Brief Answer:
DO ONE HOME PREGNANCY TEST AT THE EARLIEST.

Detailed Answer:
Hello,

Thanks for writing to us on Healthcare Magic. Followings are my comments:

1) She needs to undergo one home pregnancy test at the earliest. 95 to 99% POSITIVE result is obtained 7 days after missed period and it is already 10 days past. Morning urine sample is MOSTLY preferred.

2) On POSITIVE test, I suggest her to undergo one Trans Vaginal Ultrasound scan to know the nature of pregnancy (Intrauterine or tubal) and fetal well being. In that case, you must consult with her gynecologist.

3) She would take healthy protein rich diet with green vegetables, Prenatal Vitamins and FOLIC acid supplements for at least 3 months, drink more water and take adequate bed rest. Maintain genital hygiene properly.

Thyronorm, Berocin-CZ should be continued and IRON-CALCIUM supplements can be started from 4th MONTH onwards if she is NOT anemic.

4) She must AVOID long journey, lifting heavy object, high heal shoe, uneven surface, sexual intercourse (1st & 3rd Trimester), more ups & downs. She can travel in two wheeler if she has NO H/O previous miscarriage.

She would take all her favorite foods which are cooked properly and mostly home made. Raw foods/ EGG, Unpasteurized JUICE/ MILK, soft cheese, Pine apple, processed meat, green papayas, caffeine drinks, crabs, Longan etc should be avoided throughout the pregnancy period.

5) Do periodic check up to her doctor with necessary investigation, blood test, ultrasound scan. It will help to assess fetal well being and overall pregnancy.

Hope, it helps for your information. Kindly, close the discussion if you don't have any other query.

Wish her good health and take care yourself.

Regards,
Dr Soumen

For future query, you can directly approach me through

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326

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Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for follow up queries.

1) She has missed period for 12 days and home pregnancy test can be done at this time to get accurate result.

2) YES, she will take above medicines only after consultation with her doctor and receiving complete prescription.

3) YES, thyroid medicine should be continued even after POSITIVE test and throughout the pregnancy period to AVOID certain fetal & maternal risk and complication. Dose should be adjusted according to test result of serum TSH.

4) FOODS TO BE TAKEN:

She would take her most favorite food stuffs (like Idlies, Dhosa, Rice, Bread etc) along with some extra Protein (like Chicken, Fish, Paneer, Pulses, Soybean etc) and green vegetables during this time. Drink more water (2.5 to 3 liter/ day) for better systemic circulation.

FOODS TO BE AVOIDED:

Raw foods/ unboiled egg, Unpasteurized JUICE/ MILK, Soft cheese, Pine apple, Processed meat, Green papayas, Caffeine drinks, Crabs, Sea Fish, Longan etc

5) Cold milk or juice can be taken after proper boiling or pasteurization. Frozen item (like Cold vanilla milk shake) can be taken occasionally. However, home made juice, slight hot milk are preferable. Outside foods and drinks should be limited to avoid gastrointestinal infection. Home made cooked food is the best.

6) Yes, she can do day to day activity like cooking. However, long time standing is NOT advisable. She will sit down after sometimes and do the rest works.

Hope, I have answered your queries and it will be helpful to understand properly.

All the best and good luck. Kindly, close the discussion.

Regards,
Dr S Patra

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Brief Answer:
NEGATIVE TEST.

Detailed Answer:
Hello,

Thanks for your additional query.

It indicates NEGATIVE pregnancy test. I suggest you to undergo one blood test for beta-hCG after 5 days. It is more accurate and confirmatory test.

Sometimes LATE CONCEPTION may give POSITIVE result after 2 weeks of missed period. It is quite seen in ART (Assisted Reproductive Technique) like ICSI etc.

Hope, it helps for your understanding. Kindly, close the discussion.

Good luck and all the best.

Regards,
Dr S Patra

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Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for query.

1) Folic acid is useful for better development of fetal nervous system and to avoid Neural Tube Disease.

Ecospirin is provided to improve feto-placental circulation and avoid micro thrombus formation. It acts as blood thinner.

2) BUSARLIN injection is GnRH agonist. It is given to suppress natural hormone and leads to pituitary desensitization. This is maintained until she is ready to receive estrogen tablets.

3) Estrogen and progesterone tabs are given to develop lining of the womb at the correct time. Treatment can lasts for approximately 9-14 days and until the endometrium is sufficiently developed.

They are quite safe and useful during the procedure of FET. Kindly, consult with your treating doctor for proper management.

Hope, it helps for your information. All the best and good luck.

Regards,
Dr S Patra

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Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for your query.

1) Above injections have some adverse effects and they will be minimum within therapeutic doses. If there is some prominent reaction, you should contact with your doctor for proper dosing of the same.

BUSARLIN can cause hot flushes, dry vagina, decrease sex drive, sweating, change in breast size, appetite, weight; headache, dizziness etc. They will be overcome with the time.

2) I don't receive any type of question on that day. Kindly, consult with healthcare magic support team regarding this.

A) There is NO relation between low sperm count and circumcision. That is probably surgical scar or frenulum. Don't be worried much.

B) According to your given information, you are mostly suffering from Premature Ejaculation (PE), which is the most common sexual dysfunction among men. It can cause sexual dissatisfaction after marriage, specially to your partner.

It is defined as male ejaculates within 1-2 min of intercourse or prior to intimate with partner. The problem is basically psychological more than physiological.

There are several causes that need to be ruled out like Smoking/ alcohol, Some drugs, Hypertension, Prostate Hypertrophy/ Prostatitis, Varicocele/ hydrocele, Diabetes, Thyroid problem, Neurological causes etc.

In this circumstance, I suggest to consult with SEXOLOGIST or UROLOGIST for complete clinical examination and some tests like Total and Free Testosterone, Vitamin-D level, blood sugar, thyroid profile etc to confirm diagnosis. Please do consult with any one of them to take suggestive measures.

Some life style modification can improve your present condition and control PE to some extent:

1) Quit smoking and alcohol if you have the habit. You may need psychiatric counseling or psychotherapy for that.

2) Doing masturbation before initiation of love making may improve ejaculation time temporarily and you need to do it each time.

3) Take healthy diet with Multivitamin & Zinc supplements. Antioxidant like Co-Q 10 can be taken regularly for 6 months.

4) Do physical exercise regularly to control body weight and overall fitness. You would maintain personal hygiene properly.

5) Avoid mental stress or anxiety/ upset by regular breathing exercise, yoga or meditation in the morning (15 to 30 min).

6) Specific treatment for Premature Ejaculation: a) Stop & Start Technique - It is very good exercise and much helpful.

Squeeze technique: In this, the female partner needs to start arousing the man. When the man feels that he is almost at the point of ejaculation, she should stop arousing him. She then needs to squeeze the head for between 10 to 20 seconds. She then lets go and waits for another 30 seconds before resuming masturbation. This process is carried out several times before ejaculation is allowed to occur.

Stop-go technique- It is similar to the squeeze technique except that the woman does not squeeze the penis.

Kegel exercise or strengthening of PC muscle- by contraction and relaxation as on holding & releasing urine. Practice it several times (20-30 times daily). Here, you need to repeatedly contract and relax the muscles you use when you need to hold back urine. This needs to be done sitting on your chair when you are actually not trying to hold back urine.

b) Use anesthetic gel to desensitize penis or condom for temporary delay. You can get a prescription for this from your physician.

c) Certain drug like Dapoxetine, a class of SSRI, short acting and well approved. This is required only if the exercises don't work. Please try the exercises for 2 to 3 months before this.

d) Give more time on foreplay to heighten partner's excitation and do actual intercourse (vaginal penetration) at the time of partner climax. Here, both of you can get satisfaction/ pleasure.

7) Need proper sleep (at least 6-8 hrs daily) and avoid hot working place and tight underwear.

8) Proper psychological counseling under PSYCHIATRIST and further follow up if you need.

C) Foods for increasing sperm count: Asparagus, Avocado, Banana, Dark chocolate, Garlic, Oyster, Ginseng, Pomegranate, Walnut, egg etc.

Hope, it helps for your information. All the best and good luck.

Regards,
Dr S Patra

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Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for your additional queries.

1) 3 days or more abstinence is required mainly before semen analysis or in ART (Assisted Reproductive Technique like ICSI, IVF, IUI etc). It is NOT required for day to day love making or sexual intercourse.

Masturbation before love making will increase sexual intercourse time. However, it is NOT recommended if you want her to be pregnant during fertile period.

2) Regarding all techniques (for Premature Ejaculation) and Kegel exercise, you can do google search or watch youtube video for demonstration and information.

3) Local anesthetic gel like lignocaine is used to delay ejaculation and prolong sexual intercourse time. There are several products available in the market.

However, I suggest you CLIMAX FOR MEN SPRAY instead of gel or cream. It gives better result. It should be used on erected penis and NOT before that. You can buy it from healthkart.com or medical store.

4) Normal time span for actual penetration or sexual intercourse is 5 to 10 min. However, it varies from men to men. Longer foreplay is important in this case.

5) She can take Vitamin B capsule. However, she has to maintain a healthy life style with balanced diet, avoid fast/ spicy foods, keep bowel habit regular, drink more water, control body wt, avoid stress and take sound sleep.

Clean her face with soap free face wash 2-3 times daily. Do regular cleansing, toning and moisturizing of skin. Take antioxidant (Vit E), apply benzoyl peroxide 5% cream at bed time.

6) There are some reasons of failed ICSI repeatedly. It includes the following:

a) Embryo transferred to uterus was incompetent due to an irregular number of chromosome in embryo or genetic abnormality (most common cause).

b) Implantation dysfunction may be due to immunologic reason or very thin endometrium.

c) Technical difficulty in the performance of embryo transfer. You should consult with your treating doctor regarding this.

7) Dapoxetine is a short acting Selective Serotonin Reuptake Inhibitor (SSRI), an Anti-depressant drug. It is used to treat premature ejaculation.

It should be started with low dose and taken 1 hr prior to sexual intercourse. It is prescription only medicine and you have to consult with your doctor.

Hope, I have answered your all queries with adequate explanation for proper understanding. Kindly, close the discussion and rate the answer.

All the best and good luck.

Regards,
Dr S Patra.

Use this link for direct query to me:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326

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Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for queries.

1) It is NORMAL in some people. If you don't find any interest for love making after masturbation, then you can follow other measures to delay ejaculation.

2) You should undergo one urine examination (routine and culture) to rule out infection (if any). You must urinate before and after sex. You should practise KEGEL exercise to increase strength of pelvic muscle. It will be better.

3) FET is more better than ICSI and frozen embryo can be used in this purpose.

4) She should take the injection or tablet according to her doctor's prescription. Kindly, consult with your treating doctor if you have any confusion.

5) Yes, Climax For Men Spray is far better than usual anesthetic gel or cream. You can definitely delay your ejaculation time.

Hope, it helps for your information. Kindly, close the discussion.

All the best and good luck.

Regards,
Dr S Patra

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