10 Indications To Stop The Use Of Oral Pills

If you use oral contraceptive pills as a method of birth control, you should be aware of the side effects of the pills, which have been discussed in a previous post - 12 Side Effects Of Oral Contraceptive Pills. This post provides another important information for the pill users. While using pills you should not ignore certain symptoms which indicate the withdrawal of the pills. Read on to find what are these symptoms.


Symptoms Which Indicate Withdrawal Of Oral Pills


#1- Severe migraine i.e. periodic attacks of one sided headache usually associated with digestive disturbances.


#2- Visual disturbances


#3- Sudden pain in the chest


#4- Severe cramps in the legs


#5- Excessive weight gain


#6- Symptoms of depression such as:

• Feeling sad daily
• Loss of interest in all activities
• Lowered appetite
• Sleeplessness or excessive sleepiness
• Suicidal thoughts

#7- Six weeks before surgery in order to minimize the chances of vascular complications after the surgery


#8- Planning pregnancy in near future. Use of pills suppresses ovulation and it may take a few months before you'll be able to conceive after the withdrawal of pills. Return of fertility after pills is discussed in the post - Return Of Fertility After Contraceptives - How Long Does It Take?


#9- Use of pills beyond the age of 35 years should be done under regular medical supervision.


#10- Early symptoms of cervical cancer discussed in detail in the post Early Detection Of Cervical Cancer - Identify The Warning Signs


Also read:


12 Contraindications To The Use Of Oral Contraceptive Pills

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12 Side Effects Of Oral Contraceptive Pills

In previous post I discussed the factors which contraindicate the use of oral contraceptive pills. Today, let's see what are the possible side effects that you may have due to the use of pills. Combined pills contain the two female hormones estrogen and progesterone and prevent pregnancy by suppressing ovulation and producing atrophic changes in the inner lining of the uterus. They also cause thickening of the cervical mucus thus preventing the entry of the sperms. However, these hormones may cause some side effects in your body and it's important that you are aware of these before adopting pills as a method of birth control.


Side effects of combined oral pills


#1- You may have spotting between periods specially in the first three months of pill use.


#2- Amount of flow during periods reduces and bleeding may become very scanty.


#3- You become prone to monilial vaginitis.


#4- Long term use of oral contraceptive pills increases the risk of cervical cancer.


#5- Use of pills in nulliparous women (who have not borne children) less than 24 years of age may increase the risk of breast cancer.


#6- Milk production is suppressed in lactating mothers and therefore use of pills is not recommended while you are breast feeding your baby.


#7- You may have nausea and vomiting


#8- Liver and gall bladder may be affected.


#9- Use of pills may reduce carbohydrate tolerance and therefore contraindicated in diabetic women.


#10- Due to the effect of progestogen, you may have:

• Headache
• Irritability
• Tired feeling
• Increase in weight

#11- Increased risk of thromboembolism due to increase in clotting mechanism of blood.

#12- Oedema and irritation of eyes may occur in women who use contact lenses.

Also read:

12 Contraindications For Oral Contraceptive Pills

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12 Contraindications For Oral Contraceptive Pills

Oral contraceptive pills serve as an effective method of contraception and are used by many women for preventing unwanted pregnancy. However, before selecting pills as a method of birth control you should be aware of the contraindications and side effects of these hormonal contraceptives. In this post I'll discuss the contraindications to the use of oral contraceptive pills.

Combined oral pills are not recommended for you-

#1- If  you have hypertension or you have a tendency for high blood pressure.

#2- If you suffer from heart disease.

#3- If you have diabetes.

#4- If you have suffered in the past from any of these conditions:

• Thrombosis i.e. formation of a blood clot within a blood vessel
• Sickle cell anemia
• Severe migrane

#5- If you suffer from a chronic liver disease.

#6- If you have thyroid disease.

#7- If you have breast cancer.

#8- If you are obese or overweight.

#9- If you are lactating or breastfeeding milk to your baby.

#10- If you are using drugs which induce enzyme production, e.g.

• Rifampicin
• Antiepileptic drugs except sodium valproate

#11- If you are going to have a surgery within 4 to 6 weeks.

#12- If you are more than 45 years of age. You can use pills for several years up to the age of 35 and after that till the age of 45 if you are healthy and do not smoke. However, regular checkups and pap smears are recommended to detect cervical cancer in early stages. 

• Long term use of oral contraceptive pills is one of the risk factors for cervical cancer.

I'll discuss more about the side effects of pills in the next post.

Also read:

10 Contraindications To The Use Of Cu T and Nova T

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10 Contraindications To The Use Of Copper T and Nova T

While selecting a method of contraception which suits you the most, several factors should be considered. One such factor is its contraindications. This post deals with the conditions which contraindicate the use of Copper T and Nova T, commonly used intrauterine contraceptive devices (IUDs) containing copper. This includes Paraguard which is Cu T 380A.  

Copper IUDs are not recommended for you -

#1- If you have become pregnant

#2- If you suffer from abnormal bleeding from vagina e.g. excessive or irregular bleeding.

#3- If you suffer from lower genital tract infection or pelvic inflammatory disease (PID) now or in the past.

#4- If bearing child in future is absolutely necessary for you.

#5- If any of your previous pregnancies was abnormally located i.e. ectopic pregnancy where the fertilized ovum is implanted at a site other than the uterus.

#6- If you suffer from moderate to severe pain during your menstrual periods.

#7- If you have fibroids in the uterus.

#8- If you have iron deficiency anemia.

#9- If you suffer from heart disease.

#10- If you are a patient of Wilson's disease. It is a hereditary disorder in which increased intestinal absorption of copper results in accumulation of copper in various organs like brain, liver, kidney and cornea.

 Also read-

Return of fertility after contraceptives - How long does it take

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Onset Of Labor - Signs To Watch Out For In Last Month Of Pregnancy

In the last month of pregnancy you should be observant towards certain changes in your body which indicate that you are in labour. You should also be able to differentiate between true and false labor pains. Read on to find what symptoms appear in your body when you are in labor.

Signs Of Onset Of Labor

1. True Labor Pains

When labour starts, you will start experiencing intermittent pains in the abdomen. These pains are felt more often in the front of the abdomen and usually radiate towards the thighs. True pains must be differentiated from the false labor pains.

Difference between true and false labor pains

False pains are more often found in the women who are pregnant for the first time. Such pains may appear 1 or 2 weeks before the onset of true labor pains. Pain and discomfort is felt in the abdomen and may be confused with the true labor pains. However, false pains have these features, which differentiate them from the true pains:

	False Labor Pains	True Labor Pains
1.	Dull and continuous pain and discomfort	Intermittent  pains
2.	Felt in lower abdomen and groin	Felt in front of abdomen and radiates towards the thighs
3.	Usually relieved by sedatives	Not relieved

2. Discharge of mucus mixed with blood ('Show')

With the onset of labor, there is expulsion of cervical mucus plug mixed with few drops of blood. This is called 'Show'. Slight blood oozes out from the ruptured blood vessels as the membranes start separating from the uterine wall with the onset of labor.

Please Note:

1. Being continuously in touch with your gynecologist/obstetrician and regular visits to the clinic is absolutely necessary during pregnancy.

2. Report every change or symptom to your doctor.

3. This post is only informative in nature and best judgment of your condition can be made only by your doctor after examining you.

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Why Tetanus Vaccine Is Given In Pregnancy - What Is Tetanus

In India, injections of tetanus toxoid are given on routine basis to every pregnant woman. Immunization provides protection to the mother as well as the newborn baby from a serious disease condition called tetanus. Read on to find what exactly is the disease called tetanus and how and when the tetanus shots are given during pregnancy.

What Is Tetanus?

Tetanus is an acute infectious disease caused by the toxin(poison) of a bacteria, Clostridium tetani, which grows at the site of injury. There is a state of almost persistent painful spasms of some of the voluntary muscles.

What Are The Symptoms Of Tetanus?

• The first sign is stiffness of the jaw, muscles of the food pipe (esophagus), and some muscles of the neck.
• Soon the jaws become rigidly fixed (Trismus or Lock jaw)
• The voice is changed
• Muscles of the face contract, producing a wild excited expression, a compound of bitter laughter and crying (Risus sardonicus).
• The muscles of the back and extremities contract
• Patient may bent back in a bow (Opisthotonos), or to the side (Pleurothotonos),or forward (Emprosthotonos).
• Spasmodic contraction of muscles are excited by noises, breeze of air, or irritation of clothes.
• The temperature may become very high.
• Patient also suffers from severe pain, hunger, thirst, and want of sleep.

 P.S. - Death may occur due to insufficient supply of oxygen and exhaustion.

About Tetanus Neonatorum

It is the tetanus of the new born babies which occurs as a result of  infection of the naval caused due to lack of proper sterilization while cutting the umbilical cord.

About Puerperal Tetanus In Women

It is the tetanus that occurs in women following child birth.

Immunization In Pregnancy

Aim - Protecting mother and child from tetanus.

Dosage -

• Two intramuscular injections of 0.5 ml tetanus toxoid is given at the interval of 6 weeks.
• First shot is given preferably between 16 to 24 weeks of pregnancy.
• Women who are immunized in the past are given a booster dose in the last trimester i.e. last 3 months of pregnancy.

Please Note:

• Regular visits to the gynaecologist and pre-natal checkups during pregnancy are must for the well being of mother and the child.
• Content of this post is informative in nature and cannot replace a face to face consultation and advice of your gynaecologist.

Also read:

Tips For Pregnancy Care

See list of all articles on Pregnancy

Events Following Conception - Part II

This is in continuation with the previous post How Pregnancy Occurs - Events Following Conception - Part I.

On 10-11th day after conception, the process of implantation of the embryo in the wall of the uterus (womb) is completed. By this time it is covered on all sides by the tissue of the uterine wall.

As mentioned in the previous post, the cells on the outer side lead to the formation of placenta and membranes.

Functions of Placenta

• Provides nutrition to the baby
• Removes waste products from its circulation
• Supplies oxygen
• Forms a protective barrier against certain harmful substances in mother's blood

Membranes also protect the baby from infection and contribute to the formation of amniotic fluid which serves as a shock absorber.

While the outer cells form the protective structures, inner cell develop into the baby.

14-21 days after conception - Neural plate is formed which later forms the nervous system and brain of the child.

21-28 days after conception - Heart becomes prominent

4-6 weeks after conception - Hands and feet begin to appear and the face is formed. Size is about 4-15mm.

6-8 weeks after conception - All major structures have developed and embryo can be recognized as a human. Size reaches about 15-30 mm.

8-12 weeks after conception - External genitals of the baby form. Size of the baby is about 30-60mm.

20 weeks - Fine hairs called lanugo cover the skin.

36 weeks - Lanugo starts to disappear.

40 weeks - Nails project beyond finger tips.

Also read:

How To Know If You Are Pregnant - 5 Early Signs

How And When To Do Pregnancy Test At Home

7 Tips For Pregnancy Care

See list of all articles on Pregnancy

How Pregnancy Occurs - Events Following Conception - Part I

This is a question in many women's mind that what exactly happens when pregnancy occurs and how the baby develops inside the womb as pregnancy progresses. Seeing their baby on the monitor during first ultrasonography is an exciting and emotional experience for many women. (I was no exception!) Read on to find what happens when you conceive and how your baby develops with time.

Ovum is released from the ovary sometime around your mid-cycle. It is then picked by the fallopian tube of the uterus (womb) i.e. the uterine tube. The union of the sperm and the ovum takes place in the uterine tube. This is known as fertilization. It leads to the production of a single cell called zygote.

• Ovum + Sperm = Single cell called Zygote [Fertilization]

Sex of the baby is determined by the type of chromosome contributed by the father's sperm. X chromosome results in a girl child and Y chromosome results in the development of a boy.

• Ovum (X) + Sperm(X) = Girl (XX)
• Ovum(X) + Sperm(Y) = Boy (XY)

Single celled zygote undergoes a series of divisions. About 30 hours after fertilization first division occurs resulting in the two celled stage. After this, segmentation continues through 4 and 8 cell stage till a cluster of 16 cells is formed which resembles in appearance to a mulberry. This is known as morula. All this happens in the uterine tube. On the 4th day morula enters the uterine cavity. Inner cells of the morula form the baby and outer cells form the membranes which provide protection and nutrition to the baby.

• 0 hour - Fertilization -> single celled zygote (In uterine tube)
• 30 hours - Two cell stage
• 40-50 hours - 4 cell stage
• 72 hours/3rd day - 12 cell stage
• 96 hours/4th day - 16 celled morula (Enters the uterine cavity)

Morula remains free in the uterine cavity till the 5th day. Some fluid enters the morula resulting in a cystic structure called blastocyst. On the 6th day from fertilization (20th day of a regular 28 day cycle) blastocyst sticks to the wall of the uterus and continues to penetrate till the 10th or 11th day. This process is known as implantation or nidation.

• 5th day - Blastocyst formation
• 6-7th day - Blastocyst starts to penetrate uterine wall (Implantation started)
• 9th day - Penetration continues
• 10-11th day - Implantation completed.

I tried my best to explain a complicated subject. Hope you were able to grasp. Enough for this post now. I'll discuss further development in the next post, Events Following Conception-II.

 Also read:

How To Know If You Are Pregnant-5 Early Signs

See list of all articles on Pregnancy

7 Tips For Care During Pregnancy

Pre-natal care is necessary for a normal pregnancy. Now the question arises what exactly a normal pregnancy is. No two women will have similar experiences in pregnancy. Nature and intensity of symptoms vary from one woman to other as well as from one pregnancy to other in one woman. 

However, any pregnancy which ends between 38 to 42 weeks, with the delivery of a baby in good health with weight of 2.5 kg or more and with no complications to the mother's health, is considered to be a normal pregnancy.

Here are some tips (do's and don'ts) to have a normal pregnancy with delivery of a healthy child from a mother in good health:

1. Take Proper Diet During Pregnancy

Food a woman eats during pregnancy has many more purposes to serve than in the non-pregnant state. Adequate diet is necessary for:

• Good health of the mother
• Growth of the baby inside the womb
• Strength required during labor
• Sufficient production of milk in mother's breasts

Take nutritious and easily digestible diet rich in protein, vitamins and minerals. It would be better to supplement your daily routine diet with:

• At least half litre milk
• One Egg (Ignore if you are a pure vegetarian)
• Plenty of green vegetables
• Seasonal fruits (It's said that papaya is prohibited, as it may cause abortion)

2. Take Proper Rest And Sleep During Pregnancy

Normal activities can be continued during pregnancy, but:

• Heavy work, especially during first 3 months and last 1 and a half month of pregnancy, should be avoided.
• Take adequate sleep.
• In the last month woman should be in bed for at least 8 hours at night and 2 hours in the day time.

3. Be Careful While Taking Bath

Daily bath is good but be very careful or you may slip due to imbalance.

4. Use Proper Clothes And Foot Wear During Pregnancy

• Wear loose and comfortable clothes
• Do not wear high heels or slippery foot wear especially later in pregnancy

5. Avoid Sexual Intercourse At Crucial Times Of Pregnancy

• Coitus during first 3 months of pregnancy especially during the time of missed period may increase the risk of abortion.
• During the last month of pregnancy, coitus increases the risk of infection and induction of labor before time.

6. Take Special Care During Travel

• Avoid journey on road or vehicles having jerks especially during first 3 months of and last 1and 1/2 months of pregnancy.
• Journey between 4th to 7th months of pregnancy is comparatively safer.

7. Quit Smoking And Alcohol Consumption (If You Do)

• Heavy smoking hinders proper growth of the baby and may also cause abortion.
• Alcohol increases the risk of abnormalities and growth retardation of the baby.

P.S. - Regular visits to the gynaecologist and pre-natal checkups during pregnancy are necessary for the well being of mother and the child.

Also read:

5 Reasons To Take Folic Acid Supplements In Pregnancy

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5 Reasons To Take Folic Acid Supplement In Pregnancy

Folic acid tablets are prescribed to every pregnant woman as soon as the diagnosis of pregnancy is confirmed. Folic acid intake is essential, especially during first trimester or first three months of pregnancy as this time is crucial for the development of the nervous system and brain of your child in which folic acid plays a vital role. Read on to find important facts about folic acid and the bad effects its deficiency can have on the health of your baby.

Facts About Folic Acid

• Folic acid is a member of the vitamin B complex.
• It is also known as pteroylglutamic acid.
• It is necessary for the formation of the red blood cells.
• Daily requirement of folic acid in the non-pregnant state is about 50 micro gram.
• During pregnancy this is increased to 800 micro gram.

Natural Source Of Folic Acid

Folic acid is found naturally in:

• Green plants
• Liver
• Yeast

5 Bad Effects Of Folic Acid Deficiency In Pregnant Woman

Folic acid deficiency is responsible for a number of diseases and conditions detrimental to the health of both mother and the child, such as:

1. Anencephaly

• It is a congenital neural tube defect (NTD) in which there is an absence of brain and cranial vault
• Cerebral hemispheres of the child are either completely missing or reduced in size to small masses.
• Survival of a child affected with this condition is not possible.

2. Spina Bifida

• Another neural tube defect (NTD) found in the walls of the spinal canal.
• It is caused by lack of union between the laminae of the vertebrae.
• Mostly the lumbar portion of the spine is affected.

3. Megaloblastic anemia of pregnancy/Folic acid deficiency anemia

• Symptoms are fatigue, reduced appetite, nausea and vomiting, diarrhea, and depression.
• Urinary tract infection is usually associated.
• Soreness in the mouth may be present
• Purpura (purple patches in the skin due to hemorrhage) is sometimes present.

4. Low Birth Weight Of The Baby

• Deficiency of folic acid in the maternal blood causes an anemic condition in the mother, as a result baby receives insufficient nutrition.
• This may have a bad effect on the proper growth of the child leading to a low birth weight.

5. Premature Separation Of Placenta From Uterus

• Premature separation of a normally situated placenta after the 20th week of pregnancy is known as abruptio placentae.
• One of the probable causes of this condition is folic acid deficiency.
• It is a serious condition which may lead to death of the baby in the womb.
• Hidden or apparent bleeding occurs associated with pain.

Recommended Dosage Of Folic Acid In Early Pregnancy

• Daily dose of 4mg of FOLVITE (trade name of folic acid) is recommended, especially during first 3 months of pregnancy.

Recommended Dosage Of Folic Acid Before Pregnancy

• Its even better to start taking folic acid (daily dose of 4 mg Folvite) 3 months before conceiving and continue till the first three months of pregnancy.

Please Note:

• Regular visits to the gynaecologist and pre-natal checkups during pregnancy are must for the well being of mother and the child.
• Content of this post is informative in nature and cannot replace a face to face consultation and advice of your gynaecologist.

Also read:
Easy Formula To Calculate Your Due Date Of Delivery


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Easy Formula To Calculate Your Due Date Of Delivery

You can yourself predict the due date of your child's birth, if you remember the first date of your last menstrual period. Formula for calculating the expected date of delivery, i.e, EDD is based on the knowledge of the duration of pregnancy.

Duration Of Pregnancy

Duration of pregnancy calculated from the first day of the last menstrual period is known as the menstrual age or gestational age, which is equal to:

• 10 lunar months
• 9 calendar months and 7 days
• 280 days
• 40 weeks

Formula To Calculate The Due Date

Expected date of delivery, also called Expected date of confinement (EDC), can be calculated using the Nagele's rule or formula.

What is Nagele's Formula?

Using nagele's rule, expected date of delivery is calculated by subtracting 3 months from the month of the last menstrual period, and adding 7 days to the first day of the last menstrual period. Thus:

Month of EDD = Month of LMP - 3
Day of EDD = First day of LMP + 7

P.S. - EDD is the expected date of delivery and LMP is the last menstrual period.

For Example:

If your LMP = 12 June 2011

Using Nagele's rule

• Month of your EDD = 6 (June is the 6th month of the year) - 3

                                             = 3 i.e. third month of the year, which is March

• Day of your EDD = 12 + 7 = 19

So, if 12 June 2011 is your first day of the last menstrual period-

Your Due Date = 19 March 2012

Accuracy of prediction of due date using Nagele's formula

About 50% women deliver in the range of EDD calculated with this method +/- 7 days.

Also read:
Significance Of Ultrasonography In Early Pregnancy

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