Herpes infections are of 2 types – Oral Herpes and Genital Herpes .

Oral herpes is caused by Herpes simplex virus Type 1 and Genital herpes mostly by Herpes simplex virus type 2 though it may be caused by Type 1 too .
Oral herpes causes sores around the mouth whereas Genital herpes causes them around the genitals or rectum or on the buttocks and thighs . HSV 2 sores may be caused around the mouth as well .

How does Herpes infection get transmitted ?

HSV 1 is transmitted through kissing and by shared utensils and tooth brushes whereas HSV 2 is caused by sexual contact .
If herpes is acquired in pregnancy it may be transmitted to the baby growing in the womb too .

Why does herpes infection cause recurrences and reactivations ?

Once a person acquires herpes virus , it remains latent in the nerves. It can be dormant for many years but outbreaks can be brought on due to
decreased immunity , fever , minor infections , fatigue , stresses , hormonal changes , menstruation , immunosuppression due to chemotherapy or steroids, sexual activity etc.
Many people may have numerous episodes every year .

What are the symptoms of herpes ?

Herpes simplex virus typically causes blisters which break down to produce sores which are painful . There can be intense burning and pain especially with urination . Sometimes there may be urinary retention due to the intense pain and burning . Some people may also experience discharge from the vagina .

Some people hardly have any symptoms and don’t even realise they have it .

The first episode is generally very severe for most and repeat outbreaks much milder. In fact , a person may be contagious even without any visible sores .

During a recurrence , shortly before the appearance of sores there may be tingling , itching and burning where the infection first entered the body .

Diagnosis

Herpes can be diagnosed by taking a swab from these sores and sending them for PCR tests or viral cultures . The swabs can also be taken from the urethra.
If there are sores that are beginning to heal these may show a false negative results. False positive results are also known .
Herpes can also be tested by antibody tests .

How can Herpes be treated ?

Antiviral medication helps to reduce symptoms and help in healing these sores faster . They also reduce the number of outbreaks and recurrences .

Are there any complications associated with herpes ?

Neonatal herpes is a serious infection in newborns that can be acquired due to herpes infection during pregnancy . It can result in blindness , brain damage and even neonatal death .
Other sexually transmitted diseases may be transmitted through these open sores .
Bladder problems and rectal inflammation may also be caused .

Prevention

Safe sex and using barrier method of contraception is the most important way to prevent herpes . Avoiding intercourse with multiple partners and with your partner if he/ she has an outbreak of these sores is advised .
In pregnant patients who’ve had herpes in the past , a fresh outbreak around the time of delivery can be prevented by taking antiviral medication late in pregnancy ( generally after 36 weeks of pregnancy)

If there are any symptoms that appear like these , please consult your doctor and remember the mantra to staying safe is safe sex … because as we all know ,prevention is always better than cure !

Menstrual cups are small, flexible, funnel-shaped cups made of silicon or rubber that are inserted inside the vagina to collect menstrual eco-friendly blood. They’ve been around since the 1930s but did not gain favour till recently when they’ve resurfaced as an eco-friendly method of feminine hygiene.

Why use menstrual cups?

If you’re interested in menstrual cups do speak to your gynaecologist.

-Menstrual cups are pocket friendly. They cost much less than the sanitary napkins and tampons you need to buy every month.

-They are safer to use compared to tampons as they collect rather than absorbing blood. They hold much more blood and need to be changed after 8-12 hours depending on the flow. Tampons, on the other hand, need to be changed 4-8 hourly.
Tampons can cause the Toxic Shock Syndrome; since cups don’t absorb blood they are less likely to be a source of infection by bacterial invasion.

-These menstrual cups cause less of odour unlike sanitary pads and tampons as they don’t absorb blood which comes in contact with environmental air that causes a bad smell.

-They are more eco-friendly. Most can be used for up to 1 year or longer ( though some are disposable too); that means less trees cut and less waste in landfills due to pads, cloths, and tampons.

-You can wear menstrual cups with an IUD in place though the thread of the IUD may need to be cut shorter so that it doesn’t get pulled out with the cup.

-You can use it during sex as well. Most well-fitted cups are not even felt by you or your partner during intercourse.

What are the disadvantages of using Menstrual Cups?

-They may be difficult to insert or remove initially till practice makes perfect.

-The removal of a cup may be messy, especially in public toilets and some people may be embarrassed doing the same. You need to carry bottles of water and tissue paper to clean them. Also, you may initially find it tough to pinch the base of the cup to release the vacuum and then pull at the stem.

-It may be tough to find the right fit.

-They may cause vaginal irritation if they are not cleaned or cared for properly.

How to use the menstrual cup?

Menstrual cups are available online and in different sizes. You need to get a size that’s appropriate for you. Please speak to your health care provider regarding the same.

You need to wash your hands, apply a water-based lube or water to the rim of the cup, fold the cup ( different styles of folding seen in the images), and insert it inside the vagina rim up. The cup is then rotated and it sits in the vagina just below the cervix after a vacuum is created.

Once it is properly placed it is very comfortable and you won’t feel it. The seal of the cup is such that leaks are prevented.

How to remove the cup?

You need to empty the cup 6-12 hours later depending on the flow. Wash your hands, insert the index finger and thumb inside the vagina, feel the stem of the cup, and reach up to the base. Pinch the base, release the vacuum and then pull at the stem bringing the cup out. This can now be emptied of blood, washed, and re-inserted inside.
Re-usable cups can be used from 6 months to 10 years while disposable ones can be thrown away after use.

Price of the menstrual cup?

Most menstrual cups available online come at a price of 200 Rs up to around 1000 Rs. They come with a cloth bag in which the cup can be stored when not in use.

So make an informed choice – your body, your choices! The menstrual cup is indeed a way of empowering yourself, of clean and safe periods, and a hygienic and more eco-friendly and sustainable way of life!

The time in a woman’s life when periods stop can be seamlessly simple or it may be fraught with many problems . Gone are the days when one had to endure them ; it’s time to now seek options that help you ease into menopause .

Phases of menopause :

1. Peri menopause: The few years preceding menopause when ovaries start producing less oestrogen hormones leading to irregular or scant / heavy periods , hot flashes , mood swings , weight issues , coarse skin and hair , vaginal dryness , sore breasts and increased frequency of urination.

2 Menopause: Natural menopause happens after the age of 40 years of life . If it happens before 40, it is called Premature Menopause. Menopause implies that there are no periods for one year.

3 Post menopause: The years following menopause are referred to as the post menopausal years .
With increased life expectancy and a better socio economic class and changed life style more and more women are grappling with menopausal and post menopausal symptoms .

Symptoms of menopause are hot flashes , sweating in the head and neck region , fatigue , irritability , depression , anxiety , breast heaviness, increasing weight which may be more difficult to lose , vaginal dryness, lack of interest in sex , often due to painful intercourse due to vaginal dryness,urge to urinate more frequently and urinary tract infections.

Later on in life there may be palpitations and heart disease, osteoporosis ( weak bones and joints ) and insomnia as well .

Diagnosis:

It is that phase of life that is inevitable and most women know their bodies and can make a diagnosis on their own with the advent of these symptoms.

Your doctor may do some blood tests like
S FSH
Estradiol
Thyroid tests
S AMH
Along with these they may get an ultrasound and DEXA scan for determining your bone strength .

Treatment for menopausal symptoms involves

Hormone replacement therapy
Topical hormonal creams
Non hormonal therapy to ease vasomotor symptoms like hot flashes
Medicines and supplements like Vitamin D and calcium .

The advantages of healthy lifestyle like exercise , clean eating and keeping your weight in check are multifold and are greatly needed . Also Kegel’s exercises to tighten pelvic floor muscles and staying socially active are extremely important . Yoga , pranayam and breathing exercises and alternate forms of exercise like Tai-chi and acupuncture also have a place in treatment . Avoidance of smoking and alcohol ( or drinking in moderation ) is strongly recommended .

Remember , this is an important phase in our life and is an inevitable part of our journey . May we empower each other in this stage of life ; may we have stronger , calmer , mentally , socially and emotionally equipped band of women – strong enough to understand and adapt to the changes in our bodies …. Strong and powerful !

What is the first trimester of pregnancy ? 

This begins from the first day of your Last Menstrual Period ( LMP) till the end of the 13 th week of pregnancy . It begins even before you’re actually pregnant . 

What are the changes in your body ? 

You may have weakness and fatigue 

Nausea with or without vomiting 

Breast heaviness and tenderness 

Lower abdominal pain 

Increased frequency of urination 

Constipation and heartburn 

These symptoms may not be present and all may not be present necessarily . 

What are the expected changes in your baby ? 

Your baby develops from a fertilised egg to a ball of cells that looks like a mulberry to a fully formed fetus at the end of the 13 th week . 

Once the embryo gets implanted in the uterus it shows numerous changes. 

Your baby’s spine and brain develops from an open neural tube . 

The heart begins to take shape and heartbeat appears 

The digestive system and kidneys develop 

A soft skeleton starts to grow 

By the end of the first trimester your little one starts looking like a baby and is 2.5-3 inches long . 

What are the red flag signs to watch out for ? 

Severe abdominal pain 

Heavy bleeding or even brownish spotting 

Fainting attacks or severe dizziness 

A rapid weight gain or too little weight gain 

Remember this time is a crucial time ; some girls may glow with happiness while others may feel terribly miserable . 

Meet your doctor by scheduling an Antenatal visit . Pregnancy is a long journey ; let’s make a beginning positively and joyously .

When to plan a delivery after a Caesarean delivery 

A delivery is an overwhelming event . Even though it comes with very happy times , it is a long process often with mixed feelings . As a new mom you struggle with bodily changes of pregnancy and lactation , sleepless nights and exhaustion . A caesarean delivery may also be associated with excessive blood loss , pain and infection at the scar site . And the Caesarean section scar is not just skin deep, there’s a cut on the uterus too that heals as time passes . It takes about 6 weeks for physiological changes of pregnancy to return to that of non pregnant state . 

The longer we give time for the scar to heal , the better it is . And the longer we give time to our body to heal and recuperate ,better still. Iron stores need to be repleted, calcium levels and Vitamin D levels need to be restored , weight lost and bone and muscle mass built with diet and regular exercise . Repeated pregnancies at short intervals drains the mother not just mentally and emotionally but physically as well . 

What is the best time to plan a delivery following  a caesarean delivery ? 

The WHO recommends 2 years and the Government of India says spacing of children by 3 years is ideal and desirable but that may not always be the best for you . If you’re 35 years of age or more or if you’ve had a high risk pregnancy or problems with fertility , you may not want to delay having another baby for so long . Also , sometimes unplanned pregnancies happen very soon after a caesarean delivery . It’s best to discuss your individual case and concerns with your doctor . 

What are the concerns about conceiving very soon after a caesarean delivery ? 

There are greater chances of a weak scar on the uterus due to the previous caesarean rupturing . Also your chances of having a VBAC ( Vaginal delivery after Caesarean birth ) go down due to conceiving too soon . 

There are greater chances of placental problems like bleeding during pregnancy and an adherent placenta . 

Some studies also show chances of preterm births if you conceive too early after a caesarean delivery . 

So it’s best to wait for at least 18-24 months after a caesarean delivery to rest , recuperate , heal and take care of your first baby but still talk to your doctor should you wish too/ accidentally conceive before this .