period problems

Period problemshttp://www.telegraphindia.com/1150119/jsp/knowhow/story_9008.jsp

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Your Health - Dr. Gita Mathai

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What is the actual difference between men and women? Women can produce babies while men cannot. For this, women have a uterus and two ovaries. Although these are present from birth, they start to function at a certain age called "menarche," when menstrual bleeding or the periodic shedding of the lining of the uterus sets in.

The age of menarche varies from nine to 15 years. It depends on genetics, nutrition, environment, physical activity and body weight. Usually the BMI needs to be above 18.5, with around 15-20 per cent body fat, for menarche to occur. It is brought about by the shedding of the thickened uterine lining in response to fluctuation in levels of oestrogen and progesterone hormones. Delayed menarche may occur in families where many members mature late. Investigations may be needed if menarche does not occur after 15-16 years.

The menstrual cycle can vary in length from 21 to 35 days. The cycles may be irregular in the first year after menarche and one or two years before menopause. The bleeding usually last 3-7 days. Total blood lost is 50-60ml and requires the use of one or one and a half packets of sanitary napkins.

At any age, the commonest reason for a missed period is pregnancy. It can occur soon after childbirth and also while breast feeding without menstruation having occurred. Childbirth and breast feeding can delay periods and make them irregular.

PCOS (polycystic ovarian syndrome) occurs in almost 60 per cent women of childbearing age. Cycles are unpredictable. The periods do not appear for months on end unless medication is taken. Once bleeding sets in, it does not stop without treatment.

Athletes, women who exercise rigorously (6-7 hours a day), diet excessively and achieve extreme weight loss can have scanty, infrequent periods. The ovaries can fail gradually at a young age. Periods become scanty and may suddenly stop before the age of 40. Usually no reason can be found and this is termed "primary ovarian failure."

Uterine fibroids, ovarian cysts, endometriosis, pelvic inflammation or cancer can cause irregular, excessive bleeding.

If there has been no menstruation for three months and the pregnancy test is negative, if the flow is excessive, if there is abdominal pain, or it is associated with fever, consult a gynaecologist.

A pelvic examination and an ultrasound scan helps to make a diagnosis. Menstrual irregularities can be a reflection of a problem elsewhere in the body; thyroid function tests may be required and pituitary hormone levels may need to be estimated.

OCP (oral contraceptive pills) or progesterone only pills are usually prescribed to regularise the cycle and reduce bleeding. Correction of any underlying disease with appropriate therapy may control the problem. Surgery may be required for cysts, fibroids and other tumours.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

Happy New Year

http://www.telegraphindia.com/1150105/jsp/knowhow/story_6661.jsp

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Your Health - Dr. Gita Mathai

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New Year is the time for making resolutions. Almost every individual is declaring his or her decision to lose weight, keep diseases such as diabetes under control, reduce stress, exercise, give up cigarettes or alcohol and so on. Everyone is eager to change for the better and happy to believe that bad habits - cultivated over years - will magically disappear.

In reality, fewer than eight per cent of these people will manage to keep their promises for longer than a month. A week has already passed and many may have already forgotten their declarations.

However, you can take some simple steps to ensure this does not happen. One, resolutions must be reinforced on the smart phone, computer or written in a diary. Also, they are more likely to succeed if family or friends keep an eye out for success or failure. But most important, resolutions have to be realistic, thought out and well-planned.

I will lose weight

A good decision by itself but more likely to succeed if interspersed with: "I am going to lose 2kg a month and reach my ideal body weight by 2016." Ideal body weight is calculated by multiplying the height in metre squared by 23. Weight must be taken weekly (not every day), and a daily diary maintained of all the food, fruits, snacks and beverages consumed. Calories in Indian foods can be read off the packaging or found on the Internet. A calorie deficit of 3,500 leads to a weight loss of 2.2kg. Avoiding sweets, snacks and cola drinks is important.

I will quit smoking, alcohol

You need the help and support of family and friends, and a confessional visit to a physician. You need to set a date and probably quit cold turkey. It will be hard, so give a yourself a week to overcome cravings, tremors and sleeplessness. It will be worth it.

I will exercise

An hour of aerobic activity keeps you physically fit as well as delaying the onset of diabetes, hypertension and heart disease. It even reduces the incidence of cancer, Alzheimer's, dementia and other degenerative diseases. It prevents loss of essential muscle mass, and improves posture and balance. Most activity burns between 300 and 400 calories an hour depending on the intensity. Stair climbing is excellent as it burns about 1,000 calories an hour. Remember that aerobic activity must be combined with stretches to prevent damage to muscles. Even if you cheat on the stretches before exercise, the ones after should not be missed.

About 10,000 steps a day is the minimum amount you must walk. This can be measured with a small device called a pedometer strapped to your waist.

If you spend much of your time sitting, improve fitness by standing as much as possible. The height of your worktable can be altered for this. Otherwise slouching, stooping or craning the neck will produce other aches and pains.

You can use an exercise cycle while watching TV. Otherwise, just stand and watch and tell your children to do the same.

Consistency is the key. Try to exercise every day. Then you will probably manage 5-6 days a week. If you plan an off day, unexpected impediments will further reduce the frequency. If you miss three days in a row, much of the muscle conditioning is lost. It is almost like starting from the beginning!

I will reduce stress

The 21st century is full of stress - at home, in the workplace, regarding finances and family members. Much of this cannot be removed. But stress can be tackled, so that it does not cause insomnia or precipitate diseases like high blood pressure. Regular yoga and meditation will help you reach a state where these pinpricks of life are no longer relevant in the larger scheme of things.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

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