Menstrual health comprises the physical, social and mental aspects related to menstruation or periods. In India, women's health has been given secondary importance due to a male dominant society, illiteracy, low socio-economic conditions and ignorance.
The most common causes of menstrual problems are PCOS (Polycystic Ovarian Syndrome), and abnormal or heavy menstrual bleeding. Menstruation or monthly periods have been associated with a lot of social and cultural taboos in India.
Many young girls and women do not have facilities to manage their menses hygienically, maintaining their privacy, dignity and gender equality at home, schools and workplaces.
So, what are normal periods? A normal menstrual period lasts from 2-7 days and comes at an interval of 21-35 days. It is difficult to quantify the actual menstrual flow. In general, use of three to four XL or regular size sanitary pads per day (since they need to be changed every six to eight hours) can be considered normal on an average, but it may vary depending on the individual.
Common Menstrual Problems
1. Menstrual hygiene
2. Menstrual flow
3. Menstrual cycle
4. Menstrual hormones
Menstrual Hygiene Related Problems: Use of unclean sanitary pads or clothes can give rise to genital tract infections, anaemia and urinary tract Infection. This can be prevented by social awareness and easy availability of affordable sanitary products. It is also important to have the right knowledge about menstrual hygiene to avoid such issues from taking place.
Menstrual Flow Related Problems: One can experience excess or scanty flow during periods. Usually heavy menstrual flow can be for 1-2 days but if it continues for more than 5-7 days, it can lead to low haemoglobin and anaemia. This definitely needs to be investigated and treated along with oral iron replacement therapy. The less flow or change in flow over years can be due to hormonal imbalance. This can occur mostly after completion of family in perimenopausal age.
Menstrual Cycle Related Problems: Irregular periods, skipping or not getting periods for more than six months (also known as secondary amenorrhoea) and bleeding in between periods (called inter menstrual bleeding) are a few problems under this type of problem. The most common cause for this is Polycystic Ovarian Syndrome (PCOS), stress, anxiety and depression. Investigations in the form of pelvic sonography and hormonal investigations are necessary to make a diagnosis. Regular exercise, a balanced diet and healthy lifestyle changes are important.
Menstrual Hormone Related Problems: This usually gives rise to psychomotor issues. They can be symptoms of Premenstrual Syndrome (PMS) at any age group or peri/postmenopausal vasomotor symptoms after the age of 45. Bloating, breast tenderness, irritability and depression which occur premenstrually and disappear with onset of periods are classical symptoms of PMS. If they are affecting day to day family life, then it needs to be treated.
Every woman experiences menopausal symptoms in varying severity, starting usually 4-5 years before menopause. The night sweats, hot flushes, low moods, anxiety, irritability, joint and muscle pain, loss of interest in having sex, and weight gain are typical menopausal symptoms due to deficiency of oestorgen hormones.
No matter which type of menstrual problem you're facing, it is always advisable to visit a gynaecologist who will be able to identify all your queries after making the right diagnosis.
Nua, a new-age brand transforming the women's wellness space in India with holistic and personalised solutions that addresses real problems faced by women in managing their menstrual health and personal hygiene, provides an innovative range of products and services, including India's first customizable pack of sanitary pads and self-heating menstrual cramp patches, also available on a subscription basis. (Vaishali Joshi, #NuaExpert on Gynaecology, is an Obstetrician and Gynaecologist at Kokilaben Dhirubhai Ambani Hospital, Mumbai)
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COPD also known as chronic obstructive pulmonary disorders is a group of lung diseases that blocks airflow and makes it difficult to breathe. The most common of these diseases are emphysema and chronic bronchitis. Many people with COPD have both of these conditions. Emphysema slowly destroys air sacs in your lungs, which interferes with outward airflow. Bronchitis causes inflammation of the bronchi. COPD is a condition in which the disease worsens over time and it makes it difficult even to breathe. Asthma or Bronchitis is a very dangerous condition during pregnancy which causes fatigue, resulting in energy being diverted from the growing foetus.
Asthma can be hard to diagnose. To find out if you have asthma, your doctor takes your health history, does a physical exam and listens to your breathing.. You also may get a lung function test called spirometry. This is a test that checks how well your lungs work. During the test, you take a deep breath and exhale (blow) into a machine called a spirometer. This machine measures the amount of air you breathe in and out. It also measures how fast you can breathe. When you're pregnant, normal changes in your body can make you short of breath. This test can help your doctor know if shortness of breath is a common complication of pregnancy or if it's caused by asthma.
Treatment: Breathing Exercises with COPD
Pursed lip breathing
Pursed Lip Breathing
Pursed lip breathing has a range of benefits:
It's been shown to reduce how hard you have to work to breathe.
It helps release the air trapped in the lungs.
It promotes relaxation.
It reduces shortness of breath.
Practising this technique 4 to 5 times daily can help. Here's how to practice pursed-lip breathing:
While keeping your mouth closed, take a deep breath in through your nose, count to 2. Follow this pattern by repeating in your head "inhale, 1, 2." The breath doesn't have to be deep. A typical inhale will do. Put your lips together as if you're starting to whistle or blow out candles on a birthday cake. This is known as "pursing" your lips. While continuing to keep your lips pursed, slowly breathe out by counting to 4. Don't try to force the air out, but instead breathe out slowly through your mouth.
Tip: Pursed lip breathing is best for performing strenuous activities, such as climbing stairs.
Feeling short of breath can cause anxiety that makes you hold your breath. To prevent this from occurring, you can practice coordinated breathing using these two steps:
Inhale through your nose before beginning an exercise.
While pursuing your lips, breathe out through your mouth during the most strenuous part of the exercise. An example could be when curling upward on a bicep curl.
Tip: Coordinated breathing can be performed when you're exercising or feeling anxious.
Deep breathing prevents air from getting trapped in your lungs, which can cause you to feel short of breath. As a result, you can breathe in the more fresh air.
Here's how to practice deep breathing:
Sit or stand with your elbows slightly back. This allows your chest to expand more fully.
Inhale deeply through your nose.
Hold your breath as you count to 5.
Release the air via a slow, deep exhale, through your nose, until you feel your inhaled air has been released.
Exercise tip: It's best to do this exercise with other daily breathing exercises that can be performed for 10 minutes at a time, 3 to 4 times per day.
When you have COPD, mucus can build up more easily in your lungs. The huffing is a breathing exercise designed to help you cough up mucus effectively without making you feel too tired.
Here's how to practice the huffing:
Place yourself in a comfortable seated position. Inhale through your mouth, slightly deeper than you would when taking a normal breath.
Activate your stomach muscles to blow the air out in three even breaths while making the sounds "ha, ha, ha." Imagine you're blowing onto a mirror to cause it to steam.
Exercise tip: A huff should be less tiring than a traditional cough, and it can keep you from feeling worn out when coughing up mucus.
The diaphragm is an important muscle involved in the work of breathing.
People with COPD tend to rely more on the accessory muscles of the neck, shoulders, and back to breathe, rather than on the diaphragm. Diaphragmatic or abdominal breathing helps to retrain this muscle to work more effectively. Here's how to do it:
While sitting or lying down with your shoulders relaxed, put a hand on your chest and place the other hand on your stomach.
Take a breath in through your nose for 2 seconds, feeling your stomach move outward. You're doing the activity correctly if your stomach moves more than your chest.
Purse your lips and breathe out slowly through your mouth, pressing lightly on your stomach. This will enhance your diaphragm's ability to release air.
Repeat the exercise as you are able to.
Protect Your Lungs during Pregnancy
Since you're essentially breathing for two, take these steps to protect your lung health and your infant's health:
Tell Your Doctor About Any Shortness of Breath- There can be many reasons for shortness of breath in pregnancy. Pregnant women are no strangers to shortness of breath. Early pregnancy hormone surges and, later, the weight and bulk of your expanding womb restrict your breathing. If you're feeling short of breath, and you're worried about it for any reason, let your doctor know.
Ask for A Lung Function Test- While the parameters for the test might change as your pregnancy progresses, the simple, noninvasive lung test called spirometry can help your doctor check on your breathing.
Manage Asthma- Uncontrolled asthma during pregnancy puts both babies and you at risk. If you've been lax about your asthma medications, it's time to update your routine for pregnancy and then stick to it.
Avoid Cigarette Smoke- Don't smoke, ban smoking at home, and avoid all environments where you are exposed to cigarette smoke.(Suryalakshmi Paleri, Executive Physiotherapist, Cloudnine Group Of Hospitals, Bengaluru (Malleshwaram))
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Low back pain effects approximately 50 to 80 per cent of pregnant women. There are numerous etiologies for pregnancy-related back pain, such as mechanical effects of gravid uterus, positional stressors, and hormonal effects resulting in pain at pubic symphysis and sacroiliac joint.
Lumbar radiculopathy or true sciatica is rare and accounts only for 1 per cent of low back pain in pregnancy.
What is Sciatica?
Sciatica is also known as lumbo-sacral radicular syndrome defined as a radiating pain along the course of the sciatic nerve. The pain travels from the lower back, buttocks, posterior of the thigh, leg and the foot. It can be a deep, dull pain or a shooting, sharp pain. Sciatic pain can range from mild to severe. It often resolves with treatment.
Causes of Sciatica During Pregnancy
Sciatic pain is typically caused by lumbar spine problems, such as:
A bulging or herniated disc
Spinal narrowing or stenosis,
Osteoarthritis or degenerative disc disease
These situations can put pressure on the sciatic nerve, causing symptoms. Sciatica due to a herniated disc during pregnancy isn't common. But, sciatic-like symptoms are common with low back pain in pregnancy.
Sciatic like symptoms can also be caused by
Muscle tension and unstable joints
Pelvic bone pain
Sacroiliac (SI) joint dysfunction
Pelvic Girdle Pain (pelvic bone pain)
Pelvic Girdle Pain (PGP) describes pain in the joints that make up your pelvic girdle; this includes the symphysis pubis joint (SPJ) at the front and the sacroiliac joints (SIJ) at the back. Majority of pregnancy-related low back pain is PGP and is often misdiagnosed as sciatica.
PGP discomfort is often felt over the pubic bone at the front, below your tummy, or across one side of your lower back, or both sides. At the front, below your tummy, or across one side of your lower back, or both sides. A diagnosis of PGP can be reached based on certain signs and symptoms that you may experience during the pregnancy or afterwards. Having one or more of them may indicate the need for a physiotherapy assessment followed by advice on appropriate management.
You may experience pain in all or some of the areas shaded in the diagrams above. You may also experience the following:
Pain when standing on one leg (e.g. Climbing stairs, dressing, or getting in or out of the bath)
Pain or difficulty moving your legs apart (e.g. Getting in or out of the car)
Clicking or grinding in the pelvic area you may hear or feel this
Limited or painful hip movements (e.g. turning over in bed)
Difficulty lying in some positions (e.g. On your back or side)
Pain during normal activities of daily life
Pain and difficulty during sexual intercourse
With PGP, the degree of discomfort you are feeling may vary from being intermittent and irritating, to being very upsetting.
This is a problem with one of the main stabilizing muscles in the buttocks. This is a common cause of sciatic pain during pregnancy and can present with PGP. This is due to the tightness of the muscle and change in posture in pregnancy.
Piriformis syndrome can be due to both muscle pain from the baby's weight that can also add stress to SI joint because it puts extra pressure on your pelvis and hip joints. Occasionally, the position of your baby can add pressure to your sciatic nerve.
Obesity or weight gain (including weight gained during pregnancy)
Prolonged sitting can also increase risk of developing sciatic pain
Muscle tension and stress to the pelvic joints, sacroiliac joint problem
Symptoms of Sciatic Pain During Pregnancy
Occasional or constant pain in one side of your buttocks or leg
Pain along the sciatic nerve path, from the buttocks down the back of your thigh and to the foot
Sharp, shooting, or burning pain
Numbness, pins and needles, or weakness in the affected leg or foot
Difficulty walking, standing, or sitting
Activities to Avoid
Avoid sitting for long periods
Avoid doing pain exaggerating activity
Do not lift heavy weights often and beyond your ability
Warm packs or cold packs depending on the comfort
Rest from the pain exaggerating activity
Managing weight gain during pregnancy
Sleeping on the side that is not affected
Use a pillow for comfort and support
Stretches (as per recommend by your physiotherapist)
If the symptoms persist it is recommended to consult your Obstetrician and get referred to see a physiotherapist. These sign and symptoms should not be dismissed as normal aches and pain. (Shazia Shadab, Senior Physiotherapist, Cloudnine Group of Hospitals (Jayanagar))(By Shazia Shadab)
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New York, Aug 16 (IANS) Regular exercise, even performed in areas with air pollution, can reduce the risk of death from natural causes, a new study suggests.The study, published in the journal CMAJ (Canadian Medical Association Journal), indicates that a higher level of regular exercise compared with inactivity was beneficial, even in polluted areas, although less exposure to pollution was better."Habitual exercise reduces the risk of death regardless of exposure to air pollution, and air pollution generally increases the risk of death regardless of habitual exercise," said researcher Xiang Qian Lao from the Chinese University of Hong Kong."Thus, habitual exercise should be promoted as a health improvement strategy, even for people residing in relatively polluted areas," Lao added.For the study, the team conducted a large study, over 15 years from 2001 to 2016, with 384,130 adults in Taiwan, seeking to understand the effects of regular exercise and long-term exposure to fine particle matter on the risk of death from natural causes. "We found that a high level of habitual exercise and a low level of exposure to air pollution was associated with lower risk of death from natural causes, whereas a low level of habitual exercise and a high level of exposure was associated with a higher risk of death," the researcher said.This study adds to several other smaller studies conducted in the US, Denmark and Hong Kong that found that regular exercise, even in polluted areas, is beneficial.The authors said that "further studies in areas with more severe air pollution are required to examine the applicability of our findings". "Our study reinforces the importance of air pollution mitigation, such as to reduce the harmful effects of air pollution and maximize the beneficial effects of regular exercise," the team said.--IANSvc/rs
New York, Aug 12 (IANS) Researchers have found an important clue to a rare but serious after-effect of Covid-19 among those broadly below 12, known as multisystem inflammatory syndrome in children or MIS-C.MIS-C is characterised by fever, pain, and inflammation of multiple organs including the heart, lungs, kidneys, skin, eyes, or gastrointestinal tract. The researchers from Mount Sinai Hospital in New York, US, reported that RNA sequencing of blood samples led to the discovery that specific infection-fighting cells of the immune system are downregulated in children with MIS-C, and that this is associated with a sustained inflammatory response -- a hallmark of infection with SARS-CoV-2, the virus that causes Covid-19. The study was published in Nature Communications.The team analysed pediatric cases of MIS-C and Covid-19 and found new exploratory pathways involving complex networks and subnetworks of genes.One of the more significant of these gene networks involved the suppression of two types of immune cells: natural killer (NK) cells and CD8+ T cells. Previous research has shown that when CD8+ T cells are persistently exposed to pathogens, they enter a state of "exhaustion," resulting in a loss of their effectiveness and ability to proliferate. The researchers in the new study specifically pointed to the CD8+ T cells being in this exhausted state, thus potentially weakening the inflammatory immune response. An increase in NK cells is also associated with exhausted CD8+ T cells."Our study implicated T cell exhaustion in MIS-C patients as one of the potential drivers of this disease, suggesting that an increase in both NK cells and circulating exhausted CD8+ T cells may improve inflammatory disease symptoms," said Noam Beckmann, Assistant Professor of Genetics and Genomic Sciences at the Icahn School of Medicine at Mount Sinai. "Additionally, we found nine key regulators of this network known to have associations with NK cell and exhausted CD8+ T cell functionality," Beckmann said.Beckmann added that one of those regulators, TBX21, is a promising therapeutic target because it serves as a master coordinator of the transition of CD8+ T cells from effective to exhausted. --IANSrvt/in
Ramallah, Aug 8 (IANS) A senior Palestinian official announced that 95 per cent of the recent Covid-19 infections in the West Bank are of the Delta variant.Palestinian Health Minister Mai al-Kaila told reporters here that the Delta variant is spreading in all West Bank towns, reports Xinhua news agency.She clarified that until now, "the epidemiological situation in the West Bank does not need to go for a lockdown", adding that the Health Ministry needs assistance to limit the spread of the deadly virus, and then take all the needed measures later.Al-Kaila said that keeping cities and economic institutions opened and resuming education at schools and universities "requires a societal responsibility through citizens' awareness to prevent the virus from spreading on a large scale"."The recorded cases in Palestine are witnessing a slight increase, and the curve is rising from what it was a few days ago," she said, adding she is deeply concerned that "this is an indication of the entry of the fourth wave of the pandemic".Meanwhile, al-Kaila called on every Palestinian aged over 18 years old to immediately go to the vaccination centres in the West Bank and the Gaza Strip and abide by the precautionary measures of wearing face masks and social distancing.On Saturday, the Health Mministry recorded 136 new Covid-19 cases and 33 recoveries in the Palestinian territories.It also said 608,155 people were vaccinated in the West Bank and the Gaza Strip so far, including 423,340 who received the second dose of vaccine.--IANSksk/