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Understanding Periods: What’s This Sticky Discharge?

Understanding Periods: What’s This Sticky Discharge?


Discharge is a fluid mixture from glands in the vagina and cervix, that clean, lubricate and protect the vagina. Discharge can vary in amount, color, consistency and smell, depending on the menstrual cycle.

Younger children can experience vaginal discharge before getting their first period.

Menstruation & Discharge: 

  • Estrogen is the main hormone that regulates fluid production and progesterone inhibits it. These hormones vary throughout the menstrual cycle.
  • On the first day of the period, progesterone and estrogen levels are low. There is low fluid production.
  • After the period, as estrogen levels rise, so do fluid levels.
  • Ovulation is when an egg is released from the fallopian tubes. Closer to this phase, discharge can be white, cloudy, sticky, wet or creamy. Around ovulation, estrogen levels peak and discharge becomes more egg-like, clear and stretchy. This provides a ‘fertility window’ and filter, to allow the strongest and ‘best’ sperm to swim through to the egg.
  • When a sperm and egg meet, it is called ‘fertilization’. After fertilization, an embryo is formed – this is the first stage of development of the baby. The embryo, then sticks to the uterus – this is called ‘implantation’. If implantation occurs, pink or orange discharge may be stimulated.
  • If fertilization doesn’t happen, then after ovulation, progesterone levels rise and decrease fluid production. There is either dry and yellowish discharge or no discharge at all.

Causes of Abnormal Discharge:

As mentioned before, discharge is a normal and healthy bodily function. Factors such as sexual arousal, use of birth control pills, stress and allergic reactions can result in heavier-than-usual discharge.

Abnormal discharge is usually a symptom of infections or in rarer instances, cervical and endometrial cancers.

Below we have a chart with types of vaginal discharge and possible causes. Please remember that not everyone will experience these symptoms.

Coping During A Pandemic

Coping During A Pandemic

With the rise of coronavirus at the beginning of the 2020, our social media feeds were suddenly flooded with overwhelming bursts of information. More often than not, this influx of posts and stories created a panic stricken environment, where we were not only struggling to keep up with pandemic updates, but new trends that were presented to us under the guise of “productivity” “the right way to quarantine” and in certain cases as a sure shot cures from the virus. Naturally, this sudden pressure to “not let any time go to waste” only further added to the uncertainty and anxiety induced by the pandemic.
It is important to remember that we all respond to stress differently, and that nearly all reactions are valid. We cope according to our individual needs and priorities, which may be different from those of our peers. As we are all collectively adjusting to a new world, mindfulness and compassion are key – not just towards those around you, but towards yourself as well.
Here are some tips that we feel will help you navigate these unpredictable times:
Know the facts: There’s a surplus of rumors and “breaking news” circulating around the pandemic. Stick to reliable sources only, and take everything else with a grain of salt. If you find yourself falling into an information black-hole – stop. Breathe. Take a step back. Give yourself a time limit for all things pandemic related, so that you don’t get too overwhelmed.
Have a plan: Corona scares are immensely nerve-racking. However, having a plan, for what to do in-case you or your family are experiencing worrying symptoms, will help to curb some of that anxiety. Know where and how to get treatment, don’t only rely on home remedies circulated on social media. Remember to isolate, hydrate, wear your mask and wash your hands regularly!
Take time to unwind: With everything moving online, a lot of us are spending hours staring at our screens. Set some time away from the internet entirely, and tune in with yourself. Try out meditation, reading, cooking, or any activity that helps you feel good. Don’t feel guilty about not doing anything “productive” during your free time – sometimes, doing nothing is exactly what one needs.
Honor your body: If you’ve been telling yourself you’ll start all those saved Instagram workouts eventually, but never got around to it – don’t sweat it. Incorporating movement and good nutrition into your daily routine does not need to be overly complicated. You don’t need to train hard every day – working around the house, a short 10-minute workout or a brisk 30-minute walk is enough to stay healthy and get that feel good serotonin pumping. You may find your eating habits and sleep schedule changing drastically during this time – do not guilt yourself. Remind yourself that such changes are natural during high-stress periods. Again, planning your day can help regulate these habits, promoting a sense of well-being.
Focus on what you can control: A spiral of “what-if” thoughts aren’t good for anybody – it leads to a vicious cycle of fear, frustration, anger and hopelessness. Instead of thinking about all the things that could go wrong, start small and think about one thing you can control everyday – be it scheduling a call with a friend, watching a show for a certain amount of time etc. Make it a point to focus on things that excite you and help you relax. Reframing thoughts and redirecting our focus takes time to learn. Acknowledge your feelings, the how and why behind them, and ask yourself: is this true? what is the evidence for this? Imagine consoling a friend who expresses these thoughts to you, what would you say to help them? Come up with some affirmations to put a positive spin on these feelings, and repeat them to yourself when necessary.
Connect: Take out time to catch up with loved ones. Express your feelings to someone you trust, or, reach out and offer an ear to someone who may be struggling. We’re all learning to navigate this new world and find our new ‘normal’ while social distancing. Respect boundaries – yours and others’ – with lockdowns easing up and the sudden frenzy to return to a pre-corona state, it’s natural for anxiety levels to rise again. Maintain social distancing – if you’re not yet ready to meet in person, opt for an online meet-up instead.

Talking About SRH: It’s Not Just One Conversation

Talking About SRH: It’s Not Just One Conversation


If you read our previous post on the ‘DO’s and DON’T’s’ of talking to a child about sexual and reproductive health (SRH), you know that SRH education is not just one “big talk”. Incorporating relevant and age-appropriate details over time is essential, for as a child matures, this allows them to understand SRH at their own pace and make informed decisions.

SRH isn’t just about reproduction its knowledge is essential for overall physical as well as psychological functioning. If anything, the details of reproduction are to be discussed during early-teen years. Don’t wait until your child reaches a certain age or approaches you – there are an array of topics within SRH education to be discussed way before the reproductive process. We’ve listed some below.

Note: there is no one-conversation-fits-all approach for SRH. Discussions vary according to your child’s needs, what is age-appropriate and their current comprehension level.

  1. Anatomically Correct Terms. The words penis and vagina are usually treated as ‘dirty’ and swapped for more ‘palatable’,’ cute’ words, or ignored altogether. They are parts of your child’s body, the same way their arm or nose is. Teaching correct terms ensures that if anything is wrong in those areas, children can effectively communicate it.
  • Body Autonomy. Teach boundaries – “you need permission to touch others and give permission to be touched”. This sets the groundwork for consent. Highlight that no one should be touching their genitals and to approach you (parent) regarding such inappropriate actions. Over time, you can add what is an appropriate (good)  and bad touch..
  • Inclusive Language. Instead of ‘all boys have penises’ and ‘all girls have vaginas’, say “people with penises” and “people with vaginas”. Though these shifts in language seem subtle, they set the groundwork for future conversations about gender expression and roles.
  • Birth Stories. Telling your child their birth story can help in teaching “where babies come from”. Emphasize that not every birth story is the same, and there are lots of ways to have a child. Introducing the idea of various relationships and families, paves the way for more detailed conversations in the future.
  • Digital Safety. Regardless of whether internet use is supervised, rules on speaking to strangers online need to be established. It needs to be made clear that if at any point, your child is unsure or uncomfortable about what’s going on online, they should approach you. You don’t need to explicitly explain pornography, but highlighting that they may stumble upon these “grown-up” websites, is important. With teens, you can be more clear cut about sharing of explicit photos. Make the consequences of such actions clear – legal as well as social. Discuss what it means to be responsible and respectful online and how to tackle situations.
  • Puberty. Detailed puberty talks are to be saved for when your child, or their peers start experiencing it. When talking on puberty, highlight the physical and hormonal changes, while simultaneously assuring them that such changes are a normal part of growing up.
  • Consent & Sexual Abuse and Harassment. Although upsetting and a sensitive matter, it is important for children to learn about consent and sexual abuse, in order to protect themselves and others. It is important to note that many cases of sexual abuse often occur at home, by trusted family members and adults. Informing your child of this, in language that they would understand is key. Tell your child that if they ever find themselves in such a situation, they should immediately inform you. Abusers manipulate vulnerable children into thinking that if they tell others about their “secret touch”, their parents will become angry or will get hurt. It is important to emphasize that by telling you, no harm will come to your child or your family. If you feel this conversation becomes overwhelming, take a step back and revisit the topic later gently. With teenagers, be sure to highlight the role drugs and alcohol can play in these situations; discuss healthy relationships and how to protect themselves against violence. If your teen opens up to you, remain calm and gentle, so as to encourage them to trust in you. Make yourself available and reassure your child that you are here, to protect, guide and help them.
  • Gender Expression & Sexual Identity.  Discussing positive examples can empower your child and help them overcome stereotypes. By the time you approach this conversation with your child, they’ve likely already begun exploring and understanding their gender identity and “role” – having this conversation can help dispel any confusion and reassure them that you are available for support.  
  • Body Image & Peer Pressure. Pre-teens and teenagers may find navigating the social changes they are experiencing particularly difficult. Regularly checking in (without interrogating and snooping) is important – ask your child how they are feeling about these changes and how it affects them socially. At this stage, children are vulnerable to feeling pressured to look and present themselves a certain way. Tackling these issues, by discussing possible scenarios and the emotions they may provoke, can help in making your child feel more comfortable in their skin and their social decisions. Talking about your own personal experiences at their age can be reassuring as well.
  1. Safe Sexual Practices. Teenagers are likely to make better decisions when they are well-informed of the consequences and risks involved. Talk about the different types of birth control; maintaining hygiene and consent. Be frank – let your child know what your intentions are and that you would want them to speak with you openly about any decisions they make.
  1. Mechanics of Reproduction. The actual physical bit. Introduce this information as you see fit according to your child’s needs and comprehension. Be prepared for any and all types of reactions – remain calm and let your child express themselves. If they see you turning red in the face and getting embarrassed, they may be inclined to do the same.

Keep an eye out for future articles where we dive deeper into some of these topics.

Preparing For Periods: When Will The Flo’ Arrive?

Preparing For Periods: When Will The Flo’ Arrive?


If you’re new to experiencing it, menstruation can often be a messy, confusing, uncomfortable, or even frightening ordeal. But good news – it doesn’t have to be that way! When going through puberty, one of the biggest changes you may face is getting your period. This is a part of what’s known as the menstrual cycle. This normally happens between the ages of 8 and 13 years. Some other changes you may notice during this time as well  can be  an increase in body hair and breast development – these can possibly indicate that you’re about to get your first period.

Menstruations prepares your body so that one day, (if you want to), you can have a baby. Ordinarily, once a month, blood comes out of your vagina. Your uterus creates a thick lining of blood on a monthly basis, so that if you become pregnant, the embryo (which is the baby’s first stage of development) can have a comfortable place to grow called the endometrium. If there’s no pregnancy, the uterus empties the lining out of your vagina (this is  known as period blood is) and the cycle starts all over again.  The average period lasts for 2-7 days.

Understanding your menstrual cycle is a huge part of knowing when something isn’t quite right. However, everyone’s menstrual rhythm is different – the symptoms you experience may not be the same as those experienced by your friends – so comparing cycles may not be the most reliable way to identify any ‘abnormalities’.

One of the first things to know about your menstrual cycle is when your period is due. Whether you’re waiting for your first period or have experienced menstruation previously – knowing exactly when your period will arrive can be tricky. Not only does an unexpected period interfere with pre-planned activities, but it can also help in identifying menstrual conditions when having irregular periods.

Luckily, there are some tell-tale signs that may occur before the start of a period. PMS or the Premenstrual Syndrome is the term used to describe the physical and emotional symptoms that many people experience due to hormone induced changes a week or two before their period comes knocking every month. During PMS, you might experience acne, bloating, fatigue, backache, breast soreness, headaches, body pains, constipation, diarrhea, food craving, moodiness, stress, or irritability. You may also have some light cramping in your lower back as well as a change in vaginal discharge.

Boy, that’s a long list. But don’t worry! Not everyone experiences all of these and some of these symptoms usually disappear when your period begins.

Once you notice the aforementioned changes, you can start preparing for your period. Remember to keep your preferred menstrual hygiene product with you as well as anything you use to cope with menstrual cramps.  If you don’t have a menstrual hygiene product at hand, don’t be shy to ask a parent, friend, or adult around for one. And if you leak a little, that’s okay, just wrap something around you until you’re able to change.

So now that you know the signs of your period, you may be wondering, do I need to keep track of all this? YES! Keeping track of your cycle and the accompanying symptoms can help in identifying any abnormalities that may show up, such as, starting your period early, spotting and strange looking or smelling discharge. Keeping a log of these changes will be helpful in diagnosing any menstrual conditions, if needed.

If noting things down in a notebook doesn’t work for you, there are plenty of apps you can use.

We’ve listed some below:

  • FLO Period & Ovulation Tracker: This app is perfect for those who want to take control of their menstrual health – it includes a tracker, ovulation and fertility calendar. By logging in your symptoms, the app converts the information into easy-to-read graphs that feed you all the stats you need about your body. The more you log in, the more accurate the app’s predications become, thereby helping those with irregular cycles as well.
  • EVE by Glow: This app covers all the basics with its sex, health and period logs. Information is presented daily in a “cyclescope” that forecasts what menstrual cycle phase you’re in and the symptoms you may experience. An added bonus are some quizzes and articles offering information needed to understand your cycle and body.
  • CLUE Period Tracker: This app helps you with all your menstrual-related needs. The more information you log in, the more accurate your reminders for your next period and PMS.

Do keep in mind that these apps may not always be entirely accurate. If you feel like your period may be late, stressing over it won’t make it show up any sooner. Instead – relax, breathe and investigate as to why this may be. Look at past patterns that you’ve noted down in your notebook or app. It’s important to note that occasional changes in cycle duration are normal and often due to hormonal, lifestyle and dietary changes, so not every late period is a sign that there’s something wrong or that you’re pregnant.

The youth vaping epidemic: Addressing the rise of e-cigarettes in schools

The youth vaping epidemic: Addressing the rise of e-cigarettes in schools


Last December, the U.S. surgeon general raised an alarm regarding the rise in e-cigarette use among the nation’s youth, saying it has increased “at a rate of epidemic proportions.” According to the 2019 National Youth Tobacco Survey, over 5 million youth are currently using e-cigarettes, primarily the JUUL brand, with nearly 1 million youth using the product daily. This substantial increase in teenage vaping is seriously impacting middle and high schools across America.

ast December, the U.S. surgeon general raised an alarm regarding the rise in e-cigarette use among the nation’s youth, saying it has increased “at a rate of epidemic proportions.” According to the 2019 National Youth Tobacco Survey, over 5 million youth are currently using e-cigarettes, primarily the JUUL brand, with nearly 1 million youth using the product daily. This substantial increase in teenage vaping is seriously impacting middle and high schools across America.

Banning the sale of flavored e-cigarettes would have hefty implications on vaping companies since they employ thousands of small shop owners and hardware designers. Banning the legal sale of flavored vaping products would also create a robust black market for e-cigarettes. A black market for vapes could be lethal for youth who find themselves smoking from cartridges cut with cheaper substances

We cannot know what will happen to e-cigarettes if the minimum age increases, but we can look to the experience of increasing the minimum age on alcohol for some suggestive evidence. According to the 2017 Youth Risk Behavior Survey, 30% of youth drank some amount of alcohol while 14% of youth engaged in binge drinking. Though raising the age limit for purchasing alcohol helped reduce youth alcohol consumption, youth consumption of alcohol persists.

Beyond traditional tactics like monitoring bathrooms and hallways to confiscate vaping devices, states could also take a new approach to fighting the e-cigarette epidemic, like offering grants to schools to invest in on-site counseling. South Portland High School has been addressing teen vaping by offering mental health services and guiding students away from the social influences that encourage vaping. This school—and others, like Arrowhead High School in Milwaukee—have also been getting students involved in their anti-vaping campaign via peer-to-peer education.

The teenage vaping crisis calls for innovative solutions. In collaboration with federal and state action, local actors can look at the FDA’s Youth Tobacco Prevention Plan for insight on ways to initiate community-supported approaches that restrict access to vaping products, curb teenage-focused marketing tactics, and educate teenagers about the harmful, long-term effects of vaping.

Girls and women menstruate. Period

Girls and women menstruate. Period

Last fortnight, officials at a hostel in Bhuj checked residents so those who had their periods could be isolated. Such attitudes perpetuate gender inequalities.

Menstruation is a natural and essential part of a woman’s reproductive cycle. Without it, men, boys, women, girls would not exist. Yet, it is surrounded by myths, misconceptions and taboo.

Stigma related to menstruation reinforces discrimination and perpetuates gender inequalities. And while we know that these attitudes still prevail in some homes and communities, it is shocking to learn that educational institutions and leaders – those that are expected to bearers of light – still adopt extreme forms of shaming and blaming.

A United Nations Population Fund-commissioned photo essay in 2017 on girls’ experiences around menarche, the first occurrence of menstruation, revealed harmful practices girls are subjected to in many parts of India: Prohibition from entering the kitchen or the prayer room, being made to stay outside the house, being forced to eat in separate utensils, or not being allowed to touch certain kinds of food because they could get spoilt. These social norms isolate girls from friends and family, in turn impacting their reproductive and mental health.

Girls start considering themselves to be “impure” and “unclean” during their periods. And their trauma doesn’t end there: inadequate access to clean water, sanitation, affordable menstrual management means, and privacy, all serve to reinforce the stigma. They experience shame, fear and embarrassment. And as they grow up to be women, they internalise these gender inequitable values.

Adding to their woes, in some parts of world, including South Asia, puberty and especially menarche, are considered to signal that girls are ready for marriage and motherhood. In such contexts, parents may view child and early marriages as viable options to control girls’ sexuality or to protect against fears related to the “family’s honour”.

Breaking taboos

In 1994, during the landmark International Conference on Population and Development, and then again in 2019 during the Nairobi Summit to mark ICPD@25, the right to quality sexual and reproductive health services was squarely confirmed as pivotal to women and girls’ participation in family, community and national processes, as well as to the attainment of overall development goals.

The development goals include equal opportunity to education for girls and boys, by ensuring access to clean water and sanitation, medication to treat menstruation-related pain, and creation of safe spaces for girls.

If girls are to miss five days of school every month, how will countries attain that goal? And if women are to be confined during those five days, how will they participate in the labour market, politics, or any decision-making activity in their community?

The good news, however, is that today, India has several policies in place that address awareness about menstruation and menstrual hygiene. Many states have adopted and integrated life skills that include comprehensive sexuality education into their lower- and upper- secondary school curricula. Many civil society organisations promote girls’ education and work with parents and communities to break these taboos.

Thanks to these initiatives, the discomfort around menstruation and menstrual hygiene is beginning to gradually fade. It is now widely accepted that girls’ and women’s access to effective means of managing menstrual hygiene is strictly linked to realising their human dignity.

e must join efforts to break these taboos that have been built over centuries and are ingrained in people’s minds. Until we allow young girls to feel “normal” about menstruating, the best-intentioned policies will fall short of attaining the desired goals of equal participation of women and men.

Girls and women menstruate. Period.

Argentina Matavel Piccin is the India Representative at United Nations Population Fund or UNFPA.

“Never give up hope,” fistula survivor tells Pakistani women

“Never give up hope,” fistula survivor tells Pakistani women


ISLAMABAD, Pakistan – “Helping women suffering fistula is my mission in life,” Razia Shamshad said about the maternal injury from childbirth that she thought would ruin her life. “No woman deserves to live in misery, especially when it is treatable.”

Ms. Shamshad, 29, was born in a small village in southern Punjab. Her family did not want her to go to school, so she had only received an informal religious education by age 13, when she was married off. Ms. Shamshad was already expecting her first baby within a few weeks of her wedding. Then, when she was six months pregnant, her husband died in a road accident.

Unable to afford proper medical care, Ms. Shamshad was assisted by an unskilled traditional birth attendant who was unable to manage complications. When Ms. Shamshad suffered an obstructed labour, the birth attendant did not summon medical help. Ms. Shamshad was in agony for four days, an ordeal that could have killed her.

In the end, her daughter was stillborn, and Ms. Shamshad suffered serious damage. She developed an obstetric fistula, a hole in the birth canal. Fistula leaves women leaking urine, faeces or both, and often leads to chronic medical problems.

The condition is preventable with timely access to quality medical care, such as Caesarean section. Tragically, it persists among the most marginalized women, with pregnant adolescents and undernourished women facing particularly high risks. And its sufferers are further marginalized, often facing ostracism and discrimination. 

“People would either avoid me or just make fun of me,” she said. “I never felt clean.”

A stroke of good luck

But Ms. Shamshad was able to put her life back together. Her relatives learned about free treatment available at the Koohi Goth Women’s Hospital, which specializes in treating fistula and other conditions related to reproductive health. Two years after her ordeal, her family paid for her to travel to Karachi for care. 

Ms. Shamshad’s condition was complex, and required multiple surgeries between 2010 to 2016. Even so, she has been able to regain her life. 

“Her determination was exceptional. She was resilient and strong and was able to pull through the difficult process successfully,” said Dr. Sajjad Ahmed, who was trained by UNFPA to perform fistula repair surgeries.

Ms. Shamshad went on to meet her current husband. They adopted a little girl. And though she was not expected to be able to get pregnant again, she surprised everyone by conceiving. With regular prenatal care and a C-section, she had a healthy baby girl.

Combating fistula since 2003

In many ways, Ms. Shamshad was lucky. The story is very different for many fistula survivors in Pakistan, who are unaware that there is treatment available.

And many more women and girls are at risk.  Access to reproductive health services remains a challenge for women in Pakistan. Only an estimated 52 per cent of women give birth with the help of a skilled attendant, leaving them vulnerable to complications like prolonged, obstructed labour.

“People would either avoid me or just make fun of me,” she said. “I never felt clean.”

A stroke of good luck

But Ms. Shamshad was able to put her life back together. Her relatives learned about free treatment available at the Koohi Goth Women’s Hospital, which specializes in treating fistula and other conditions related to reproductive health. Two years after her ordeal, her family paid for her to travel to Karachi for care. 

Ms. Shamshad’s condition was complex, and required multiple surgeries between 2010 to 2016. Even so, she has been able to regain her life. 

“Her determination was exceptional. She was resilient and strong and was able to pull through the difficult process successfully,” said Dr. Sajjad Ahmed, who was trained by UNFPA to perform fistula repair surgeries.

Ms. Shamshad went on to meet her current husband. They adopted a little girl. And though she was not expected to be able to get pregnant again, she surprised everyone by conceiving. With regular prenatal care and a C-section, she had a healthy baby girl.

Combating fistula since 2003

In many ways, Ms. Shamshad was lucky. The story is very different for many fistula survivors in Pakistan, who are unaware that there is treatment available.

And many more women and girls are at risk.  Access to reproductive health services remains a challenge for women in Pakistan. Only an estimated 52 per cent of women give birth with the help of a skilled attendant, leaving them vulnerable to complications like prolonged, obstructed labour.

Effectiveness of contraceptive counseling strategies

Effectiveness of contraceptive counseling strategies

January 8, 2020

Counseling strategies for modern contraception that target women initiating a method, including structured counseling on side effects, tend to have positive effects on contraceptive continuation, according to a systematic review in BMJ Sexual & Reproductive Health. But in most cases, provider training and decision-making tools for method choice did not have an effect.

On the other hand, additional antenatal or postpartum counseling sessions resulted in an increased rate of postpartum contraceptive use, regardless of their timing in pregnancy or postpartum. But dedicated pre-abortion contraceptive counseling was linked to increased use only when accompanied by a broader contraceptive method provision. The review also found that male partner or couples counseling can be effective at increasing contraceptive use among non-users, or in women initiating contraceptive implants or seeking abortion.

The investigators, who were from several countries, searched six electronic databases for relevant studies of women or couples published in English since 1990: MedlineEmbaseGlobal HealthPopline, the Cumulative Index of Nursing and Allied Health Literature (CINAHL) Plus and Cochrane Library. A total of 61 studies from 63 publications met the inclusion criteria, for which there was substantial heterogeneity in study settings, interventions, and outcome measures. However, high-quality evidence was absent for the majority of intervention types.

In summarizing the advantages and disadvantages of different counseling intervention methods, a few studies noted the increased cost of  staffing, resources, and contraceptive products when providing additional and longer patient consultations. Conversely, interventions like digital tools during waiting times prior to consultation can potentially save provider time. However, counseling satisfaction with digital tools alone was low, and best used in conjunction with face-to-face counseling.

While telephone-based interventions provide access to many women at low cost, these interventions are unable to reach women without phones and may require multiple attempts to reach participants with phones.

Counseling up to the time of birth or abortion for women who may not access services later allows for a fuller discussion of different contraceptive methods, yet some women may be reluctant to initiate contraception immediately, thus effective follow-up mechanisms are necessary. Routine postpartum counseling at 3 to 6 weeks may help some women after they have resumed sexual activity.

Including male partners in counseling sessions may also be valuable, if they are the main contraceptive decision-maker. But partner availability poses logistical challenges.

“Our focus on comparing counseling strategies is critical to help identify successful interventions to improve contraceptive services,” the authors wrote. “However, preventing unmet need for contraception and unwanted pregnancies (influenced by multiple other factors) is the ultimate objective from a public health standpoint, and counseling process indicators such as client participation and knowledge are also important.”

Three limitations of the review are that study quality was variable; substantial heterogeneity existed in study settings, interventions and outcomes, thereby limiting comparability of studies; and many of the included studies failed to clearly state whether the intervention targeted women initiating, switching, and/or continuing contraception, plus women switching methods were often grouped with initiators.

Nonetheless, the findings underscore that when feasible, repeated counseling throughout pregnancy and postpartum can contribute to maximum access to information and contraceptive uptake. However, interventions seeking to improve contraceptive counseling need to be tailored to patient flow, record flow, and the contraceptive methods available, while embedded within broader quality-of-care improvements, including clinical training.

The authors noted that further research is needed to determine the effectiveness of many contraceptive counseling interventions, including novel efficacious interventions, among various settings.

What Are The Best Multi-Vitamins For Women?

What Are The Best Multi-Vitamins For Women?


By Staff ReporterDec 30, 2019 10:57 AM EST

Our modern society is quite unhealthy, with fast food and processed sugars available around every corner. As a direct result of the unhealthy environment they inhabit, many American women are struggling with their long-term health, especially when it comes to ensuring they have enough vitamins and a proper diet. It can be incredibly hard to find authoritative information pertaining to women’s health, too, leading many young women to simply give up altogether.

Rather than ignoring your health, you should be taking proactive steps to bolster it, like consuming healthy supplements. Which are the best multi-vitamins for women, and how else can they remain healthy? Here’s how to ensure your lifestyle is a healthy and prosperous one.

Find authoritative sources

The first thing you should do when searching for the best multi-vitamin for women is find an authoritative source that can give you valid information which you can depend upon. Many blogs exist and will tell you what supplements to take, but the truth of the matter is that these are often hosted by non-professionals who lack formal medical degrees. You should be relying strictly on valid sources of information that have science to back up their arguments. Look for websites that end in .gov, and you’ll generally know you’re in the clear when it comes to the medical data you’re reading.

The U.S. Department of Health and Human Services has anexcellent webpage provided by the Office on Women’s Health, for instance, and it should frequently be reviewed by women who want to maintain healthy lifestyles for themselves. Ensuring you have enough vitamin B9, for instance, is particularly important for pregnant women who may be deprived of valid information to rely on as they prepare for a new chapter in their lives.

Many women have a vitamin B-12 deficiency, too, which is a helpful reminder to talk to your medical professionals about what your body might need that it’s naturally lacking. It’s important to remember thatnutritional supplements are only one source of these vitamins – many people often get enough in their regular diets, though some dietary restrictions may impede your ability to ingest enough of them in your food. When it comes to B-12 deficiencies, for instance, you can try to amend them by increasing the amount of fat-free milk, eggs, poultry, and nutritional yeast you consume on a regular basis.

Many women find themselves suffering from calcium deficiencies, and these can’t always be amended by eating more food groups that are rich in calcium. Young girls who are still growing may be in particular need of calcium supplements because they can be very important when it comes to bone growth and hitting your appropriate height.

Learn about multi-vitamin trends

To find the best multi-vitamins and to determine which are popular and which are fading, it can be helpful to familiarize yourself with multi-vitamin trends across the nation. The past few years have seen ageneral decline in the number of multi-vitamins consumed by American adults, for instance, though it’s not yet clear why people are taking fewer and fewer of them. Americans are taking more vitamin D, for instance, but overall the total amount of supplements they’re taking is going down.

It’s important to speak with your medical providers to ensure that you’re not following national trends which may be popular but nevertheless unhealthy when your specific body is considered. Women of reproductive age in particular are taking fewer supplements,according to data made available by the CDC, though this is often impacted by the age and ethnicity of the individuals in question.

Vitamins A, C, E, and D remain some of the most popular supplements with women even in light of this decline, however. Calcium is also particularly important for developing women of a younger age. Before ingesting any supplements, ensure their sourcing is authentic and that there are no regulatory embargos on the substance you’re consuming. By finding authoritative and well-regulated providers of supplements, you can bolster your health, but taking shady supplements from lackluster sources is highly inadvisable. Never be afraid to talk to your medical professional about taking certain multi-vitamins or a particular supplement you’ve encountered online.  

Breaking silence on menstruation

Breaking silence on menstruation


Ebad AhmedSpecial ReportNovember 24, 2019

It was May 2018 when two sisters in Karachi formally set up their dream project in a bid to help underprivileged women improve their menstrual health and hygiene. Enter HER Pakistan, a not-for-profit organisation which aims to shatter the myths and taboos surrounding menstruation through programmes that educate young girls, women and the society about a subject that is rarely ever talked about.

“I was working with a not-for-profit school network in Karachi and during a visit to one of the slums, I found out that girls were being forced to miss school, and at times, even drop out of school when they started menstruating,” says Sana Lokhandwala, co-founder of HER Pakistan. “And it wasn’t just that. I also came across a lot of myths and misconceptions around menstruation that prevail in our communities,” she adds. A communication specialist previously affiliated with the news industry, Sana now runs the project with her sister, Sumaira Lokhandwala.

During her eight years of experience as a healthcare marketeer, Sumaira says she realised how sexual and reproductive health, a major component of women’s overall health, was being largely neglected in Pakistan. “Subjects as normal as menstruation are considered taboo. Thousands of women do not have access to information and facilities in order to live a healthy and empowered life,” says Sumaira.

A research by Real Medicine Foundation in 2017, a non-profit organisation working to improve the health sector in disaster-hit regions, found that an alarming 79 percent of Pakistani women were not properly managing their menstrual hygiene due to lack of information. During their fieldwork, the Lokhandwala sisters made the same observation.

Their dream soon turned into reality and HER Pakistan was founded with an objective to improve sexual and reproductive health, particularly menstrual health and hygiene, for girls and women in Pakistan regardless of their socio-economic background. To date Sana and Sumaira Lokhandwala have successfully reached out to schools and communities in areas like Old Golimar, Rehri Goth, Machhar Colony, Kemari, Lyari, Gulbai, Moach Goth, Steel Town, Malir, Baldia Town and Qayyumabad.

The initiative is running as many as three projects simultaneously, starting with the School Puberty Education Programme, which prepares adolescents, their parents and teachers for puberty and associated changes and challenges.

“The programme takes a holistic approach by training parents and teachers simultaneously, so they can ensure a safe and healthy environment for adolescents after the sessions,” explain the Lokhandwala sisters. The basic components of the session include understanding gender and gender roles, introduction to puberty, physical, psychological and social changes during puberty, hygiene management, myths and misconceptions related to puberty, body positivity, bullying and harassment and a special focus on menstruation for girls. “The sessions are mostly tailored according to the needs of the students and the schools’ management.”

The initiative has reached out to as many as eight schools in Karachi and two in Gilgit Baltistan. The founders, however, believe that this is just the beginning. They aspire to take it to schools and communities all over Pakistan.

The community education programme, Menstrual Hygiene Drives, focuses on awareness sessions through peer-to-peer counselling and interactive teaching tools. The sessions are held in underprivileged communities in which women of all ages and backgrounds meet to discuss menstruation and it being a natural phenomenon, and its hygiene management.

The organisation has also launched a digital community group – Oh My Period! The Facebook group aims to provide a safe space for women to talk about everything related to menstruation, to be able to learn from one another’s experiences and to help each other.

“The aim is to create a friendly space where anyone can talk about their periods freely and ask questions without being judged,” says Sana.

The journey wasn’t a joy ride. It came with its set of challenges. But the Lokhandwala sisters say these challenges were not strong enough to unnerve them or shake their commitment. The sisters say that they faced harassment, bullying and even death and rape threats from men on digital platforms and in the real world.

“Everything related to a female body that does not serve the patriarchal needs of pleasure and procreation is considered a taboo. Everyone loves to objectify a woman’s body but no one wants to talk about menstruation or breast cancer or women’s other health-related problems,” says Sumaira.

She says the stigma exists because the society has attached shame to women’s bodies. “It’s these taboos that have conditioned the society to view menstruation as something shameful or as something to be ashamed about. It is because of this that the way we view menstruation is going to change very slowly because of our deeply ingrained cultural taboos,” she adds.

They acknowledge the role their families and friends have played in supporting the organisation and its work. “HER Pakistan is a community-driven initiative and we wouldn’t be where we are without the support we received from our generous supporters, volunteers, partners and donors.”

“Discussing and educating people – men, women, girls and boys – about menstrual hygiene and dismissing taboos associated with it, in a patriarchal society, are things that scare a lot of people. We would be lying if we say we weren’t scared,” says Sana. “We were. But we were adamant to change the menstrual health situation in Pakistan. And we can confidently say that the change is happening.”

The writer is a human rights reporter based in Karachi. He covers conflict, environment and culture.