Saturday, January 10, 2009

FAQ's about Periods

Why does it pain during periods?

Just before the periods start, cells in the inner lining of the uterus die before being shed. This cell destruction produces chemicals called prostaglandins, and may cause pain. The muscular portion of uterus also contracts, so, depending on her sensitivity, a woman may find her lower back, abdomen or thighs hurting. This generally starts on the day of the periods and may continue for a day or two longer.

What is white discharge?

Our body is full of fluids. Eyes have a certain fluid, which they discharge. Ears discharge wax, nose discharges mucus etc. Similarly the vagina and the reproductive organs produce a discharge that is white in colour. This discharge is acidic in nature and it prevents infection. It stains the undergarments a yellowish, brown and this is normal.

Sometimes in case of infection there maybe a foul smell and itching, in which case you can go to a doctor to get it checked.

Can we take tablets to postpone periods? Is it unsafe for further procreation?

The tablets contain hormones and they ensure that you will not get your periods as long you keep taking them (provided the tablets are started 5-7 days before the expected date). They don’t damage you system, but do interfere with your normal cycle. They do not affect future childbearing.

Many girls take these tablets when travelling or to attend religious ceremonies. By taking extra care or by using tampons while traveling one can manage very well and there is no need to postpone periods. God made our bodies and periods are in no way ‘dirty’ or unholy. Breaking the natural rhythm of you body is best avoided. There is no reason to postpone periods.

Can we swim during periods?

Yes but you need to wear tampons to ensure that the menstrual blood does not come out during your swim.

What is hymen?

Hymen is a thin tissue (membrane) that partially covers the vaginal opening. The membrane has an opening in it to let out the menstrual blood. The size of the opening, and the elasticity and number of blood vessels in the hymen varies from person to person. The hymen may tear during vigorous exercise, gymnastics, horse riding, injury or sex. If the hymen opening is large and the hymen elastic, then sex may happen without tearing it. Therefore it is not always possible to ‘test’ for virginity by examining the hymen. It is not true that bleeding should happen during first sexual intercourse.

What is menstruation?

If the egg gets fertilized, it will need a place to grow. This place is the inner lining of the uterus, which becomes spongy and soft during ovulation. This lining has lots of blood and oxygen to nourish a potential baby. The outer edge is also muscular and will stretch as the child grows before contracting as it is delivered.

However, there is the chance that the egg-in the 24 hours that it lives-will not be fertilized. On this occasion, the inner lining (that had been altered to welcome the baby) is shed though the vagina in a process called menstruation. Most of it is made of blood, which trickles out over a period of 4-5 days.

When do girls get their periods?

Menstruation usually begins anywhere from 9 ½ to 16 years – 11 ½ is the mean. This often happens after the breasts have relatively grown, and a considerable amount of pubic hair is present. Pubic hair also first appears about 2 years before menstruation starts, and a mucous-like vaginal discharge is also normal at this time. The pubertal growth spurt has also occurred.

Can I change the timing of my periods?

There is no natural method of doing this. Periods depend on the hormonal balance in the body, and altering this is quite risky. Many claim that exercise increases the blood flow or pre-pones the periods, but this is entirely baseless.

What are sanitary napkins?

Menstrual fluid has mostly blood in it, so women use sanitary napkins to prevent it from staining their clothes. The pad is worn between the legs and covers the vaginal opening. It sticks to the underwear and can be tied to a thin elastic belt around the waist.

I do not get my periods regularly. Is something wrong?

For periods to come regularly, perfect synchronization of all the hormones is needed. This takes quite a while to develop, so for the first 1-2 years after periods start, it is normal for them not to be regular. A girl may bleed only once in 2, 3 or even 6 months.

As a girl grows older, the periods should begin to come regularly. Most have 28-day cycles, but these can be 21-35 day cycles too.

Blood loss is around 30-50 ml during periods. People usually use 10-15 pads per cycle. In the initial years, it is normal to have bleeding for 1-2 days alone. However, heavy bleeding for over 7 days on any occasion is abnormal, and a doctor must be consulted.

How does one reduce the pain during periods?

Doing yoga or being physically active reduces the pain during periods. One may also take a few painkillers, particularly those with mefenamic acid (Meftal spas), but only with food. Using three or four of the latter per month is neither ‘habit-forming’, nor does it cause any long-term damage.

How does a girl maintain genital hygiene?

It is very important to wash the pubic area with soap and water during a daily bath. The folds of skin – the labia minora and labia majora – must also be cleaned, as secretions tend to collect there. After passing fecal matter, always wipe from the front to the back, so as to prevent the vagina from being infected.

Some people think the hair should not be washed during menstruation. This is entirely baseless – a woman can wash her hair whenever she wants to.

What are tampons?

Tampon is a thin, narrow bundle of tightly packed cotton that can be inserted into the vagina to absorb menstrual blood. It has a string attached, so it can be removed easily. When a tampon needs changing, the string is usually soaked. Tampons should be changed when soaked or every 4-6 hrs, which ever is earlier. The advantage of using these items is that one can go swimming during menstruation. They are also small, and may be flushed in any toilet. The disadvantage is that, since tampon cannot be seen, there is a serious risk of forgetting it is there and removing it. Bacteria will be attracted to the blood, especially if the tampon isn’t changed in 6 hours. Toxic Shock Syndrome is a dangerous infection of the blood stream caused by a forgotten tampon.

Should one shave the pubic hair off?

Pubic hair is there to protect the sensitive genital area and trap the natural body odour, so shaving is off is rather pointless. The hair may get matted with blood during menstruation, but this only requires some thorough washing to handle. If you do wish to trim it, use a scissors, but be careful not to cut the skin.

Pubic hair doesn’t interfere with having sex, so one doesn’t have to shave it off before marriage. In fact since it traps one’s natural pheromones (chemicals in body secretions) it helps in sexual arousal.

Should there be food restrictions during menstruation?

Certainly not. If anything, Indian women need more iron-containing foods during their periods, as 80% of them are anemic. Menstrual blood in no way harms plants or foods – if that were the case, women would have been incapable of farming. In addition, there should not be any physical restrictions; exercising doesn’t increment blood flow.

Friday, January 9, 2009

What is the Safe Time to Have Sex and avoid Pregency?

Let us assume that one has a 28 day menstrual cycle and period happened on say 1st May. Ovulation happens 14 days before the next period, so it can be 14th May but since the next period has not happened yet you can’t be sure of the ovulation date.
Also the ovum is alive for a 1- 1 ½ days so 14th is very unsafe i.e. there is very good chance of getting pregnant. Next period may not come on 28th May but 3-4 days early or late. If it comes 4 days early, then ovulation would have happened on 10th may and if late, then on 18th May.
Another important thing to be kept in mind is that the sperm can stay alive inside the uterus for about 3 days so if sex happened 3 days before ovulation it is not safe. So effectively the time from 7th May till 19th May is not safe for sex. The rule for a 28 day cycle is that 7 days from the day of starting periods is safe, and the last 7 days of the cycle (21st to 28th ) are safe. Middle 14 days or two weeks are not safe.
This is not a effective method of contraception to use as we are calculating based on an unknown fact (the next period).

Thursday, January 8, 2009

OVULATION & MENSTRUATION

At the start of puberty, pituitary gland in the brain gives signals to the ovaries to start releasing estrogen hormone. Estrogen produces physical and emotional changes in the person, changing the girl into an adult female.

The ovaries start maturing and releasing the ova (female reproductive cell). This occurs about once a month (one ovary releases one egg in one month, the other ovary releases an egg the following month). This process is called Ovulation.

Once the ovum has been released by the ovary it is picked up by the Fallopian tube. The ova stays alive in the fallopian tube for about 12 - 24 hrs. There after it dies and is absorbed by the body. If the sperms have been deposited in (or sometimes even at the opening of) the vagina, they swim up the uterus and into the fallopian tube to meet with the Ovum. This process is called Fertilization. The fallopian tube is joined to the uterus and helps move the fertilized Egg to the uterus. Here the egg will implant itself in the nourishing lining of the uterus called the Endometrium and develop into a baby in 9 months.

If fertilization does not take place, the soft endometrium is not required and is expelled from the body through the vaginal opening. This process is called menstruation or the period.

Menstruation lasts anywhere between 2 to 7 days. The blood that is expelled is absorbed on a pad or a tampon. Sometimes girls experience backaches and abdominal cramps during this time. All this is normal.

Tuesday, December 23, 2008

ERECTION, EJACULATION & WET DREAMS

At the start of puberty, pituitary gland in the brain gives signals to the testicles to start releasing testosterone. Testosterone produces physical and emotional changes in the person, changing the boy into an adult male.

Under the influence of testosterone, the testicles start producing sperm – the male reproductive cell. Both the testicles are contained in a sac called the Scrotum- which helps in regulating temperature as sperm producing cells are very temperature sensitive. Sperms move from the testis into the Epididymus where they mature. Ejacualation is the process where the sperms are released from the body through the penis. Just before ejaculation the sperm move from the epididymus into the Vas deferens. Here they collect Semen - a whitish fluid that provides the sperm with nourishment. Semen is a combination of the fluid given by the Seminal vesicles, Prostate Gland and the Cowper's Gland.

Ejaculation can occur only when the penis is erect. When sexual feelings arise in the brain, it releases chemicals that increase blood flow into the Penis. The penis become hard, engorged and erect because of this rush of blood and this is called an erection. At the height of sexual pleasure the semen is released from the body through the Urethra- the same tube that is used for urination. There is a special mechanism that prevents urine from coming out during ejaculation. Once semen has been released, the blood flow returns to normal and the penis returns to its original state.

A man produces millions of sperm everyday. There are approximately 100 million sperms in 1ml of semen. Typically 2-5 ml of semen is released with each ejaculation.

During puberty a boy may experience erection and ejaculation during sleep. This is called a wet dream or night fall and is very normal.

Changes during Puberty / Adolescence

We have a biological clock built in our brains that ‘switches’ on at around 8 -9 yrs to start the process of changing a child into an adult. The process takes anywhere up to 10 -15 yrs, physical maturity generally preceding mental and emotional maturity.
The process of physical maturation is called puberty while adolescence includes the psychological and emotional changes as well.
Physical changes during puberty
Girls mature about 2 years earlier than boys. Here is a short summary of the physical changes which occur.
Changes that occur in Girls
  • Height Increases rapidly. Starts at around 9 years and peaks at around 12-13 years. About 6cms are added on after the periods start.
  • Structure Pelvis widens for childbirth. Store more fat in the body.
  • Voice deepens and becomes less high pitched
  • Thyroid gland slight, temporary increase
  • Development of pubic hair starts at 10 years Can begin as early as 8 years.
  • Underarm hair develops last, sometimes after menstruation begins.
  • Blushing at slightest provocation during puberty.
  • Pimples start 1-2 years after onset of puberty and remain till late adolescence, subside on their own
  • Breast Development starts around 9- 10 years, develops by 14- 16 years.
    Breast and areola are enlarged, nipple projects outwards.
  • Development of reproductive organs Lips of vulva thicken and enlarge. Mucus like vaginal discharge starts about 2 years before menses starts- often leaves yellowish stains on underwear.Menstruation usually start about 2 years after pubic hair starts appearing. Normally around 11-12 years, but range is 9-15 years.

Similarly boys also undergo some physical changes. Here is the summary of changes in boys

Changes that occur in Boys

  • Height Increases rapidly. Starts around 10-12years and peaks at around 14-15 years.
  • Structure Shoulders broaden. Develop more muscle in the body.
  • Voice first cracks, then deepens
  • Thyroid gland Slight, temporary increase
  • Development of pubic hair Starts around 10 years.
  • Underarm hair Last to develop.
  • Blushing at slightest provocation during puberty.
  • Pimples start 1-2 years after onset of puberty and remain till late adolescence, subside on their own
  • Breast Development Breast develops slightly during puberty. May be sensitive to touch
  • Development of reproductive organs Penis and testes start enlarging at around 10 years and continues till 15 years. Erection of the penis during a bath or on getting up from sleep is common from younger age, but ejaculation develops by 12-14 years.

As the body is changing there are also some Emotional & Psychological changes that both boys and girls go through. here is the list...

  • Forming one’s identity
  • Setting goals
  • Forming one’s values
  • Looking for independence
  • Desire to explore, take risks
  • Need for acceptance- especially by the peer group.
  • Wanting to fit in with peer group
  • Mood swings
  • Self –conscious
  • Curiosity about body and how it works
  • Feelings of sexual attraction

Tuesday, December 16, 2008

Are you a Victim of Child Sexual Abuse?

Are you a victim of child sexual abuse? Do you think it all happened because of you? STOP! Don't think that way. Do you feel guilty if you fall sick ? Do you feel guilty, if you were waiting in your car on the traffic signal and someone comes and hits your vehicle from behind? NO ! you don't. Similarly, an abuse is never your fault. Sometimes you are too scared to resist. Sometimes you are too young to understand that you are being abused. You can't even differentiate between what is right and what is wrong. You think that may be its a bad dream that you are seeing. Its only much later you come to realize what happened with you. But, then, its very similar to someone hitting your car on traffic signal, you falling sick of a virus.. it is never your fault. Perpetrators of these crimes are like Virus of our society, they infect people around them and make them sick. What YOU need to understand is that it is this virus who is at fault and not YOU. Like we take medicine to fight a virus attack, we need to get ourselves informed, resist their act - this is the only medicine the society has against these virus.
Believe in yourself. You are unique, you are good and that no one can deny. Once you start believing in yourself, things will improve. Things will change for better. And probably you would save a fellow human being from infected by this virus.
So, don't be shy, don't be afraid. It is not YOUR fault.

Wednesday, November 19, 2008

On Track - a workbook series on Life Skills and Personal Safety is released on 19th Nov 2008 in Bangalore

Dr Sangeeta Saksena and Dr Shoiba Saldanha, founder members of Enfold, have co authored this workbook series along with Dr Shekhar Seshadri, a well known child psychiatrist at NIMHANS. This workbook is for use by school children of std 3 through 9 and aims at improving a child's mental emotional and physical well being. It aims at prevention of child sexual abuse by building children's self esteem , communication skills and thus empowering them to resist and report abuse. The workbooks come with teacher's and parent's manuals and are published and marketed by Macmillan India. They are available at Macmillan showroom in Shrungar Complex on MG Road, Bangalore and at all Macmillan showrooms across India.