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Contraception

Planning to get an IUD? Here’s all you need to know

Planning a family is a big decision &, understandably, a few people may want to delay it at any given time. Over the years, this has been possible in large part due to the development of various contraception methods.

Your choice of birth control should depend on several factors including your health, frequency of sexual activity, number of sexual partners, and the desire to have children in the future.

There are different types of contraception:

  • To prevent sperm from getting the eggs, contraception methods include condoms, diaphragms, cervical caps, and contraceptive sponges.
  • Measures that keep the women’s ovaries from releasing eggs that can be fertilized include birth control pills, patches, shots, vaginal rings, and emergency contraceptive pills.
  • Long terms measures for birth control include Intrauterine devices (IUD), intrauterine systems (IUS) that are implanted into the uterus. They can be kept in for several years

IUD is considered effective and safe for most women. They are also a long-lasting option. Let’s learn more about it.

What is an IUD?

An IUD may be a small T-shaped plastic or copper device that’s inserted into the uterus by a doctor or nurse. Copper ions are released inside the uterus prevents pregnancy and protects for anywhere between 3 to 10 years. It is also called a ‘coil’ or ‘copper coil’. Unfortunately, there is a lot of misinformation regarding IUD that makes the patients apprehensive about the insertion.

IUDs aren’t the only form of birth control. An alternative to that is the Intrauterine System or IUS, which prevents pregnancy by releasing hormones in the uterus.

What is the difference between IUD and IUS?

Copper IUDs are made up of plastic frames with copper coil wound around them, IUS is made up of plastic frame which consists hormones. The main difference between IUD and IUS is that IUD releases Copper ions and IUS releases a hormone called progestogen and hormone Levernorgestrel (LNG). But unlike any other contraceptive pills or hormone contraception, the hormones in IUS are local which means they only work around the area of your uterus. This means they are likely to have an impact on your mood or cause any other physical symptoms which usually occur in other hormonal contraception.

A few facts about IUD

  • It can be placed at any time during your menstrual cycle.
  • When inserted correctly it can be 99% effective.
  • It works as soon as it is inserted and lasts for between 3-10 years.
  • It can be taken out whenever you want by a trained nurse or doctor.
  • Your periods can be heavier, longer or more painful for 3 to 6 months after inserting in an IUD. Spotting or bleeding in between periods is also possible.

How does it work?

An IUD  releases copper ions in the uterus which alters the cervical mucus, hence making it more difficult for sperm to reach the egg and survive. The copper ions released by the IUDs also work as a spermicide. It can also help a fertilized egg from being able to implant itself. Most healthy women can use an IUD. Women who are allergic to copper cannot use copper IUDs. They’re especially suited to women with one partner and at low risk of contracting an STD. IUDs don’t protect against STDs.

Benefits of IUDs

  • They last for a long time.
  • Mostly hassle-free, once inserted you or your partner don’t have to think about it.
  • Safe to use even while you are breastfeeding.
  • Cost-effective.
  • There are no hormonal side effects such as acne, headaches, or breast tenderness.
  • It is not affected by other medicines.
  • Does not cause obstacles to intercourse.
  • There is no evidence that an IUD will make you gain/lose weight or increase the risk of cervical cancer, womb cancer, or ovarian cancer.

How is an IUD inserted?

The IUD procedure takes place during a woman’s menstrual cycle (Secretary phase of the menstrual cycle). Before the procedure, a GP or nurse will check inside the vagina to understand the size and position of the womb uterus. Doctors may also test for infections such as STIs and give antibiotic medicines accordingly. After the examinations are done, the doctor will insert the IUD through the cervix and into the uterus. The entire procedure takes around 20-30 minutes to complete.

Is IUD insertion going to be painful?

The IUD insertion procedure depends from person to person. A few women may experience pain during the procedure. Your doctor knows what is best for you & may give an anesthetic or painkiller before they place the IUD. A few women may experience symptoms like cramps or bleeding once it is done. Post fitting, it is advisable to visit a GP after 3-6 weeks to make sure everything is okay.

While an IUD procedure is pretty common, it is always in your best interest to know about issues that may occur after it. Some of these include –

  • Heavier, painful, or longer periods. This may improve in few months.
  • Probability of Pelvic Infection
  • An IUD doesn’t offer protection from STDs.

Most of the above-mentioned side effects are extremely uncommon and if one does feel the need to use an IUD, it is advisable to consult your healthcare professional and find out if the contraceptive method is correct for you.

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Heart Attack

Drug Eluting Stent- An Overview

A coronary artery disease or CAD occurs when there is a build-up in the arteries. In such conditions, it can interrupt the flow of blood to your heart. Plaque causes narrowing or blockage which can result in a greater risk of having a heart attack. Symptoms could include chest pain, discomfort in breathing and shortness of breath.

Cardiovascular diseases are the leading cause of death globally, according to World Health Organisation, it takes an estimate of 17.9 million lives each year. More than four out of five deaths are due to heart attacks or stroke. The most important behavioral risk factors are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. If you have CAD your doctor might suggest using a stent to treat it. It’s a procedure called Coronary Angioplasty in which the doctor will insert a stent into your coronary arteries. A stent is a small tube made up of metal mesh that is designed to support your artery walls and prevent plaque from blocking your blood flow. It helps the blood flow more freely to your heart. During angioplasty, a thin tube known as a guiding catheter is inserted through the groin or wrist and is then moved towards the site of the blockage. A small balloon at the tip of the balloon catheter is inserted through the guiding catheter near the blocked or narrowed area of the coronary artery. When the balloon mounted with the stent, is inflated, the fatty plaque or blockage is compressed against the artery walls and the diameter of the blood vessel is widened (dilated) to increase blood flow to the heart. Once the plaque is compressed and the artery is opened sufficiently, the balloon catheter is deflated and removed. The stent will remain as a permanent implant in the coronary artery.

Your doctor may use a bare-metal stent(BMS), Drug-eluting stent (DES), or BioResorbable Scaffold (BRS). A drug-eluting stent is the most common type of stent used lately. The new and improved versions of drug-eluting stents are considered safe and effective in most cases. They have ultra-low strut thickness that promotes early vascular healing, the variable strut width, and variable crown design ensure adequate radial strength. However, BRS is a next-generation bioresorbable technology with a low strut thickness of 100 microns which fully resorbs naturally in the artery within 2-3 years, thus restoring the vessel to its true form and nature.

In this blog, you will learn more about Drug-Eluting stents and their benefits.

So what is a Drug-eluting stent? 

DES is a standard metallic coronary stent that has a polymer coating and an antiproliferative drug. It allows drug elution into the coronary wall for weeks and months after stent implantation. It releases medication directly into your artery which helps the scar tissues from forming within the stent and narrowing your blood vessels again. That’s how Drug Eluting stents work you might need to take additional medications including blood thinners after the procedure. 

Benefits of Drug-Eluting Stent 

They can prevent plaque build-up, relieve chest pain, and promote good blood flow to your heart. They may also lower your chances of having a heart attack. 

As it’s a less invasive procedure than coronary bypass surgery, which is recommended to people who have more than two narrowed arteries. So most people recover within few days of inserting the stent. A stent helps you get back to your regular schedule faster. In contrast, coronary bypass surgery takes six weeks or more to recover. 

With Benefits, Drug-Eluting Stents even have risks: 

Like any medical procedure, coronary angioplasty or stenting do involve risks, including: 

  • Bleeding or clotting 
  • Damage to your blood vessel
  • Infection 
  • Kidney damage caused by the dye 
  • Allergic reaction to the anesthetic, dyes, or other material used 
  • Scarring of your blood vessels 
  • Heart attack and stroke, which is rare

If you form scar tissue after stenting, the doctor may need to repeat the procedure. In case you have chest pain report to your doctor immediately as it could be a sign of serious complication. 

There are also few other things you should consider before getting a drug-eluting stent.  

For patients with a history of bleeding problems, a drug-eluting stent might not be a good option. Apart from this, you might need to take blood thinners for the rest of your life to prevent your blood from thickening and causing the risk of clots in the stent. Your doctor would give you additional information on what to expect before and after angioplasty. 

How to live with a stent? 

Having a stent doesn’t mean you have to live differently. But you will have to take extra care of your heart by eating right and healthy. Be active and take your medications. Follow few precautions such as: 

  • Take your blood-thinning medication this would prevent heart attack and stroke. After stenting, you will take aspirin plus another antiplatelet for at least 6 months. If you are at a high risk of bleeding your doctor with shortening the duration of these medicines. Work with your doctor to decide how long you will be needing the medications. The decision depends upon your risk of having a heart attack, risk of bleeding, and your preferences about taking the medicines. 
  • Stent identification card- Your doctor will provide you with a stent identification card that you can show to your health professionals so that they know you have a stent.    

Protect your heart health

You can lower your risk of developing blocked arteries or having a heart attack by practicing healthy habits. Common risks for heart disease include high cholesterol, high blood pressure, and being overweight. All of which can be managed with a healthy lifestyle. For example, having a balanced diet and regular exercising can go a long way towards keeping your heart healthy and strong. Smoking would put you at risk. If you are a smoker then now would be a good time to call quits. 

If you are diagnosed with CAD, to prevent complications follow your doctor’s instructions and treat it. Drug-eluting stents are a good option for patients with CAD but they are only one part of the solution. You may have to take statins, aspirin, or other medications. 

Follow your doctor’s advice and take their prescribed medicines and also follow their recommended lifestyle which will keep your heart healthy. 

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Knee Replacement

Why Gold Knee Implant Is A Better Option For Total Knee Replacement

Suffering from severe arthritis of the knees can be a tedious condition with consistent symptoms such as pain in the knees that worsens over time, stiffness, swelling of joints, etc. These persistent symptoms can become a hindrance in one’s day-to-day functioning.

Non-operative treatments like knee joint injections, activity modification, and anti-inflammatory medications can be the first option for most people, but when these have failed to provide adequate relief, Knee replacement surgery can be of help.

Knee replacement, also known as knee arthroplasty or total knee replacement, is a surgical procedure to resurface a knee damaged by arthritis. Metal and plastic parts are used to cap the ends of the bones that form the knee joint, along with the kneecap.

Traditional total knee replacement involves an incision over the knee of about 7-8 inches, and a recovery period of 3-5 days at the hospital.

According to an article by UW Medicine Orthopaedics & Sports Medicine on Total Knee Replacement surgery most reports of surgeons performing knee replacement surgery have been excellent and the results have shown ten-year success rates above 90 percent.

More than 90 percent of total knee replacement patients experience substantial or complete relief of pain once they have recovered from the procedure. The large majority do not require a cane even if there is the one used before the surgery and can walk without a limp.

The major benefit of total knee replacement surgery is the better quality of life. There is a restoration of the ability to carry out activities that they could not do before, due to the pain and stiffness, etc. The pain and the stiffness from the arthritis are relieved by the surgery. It is reported that the distance one can walk will improve well because of the diminished pain. 

One major complication that can hinder a total knee replacement surgery is the patient’s allergy to metal components. Some people may experience a reaction to the metal that is used in the artificial knee joint as implants may contain titanium or cobalt-chromium-based alloy. This is where Gold Knee Implants come in.

What are Gold Knee Implants?

For patients who have shown an allergic reaction to metals, the Gold knee replacement procedure can be considered a very good option. The knee implants used for the surgery have a Titanium Niobium Nitride (TiNbN) coating on their surface. This coating gives a golden color to the implant and makes it allergy-proof because of inert material’s coating.

Why one should opt for Gold Knee Implants?

The implant gold knee is one of the best artificial joint. It has a longer life span and does not trigger any allergic reactions. According to an article by Bone and Joint 360 the Golden knee implant is compatible with human tissues, and it is highly recommended for patients that are 60 years of age or below.

Knee implants are normally made of an alloy of chromium and cobalt and sometimes they tend to release metal ions inside your body. Patients who may experience an allergic reaction tend to experience inflammation in the knee joint because of the same. Eventually, complications like infections, loosening of the joint, and persisting knee pain develop.

Benefits of a Gold Knee Implant

  • Durable implants due to the titanium coating.
  • The higher life span of the Gold Knee implant as compared to regular knee implants.
  • Works well with new-age surgical techniques. The outcomes are better when compared to regular implants.

There are various types of implants used other than Gold Knee Implants as well, such as metal on plastic implants, which are the most common type of implants, or ceramic on plastic implants, for people who have a sensitivity to nickel used in metal implants, leading to an allergic reaction or people who are sensitive to nickel used in metal implants.

It is important to evaluate all your options before opting for a total knee replacement surgery, the cost, the biocompatibility, and especially about the type of metal that is used, in case the patient is allergic to a certain metal or alloy.

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Cancer

Keeping Ovarian Cancer At Bay

Cancer refers to a disease/condition in which cells grow and multiply uncontrollably in one organ to form a tumor, and spreads to the other parts of the body. Tumors can either be cancerous or benign. As the name itself suggests, ovarian cancer is a type of cancer that develops in the ovaries. The female reproductive system contains two ovaries on each side of the uterus, which are responsible for producing eggs and estrogen.

Though not common, ovarian cancer causes more deaths among women than other types of cancers. In most cases, it is difficult to detect ovarian cancer in the early stages. Ovarian cancer goes undetected until it has spread to the pelvis, abdomen, and nearby areas.  In this advanced stage, the cancer is quite difficult to treat. However, early-stage ovarian cancer that is confined to the ovaries is more likely to be treated successfully.

Symptoms of Ovarian Cancer

As mentioned earlier, ovarian cancer is unlikely to be detected in the earlier stages as there may be fewer to no symptoms. The early symptoms may also resemble those of other conditions such as premenstrual syndrome and other bladder-related problems. However, it is important to consult with your medical practitioner if the symptoms persist. Some of the most common ovarian cancer symptoms include:

  • Immense pain or pressure in the pelvic area
  • Abnormal bloating
  • Pain in the back/abdomen
  • Unusually frequent/less frequent urination
  • Changes in bowel habits
  • Weight loss
  • Loss of appetite
  • Nausea
  • Shortness of breath
  • Fatigue
  • Irregular periods
  • Vaginal bleeding

The symptoms also tend to change when cancer spreads to other parts of the body. It is important to make an appointment with your doctor if any of these symptoms worry you, or if you have a family history of ovarian cancer.

Causes of Ovarian Cancer

Though there are no definitive causes that lead to ovarian cancer, there are several factors that can increase the risk of one being diagnosed with ovarian cancer. These risk factors include:

Age

The risk of developing ovarian cancer increases with age. Ovarian cancer mostly develops in women who have reached menopause. Around 50% of ovarian cancer cases are found in women above the age of 63.

Family history of cancer

Having a near family member with a history of ovarian cancer, breast cancer, or even colorectal cancer, can increase the risk of developing the condition. This is because cancer can be caused by an inherited mutation in certain genes.

Hormone replacement therapy

Women undergoing Hormone Replacement Therapy (HRT) after menopause is at an increased risk of developing ovarian cancer. The longer the Hormone Replacement Therapy is given, the higher the risk. However, the risk reduces when the treatment stops.

Reproductive history

Women who have undergone one or more full-term pregnancies are at a lower risk of developing ovarian cancer. Breastfeeding also contributes to reducing the risk of ovarian cancer. However, having children after the age of 35 or never having a full-term pregnancy can increase the risk.

Breast cancer

Women diagnosed with breast cancer or with a history of breast cancer are also at a higher risk of developing ovarian cancer. This is mostly due to the changes in the BRCA gene.

Obesity

Obesity has been linked to the risk of developing many types of cancer. Women with a Body Mass Index (BMI) of over 30 are more likely to develop breast cancer.

Androgens

Having high levels of androgens (male hormones), such as testosterone may increase the risk of ovarian cancer. Certain androgens lead to specific types of ovarian cancers.

Prevention of  Ovarian Cancer

Most women are likely to have one or more risk factors that may lead to ovarian cancer. Like most cancers, though there aren’t sure-shot ways to prevent ovarian cancer, you can work towards reducing and eliminating certain risk factors that may lead to the condition. Some of the precautions that can be taken to reduce the risk are:

Maintain a healthy weight

One of the most common causes/risk factors for all cancers is obesity. Ensure that you maintain a healthy weight and follow good dietary habits with an exercise routine to keep your Body Mass Index (BMI) in check.

Avoid HRT

Avoiding Estrogen Hormone Replacement Therapy after menopause can reduce the risk of developing the disease considerably.

Birth control pills

Using oral contraceptives, commonly known as birth control pills, decreases the risk of developing ovarian cancer. Talk to your healthcare provider about birth control pills and which ones may be right for you. However, birth control pills also have certain side effects and other associated risks, so discuss the advantages and disadvantages before taking them.

Gynecologic surgeries

Gynecologic procedures such as tubal ligation and hysterectomy may help in reducing the risk of certain types of ovarian cancer. However, these procedures have to be done only for valid medical conditions, and not just the reduce the risk of ovarian cancer.

Pregnancy and breastfeeding

Women who have had one or more full-term pregnancies before the age of 26 have a lower risk of developing ovarian cancer as compared to women who have not. Breastfeeding helps in lowering the risk even further.

If you or your loved one has been diagnosed with ovarian cancer, you can discuss with your medical practitioner about the various treatment methods. You need to understand the pros and cons of each treatment option before finalizing one. Some of the most common treatment options for ovarian cancer include surgery to remove the tumors, radiation therapy, chemotherapy, hormone therapy, and targeted therapy. Treatment can also vary depending on the type and stage of ovarian cancer.

Though there are no definitive ways to prevent ovarian cancer, it is important to be aware and fully informed of the symptoms. Approach your doctor or healthcare provider immediately, if you notice one or more of these symptoms in you or your loved ones; as early detection saves lives. You can also work towards reducing certain risks associated with the disease by following a healthy lifestyle and taking precautions. Remember, prevention is better than cure!

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Cancer

Ovarian Cancer: Diagnosis and Treatment

Ovarian cancer is the third most common gynecological cancer in Indian women. and it causes more deaths than any other cancer of the female reproductive system. While the rate at which ovarian cancer can be fatal is 1 in 108, it is a hopeful statistic that the rate at which women are diagnosed with ovarian cancer has been slowly falling over the past 20 years.

What is Ovarian Cancer?

The ovaries are small organs located on either side of the uterus. Their function is to produce eggs for reproduction. Ovarian cancer can form in different parts of the ovary.

Germ cells are the cells that become eggs in the ovaries, stromal cells make up the substance of the ovary,  and epithelial cells are the outer layer of the ovary. Ovarian cancer can start in either of these cells.

Genetic mutations that are responsible for cancer may be hereditary or they can be acquired. Doctors studying ovarian cancer are trying to identify which of these mutations are responsible for cancer. Ovarian cancer can develop in a woman of any age, although it is most commonly diagnosed in postmenopausal women between the ages of 55 and 64

How is Ovarian Cancer Diagnosed?

Pelvic Exam

Pelvic exams are routine exams done by a primary-care doctor or an obstetrician-gynecologist. The doctor feels for an enlarged ovary and any signs of fluid in the abdomen by inserting two gloved fingers into the vagina and places the other hand on the abdomen. This helps the doctor to check the size, shape, and consistency of the ovaries and uterus.

A pelvic exam may also help to detect conditions such as pelvic inflammatory disease, cervical polyps, uterine fibroids, genital warts, bacterial vaginosis, etc.

While detecting ovarian cancer through a pelvic exam is rare. The doctor may ask the patient to take a few more tests to confirm a diagnosis.

Imaging tests

Transvaginal ultrasound:

Imaging tests such as a transvaginal ultrasound uses high-energy sound waves to detect abnormalities like ovarian tumors, etc. These abnormalities may appear as solid or as a fluid-filled cyst. This imaging test also helps visualize the size of the ovary along with other irregularities in the reproductive system, i.e, the vagina, the bladder, the fallopian tubes.

The doctor or ultrasound technician inserts a probe into the vagina to capture images of the organs and tissues.

Ovarian biopsy: While ultrasound can detect an irregularity, it can’t determine whether the mass is cancerous or not. This requires a biopsy.

A CT scan or a Computed tomography is used to locate a tumor before surgery. It can also help determine tumor size, and detect whether or not the other organs are affected. An MRI or magnetic resonance imaging has greater soft tissue contrast than a CT scan and hence is extremely useful in detecting tumors or recurrences in other organs in the body. This is why an MRI is often used in combination with other tests as part of the evaluation process.

Positron emission tomography-computed tomography or a (PET/CT) scan is sometimes used to help diagnose ovarian, fallopian tube, or peritoneal cancer. The scan can measure a tumor’s ability to use a type of sugar: glucose. Faster growing cells utilize more sugar and show up brighter on this imaging test, hence indicating the presence of cancer.

Treatment of Ovarian Cancer

The treatment of ovarian cancer depends on factors such as the type of ovarian cancer, the stage at which it is, and whether or not one wants to have children in the future.

Surgery

Once the diagnosis and the stage of the cancer are determined, cancer can be removed via surgery. During the procedure, the surgeon will remove all the tissue that contains cancer. The doctor might also ask the patient to take a biopsy to see if cancer has spread.

If one wants to have children in the future but has stage 1 cancer, the surgery can include the following modifications:

  • removal of the ovary that has cancer
  • biopsy of the other ovary
  • biopsies of other tissues and collection of fluid inside of the abdomen for further evaluation
  • removal of the fatty tissue, or omentum connecting to the abdominal organs
  • removal of abdominal and pelvic lymph nodes

Advanced ovarian cancer surgery

If one has stage 2.3 or 4 cancer, and one does not want to have children in the future, the surgery is more extensive.

The procedure includes the complete removal of areas and organs involved with cancer

Removal of:

  • The Uterus
  • Both the ovaries and fallopian tubes
  • The omentum
  • As much tissue that has cancer cells

And biopsies of any tissue that might be cancerous.

Chemotherapy

Chemotherapy is usually the next step after surgery. Medications can be given through the abdomen or intravenously.

Some side effects of chemotherapy can include:

  • nausea
  • vomiting
  • hair loss
  • fatigue
  • problems sleeping

Ovarian cancer is a serious condition that comes with a physical as well as an emotional toll on the patient. It is highly advisable that one that is experiencing the symptoms mentioned above immediately consult their doctor to undergo the proper diagnosis. It is important to understand every aspect of the condition before going into treatment.

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