A feeling of fullness or pressure in your pelvis (you may describe it as a feeling of sitting on a small ball)
  • Low back pain
  • Feeling that something is coming out of your vagina
  • Painful sexual intercourse
  • Difficulty with urination or moving your bowels
  • Discomfort walking

When to Seek Medical Care

Notify your health care provider if you experience any of the following symptoms :

  • You feel the cervix near the opening of the vaginal canal or you feel pressure in your vaginal canal and the feeling of something coming out of your vagina.
  • You suffer persistent discomfort from urinary dribbling or the urge to have a bowel movement (rectal urgency).
  • You have continuing low back pain with difficulty in walking, urinating, and moving your bowels.

Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas (lie-o-my-O-muhs) or myomas, uterine fibroids aren’t associated with an increased risk of uterine cancer and almost never develop into cancer.
Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. You can have a single fibroid or multiple ones. In extreme cases, multiple fibroids can expand the uterus so much that it reaches the rib cage.
Many women have uterine fibroids sometime during their lives. But most women don’t know they have uterine fibroids because they often cause no symptoms. Your doctor may discover fibroids incidentally during a pelvic exam or prenatal ultrasound.

Symptoms :

Many women who have fibroids don’t have any symptoms. In those that do, symptoms can be influenced by the location, size and number of fibroids. In women who have symptoms, the most common symptoms of uterine fibroids include:

  • Heavy menstrual bleeding
  • Menstrual periods lasting more than a week
  • Pelvic pressure or pain
  • Frequent urination
  • Difficulty emptying the bladder
  • Constipation
  • Backache or leg pains

Rarely, a fibroid can cause acute pain when it outgrows its blood supply, and begins to die.

Fibroids are generally classified by their location. Intramural fibroids grow within the muscular uterine wall. Submucosal fibroids bulge into the uterine cavity. Subserosal fibroids project to the outside of the uterus.

When to see a doctor

See your doctor if you have :

  • Pelvic pain that doesn’t go away
  • Overly heavy, prolonged or painful periods
  • Spotting or bleeding between periods
  • Difficulty emptying your bladder

Adolescence is a sensitive and important phase in an individual’s life during which a multidisciplinary approach must be taken to both understanding and solving his/her problems. An estimated 25% of India’s population of 138 million is aged 15-25 years. Girls aged 10-19 years comprise about 22% of the female population. A wide range of issues and concerns face adolescents in India, including nutritional deficiencies, reproductive health problems, sexually transmitted diseases, and mental and physical stress-related problems. Stress often results in the abuse of tobacco and other habit-forming drugs. The author discusses nutrition, reproductive health, pregnancy, sexuality, and mental and social concerns as they are related to adolescents.

Although pelvic pain often refers to pain in the region of women’s internal reproductive organs, pelvic pain can be present in men, too, and can stem from multiple causes. Pelvic pain may be a symptom of infection or may arise from pain in the pelvic bone or in non-reproductive internal organs, such as the bladder or colon. In women, however, pelvic pain can very well be an indication that there may be a problem with one of the reproductive organs in the pelvic area (uterus, ovaries, fallopian tubes, cervix, or vagina).

What Causes Pelvic Pain ?

Possible causes of pelvic pain in both men and women may include :

  • Appendicitis
  • Bladder disorders
  • Sexually transmitted diseases
  • Kidney infection or kidney stones
  • Intestinal disorders
  • Nerve conditions
  • Hernia
  • Pelvis disorder
  • Broken pelvis
  • Psychogenic pain

Contraception is a way to prevent pregnancy and there are many different method and types to prevent pregnancy.

Choice of contraception may vary depending on age, health and the status of relationship. Although different contraceptive methods work in different ways, contraception usually prevents sperm from reaching and fertilizing an egg which is how a pregnancy starts.

METHODS OF CONTRACEPTION

Long – Acting Reversible Contraception (LARC)/strong

Intrauterine device (IUD) – For five or more years

The main way an IUD works is by preventing fertilisation of the egg. An IUD is a small device that fits inside your womb. Copper and Mirena IUDs are at least 99% effective in preventing pregnancy.

Copper IUD – This contains copper
Mirena – This has a progestogen hormone which is slowly released into womb.

Hormonal Contraceptives

“The Pill” is one of the most popular contraceptive method. They are over 99% effective at preventing pregnancy when taken correctly. The Pill comes in two forms.

Combined Oral Contraceptive Pill (COC) – COC pill contains the hormones oestrogen and progestogen which stop the eggs developing, so there is no egg released from the ovary.
Progestogen – Only pill (POP) : POP contains one hormone – progestogen. It mainly thickens the mucus in the cervix so that sperm can’t t
Depo Provera injection –For three months
Vaginal ring – For one month

Barrier Methods

Barrier methods stop sperm from entering the vagina. Condoms protect against sexually transmissible infections (STIs) as well. There are two main barrier methods of contraception:

Male condoms – a form of contraception for men
Female condoms – a form of contraception for women
If used correctly every time during sex, condoms provide very good protection from pregnancy and infection.

Emergency Contraception

Two options for emergency contraception –

Emergency Contraceptive Pill (ECP) – The ECP is taken after unprotected sex to prevent pregnancy. It prevents the sperm from fertilising an egg by changing the way the sperm moves in your body.
Copper IUD – The copper from the IUD stops the sperm moving through the womb towards the egg and implantation of fertilised ovum.

Permanent Contraception

Permanent contraception is sterilisation that permanently prevents pregnancy.

Vasectomy – It is a procedure for men, a simple operation. After a vasectomy there are no sperm in men’s semen, testicles still make sperm but they are absorbed by the body.
Tubal ligation – It is a procedure for sterilisation of women. This procedure is to close both fallopian tubes.

Fertility Awareness

Fertility awareness is a method to plan or avoid a pregnancy by recognising the signs of fertility in a woman’s menstrual cycle.