Think PINK, Protect yourself!

Hello, my beautiful people!
Today we'll throw light on a much-feared, less-talked-about & common disease. Breast Cancer.
Why? Because breast cancer is the most common cancer in Indian women.

Every 4 minutes, 1 woman is diagnosed with breast cancer in India.

Every 8 minutes, 1 woman dies of breast cancer in India!

Breast cancer 5-year survival rate in USA has steadily increased and is now around 90%, whereas it only 60% in India. This is mainly due to lack of awareness & screening and patients present in late stages of cancer in which the outcomes are poor.
The Pink Ribbon is the international symbol of Breast Cancer Awareness.

So here I am, once again, to break it all down for you into easily digestible chunks of info. Let's get started!

First things first - Breast cancer can happen to ANYBODY. Yes, it can happen to me, to you, to your mother, sister, girlfriend, wife, grandmother... You get the gist! Though there are certain risk factors which put you at an increased risk, and here they are!

Risk factors for Breast cancer - 
Non - modifiable - Not in your control.

1. Age - Your chances of getting breast cancer increase with age. Though it does not mean that younger women cannot get breast cancer.
2. Early age of starting menses (Menarche) and Late age of Stopping menses (Menopause).
3. History of Breast Cancer in Family (Mother, Sister, Aunts, Grandmothers). Presence of BrCa gene mutation increases your chances of getting Breast or Ovarian cancer.
4. Certain races - like African-Americans, have higher cases of breast cancer.

Modifiable - In your control.

1. Late pregnancy (after the age of 30) or no pregnancy - Nuns are at a higher risk.
2. Not breastfeeding your baby. 
3. Obesity / being overweight - especially after menopause.
4. Alcohol and Smoking.

Needless to say, women should strive to maintain a healthy weight, avoid alcohol and smoking and try to breastfeed their babies as much as possible to reduce their chances of getting breast cancer.

As you've seen, we can reduce the risk to a certain degree but some things are just not in our control! So, what is the next best thing you and I can do?

EARLY DETECTION!

As you know, the best chances of beating any cancer are when we catch it in the early stages. So what steps can we take to catch breast cancer in the bud?

1. Self Breast Examination or SBE - is the regular check up of breasts by a woman herself, every month, starting from the age of 20 years. It includes Looking at both breasts in mirror to check for any changes in skin, size of breasts or nipple changes. Then the woman should methodically Touch & Feel both breasts with the flat of her fingers for any lumps, feel the armpits and press nipples for any discharge. More on SBE in next post. It should be done after menses are over or on any fixed day of the month for pregnant and menopausal women. 
2. Clinical Breast Examination or CBE - is the checkup of breasts by a doctor. It should be done every 2 years from the ages of 20 to 40.
3. Mammography - it is a low-dose X-ray of the breasts & can detect even the smallest lumps which cannot be felt by hands. It is also supplemented by Sonography of the breasts. It should be done every 2 years between the ages of 40 to 50 and every year from ages of 50 to 75. In high risk women, it maybe started even from the age of 25.

What to do if you find a lump or any other abnormality?


DON'T PANIC !
All breast lumps are NOT cancer. In fact, only 15 - 20% of breast lumps are cancerous / malignant. But do consult your doctor immediately and get the lump checked.

Au revoir, people, until next time!

Welcome to the CYSTer-hood..!

Polycystic Ovarian Syndrome / Disease (PCOS / PCOD) - the great enigma of our times! So exceedingly common (1 in 10 women have PCOS), yet we are still learning...
Initially described almost a 100 years ago by doctors Stein & Leventhal, the understanding of the disease continues to evolve even today!


To say a woman has PCOS, 2 out of the following 3 are necessary :-

1. Irregular Periods (2-3 monthly or more)
2. Excess facial / body hair, excess Acne (Pimples)
3. Ultrasonography done on 2nd day of periods showing Polycystic Ovaries (famous "String of Pearls" appearance)

NOTE :- NO BLOOD TESTS are necessary to Diagnose PCOS. They are only needed to rule out other diseases.


First and foremost, PCOS is a LIFESTYLE DISORDER.
It is NOT a purely Gynec or Cosmetic condition. It IS a METABOLIC condition. Just like Diabetes (both have the same underlying cause - Insulin Resistance).

What exactly is PCOS..?!

Insulin Resistance (body's inablility to use Insulin effectively) is the BASIC disorder that leads to polycystic ovaries, irregular periods, excess hair/pimples and later on - Diabetes, Heart disease, high risk of Cancer of Uterus and/or Ovaries.

Irregular Periods due to PCOS lead to difficulties in getting pregnant (Infertility) too. 

PCOS and Obesity - Because of Insulin Resistance, the women Gain Fat easily and have a hard time losing it. They also tend to put on fat mainly around the tummy, which is linked with higher risk of heart disease. 

Hence, rather than Scale weight or the commonly used BMI (Body Mass Index), it is better to measure Waist-Hip Ratio (WHR), to correctly estimate fat deposition around the tummy. WHR < 0.8 is considered ideal/normal for women (and < 0.9 for men).

What can YOU do?

Healthy Lifestyle (Healthy Eating Habits & Regular Exercise) goes a long way in managing PCOS!

It is the Primary and THE most effective form of management for PCOS, especially to prevent the long term diseases.

So, ladies, if you are suffering from Irregular periods and/or Excess hair/pimples, head to your Gynecologist first to find out whether you have PCOS. 

Make way for the HPV vaccine...!

Hello, my bunch of empowered, healthy women!

In my last blog we talked about the benefits of regular Pap test to catch cervical cancer early.
Today, we'll discuss how to keep cervical cancer at bay!

Cervical cancer is caused by a VIRAL infection of the cervix (by the Human Papilloma Virus aka HPV). HPV also causes Anal cancers, Vaginal & Vulval cancers, Penile cancers, Mouth cancers and Genital Warts.
Cervical cancer is one of the 3 cancers caused by a Infection (others are Stomach & Liver cancer). The good news is that it can be Prevented by a Vaccine against the virus!
Enter - HPV vaccine! Tadaaa...!!

Now, HPV is contracted by Sexual Exposure. So, it makes most sense to get the vaccine BEFORE there is ANY sexual exposure (ideally, teenage).
Also, response of the body in building immunity against the infection when given the vaccine is best at a young age. 

In an ideal world, all children and young adults between 9-26 years should be vaccinated (yes, Boys too! Women get the infection from males, don't they?!).
In India, we are yet to introduce it in our NIS (National Immunization Schedule) due to cost concerns.

BUT, the vaccine is sold by private manufacturers and if you can afford it, you should definitely go for it!
Also, if you are already sexually active and/or above the age of 26 years, you MAY take the vaccine if you wish, but it's effect will not be as good as in those who are not sexually active / younger.

There are 2 brands currently available in India:
Cervarix (by GSK) protects against 2 sub-types of the virus. Each dose costs around Rs 2500 and 3 doses are required to complete the course (at 0, 1 and 6 months of starting the course).

Gardasil (by Merck) covers 4 sub-types of the virus and also protects against genital warts in addition to cervical cancer. It costs Rs 3200 per dose and 3 doses are required (at 0, 2 and 6 months of starting the course).
A newer vaccine, Gardasil 9 protects against 9 sub-types but is currently not available in India.
No booster shots are needed after taking full course of either vaccine.
All the available vaccines are completely SAFE with no major side-effects. Please do not believe half-truths on the internet discouraging vaccination.🙏 Please contact me regarding any doubts you have.

Common query 💭 My daughter/ I have taken the HPV Vaccine. Do I still need to get the regular Pap tests?😕

Uh... YES! Cervical cancer is MAINLY caused by HPV but there are few cases that occur independent of the infection. Also, vaccine protects against the COMMON viral subtypes, NOT ALL.
So, do continue regular 3-yearly Pap test screening! There's absolutely no substitute for it at present.

Well, now that you are well armed with the knowledge to prevent this deadly & 2nd most common cancer in India, head over to your Gynecologist and get yourselves protected!

PS : Getting the vaccine is NOT a free pass to avoid Pap tests or to practice high-risk behaviour. 

Let's get intimate! Sing a Rap, for your Pap!

Let's get intimate!

Today we will discuss the nooks & crevices that even your significant other may not have explored..
Yes, I am talking about Cervical Cancer & Pap Smear.

Cervix is the lower most part of the uterus. It is seen by your Gynecologist from below (unlike uterus, tubes & Ovaries, which are inside the abdomen & can be seen only on Ultrasound).

Cervical cancer is very common in India (risk is increased in sexually active women, multiple partners, early & multiple pregnancies, low immunity).
(There is a Vaccine available for the virus that causes Cervical Cancer, more on it in another post).
The good news is that is can be caught in the very early stage itself! And as you are aware, earlier the diagnosis, better the prognosis!

What is a Pap Smear?

It is a simple, 2-minute test performed in the OPD itself which picks up this deadly disease. Oh yeah!
First, your gyno puts in a duck-bill shaped device called a speculum in your vagina & looks at your Cervix.
Then, he/she rubs a small Brush over the cervix which picks up microscopic cells and spreads them over a small glass slide.
The slide is sent to the laboratory where a pathologist examines it under a microscope (device which magnifies minuscle things so that they can be studied) & comments whether "All is Well" or early cancer changes have set in.

Q. Who?
A. All women above the age of 25.
It's ok if you're above 25 & have never had a pap before. You can start today. "जब जागो तब सवेरा", you know!

Q. When?
A. Any day of the month when you not having your menses.

Q. Is once enough or is it to be done regularly..?
A. Women with normal test reports should repeat Pap smear every 3 years, till the age of 65 years.
If a blood test called HPV-DNA is also along with the Pap, testing interval can be extended to 5 years.

So, now that you are armed with all the information that you need to protect yourself from this cancer,

Call your Gynec, Schedule your Pap & Beat cancer!
TODAY!

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What doesn't Kill you makes you Stronger.. Or does it..?!

That time of the month again.. When you are already dealing with your body pouring blood, enter the Period Pains..!! When you tummy aches and your back hurts & legs pain and you wish you could just curl up in bed all day and die? Well, wish no more! Today, we talk about Menstrual cramps, the How, the Why and What can be done to relieve them so that you are back to your old kicking self, even when you bleed!


The 'Why...?'

First read up the Normal Menstrual Cycle that I've written about (if not read already).

Now, at the time of menses, the uterus sheds it's lining (bed-like thing that it had prepared in anticipation of pregnancy). Some blood also accompanies the lining. This is Period blood. Period.
Substances called Prostaglandins increase in the blood stream, act on the uterus & make it contract to fully expel it's lining (imagine wringing a soaked towel. Yeah, that's how painful it is!).
This Contraction of uterus is what causes Period Pains a.k.a Menstrual Cramps. Simple. Normal occurrence.

Though Period Pain IS Normal, it doesn't mean that you must Suffer!
Old-wives may say to grin & bear it, but frankly, who has the time to rest when you could be juggling school/college, work, home, gym & family?!
You NEED NOT take a few days off every month. It is a normal occurrence. Pain will accompany. Let's beat it, girl..!!


Some people breeze through their cycles without a blink, while others are debilated for days! If you belong to the former group, rejoice! However, if you are somewhere in between, you need to read further!

The 'What can be done..?'

Irrespective of which group you fall in, do continue the Lifestyle measures that I talk about in my previous post on Pre Menstrual Syndrome.

Fresh foods, Exercise, Less caffeine, More water & Sleep go a long way in making your periods comfortable. Yay..!


However, if you still continue to suffer from cramps:-

1. Hot compress using Hot water bags or Electric Heating Belts.
2. Over-The-Counter (OTC) Pain Killers (Paracetemol or Crocin, Combiflam etc). These drugs do not require a doctor's prescription (not in India, at least). Do try them & see if your pains are relieved. Usually, 1-2 tablets on days 1 & 2 maybe sufficient for majority of women who have mild cramps. There are NO long-term harmful effects of pain killers when taken for a few days every month. None. DO NOT FEAR pain killers. They're here to save you, not Kill you! 
3. Anti Spasmodics (meds which relieve the uterine contractions) - like Meftal spas or Cyclopam maybe helpful when Crocin or Combiflam fail or are less effective. These are also OTC.
4. Visit your Gynecologist! Very severe pains that do not go away with the above meds need to be checked. Your gyno will usually perform or prescribe an Ultrasound examination of the uterus & Ovaries for any abnormalities (like Fibroids, Endometriosis, Ovarian cysts etc) & suggest appropriate treatment for the same.
5. Birth Control Pills may need to be prescribed to make your period cycles Anovulatory (suspend the monthly Ovulation but still get periods).

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"Today is NOT the day you cross me..!" THAT time of the month...

"I am Hungry.. No, I am Sad.. Maybe I am Angry that I am sad & hungry.. Hangry? Chocolate? Movie? Wine?"

Sounds familiar, ladies? Even guys, when you have to deal with your bae's "THAT" time of the month.. When she goes from your sweet, cute, lovey-dovey pie to a hangry, raging monster who cries/screams at the drop of a pin? Eh? And you know that her period is coming soon & no one could be happier & more relieved than you? Imagine what she's going through! Today, we'll discuss the monster that is Pre Menstrual period.


Pre Menstrual period is roughly 7-10 days BEFORE your period & symptoms subside in a few days after periods begin. It consists mainly of 2 types of symptoms: -

1. Physical - 
1. Bloating - clothes / rings feel tighter
2. Heavy & painful breasts
3. Acne
4. Fatigue & tiredness
5. Sleep disturbances
6. Appetite changes & Cravings
7. Abdominal cramps
8. Constipation/Diarrhoea
9. Lower back pain
2. Psychological - 
1. Increased emotional sensitivity
2. Mood swings
3. Anger & Irritability
4. Anxiety
5. Depression
6. Crying

• 80-90% of menstruating females suffer from 1 or more symptoms at some point in their lifetime.
• 20-30% women suffer from symptoms that affect daily functioning - Pre-Menstrual Syndrome (PMS).
• 3-8% women suffer from greater psychological symptoms - Pre-Menstrual Dysmorphic Disorder (PMDD)

Now, why are we women cursed with it❓❓ Well, it is a part-and-parcel of the reproductive cycle. Estrogen & Progesterone are out best friends during the reproductive years & they're partly responsible. Here's how: -

• Estrogen produced in the body during egg maturation causes the body to hold onto excess salt & water ➝ Physical symptoms of bloating, weight gain etc.
• Progesterone produced after egg has ruptured - binds to the GABA receptors in the brain. GABA is an inhibitory neurotransmitter (yeah, big word!) & helps one to tackle stressful situations. Low GABA = Anxiety & Irritability!
• Low levels of Serotonin (a feel-good hormone) are found in the premenstrual phase in some women which lead to depression & crying.

What can you do?
PMS & PMDD surely warrant a Gynec consult & treatment. There maybe some underlying illnesses that need to be looked for & treated if present.

But the rest of us can take care of few things to make our monthly cycles more comfortable at home itself!

1. Drink lots of water. And other fluids. Duh. You didn't see that one coming, did you? Water dilutes the excess salt (which causes the water retention). "लोह लोहे को काट ता है", you know! 
2. Put that salt-shaker down (your body is already holding onto salt!).
3. Ease up on the Caffeine (Coffee, Tea, Colas).
4. Move your body. Now..! Exercise releases feel-good hormones called Endorphins which lighten your mood. And relieves the cramps & body ache.
5. Eat whole, un-processed foods (Atta or whole flour instead of maida or refined flour, brown rice instead of white, fresh fruit instead of juices, etc).
6. Stock up on almonds, apples, pears, citrus fruits, tuna etc.
7. Let Go! Of all stress..! Try meditation, soothing music, a hot bath, a hot cup of green tea or hot chocolate (you know you are craving it!).

PS - If you still feel like a raging She-Hulk, maybe it's time to head to your Gyno who can prescribe some meds to turn you back into Bruce Banner 😉 Cheers!


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RED! The colour of Love, Roses, Wine & more..

RED!
The colour of Love..
The smell of red Roses..
The alluring red Lips & Nails..
The intoxicating red Wine..

When we love all things red, why do we hate/fear our period?


For centuries, women have been told that they're impure, dirty, weak etc when menstruating. But they are NOT! A Period is very much a normal phenomenon in every woman's life, just like eating, drinking, sleeping, pissing & pooping! To belittle an entire subgroup of population on the basis of a normal, biological occurrence should be Criminal!
Then again, I think - maybe people do not understand the science/logic behind periods.. So, today, let's understand what periods are & why they are so important.

The organs concerned with periods & pregnancy are - Uterus & Ovaries (connected via Fallopian tubes).
The Ovaries contain the female sex cells or eggs (1 sex cell from male & female each is required for pregnancy)

1 Egg grows in size ever month & ruptures when mature = Ovulation (best time for pregnancy & it occurs if there's intercourse around that time & the sperm makes it's way to the egg).

Meanwhile, the uterus also prepares itself to receive a pregnancy. It's inner lining grows & thickens.

IF there's a successful conception, it makes it's way to the uterus & embeds in its wall & pregnancy grows (= No Menses)
IF there's NO conception, approx 14 days after Ovulation, the uterus sheds it's lining (Hallelujah! Menses!!) & the cycle repeats itself.

See? Basic, pure, simple Biology! Not rocket science.. Not dirty.. Not impure.. Just the body functioning exactly the way it should, as nature wanted it to!

Let each & every one of us pledge today not to belittle/discriminate any woman on basis of periods. In our own little way, let's make them comfortable. Let them know that you are not grossed out by them & it's a completely normal & natural occurrence.

And women, let men know that YOU'RE A BADASS - Coz you can Bleed for a week every month without dying! Muah!!

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