Top 5 Tips for Pregnant Women During Winter

Winter

Courtesy: http://www.freevector.com/site_media/preview_images/FreeVector-Silhouettes-Of-Pregnant-Women.jpg

During pregnancy, every woman, particularly in India, will experience the harshness of summer and winter. While many underestimate winter in South India,  it can be challenging for expecting moms irrespective of where they reside. These top 5 tips for pregnant women during winter will surely help in taking extra care of your baby and your health.

You might be longing for winter as you’ve had enough of the scorching heat and humid days, but be prepared to experience its peculiarities especially when you’re pregnant. The following points will help you gear up for the colder months and keep you safe from woes like infections, dryness and itchiness, etc. 

Top 5 tips for pregnant women during winter

 #1 Avoid dehydration

If you thought dehydration happens only during summer then remember winter air can also be dry, making your body overheated from within. Dehydration usually occurs when the body starts losing its fluid faster than its intake. During pregnancy, dehydration can be risky as it first affects the baby.

How dehydration is risky during pregnancy?

Water in an expecting mom’s body helps to form the placenta, through which the unborn baby draws its necessary nutrients. Besides, water also helps in forming the amniotic sac in the last stage of pregnancy; therefore it  becomes extremely necessary to stay well-hydrated.

#2 Protect yourself from infections

Winter also brings assorted infections including flu, cold and sneezing. Since you are pregnant you cannot simply take any anti-allergy pills or antibiotics. The best way to avoid cold and infections is by always keeping your hands clean. Unknowingly, germs get transmitted easily through our hands when we touch our mouth and nose.

It is recommended that pregnant women should get vaccinated against influenza. It is ideal to also get a whooping cough booster vaccine, on your doctor’s advice.

#3 Go in for layering

Instead of spending a fortune on an oversized coat that is pretty useless post pregnancy, it’s better to wear winter clothes in layers. Start with lighter layers underneath and end with a bulky sweater which you remove anytime the temperature goes up.

#4 Eat healthy

No matter the season, expecting moms should always take care of their diet. Extra attention should be given to what they eat in winter. Here are some Do’s:

  • Since winter blesses us with several types of fruit, try consuming them in plenty, especially as juice to stay hydrated.
  • Try to munch on Indian gooseberry (Amla), as it’s loaded with Vitamin C which not only helps fight against infections, but also acts as anti-oxidant and saves skin from dryness.
  • Add saffron to your milk. It maintains body temperature and boosts immunity.
  • Make sure you munch on a handful of nuts regularly as they are enriched with vitamins and natural oils. Since nuts are tasty, you can easily replace oily snacks with nuts.
  • Do not hesitate to have sweets such as patti, gajak, chikki, til ke laddu etc. While gud or jaggery gives you zinc and is healthier than sugar; til is a rich source of calcium.

#5 Do not cut off your exercise

We admit, winter makes you feel lazy and during pregnancy you wouldn’t want to come out of your blanket. Exercise during pregnancy is essential. So if you are not comfortable walking in the mornings then try going out for a brisk walk around 4-5 pm. You can also join a prenatal fitness programme where you can benefit a lot and stay healthy throughout your pregnancy.

Hope you found this post on top 5 tips for pregnant women during winter useful!

 

All You Wanted to Know About Pelvic Exercises During Pregnancy

 Ex1.jpg

Pic courtesyhttp://www.bepilates.org/

While pregnancy is physically demanding, exercise becomes necessary to cope with the physical as well as biological changes that affect specific areas such as muscles, joints, backbone and especially the pelvic floor. In this post, we are going to share how pelvic floor exercises during pregnancy are important since they not only help reduce pelvic pain but also ease the childbirth procedure.

Your takeaway from this blog post on pelvic floor exercises during pregnancy

  • Where are pelvic floor muscles located
  • How to locate pelvic floor muscles
  • Why is pelvic floor exercise so important
  • How does pregnancy affect pelvic floor
  • Benefits of pelvic floor exercises
  • Types of pelvic floor muscle exercises
  • What else you should know about pelvic floor exercises

Before we jump into the workout section, let’s have a quick intro on pelvic floor –

Ex2

Pic courtesy- http://pelvicguru.com/2013/06/22/dear-crossfit-and-crossfit-gynecologist-im-appalled-theres-help-for-peeing-during-workouts/

 Where are pelvic floor muscles located?

As the name suggests, the pelvic floor muscles form the base of the pelvis.

Pelvic floor is a group of muscles, ligaments and sheet-like tissues that stretch from the front side to the back side i.e. base of your spine. These muscles are attached to the pelvis sides (the bones that we sit upon). They are also attached to the pubic bone and the coccyx i.e. tailbone. These muscles pass through the vagina, anus and urethra, as shown in the image.

What do pelvic floor muscles do?

  • They help in supporting the bladder, uterus and intestines.
  • They help in controlling bowel and bladder movement.
  • They help in sneezing, coughing and lifting heavy objects.
  • They support the spine and help during sex.

How to locate pelvic floor muscles?

Try to control your flow while urinating, and you can soon identify the muscles which help you stop the flow in the middle of urinating. However, it is not ideal to do this as an exercise as stopping the flow can affect your bladder.

Another way of identifying these muscles is by inserting two fingers into your vagina and try squeezing them. You will soon understand the mechanism.

Ex3

Pic courtesy – http://www.xft-china.com/support/detail_17_85.html

Why is pelvic floor exercise so important?

  • As already discussed above, the pelvic floor muscles support the uterus and help in bowel as well as bladder movement, so if the pelvic floor is weakened then the muscles become harder to be squeezed which affects urinating and bowel movement.
  • Weak pelvic muscles may also put you in an embarrassing situation as you may pee a little while coughing or sneezing. This further leads to a heavy dragging-like feeling because of improper bladder and womb movement.
  • Weak pelvic muscles also affect vaginal muscles.
  • Not only during pregnancy but pelvic muscles should be well maintained as post menopause hormonal changes worsen the abovementioned problems, thereby causing sagging of the uterus and bladder towards the walls of the vagina.

By regularly doing a few pelvic floor exercises, bladder weakness or prolapse symptoms are kept at bay, while reducing the pelvic pain during pregnancy and labour pain as well. 

How does pregnancy affect the pelvic floor?

The extra pounds that you put on following pregnancy exert pressure on your pelvic floor muscles, thereby leading to weakness that persists even after the childbirth. The pelvic floor tends to become weak as early as 12 weeks into your pregnancy.

As constipation is one of the common health problems for expecting moms, it can put more strain on your pelvic floor thus increasing the pelvic pain.

Benefits of doing pelvic floor exercises

  • They help in toning up the pelvic floor.
  • They help in reducing the risk of uterine/bladder prolapse.
  • They help during labour, while improving the recovery time.
  • They help in reducing post-partum discomforts such as perineal swelling and hemorrhoids.
  • They help in healing the area between anus and vagina i.e. perineum post-partum, by improving the blood circulation.
  • They help in reducing perineal tearing and the likelihood of episiotomy.
  • They help in the complete emptying of the bladder and bowel.
  • They help in maintaining the muscle tone of the vagina thereby easing the delivery process.
  • They help in preventing urinary leakage during pregnancy.

Types of pelvic floor exercises

Ex4

Pic courtesy – http://v-tightgelreviews.net/ultimate-guide-kegel-exercises/

Since your pelvic floor muscles comprise two types of fibres — fast fibres that render strength and slow fibres that render stamina; we offer you two types of pelvic exercises during pregnancy for best results.

Short squeezes in pelvic floor exercise –

  1. Sit down comfortably by slightly stretching your knees. Stretch the muscles around the back passage just as you would do to stop your bowel movement.
  2. Now do the same thing at the front, as if you are squeezing your vagina to stop urinating.
  3. Make sure the squeezes are strongly executed in as much that you feel a definite ‘let go’.
  4. These types of short squeezes should not last for more than a few seconds.
  5. Try to do three sets per day in different positions.

Long squeezes in pelvic exercises during pregnancy

  1. Sit down in the same position as you had done for short squeezes and repeat the above step. The only difference is you need to hold it for a longer time i.e. a few extra seconds. But always remember to breathe normally.
  2. Make sure in the process you’re not constricting your buttock muscles. You can stress your lower abdominal muscles a bit but don’t squeeze out your anus.
  3. Take a break of few seconds before repeating the above step. However, you should stop immediately if you feel your muscles are tired.
  4. Try to find out how long you can hold on to the squeezing, say 4 seconds. This will help you do the long squeezes better.
  5. Now when you become comfortable with the 4-second long squeeze, try to increase it to say 10 seconds. You can gradually increase the counts with each workout.

Bonus points — What else you should know about pelvic floor exercises?

It is equally important to relax pelvic floor muscles as it is to tighten and squeeze them. It is especially important when the baby starts crowning its head during second stage of labour. The pelvic muscles need to be relaxed during this stage, so as to avoid episiotomy.

Make sure you drink a lot of fluid and that you urinate only when you feel your bladder is completely full. Since the frequency of urinating increases during pregnancy, do not try to hold on for too long as it affects the bladder.

Intrauterine Insemination (IUI)

What is Intrauterine insemination ?

The technique of Intrauterine insemination (IUI) is a widely popular assisted reproductive technique due to its simplicity and affordability. The IUI procedure involves introducing washed and actively motile sperms directly into the uterine cavity (womb), at or around the time of ovulation, with the aim of increasing the chances of pregnancy. The purpose of IUI is to increase the number of active sperms reaching the egg in the fallopian tube, bypassing the vagina and cervix, thus, shortening the distance to be travelled by the sperms.

IUI is a simple procedure and can be performed whether or not the woman is receiving medication for egg formation. However, stimulation of egg development by medication does improve success rates, as more than one egg will develop. Monitoring by USG is essential to track follicular growth and to time the ovulation. Once the follicle reaches maturity, the patient is given hCG injection (human chorionic gonadotropin) for ovulation, which usually takes place within 24 to 36 hours of the injection.

IUI

Pic courtesy:  http://thefertilityblogs.com/trying-to-conceive/third-party-reproduction/what-is-an-iui/4201/


Who are eligible for IUI procedure?

To consider IUI :

  • The female partner should be ovulating normally or should be able to ovulate with medication for ovulation
  • She should have open fallopian tubes or at least one fallopian tube should be patent and

healthy

  • The male partner should have satisfactory sperm counts, motility and morphology

IUI not indicated in following conditions

  • Female partner with

– tubal block on both sides

– inability to develop eggs

– age > 40 years

– advanced stages of endometriosis

  • Male partner with azoospermia (absence of sperms in semen) or very low scores of sperm count, motility and morphology.

What is the procedure for IUI?

The total procedure has three components. One is semen collection, second is semen preparation and the third is deposition of active sperms in the uterine cavity. The entire procedure takes approximately 1 – 3 hours.

Semen collection and preparation

A short period i.e. 2 days of ejaculatory abstinence is advised prior to the scheduled IUI. At the predicted time of ovulation, the male partner is asked to collect semen into a sterile container and submit it in the laboratory for sperm preparation. Here semen analysis is performed to check for initial parameters. Then it is processed. Best quality active sperms are separated and made into a small quantity (0.25 ml). Rest of the seminal fluid containing dead sperms, bacteria and other components which can cause painful contractions of the uterus, is discarded. Post-wash active sperm count is noted for sample adequacy for insemination. Minimum count of five millions of active sperms is acceptable. Success rates are low with lower counts.

Actual IUI procedure

Once the specimen is ready, the female partner is called for IUI procedure to the insemination room. She is made to lie down on the couch with legs flexed. A speculum is introduced into the vagina to expose the cervix and it is gently cleaned. Prepared sperms are loaded into a slender semi flexible sterile catheter with a plunger. It is then passed through the cervix into the uterine cavity and the sperms are injected by pushing the plunger.

How much time does the actual IUI take and will it cause any pain?

Actual IUI (deposition of active sperms into the uterus) procedure takes only a couple of minutes. The procedure is usually painless, although 10% of the women may experience a menstrual cramp like pain. There may be a little vaginal spotting or discharge after IUI.


 

Is rest necessary after IUI?

The female partner will be asked to lie down for a few minutes after IUI (10 – 15 minutes). Then she can resume her regular activities. The sperms will not escape from the uterine cavity if she gets up.

Is intercourse advised after IUI ?

Yes, this will increase the chances of conception.

How many sittings of IUI are performed in one cycle?

Usually one single properly timed insemination is sufficient.

How many cycles of IUI are recommended?

Four to six cycles of IUI may be tried as there is no improved success seen later.

Chances of success with IUI

Average success rate ranges from 15-20 % in a single cycle. The success rates may be high in stimulated cycles and if the total sperm count is more than 20 million/ml.

What are the risks involved with IUI?

Procedure related complications are infrequent. They include infection where women can suffer with lower abdominal pain, vaginal discharge.

Hysterosalpingogram

What is Hysterosalpingogram ?

Hysterosalpingogram (HSG) is an X-ray test done to know about the patency of the fallopian tubes, which help in the transport of the egg and the fertilized embryo. It is usually done on 7th or 8th day of the menstrual cycle.

Hysterosalpingogram

Pic courtesy:   http://www.aiwhc.com/patient-education-hysterosalpingogram.html


Procedure and Instructions to be Followed for the Investigation

  1. In this test, a small amount of liquid (dye) is pushed into the uterus through a small instrument (speculum) placed in the vagina and an abdominal X-ray is taken. There can be period-like crampy pain during the procedure.
  1. To prevent pain, we advise Tab. Meftal spas to be taken with food, 1 hour before HSG and to continue it 8th hourly depending on the pain for the next two to three days.
  1. This test delineates the uterine cavity and the tubes. If the tubes are open, the dye flows out of the tubes and can be seen on the X-ray film.
  1. As this test involves pushing some liquid into the uterus, there can be a small risk of infection. In order to avoid this, we advise antibiotic Tab. Doxycycline 100 mg two times a day after food, starting from the day of HSG which has to be continued for a total of five days.
  1. Once HSG test is done, a gynaecology consultation (by appointment) with the report is advised.

Medical Ectopic Pregnancy

Ectopic pregnancy (EP) is a pregnancy situated outside the uterine cavity (normal location). Early diagnosis of EP is possible with the advent of high resolution ultrasound and judicious use of serum Beta hCG levels (blood test), which in turn allow medical management in most cases. The choice of treatment should be guided by eligibility criteria and patient’s choice after discussing risks and benefits. Methotrexate (MTX) is the drug used for medical management of EP, sometimes in combination with mifepristone.

EctopicPregnancy

Pic courtesy:  http://www.innercircle.org/


Prerequisites for Medical Management

  • Asymptomatic women with unruptured EP who are clinically stable, have normal baseline blood investigations (blood counts, liver and kidney function tests) and are willing for regular follow-up for 4-6 weeks, can be offered medical management.
  • High serum Beta hCG levels (> 3500 mIU / ml), ectopic mass size > 3.5 cm and / or presence of cardiac activity in EP are relative contra indications to medical management.
  • It should not be offered to those with significant bleeding into the abdomen or those with a coexisting viable intrauterine pregnancy.

Methotrexate Administration

Two protocols are currently used for medical treatment of EP : “Single Dose” MTX therapy at a dose of 50mg/m2 of body surface area and “Multidose” regimen consisting of 1mg / kg of MTX alternating with 0.1mg / kg of leucovorin for upto 4 doses of each agent. Both regimens are found to be effective.

  • MTX can be given on Out Patient basis and intramuscular administration is the preferred route.
  • Multidose regimen is preferred in women with high serum Beta hCG levels or those with presence of cardiac activity on ultrasound. In the single dose regimen, further doses of MTX may be repeated (upto a maximum of 3) if there is an inadequate response (<15% drop in serum Beta hCG).
  • In the single dose regimen, further doses of MTX may be repeated (upto a maximum of 3) if there is an inadequate response (<15% drop in serum Beta hCG).

Laparoscopy is indicated if :

  • Severe abdominal pain or signs suggestive of tubal rupture develop.
  • There is no satisfactory drop in serum Beta hCG levels even after 3 doses in the single dose regimen or 4 doses in multidose regimen.

Anti D:

Regardless of the method of treatment Anti D should be given to all Rh negative women who have an EP.

Patient Should Be Advised To

  • Avoid sexual intercourse until Beta hCG is <10 mIU / ml.
  • Avoid pregnancy for three months after MTX injection, due to the theoretical risk of birth defects with MTX.
  • Avoid sun exposure to limit risk of MTX dermatitis.
  • Avoid foods and vitamins containing folic acid.

Post Treatment Management

Beta hCG   Serial serum Beta hCG levels need to be checked on days 4 and 7 after MTX.

  • If there is >15% decrease between days 4 and 7, weekly follow up is advised until Beta hCG is <10 mIU / mL.
  • If <15% decrease is noted by day 7, 2nd dose of MTX is advised.
  • In multidose regimen, serum Beta hCG levels are checked every 48 hours till significant decrease is noted and weekly thereafter.

Ultrasound It is generally not repeated except to evaluate severe pain or suspected rupture or for patients with cardiac activity in the EP.

After completion of treatment, an ultrasound is advised to check for resolution of the EP which may take upto 3 months at times.

Efficacy

  • Overall success of medical management is 88 – 90%.
  • Around 14% of patients require a 2nd dose and less than 1% of women require more than 2 doses of MTX.

Side Effects

Drug related

Adverse reactions to MTX are usually mild and self-limited. Approximately 30% of patients in the single dose protocol will experience side effects, the most common are mouth ulcers and conjunctivitis.

Separation pain

Up to 75% of patients may complain of pain between days 2-7 after receiving the medication. This pain is usually mild and can be managed with paracetamol. Women with severe pain require further evaluation to rule out rupture of EP and the need for surgery.

Subsequent Reproductive Performance

  • There is no evidence of adverse effects of MTX treatment on future pregnancies.
  • Studies have shown a subsequent intra uterine pregnancy rate of 60-90%.
  • The incidence of recurrent EP is approximately 7-15%.
  • Women should be instructed to undergo an early ultrasound evaluation in subsequent pregnancies to confirm normal intrauterine location.

Colposcopy

What is Colposcopy ?

Colposcopy is a detailed examination of the cervix (neck of the womb). A colposcope is like a large magnifying glass which magnifies the image to approximately 15 times. It allows the doctor to look more clearly at cell changes in the cervix.

Colposcopy is simple, quick and generally painless. The actual examination takes only about 15 minutes. It is not done during menses. It can be done safely during pregnancy and will not affect delivery of the baby. However, treatment is usually postponed until after delivery.

Colposcopy

Pic courtesy:   http://dronuma.com.au/cervical-smears-colposcopy/

Why do I need a colposcopy ?

Colposcopy is usually indicated when the routine cervical screening test i.e. Pap smear test, has picked up abnormal cells from the cervix.

An abnormal result is not unusual – it happens in about one in twenty tests. An abnormal result usually means that small changes have been found in the cells on the cervix. It is important to remember that it is very rare indeed for these abnormalities to be cancer.

Colposcopy identifies the source of the cell change and helps to decide on further treatment. It is not a treatment by itself.

What exactly happens during a colposcopy ?

A speculum is passed into the vagina and the doctor applies different solutions onto the cervix to help identify and highlight any areas with abnormal cells. The abnormal areas will appear white after the application of vinegar (acetic acid 3 – 5 %). An iodine based stain may also be applied to the cervix to look for other abnormal areas. If any abnormal area is identified, a small sample of tissue (few mm in size) may be taken from the surface of the cervix for a biopsy. This is usually not painful.

It is necessary to wait for the biopsy results before deciding on further treatment. For some women the changes in the cervix return to normal by themselves. Other women may need some simple treatment.

What happens after colposcopy ?

After a colposcopic examination, normal activity can be resumed. If a biopsy has been taken, a light bloodstained discharge may occur for a few days following the procedure. This is normal and should clear by itself. It is best, however, to refrain from intercourse for up to five days to allow the biopsy site to heal.

Follow up

A review appointment with biopsy report will be scheduled in a week to 10 days’ time. Depending on the results of the biopsy, further treatment may be advised if required, or, one may be asked to return for a repeat pap smear in 6 months or routine screening.

Treatment options

If the biopsy warrants treatment, further procedures may be needed. Types of treatment vary, but all aim to destroy (cryotherapy) or to remove (loop excision) the abnormal cells. These treatments can be performed on an out-patient basis under local anaesthesia or under general anaesthesia.

Cryotherapy involves destruction of abnormal tissue by freezing it with nitrous oxide. It is a relatively painless procedure which takes around 15 to 20 minutes. After the cryotherapy, the frozen cells will slough off and new cells will grow underneath.

In loop excision, a small heated fine wire loop is used to remove the abnormal area from the cervix under local or general anaesthesia, and a sample is sent for analysis. The procedure may take around 20 to 30 minutes.

What happens after the treatment ?

Following cryotherapy, there may be watery vaginal discharge for 3 to 4 weeks.

Following loop excision, bloodstained vaginal discharge may be noticed for about two weeks, although it can last for 4 to 6 weeks.

The discharge should not be heavier than normal menses and should get progressively lighter. Abstinence from sexual intercourse is advised for six weeks. Follow-up is scheduled six weeks after cryotherapy or two weeks after loop excision.

Cervical Cancer

Cervical Cancer CAN be avoided

The thought of cervical cancer is a particularly alarming one for all women, since no one knows exactly how it is caused. Many factors appear to be involved and not all of these will be present for every woman.

CervicalCancer

Pic courtesy:   http://www.healthcare-online.org/Cervical-Cancer-Symptoms.html

Why have a Cervical Smear Test?

Cervix is the lowermost part of the uterus. If detected early, the majority of cervical cancer cases can be avoided and the disease can be halted. Unfortunately, during the early stages there are no signs to tell a woman that she may be at risk. One of the simple ways to detect it, is by having a cervical smear test (also called a PAP SMEAR). Once it is discovered, treatment to counteract can be initiated. The early warning signals can be detected, which if left untreated could lead to cancer.

What is a Cervical Smear Test?

A smear test is a very simple way of checking the health of the cervix. By looking at the smear, experts can confirm if the cervix is normal and healthy, or abnormal. Presence of abnormal cells suggests cancer may develop in the future.

When to have the Smear Test?

  • Women between the ages of 20 – 60 years should do the test every 3 years.
  • Women who have excess / recurrent attacks of vaginal discharge or bleeding after sexual intercourse should do the test, regardless of their age.
  • It should be done within 10 days of the onset of periods.
  • There should be no bleeding at the time of the test.

How is a Smear Test done?

The smear test is a simple out patient procedure where the gynaecologist scrapes some of the cells from the cervix (the neck of the uterus), and smears it on a glass slide and sends it to the lab for examination.

What happens after the Test?

It takes 3-4 days to get the results from the lab. If the smear test is normal, (as it is in a majority of cases), then it should be repeated after 3 years.

If the test discloses some “abnormalities”, this usually means that some changes have occurred in the cells, which, if left untreated, could develop into cancer after many years. Remember, most women who have had an abnormal smear test are successfully treated.

Once treatment is started, it will be necessary to repeat the test after some months. If the subsequent smear tests are normal, then the tests should be done every 3 years.

If, however, the subsequent smear tests are not normal and continue to show some abnormalities, then it will be necessary to investigate further.

One of the easiest and most accurate ways of studying the cervix and confirming the disease is by undergoing a Colposcopy.

Cervical Cancer

Colposcopy?

Colposcopy is an in-depth examination of the cervix, through a special microscope called a colposcope. A colposcope acts like a magnifying glass with a light and allows the doctor to have a closer look at the cervix.

What happens during Colposcopy?

A Colposcopy examination is an out patient procedure, just like the smear test. A solution is applied to the cervix, which will cause any problem areas to turn white. The cervix is then viewed through the colposcope, which is placed just outside the vagina. If there are any abnormal areas on the cervix, a tiny sample of tissue is taken (biopsy) and sent to the lab for further testing.

After Colposcopy

There is no need for an overnight stay in the hospital after a Colposcopy. As mentioned earlier, it is an out patient procedure. If some tissue is taken from your cervix, you may experience some mild cramping or light bleeding for a few days, which can be relieved by any anti-inflammatory medication. It is advisable to abstain from sexual intercourse for a few days after a biopsy.

he results of the biopsy will determine the course of action to be taken. Feel free to talk to your gynaecologist about the type of treatment, the duration, and the options available.

Cervical Cancer

Prevention of Cervical Cancer (HPV Vaccine)

What is HPV ?

HPV (Human Papilloma Virus) is a common virus that is passed from one person to another through direct skin-to-skin contact during sexual activity. Most sexually active people will get HPV at some time in their lives, though most will never even know it. HPV infection is most common in late teens and early 20s.

There are many strains (types) of HPV that can infect the genital areas of men and women. Most HPV types cause no symptoms and go away on their own. But some types can cause cervical cancer in women and other less common cancers – like cancers of the anus, penis, vagina, and vulva (area around the opening of the vagina) and oropharynx (back of throat including base of tongue and tonsils). Other types of HPV can cause warts in the genital areas of men and women. These genital warts are not life-threatening. However, they can cause emotional stress and the treatment can be very uncomfortable.

HPV1

Pic courtesy:  http://www.virology.wisc.edu/virusworld/viruslist.php?virus=hpv

Why are HPV vaccines important ?

The vaccines target the HPV types that most commonly cause cervical cancer. One of the two currently available vaccines also protects against genital warts caused by HPV. Both vaccines are highly effective in preventing specific HPV types.

What is the vaccination schedule ?

The schedule is three doses of intramuscular injections, administered over a period of six months.

Who needs to get vaccinated ?

HPV vaccination is recommended for girls and women (9 to 45 years of age).

Can pregnant women take the vaccine ?

The vaccines are not recommended for pregnant women. Although studies show that HPV vaccines do not cause problems for babies born to women who received HPV vaccination when pregnant, more research is still needed. If the patient becomes pregnant in the middle of the vaccine series, then the doses should be completed after delivery. Vaccination can be given during breastfeeding.

Should girls and women be screened for cervical cancer before getting vaccinated?

Girls and women do not need to get an HPV test or Pap test to find out if they should get the vaccine. However it is important that women continue to be screened for cervical cancer, even after getting all three shots of the HPV vaccine.

How effective is the vaccination ?

It is a prophylactic vaccine. As with any vaccine, a protective immune response may not be elicited in all cases. The vaccines are less effective in preventing HPV-related disease in young women who have already been exposed to one or more HPV types. That is because the vaccines can prevent HPV only before a person is exposed to it. HPV vaccines do not treat existing HPV infections or HPV-associated diseases.

How long does the vaccine protection last ?

Research suggests that the vaccine protection is long-lasting. Current studies (with up to about seven years of follow-up data) indicate that the vaccines are effective long term, with no evidence of decreasing immunity.

Do the vaccines protect against all HPV types ?

The vaccines do not protect against all HPV types. They are ineffective in about 30% of cervical cancers. It is important, therefore, for women to continue regular screening (Pap tests) for cervical cancer.

How safe is the vaccine ?

Both vaccines have been licensed by the Food and Drug Administration (FDA) and approved by Centre for Disease Control (CDC) as safe and effective. Common mild adverse events reported during these studies include pain at the injection site, fever, dizziness and nausea.

In what other ways can women prevent cervical cancer ?

Regular cervical cancer screening and follow-up can prevent most cases of cervical cancer. The Pap test can detect cell changes in the cervix before they turn into cancer. Pap tests can also detect most, but not all, cervical cancers at an early treatable stage. There are HPV tests, which may be used with the Pap test in certain cases, to help determine the next step in cervical cancer screening. Use of condoms and limiting the number of sexual partners may lower the chances of getting HPV.

Regular cervical cancer screening and follow-up can prevent most cases of cervical cancer. The Pap test can detect cell changes in the cervix before they turn into cancer. Pap tests can also detect most, but not all, cervical cancers at an early treatable stage. There are HPV tests, which may be used with the Pap test in certain cases, to help determine the next step in cervical cancer screening. Use of condoms and limiting the number of sexual partners may lower the chances of getting HPV.

Breast Cancer – Early Detection And Prevention

Breast cancer is now becoming the most common cancer in women in India. For the year 2015, there will be an estimated 1,55,000 new cases of breast cancer and about 76,000 women in India are expected to die of the disease. The gap only seems to be widening, which means, we need to work aggressively on early detection. (Statistics of Breast Cancer in India: Global Comparison)

S

Pic Courtesy: http://www.discussingbreastcancer.com/breast-cancer-prevention-and-early-detection-tips/


Tips for prevention and early diagnosis

Exercise :

Women who exercise about 30 minutes, three to four times a week, can decrease the risk of breast cancer by 26%.

Breastfeeding Your Child :

Women who breastfeed their children will have reduced risk of breast cancer.

Maintaining Weight :

Women who gained 25 kgs above what they weighed after the age of 18 have 45% risk of developing breast cancer compared to women who maintained their weight.

Weight Loss After Menopause :

Women who reduced 10 kgs after menopause compared to pre-menopause weight also reduce their risk of developing breast cancer by 45%.

Avoid Alcohol :

Women who have 1 or 2 alcohol drinks a day increase their risk of breast cancer by 10%. Even moderate alcohol intake increases endogenous estrogen levels and provide a potential mechanism for breast cancer development.

Regular Screening After Age 40 :

Breast cancer, if detected early, can be cured completely. Monthly breast self-examination, yearly medical check and mammogram will detect cancer in its early stage. Monthly breast self-examination should start as early as in teens.

Eating Right :

A plant-based diet of at least two cups of a variety of vegetables or fruits is beneficial. There is evidence that minerals, vitamins, and phytochemicals in plant foods interact in different ways to boost an individual’s anticancer effects.

The top picks for cancer prevention include beans, berries, cruciferous vegetables (broccoli, cauliflower, cabbage, brussels sprouts), dark leafy green vegetables (spinach, mustard greens etc), flaxseed, garlic, grapes/grape juice, green tea, soy, tomatoes and whole grains.

Central Obesity :

Excess belly fat seems to be particularly harmful, most likely because of its effects on inflammation and its association with elevated insulin levels. So if you tend to be more “apple shaped” and carry extra weight in your belly, it is especially important to lose weight. Exercise regularly, and limit refined grains, sugar sweetened beverages, and added sugar in your diet.

How To Do Breast Self-Examination

Why Do  Breast Self-Examination

There are many good reasons for doing breast self-examination each month. It is easy to do. When you get to know how your breasts normally feel, you may be able to feel any changes. With practice, it should take about 15 minutes each month. Early detection of likely cancerous lumps is the key to successful treatment and cure.

Look for Changes

Look for changes in front of a mirror. View the front and each side in three positions. Relax arms at your sides. Look for changes in shape, colour, or any puckering, dimpling, skin changes or nipple discharge.

BreastExamination1

Raise hands above your head. Check again for puckering, dimpling and skin changes.

Place hands on hips, press down, and bend forward. Check nipple direction and general appearance.

Palpation Technique

Use the pads of the middle three fingers of each hand to examine the breast on the opposite side. Do not use fingertips. Keep fingers together.

BreastExamination2

Move fingers in small circles, using the three levels of pressure in each spot. Keep fingers, knuckles, and wrists straight. “Walk and slide” finger pads along so no breast tissue is missed.

Feel for Changes Lying Down

Pressure : Lumps can occur at any depth. Use three levels of pressure to examine each spot thoroughly.

Light : Use very light pressure on the first circle. The pressure should be just enough to move the skin without disturbing the tissue underneath. Pressing too hard at first could cause the lump to move out of the way.

 BreastExamination3

Medium : On the second circle, use medium pressure to feel for changes below the surface up to the mid-level of the breast tissue.

Deep : On the third circle, check for lumps deep in the breast tissue.

Pattern :  Use a vertical strip pattern to check the entire breast area. Imagine mowing a lawn with straight, vertical, overlapping rows. When you reach the end of each row, move over about one finger width and start the next row.

Once you start, do not lift fingers from the breast area. Be sure to examine the nipple with the same palpation technique you use to examine the rest of the breast tissue. The area to be examined includes sides, top and bottom of the breast. Sides include the line from the middle of the armpit (axilla), the area beyond the breast fullness, down to the bottom bra line and over to the middle of the breast bone.

BreastExamination4

The top starts after a two finger gap above the collar bone. Two finger-widths below the bra line indicate the bottom of the breast.

Check the Lymph Nodes

Lymph nodes drain the breast tissue. The lymph nodes that drain the breast tissue are located in three spots :

  • Above your collar bone—
  • Below your collar bone
  • In the armpit you will want to know if any nodes are enlarged, movable or unmovable

Position for Examination

BreastExamination5

Position 1 :  Spread the breast tissue evenly over the rib cage. Turn on your side with the knee bent. Lean the shoulder back towards the outside (away from your hip) and put your hand on your forehead. Place a pillow under your lower back to make it more comfortable. You are in the right position when your nipple seems to “float” at the top of the mound of your breast tissue.

BreastExamination6

Position 2 :  When the search pattern reaches the nipple, hold fingers in place on the nipple and roll back into a position. Lie flat on your back. The arm on the side being examined should now be extended directly away from the body (at a right angle).

When to Do Breast Self-Examination?

The best time to do breast self-examination is right after your periods, when the breasts are not tender or swollen. If you do not have regular periods or sometimes skip a month, choose a day and do it the same time every month.

Remember the ABCs of Breast Health

  • A Screening mammogram
  • Breast self-examination
  • Clinical breast examination

Breast self-examination can save your life. Most breast lumps are found by women themselves or their partner. Most lumps in the breast are not cancerous. Any lump or change should be checked by a doctor.

Early detection is your best protection!