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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With a whopping 77 million people in India living with diabetes, a simultaneous and sharp rise has been observed in the prevalence of diabetes-related preventable vision loss, particularly among the young people, say experts.
Diabetic retinopathy is a chronic, progressive retinal disease that is a leading cause of vision impairment in today's young adults, working population. It's of major concern among children suffering from juvenile diabetes (Type-1 diabetes) and especially if they have had diabetes for over 10 years.
It is estimated that approximately 1.1-crore people are suffering from retinal disorders in India and more alarmingly, about one in every three people living with diabetes have some degree of diabetic retinopathy, a diabetes complication that affects eyes.
"With the growing incidence of diabetes, it has been estimated that diabetic retinopathy affects one in three people with diabetes and remains the leading cause of blindness in young working-aged adults," Dr Mahipal Sachdev, Medical Director and Chairman, Centre for Sight Group of Eye Hospital, told IANS.
"Approximately 7-10 per cent of young diabetics will go on to develop diabetic retinopathy, of which 2-4 per cent will have vision threatening sequelae if not taken proper treatment." added Dr. Aditya Sudhalkar, M.S. Ophthalmology, Consultant Vitreoretinal Surgeon.
The most common form of diabetic retinopathy is Diabetic Macular Edema (DME) which arises when the damaged blood vessels swell and flow into the macula of the retina causing visibility issues in the normal vision.
According to Dr. Chaitra Jayadev, senior vitreo-retinal consultant, Narayana Nethralaya Eye Institute Karnataka, studies have shown that the prevalence of DME and diabetic retinopathy is higher and more severe in young diabetics with a longer duration of diabetes.
"Diabetes in the younger is a distinct pathological entity characterised by a more aggressive presentation and manifestation. An earlier onset of diabetes leads to a longer exposure to insulin resistance and hyperglycemia. This gives rise to a greater propensity for developing long-term microvascular and macrovascular complications," Dr. Jayadev said.
Thus, screening for diabetes is of utmost importance, even if one is "young" and has no symptoms. It becomes more crucial if one has risk factors such as family history, obesity, sedentary lifestyle, or on long term steroid medications.
Dr. Sudhalkar said that in India, there is a general reluctance towards attending clinics and nearly 25 per cent of young patients with DME come late for diagnosis.
"It's important to know, only 11 per cent of diabetic retinopathy patients can actually reverse vision threatening sequelae once they set in. The rest continue to progress even with strict glycemic control," he noted.
"Retinopathy, unfortunately, is the most neglected complication of diabetes. We see so many patients come to OPD where eyes have not been checked for. So the screening, also known as Funduscopy, should be done at the time of diagnosis of Type-2 diabetes, in adults, and in children, five years after the onset of diabetes, and thereafter annually," Dr Dheeraj Kapoor, HOD, Endocrinology at Artemis, Gurugram, told IANS.
If diabetes occurs near puberty, then funduscopy should be checked for potential retinopathy.
"It is important because the condition poses no symptoms in the initial days. And once symptoms set in, such as bleeding in the eye, red vision, sudden loss of vision, it's too late," Kapoor said.
The doctors advised to adhere to the treatment and maintain a healthy lifestyle to effectively manage diabetes and to prevent the onset or progression of eye diseases.
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Heartfulness meditation, a simple heart-based meditation practice aimed at attaining a balanced state of mind, helps in reducing stress and improving the quality of sleep, revealed a study.
The mixed-method study was conducted by US researchers during the Covid-19 pandemic and was published recently in the International Journal of Environmental Research and Public Health, said Heartfulness Institute, which has its global headquarters in Hyderabad.
Heartfulness meditation was associated with significant reduction in perceived stress and improvement in the quality of sleep of participants who completed the online-based meditation programme.
Kamlesh Patel, also known as Daaji, the guide of Heartfulness meditation, underlines the need to immediately address stress in one's life.
"The simple focus of life is to become better and better each day. To achieve this we need to be in a state of complete awareness about our self and raise our consciousness in tune with our true nature. Stress is the modern day ill created by our inability to focus on things that matter. Stress and its negative impact on our overall wellbeing has slowly but steadily taken control of every individual," he said.
"While we know Covid-19 as the pandemic, the build-up of stress and its ill impacts is the bigger pandemic and equally a bigger health crisis. Stress needs our urgent attention as well and in consistent practice of meditation we have the most effective vaccination to ward off stress and is the visa for living your life in joy," he added.
The study was conducted by Dr Kunal Desai, Dr Priti Parikh and Dr Alpa Desai of the Department of Internal Medicine, Boonshoft School of Medicine at Wright University, Ohio, and Prof Dr Pratibha Gupta, Food Nutrition and Health Agricultural Research Development Programme, Central State University, Ohio.
Stress and lack of quality sleep are considered serious public health challenges despite modern lifestyles, comforts, and technological advances. The Covid-19 pandemic has genuinely brought attention to this pre-existing stress problem by making it significantly worse.
The study aimed to investigate whether using a virtual heart-based meditation program is associated with improved stress levels and quality of sleep. The researchers enrolled 63 participants to receive an eight-week virtually conducted Heartfulness meditation program. Of these, 36 (57 per cent) completed the entire eight weeks of the Heartfulness meditation programme.
The participants were recommended to attend a minimum of two out of a total of eight virtual trainer-guided group Heartfulness relaxation and meditation sessions each week. These sessions, conducted by one of the authors and a Heartfulness trainer (KD), included 5-7 min of relaxation followed by 20 min of meditation.
They were also provided instructions on using the phone application called 'HeartsApp' on their phones. They could connect as an anonymous seeker with a Heartfulness trainer through the application and meditate without any audiovisual interaction. They were also suggested self-practices to the best of their abilities.
"Our study showed that following Heartfulness meditation practice, PSS and PSQI improved significantly in the participants from different parts of the United States. About 31 per cent were healthcare professionals, and the entire programme was conducted virtually. Based on these observations, we propose that meditation programmes offered via virtual platforms can offer a convenient, helpful, and easily accessible tool to a large community at once to help improve the psychological wellbeing of individuals," said Dr Kunal Desai, who led the study.
"The results of qualitative analysis in our study bring a unique perspective to this aspect as we were able to show that the participants' subjective experiences strongly supported the results of the survey findings. Thus, these results enhance our understanding of how Heartfulness meditation practice helps reduce stress and improve the quality of sleep. Our qualitative analysis suggests these effects could be because a simple heart-based meditation brought a 'calming effect' in our participants, resulting in an 'inner peace'. Such an effect also resulted in inner changes in our participants, including positive thinking, accepting and empathic attitude, and an increase in awareness of one's own emotions and the needs of others."
This study adds to the existing literature supporting the benefits of Heartfulness practice, as reported by some previous studies showing the benefit of Heartfulness relaxation and meditation to reduce stress, burnout, loneliness, and improve the quality of sleep.
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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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Many people believe that heart disease typically affects men. Unfortunately, this is far from the truth. Coronary heart disease is the leading cause of mortality not only among men, but also among women. But women are actually at greater risk if not detected early, and this exacerbates the issue.
Signs of poor heart health do not appear as visibly in women as it does in men. What this means is that if a man has a heart issue, there are specific symptoms like angina which can be spotted easily and the right course of action be recommended. The same issue in a woman may not result in a sign or symptom that can be easily spotted. So often, their symptoms go ignored or unrecognised and they do not receive timely intervention to correct the problem. The issue is so acute that today 1 in 3 deaths among women is due to coronary heart disease.
There is also a significant lack of self-awareness among women about risk factors and the prevention of CVDs. Women don't only attend to matters of the home, but they hold positions at leading companies, and continue to rise to the occasion and meet impossible demands on their time. Through all of this, they take care of the emotional needs of their family members and loved ones; and still culturally are predisposed to putting the needs of others before their own. The stress they experience, among other common risk factors, often goes unnoticed by those around them. And stress has a greater influence on CVD risk in women vs men. Along with stress, other factors like diet quantity and quality also have a greater influence on CVD risk in women vs men. Additionally, women are also impacted by female-specific risk factors for CVD like polycystic Ovarian syndrome PCOS, preeclampsia, pregnancy induced hypertension and gestational diabetes.
In such a situation where symptoms of a heart problem do not manifest visibly, it is extremely important for women to be aware of their own risk factors and adopt proactive measures to take care of their heart health. For example, one risk factor, stress has been linked to a greater intake of energy and nutrient-dense foods, mainly sources of sugar and fat, and to poor diet quality. Women can take simple steps like reducing unhealthy fats and products with high content of sugar and salt to improve the quality of their diet. Choose ingredients that are good for the heart, like oatmeal, wholegrains, fiber rich vegetables, blended oils with the right balance of fatty acids, legumes, soy products, and the like. Regular and consistent exercise, adequate sleep, and other such lifestyle modifications can help maintain heart health in the long term.
Furthermore with signs of poor heart health not manifesting visibly in women, it is crucial that they get regular health check-ups done to assess their risk proactively. Self-awareness and early identification of cardiovascular risk factors can lead to better prevention of CVD in women.
This World Heart Day, let's choose self-care. Get a simple heart check-up done and encourage other women in yourselves too, to get the same done. Take proactive steps for heart health today.
(By Brajesh Kunwar)
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हैदराबाद- विश्व हृदय दिवस पर डॉक्टरों का कहना है कि 50 साल से कम उम्र के करीब 75 फीसदी आबादी को दिल का दौरा पड़ने का खतरा है, ऐसे में दिल की जटिलताएं एक बड़ी बीमारी है, जिसे नजरअंदाज नहीं किया जा सकता है। देश भर में चिकित्सा पेशेवरों द्वारा किए गए अध्ययनों से संकेत मिलता है कि 40 वर्ष से कम आयु के कम से कम 25 प्रतिशत भारतीयों को दिल का दौरा पड़ने या दिल से संबंधित किसी अन्य गंभीर जटिलता से पीड़ित होने का खतरा है; और यह जोखिम 40 से 50 वर्ष की आयु के बीच 50 प्रतिशत आबादी तक बढ़ सकता है।
डॉक्टरों का मनाना है कि भारतीय युवाओं और मध्यम आयु वर्ग की आबादी के बीच स्वस्थ भोजन और सक्रिय जीवन को प्रोत्साहित करना चाहिए। यह सुनिश्चित करने के लिए कदम उठाए जाने चाहिए कि अपेक्षाकृत युवा आबादी में दिल के दौरे के मामलों में वृद्धि को तत्काल नियंत्रित किया जाए। तनाव के स्तर में वृद्धि और अनुचित जीवनशैली दिल से संबंधित बीमारियों के बढ़ने के दो प्रमुख कारण हैं।
चीफ इंटरवेंशनल कार्डियोलॉजिस्ट,ग्लेनीगल्स ग्लोबल हॉस्पिटल के एम साई सुधाकर ने कहा,कई सामाजिक मानकों पर भारत की रेटिंग खराब है, और यह हर गुजरते साल के साथ अधिक से अधिक लोगों को तनावपूर्ण स्थितियों में और अधिक गहराई तक धकेलने का एक प्रमुख कारण है। व्यक्तिगत मुद्दों के साथ ये सामाजिक समस्याएं मानसिक तनाव से पीड़ित लोगों के लिए प्रमुख कारण हैं। उनके दिल पर सीधा प्रभाव पड़ता है। जबकि अधिक पुरुषों को इस समस्या का शिकार माना जाता है।
सीनियर इंटरवेंशनल कार्डियोलॉजिस्ट, एसएलजी हॉस्पिटल्स के वी.हरिराम ने बताया कि भारतीय ट्रांस फैट के अभ्यस्त उपभोक्ता हैं, और यह खराब जीवनशैली, अनियमित कामकाजी समय, शराब, धूम्रपान तंबाकू के साथ-साथ हृदय रोग का खतरा बढ़ाता है और ऐसे व्यक्ति अत्यधिक कमजोर होते है।
अचानक दिल के दौरे के मामलों की संख्या में काफी वृद्धि हुई है। जो हार्मोनल असंतुलन के कारण हो सकता है। मधुमेह, उच्च रक्तचाप और हृदय रोग वाले लोग इसकी चपेट में आ सकते हैं। यह महत्वपूर्ण है कि लोग संभावित हृदय समस्या के किसी भी प्रारंभिक चेतावनी संकेतों को अनदेखा न करें और समय पर चिकित्सा की सलाह ले।
राजीव गर्ग, सीनियर कंसल्टेंट इंटरवेंशनल कार्डियोलॉजिस्ट, अवेयर ग्लेनीगल्स ग्लोबल हॉस्पिटल का मानना है कि कुछ सरल लेकिन अत्यधिक प्रभावी कदम संभवत: युवा भारतीयों में दिल के दौरे के जोखिम को कम कर सकते हैं। भोजन की आदतों में नियमित रूप और संयम सबसे सरल लेकिन शक्तिशाली आदतें हैं, जिन्हें लोग अपने दिल के जोखिम को कम करने के लिए कर सकते हैं। प्रत्येक व्यक्ति का शरीर अलग होता है और तनाव को कम करने की एक अलग क्षमता होती है लेकिन उचित जीवन शैली को बनाए रखना और शारीरिक रूप से सक्रिय रहना है। इस जोखिम को कम करने के लिए सबसे अच्छा हो सकता है।
डॉक्टर ने सलाह दी हैं कि लोगों को शुरूआती चेतावनी के संकेतों जैसे सांस फूलना, सीने में दर्द, अत्यधिक पसीना, चक्कर आना आदि को नजरअंदाज नहीं करना चाहिए और समय पर चिकित्सा शुरू कर देना चाहिए। यह भी महत्वपूर्ण है कि मोटे व्यक्ति और पहले से मौजूद स्वास्थ्य जटिलताओं वाले लोग धूम्रपान छोड़ दें और शराब का सेवन बंद कर दें (यदि उनमें ये दोनों आदतें हैं)। यह भी कहा कि 30 वर्ष से कम आयु के युवा, जिनका हृदय रोगों का पारिवारिक चलता आ रहा है,उनको नियमित रूप से चिकित्सा जांच करवाना चाहिए हैं।
यह भी पढ़े► मधुमेह वाले कुछ लोगों के लिए कोविड क्यों अधिक घातक?