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1. R.P, Mangalore
*My son aged 6 years, has a habit of teeth biting at night. When he is in a deep sleep he bits his teeth so hardly that someone will think he is biting the stones. Could you please tell me why he is doing this? Is there any remedy for that?
** Teeth grinding is a harmless habit which disturbs the parents and not the affected child. In some older and school going children teeth grinding may be associated with talking during sleep.
This behavior mostly reflects that the child is not able to assimilate adequately and to manage his tensions of the day and they spill over while he is in sleep. If the teeth grinding behavior is associated with sleep talking and if the parents can make out the contents of his talk, the source of his tensions can be made out.
As the child grows he will be able to manage the tensions of his surroundings and the habit of teeth grinding is also likely to disappear. At this juncture no intervention may be required. However you may just try to find out if there is anything that puts stress on him.
2. J.R. UAE
*My age is 38 years. I am working abroad for the past few years. Married for 9 years, having two kids. I am normally having erections in early morning; I feel that I don't have sensation at the shaft. Now a days even erection is becoming less i.e. less even I am doing intercourse. How this can solved.
** The terminal part of the male organ, called glans is the sensitive part in the male organ and the sensation on the shaft is not significant. If you feel loss of sensation is only during erections, you may just ignore it. If there is loss of sensation even at the non-erectile state then it can be due to some problem and you may have to consult a neurologist.
I presume, your perception of less erection is reduction in the firmness. As the age advances the quality and frequency of erection also gets reduced gradually, this is probably due to gradual reduction in the hormone levels in males. The erection also depends on the frequency of ejaculation with or without sexual union. If one has daily ejaculations then the firmness of erection may be less. If the ejaculations are occasional, then the organ may be more hard on erection. However this has no bearing in sexual union. Man does not require very firm and hard erection for physical union. Moderate erection can also be sufficient for proper union. And male erection has no influence on satisfaction for the female partner.
However you may check your blood sugar level. If it is normal just ignore the problem.
3. R.C. Mumbai
*I am 35 years old and have 1 son age of 10. But now I am pregnant for the 2nd time after long gap (after 10 years). We were trying for the 2nd child but I was not conceiving until now. Is there is any problem for the child because of gap? Doctor said everything is fine in scanning.
**The problems related to pregnancy and child birth are more common in women who conceive for the first time at the age of 35 or above (known as elderly primy). In other women, who have already undergone childbirth, the incidence of complications is relatively rare.
The most common problems seen in elderly mothers are hypertension and diabetes of pregnancy, but all the elder mothers do not get them. Moreover there are medicines which can control these. As you are under regular medical supervision, you need not have any problem.
4. A.A. Pune
*Is it safe to have sex during pregnancy; my wife is pregnant for 3 months. Can we have full sex? Please let me know till when we have to avoid?
** There is no need to abstain from regular sexual activity during pregnancy except when it is contraindicated due to ill health of the pregnant partner. Most of the couple has an additional emotional surge of feelings during pregnancy and they are able to express this most effectively through sexual union. Couple can have regular and normal activity during entire pregnancy.
However certain precautions may be taken while having sex during pregnancy:
• Physical union has to be avoided if the lady had abortion in previous pregnancies, especially in the first trimester. (First three months)
• Precautions are to be taken not to put stress if there was spotting or minimal bleeding during pregnancy.
• It may be ideal not to put stress on the pregnant lady in the first few weeks of first pregnancy
• During the last months of pregnancy, the couple may chose an position such that no stress is put on the pregnant uterus. (Rear position, side position or chair position may be opted)
5. P.F, Udupi
*I am 33 years, married since 7 years and my wife is with me. We do not have a baby and I had been operated for vericocele problem and still my sperm counts and motility is less I had taken Proviron and Clomid tablet yet the sperm count is not increasing. Please guide me to overcome this problem.
** There are incidences of fertility even when sperm counts are low. There are various modern methods to facilitate the same. Their success rate is guarded and the techniques are relatively costly. If you are interested in this, you may consult a fertility specialist. They are normally attached to obstetrics and gynecology departments in the major institutions. They may also advise you to take some other drugs which might help to increase sperm counts.
6. B. R. Bangalore.
*I am 20 years of age. Every time I go to the bathroom, I check my underwear and there is this white creamy stuff on it. I wipe it off with toilet paper and it seems to be a slimy, sticky type of clearish gel. The clearish gel happens when I wipe after I urinate and the creamy white stuff just sits on my underwear. There is no strong odor but sometimes there can be. What do I do? Should I be concerned? Please help. This has been going on for about 3 weeks. Also, I shave my private area and sometimes it itches really badly. Is this due to the hair growing back or do I have a problem?
** In almost all the women in the child bearing age some amount of secretions in the external genital tract is common. These are discharged and may stain the inner garments. The quantity and the quality of the discharge depend on the hormones of the menstrual cycle. This is a normal phenomenon and may be just ignored.
If the discharge is copious and associated with symptoms like itching, bad odour then it is better to consult a gynecologist. Normally there can be mild, tolerable odour which is insignificant. These symptoms can be due to various causes including infections of the genital tract. If the discharge is moderate, varies in a month and is not associated with any symptoms nothing need to be done.
There is no harm or benefit by shaving the hair around the genital region. However there can be minor cuts during shaving which might precipitate fungal growth in susceptible individuals, especially when the moisture of the region is more. If the itching is mild and only for few days after shaving, it may be due to the growth of new hair. After bathing wipe the region dry and see that moisture does not accumulate.
7. K. A. Mysore
* I am 28 years of age. I have completed one pack of oral contraceptives and had my periods on 16th and ended on 23rd and then I didn’t take the pills. Now I want to start it again. When shall I start and how long can I take it? I don't want to conceive for another two years. And if after sex the condom breaks and the semen falls on the vagina and not in the vagina, can one get pregnant? When only condom can be relied on?.
**To avoid conception during active sex life, oral pills are to be taken regularly and daily. They are to be started either on the 1st or on the 5th day of onset of menstrual flow and to be continued regularly for 21 days. Menstrual flow (when on oral pills this is known as break through bleeding) starts within 3 to 5 days of stopping the tablets. After a gap of 7 days since the last dose, the tablets should be started again. More about this is also available in the patient information normally accompanying the tablets.
If you want to continue the pills start them again from the next cycle.
The woman is unlikely to conceive if the semen has not fallen inside the genital tract. But if the condom has broken or slipped inside then there can be conception if the woman is in the fertile period.
Proper and careful use of good quality condoms may be safe. However many a times the couple takes chance or the condom slips or breaks inside. The incidence of failure is almost up to 15 to 20% when only the condoms are used. In women who have regular cycles, use of condoms during the mid-third of the cycle is more practicable.(For example if a lady has 30 day cycle, use of condoms for about 10 days is sufficient) Even then there can be occasional failures and the couple should be ready to accept this.
If you want to avoid conception for a long period like two to three years, the IUD-or loop may be the best device. You may consult the gynecologist to know more about the loop and its feasibility in you.
*I am 54 years of age, and I have been working abroad for the past 25 years. Every year I use to go to Mangalore and I used to have wonderful time with my wife, especially sex. Both of us had no problems to have total fulfillment in sex.
I am a diabetic, diagnosed 5 years ago, but still I am controlling my levels. For the past two years I am facing lot of problems specially to have proper sex with my wife. There are few points I want to mention. I have no proper excitement and the erection power has reduced by 50%. I ejaculate early and I also feel that my organ has become small. Is it due to age factor? So please give me your suggestions and advice how to increase my sex life back to normal or any medicine related to this.
** Your present problem seems to be having a direct bearing on the diabetes mellitus. In this state in some individuals a few of the nerves are affected. When the nerves supplying the genitor-urinal region are affected they may lead to erection problems, as expressed by you. There are good and effective medicines for this problem.
Mean time you will have to seriously consider the irregular diabetic status and try to get it under control. You may also express your sexual problems to the physician who is treating you for diabetes. He will guide you properly regarding this. If required urologist also may be consulted. By controlling diabetes and taking appropriate medicines as per the advice of your doctor, the problem can be resolved.
9 F. P. U.K
*Is it possible to get pregnant while on the Depo shot?
**No. If one is regular on Depo shot there is very less chance (0.3%) of conception.
Depo shot or Depo Provera is a hormone injection that lasts for 3 months to prevent pregnancy. The injection has synthetic progesterone and no estrogen. It is usually given in the arm or rear, delivering a high level of progesterone into the body. Depo Provera stops the ovaries from releasing eggs. It thickens the cervical mucus and changes the uterine lining, making it harder for sperm to enter or survive in the uterus. These changes prevent fertilization.
Depo Provera is increasingly becomes popular as it is a very private form of birth control because it cannot be seen on the body and requires no home supplies. It does, however, require a clinic appointment every 3 months. Depo Provera is 99.7% effective as birth control. It does not protect against reproductive tract infections, including HIV/AIDS.
The first shot of Depo Provera is usually given during or a few days after the start of a menstrual period. After 24 hours, the shot is effective birth control for the next 13 weeks.
Every woman is different and Depo Provera is not recommended for all women. Due to the risk of serious health problems, women with the following conditions should not use Depo Provera:
• Unexplained vaginal bleeding
• Known or suspected pregnancy
Depo Provera may not be recommended for women who are planning on becoming pregnant in the near future, are concerned over weight gain, have liver disease, gallbladder disease, or a history of depression. It is always better to consult the doctor before starting depo shot.
There are other risks also:
• Some women have allergic reactions to Depo Provera.
• Women who use Depo Provera may face an increased risk of osteoporosis and are advised to exercise and take in plenty of calcium.
• If a woman becomes pregnant while using Depo Provera, and continues her pregnancy, there may be an increased risk of premature birth.
• The effects of Depo Provera on breast cancer are still unknown.
• 70 % of women of use Depo Provera gain weight. Almost half of the women using Depo Provera gain more than 5 pounds after one year of use. Many women gain more than 10 pounds.
• Irregular, heavy, or no bleeding are common side effects of Depo Provera. After a year of use, many women stop having periods. Lack of a period becomes increasingly common with longer use.
• Other side effects of Depo Provera can include headaches, nervousness, mood changes, bloating, hot flashes, decreased interest in sex, breast tenderness, acne, hair loss, and back ache.
After the last shot of Depo Provera, it can take over 6 months for the drug to leave the body. Side effects may linger until the drug is completely gone
10. P.K, Karkala
*I am 26 now. I have habit of masturbation from age 17 and till now I have it. Actually I am not addicted but please tell me is there any problems to my health or any other things please do tell me.
** I have answered similar questions earlier. The misconception and wrong information regarding masturbation is so much, most of the young men worry about it.
Masturbation is a common and harmless habit during youth. Almost every man would have masturbated during youth. In a few of the men the habit persists even in marriage without affecting their marital life. It has no effect on general or sexual health.
But if one worries about it then there can be psychological stress which might lead to sexual difficulties. The person with such worries has to be convinced that masturbation is a common habit and every man had this habit at one or other part of his life. If he is convinced that there are no problems because of masturbation, he will be able to lead a normal sex life.
11. T. S. Udupi
*I am 24 years, married about a year ago. I am having irregular cycle. I had taken scan on 15th day , found no follicle. What may be the reason.
**Absence of follicle indicates that there was no ovulation. When there is no maturation or release of ovum from the ovary, the condition is termed as ‘anovulation’. It means there was no maturation of the egg and therefore no egg were released out. In some of the cycles there may not be ovulation even in a normal woman. However if no ovulation occurs at all, then further investigation to confirm the problem and to find the cause may be required.
Anovulation is a condition in which the ovary does not release a ripened egg each month as part of a woman's normal cycle in her reproductive years. Naturally, with no egg available for sperm, a woman cannot become pregnant. Thus, anovulation is a prime factor in infertility. This can be associated with scanty flow or no bleeding at all during menstrual cycle. There are many causes for it.
• Excessive exercise and weight loss. A prolonged, strenuous program of exercise, such as running, can interfere with the ovulatory cycle by suppressing the output of hormones from the hypothalamus in the brain. This type of anovulation is generally accompanied by absence of menstruation (amenorrhea) and normal menstruation returns when the woman adjusts her regimen so that it is more in since with her body's physiology.
• Stress. Anxiety and other forms of emotional stress can take their toll on normal ovulation. Some women can resolve the stress in their daily lives while others need the help of a psychiatrist or psychotherapist. Occasionally, through therapy or meditation, a woman will gain insight into a subconscious but significant reservation she has about becoming pregnant.
• Drugs. Another possible contributor to anovulation is the long-term use of certain medications. Steroidal oral contraceptives (the Pill) are sometimes responsible. These drugs work by intentionally disrupting hormone release. By this they suppress ovulation and thereby prevent pregnancy. For women using long-acting injectable steroid contraceptives (Depo-Provera), it appears likely that the longer the contraceptive is continued the more likely it is that amenorrhea will result.
• Other causes. These might include estrogen and progesterone imbalances. a malfunctioning corpus luteum, congenital adrenal hyperplasia, premature ovarian failure, and hyperprolactinemia- a hormone imbalance.
If you are having the problem of anovulation, the gynecologist will be able to find the cause. It can be set right by proper medication.
*I am 36 years and I am 8th month pregnant and so far no complication but last week doctor told sugar is little bit high and she told me to control it and she told me my child's head is up(breech) is there any problem in this please suggest and how to control sugar it is 147?
** The detection of increased blood glucose level in mother during pregnancy is known as ‘gestational diabetes’. Gestational diabetes(GDM) is defined as glucose intolerance of variable degree with onset or first recognition during the present pregnancy. The growth and maturation of the fetus are closely associated with the delivery of maternal nutrients, particularly glucose. This is most crucial in the third trimester and is directly related to the duration and degree of maternal glucose elevation. Gestational diabetes is pathophysiologically similar to type II diabetes. Approximately 90% of the persons identified have a deficiency of insulin receptors(prior to pregnancy) or a marked increase in weight that has been placed on the abdominal region. The other 10% have deficient insulin production and will proceed to develop mature-onset insulin-dependent diabetes later.
The diabetic status has to be brought under control to prevent various maternal and foetal problems. Your doctor must have advised you what precautions to be taken, how frequently blood sugar levels are to be evaluated. Nutritional counseling is the mainstay of therapy for the gestational diabetic woman. The optimal dietary prescription would be one that provides the calories and nutrients necessary for maternal and fetal health, results in normal blood sugar level, prevents diabetic complications and results in appropriate weight gain. One of the difficulties with dietary prescription for women with GDM is the difference between lean and obese women. Obese women with GDM may benefit from a low calorie diet and weight reduction to reverse the metabolic disturbances, but proper nutrition is needed to assure fetal growth and development.
If diet is not successful in maintaining relative normal blood glucose level, then insulin therapy is recommended. To identify the women who will require insulin, circulating glucose levels should be monitored at frequent intervals.
At present your blood glucose level (presuming it was done on fasting) is not very high. You may check the blood sugar level approximately 2 hours after meals and at random. If the blood sugar is really above the normal, then try with dietary restriction. The doctor will decide if you are to be put on insulin.
Your doctor has also mentioned that the child has not seated properly. It is unlikely for the child to move in the maternal womb after 7th month to correct the position. The doctor may be having different plans for you.( I do not ant to confuse you regarding the management of malposition,) You have to consult and follow your doctor’s advice.
13. P.D. Kuwait
*I am 30 years old, married for 4 years now. Last month I noticed that my penis skin itching which causes my penis to form white color fungus on the top and also slight bad smell. I visited the doctor who told me that happens when one have intercourse with pregnant woman. My wife is 2 months pregnant. We had sex and after that I feel I got this problem. There was no intimate relation with any other woman. Please advise if this happens when we have sex with pregnant woman and to how long it exists once the treatment started? Although the treatment has started for two weeks now, I still have the itching on the penis. The doctor has advised to clean the penis twice a day before applying the ointment both inside and outside the skin. Also let me know if it is safe to have sex especially when a woman is pregnant? Also please advise if any other treatment to be made or seek another doctor is the itching still exists?
** There is absolutely no problem to have normal physical relationship with pregnant woman unless it is contraindicated because of previous abortions etc. (Details are in the previous editions of this column). Most of the couple continue to have sexual relationship during entire pregnancy.
It is possible that your wife has certain fungal infection in the genital tract and you have probably acquired fungal infection from your wife. Incidence of fungal infection is not rare in pregnancy. They may be harboring it in the depths of the genital tract and may not appreciate symptoms. The inner part of the female genital tract has no sensation.
You have to get proper medication for the problem. It may be better if you consult a skin specialist. Mean time your wife also require assessment of the condition and treatment. Unless she is treated, you might get re-infection in future contacts. You may seek the help of her gynecologist for this. Till the problem is properly treated you may continue physical relationship using barriers like condoms.
14. J. D'S. Mangalore
*I am married and have 2 children. Now my second baby is 4 months of age. I am breast feeding my baby. After 40 days of maternity leave, I resumed my duties.. Since then, during day time I am giving bottle feed for my baby and night breast feed. My question is until now I didn’t get my periods. I am feeling very tired and uneasiness after working hours. I checked with many of my friends regarding this, but everyone's answer is that “because I am breast feeding, I am not getting my periods” Is it true? Please advise me what should I do to get my periods?
** Many of the mothers who breast feed the baby do not menstruate (amenorrhea) - it is not an abnormality or a problem. While the baby sucks the breast certain hormones are released and of these prolactin hormone has an effect on menstruation. The ovum (or egg) do not mature and as a result woman do not menstruate. This is known as lactation amenorrhea and normally women do not conceive during this period. This is known as lactation induced infertility.
Lactation induces infertility, providing the basis of the lactational amenorrhea method (LAM) for family planning. However, lactational amenorrhea duration varies in different women and countries. Most of the studies reveal that only about half of the women who fully breastfeed have a post-partum amenorrhea which lasts more than 6 months. Women who will experience a long lactational amenorrhea (defined as lasting more than 6 months) have higher prolactin (PRL) concentrations and a greater PRL response to suckling than those women whose lactational amenorrhea lasted less than 6 months. Oestradiol concentration (hormone required for the maturation of ovum or egg) also differed between these groups.
The feeling of tired and uneasiness is not related to lactation amenorrhea. However worries related to amenorrhea can cause these feelings without any physical abnormality. You may consult your doctor and get blood examination for hemoglobin level.
Menstruation normally sets in once breast feeding is stopped. But this may happen even when the baby is still on breast feeds. There are incidences of conception even when the woman was breast feeding. So during breast feeding, lactation induced infertility can not be guaranteed to all and to avoid conception other precautions are required.
15. S. C. Thane
*Is it possible to breath correctly from having beef in a meal that was not supposed to have it , after not eating meat for about five years cause if not what could it be?
** Unless one has severe allergic reaction to beef, there is no relation between breathing and beef in the meal. Some people might develop allergic reaction to protein part of a particular item. For example some individuals have allergy to eggs, a few have for ground nuts, some people are not able to tolerate fish. These people will develop various symptoms if those particular items are consumed. The allergic reaction may vary from simple skin rash to severe asthmatic attack. The severe allergic response is known as anaphylaxis and there are incidences of deaths in this.
If one has no allergy to beef there need not be any problem even if it is consumed after five or ten years. However the allergic response may be spontaneous and if you have developed breathing problem after eating beef, consult your doctor and confirm whether you had any other cause for breathing problem. If you have developed allergy to beef, it is better not to consume it in future.
16. S. B., Mumbai
*I want to be pregnant but for baby boy so please if there is any solution for that but not tedious some easy one?
** I have answered similar questions earlier. There is no way to programme physical union or conception to get the baby of a particular sex. By luck this is not yet known to humans and the secret is still with God! Otherwise majority of the parents would have opted for males with severe shortage of girls. There would have been chaos by this.
17. E. J. G, Goa
*I think that I had a miscarriage, but am not certain. I had my period about 3 days late, but on the first day something long and wide that looked pinkish with a string of blood attached to the end came out. I had unprotected sex with my fiancée prior to this. I held it with a paper because I was curious and squeezed it to see if it was just a clog of blood, but it didn't break it maintained its form and it was soft. I can't think of anything else it can be but a spontaneous miscarriage, and if it is what should I do now?
** I do not think so. Even if you had conceived, the fetus on the 17th day (the day on which you detected the strange material), is too small to be seen through naked eyes. Even if it is expelled with surrounding tissues, one can not detect it even with ordinary microscope in the first few weeks. The material you saw may be one of the tissues of the endometrium or a thick blood clot. Sometimes even the blood clot may be difficult to squeeze into pieces.
You may just forget the issue, but be careful when you have physical union in future. Unprotected sex can lead to unwanted pregnancy.
18. R. D’S, Kuwait.
**I have two children - the second one is now 8 months old. My delivery was normal. After the third month of my second delivery I started bleeding in my rectum every time. I am not able to eat any non-veg items. If I eat only vegetables there is no bleeding. Please advise.
** You have not mentioned whether the bleeding is associated with pain. If it is painless probably you have developed piles (or hemorrhoids). It can be seen first after delivery, even though delivery has nothing to do with the developments of piles. Many of the men also suffer from these problems. In your case the problem has started after three months, so may not have any bearing on delivery. If bleeding is associated with pain it may be due to fissure-a small linear tear in the anal mucosa, which pains and bleeds while passing motion. Traditionally many of the women do not consume enough fluids during early weeks after delivery (due to a traditional belief that fluids cause ‘sheetha’-cold to thee mother and child. This is a wrong notion). Added to this they consume spicy preparations and at times locally prepared medicines. As a result they constipate and go into the problems of piles or fissures. Non vegetarian food may be causing hard stools which incite bleeding. Even when you consume non-veg food, see that you take good amount of vegetables and fruits. Drinking lot of water after the meals also helps in softening the stools.
But in any case you have to consult a surgeon to assess the condition. Frequent bleeding may lead to anemia.
19. F. D, Mangalore
*I am 22 years, two lumps have developed on my lower gums but I have no pain or any other troubles relating to it. Is it normal?
**Unusual lumps anywhere are not normal. You may consult a general surgeon to know what it is and he might advise you to go to other specialists if required.
20. M. D'S, Mangalore
*I am a lady, aged 48 years; I get a catch in my back near the rib case and often in knee joints. Sometimes I get the aching feeling in my hips and shoulder too. Two days back I got a very bad ache in my back near the rib case and across and started getting cramps every now and then. I had eaten shells for dinner and also had dhal the same afternoon. Usually I get this pain when I eat any pulses or beans etc. Is there a permanent cure? Can you suggest some medicine? Is it because of weakening of the bones? Should I take B-complex tablets?
** There is a wrong but strong belief among our people that certain types of joint and body aches are due to excess gas production in the body! This belief was probably related to ‘vatha’of Ayurveda. But, the real meaning of ‘vatha’ is not gas. The belief that the food items producing gas aggravate the pain might be acting on our mind and reduce the tolerability of pain. This may be the reason why only a few people appreciate increase in the pain after consuming certain food items. There is no established relationship between vague joint pains and food intake. Even the pain of gout has no direct relationship on consumption of certain food items which were believed to increase uric acid in the body.
Your problem of vague pains may have to be investigated. You may consult a rheumatologist or an orthopaedic surgeon. After clinical examination they might ask you to get certain laboratory investigations to find the cause of the problem.
Weakening of the bones or osteoporosis is a common problem among post-menopausal woman, but this problem manifests without any specific symptoms. In most of the people osteoporosis is detected when the person is brought with a fracture. Hence the problem is termed as silent stealer of bone!
B-Complex tablets, capsules and tonics are the most commonly abused medicines. Many people take these medicines faithfully for years without knowing that they are not required. Luckily B-complex medicine do not cause any harm even if they are consumed when not indicated. They are excreted from the body in the urine. You need not waste your money on B-Complex unless you are advised by your doctor. B-complex deficiencies do not cause joint pains.