Madeeha Syed

How Your Menstrual Cycle Affects Your Mental Health

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How To Heal From Grief?

Overview

Grief is a natural reaction to any kind of loss. It&rsquo;s something we all experience, but the way it manifests itself varies from person to person. Some people are able to move on quickly, while others find it harder to heal. In this article I&rsquo;ll explain how the stages of grief work and give some tips on how you can help yourself or a loved one through their grieving process. 
&nbsp;

Tips to Heal From Grief

Denial is a defense mechanism. It&rsquo;s a way to protect yourself from the pain of loss, or at least postpone facing it. You may have heard of denial as something that happens during the grieving process, but this isn&rsquo;t quite accurate. Denial doesn&rsquo;t necessarily kick in once someone has died; it can also be an immediate coping mechanism for people who aren&rsquo;t yet ready to admit their loved one is gone.

Denial helps shield you from the <a href="https://merisehat.pk/article/natural-remedies-for-pain">pain</a> of grief by avoiding reality and hiding from feelings you&rsquo;d rather not experience (such as anger and sadness). 
&nbsp;

Anger is a natural and healthy reaction to loss. Anger can help you express your feelings, release negative emotions and show others that you are upset or hurt by what happened.

However, while it is normal to feel angry after the loss of someone or something close to you, there are some things that should be avoided when expressing anger:

Don&rsquo;t direct your anger at anyone else. You may have some pent-up frustrations with people associated with the loss (e.g., family members or friends), but directing your rage toward them will only make things worse for everyone involved.&nbsp;

Directing your anger inward instead by staying home from work or school can also be harmful because it could prevent you from accomplishing goals (such as getting back into college).&nbsp;

It&rsquo;s best not to let anger boil over into lashing out at others unnecessarily; instead, find other outlets for releasing negative emotion such as yoga classes or therapy sessions with a counsellor who specialises in grief counselling. 
&nbsp;

When you are bargaining, you are essentially trying to make the best of an intolerable situation. You may start thinking that there is something you could have done differently or something that will help save your loved one&rsquo;s life. You might even try to bargain with God or a higher power in order to get them back again.

For example, you might think, &ldquo;If only I had spent more time with my husband before he died!&rdquo;, &ldquo;If only I hadn&rsquo;t taken so long buying groceries!&rdquo; or &ldquo;If only I had remembered to call him earlier!&rdquo;&nbsp;

While these thoughts and feelings aren&rsquo;t necessarily accurate (the reality is that death or breakups happens when they happen), they can still be helpful if they allow you some peace of mind and perspective during this difficult time of grieving. 
&nbsp;

Bargaining can also manifest itself as guilt &mdash; for instance, if someone close dies from an illness but another person survives the same illness, there may be some sense that it should&rsquo;ve been the other way around, even though there&rsquo;s no real reason for this feeling beyond just being human (and overthinking things).&nbsp;

If this sounds like how you&rsquo;re feeling right now &mdash; like maybe there was something else r someone else who could&rsquo;ve helped prevent their death (for example) &mdash; it might be helpful for friends and family members who care about your well-being (or just want their own questions answered) not dismiss these thoughts or feelings outright by saying things like, &ldquo;It wasn&rsquo;t your fault&rdquo; or &ldquo;Of course everything would have been different if only...&rdquo;&nbsp;

Instead, they could take those questions seriously while acknowledging how hard they must be on whoever lost their loved ones without belittling them at all &mdash; because sometimes just recognising how painful it must feel helps us move forward without letting ourselves stay stuck in grief forever.&rdquo; 
&nbsp;

The final stage of grief is sadness and acceptance. The loss of someone leaves you feeling helpless. There will be times when you are too distracted by the world and work to think about it but at times, it is common to have a depressive episode and completely lose your pace or focus.&nbsp;

People who are unable to cope and accept tend to go into depression at this stage and numb themselves towards the outside world. The only way to avoid suffering from this illness is to deal with your loss and come to terms with it mentally. This requires your maximum input as your experience life without the person, the need for acceptance and doing things differently now. The only way is the way forward.&nbsp; 
&nbsp;

The stages of grief are not a checklist, nor are they rules to follow. They aren&rsquo;t even in the same order for everyone.

The five stages &mdash; denial, anger, bargaining, sadness and acceptance &mdash; are merely a general guide to help you understand what your loved one might be experiencing during their time of grieving. However, everyone grieves differently and no two people will go through all five stages at the same time or in the same way. It&rsquo;s important to remember that every person needs different kinds of support during times like these: some may need lots of love and affection as they work through their feelings; others will want space from others so they can take care of themselves first before reaching out for support later on. 
&nbsp;

The most important thing that needs to be acknowledged is that there is no shortcut to coping with grief. You cannot skip the stages. However, you can make it easy for yourself to handle your grief and speed up the process. Following are the steps that are age-old practices employed by people to help them cope:

<ul>
	<li>There are people around you who care about you, lean on them. Share your feelings with your friends and family. Hangout with them more to keep yourself distracted.</li>
	<li>Be acceptable for whatever support you are getting. Not many people know what to say or how to act around someone grieving, appreciate their efforts. They are doing it because they care.</li>
	<li>Religion has been a very strong catalyst for people struggling with grief. If you believe in one, resort to your faith. Praying can be very relaxing for the mind.</li>
	<li>A support group or therapy. Both allows you to talk about your experience, how it has affected you without getting a biased answer from the other side.&nbsp; 
	&nbsp;</li>
</ul>

Bottom Line

Grief is a normal part of life and it can be hard to deal with. But remember, there are ways to cope with your feelings and move on from them. If you&rsquo;re struggling with grief or have lost someone close to you, remember that you&rsquo;re not alone. Reach out for help if needed, but don&rsquo;t forget that it may take time before things feel better again!

Umna Salah

Online Consultation

Ismail Munir

Common Menstrual Myths In The Society

Introduction

If you belong to the latter group, then chances are that once you got over the dying part and gathered the courage to speak to a family member, they informed you of your body&#39;s natural function and likely a few additional pieces of information regarding menses. As per results from a recent study, only 28% of women in Karachi, Pakistan had adequate menstrual health knowledge prior to their first <a href="https://www.merisehat.pk/article/natural-remedies-to-help-regulate-your-periods">period</a>.<a href="#accordion">[1]</a> 
&nbsp;

Understanding Myths Associated With Menstruation

Almost 50% of Pakistan&#39;s population is composed of females.<a href="#accordion">[2]</a>&nbsp;Despite the high prevalence of females, awareness of women&#39;s health issues is limited. There is an unfortunate stigmatization of menstruation in low-income countries, for e.g., sanitary napkins are often sold in brown paper bags and menstrual concerns are not a widely discussed topic. This stigmatization of menstruation and lack of awareness leads to the spread of incorrect practices and knowledge among women. This could be a source of concern as these practices can later have harmful implications on the lives of women and girls.&nbsp;

Every woman has been likely exposed to several myths and superstitions pertaining to periods. The following article will help to shed light on some of these myths.&nbsp; 
&nbsp;

<ul dir="ltr">
	<li>
	<h5>No Baths Allowed</h5>
	</li>
</ul>

A multi-center study conducted on menstrual hygiene practices among Pakistani girls reported that 39% of girls avoid bathing during menstruation.<a href="#accordion">[3]</a>The most common reason for avoiding taking a bath is that it can cause an irregular flow.<a href="#accordion">[1]</a>&nbsp;However, such practices can affect one&#39;s hygiene and predispose girls to reproductive tract infections. Moreover, research has pointed out that there is no link between irregular flow and bathing during menstruation. Instead, warm baths are often encouraged to help relieve painful menstrual cramps in women.<a href="#accordion">[4]</a>&nbsp; 
&nbsp;

<ul dir="ltr">
	<li>
	<h5>Don&#39;t Eat The Pickle</h5>
	</li>
</ul>

Cold water, pickles, eggs, and milk are just some of the food items various cultures advise against consuming during menstruation. Approximately 50% of Pakistani girls report avoiding &#39;cold foods&#39;(e.g., yogurt, ice cream) as they fear that it will stop their periods and increase the chances of blood clots.<a href="#accordion">[3]</a>&nbsp;Similarly, &#39; hot foods&#39; (e.g., liver, eggs, dry fruits) are also avoided for fear of menstrual irregularities. However, there is a lack of scientific evidence linking cold or hot food to menstrual cycle abnormalities.&nbsp; 
&nbsp;

<ul dir="ltr">
	<li>
	<h5>Avoid Exercising</h5>
	</li>
</ul>

Among the general population in Karachi, approximately 53% of women restrict physical activity during menstruation to avoid heavy periods.<a href="#accordion">[1]</a>&nbsp;Walking, sitting, and lifting weights are some of the commonly avoided physical activities among girls and women. However, research shows that aerobic exercise can be beneficial for painful menstrual cramps.<a href="#accordion">[5]</a> 
&nbsp;

Conclusion

In many low- and middle-income countries, periods are considered impure and a process of dirty or impure blood leaving the body. This is likely due to a lack of education regarding reproductive health. Young adolescent girls are often too shy or scared to discuss menstrual issues with their mothers. Moreover, a majority of adult women are also not aware of the physiology of menstruation or good hygiene practices. As a result, there is a high prevalence of misinformation among girls and women. Almost 70% of Pakistani university-going girls believe the source of bleeding in menstruation to be the vagina instead of the uterus.<a href="#accordion">[3]</a>

Therefore, there is a need for the introduction of regular menstrual education awareness programs in schools and universities. Furthermore, primary care physicians should be aware of the common myths and misconceptions regarding menstrual health in a population. Health education campaigns on a community level can ultimately help destigmatize reproductive health issues.&nbsp; 
&nbsp;

Key Points

<ul>
</ul>

<ul>
	<li>Menstruation is a natural phenomenon in a woman&#39;s life that is often stigmatized in various cultures.</li>
	<li>A lack of awareness has led to the development of various myths and practices regarding menstruation. The most common of which is avoidance of taking a bath during periods, not eating certain foods, and avoiding exercise.</li>
	<li>Community-based health education programs can help destigmatize menstruation and propagate correct information and practices among girls and women.</li>
</ul>

[1] Ali, S. A. et al., 2020. Perceptions, Practices, and Challenges Regarding Menstrual Hygiene Among Women in Karachi, Pakistan: A Comparison Between General Population and Healthcare Workers. Cureus, 12(8).

[2] Pakistan Bureau of Statistics, n.d. Census 2017. [Online].

[3] Mansoor, H. et al., 2020. Menstrual knowledge and practices of Pakistani girls: A multicenter, cross-sectional study. Heliyon, 6(1).

[4] Jo, J. & Lee, S. H., 2018. Heat therapy for primary dysmenorrhea: A systematic review and meta-analysis of its effects on pain relief and quality of life. Scientific Reports, Volume 8.

[5] Dehnavi, Z. M., Jafarnejad, F. & Kamali, Z., 2018. The Effect of aerobic exercise on primary dysmenorrhea: A clinical trial study. Journal of Education and Health Promotion, 7(3).

Nimrah H. Sattar

To Meat Or Not To Meat?

Research over the years has shown that a strict vegetarian diet excluding all animal fats can lead to vitamin B12 deficiency. Thus, increasing the risk of developing anemia. Newer research also suggests that a more lenient diet puts people at risk of developing <a href="https://www.merisehat.pk/disease/anemia">anemia </a>and heart disease.

There are various reasons behind people giving up eating meat and animal products (milk, cheese, and eggs). However, doing so might increase their risk of anemia, which is a potentially serious condition in which the body does not make enough red blood cells. For vegetarians, vitamin B12 deficiency anemia is typically caused because of eliminating meat from their diet. Similarly, for vegans, giving up all animal products including dairy, eggs, and even honey increases the risk of developing anemia.&nbsp; 
&nbsp;

Understanding Ways To Diversify Iron Sources In Vegetarian And Vegan Diets

A lack of vitamin B12 in your diet can cause pernicious anemia. The body needs vitamin B12 from foods such as meat, poultry, fish and eggs to make red blood cells. Pernicious anemia is a rare type of anemia in which the body is unable to absorb vitamin B12. The vitamin is only available in meat and animal products. While vegetarians who eat dairy and eggs are getting enough vitamin B12 through these sources, vegans must find other ways to include it in their diets, for example, through vitamin B12 supplements. 
&nbsp;

Vitamin B12 deficiency can boost the levels of homocysteine in the blood, a common amino acid that is associated with a higher risk of heart disease. Studies also suggest that the level of this amino acid can over time cause blockages in arteries and lead to heart disease or stroke. Vitamin B12, unlike B vitamins, is not found in any plant derived foods and fortified cereals. However, many types of meat and fish are abundant in vitamin B12. Thus, making it difficult for people following a strict vegetarian diet to get the necessary amount of vitamin B12. The answer is to eat a well-balanced diet and get the needed B12 from other sources, such as vitamin B12 supplementation, to prevent anemia.&nbsp; 
&nbsp;

Look for foods fortified with vitamin B12. Read the nutrition label on packaged foods. Some examples of processed foods that contain vitamin B12 are:&nbsp;

<ul>
	<li>Fortified rice&nbsp;</li>
	<li>Soy milk&nbsp;</li>
	<li>Grain products and cereal&nbsp;</li>
	<li>Meat substitutes</li>
	<li>Dietary supplements containing B complex&nbsp;</li>
	<li>Nutritional yeast&nbsp; 
	&nbsp;</li>
</ul>

Whether you are on a vegan or vegetarian diet, you need to create a healthy and balanced diet that includes enough vitamin B12 to prevent anemia. While fortified cereals are a good choice because of their good bioavailability, meaning it doesn&rsquo;t need to break down before the body absorbs them, vegetarians should consume the following foods on a regular basis:&nbsp;

<ul>
	<li>8 ounces (oz) of yogurt contains about 1.1 mcg of vitamin B12</li>
	<li>1 cup of low-fat milk can provide 1.2 mcg of vitamin B12</li>
	<li>1 oz of Swiss cheese can contain 0.95 mcg of vitamin B12</li>
	<li>1 large egg contains 0.6 mcg of vitamin B12</li>
</ul>

Nutritional yeast is also popular among vegetarians because of its rich, cheesy, and nutty flavor. The yeast can either be added to cooked meals or sprinkled on foods and snacks.

<div>
Since vegans avoid all animal-derived products, they may rely on vitamin B12 fortified breakfast cereals and nutritional yeast, as an alternative source of vitamin B12. For example, fortified non-dairy milk, meat substitutes, breakfast cereals, nutritional yeast, and vegan spreads. However, it is essential to read the labels of the foods as some may not be fortified in vitamin B12.&nbsp;

For those who are deficient in vitamin B12, supplemental vitamins in the form of capsules may be required.&nbsp; 
&nbsp;
</div>

<h4>"All that meat is great for your anemia. But can it also be affecting the heart rate? Get your reading with our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan</a>!" </h4>

If you decide on taking a dietary supplement, there are some ground rules. A healthy body does not readily absorb all the vitamin B12 in a supplement. Food supplements should never be used as a substitute for a balanced diet and healthy lifestyle. Therefore, it is essential that you talk to your doctor or nutritionist to know the amount of vitamin B12 supplement that is right for you.&nbsp; 
&nbsp;

<ul>
	<li>Vegetarians and vegans need to take steps to make sure that they are including an adequate amount of vitamin B12 in their diet. Not maintaining proper levels of vitamin B12 increases the risk of developing anemia.</li>
	<li>Similarly, since there are no plant-derived foods that contain vitamin B12, it is essential to look into alternative sources, for example, fortified foods and vitamin B12 supplements.</li>
	<li>Speak with a healthcare provider for advice on how much you need to take and where to find sources of vitamin B12.</li>
</ul>

[1] Pawlak, R., Parrott, S.J., Raj, S., Cullum-Dugan, D. and Lucus, D., 2013. How prevalent is vitamin B12 deficiency among vegetarians? Nutrition reviews, 71(2), pp.110-117.

[2] Walsh, S., Appleby, P., Baron, L., Dallas-Chapman, G., Davis, B. and Harris, W., 2001. What every vegan should know about vitamin B12. Birmingham: Vegan Society.

[3] Watanabe, F., Yabuta, Y., Bito, T. and Teng, F., 2014. Vitamin B12-containing plant food sources for vegetarians. Nutrients, 6(5), pp.1861-1873.

Staff Writer

Can't Go To Sleep? Here’s Why And How To Fix It

You&rsquo;re lying in bed, trying to fall asleep. You&rsquo;ve tried everything: reading a book, taking a bath, meditating, nothing seems to work. If this sounds like you, don&rsquo;t worry, I&rsquo;m here to help. In this article, we&rsquo;ll explore some of the most common reasons why people can&rsquo;t fall asleep and what you can do about them. 
&nbsp;

trick your body into sleeping

It&rsquo;s hard to shut down the mind, but if you can allow yourself to be free of all thoughts, worries and overthinking, it&rsquo;s easier to get a good night&rsquo;s sleep. This is why meditation has become so popular as a way to relax and clear your mind.

If you are having trouble going to sleep at night because you have too much on your mind, try focusing on relaxing exercises, such as taking deep breaths for 10 minutes or listening to calming music before bedtime.

If you feel like there is simply too much for your mind to process before bedtime, try not to think about anything at all until after midnight (or whenever you plan on falling asleep). That means no worrying about things that happened earlier in the day or what needs doing tomorrow morning&mdash;just let everything go until it&#39;s time for bed!

&nbsp;

Your environment can also influence the quality of your sleep. If you are sharing a bed with a partner who snores, or have pets that are noisy at night, this can affect your ability to get into REM and deep sleep stages of sleep. If you suffer from these problems, try to keep your pets out during night time.

&nbsp;

If you nap during the day, this can make it harder to fall asleep at night. This is because napping reduces your total sleep time and delays your internal circadian rhythm. In other words, it makes for a long period of time with reduced sleep quality and quantity, which makes falling asleep at night even more difficult.

Napping during the day also makes you feel groggy when it&rsquo;s time to go to bed. It&rsquo;s like drinking coffee in the morning. Once the caffeine has worn off, you may find yourself struggling to stay awake until lunchtime, instead of the usual 3pm!

If you want an afternoon nap but don&rsquo;t want these side effects on your nighttime slumber, consider power naps (naps lasting between 15 minutes and 1 hour), instead of full-on snoozing sessions (which can last longer than 90 minutes). Naps are great if they help improve alertness or performance, however, they shouldn&#39;t be used as a substitute for nighttime sleep if that&rsquo;s what you need most!

&nbsp;

You may have heard that it&#39;s important to go to bed at the same time every night and wake up at the same time every morning. This is true, but even more important is your schedule on weekends and weekdays. If you get enough sleep every night, then it doesn&rsquo;t matter if you sleep in on Saturdays or stay up late on Sundays, your body will adjust to these changes when they happen.&nbsp;

However, if you&rsquo;re not getting enough sleep overall, especially if it&rsquo;s because of inconsistent nighttime habits, then your body might have trouble adjusting to irregular schedules.

&nbsp;

Imagine this scenario: you go to bed at 10pm as usual, but you&rsquo;re not tired. You try and get comfortable, but you can&rsquo;t stop thinking about all of the things that happened during the day &mdash; the conversations you had with colleagues, how much work is left to do tomorrow, or what your friends are doing right now. You start worrying about them and then feel guilty because they don&rsquo;t have time for a phone call when they could be sleeping.&nbsp;

Then another thought pops into your head: did I switch off my iron? Should I check? Now we all know that checking whether an appliance is turned off isn&rsquo;t going to help us sleep any better than worrying if our friends are safe (unless there&rsquo;s a fire nearby somewhere), but this process repeats itself over and over again until suddenly, it&rsquo;s 2am, and there&rsquo;s no hope for rest tonight either!

So how can we avoid these situations? The key is finding something else, anything else, to occupy our minds instead of keeping track of every single little thing that crosses our minds throughout the day.

&nbsp;

Pillow size is another important consideration. Your pillow should be firm enough to support your head and neck, but soft enough to mold around your head and neck as you sleep. A proper pillow will also allow you to keep your spine in alignment while sleeping on either side or on your back, which helps with good posture.

If you have been using the same old pillows for years, it may be time for an upgrade. If a new pillow doesn&rsquo;t work right away, try adjusting its height (keep adding or removing stuffing) until you find one that works for you 
&nbsp;

Don&rsquo;t forget about the other side of the bed - do not share a bed with someone if that person snores heavily. Snoring can really affect quality of life. If a partner snores loudly enough at night that it keeps other people awake or keeps them from getting enough sleep themselves, then this could lead to fights between couples over who gets up earlier so they don&rsquo;t disturb their spouse&#39;s slumber. This problem can be resolved by setting up separate bedrooms for each person or getting rid of noisy beds altogether by buying two twin mattresses instead!

&nbsp;

If you can&rsquo;t get to sleep, it could be for any number of reasons. There are a lot of things that can keep you from drifting off into blissful slumber.

<ul>
	<li>You have too much going on. If there&rsquo;s something weighing on your mind, or if you&rsquo;re in an environment that&rsquo;s too stimulating (like a loud restaurant or party), try taking a moment to reflect on everything that&rsquo;s stressing you out and how it might affect your sleep quality. Try jotting down some notes and setting aside time tomorrow to talk over those issues with someone else so they&rsquo;re not still bothering you when it&rsquo;s bedtime.</li>
	<li>You napped during the day or had too much caffeine/food/alcohol before bedtime. When we nap during the day, we tend to wake up feeling more alert than usual, and while this can be helpful if we have somewhere important to go after work and need the extra boost, it can also hinder our ability to fall asleep at night when all we want is rest.</li>
	<li>Your sleep schedule is off-kilter or irregularly shifted throughout the week due to travel changes etcetera. This will make it harder for us humans whose bodies are programmed over thousands of years by evolution just like all animals&rsquo; bodies, except ours has evolved way faster so now sometimes ours needs work done on them sometimes too. Thus, needing proper rest does matter, so here are some tips. 
	&nbsp;</li>
</ul>

If you are listening to music, watching TV, or playing video games, shut it off! Your brain may be losing focus and this makes it hard for you to sleep.

If you can&rsquo;t sleep, get up and do something else before going back to bed. The more time spent lying awake in bed the more difficult it becomes to fall asleep again.

&nbsp;

On a personal note, I have always <a href="https://merisehat.pk/article/are-you-sleeping-on-your-sleep-cycle" target="_blank">struggled with sleeping</a>. When I was younger, I had to have my mom read me bedtime stories to help me fall asleep and would still be up way past midnight reading under my covers. These days, it&rsquo;s not as bad but there are still nights where my mind won&rsquo;t shut off and I find myself lying awake for hours. Sometimes it&rsquo;s because of something that happened earlier in the day or week; other times it&#39;s just a matter of getting enough rest.

As you can imagine, this can be frustrating when you want nothing more than to turn off your brain and go to sleep! But there are ways you can get better at falling asleep faster, and even staying asleep all night long if you want.

&nbsp;

If you have tried all of these tricks and still can&rsquo;t sleep, there&rsquo;s nothing left to do but wait it out! Just remember, sometimes things happen in life that are out of our control. If you are lying there tossing and turning, just try to breathe deeply and stay calm. It may take some time for us humans to get back into a <a href="https://merisehat.pk/article/are-you-sleeping-on-your-sleep-cycle">regular sleeping cycle</a> again, so don&rsquo;t be discouraged if you&rsquo;re stuck in bed all day without any hope of going anywhere else anytime soon!

The Power Of Stepping Forward

There&rsquo;s a widely held perception that <a href="https://merisehat.pk/article/body-weight-exercises-for-strength-training">effective exercises</a> are meant to exhaust you and be physically difficult. When looking to build an exercise regime, most of us are quick to add high-intensity activities like weightlifting and running. Rarely, if ever, does one consider beginning with the simplest and easily accessible activity: walking.&nbsp;

While it may not necessarily outweigh the benefits of a high-intensity strength circuit, walking comes with a host of benefits for both the body and mind. If one is completely new to exercising, or even returning after a long hiatus, walking is a more sustainable place to start. There is no learning curve because it is the one movement that&rsquo;s been inherent to our lives since infancy. It also allows you to start with a gentle pace and build up as your body allows. Whether you start with a moderate pace for ten minutes a day or walk at a faster pace for an hour, you will still be able to reap the many benefits of this activity. 
&nbsp;

Benefits of walking

Walking has been shown to improve blood circulation in the body and lower one&rsquo;s resting heart rate, while lowering blood pressure and cholesterol. A six-year study found that moderately paced walking showed similar reductions in the risk of high blood pressure and cholesterol when compared to vigorous running. A study of post-menopausal woman also showed that walking just one to two miles a day can lower blood pressure by 11 points in 24 weeks. 
&nbsp;

&nbsp;Research shows that walking contributes towards preventing a range of diseases. Improvement in cardiovascular health leads to a decrease in risk of heart disease. In one study, women who walked 30 minutes a day showed a 20 percent decrease in the possibility of having a stroke. Those who walked at a faster, above average pace showed a 40 percent decrease.

In another study, women who walked seven or more hours a week were shown to be 14 percent less likely to get breast cancer as compared to women who walked less than three hours. Even women with other risk factors, such as being on supplemental hormones, were less likely to get the disease.&nbsp;

With its benefits to overall health, regular walking has been shown to reduce risk of early death by upto 39 percent as compared to a sedentary lifestyle. 
&nbsp;

&nbsp;Walking has also been shown to reduce risks of developing Type 2 diabetes, as it helps to balance blood sugar levels. A meta-analysis of 300,000 showed that walking regular decreases the likelihood of Type 2 diabetes by 30 percent. Walking at a brisk pace, of more than 20 minutes to a mile, is even more effective, reducing risk by 41 percent. Meanwhile, a smaller study, of 201 people with Type 2 diabetes showed that every additional 2,600 steps in daily activity was associated with a 0.2 percent decrease in blood sugar level. 
&nbsp;

&nbsp;A joint is the point where two or more bones are joined, such as our knees and elbows. The health of our joints greatly impacts our overall mobility and is essential for living comfortably and pain free. Walking has been shown to improve joint health while reducing chances of osteoarthritis. It lubricates the joints, which protects our bones from friction, and strengthens the muscles that support them. Research has shown that people who walk regularly experienced a 40 percent reduction in knee pain as opposed to those who didn&rsquo;t. 
&nbsp;

&nbsp;Walking has been proven to boost our immune system&rsquo;s ability to protect us against illness. A study tracked 1,000 adults during flu season. Those who walked at a moderate pace for 30 to 45 minutes a day faced 43 percent less sick days and suffered from fewer respiratory infections overall. Even if they did get sick, their symptoms were not as severe or long-lasting when compared to adults with sedentary lifestyles. 
&nbsp;

&nbsp;Like other forms of exercise, walking causes our body to release endorphins. These are neurotransmitters which elevate our mood and alleviate pain. There is ample evidence to support the positive relationship between walking and mental health. One study showed that the more steps people took in a day, the better their mood was. Just 12 minutes of walking resulted in more self-confidence and a better mood in the subjects of another study.

Walking in nature helps us ruminate less over negative experiences, which in turn decreases negative emotions and risk of depression. A study of post-menopausal women showed that walking three times a week for 40 minutes provided relief from symptoms of depression. With all the research to support walking, it&rsquo;s no surprise that psychologists agree a 10-minute walk can be as effective as a 45-minute vigorous workout when it comes to relieving depression. 
&nbsp;

&nbsp;For creative professionals, walking can be a valuable tool in facilitating idea generation. One study compared people trying to think of new ideas while they were walking with those who were sitting. Participants who were walking did better, especially if they were walking outdoors. Research has also shown that walking improves creative output by more than 60 percent. Science shows that engaging in activities that allow our mind to wander creates a mental state that is conducive to coming up with ideas. If we are able to let go of our thoughts while walking, we can go to a place where ideas flow freely to us.

Although simple, walking has incredible and wide-ranging benefits for your body and mental health and should definitely be incorporated as a part of your lifestyle.&nbsp;

Ayesha Binte Rashid

Iqra Mazhar

Anemia: Best Meals For Boosting Iron

Iron deficiency anemia is the most common nutritional disorder in the world according to the World Health Organization. A deficiency in the mineral i.e. iron leads to a deficiency in red blood cells, which causes anemia. Oxygen binds to the hemoglobin in the red blood cells and is transported to the organs and tissues. In anemia, the blood is not carrying enough oxygen to the cells of the body. Thus, causing you to feel weak and tired.

There are several causes of iron deficiency anemia, but inadequate dietary intake and a loss of blood are the two most common causes. Doctors typically prescribe oral iron supplements and intravenous (IV) iron to treat iron deficiency.&nbsp;

Similarly, people with iron deficiency anemia are also encouraged to follow a diet plan specifically designed for iron deficiency. The diet includes animal- and plant-based iron-rich foods, such as poultry, meat, seafood, nuts, seeds, and beans. While an iron-rich diet is necessary, you also need to include foods in your diet that improve the body&rsquo;s absorption of iron, in addition to avoiding foods that may interfere with the process.&nbsp;

&nbsp;

Understanding Ways To Increase Dietary Iron

Adding iron-rich foods to your diet and foods that increase the absorption of iron is the best way to curb iron-deficiency anemia. Iron-fortified cereals, bread products, orange juice, rice, and bread help with bringing iron levels back up. Below is a diet plan that a person with anemia may follow:&nbsp;

&nbsp;

<h5 dir="ltr">Breakfast&nbsp;</h5>

<ul>
	<li>
	Option 1: Unsweetened, iron-fortified oatmeal topped with either almonds, cashews, or walnuts, and a glass (8 ounces) of 100% orange juice which may help increase the absorption of iron in your body.&nbsp;
	</li>
	<li>Option 2: Brown bread, eggs, and apples, with a hand full of iron-rich nuts. Avoid tea and coffee with your meals as it inhibits the absorption of iron.&nbsp;</li>
</ul>

&nbsp;

<h5 dir="ltr">Lunch&nbsp;</h5>

<ul>
	<li>
	Option 1: Boiled rice, chickpeas, or lentils with beef, chicken, or fish.&nbsp;
	</li>
	<li>Option 2: Chapati, leafy green vegetables, for example, spinach, or any other iron-rich vegetables, such as potatoes, beef, chicken, or fish curry.&nbsp;</li>
</ul>

&nbsp;

<h5 dir="ltr">Dinner&nbsp;</h5>

<ul>
	<li>
	Option 1: Mutton curry or chops with chapati, or boiled rice with a leafy green vegetable on the side.&nbsp;
	</li>
	<li>Option 2: Stew any kind of meat with <a href="https://www.merisehat.pk/disease/chronic-kidney-disease">kidney</a> beans, chickpeas, and tomatoes with either boiled rice or chapati.</li>
</ul>

&nbsp;

<h4>"Feeling tired because of your anemia? Try our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan</a> to see whether your anemia is bringing down your heart rate!" </h4>

There are many foods that contain high levels of iron and can be combined to make nutritious meals to help with the intake of iron. Foods rich in vitamin C, such as tomatoes, cauliflower, apples, and oranges should also be added to your diet because they help with the absorption of iron. Below is a list of foods that you can add to your diet to help with iron-deficiency anemia:

&nbsp;

<h5 dir="ltr">Fruits And Vegetables&nbsp;</h5>

<ul>
	<li>Spinach&nbsp;</li>
	<li>Beetroot&nbsp;</li>
	<li>Soybean&nbsp;</li>
	<li>Kale&nbsp;</li>
	<li>Broccoli&nbsp;</li>
	<li>Citrus fruits, oranges, grapefruit&nbsp;</li>
	<li>Pomegranate&nbsp;</li>
</ul>

&nbsp;

<h5 dir="ltr">Nuts&nbsp;</h5>

<ul>
</ul>

<ul>
	<li>Cashews&nbsp;</li>
	<li>Pistachios&nbsp;</li>
	<li>Almonds&nbsp;</li>
	<li>Walnuts</li>
</ul>

&nbsp;

<h5 dir="ltr">Meat And Fish&nbsp;</h5>

<ul>
</ul>

<ul>
	<li>Beef&nbsp;</li>
	<li>Lamb&nbsp;</li>
	<li>Venison&nbsp;</li>
	<li>Liver&nbsp;</li>
	<li>Shrimp&nbsp;</li>
	<li>Salmon&nbsp;</li>
	<li>Tuna&nbsp;</li>
</ul>

&nbsp;

<h5 dir="ltr">Beans And Pulses&nbsp;</h5>

<ul>
	<li>Kidney beans&nbsp;</li>
	<li>Chickpeas&nbsp;</li>
	<li>Soybeans&nbsp;</li>
	<li>Black beans&nbsp;</li>
	<li>Pinto beans&nbsp;</li>
	<li>Peas&nbsp;</li>
</ul>

&nbsp;

If you have been diagnosed with iron deficiency anemia, there are a few foods and drinks you should avoid because they can keep your body from absorbing iron into your system.&nbsp;

<ul>
	<li>Black and green teas make the iron from plant sources indigestible.&nbsp;</li>
	<li>Coffee also prevents iron from being absorbed&nbsp;into your system. If you are taking iron-rich supplements or an iron-rich meal, avoid drinking coffee an hour before and after.&nbsp;</li>
	<li>Calcium-rich foods, for example, milk, yogurt, bananas, and some nuts interfere with the absorption of iron in the body.</li>
	<li>Gluten-containing foods such as pasta, barley, rye, wheat products, and oats, damage the intestinal walls and prevent the absorption of iron.&nbsp;</li>
	<li>Foods that contain phytates, such as legumes, whole-grain wheat, and brown rice should also be avoided because they prevent the absorption of iron.&nbsp;</li>
	<li>Foods containing oxalic acids, such as peanuts, parsley, chocolates, and spinach should also be eaten in a limited quantity if you are on iron medication.&nbsp;</li>
	<li>Tannins containing foods, such as grapes and corn should also be avoided.</li>
</ul>

&nbsp;

Although iron-rich foods help raise the levels of iron in the blood, to achieve a healthy iron status, most people also need to take supplements alongside following a healthy diet. Some people also do not absorb iron well and may need IV iron treatments. Your doctor will best advise treatment based on your needs. However, the following tips can help with increasing the absorption of iron:

<ul>
	<li>Avoid tea and coffee with meals.</li>
	<li>Avoid calcium-rich foods.</li>
	<li>Have iron-rich foods with those rich in vitamin C.</li>
	<li>Cook food for shorter periods on a cast-iron skillet.</li>
</ul>

&nbsp;

Following an iron-rich meal is perhaps the easiest way to recover from anemia. All the foods mentioned on the list are easily available at well-stocked grocery stores. If you&rsquo;ve tried changing your diet, but failed at bringing your iron levels back to normal, you should speak with a doctor or dietician. They will recommend a supplement that is most effective for you, based on your needs.&nbsp;

&nbsp;

Mental Health Tips For Dysmenorrhea

If you&#39;re a woman in your 20s, 30s, or really any age, there must have been days when you struggled with your mental health. Dark thoughts, anxiety, low mood, an inability to carry out normal day-to-day chores, chances are you&#39;ve experienced them all. And if you suffer from <a href="https://www.merisehat.pk/disease/dysmenorrhea">dysmenorrhea</a>, then the chances of anxiety, irritability, etc. become much higher. Despite society conditioning us into thinking that period pain is a part of life, there is nothing okay about having to deal with debilitating pain on a monthly basis.

<a href="https://www.merisehat.pk/disease/dysmenorrhea">Dysmenorrhea</a>, also called painful menstruation, affects more than 50% of university students in Pakistan<a href="#accordion">[1]</a>. Along with severe pain, many women also report sleep disturbances, difficulty concentrating on work or studies, and frequent leaves from work or school<a href="#accordion">[2]</a>. Additionally, women with dysmenorrhea have higher depression and anxiety scores<a href="#accordion">[3]</a>. Thus, significantly impacting their quality of life.

So, if you&#39;re someone struggling with dysmenorrhea and its mental health effects, here are some of the things you can do to feel better.

&nbsp;

Understanding Dysmenorrhea And Mental Health

Over five thousand years ago, people in Northern India developed what we now call yoga. The exercise and relaxation method has evolved over the years, but what has remained the same is its ability to help people heal, both physically and emotionally. Yoga isn&#39;t just some exercise. It is also a way for people ground themselves and connect with their thoughts.

In dysmenorrhea, the increased levels of prostaglandins and estrogen cause the uterine muscles to contract. As these muscles contract, they push against the surrounding blood vessels, temporarily cutting off the oxygen supply to the muscle. Thus, resulting in pain around the lower abdomen and back.&nbsp;

Various yoga poses can help relax the muscles and improve the blood supply to the pelvic region. Moreover, the various stretches also help calm the mind and revive your energy. However, no one&#39;s asking you to twist your body into crazy positions. You can start by practicing simple poses such as the pigeon pose, fish pose, bound angle pose, and child&#39;s pose. It&#39;s best to avoid leg lifts and any rigorous physical activity during the first few days of your periods.&nbsp;

&nbsp;

Deep breathing exercises involve a combination of slow, deep inhales and exhales. They help increase blood flow in the blood vessels, relax muscles, and reduce pain perception. Thus, relieving anxiety and depression symptoms among people. It is also one of non-pharmacological methods of reducing pain in women with dysmenorrhea.

&nbsp;

Here&#39;s a simple deep breathing exercise you can try next time you feel anxious or low on emery:

<ol>
	<li>Lie on your back in bed or on a yoga mat.</li>
	<li>Inhale and exhale to relax your body.</li>
	<li>Now place a hand on your belly.</li>
	<li>As you take a deep breath in, feel your belly rise into your hand.</li>
	<li>Breath out slowly and feel the belly move down as the air exits your body.</li>
	<li>Take three more breaths like this, focusing on the movement of your belly and feeling the air filling your body and leaving with every exhale.</li>
</ol>

&nbsp;

Dysmenorrhea can be an extremely debilitating condition for women. Coupled with pain, women are also affected with mental health disorders such as depression and anxiety. Therefore, it is important to increase awareness about the mental health implications of this gynecological disorder. Moreover, researchers believe that psychiatric intervention can help women and adolescent girls suffering from dysmenorrhea have a better quality of life.

<ul>
</ul>

<ul>
	<li>Dysmenorrhea, defined as painful menstruation, is associated with higher depression and anxiety levels among women.</li>
	<li>Yoga is a simple exercise technique that can help relax muscles and calm the mind, helping ease symptoms of depression and anxiety in women with dysmenorrhea.</li>
	<li>Deep breathing exercises involve slow, deep breaths that increase oxygenation of muscles and blood vessels; thus, relaxing muscles and reducing anxiety and depression.</li>
	<li>There is a need for a multidisciplinary approach in women suffering from dysmenorrhea. Psychological intervention can help improve their quality of life.</li>
</ul>

&nbsp;

[1] Yasir, S., Kant, B. & Dar, M. F., 2014. FREQUENCY OF DYSMENORRHOEA, ITS IMPACT AND MANAGEMENT STRATEGIES ADOPTED BY MEDICAL STUDENTS. Journal of Ayub Medical College Abbotabad, 26(3).

[2] Unsal, A. et al., 2010. Prevalence of dysmenorrhea and its effect on quality of life among a group of female university students. Upsala Journal of Medical Sciences, 115(2), pp. 138-145.

[3] Sahin, N. et al., 2018. Assessment of anxiety-depression levels and perceptions of quality of life in adolescents with dysmenorrhea. Reproductive Health, Volume 15.

Medilink Consultant clinic

Saad Ullah Siddiqui

Managing Pain In Dysmenorrhea

<a href="https://www.merisehat.pk/disease/dysmenorrhea">Dysmenorrhea</a> is a common occurrence among adolescent girls<a href="#accordion">[1]</a>. Also called painful menstruation, the condition affects 50% of university students across Pakistan<a href="#accordion">[2]</a>. In the majority of women, the pain is also associated with nausea, vomiting, fatigue, and mood disturbances.&nbsp;

Dysmenorrhea is of two types: primary and secondary. Primary dysmenorrhea develops in the absence of any underlying medical condition and is usually caused by an increase in prostaglandin activity. On the other hand, secondary dysmenorrhea results from pelvic pathology such as fibroids, endometriosis, pelvic inflammatory disease (PID), ovarian cysts, or several others.&nbsp;

While the level of pain varies from person to person, in many the symptom of dysmenorrhea significantly impacts their quality of life. Difficulty concentrating on studies, sleep disturbances, limited participation in sports, and frequent class and work absenteeism are common feature<a href="#accordion">[3]</a>.&nbsp;

Therefore, effective pain management techniques are highly important in helping women achieve some normalcy in life. There are several pharmacological and nonpharmacological methods available to help relieve pain.&nbsp;

&nbsp;

Understanding Dysmenorrhea And Pain Management

These include conventional treatments such as over-the-counter pain relief medications and hormonal contraceptives:

&nbsp;

<h5>1. Pain Relievers</h5>

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are effective at reducing the levels of prostaglandins in the body. This in turn reduces uterine contraction and helps relieve dysmenorrhea. They are used for both primary and secondary dysmenorrhea. However, their use is contraindicated in people with gastritis, peptic ulcer, renal problems, or bleeding conditions due to adverse effects. Moreover, for many women NSAIDs fail to provide the desired effect of pain relief.&nbsp;In some women, doctors may also prescribe analgesics such as aspirin and acetaminophen in combination with NSAIDs or alone.

&nbsp;

<h5>2. Hormonal Contraceptives</h5>

These work by blocking ovulation and decreasing menstrual flow; thus, alleviating pain. Some options include oral contraceptive pills, hormonal intrauterine contraceptive devices (IUCD), and hormonal injections. While they can provide better relief of pain than NSAIDs, they are associated with side effects such as weight gain, menstrual irregularities, and mood changes. Moreover, they are often prescribed to women not looking to conceive.&nbsp;

&nbsp;

Over the years, the use of nonpharmacological methods which commonly involve complementary and alternative medicine has steadily increased<a href="#accordion">[4]</a>.&nbsp;Bed rest is one of the most common methods employed by university students in Pakistan for pain management followed by oil massage, drinking turmeric milk, and using hot water bottles<a href="#accordion">[5]</a>.&nbsp;

 
Generally, at-home treatments for relieving dysmenorrhea include:

<ul>
	<li>Placing a heating pad or hot water bottle on the pelvic and back area can help reduce muscular spasms.</li>
	<li>Massaging the abdomen and back using essential oils such as lavender, rose, and peppermint.</li>
	<li>Taking warm baths.</li>
	<li>Taking vitamin B1 (thiamine) supplements daily.</li>
	<li>Avoiding caffeine, smoking, and alcohol.&nbsp;</li>
	<li>Daily exercise can also help prevent painful menstrual cramps.</li>
</ul>

&nbsp;

<ul>
	<li>
	<h5>Ginger</h5>
	</li>
</ul>

The use of ginger has also been shown to cause a significant reduction in pain. Researchers attribute the effects to ginger&#39;s anti-inflammatory action that is brought about by the inhibition of prostaglandin synthesis. In a study, ginger was shown to be as effective as ibuprofen and mefenamic acid in relieving pain in women with primary dysmenorrhea<a href="#accordion">[6]</a>.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Complementary Methods</h5>
	</li>
</ul>

Some alternative or complementary methods may also be employed for dysmenorrhea. These include:

&nbsp;

<h5>1. Yoga</h5>

Several yoga poses can provide relief from painful menstruation. The gentle exercise has been linked to the release of endorphins and reducing menstrual pain.

&nbsp;

<h5>2.&nbsp;Acupuncture And Acupressure</h5>

Certain acupuncture points help reduce muscular contractions by regulating blood flow to these areas. Thus, reducing pain.

&nbsp;

<h5>3. Herbs</h5>

Herbal remedies such as chamomile tea, fennel seeds, and cinnamon have anti-inflammatory and antispasmodic action that reduce muscular contractors and relieve pain.&nbsp;

&nbsp;

<h5>4.&nbsp;Transcutaneous Electrical Nerve Stimulation (TENS)</h5>

Through electrical pulses, the body is stimulated to release endorphins which help reduce pain.

&nbsp;

Menstrual pain is often dismissed as a normal part of women&#39;s lives. This results in young women never seeking medical attention for dysmenorrhea. Thus, causing significant physical and emotional distress. Not only can dysmenorrhea affect one&#39;s academic performance but also limit their day-to-day functioning.&nbsp;

Despite the high prevalence of dysmenorrhea, there is a lack of awareness among women about the various pain management methods available to them. The majority of women self-medicate with NSAIDs or analgesics. However, these often cause side effects and/or fail to provide relief. Therefore, there is a need for more effective and safe pain management strategies. Moreover, women should be counseled about the various complementary and alternative medicine methods such as yoga and breathing exercises that can provide relief of symptoms.

&nbsp;

<ul></ul><ul><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">Dysmenorrhea is defined as painful menstruation and leads to significant reduction in quality of life.</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">Pharmacological methods for pain relief involve the use of over-the-counter pain medications such as NSAIDS and hormonal contraceptives.</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">Since pharmacological therapies can have side effects, many women resort to home remedies such as massage, heating pads, massage, and exercise.</li><li style="line-height: 1.2; margin-top: 0pt; margin-bottom: 0pt;">Complementary and alternative medicine methods such as yoga, acupuncture, and herbal supplements are also gaining momentum for treatment of dysmenorrhea.</li></ul>

[1] Ullah, A. et al., 2021. Prevalence of Dysmenorrhea and Determinants of Pain Intensity Among University-Age Women. Pain Medicine, 22(12), pp. 2851-2862.

[2] Yasir, S., Kant, B. & Dar, M. F., 2014. FREQUENCY OF DYSMENORRHOEA, ITS IMPACT AND MANAGEMENT STRATEGIES ADOPTED BY MEDICAL STUDENTS. Journal of Ayub Medical College Abbotabad, 26(3).

[3] Unsal, A. et al., 2010. Prevalence of dysmenorrhea and its effect on quality of life among a group of female university students. Upsala Journal of Medical Sciences, 115(2), pp. 138-145.

[4] Yu, A., 2014. Complementary and alternative treatments for primary dysmenorrhea in adolescents. The Nurse Practitioner, 39(11), pp. 1-12.

[5] Mansoor, H. et al., 2020. Menstrual knowledge and practices of Pakistani girls: A multicenter, cross-sectional study. Heliyon, 6(1).

[6] Jenabi, E., 2013. The effect of ginger for relieving of primary dysmenorrhoea. Journal of the Pakistan Medical Association, 63(1).

Humza Khizer

Should I Be Anxious About My IBS?

<a href="https://www.merisehat.pk/disease/irritable-bowel-syndrome-62">Irritable Bowel Syndrome (IBS)</a> is defined as a type of gastrointestinal condition that causes problems in the digestive system. IBS affects 10 to 15 percent of the world&rsquo;s population. However, the symptoms are different for every person. While IBS is not a life-threatening condition, it can have a significant impact on one&rsquo;s well-being by affecting one&rsquo;s quality of life. The situation worsens when a person suffers from anxiety and IBS.

&nbsp;

Understanding Link Between Anxiety And IBS

Anxiety disorders is an umbrella term used for general anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD) and social anxiety disorder. A shared symptom of these disorders is excessive worry or anxiety.&nbsp; Physical symptoms of anxiety disorders include fast heart rate, sweating and fatigue. This may interfere with one&rsquo;s ability to get through normal everyday activities.&nbsp;

&nbsp;

IBS is a disorder of the digestive tract that causes abnormal bowel movements. Unlike Crohn&rsquo;s disease or ulcerative colitis, the physical structure of the digestive tract is unaffected, i.e. IBS is not a functional disorder. Common symptoms of IBS include diarrhea, constipation, and abdominal pain. Anxiety disorders affect more than a third of all U.S. adults while IBS affects 7% to 21% of the U.S. population. However, there is no reliable data for how many people experience both anxiety disorder and IBS. Some studies have shown that anxiety disorders are more common in people with IBS. According to a study assessing the prevalence of anxiety disorders and IBS, 44% of people with IBS had an anxiety disorder, compared to 8% of people without IBS.&nbsp;

&nbsp;

According to scientists, the mind and gut are intertwined. This is what scientists refer to as the gut-brain axis, which is a two-way signaling system between the gut and the brain. In response to our thoughts, feelings, and environment, our bodies release chemicals that affect different processes in our bodies. However, in the case of anxiety and IBS, whenever you feel anxious, your body releases stress-related chemicals in the gut causing inflammation leading to abnormal bowel movements, abdominal pain, and a change in gut bacteria.

Additionally, a poorly functioning gut has also been linked with mental health problems. Scientists explain that this is because our brain depends on the chemicals and hormones made by the bacteria in the gut for e.g. 90% of the serotonin (which is an important chemical that controls our mood and keeps anxiety levels low) is produced in our gut. Mental health problems are associated with increased and decreased production of serotonin.&nbsp;

&nbsp;

Unfortunately, the causative factors of IBS have yet to be elucidated. However, there is reason to believe that it may depend on a person&rsquo;s mental health. Anxiety and other health conditions may trigger IBS.&nbsp;

Certain other risk factors may increase one&rsquo;s risk of IBS, including:&nbsp;

<ul>
	<li>Having a family history of IBS&nbsp;</li>
	<li>Females are at a higher risk of developing IBS than males</li>
	<li>Being younger than 50 years of age</li>
	<li>History of severe gut infections&nbsp;</li>
	<li>Chronic psychological stress either caused by traumatic life events or alcohol addiction&nbsp;</li>
	<li>Smoking&nbsp;</li>
	<li>Certain medications that cause changes in the gut bacteria</li>
</ul>

&nbsp;

Studies have shown that keeping stress under control can help prevent or ease the symptoms of IBS. This is because the gut has a brain of its own, known as the enteric nervous system which is why you get butterflies in your stomach when you are nervous. Also, this &ldquo;second brain&rdquo; of yours also controls how food is digested. This second brain is in constant communication with your brain via the gut-brain axis. Thus, this connection can help manage your IBS. You can try and get rid of the tension by incorporating simple things in your daily routine, for example, going shopping, listening to music, reading, or talking to a friend. Other ways to alleviate stress and anxiety include:

&nbsp;

<ul>
	<li>
	<h5>Exercise&nbsp;</h5>
	</li>
</ul>

Exercising, for example, walking, swimming, running or other such physical activities can help you cope with anxiety and depression. Exercise also helps with normal bowel contractions.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Mind-Body Exercise, Mindfulness, And Meditation&nbsp;</h5>
	</li>
</ul>

Meditation can help trigger your body&rsquo;s relaxation response. You can either sign up for meditation, breathing or yoga classes offered online or in person. They will help you manage stress by targeting the gut-mind connection and changing the way you think.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Relaxation Exercises&nbsp;</h5>
	</li>
</ul>

Relaxation techniques, such as deep breathing, can help you feel calmer. The purpose of relaxation techniques is to learn about visualization and to imagine a peaceful scene. These techniques will also help you get enough sleep and eat well. You can also consider joining a self-help group for people with IBS or other digestive disorders. Members of the group will know what it is like to deal with IBS and may also be able to offer more meaningful support that you may not be able to get from even your closest friends.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Diet And Lifestyle Changes&nbsp;</h5>
	</li>
</ul>

The food we eat has a huge impact on our overall health. Your stomach and intestines are some of the first organs that feel the effect of the food you are eating. For treating IBS, you must start with your diet. There are specific foods that can trigger the symptoms of IBS. However, these triggers differ for everyone. Maintain a food/bowel movement journal wherein you can write about how different foods affect your bowel movements. This journal could also be helpful for discussing treatment options with your doctor. Research shows that avoiding certain foods can help prevent symptoms of IBS:&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Gas-Producing Foods</h5>
	</li>
</ul>

People with IBS are more sensitive to foods that make a person gassy for example, beans, bananas, and brussel sprouts. These foods may trigger discomfort after eating them.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Dairy&nbsp;</h5>
	</li>
</ul>

Even if lactose is not an issue for you, you may be sensitive to other milk proteins due to your IBS.&nbsp; Try using dairy-free alternatives, such as soy or oat milk to ease bloating and other stomach issues.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Foods High In FODMAPs</h5>
	</li>
</ul>

Foods high in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are short carbohydrates, such as fructose and sorbitol that appear in many fruits, vegetables, honey, and wheat. Studies have shown that these FODMAPs can linger in our guts, absorb water, and ferment, which can then cause irregular bowel movements. If you struggle with constipation, then it is recommended you stay well hydrated and eat 4-5 small meals regularly rather than eating 3 large meals a day. A diet high in fiber and soluble fiber, such as psyllium may also be helpful. Similarly, alcohol, tobacco, and caffeine aggravate symptoms of both IBS and anxiety, so reduce their consumption.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Cognitive Behavioral Therapy&nbsp;</h5>
	</li>
</ul>

Studies have shown that cognitive behavioral therapy is an effective treatment for IBS. However, before starting with CBT, practitioners need to rule out alternative diagnoses. The most important medical conditions to rule out include inflammatory bowel disease, Crohn&rsquo;s disease, and celiac disease. Baseline blood and stool tests are generally enough to rule out these conditions. The next step is to educate the patient about the gut-brain link and how stress can directly impact gut health.

The CBT practitioner will first help train the patient in relaxation techniques including deep belly breathing. Once the patients are able to use the relaxation techniques CBT is introduced. The focus of CBT is to educate the patient that the beliefs that affect our emotions negatively can be baseless. For example, if a person is embarrassed to go to the bathroom in a public place, it can be helpful to send them to a movie theater and have them sit at the back of the theater to count the number of people who get up to use the bathroom and return. The patient will be able to see two things: the frequency of people getting up to use the bathroom and the lack of reaction towards this behavior by the surrounding people. This will help the patient understand that it is not a big deal to get up and use the bathroom.&nbsp;

Similarly, CBT exposure therapy focuses on patients overcoming their fear of doing things that they have been avoiding. For example, if a person is afraid of long car trips, make them sit in a parked car for thirty minutes. Once this gets boring, drive them around the area. Once this gets easy, drive them a mile away from home and back. If the patient worries about not being able to &ldquo;hold it&rdquo;, experiment with them to &ldquo;hold it&rdquo; for 30 seconds, then a minute, and then 5 minutes. This will prove that they can hold it and worry is unnecessary.

&nbsp;

<ul>
	<li>
	<h5>Medications&nbsp;</h5>
	</li>
</ul>

If diet and lifestyle changes are not enough to curb the problem of anxiety and IBS, many medications will help relieve symptoms.

<ul>
	<li>Metamucil, or soluble fibers available over the counter, for constipation relief.</li>
	<li>Miralax helps pull water into the intestines and encourages bowel movements.</li>
	<li>Medications approved by the FDA for IBS-related constipation, Amtizia, Linzess, and Zelnorm.&nbsp;</li>
	<li>Antidepressants, including tricyclic antidepressants and selective serotonin reuptake inhibitors.</li>
	<li>Imodium is a popular over-the-counter medication that slows down gut and bowel movements and treats IBS-related diarrhea.&nbsp;</li>
	<li>Antispasmodics relax the muscles of the digestive system and relieve IBS-related abdominal pain.&nbsp;</li>
</ul>

&nbsp;

<ul>
	<li>Although there is no clear answer as to how anxiety affects your IBS or vice versa, both conditions are triggered by many different factors.</li>
	<li>If you have IBS, then there are many treatment options (medications, cognitive behavior therapy, etc.) and lifestyle changes that have been shown to help relieve symptoms and stress.&nbsp;</li>
	<li>You can discuss these treatment options with a healthcare provider and implement whatever works best for you.</li>
</ul>

&nbsp;

[1] Banerjee, A., Sarkhel, S., Sarkar, R. and Dhali, G.K., 2017. Anxiety and depression in irritable bowel syndrome. Indian journal of psychological medicine, 39(6), pp.741-745.

[2] Locke, G.R., Olden, K., Peterson, W., Quigley, E., Schoenfeld, P., Schuster, M. and Talley, N., 2002. Systematic review on the management of irritable bowel syndrome in North America. Am J Gastroenterol, 97, pp.S7-26.

[3] Camilleri, M., 2018, December. Management options for irritable bowel syndrome. In Mayo Clinic Proceedings (Vol. 93, No. 12, pp. 1858-1872). Elsevier.

[4] Johns Hopkins Medicine: "The Brain-Gut Connection."

[5] U.S. National Library of Medicine: "Irritable bowel syndrome treatment: cognitive behavioral therapy versus medical treatment."

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I’m Hot. It’s Not Summer, It’s Just Menopause

<a href="https://www.merisehat.pk/disease/menopause">Menopause</a> marks the evident end of regular menstrual cycles. The term can depict any progressions one goes through nearing the end of menstruation, or what one may experience closely after it, indicating the completion of your reproductive years and stages.&nbsp; 
&nbsp;

Menopause and perimenopause can cause side effects like nervousness, mood swings, mind haze, hot flushes, and irregular periods. These side effects can begin a long time before the end of the menstrual cycle and continue a while later. Menopause and perimenopause side effects can hugely affect the individual&rsquo;s life, including social interactions and work. However, there are multiple ways that can help you deal with these side effects. Several medications, for instance, can help replace the missing or reduced chemicals associated with menopause and help ease the unavoidable signs and symptoms.

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Understanding menopause and how to deal with its symptoms

Menopause is a natural process that all menstruating women must go through. It may occur due to one of the following reasons: 
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<ul>
	<li>Natural Menopause: During their 40s, most women observe changes to their regular cycles. The cycles may become longer or more limited, heavier or lighter, more frequent or with much significant dry spells, until the ovaries stop producing eggs and menopause commences. This occurs, on average, by the age of 51 years<a href="#accordion">[1]</a>. 
	&nbsp;</li>
	<li>Surgical Procedures: Surgical procedures such as oophorectomy or removal of ovaries are also associated with causing menopause. The ovaries are responsible for producing hormones, including estrogen and progesterone that control, monitor, and synchronize the monthly menstrual cycle. Thus, medical procedures to remove the ovaries cause early and prompt menopause. The monthly periods halt, and the person goes through the various menopausal signs and symptoms<a href="#accordion">[1]</a>. 
	&nbsp;</li>
	<li>Chemotherapy Or Radiation Therapy: These disease treatments can affect menopause by causing side effects such as hot flashes during or not long after the course of treatment. Following chemotherapy, the stop to the monthly cycle (and fertility) is not necessarily irreversible or long-lasting, so contraceptive measures might be needed<a href="#accordion">[1]</a>. 
	&nbsp;</li>
	<li>Primary Ovarian Insufficiency: Early menopause might result from the inadequate production of reproductive hormones by the ovaries, a condition called primary ovarian insufficiency. It can result from hereditary elements or immune system illness. Hormone treatment is regularly suggested until the normal period of menopause to safeguard the cerebrum, heart, and bones<a href="#accordion">[2]</a>.&nbsp;</li>
</ul>

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Menopause is not easily self-diagnosed and missing a period for more than three months is a concerning state. The most common symptoms of menopause include: 
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<ul>
	<li>Hot Flashes</li>
	<li>Insomnia</li>
	<li>Vaginal Dryness</li>
	<li>Urinary Incontinence</li>
	<li>Mood Changes 
	&nbsp;</li>
</ul>

An individual may experience one or more symptoms and should consult medical healthcare providers to confirm the suspicion of menopause. They will monitor and examine your symptoms to guide you towards an efficient treatment.&nbsp; 
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While certain lifestyle changes and drugs may forestall menopause, it is a natural and inevitable process every menstruating woman must go through. However, certain measures may help alleviate its symptoms.

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<h5>1. Hot Flashes</h5>

Hot flashes are the most prevalent symptoms of menopause. It is the unexpected sensation of warmth in the chest area, but is normally experienced with a greater sensation over the face, neck, and chest. Your skin can blush, as though you are becoming embarrassed. A hot flash can likewise cause extreme perspiration. Assuming you lose a lot of body heat, you can feel chills a short time later. Night sweats are hot flashes that occur at night<a href="#accordion">[3]</a>. 
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Phytoestrogens naturally occur in plants and certain food sources. Research suggests that these substances can, to some extent, reverse the hormonal imbalance associated with menopause<a href="#accordion">[4]</a>. Soy-based food varieties contain elevated degrees of phytoestrogens, so eating loads of tofu is recommended to decrease the overwhelming effects of hot flashes. Moreover, it is highly recommended to stay away from food triggers that can make you sweat as they increase your basal temperature. These include hot drinks, spicy food, and liquor. And remember to stay hydrated! 
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Exercise likewise facilitates the discomfort of hot flashes by bringing down levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Try to get at least 20 minutes of physical activity, three times each week. As per the National Center for Complementary and Integrative Health, acupuncture can also help reduce hot flashes in postmenopausal women<a href="#accordion">[5]</a>. 
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<h5>2. Insomnia</h5>

During menopause, it appears as though you are constantly drained and exhausted. To exacerbate the situation, hot flashes and various other side effects disrupt a person&rsquo;s sleep. Having a consistent sleep routine helps individuals to get the necessary amount of rest, especially during menopause when they are fatigued. To adhere to a timetable, set up your brain and body for rest by fostering a soothing bedtime ritual that starts around a similar time each night. For instance, clean up, listen to calming music, read a book, or do different exercises that help you relax. These practices indicate to your body that it&rsquo;s almost time to sleep. Thus, helping you to nod off with ease. 
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Once you get in bed, abstain from staring at the TV, using your laptop, or checking your phone. The blue light from gleaming electronic screens smothers your body&#39;s development of melatonin, a hormone that affects sleep. Moreover, try to abstain from working, eating, and having a serious conversation with anyone especially your spouse once you have settled into your bedroom. Reinforcing the relationship between your bed and rest might assist you with clearing your brain at bedtime. Ensure you are in a comfortable atmosphere by adjusting the temperature of the AC or heater, and getting a new fluffier pillow. If you live in a metropolitan city, get ear plugs so that the noises outside do not disturb you, and drink a cup of chamomile tea before going to bed.&nbsp; 
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<h5>3. Vaginal Dryness</h5>

The vagina might become dry, or irritated because of menopause and perimenopause. A GP can prescribe estrogen medicines that can be placed into the vagina, in the form of a tablet, cream, or ring. This multifaceted treatment can also help alleviate any urinary side effects of menopause and perimenopause, such as urinary incontinence. These vaginal estrogen medicines cannot enter the circulatory system and just have a local effect. Moreover, they do not have a rigid time frame and can be used throughout the post-menopause stage. Discontinuing the use of the product might bring back the unpleasant symptoms. There have not been any recorded repercussions, therefore, vaginal estrogen is safe to be used with hormone replacement therapy (HRT)<a href="#accordion">[6]</a>. 
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Over-the-counter vaginal lubricants are recommended to address vaginal dryness experienced during intercourse. These items lower the frictional erosion associated with vaginal dryness and prevent any sexual discomfort. It should be noted that only water-soluble lubricants are recommended as the counterpart oil-soluble items, for example, Vaseline increases discomfort and make the situation more complex. Reach out for products intended for the vagina; keep away from hand creams and moisturizers containing alcohol or those that are scented. These can disturb the vaginal tissue and disrupt the vaginal pH<a href="#accordion">[7]</a>.&nbsp;&nbsp; 
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<h5>4. Urinary Incontinence&nbsp;</h5>

While it is characterized as the constant and uncontrollable urge to urinate, most individuals would agree that urinary incontinence is an unwanted disturbance. Fortunately, there are systems to assist with various types of incontinence without drugs or medical procedures. Ensure you are drinking satisfactory water to keep urine diluted. This can be confirmed if the urine is clear or has a light-yellow hue. Keep away from food varieties or refreshments with a high acid or caffeine content, as that can disturb the bladder lining. These include grapefruits, oranges, tomatoes, coffee, and caffeine-containing sodas. Likewise, attempt Kegel exercises to reinforce your pelvic floor muscles and diminish incontinence episodes<a href="#accordion">[7].</a>&nbsp; 
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<h5>5. Mood Changes</h5>

Discussing your mood swings with a healthcare professional can assist you with recognizing the reason, gauging the probability of depression, and settling on the most suitable mediation. For depression, treatment would be different as your doctor might prescribe drugs that alter the chemical imbalance associated with menopause. Normally, these medications take half a month to bring about any noticeable improvement. A few antidepressants have, likewise, been found to treat hot flashes.&nbsp;Antidepressants work best when combined with therapy or psychotherapy. 
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When you reach menopause, you might anxiously wait to transition to post-menopause. This is the period after menopause. However, that does not guarantee complete liberty from discomforting menopausal symptoms. 
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There is no conclusive timetable for when menopausal symptoms begin and end. Your experience generally depends on hereditary qualities. Figuring out how to adapt to your symptoms can bring you long stretches of solace as you progress to the next chapter of your life. 
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While there are no treatments to reverse menopause, an individual can make certain changes in their lifestyle to alleviate the persisting symptoms: 
&nbsp;

<ul>
	<li>Stay hydrated and wear light clothes to avoid intense hot flashes. Also, keep away from spicy food and hot beverages.</li>
	<li>Try to include physical fitness and exercise into your routine to help with hot flashes and insomnia.</li>
	<li>Do not be fickle with your sleep routine. Adhere to a consistent cycle, even on weekends, to get uninterrupted sleep.</li>
	<li>Schedule an appointment with a counselor or therapist to address mood changes in a comfortable and safe environment.</li>
	<li>Engage yourself in social gatherings to increase serotonin.</li>
	<li>Try Kegel exercises to strengthen pelvic bone muscles and reduce the recurrence of urinary incontinence.</li>
</ul>

&nbsp;

[1].Mayo Clinic. (2022). Menopause.

[2].Welt, C. (2020, September 8). Clinical manifestations and diagnosis of spontaneous primary ovarian insufficiency (premature ovarian failure).

[3].Santen, R. J., Loprinzi, C. L., & Casper, R. F. (2020, Feburary 18). Menopausal hot flashes.

[4].Chen, M. N., Lin, C. C., & Liu, C. F. (2014). Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review. Climacteric, Vol 18(2), 260-269.

[5].Mudd, L., & Shurtleff, D. (2017, May). Menopausal Symptoms: In Depth. Retrieved from National Center for Complementary and Integrative Health: https://www.nccih.nih.gov/health/menopausal-symptoms-in-depth#hed3

[6].NHS. (2022, May 7). Menopause. Retrieved from NHS

[7].NAMS. (2022). Five Solutions for Menopause Symptoms. Retrieved from The North American Menopause Society:

Zarlish Kazmi

Our mental health is closely linked to the reproductive cycle that our body undergoes every month. Researchers believe this is linked to the hormonal changes that we go through. Rising and falling to varying levels through the month, oestrogen and progesterone impact neurotransmitters in our brain. This impacts a range of emotional and neural parameters, such as energy levels, appetite, and sleep cycle. 
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The Menstrual Cycle

Our menstrual cycle starts with the first day of menstruation, when oestrogen and progesterone are at their lowest in our bodies. Both hormones begin to rise the day after menstruation ends and peak right before ovulation. 
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During the luteal phase between ovulation and menstruation, oestrogen and progesterone begin to drop. They rise again during this period, to a lesser degree, and begin to fall once again reaching their lowest levels during menstruation. This entire cycle unfolds over approximately a month. 
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The luteal phase lasts approximately two weeks before our periods, but this may be longer and shorter for some women. It is during this period that most women begin to experience symptoms of premenstrual syndrome (PMS) or, it&rsquo;s more severe version, premenstrual dysphoric disorder (PMDD). 
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The drastic rise and fall of oestrogen and progesterone impacts the release of two major neurotransmitters &mdash; serotonin and dopamine. Research has shown that lower levels of oestrogen correlates to lower levels of serotonin in particular. Both chemicals have varying functions but generally impact our mood, motivation, and energy. When they are present in low quantities in our nervous system, it can lead to sadness, anxiety, sleep problems, and food cravings. 
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Physical symptoms of PMS and PMDD include:

<ul>
	<li>bloating </li>
	<li>skin breakouts </li>
	<li>cramps </li>
	<li>headaches </li>
	<li>joint and muscle pains </li>
	<li>tender breasts </li>
	<li>nausea </li>
	<li>trouble sleeping </li>
	<li>changes in appetite 
	&nbsp;</li>
</ul>

Mental health symptoms include:

<ul>
	<li>feelings of sadness </li>
	<li>anxiety </li>
	<li>feeling overwhelmed </li>
	<li>emotional vulnerability </li>
	<li>rapidly changing moods</li>
	<li>irritability and stress </li>
	<li>fatigue 
	&nbsp;</li>
</ul>

In the two weeks leading up to our period, the emotional symptoms of PMS can manifest in a number of ways. We may find ourselves crying easily. Criticism may hurt more than usual. The smallest triggers may impact us strongly. Life around us could seem overwhelming, or even empty. We may want to withdraw into solitude. Social gatherings might lose their appeal and we could feel aloof from the people around us. 
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Some of us may want to indulge in unhealthy foods while others might lose their appetites. Sexually intimacy may not appeal to us as much but we might want more affection than usual. We may feel a usually strong dislike of our bodies and be harsh with ourselves. We could become angrier and more easily stressed by situations that would not trigger us usually. As motivation dips, everyday tasks could seem tedious. We might want to slack on work or be unable to focus on it. Everything around us might seem to be going wrong. We could start questioning aspects of our career and relationships. 
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<quillbot-extension-portal></quillbot-extension-portal>

Lifestyle Habits

Symptoms of PMS can be managed by adopting certain lifestyle habits. Tracking your cycle is the first step you can take towards this. If you are aware of the emotional and physical impact of your cycle, you can plan accordingly. In the weeks leading up to your period, you could schedule some extra down time for yourself. You can ensure that you don&rsquo;t have any big or stressful tasks planned. This frees you up to tend to yourself, self-reflecting and doing activities that give you joy and don&rsquo;t require too much effort. This would be a good time to perhaps book a massage, or take a restorative yoga class. 
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<ul>
	<li>Well-Balanced Diet: Eating a well-balanced diet throughout the month may enable your body to cope better with the hormonal changes it undergoes. Eat as many whole foods as possible while avoiding processed foods in excess. Ensure that your diet is rich in protein, essential fats, and fibres. Micronutrients like vitamins and minerals will also help balance your hormones. During your period, it&rsquo;s important to continue such a diet and resist the temptation to indulge excessively in sugar and starchy carbs. Avoid smoking, as well as caffeine and alcohol as these may exacerbate symptoms. 
	&nbsp;</li>
	<li>Exercise: Supplement your diet with regular movement. These can be anything from daily walks to weightlifting sessions. Exercise helps our bodies function optimally. During our periods, movement can be particularly helpful. Apart from the endorphin rush, it can help ground us in the bodies and the present, giving us respite from our feelings and thoughts. 
	&nbsp;</li>
	<li>Getting Enough Sleep: Maintain a regular sleeping routine throughout the month. Try to sleep and wake up at the same time as consistently as possible. During our periods, we may experience increased fatigue while also having a hard time sleeping at night. Creating a calming routing and environment may counter this. Dim the lights in your house at night, turn off devices and screens. Explore different ways to help yourself wind down before bedtime. Take a hot shower, go for a walk before bed, read a book, journal, or listen to some soothing music. Essential oils like lavender can also help you fall asleep. 
	&nbsp;</li>
</ul>

Commonly cited research states that 90 percent of menstruating women experience at least one symptom of PMS. Some women are more sensitive to hormonal changes than others. They may experience stronger symptoms, even if their hormones don&rsquo;t fluctuate more than what is considered average. This may be due to a number of factors. Genetics could determine how sensitive we are to hormonal changes. Women with a history of trauma or mental health struggles may also be more likely to experience mental health symptoms. Since there is so much variation in our individual cycles, PMS can look different for everyone. 
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Sometimes, symptoms of PMS may begin to feel too severe or impact your life and wellbeing. Using over-the-counter medicines and lifestyle habits may not relieve them. In this case, it&rsquo;s advisable to see a healthcare professional. About 10 percent of women may also be diagnosed with PMDD if their symptoms are particularly intense and consistent. 
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A number of factors could indicate the necessity of professional healthcare. Your relationships may start suffering. You could find yourself picking fights that have a lasting impact on your relationships. Increasingly, you may start withdrawing from others and isolating yourself. You could start neglecting necessary tasks at work to the point that your career begins to suffer. Your inner voice may become overwhelmingly critical, tipping you to the point of self-loathing. 
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Anxiety attacks may become common and you might find yourself experiencing heart palpitations and breathing difficulties too often. Feelings of depression and anger may become very intense, making you want to harm yourself or others. In very severe cases, suicidal thoughts might become very loud. 
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Untreated PMDD could lead to acute depression, constant anxiety, causing extreme emotional distress and irreparable damage to your life. Medical help can be crucial in alleviating your symptoms. A doctor can treat you in a number of ways, from hormonal therapy to psychotherapy. 
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