Women’s Health

Present day is the day of internet (high tech world), almost all services are available online including online doctors consultation. Medical consultation online (telemedicine or telehealth) for any medical problem has many advantages, like the easier accessibility, affordability (cheap and sometimes it may be free), 24 hours service etc. to name a few advantages. You can get consultations, drug prescriptions, and other health services by means of email, telephone, video, and Internet. Telemedicine is slowly becoming a future trend and it is picking up its momentum.

Online consultation for women’s health problem is slowly increasing these days. The reason is, some women may not feel comfortable explaining their problems to someone, but they have no hesitation in explaining their health problems to an online doctor. It is easier to get medical consultation by expert and qualified gynecologists, medical specialists, child specialists, skin doctors and many more specialties.

Another reason why online medical consultation is gaining popularity is because it is seen that more than two third of the visits to doctor is for consultation only and these consultations can be handled easily over phone or by email or by other means of telecommunication. Due to the success of online consultations these days many hospitals are investing in telemedicine. The number of online medical consultations is increasing day by day.

There is no problem in securing a Doctors Excuse notes online. Telemedicine or medical consultation online can give you some non medical use also, like getting a doctors excuse notes or a medical certificate in simple term. These doctors excuse notes can be used for negative consequences of missing work or scheduled legal obligation.

Some women experience certain premenstrual symptoms called premenstrual tension about 7-10 days before the start of menstrual bleeding. These premenstrual symptoms include irritability, malaise, lassitude, headache, gastrointestinal upset like constipation and spasm of colon, feeling of fullness of the breasts and abdomen, frequency of urination etc. There may also be feeling of congestion in the feet and face. In some women these symptoms become exaggerated and form a well marked psychosomatic disorder.

In some of the cases of premenstrual tension water retention can be demonstrated by an increase of body weight up to 5 kilos which is accompanied by pedal edema. This is more marked if the patient has history of phlebothrombosis. The fullness of breasts can be prominent symptom and can be accompanied by breast tenderness. On examination of breasts, there is hardness and lumpy feeling and there is also tenderness. Some women with premenstrual tension suffer from migraine headache which disappear if the woman become pregnant.

The cause or etiology of premenstrual tension is not clear. It is suggested (but not proved) that premenstrual tension may be due to excess production of estrogen and abnormal or disturbance in adrenal function, because there is always an increase of extra-cellular water throughout the body. This is because estrogen is recognized to cause water and sodium retention as seen in carcinoma of prostate, where there is excess production of estrogen. But presence of large amount of estrogen does not always produce water retention as seen in granulose cell tumor. Adrenal cortical steroids and progesterone (progesterone containing oral contraceptive pills may are well known for their water retention properties) can also cause water retention, so it may not be always due to estrogen excess.

Travel during pregnancy is a great concern for the pregnant woman. Before starting travel many important aspects should be considered. A woman’s medical history and itinerary, the quality of medical care at her destination, and her degree of flexibility should be the determining factors for travel during pregnancy. The safest part of pregnancy in which to travel can be done is between 18 and 24 weeks, when there is the least danger of spontaneous abortion and also premature labor, according to the American College of Obstetrics and Gynecology. Many obstetricians prefer that women should stay within a few hundred miles of home after the 28th week of pregnancy. But in general there is no danger in travel during pregnancy if the pregnant woman is healthy.

Travel should be avoided during pregnancy if there is a history of miscarriage, premature labor, incompetent cervix, or toxemia. Travel should also be avoided if there are general medical conditions like diabetes, heart failure, severe anemia, or a history of thrombo-embolic disease in pregnant woman. Pregnant women should not go to a place where there is excessive risk to the growing fetus as well as to the pregnant woman like those at high altitudes and those where live-virus vaccines are required or where multi drug-resistant malaria is endemic.

Pregnant women should be very cautious about traveler’s diarrhea during travel. Dehydration due to travelers’ diarrhea can lead to inadequate placental blood flow and lead to hypoxia and growth retardation to the fetus. The dehydration of traveler’s diarrhea should be promptly corrected by adequate fluid replacement.

Air travel is not risky to the healthy pregnant woman or to the fetus. The higher radiation levels reported at altitudes of more than 10,500 m (35,000 ft) during air travel also should pose no problem to the healthy pregnant traveler. Each airline has a policy regarding pregnancy and flying and it is best to check with the specific carrier when booking reservations. Domestic air travel is generally permitted till the 36th week of pregnancy, and international air travel is generally permitted till the 31st week of pregnancy.

There are no known risks for pregnant women for travel to high-altitude destinations and stay for short periods but there are no data of safety of pregnant women at altitudes of more than 4500 meter (15,000 ft).

The exact cause of spasmodic dysmenorrhea is not known. The pain is due to spasm of the muscles and severe enough to cause ischemia or loss of blood supply to the particular area. The following factors are considered to be causative:

• Cervical Obstruction: Obstruction of the cervix can cause severe pain but it is very rare. The pin-point os and narrow cervical canal are associated with anteverted uterus or retroverted uterus and can cause delay in passage of menstrual blood and clot. Surgical dilation of the cervix sometimes relief the menstrual pain. If there is any anomaly in uterus like unicornuate or bicornuate uterus can also cause spasmodic dysmenorrhea.
• Psychogenic causes of dysmenorrhea: the incidence of spasmodic dysmenorrhea is commonest among affluent women and pain is always exaggerated when undue concern is shown by the concerned relatives. Women have lower pain threshold (feel more pain with the same stimulus of pain) and due to predisposition of undue fear and anxiety is more susceptible to dysmenorrhea.
• Endocrine causes: dysmenorrhea is associated to ovulatory menstrual cycles. Women who are taking oral contraceptive pills are rendered anovulatory and thus they do not get spasmodic pain is the proof that endocrines play an important role in the causation of spasmodic dysmenorrhea. Progesterone can stimulate contraction of the muscle layer of the cervix and can cause narrowing of the cervical canal. Progesterone can also stimulate the production of prostaglandin F₂? which can also aggravate the pain.
• Nervous system causes: It is suggested that muscle spasm of uterus may be due to imbalance of autonomic nerve supply to the uterus. Surgical resection of the pre-sacral nerve, which supply uterus can relieve the pain during menstruation. But there is no evidence of motor nerve involvement at present.

IUCDs (intra uterine contraceptive devices) can also cause spasmodic type of pain (spasmodic dysmenorrhea) due to cramps of the uterus by the foreign body or due to increased secretion of prostaglandins. The reason of excess secretion of prostaglandins (F₂?) is not clear while using IUCDs, but this is the main reason of spasmodic dysmenorrhea.

Drug addiction is a social evil. No nation in the world is immune from drug addiction. To tackle the drug addiction problem we need multi-disciplinary approach, where doctors treating drug addicts should be helped actively by community leaders, sociologists, and psychologists and by volunteers and also by the local Governments with legal and financial help. United States is one of the worst affected nations from drug addiction and alcohol abuse problems.

There are many drug rehab centers (drug rehabilitation centers) in the United States which are providing exemplary service to the cause of drug de-addiction. These drug rehab centers provide comprehensive drug rehab program, that not only help the drug addict to get rid of his addiction, but also provide employment rehabilitation after de-addiction, counseling, emotional and psychological support and also provide re-treatment facility if the drug addict become addicted again after successful treatment.

A good drug rehab center will provide many facilities. While choosing a good drug rehabilitation center you should look into certain facilities like the quality of the team of treating doctors, nurses and supporting paramedics; the drug rehab centers success rate, re-treatment facility, rehabilitation program (post treatment), involvement of other supporting axillaries, the history of the drug rehab center etc. Another important aspect of a good drug rehab center is their engagement with the previous addicts who were treated successfully and now leading a good life after de-addiction. They can be used as ideal role models for the addicts who are to be treated. You should also see the details of their drug rehab program, which is the most essential part of a good quality drug rehab center. Many drug rehab centers also provide treatment facilities that are not directly related to drug or alcohol addiction like eating disorders, depression etc.

Spasmodic Dysmenorrhea (severe pain) generally does not become manifested until few years (2 to 3 years) of menarche although there may be discomfort associated with menstrual periods.

For some patients the menstrual period is painless till the age of 18 or 19 years and than suddenly severe menstrual pain develops. This is of great importance, because the menstruation before the start of severe pain in these patients is due to estrogen withdrawal and the menstrual cycles are anovulatory (no ovulation takes place). The fact is that, when the menstrual cycles become very painful, they can be made painless by preventing ovulation by giving estrogen. So it can be concluded that this severe pain during menstruation is due to secretion and withdrawal of progesterone. The most severe form of spasmodic pain is seen in patients between ages of 19 to 21 years. It is rare to see a case of severe spasmodic pain after the age of 35 years. The reason is unknown but the pain may persist till menopause though excruciating pain reduces after the age of 35 years.

Spasmodic dysmenorrhea can be generally cured by pregnancy and exception to this is very rare. A woman who has one child has much more chance of having spasmodic dysmenorrhea than a woman who has several children. Spasmodic dysmenorrhea can be cure by marriage and almost all the women report that they have not suffered much after marriage. But it is too optimistic to advice “therapeutic marriage” (advising to get married to cure spasmodic dysmenorrhea). So it is not wise to advice marriage to a patient of spasmodic dysmenorrhea and to have children. The doctor also should consider the fate of unfortunate male victim of “therapeutic marriage”.

The women who are sterile do not suffer from spasmodic dysmenorrhea. The anovulatory cycles are painless and that is why sterile women do not suffer from of spasmodic dysmenorrhea. It is not uncommon to have some degree of menstrual irregularity in case of spasmodic dysmenorrhea. The menstrual loss is also less than usual and some times the menarche may be delayed.

Out of the three main types of dysmenorrhea, spasmodic dysmenorrhea is the most common type. It is said that almost half of adult female population suffer from varying degree of spasmodic dysmenorrhea at some time of their life. But only 10% of them will seek medical attention for the problem. It is generally taken that if a patient’s main problem is dysmenorrhea than it is spasmodic dysmenorrhea. This is because the main symptoms of other two types of dysmenorrhea are not dysmenorrhea but abdominal pain, menorrhagia etc.

The clinical symptoms of spasmodic dysmenorrhea are characteristic and the pain starts on the first day of menstrual bleeding, when severe excruciating lower abdominal pain is felt that last for a short time of approximately 30 minutes to one hour. This pain is severe and intermittent and spasmodic in nature and can lead to nausea, vomiting, fainting and collapse. Sometimes there may be mild shock if the pain is very severe. This initial severe pain of short duration is followed by less severe type of pain that is felt in the lower abdomen, pelvis and sometimes down in the antero-medial aspect of thigh. This pain usually lasts for less than 12 hours.

But there can be variation of symptoms mainly pain in spasmodic dysmenorrhea, to a great extent and it should be realized. Sometimes severe discomfort may start a day before menstrual flow and may persist for more than 12 to 24 hours. The premenstrual pain is felt in the back or in the lower abdomen and lead to excruciating pain felt during first day of menstruation. The presence of premenstrual pain does not mean it is congestive dysmenorrhea, but this a variation of spasmodic dysmenorrhea. The severity of pain very greatly, sometimes it causes extremely severe pain causing shock and incapacitating the woman from her employment. The severity of pain can be determined by asking the patient about vomiting, fainting and degree to which the woman is incapacitated.

With perseverance mankind has found some of the answers of aging process and also to some extent the answer of preventing (it is more of delaying than preventing because it is not yet possible to prevent natural process of aging, we can only delay certain processes of aging) aging process.

But you as a user of anti-aging products have to be very careful in selecting an anti aging product before using. Because of the hype the anti aging products has produced. The hype is more than the actual fact of these products. Because of excess hype of these anti aging products, many companies which produce these products are concentrating in the marketing of the products rather than concentrating on the quality of the products. So if you do not select a reputed company, you might end up losing faith in these anti wrinkle products. So selecting a good company for buying the anti aging product is most important. If a good quality product is selected from a reputed company, these products can act wonder in removing the skin (especially of face) wrinkles which are the main signs of aging.

Women hate wrinkles, especially in the face and around the eyes. There are also many eye cream that are available in the market that are good in removing the wrinkle from around the eyes. Instead of using eye lifts or injections you should prefer the use of eye creams from a well known and reputed company. The side effects are also much less compare to eye lift and injections. But before you use an eye cream you should consult a skin doctor or a beautician for better understanding of the product and also to know if these products have some adverse effects

There are many wonders science has given us particularly in the field of medicine, like discovery of penicillin and eradication of smallpox to name a few. Resveratrol is one of such excellent discovery of medical science. Resveratrol is the result of scientific research in search of answer to infection the way penicillin was the answer to the problem of infection in the last century. It is actually a plant product, which plants produce naturally when attacked by certain pathogens like bacteria and fungus. Some of these plant pathogens also can attack humans and at that time these Resveratrol can be of use to humans to treat these specific infections. Resveratrol acts in case of such infections as it acts in case of plants in protecting the plant from infections by bacteria and fungi. All the plants can not produce Resveratrol.

Resveratrol has many health benefits, besides acting as anti-pathogen in humans. The other health benefits of Resveratrol are anti inflammatory actions, blood sugar regulation in diabetics and lower incidences of heart disease, cerebral stroke, Alzheimers disease etc. Resveratrol also has anti carcinogenic effects (prevent cancer from developing) and can protect cells form radiation. There are also many benefits of Resveratrol which are not mentioned here. The qualities of Resveratrol are very impressive and it is becoming very popular slowly but steadily.

Despite all the above qualities of Resveratrol, it did not get enough media attention. But there are some good websites which are dedicated to the cause of Resveratrol and there are excellent resveratrol reviews on these sites. But one has to be careful in selecting the sites, because some of the sites may give wrong information about Resveratrol in order to promote it.

Membranous dysmenorrhea can be regarded as extreme form of spasmodic dysmenorrhea. Though it is a severe medical condition, fortunately it is very rare. Membranous dysmenorrhea usually runs in families and can recur after pregnancy.

Membranous dysmenorrhea is accompanied by passing of membranes that may take form of cast in the uterine cavity and microscopically the casts have the appearance of the endometrium of uterus during menstruation except that the disintegrative processes are ill defined. Most likely it is due to deficiency of the tryptic ferment secreted by the endimetrium in normal menstruation. But normal women can pass small membranes during menstruation who are not suffering from Membranous dysmenorrhea. Usually there are no inflammatory infiltrations of tissues of the casts and there is no reason to suspect that Membranous dysmenorrhea is due to chronic inflammation of the uterus.

The treatment of membranous dysmenorrhea is same as that of spasmodic dysmenorrhea. Patient should be educated on the subjects of menstruation and sex education and reassured. Patient should be advised nutritious diet, regular exercise, correction of constipation and inculcation of regular healthy habits. Simple analgesics like aspirin or Buscopan, hormonal contraceptives, prostaglandin synthetase inhibitors like mefanamic acid, danazol etc. are used in treatment of Membranous dysmenorrhea. Surgical dilatation of cervix is also done in many cases. In extreme cases hysterectomy (surgical removal of uterus) is reserved if the patient has completed her family or not desirous of having child any more. Despite all these treatments, the prognosis of Membranous dysmenorrhea is worse than spasmodic dysmenorrhea (except hysterectomy).