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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Along with physical and mental health, sexual health problems are also aggravated by the ongoing pandemic, a primary reason being increasing stress due to factors such as job, work life balance, financial challenges, lack of socialising and strained relationships. A recent study has revealed that Covid-19 increases the risk of developing erectile dysfunction (ED) by nearly six times.
Sexual health and wellness is defined as a state of physical, emotional, mental, social, and spiritual dimensions in relation to sexuality. Sexual intimacy is a highly stigmatised and taboo topic in India, and people are usually unwilling to talk openly about their sexuality and sexual health.
Stress directly affects our hormones and mood and can take away a person's libido, thereby affecting quality time of a couple. It can also cause one to indulge in smoking or alcohol consumption which in turn can adversely affect sexual performance. These can lead to problems such as premature ejaculation, erectile dysfunction, reduced libido, and male fertility.
Erectile dysfunction, or ED, is a common condition that can make sexual activity difficult. It may lead to a loss of intimacy in a marriage or long-term relationship, affecting the mental well-being of both partners. Some leading Indian andrologists share their thoughts on the recent study and the co-relation between the coronavirus and erectile dysfunction.
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Pramod Krishnappa, Consultant Andrologist, NU Hospitals, Bangalore tells IANSlife: "The Covid-19 pandemic has wreaked havoc on humans causing both physical and mental illness. Although the lung is the most prominent organ affected, a recent research paper from Miami has revealed the presence of Covid-19 viral particles in the most sensitive organ, penis. The authors have also hypothesised that this widespread endothelial dysfunction could lead to erectile dysfunction. An Italian survey led by Sansone also revealed that the erectile dysfunction was common among those who had Covid-19 infection in the past and very aptly commented that "Mask up to keep IT up"."
Raman Tanwar, MBBS, MS, FMAS, MCh (Urology) Gold Medallist, Department of Urology and Andrology at Uro centre, Jyoti Hospital, Gurugram adds, "Covid-19 infection leads to widespread endothelial dysfunction which means that the linings of blood vessels do not function properly once infected. For erection the optimal function of blood vessel lining is needed and many studies across the world are finding an increased incidence of erectile dysfunction in patients who are positive. Studies have also pointed that those who have ED are more likely to have Covid-19 infection."
If an individual is diagnosed with ED, the first step is to reach out to a doctor as it can be a sign of underlying health problem. Heart diseases, clogged blood vessels, high blood pressure, cholesterol, diabetes, obesity, anxiety, stress, depression and lifestyle habits like smoking and alcohol consumption are a few of the main causes of erectile dysfunction.
Vineet Malhotra, Clinical Director, Diyos Men's Health Centre shares: "The recent study conducted at the Miller School of medicine, Miami, USA notes the presence of Covid-19 in the penis even 7 months post infection. The increased risk of endothelial dysfunction can lead to a risk of erectile dysfunction in affected men."
Sanjay Pandey, Head of Uro-Andrology at Kokilaben Dhirubhai Ambani Hospital, Mumbai tells IANSlife: "Covid-19 affects different men in different ways. There is a possibility that some men might develop ED after suffering from Covid-19. So particularly for young and healthy people who abruptly develop erectile dysfunction, and especially after having Covid-19, this can be a sign of something more serious going on. This could last for long term or short term. ED is usually a symptom of another medical condition. If your health isn't great to begin with, you're more likely to have severe or unwanted symptoms from Covid-19, such as ED."
Doctors suggest that with the number of cases increasing every day and multiple studies indicating that men are more prone to Covid-19, this study makes it more imperative that men must be extra cautious in their everyday life ignoring which could affect various aspects of their lives.
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Nandpora at Saidakadal locality here wears a deserted look. The only visitor, a stray dog that lies dozing in the compound, basking in the mild May sun. In the pre-pandemic times, however, the health centre was the hub of many a bustling activity. Awareness campaigns around the importance of menstrual health would be held every fortnight, refuting myths and misperceptions around mensuration. The World Menstrual Hygiene Day, which falls on May 28, would have especially been a lively affair. But in these pandemic times, like every other non-Covid healthcare intervention, menstrual health has taken a backseat. With every resource being diverted to the crisis at hand, a crushing blow has been dealt to menstrual awareness efforts in the valley.Auqfeen Nisar (30), a resident doctor at Shri Maharaja Hari Singh (SMHS) Hospital, initiated a first-of-its-kind, crowd-funded campaign against menstrual taboo, 'Panin Fikr', when she was still a post-graduate student. She has been championing the cause since 2019, leading a six-member team comprising two nurses and four ASHA (Accredited Social Health Activist) workers. She conducted her campaign from the health centre in Nandpora where she was posted, catering to a community of around 4,000 women, of whom 200 are adolescent girls.She notes that the Covid-19 pandemic and the ensuing lockdown has unleashed a sanitary napkin crisis in the valley. "After the pandemic began, the donations stopped pouring in. Our funds have completely dried up and we are unable to provide sanitary napkins free of cost to the registered population under the initiative. Moreover, door-to-door and mass awareness campaigns are not possible at this time, when social gatherings are disallowed," Auqfeen rued.She said it took them a lot of time to bring about behavioural changes in women regarding menstrual hygiene. "The free napkins were a great source of motivation for them. However, all our efforts will go to waste if things continue like this. They will resort to their old, unhygienic practices, if they haven't done so already," Auqfeen said.She cites the example of a 35-year-old woman from Nandpora, who had attended several awareness programs, subsequently shifting from cloth to sanitary pads. However, when Auqfeen met her recently, she was saddened to hear that the woman had reverted back to using cloth.The pandemic had reduced her income, and so pads had become unaffordable.Similarly, entrepreneur Aqib Peerzada (28), popularly knowns as `Padman of Kashmir' for launching organic sanitary napkins, concurs that the pandemic has exacerbated women's deprivation of menstrual hygiene products."Before the crisis, we at Seha Health and Hygiene were engaged in distributing packs of sanitary napkins to teenage girls at affordable prices as well as free of cost to many others across the valley. Our mission was to create awareness about menstruation in addition to manufacturing affordable and organic sanitary napkins," he said. However, the lockdown severely hampered their production and operations. Their manufacturing units were shutdown, and the lack of manpower ensured that the production of sanitary pads came to a screeching halt. Aqib himself came down with Covid-19 pneumonia and had to stay away from Seha during his month-long hospitalisation and recuperation. "Eventually stocks were exhausted in many places and women had to resort to unhealthy alternatives," he said.However, despite the lockdown and threat of infection, Seha has managed to distribute many boxes of napkins, especially to women in quarantine. "I have faced many hurdles and difficulties during this time but still I personally delivered many boxes to needy girls during this crisis. I believe that it's our priority to not think about profits and targets but come forward and help people as much as we can," he said.The crisis is aggravated by the fact that the mobility of women is severely restricted during the lockdown. Irfana Zargar (30), the founder of `Eva's Safety Door' campaign, illustrates this. As part of her campaign to raise awareness, she used to distribute sanitary napkin packs for free among the attendants of public toilets in Srinagar city so that the women coming there could use them. With the toilets now shut, the campaign has also gone for a toss."The lockdown has resulted in restricted access and mobility, making it even more difficult for girls to manage their monthly cycle in a dignified healthy way," she said. Meanwhile, Irfana who also works at the Srinagar Municipal Corporation, is deputed these days at the round-the-clock district control room Srinagar that handles Covid-19 related complaints."The work is so taxing that there is no time to devote to altering the campaign to meet the pandemic needs," Irfana said.Nausheen Khan, a senior gynaecologist at Lal Ded, the lone maternity hospital in Srinagar, said after lockdown, the distribution of the sanitary pads has hit a dead end."The government must ensure that the sanitary pads are distributed to females in the community through Auxiliary Nurse-Midwives (ANMs) and ASHAs. Even if sanitary napkins are not available, they should educate them on how to make sanitary napkins at home. The napkins can be made from cotton cloth and changed frequently. They should be washed properly before using it again," she said.Khan pointed out that subsidised sanitary pads can also be made available for sale through the ration shops. "An inclusive and gender-sensitive response to COVID-19 must involve catering to the menstrual health and hygiene needs of women and girls especially from the most marginalised sections," she said.(The author is a Srinagar-based freelance journalist and a member of 101Reporters.com, a pan-India network of grassroots reporters)--IANS<br>sdr/
New York, May 12 (IANS) US researchers have for the first time demonstrated that Covid-19 can be present in the penis tissue long after men recover from the infection and lead to erectile dysfunction.The Covid-19 infection can cause widespread blood vessel dysfunction, or endothelial dysfunction, which can then contribute to erectile dysfunction, said the researchers from the University of Miami.Endothelial dysfunction is a condition in which the lining of the small blood vessels fails to perform all of its functions normally. As a result, the tissues supplied by those vessels could undergo damage.The team found that Covid-19 was present in the penile tissue of both men who had been infected, but not in the men with no history of the virus. The men had been infected six and eight months prior, respectively. These men had evidence of endothelial dysfunction, while the men who had been free of the virus did not. The findings, of the pilot study, are published in the World Journal of Men's Health."Our research shows that Covid-19 can cause widespread endothelial dysfunction in organ systems beyond the lungs and kidneys. The underlying endothelial dysfunction that happens because of Covid-19 can enter the endothelial cells and affect many organs, including the penis," said Ranjith Ramasamy, Associate Professor at the varsity."In our pilot study, we found that men who previously did not complain of erectile dysfunction developed pretty severe erectile dysfunction after the onset of Covid-19 infection," Ramasamy added.The team collected penile tissue from two men with a history of Covid-19 infection who underwent penile prosthesis surgery for erectile dysfunction. One of the men was hospitalised for Covid-19, while the other patient only had mild symptoms when he contracted the virus.The researchers also collected tissue from two additional men with no history of Covid-19 infection undergoing the same surgery for erectile dysfunction. The investigators analysed all the tissue samples for not only evidence of the virus but also endothelial dysfunction.Similar to other Covid-19 related complications, widespread infection and subsequent endothelial dysfunction could result in erectile dysfunction, and its worsening could be due to the virus's presence in the penile tissue itself, the researchers said.--IANSrvt/ash
New Delhi, March 10 (IANS) An Apple-led study has validated women's experiences of a wide range of menstrual cycle symptoms, including some that are less commonly known or discussed that will help destigmatise menstrual symptoms.The Apple Women's Health Study team at Harvard T.H. Chan School of Public Health on Wednesday released a preliminary study update, offering pioneering scientific insights on women and their menstrual symptoms, made possible through the innovative research methodology of the Research app.The update, based on a cohort of 10,000 participants and inclusive of varying ages and races across the US, highlights how large-scale, longitudinal research on menstruation can help advance the science around women's health.The study found that most frequently tracked symptoms were abdominal cramps, bloating and tiredness, all of which were experienced by more than 60 per cent of participants who logged symptoms.More than half of the participants who logged symptoms reported acne and headaches. Some less widely recognised symptoms, like diarrhoea and sleep changes, were tracked by 37 per cent of participants logging symptoms."These findings take us a step further in validating and destigmatising period symptoms," said Dr Sumbul Desai, Apple's vice president of Health.Initial analysis also suggests these symptom trends hold true across a wide range of demographics, including age, race, and geographic location.For example, across Black, Hispanic, and white participants, the most commonly reported symptoms were abdominal cramps, bloating and tiredness."Our study will help to achieve a more gender equal future, in which all people with menstrual cycles have access to the health services and menstrual products needed to feel safe and empowered," said Dr Michelle Williams, Dean of the Faculty at Harvard Chan School.The team will further investigate the preliminary data and submit a detailed analysis, including a breakdown of methods, for peer review and journal publication."The preliminary data we are sharing today suggests women across the country have a shared experience of a wide range of menstrual symptoms, and that this natural monthly occurrence is something we should be having more discussions about," said Dr Shruthi Mahalingaiah, one of the study's principal investigators.--IANSna/
An Apple-led study has validated womens experiences of a wide range of menstrual cycle symptoms, including some that are less commonly known or discussed, that will help destigmatise menstrual symptoms.
The Apple Women's Health Study team at Harvard T.H. Chan School of Public Health on Wednesday released a preliminary study update, offering pioneering scientific insights on women and their menstrual symptoms, made possible through the innovative research methodology of the Research app.
The update, based on a cohort of 10,000 participants and inclusive of varying ages and races across the US, highlights how large-scale, longitudinal research on menstruation can help advance the science around women's health.
The study found that most frequently tracked symptoms were abdominal cramps, bloating and tiredness, all of which were experienced by more than 60 per cent of participants who logged symptoms.
More than half of the participants who logged symptoms reported acne and headaches. Some less widely recognised symptoms, like diarrhoea and sleep changes, were tracked by 37 per cent of participants logging symptoms.
"These findings take us a step further in validating and destigmatising period symptoms," said Dr Sumbul Desai, Apple's vice president of Health.
Initial analysis also suggests these symptom trends hold true across a wide range of demographics, including age, race, and geographic location.
For example, across Black, Hispanic, and white participants, the most commonly reported symptoms were abdominal cramps, bloating and tiredness.
"Our study will help to achieve a more gender equal future, in which all people with menstrual cycles have access to the health services and menstrual products needed to feel safe and empowered," said Dr Michelle Williams, Dean of the Faculty at Harvard Chan School.
The team will further investigate the preliminary data and submit a detailed analysis, including a breakdown of methods, for peer review and journal publication.
"The preliminary data we are sharing today suggests women across the country have a shared experience of a wide range of menstrual symptoms, and that this natural monthly occurrence is something we should be having more discussions about," said Dr Shruthi Mahalingaiah, one of the study's principal investigators. (IANS)