Pain during menstruation

Menstrual cramps (dysmenorrhea) are throbbing or cramping pains in the lower abdomen. Many women experience menstrual cramps just before and during their menstrual periods.

For some women, the discomfort is merely annoying. For others, menstrual cramps can be severe enough to interfere with everyday activities for a few days every month.

Menstrual cramps that aren’t caused by an underlying condition tend to lessen with age and often improve once a woman has given birth.


Symptoms of menstrual cramps include:

  • Throbbing or cramping pain in your lower abdomen that may be intense
  • Dull, constant ache
  • Pain that radiates to your lower back and thighs

Some women also experience:

  • Nausea
  • Loose stools
  • Headache
  • Dizziness


During your menstrual period, your uterus contracts to help expel its lining. Hormone-like substances (prostaglandins) involved in pain and inflammation trigger the uterine muscle contractions. Higher levels of prostaglandins are associated with more-severe menstrual cramps.

Severe contractions may constrict the blood vessels feeding the uterus. The resulting pain can be compared to the chest pain that occurs when blocked blood vessels starve portions of the heart of food and oxygen.

Menstrual cramps may also be caused by:

  • Endometriosis. In this painful condition, the tissue that lines your uterus becomes implanted outside your uterus, most commonly on your fallopian tubes, ovaries or the tissue lining your pelvis.
  • Uterine fibroids. These noncancerous growths in the wall of the uterus may be the cause of pain.
  • Adenomyosis. In this condition, the tissue that lines your uterus begins to grow into the muscular walls of the uterus.
  • Pelvic inflammatory disease (PID). This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.
  • Cervical stenosis. In some women, the opening of the cervix may be so small that it impedes menstrual flow, causing a painful increase of pressure within the uterus.

Risk factors:

You may be at greater risk of menstrual cramps if:

  • You’re younger than age 30
  • You started puberty early, at age 11 or younger
  • You have heavy bleeding during periods (menorrhagia)
  • You have irregular menstrual bleeding (metrorrhagia)
  • You’ve never given birth
  • You have a family history of dysmenorrhea
  • You’re a smoker


Menstrual cramps don’t cause any other medical complications, but they can interfere with school, work and social activities.

Certain conditions associated with menstrual cramps may have complications, though. For example, endometriosis can cause fertility problems. Pelvic inflammatory disease can scar your fallopian tubes, increasing the risk of a fertilized egg implanting outside of your uterus (ectopic pregnancy).

What You Can Do:

If you have mild menstrual cramps, take pain reliever, such as acetaminophenibuprofen, or naproxen. For best relief, you must take these medications as soon as bleeding or cramping starts.

Things you may want to try at home include:

  • Exercise. Studies have found that regular physical activity may ease the pain of menstrual cramps.
  • Heat. Soaking in a hot bath or using a heating pad, hot water bottle or heat patch on your lower abdomen may ease menstrual cramps. Applying heat may be just as effective as over-the-counter pain medication for relieving menstrual cramps.
  • Avoiding alcohol and tobacco. These substances can make menstrual cramps worse.
  • Reducing stress. Psychological stress may increase your risk of menstrual cramps and their severity.

Reference :




Premature Ejaculation

Ejaculation is the release of semen from the body. Premature ejaculation (PE) is when ejaculation happens sooner than a man or his partner would like during sex. Occasional PE is also known as rapid ejaculation, premature climax or early ejaculation. PE might not be a cause for worry. It can be frustrating if it makes sex less enjoyable and impacts relationships.  It may result in unsatisfactory sex for both partners. This can increase the anxiety that may add to the problem. It is one of the most common forms of male sexual dysfunction.

If premature ejaculation happens infrequently, it’s not cause for concern.

You might be diagnosed with premature ejaculation if you:

  •         Always or nearly always ejaculate within one minute of penetration
  •         Are unable to delay ejaculation during intercourse all or nearly all of the time
  •         Feel stressed and frustrated, and tend to avoid sexual intimacy as a result.

When to see a doctor

It’s common for men to feel embarrassed about discussing sexual health concerns, but don’t let that keep you from talking to your doctor. Premature ejaculation is a common and treatable problem. Your doctor will discuss your medical and sexual history with you. He will do a thorough physical exam. Your doctor may want to talk to your partner also. Premature ejaculation can have many causes. So your doctor may order lab tests to rule out any other medical problem.

Common causes-

  1. Emotional and psychological factors –




            Performance anxiety

             Early sexual experiences

             Sexual abuse

             Poor body image

             Worrying about premature ejaculation

              Guilty feelings that increase your tendency to rush through sexual encounters

  1. Erectile dysfunction (ED)- Erectile dysfunction is when the penis does not remain        firm enough for sex. Men who are worried they could lose their erection may develop a pattern of rushing to ejaculate.
  2. Anxiety.
  3. Relationship problems.

How Is It Treated?

Ninety-five percent of men are helped by behavioural techniques that help control ejaculation.

Stop and start: You or your partner stimulate your penis until you feel like you’re going to have an orgasm. Stop the arousal for about 30 seconds or until the feeling passes. Start the stimulation again and repeat three or four more times before you actually ejaculate.

The Squeeze: It works the same way as the start and stop method. But, when you feel like you’re reaching orgasm, you or your partner squeezes the head of your penis very gently until you lose the erection. Repeat this a few times before ejaculating.

Some men find that if they think of something else during sex they can last longer.

Pelvic floor exercises in males

Weak pelvic floor muscles might impair your ability to delay ejaculation. Pelvic floor exercises (Kegel exercises) can help strengthen these muscles.


Condoms might decrease penis sensitivity, which can help delay ejaculation. “Climax control” condoms are available over the counter. These condoms contain numbing agents such as benzocaine or lidocaine or are made of thicker latex to delay ejaculation.

Psychological Therapy

Therapy is a way to address the negative feelings and emotions that lead to problems with sexual relationships. Psychological therapy can be used as the only treatment, or it may be used along with medical or behavioural therapy.

With the simple techniques listed here, about 95 out of 100 men will recover from PE. There is no way to promise recovery, but learning how to relax helps. If the problem remains, continue to work with your healthcare provider to find solutions.

-Dr Prerna Gaur




Erectile dysfunction is defined as an inability to achieve or maintain an erection firm enough to have sexual intercourse.

There are three types of erections — those caused by tactile stimulation( Touch), those caused by mental stimulation, and those that men experience while sleeping.

On average, a healthy adult male experience 3 to 5 erections per night that last up to 30 minutes.

It is a common misconception that ED means there is something wrong with penis itself and nothing else.

Sexual arousal in men is a complicated process that involves hormones, emotions, brain, muscles, blood vessels, and nerves. Anything that affects these components of male sexual arousal can also contribute to the occurrence of erectile dysfunction.

It is the combination of physical and psychological factors that play the role in most cases.

The causes Erectile dysfunction can be divided into the following groups.

  1. Psychological causes – Stress, performance anxiety, loss of feeling towards partner .
  2. Hormonal causes – Low testosterone levels. Thyroid hormone abnormalities, Hyperprolactinemia, Addison’s disease(inadequate secretion of hormones by the adrenal cortex), Cushing’s disease ( Increased secretion of cortisol ) and diabetes.
  3. Vascular disorders –Diseases affecting blood flow such as hardening of the arteries.
  4. Neurological causes –stroke, dementia, spinal cord injury, epilepsy.
  5. Risk factors – obesity, smoking, alcoholism, Hypertension, high cholesterol levels, lack of exercise, use of certain medications

It is important to consult with your doctor if you are suffering from ED , so that a detailed evaluation can be made .

There are many options for men who suffer from erectile dysfunction. The basic approach to treatment is to treat/rectify the underlying cause.

Before suggesting pharmacological help, the doctor may suggest a change in lifestyle habits. Since many causes of erectile dysfunction are disorders in which lifestyle changes will have a positive effect, addressing these issues can be helpful.

Regular exercise, a healthy diet, smoking cessation, and limiting alcohol consumption can all have an impact on erectile function.

If the lifestyle changes do not give satisfactory results, there is medical options available like- Oral pharmacological treatment, transurethral therapy, Intracavernous injections.

– Dr.Afroze Fatima




-Sexual dysfunction is any physical or psychological problem that prevents you or your partner from getting sexual satisfaction. Male sexual dysfunction is a common health problem affecting men of all ages, but is more common with increasing age.

-Common factors that affect sexual function in men result from psychological, physical, and emotional problems due to lifestyle influences. Heart disease, hypertension,alcoholism, diabetes and use of drugs can also contribute to sexual dysfunctions. Here are some of the most common sexual problems in men.

-Many problems with sexual health can be treated. Therefore, it is important for a man to discuss these issues with a physician.

-Here are a few known causes of sexual dysfunction in men-

  1. Unhealthy lifestyle. Drinking alcohol and smoking, for example
  2. Depression
  3. Stress – Physical and/or mental
  4. Lack of time
  5. Hormonal problems such as hyperthyroidism, hypothyroidism
  6. Testosterone deficiency
  7. Medicines. Antidepressants, for example
  8. Diabetes
  9. Psychological causes – Performance anxiety, feelings of guilt, low self-esteem, Negative body image
  10. High cholesterol
  11. Cardiovascular conditions
  12. Chronic illnesses
  13. Male genital problems – Inflammation and infection of urethra or prostate
  14. Relationship problems or past history of abuse
  15. Sleep problems – as in night shift workers.


Most cases of sexual dysfunction are best dealt with by overcoming the underlying causes.

Many sexual and performance issues can be delayed, maybe even prevented, by the usual things like good diet and exercise, stopping smoking, keeping weight down

Even though medication may still be needed, proper diet and exercise can boost both testosterone levels and sexual function

Talking to your doctor at an early time can help a lot!

– Dr.Afroze






-The definition of sexual dysfunction is the inability to have a satisfactory sexual relationship.

-Sexual activity involves coordination between various systems of the body.

-Hormones and neurological pathways must be in sync for sexual desire to be present. Blood vessels, nerves, and muscle coordination and penile integrity must all be present for an adequate erection and its maintenance during the sexual relation.

– Sexual issues may signal more serious health conditions. In most cases, these can be treated. Don’t be afraid to talk to your doctor early on to determine the underlying cause, and develop a plan of action.

-When sexual dysfunction is present, the physician evaluates all the possible problems in this chain of events.

-Common factors that affect sexual function in men result from psychological, physical and emotional problems.

-Heart disease, Hypertension, alcoholism, diabetes, and use of drugs can also contribute to sexual dysfunctions.

-It must be kept in mind that sexual problems are treatable , but you have to be proactive and speak to your doctor if you face any of the following.

  1. Erection problems -not being able to achieve or maintain enough of an erection to have sex.
  2. Low libido – low sexual interest
  3. 3. Ejaculation problems:

Premature-one that occurs prior to or within one minute of the start of sexual stimulation

Delayed ejaculation- occurs when a man is unable to ejaculate or has a hard time doing it.  A problem wherein a man needs an extended period of sexual stimulation to reach sexual climax and ejaculate.

  1. Curved penis or painful erections– especially if recent in onset.
  2. Disordered Orgasm-when a man is unable to achieve orgasm even with adequate stimulation.
  3. Prolonged Erection (Priapism) – Men who experience an erection lasting more than four hours should seek help in the emergency room. Treatment needs to occur within eight hours of the start of an erection to avoid permanent damage to the penis.


Dr.Afroze Fatima

References :


Can a mother really have INSUFFICIENT or NO MILK

Infants who are not exclusively breastfed are 14 times more likely to die due to diarrhea, 3 times more likely to die of respiratory infection, and twice as likely to die of other infections than an exclusively breast-fed child. Hence, a mother’s concern of insufficient or no milk needs to be addressed with utmost care and empathy.

Did you know that only ONE in a thousand mothers may not be able to breastfeed. The so-called lactation failure is very very rare among mothers. So practically there is no such thing as insufficient milk or no milk, but unfortunately all the important people in a mother’s life including husband, mother, mother-in-law, pediatrician or even the newborn are ignorant of or refuse to accept this fact.

The complaint of “insufficient milk” is just a wrong perception of the mother, fostered by  :

  • Mother’s uncertainty about her capacity to feed her baby properly. New-age mothers do not have first-hand experience of seeing successful breastfeeding and cannot have enough conviction in the process. Even the slightest doubt or difficulty can be discouraging.
  • No knowledge about the normal behavior of a baby (who usually nurses frequently)
  • Negative opinions of significant persons -often in Indian households, mother or mother-in-law who has not breastfed her own children does not particularly encourage breastfeeding. Sometimes they induce doubts in the mother’s mind every time the baby cries or is uneasy.

The reasons why a mother feels that she has insufficient milk are because the baby cries often, wakes up frequently, demands frequent feeds, or is irritable.

It is important to discuss with the mother signs that enough milk is being supplied :

  • Weight gain of 500–1000 gm/month
  • passing urine at least 6–8 times/day is definitely getting enough milk

The following signs indicate that an infant is not receiving enough milk in the first weeks of life:

  • Weight loss greater than 10% of the birth weight, not regaining birth weight up to 2 weeks of life,
  • No urinary output for 24 hours,
  • Absence of yellow stools in the first week and
  • clinical signs of dehydration

Crying among babies is a natural response to express all kinds of feelings of discomfort. Colic pains, extreme heat or cold, blocked nose, new caregiver, unclean caregiver, time of the day, etc are some of the trivial triggers for crying in a baby.

Lactation insufficiency is a public health concern, as the use of breast milk substitutes increases the risk of morbidity and mortality among infants in developing countries, and these supplements are the most common cause of malnutrition.


Sultana A, Rahman KU, manjula SM  2013 CLINICAL UPDATE AND TREATMENT OF LACTATION INSUFFICIENCY. Medical Journal of Islamic World Academy of Sciences 21:1, 19-28,

Preventive measures for women’s health

Preventive measures for women's health

As we grower older, our body needs to be cared better as the chances of health issues are much greater. Especially for women, as time passes, they need to pay more attention to their well being because several changes are taking place in their bodies about which they need to be aware of.  Continue reading “Preventive measures for women’s health”

Modifying lifestyle at menopause

lifestyle changes at menopause

Menopause is basically the cessation of menstruation characterised by a drop in the levels of hormones estrogen and progesterone, typically occurring at the age of 45-55 years. Estrogen is mainly a female sex hormone associated with normal menstruation and more importantly with maintenance of skin tension, stabilizing the bones, preventing bone loss, increasing good (HDL) cholesterol, decreasing bad (LDL) cholesterol levels in blood, and protecting against heart problems. Lowering of the normal estrogen levels is responsible for the noticeable increase in waist circumference among postmenopausal women. Basically, all the protective functions of estrogens are lost once women enter into menopause which requires women to take greater care of their diet and lifestyle. Continue reading “Modifying lifestyle at menopause”

13 risk factors of Breast cancer

Over last ten years or so, breast cancer has been rising steadily and for the first time breast cancer is the most common cancer in women in India, way ahead of cervical cancer. Both the incidence, as well as deaths due to breast cancer are more than cervical cancer.

-Dr. Pooja, Senior Nutritionist

Continue reading “13 risk factors of Breast cancer”