DHEA: DIHYDROEPIANDROSTERONE

 

What is DHEA; a hormone easily available in many countries over the counter and in many countries in the nutritional section of tablets? In many countries women use it freely as a heath product often without proper advice. They think it helps their wellbeing, muscle strength, lose weight, cognition, boost immunity and sexual function. Some also feel benefitted from hot flushes and depression. It    is available as tablets, topical cream, powder, capsules, and gel. The studies on this subject are confusing. Only one study has suggested in a small number of women that helped with hot flushes, sexual dysfunction. Off course it helps with bone density. It has a few side effects such as, headaches, fatigue, insomnia, abnormal bleeding, acne, may be loss of hair and hairiness (Hirsutism).They can also interact with some important drugs such as blood thinners, anticonvulsants and drugs used for heart or liver disease. One situation it is useful in, is vaginal atrophy due to menopause. It has no systemic effect hence can be useful in women after treatment for breast cancer. It is helpful in sexual function due to prevention of pain, it is not believed that it helps in improving libido in any other way. Using DHEA women, also risk getting problems with, Thyroid, HDL, PCOD, and Clotting problems. I have come across many menopausal women taking DHEAS to prevent aging effects, wellbeing and feel better sexually; my suggestion to them is not to take this without proper advice, it does nothing for aging, may be a bit for menopausal symptoms and surely helps with vaginal atrophy and bone density.

EMERGENCY CONTRACEPTION

 Contraception is a constant bane in a women’s life, from the moment she becomes mature as a woman, until one or two years after menopause. In the scheme of life, we usually have 2-3 children and in our 40-50 years of reproductive life, we have to keep protecting ourselves from getting pregnant. There are several ways to do so, however every now and then we get mixed up. Involved in different and other stressful situations, we forget about contraception, and the problem starts for emergency contraception (EC). When do women need this, when they have forgotten to take two pills in the first week of the cycle, did not take the progesterone only pill, and did not put the vaginal ring or the skin patch on in time? Some times bigger things are forgotten such as changing IUCD on time, skin implant not renewed. Besides these the condom breaks during sex, sexually assaulted and diarrhea and vomiting disrupted the pill cycle. Sometimes women assume it is ok to have sex, soon after having had a baby, however one can get pregnant again, and 21 days after having had a baby.  So many situations when one needs emergency contraception (EC). I am sure you will be able to think of many other different situations. 

Now what are the methods of EC? These act by preventing ovulation, altering the lining of the uterus, making it unsuitable for an egg to settle down. Ordinary contraceptive pills are packed as four together to be taken as a single dose. There is also a method called YUZPE method in which two hormones are given to be taken 12 hours apart. Both these pill systems can cause vomiting due to high doses of estrogens, if this happens the dose should be repeated after 2 hours. The three best recognized methods are again two hormone tablets prepared for this purpose. They are called the morning after, however they can be taken up to 72 hours and one after 120 hours. Both these hormone tablets can be bought from a pharmacy, a family planning clinic, sexual health clinic, no script is needed. Some GP’s also can give it. 

 

There is another morning after pill which is very effective, however in some countries you need a script for this, so the cost goes up and as such it is expensive .The next method is insertion of a copper intrauterine device, it can be done up to five days. One must make sure about the sexual history of the woman, exclude the likely hood of any pelvic infection. The morning after pill or copper IUCD does not protect women from STI’s, it is important to test for STI’s. The pill can cause side effects in a small number of women, these are nausea, dizziness, headaches, breast tenderness, and lower abdominal pain. There can be spotting and the next period can be late. Please do not use the morning after method as your regular method of contraception. Always keep STI’s in mind and protect yourself from them and always have a test done for them. If an IUCD insertion is used it is good as it can continue as a regular contraception for up to five years if you wish.

To summarize, emergency  contraception  provides good service, if your regular method fails with your regular partner it is safe, do not make it a habit with new partners it cannot be used twice in the same month,  protection from STI’s is essential. In some parts of the world it can be expensive.