Vitamin B11 (Pteryl-hepta-glutamic acid) is a form of Vitamin B9 (Folic acid), one of five folates necessary for humans, and now known as ‘chick growth factor. Vitamin B11, also called salicylic acid, comes from vitamin B9. It is an essential folate the body needs to work properly.
Not a lot of information is available on this B-vitamin. We do know that it is involved with metabolizing fats and proteins. It is also important for the production of red blood cells.
Vitamin B11 is present in both animal and plant kingdom.
Animal sources: The sources from animal kingdom egg yolk, meat, liver, and poultry
Plant sources: The sources from plants are oranges, potatoes, as well as green leafy vegetables such as spinach etc.
green leafy vegetables
whole grains
molasses
eggs
yogurt
wheat germ
Health Benefit of Vitamin B11
This vitamin has been linked to various other benefits as well:
Involved in the creation of DNA and RNA
Increases production of breast milk
Helps increase desire to eat for those with a loss of appetite
Acts as a pain killer
Boosts immunity in children
Aids in the fight against cancer
While browsing skin lotions, you may notice certain brands advertise that they have salicylic as an ingredient, this is vitamin B11, which helps to exfoliate and remove excess skin.
Another way vitamin B11 helps keep your skin healthy is by preventing acne. When used as a lotion, salicylic acid makes its way deep into your pores to clean out any clogged dirt and debris. Furthermore, this vitamin helps improve blood flow which helps clear pimples more quickly.
Vitamin B11 in accompany with vitamin B12 take part in the formation of RNA and DNA,
It is also necessary for the growth and in the formation of tissues of the body.
Vitamin B11 is extremely essential and plays role in the formation of brains and the spinal cord in the fetus during embryogenesis.
DNA and RNA syntheses
Cell division
Development of the fetus nervous system
This vitamin is also an important element of the red blood bodies and blood plasma.
Salicylic acid is used in the manufactures of certain creams for treating acne. It acts to correct the faulty desquamation function of the skin causing new growth off skin earlier while sloughing off the dead skin. It is found to penetrate the follicles, therefore, it is good and beneficial in the treatment of acne.
Salicylic acid is also beneficial in the treatment of psoriasis, corns, dandruff, calluses, warts, and many more skin diseases
Vitamin B10 also known as PABA (para amino benzoic acid), is an essential vitamin belonging to the class of B complex vitamins. Earlier, vitamin B10 was referred to as vitamin R, but it has recently been renamed to PABA.
Para-aminobenzoic acid (PABA) is a naturally occurring, non-protein amino acid. It was once thought to be a B vitamin, but is now known to be neither a vitamin nor an essential nutrient in humans. Dietary PABA deficiency is not an issue in humans, though PABA can be found in liver, kidney, wheat germ, bran, and yogurt. PABA is most well-known as a part of some sunscreen products, since it can absorb ultraviolet (UV) light. PABA is also part of many different agents, including those that treat abnormal heart rhythms, bacterial infection, seizures, nausea and vomiting, cancer, mental illnesses, stomach issues, and pain.
Deficiency Symptoms of Vitamin B10
Deficiency of vitamin B10 leads to the following symptoms and conditions
Vitamin B10 is found abundantly in plant and animal sources. Rich sources of vitamin B10 include:
green leafy vegetables
whole grains
molasses
eggs
yogurt
wheat germ
mushrooms
Dosage of Vitamin B10 Supplements
The amount of vitamin B10 to be taken has not yet been established. However, the Food and Nutrition Board has given certain dietary guidelines mentioned below:
Despite the lack of any recognized syndromes of PABA deficiency in humans, except for a few people who lack the bacteria that generate PABA in their colons, many claims of benefit are made by commercial suppliers of PABA as a nutritional supplement. Benefit is claimed for fatigue, irritability, depression, weeping eczema (moist eczema), scleroderma (premature hardening of skin), patchy pigment loss in skin (vitiligo), and premature grey hair.
Vitamin B10 is used for the growth of beneficial microorganisms inside the body. It also prevents the bacteriostatic properties of certain drugs as it has a chemical structure similar to sulphonamides.
Vitamin B10 protects the skin from free radicals that may otherwise damage the skin and make it prone to infections. The free radicals that the skin may be exposed to are in the harmful chemicals present in polluted air and ultraviolet rays of the sun. Sunscreen lotion, containing PABA, when applied externally on the skin prevents pigmentation. Apart from its protective effect on the skin, vitamin B10 also treats various skin diseases known as fibrotic disorder.
Supplementation of vitamin B10 also corrects irritable bowel syndrome, gastrointestinal disturbances and various inflammatory reactions. PABA also acts as a coenzyme which aids in optimal utilization of protein by the cells.
Vitamin B10 acts as an anti allergen, which means it will treat and prevent skin allergies and diseases such as eczema and vitiligo. It has shown positive health effects in curing rheumatic fever. It is also effective as an anti ageing agent; it removes the fine lines, wrinkles and dark spots from the skin and prevents premature ageing. The use of vitamin B10 in various skin lotions has been the reason for cause of allergy in some individuals. Hence its use has been limited. Individuals prone to allergy should discontinue its use.
Vitamin B10 is used in the production of folic acid by the intestinal bacteria inside our body. It also acts as a coenzyme for its active role in protein metabolism and formation of red blood cells.
The potassium salt is used as a drug against fibrotic skin disorders, such as Peyronie’s disease, under the trade name Potaba. PABA is also occasionally used in pill form by sufferers of irritable bowel syndrome to treat its associated gastrointestinal symptoms, and in nutritional epidemiological studies to assess the completeness of 24-hour urine collection for the determination of urinary sodium, potassium, or nitrogen levels.
Vitamin B10 is found helpful in the formation of erythrocyte also called red blood cells.
This vitamin is essential for the synthesis of for folic acid.
It is very useful when used in sunscreen. It is also necessary for those individuals who want to avoid the ultraviolet UV) rays coming from the sun that can lead to skin neoplasia.
It is also found to be beneficial in hair pigmentation and skin.
Vitamin B11 has anti-allergic and anti-inflammatory effects.
It is essential for the growth of skin and its normal color.
It is important for smooth amino acids metabolism.
It was once used to combat rheumatic fever.
It provides protection from damaging effects of ozone
It acts as a coenzyme and causes protein utilization in the body.
Vitamin B9 is one of the B vitamins. Folic acid is a form of vitamin B-9 that can dissolve in water. It is a key ingredient in the making of the nucleic acid that forms part of all genetic material.The recommended daily intake of folate in the US is 400 micrograms from foods or dietary supplements. Folate in the form of folic acid is used to treat anemia caused by folic acid deficiency. Folic acid is also used as a supplement by women during pregnancy to prevent neural tube defects(NTD) in the baby. Low levels in early pregnancy are believed to be the cause of more than half of babies born with neural tube defects. More than 50 countries use fortification of certain foods with folic acid as a measure to decrease the rate of NTDs in the population. Long term supplementation is also associated with small reductions in the risk of stroke and cardiovascular disease.It may be taken by mouth or by injection.
Symptoms of Vitamin B9 Deficiency
Folic acid deficiency occurs when the newborn baby does not receive enough of this vitamin in the womb. A fetus that has received insufficient quantities of folic acid has strong possibilities of being born with spina bifida and may also suffer from serious defects of the nervous system.
Deficiency of folic acid may also lead to the following
anemia(macrocytic, megaloblastic anemia) can be a sign of advanced folate deficiency.
Women with folate deficiency who become pregnant are more likely to give birth to low birth weight premature infants, and infants with neural tube defects.
In infants and children, folate deficiency can lead to failure to thrive or slow growth rate,
diarrhea,
oral ulcers,
megaloblastic anemia,
neurological deterioration.
Microcephaly,
seizures,
blindness and cerebellar ataxia can also be observed.
Folic acid has many roles to play in the development of bones and iron uptake by the cells. Hence its deficiency may lead to malfunctioning of the vital systems.
Recommended Intakes of Vitamin B9
Intake recommendations for folate and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine (IOM) of the National Academies (formerly National Academy of Sciences) . DRI is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. These values, which vary by age and gender, include:
Recommended Dietary Allowance (RDA) – Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals.
Adequate Intake (AI) – Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA.
Estimated Average Requirement (EAR) – Average daily level of intake estimated to meet the requirements of 50% of healthy individuals; usually used to assess the nutrient intakes of groups of people and to plan nutritionally adequate diets for them; can also be used to assess the nutrient intakes of individuals.
Tolerable Upper Intake Level (UL) – Maximum daily intake unlikely to cause adverse health effects.
Table 1 lists the current RDAs for folate as micrograms (mcg) of dietary folate equivalents (DFEs). The FNB developed DFEs to reflect the higher bioavailability of folic acid than that of food folate. At least 85% of folic acid is estimated to be bioavailable when taken with food, whereas only about 50% of folate naturally present in food is bioavailable . Based on these values, the FNB defined DFE as follows:
1 mcg DFE = 1 mcg food folate
1 mcg DFE = 0.6 mcg folic acid from fortified foods or dietary supplements consumed with foods
1 mcg DFE = 0.5 mcg folic acid from dietary supplements taken on an empty stomach
For infants from birth to 12 months, the FNB established an AI for folate that is equivalent to the mean intake of folate in healthy, breastfed infants in the United States.
Recommended Dietary Allowances (RDAs) for Folate
Age
Male
Female
Pregnant
Lactating
Birth to 6 months*
65 mcg DFE*
65 mcg DFE*
7–12 months*
80 mcg DFE*
80 mcg DFE*
1–3 years
150 mcg DFE
150 mcg DFE
4–8 years
200 mcg DFE
200 mcg DFE
9–13 years
300 mcg DFE
300 mcg DFE
14–18 years
400 mcg DFE
400 mcg DFE
600 mcg DFE
500 mcg DFE
19+ years
400 mcg DFE
400 mcg DFE
600 mcg DFE
500 mcg DFE
* Adequate Intake (AI)
Food Source of Vitamin B9
Selected Food Sources of Folate and Folic Acid
Food
mcg DFE
per serving
Percent DV*
Beef liver, braised, 3 ounces
215
54
Spinach, boiled, ½ cup
131
33
Black-eyed peas (cowpeas), boiled, ½ cup
105
26
Breakfast cereals, fortified with 25% of the DV†
100
25
Rice, white, medium-grain, cooked, ½ cup†
90
23
Asparagus, boiled, 4 spears
89
22
Spaghetti, cooked, enriched, ½ cup†
83
21
Brussels sprouts, frozen, boiled, ½ cup
78
20
Lettuce, romaine, shredded, 1 cup
64
16
Avocado, raw, sliced, ½ cup
59
15
Spinach, raw, 1 cup
58
15
Broccoli, chopped, frozen, cooked, ½ cup
52
13
Mustard greens, chopped, frozen, boiled, ½ cup
52
13
Green peas, frozen, boiled, ½ cup
47
12
Kidney beans, canned, ½ cup
46
12
Bread, white, 1 slice†
43
11
Peanuts, dry roasted, 1 ounce
41
10
Wheat germ, 2 tablespoons
40
10
Tomato juice, canned, ¾ cup
36
9
Crab, Dungeness, 3 ounces
36
9
Orange juice, ¾ cup
35
9
Turnip greens, frozen, boiled, ½ cup
32
8
Orange, fresh, 1 small
29
7
Papaya, raw, cubed, ½ cup
27
7
Banana, 1 medium
24
6
Yeast, baker’s, ¼ teaspoon
23
6
Egg, whole, hard-boiled, 1 large
22
6
Vegetarian baked beans, canned, ½ cup
15
4
Cantaloupe, raw, 1 wedge
14
4
Fish, halibut, cooked, 3 ounces
12
3
Milk, 1% fat, 1 cup
12
3
Ground beef, 85% lean, cooked, 3 ounces
7
2
Chicken breast, roasted, ½ breast
3
1
* DV = Daily Value. The FDA developed DVs to help consumers compare the nutrient contents of products within the context of a total diet. The DV for folate is 400 mcg for adults and children aged 4 and older. However, the FDA does not require food labels to list folate content unless a food has been fortified with this nutrient. Foods providing 20% or more of the DV are considered to be high sources of a nutrient.
† Fortified with folic acid as part of the folate fortification program.
The U.S. Department of Agriculture’s Nutrient Database Web site lists the nutrient content of many foods and provides a comprehensive list of foods containing folate arranged by nutrient content and by food name.
Serious kidney disease. About 85% of people with serious kidney disease have high levels of homocysteine. High levels of homocysteine have been linked to heart disease and stroke. Taking folic acid lowers homocysteine levels in people with serious kidney disease. However, folic acid supplementation does not appear to reduce the risk of heart disease-related events.
High amounts of homocysteine in the blood (hyperhomocysteinemia). High levels of homocysteine have been linked to heart disease and stroke. Taking folic acid lowers homocysteine levels by 20% to 30% in people with normal to slightly elevated homocysteine levels. It is recommended that people with homocysteine levels greater than 11 micromoles/L supplement with folic acid and vitamin B12.
Reducing harmful effects of a medicine called methotrexate. Taking folic acid seems to reduce nausea and vomiting, which are possible side effects of methotrexate treatment.
Birth defects (neural tube defects). Folic acid during pregnancy reduces the risk of neural tube birth defects. It is recommended that pregnant women get 600-800 mcg of folic acid per day from their diet or supplements starting 1 month before pregnancy and during pregnancy. Pregnant women with a history of neural tube birth defects are advised to get 4000 mcg of folic acid per day.
Possibly Effective for
Age-related vision loss (age-related macular degeneration). Research shows that taking folic acid with other vitamins including vitamin B6 and vitamin B12 reduces the risk of developing age-related vision loss.
Depression. Limited research shows that taking folic acid along with antidepressants seems to improve symptoms in people with depression.
High blood pressure. Research shows that taking folic acid daily for at least 6 weeks reduces blood pressure in people with high blood pressure. But Taking folic acid with blood pressure medication does not seem to lower blood pressure more than taking only blood pressure medicine
Gum problems due to a drug called phenytoin. Applying folic acid to the gums seems to prevent gum problems caused by phenytoin. However, taking folic acid by mouth does not seem to improve symptoms of this condition.
Gum disease during pregnancy. Applying folic acid to the gums seems to improve gum disease during pregnancy.
Stroke. Taking folic acid can reduce the risk of stroke by 10% to 25% in people who live in countries that don’t fortify grain products with folic acid. But folic acid doesn’t seem to prevent strokes in most people who live in countries that do fortify grain products with folic acid.
A skin discoloration disorder called vitiligo. Taking folic acid by mouth seems to improve symptoms of vitiligo.
Cancer of the white blood cells (acute lymphoblastic leukemia). Taking folate during pregnancy does not reduce the risk of childhood cancer of the white blood cells.
Iron deficiency. Taking folic acid with iron supplements is not more effective than taking the iron supplements without folic acid for treating and preventing iron deficiency and anemia caused by too little iron in the body.
Memory and thinking skills in older people. Most research shows that taking folic acid does not prevent decline in memory and thinking skills in the elderly.
Preventing re-blockage of blood vessels after angioplasty. There is inconsistent evidence on the benefits of taking folic acid after a procedure to widen the blood vessels. But taking folic acid plus vitamin B6 and vitamin B12 might actually interfere with healing in cases where a device (stent) is inserted in the blood vessel to keep it open.
Breast cancer. Consuming folate in the diet might lower the risk of developing breast cancer in women who also eat high amounts of methionine, vitamin B12 (cyanocobalamin), or vitamin B6 (pyridoxine), but research is not consistent. Other research suggests that taking folic acid supplements alone does not lower the risk of breast cancer.
Heart disease. Most research shows that taking folic acid alone or with other B vitamins does not reduce the risk of death or heart disease-related events in people with heart disease.
Cataracts. Research shows that taking folic acid with other vitamins including vitamin B6 and vitamin B12 does not prevent cataracts. In fact, it might increase the chance of needing to have cataracts removed.
Chronic fatigue syndrome. Daily injections of folic acid appear to have no effect on symptoms of chronic fatigue syndrome.
Diarrhea. Taking a specific nutritional supplement with added folic acid and possibly vitamin B12 does not seem to prevent diarrhea in children at risk of malnutrition. Taking this product may increase the risk of having diarrhea last more than a few days.
Preventing falls. Taking folic acid with vitamin B-12 does not seem to prevent falls in older people who are also taking vitamin D.
Fetal and early infant death. Taking folic acid during pregnancy does not seem to reduce the risk of having a baby die just before or after birth.
Toxicity from the drug lometrexol. Daily injections of folic acid appear to have no effect on symptoms of chronic fatigue syndrome.
Lower respiratory tract infections.Taking a specific nutritional supplement with added folic acid and possibly vitamin B12 does not seem to prevent infections in the lungs in children at risk of malnutrition.
Weak bones (osteoporosis). In elderly individuals with osteoporosis, taking folic acid with vitamin B12 and possibly vitamin B6 (pyridoxine) does not seem to prevent broken bones.
Performance in older people. Taking folic acid with vitamin B-12 doesn’t seem to help older people walk better or have stronger hands.
Growths in the large intestine and rectum (colorectal adenoma).Taking folic acid supplements does not seem to prevent growths in the large intestine or rectum.
Inherited disease called Fragile-X syndrome.Taking folic acid by mouth does not improve symptoms of fragile-X-syndrome.
Premature infants. Taking folic acid during pregnancy does not decrease the risk of having a premature baby.
Insufficient Evidence for
Acne. Limited evidence suggests that taking a specific nutritional supplement, containing vitamin B3 (nicotinamide), a compound isolated from grains (azelaic acid), zinc, vitamin B6 (pyridoxine), copper, and folic acid (NicAzel, Elorac Inc., Vernon Hills, IL) appears to reduce inflammation associated with pimples on the face.
Alzheimer’s disease. Limited evidence suggests that elderly people who consume more folic acid than the recommended dietary allowance (RDA) appear to have a lower risk of developing Alzheimer’s disease than people who consume less folic acid.
Autism. Limited research suggests taking folic acid during pregnancy might reduce the risk of autism in the child.
Beta-thalassemia. Beta-thalassemia is a disorder of the blood that results in the production of less hemoglobin, the protein that carries oxygen in the blood. Patients with beta-thalassemia usually have bone and muscle pain and have less strength. In children with this disorder, limited research suggests taking folic acid by itself, or with L-carnitine a compound similar to an amino acid from protein, might reduce bone pain and help increase strength.
Bipolar disorder. Taking folic acid does not appear to improve the antidepressant effects of lithium in people with bipolar disorder. However, taking folate with the medication valproate improves the effects of valproate.
Cervical cancer. There is some evidence that increasing folic acid and folate intake from dietary and supplement sources, along with thiamine, riboflavin, and vitamin B12, might help to prevent cervical cancer.
Long-term kidney disease (chronic kidney disease, CKD). Taking folic acid might help slow kidney function decline in people with CKD. But it is not beneficial when used along with vitamin B12 (cyanocobalamin). In fact, the combination might make kidney disease worse.
Colon cancer, rectal cancer. Research suggests that taking folic acid or eating folate in the diet can reduce the risk of developing colon or rectal cancer. However, there is some research that does not suggest that taking folic acid or folate in the diet offers the same benefit. It is possible that folic acid may be more helpful for preventing colon cancer than rectal cancer or it may be more helpful for specific kinds of colon cancer.
Diabetes. Taking folic acid supplements does not seem to benefit people with diabetes.
Epilepsy. Taking folic acid does not reduce seizures in people with epilepsy.
Esophageal cancer. Research suggests that consuming more folate in the diet lowers the risk for developing esophageal cancer.
High amounts of homocysteine in the blood caused by the drug fenofibrate.Taking folic acid every other day might lower levels of homocysteine in the blood caused by the drug fenofibrate.
Stomach cancer. Research suggests that taking folic acid reduces the risk of developing some types of stomach cancer.
Gout. Early research suggests that folate might reduce the risk of gout.
Head and neck cancer. Getting more folic acid from the diet has been linked to a lower risk of head and neck cancer.
Hearing loss. Low levels of folate in the blood seem to be related to the risk for sudden hearing loss in adults. Some evidence suggests that taking folic acid daily for 3 years slows the decline of hearing loss in older people who have low folate levels. It is not clear if folic acid supplementation reduces hearing loss in people with normal folate levels.
Male infertility. Some research suggests that taking folic acid plus zinc sulfate daily can increase sperm count in men with low sperm counts.
Low birth weight. Taking folic acid during pregnancy does not prevent some babies from being born at a low birth weight but it does seem to increase the overall average of birth weights. However, some early research suggests that taking folic acid before getting pregnant might reduce the risk of having a baby that is too small even when born full term. Although this risk is not reduced in mothers that start supplementation after the baby is conceived.
Lung cancer. There does not appear to be a relationship between low levels of folic acid and lung cancer in most people.
A type of skin cancer called melanoma. Early research shows that taking folic acid might reduce the risk of melanoma.
Helping medicines used for chest pain work longer. Some evidence suggests that taking folic acid does not help medications for chest pain (nitrates) work longer.
Cleft lip. Some research suggests that taking folic acid during pregnancy lowers the risk of left lip. However, other research shows no effect.
Pancreatic cancer. Eating more than 280 mcg of folate in the diet daily is linked to a lower risk of developing pancreatic cancer. However, other research suggests that folate intake is not linked to pancreatic cancer risk.
Nerve pain (peripheral neuropathy). There is conflicting evidence about the role of folic acid in nerve pain for people with diabetes (diabetic neuropathy). Some research suggests that taking folic acid with vitamin B6 (pyridoxine) and vitamin B12 improves some symptoms of nerve pain so that people feel happier. However, the nerves do not seem to function any better.
Cancer of the throat. Limited research suggests folic acid and folate from dietary and sources and supplements may protect against oropharyngeal cancer, a specific type of throat cancer.
Pre-eclampsia. Pre-eclampsia is marked by high blood pressure and protein in the urine during pregnancy. Limited research suggests taking folic acid supplements during pregnancy does not reduce the risk of pre-eclampsia.
Pregnancy-induced high blood pressure. Limited research suggests that taking folic acid during pregnancy does not reduce the risk of high blood pressure (gestational hypertension).
A disorder that causes a strong urge to move ones legs (restless legs syndrome; RLS). Taking folic acid seems to reduce symptoms of restless legs syndrome. Researchers are studying whether folic acid deficiency causes restless legs syndrome.
Schizophrenia. Taking a combination of folic acid and vitamin B12 may reduce some of the negative symptoms associated with schizophrenia, but only in some patients with a specific genetic make-up. In most people, folic acid does not help with these symptoms.
Sickle-cell disease. Taking folic acid might lower homocysteine levels. However, it is not known if this will benefit people with sickle-cell disease.
Alcoholism.
Liver disease.
The European Food Safety Authority (EFSA), which provides scientific advice to assist policy makers, has confirmed that clear health benefits have been established for the dietary intake of folate (vitamin B9) in contributing to:
normal blood formation;
normal homocysteine;
a normal metabolism of the immune system;
normal cell division;
normal maternal tissue growth during pregnancy;
normal amino acid synthesis;
normal psychological functions;
the reduction of tiredness and fatigue;
maintanance of normal vision;
In addition, the EFSA has confirmed that supplemental folate intake increases maternal folate status, which contributes to the reduction of the risk of neural tube defects (NTD).
Vitamin C is a water-soluble vitamin, antioxidant, and essential co-factor for collagen biosynthesis, carnitine and catecholamine metabolism, and dietary iron absorption. Humans are unable to synthesize vitamin C, so they can only obtain it through the dietary intake of fruits and vegetables. Citrus fruits, berries, tomatoes, potatoes, and green leafy vegetables are excellent sources of vitamin C. Although most vitamin C is completely absorbed in the small intestine, the percentage of absorbed vitamin C decreases as intraluminal concentrations increase. Proline residues on procollagen require vitamin C for the hydroxylation, making it necessary for the triple-helix formation of mature collagen. The lack of a stable triple-helical structure compromises the integrity of the skin, mucous membranes, blood vessels, and bone. Consequently, a deficiency in vitamin C results in scurvy, which presents with hemorrhage, hyperkeratosis, and hematological abnormalities.[rx][rx][rx][rx][rx]
Vitamin C is a vitamin found in food and used as a dietary supplement. The disease scurvy is prevented and treated with vitamin C-containing foods or dietary supplements. Evidence does not support use in the general population for the prevention of the common cold. There is, however, some evidence that regular use may shorten the length of colds. It is unclear if supplementation affects the risk of cancer, cardiovascular disease, or dementia. It may be taken by mouth or by injection.
Types of Vitamin C
The form of vitamin C most frequently used in supplements is ascorbic acid, which has a bioavailability that is equivalent to the vitamin C that naturally occurs in foods like orange juice and broccoli.
Other types of vitamin C include
sodium ascorbate (mineral ascorbate)
calcium ascorbate (mineral ascorbate)
other mineral ascorbates (it’s a long list!)
ascorbic acid with bioflavonoids
combination of vitamin C products that blend different forms
Other Common Esters or Derivates of Vitamin C
Ascorbyl Palmitate
Ascorbyl Silanol
Sodium Ascorbate
Ascorbyl Glucoside
Ascorbyl Glucosamine
Ascorbyl Methylsilanol Pectinate
Warning Signs You Are Vitamin C Deficient
Concerned you might be vitamin C deficient? Here are some signs you should be watching out for:
1. Easy Bruising
Bruising, caused when small blood vessels near the skin’s surface (known as capillaries) break and leak red blood cells, is a natural and normal response to certain injuries like a fall or a knock.
While a certain amount of bruising is to be expected, excessive or unexplained reddish-purple marks on the skin may point to a shortage of vitamin C in the diet due to weakened capillaries.
The University of Michigan Health System states that even minor deficiencies of vitamin C can lead to increased bruising. They recommend that people who bruise easily should try to increase their intake of vitamin C to see if that has an effect, as consuming more vitamin C has been found to reduce bruising in those who aren’t already getting enough.
2. Slow Wound Healing
If you notice your cuts and scrapes are slow to heal, have a closer look at your diet. As vitamin C is essential to the formation of collagen in the skin – a new connective tissue that binds a healing wound, a lack will lead to slow healing.
This link has been given recognition in medical literature since 1937 when Harvard Medical School surgeons noticed that the spontaneous breakdown of surgical wounds occurred in patients with low levels of vitamin C.
Along with playing a role in collagen formation in healing wounds, vitamin C acts as a powerful antioxidant and immune system booster – both of which encourage faster healing.
3. Swollen, Bleeding or Inflamed Gums
Oral health problems, like swollen or bleeding gums or recurrent mouth ulcers, are often linked to suboptimal levels of vitamin C. Again, collagen is important as it supports the gums. It’s estimated that gums turn over at least 20% of their collagen every day, meaning regular hits of vitamin C are vital for good teeth and gums.
Low levels of the vitamin are linked with an increased risk of gum disease which can range from simple gum inflammation to major soft tissue damage!
If not addressed, low vitamin C intake can progress and eventually lead to scurvy, a disease characterized by bleeding, oozing gums and the loss of teeth.
4. Dry or Splitting Hair and Nails
A shiny head of hair and strong nails can often be a good indicator of a balanced diet. Likewise, a lackluster mane that is dry and splitting may highlight a problem.
Because hair is a non-essential tissue, nutrients such as vitamin C are sent to more important organs and tissues first, before making their way to the hair. So if you have less than ideal levels of the vitamin, you may find your hair is suffering.
Furthermore, vitamin C is vital for the absorption of iron – a deficiency of which can cause chronic hair loss and slow hair growth, along with brittle and concave nails.
5. Red, Rough or Dry Skin
One of the first signs of scurvy is rough and dry skin caused by a lack of collagen. Low levels of vitamin C are also linked to the common but harmless skin problem keratosis pilaris – characterized by the presence of small, hard bumps on the upper arms, thighs, buttocks and face.
The good news is that simply upping your intake of vitamin C rich foods can greatly improve skin tone and texture.
Studies show that diets high in vitamin C are associated with better skin appearance and less wrinkling. Other research demonstrates that vitamin C can offset some of the damage caused by the sun’s UV rays, thanks to antioxidant activity; and may inhibit water loss from the skin, preventing dry skin.
6. Frequent Nosebleeds
Over 90% of nosebleeds come from capillaries in the front of the nose. Because adequate vitamin C intake decreases the fragility of these small blood vessels, a lack of it may cause regular nosebleeds.
If you’re experiencing these frequently, or at least more often than usual, don’t dismiss an inadequate diet as the underlying cause. If your deficiency progresses to scurvy, you can expect easily provoked bleeding from the nose and gums.
7. Poor Immune Function
The immune system, our body’s protection against infection and disease, is strongly influenced by the intake of nutrients, particularly vitamin C.
Several cells in our immune system need the vitamin to perform their tasks so naturally a deficiency leads to a reduced resistance against certain pathogens. Getting enough vitamin C means that our immune system will be in tip-top shape to reduce the risk, severity and duration of certain infectious diseases.
Despite popular opinion though, vitamin C may not ward off the common cold. While some studies say vitamin C may slightly reduce the duration of the illness (but not affect its incidence or severity), others show contradictory results.
Nevertheless, getting enough vitamin C is important for overall health, especially if you are under physical strain or already have insufficient intake of the vitamin.
8. Swollen and Painful Joints
Pain and swelling of the joints caused by inflammatory arthritis may be another sign you need to overhaul your diet.
A 2004 study, conducted in Great Britain, found that people who had low levels of vitamin C were three times more likely to develop rheumatoid arthritis than those whose diets included foods rich in the vitamin.
9. Fatigue or Depression
Fatigue and low mood are symptoms of so many illnesses, so it can be hard to identify a specific condition based on exhaustion alone. But when coupled with other symptoms, it may help to identify a lack of vitamin C.
There is a well-known link between vitamin C deficiency and psychological state, say, researchers. What’s more, studies of hospitalized patients (who often have suboptimal vitamin C levels) demonstrate a perceived improvement in mood after vitamin C supplementation – by up to 34%!
10. Unexplained Weight Gain
Too little vitamin C in the bloodstream leads to an increase in body fat and waist circumference.
In 2006, Arizona State University researchers found that the amount of vitamin C we absorb directly affects our body’s ability to use fat as a fuel source during both exercises and when at rest.
During the four week study, 20 obese men and women were put on a low-fat diet which contained 67% of the recommended daily allowance of vitamin C. They were also randomly given either a 500 mg vitamin C capsule daily or a placebo.
Assists in the formation of new collagen to restore healthy protein fibers
It provides antioxidant protection against environmental damage by defending the skin from a free radical activity which causes photo-aging.
Shields the skin from aging and DNA damage caused by pollution
Promotes skin repair and wound healing
Brightens the skin and reduces uneven skin tone
Improves hyperpigmentation by regulating melanocyte functioning
Reduces redness (erythema) and has anti-inflammatory benefits
Improves hydration levels
Promotes a youthful, healthy skin
Recommended Intakes
Table 3: Tolerable Upper Intake Levels (ULs) for Vitamin C
Age
Male
Female
Pregnancy
Lactation
0–12 months
Not possible to establish*
Not possible to establish*
1–3 years
400 mg
400 mg
4–8 years
650 mg
650 mg
9–13 years
1,200 mg
1,200 mg
14–18 years
1,800 mg
1,800 mg
1,800 mg
1,800 mg
19+ years
2,000 mg
2,000 mg
2,000 mg
2,000 mg
*Formula and food should be the only sources of vitamin C for infants.
Intake recommendations for vitamin C and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine (IOM) of the National Academies (formerly National Academy of Sciences). DRI is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. These values, which vary by age and gender, include:
Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals.
Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA.
Estimated Average Requirement (EAR): Average daily level of intake estimated to meet the requirements of 50% of healthy individuals; usually used to assess the nutrient intakes of groups of people and to plan nutritionally adequate diets for them; can also be used to assess the nutrient intakes of individuals.
Tolerable Upper Intake Level (UL): Maximum daily intake unlikely to cause adverse health effects.
Table 1 lists the current RDAs for vitamin C. The RDAs for vitamin C are based on its known physiological and antioxidant functions in white blood cells and are much higher than the amount required for protection from deficiency. For infants from birth to 12 months, the FNB established an AI for vitamin C that is equivalent to the mean intake of vitamin C in healthy, breastfed infants.
Table 1: Recommended Dietary Allowances (RDAs) for Vitamin C
Age
Male
Female
Pregnancy
Lactation
0–6 months
40 mg*
40 mg*
7–12 months
50 mg*
50 mg*
1–3 years
15 mg
15 mg
4–8 years
25 mg
25 mg
9–13 years
45 mg
45 mg
14–18 years
75 mg
65 mg
80 mg
115 mg
19+ years
90 mg
75 mg
85 mg
120 mg
Smokers
Individuals who smoke require 35 mg/day
more vitamin C than nonsmokers.
* Adequate Intake (AI)
Sources of Vitamin C
Food
Fruits and vegetables are the best sources of vitamin C. Citrus fruits, tomatoes, and tomato juice, and potatoes are major contributors of vitamin C to the American diet. Other good food sources include red and green peppers, kiwifruit, broccoli, strawberries, Brussels sprouts, and cantaloupe. Although vitamin C is not naturally present in grains, it is added to some fortified breakfast cereals. The vitamin C content of food may be reduced by prolonged storage and by cooking because ascorbic acid is water-soluble and is destroyed by heat. Steaming or microwaving may lessen cooking losses. Fortunately, many of the best food sources of vitamin C, such as fruits and vegetables, are usually consumed raw. Consuming five varied servings of fruits and vegetables a day can provide more than 200 mg of vitamin C.
Table 2: Selected Food Sources of Vitamin C
Food
Milligrams (mg) per serving
Percent (%) DV*
Red pepper, sweet, raw, ½ cup
95
158
Orange juice, ¾ cup
93
155
Orange, 1 medium
70
117
Grapefruit juice, ¾ cup
70
117
Kiwifruit, 1 medium
64
107
Green pepper, sweet, raw, ½ cup
60
100
Broccoli, cooked, ½ cup
51
85
Strawberries, fresh, sliced, ½ cup
49
82
Brussels sprouts, cooked, ½ cup
48
80
Grapefruit, ½ medium
39
65
Broccoli, raw, ½ cup
39
65
Tomato juice, ¾ cup
33
55
Cantaloupe, ½ cup
29
48
Cabbage, cooked, ½ cup
28
47
Cauliflower, raw, ½ cup
26
43
Potato, baked, 1 medium
17
28
Tomato, raw, 1 medium
17
28
Spinach, cooked, ½ cup
9
15
Green peas, frozen, cooked, ½ cup
8
13
*DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration (FDA) to help consumers compare the nutrient contents of products within the context of a total diet. The DV for vitamin C is 60 mg for adults and children aged 4 and older. The FDA requires all food labels to list the percent DV for vitamin C. Foods providing 20% or more of the DV are considered to be high sources of a nutrient.
The U.S. Department of Agriculture’s (USDA’s) Nutrient Database Web site lists the nutrient content of many foods and provides a comprehensive list of foods containing vitamin C arranged by nutrient content and by food name.
Health Benefit of Vitamin C
Likely Effective for
Iron absorption – Administering vitamin C along with iron can increase how much iron the body absorbs in adults and children.
A genetic disorder in newborns called tyrosinemia – Taking vitamin C by mouth or as a shot improves a genetic disorder in newborns in which blood levels of the amino acid tyrosine are too high.
Possibly Effective for
Age-related vision loss (age-related macular degeneration; AMD) – Taking vitamin C, vitamin E, beta-carotene, and zinc helps prevent AMD from becoming worse in people at high risk for developing advanced AMD. It’s too soon to know if the combination helps people at lower risk for developing advanced AMD. Also, it’s too soon to known if vitamin C helps prevents AMD.
Increasing protein in the urine (albuminuria) – Taking vitamin C plus vitamin E can reduce protein in the urine in people with diabetes.
Irregular heartbeat (atrial fibrillation) – Taking vitamin C before and for a few days after heart surgery helps prevent irregular heartbeat after heart surgery.
For emptying the colon before a colonoscopy – Before a person undergoes a colonoscopy, the person must make sure that their colon is empty. This emptying is called bowel preparation. Some bowel preparation involves drinking 4 liters of medicated fluid. If vitamin C is included in the medicated fluid, the person only needs to drink 2 liters. This makes people more likely to follow through with the emptying procedure. Also fewer side effects occur. A specific medicated fluid containing vitamin C has been approved by the U.S. Food and Drug Administration (FDA) for bowel preparation.
Common cold – There is some controversy about the effectiveness of vitamin C for treating the common cold. However, most research shows that taking 1-3 grams of vitamin C might shorten the course of the cold by 1 to 1.5 days. Taking vitamin C does not appear to prevent colds.
A chronic pain condition called complex regional pain syndrome – Taking vitamin C after surgery or injury to the arm or leg seems to prevent complex regional pain syndrome from developing.
Redness (erythema) after cosmetic skin procedures – Using a skin cream containing vitamin C might decrease skin redness following laser resurfacing for scar and wrinkle removal.
Upper airway infections caused by heavy exercise – Using vitamin C before heavy physical exercise, such as a marathon, might prevent upper airway infections that can occur after heavy exercise.
Stomach inflammation (gastritis) – Some medicine used to treat H. pylori infection can worsen stomach inflammation. Taking vitamin C along with one of these medicines called omeprazole might decrease this side effect.
Gout – Higher intake of vitamin C from the diet is linked to a lower risk of gout in men. But vitamin C doesn’t help treat gout.
Worsening of stomach inflammation caused by medicine used to treat H – pylori infection. Some medications used to treat H. pylori infection can worsen stomach inflammation. Taking vitamin C along with one of these medicines called omeprazole might decrease this side effect.
Abnormal breakdown of red blood cells (hemolytic anemia) – Taking vitamin C supplements might help manage anemia in people undergoing dialysis.
High blood pressure – Taking vitamin C along with medicine to lower blood pressure helps lower systolic blood pressure (the top number in a blood pressure reading) by a small amount. But it does not seem to lower diastolic pressure (the bottom number). Taking vitamin C does not seem to lower blood pressure when taken without medicine to lower blood pressure.
High cholesterol – Taking vitamin C might reduce low-density lipoprotein (LDL or “bad”) cholesterol in people with high cholesterol.
Lead poisoning – Consuming vitamin C in the diet seems to lower blood levels of lead.
Helping medicines used for chest pain work longer – In some people who take medicines for chest pain, the body develops tolerance and the medicines stop working as well. Taking vitamin C seems to help these medicines, such as nitroglycerine, work for longer.
Osteoarthritis – Taking vitamin C from dietary sources or from calcium ascorbate supplements seems to prevent cartilage loss and worsening of symptoms in people with osteoarthritis.
Physical performance – Eating more vitamin C as part of the diet might improve physical performance and muscle strength in older people. Also, taking vitamin C supplements might improve oxygen intake during exercise in teenage boys. However, taking vitamin C with vitamin E does not seem to improve muscle strength in older men also doing a strength training program.
Sunburn – Taking vitamin C by mouth or applying it to the skin along with vitamin E might prevent sunburn. But taking vitamin C alone does not prevent sunburn.
Wrinkled skin – Skin creams containing vitamin C seem to improve the appearance of wrinkled skin.
Possibly Ineffective for
Bronchitis – Taking vitamin C by mouth does not seem to have any effect on bronchitis.
Asthma – Some people with asthma have low vitamin C levels in their blood. But taking vitamin C does not seem to reduce the chance of getting asthma or improve asthma symptoms in people who already have asthma.
Hardening of the arteries (atherosclerosis) – Higher intake of vitamin C as part of the diet is not linked with a reduced risk of atherosclerosis. Also, taking vitamin C supplements does not seem to prevent atherosclerosis from becoming worse in most people with this condition.
Bladder cancer – Taking vitamin C supplements does not seem to prevent bladder cancer or reduce bladder cancer-related deaths in men.
Colon cancer – Higher intake of vitamin C from food or supplements is not linked with a lower risk of cancer in the colon or rectum.
Fracture – Taking vitamin C does not seem to improve function, symptoms, or healing rates in people with a wrist fracture.
Ulcers caused by a bacterium called Helicobacter pylori (H. pylori) – Taking vitamin C along with medicines used to treat H. pylori infection doesn’t seem to get rid of H. pylori better than taking the medicines alone.
Inherited nerve damage (hereditary motor and sensory neuropathy) – Charcot-Marie-Tooth disease is a group of inherited disorders that cause nerve damage. Taking vitamin C does not seem to prevent nerve damage from becoming worse in people with this condition.
Eye damage associated with a medicine called interferon – Taking vitamin C by mouth does not seem to prevent eye damage in people receiving interferon therapy for liver disease.
Leukemia – Taking vitamin C does not seem to prevent leukemia or death due to leukemia in men.
Lung cancer – Taking vitamin C, alone or with vitamin E, does not seem to prevent lung cancer or death due to lung cancer.
Melanoma – Taking vitamin C, alone or with vitamin E, does not prevent melanoma or death due to melanoma.
The overall risk of death – High blood levels of vitamin C have been linked with a reduced risk of death from any cause. But taking vitamin C supplements along with other antioxidants does not seem to prevent death.
Pancreatic cancer – Taking vitamin C together with beta-carotene plus vitamin E does not prevent pancreatic cancer.
High blood pressure during pregnancy (pre-eclampsia) – Most research shows that taking vitamin C with vitamin E does not prevent high blood pressure during pregnancy.
Prostate cancer – Taking vitamin C supplements does not seem to prevent prostate cancer.
Skin problems related to radiation cancer treatments – Applying a vitamin C solution to the skin does not prevent skin problems caused by radiation treatments.
Insufficient Evidence for
Hay fever – Using nasal spray containing vitamin C seems to improve nasal symptoms in people with allergies that last all year. Taking vitamin C by mouth might block histamine in people with seasonal allergies. But results are conflicting.
Alzheimer’s disease – Higher intake of vitamin C from food is linked with a reduced risk of Alzheimer’s disease.
Amyotrophic lateral sclerosis (ALS, Lou Gehrig’s disease) – Higher intake of vitamin C from food or supplements is not linked with a reduced risk of ALS.
Stomach damage caused by aspirin – Taking vitamin C might prevent stomach damage caused by aspirin.
A condition associated with an increased risk for developing allergic reactions (atopic disease) – Higher intake of vitamin C is not linked with a lower risk of eczema, wheezing, food allergies, or allergic sensitization.
Attention deficit-hyperactivity disorder (ADHD) – Taking high doses of vitamins, including vitamin C, does not seem to reduce ADHD symptoms. But taking lower doses of vitamin C along with flaxseed oil might improve some symptoms, such as restlessness and self-control.
Autism – Early research shows that taking vitamin C might reduce the severity of autism symptoms in children.
Breast cancer – It’s too soon to know if a higher intake of vitamin C from food helps prevent breast cancer from developing. But a higher intake of vitamin C from food seems to be linked with a reduced risk of death in people diagnosed with breast cancer. Also, taking vitamin C supplements after being diagnosed with breast cancer seems to help reduce the risk of dying from breast cancer.
Burns – Early research suggests that receiving a vitamin C infusion within the first 24 hours of severe burns reduces wound swelling.
Cancer – Higher intake of vitamin C from food is linked with a lower risk of developing cancer. But taking vitamin C supplements doesn’t seem to prevent cancer. In people diagnosed with advanced cancer, taking large doses (10 grams) of vitamin C by mouth doesn’t seem to improve survival or prevent cancer from getting worse. But high doses of vitamin C might increase survival when given by IV.
Hardening of the arteries after heart transplant – Early research shows that taking vitamin C and vitamin E for a year after a heart transplant helps prevent hardening of the arteries.
Heart disease – Research on the use of vitamin C for heart disease is controversial. More research on the use of vitamin C supplements for preventing heart disease is needed. But increasing intake of vitamin C from food might provide some benefit.
Cataracts – Higher intake of vitamin C from food is linked with a lower risk of developing cataracts. Some early research shows that people who take supplements containing vitamin C for at least 10 years have a lower risk of developing cataracts. But taking supplements containing vitamin C for less time doesn’t seem to help.
Cervical cancer – Some early research suggests that taking vitamin C reduces the risk of cervical cancer.
Side effects caused by chemotherapy – Early research suggests that higher intake of vitamin C from food is linked with fewer chemotherapy side effects in children being treated for leukemia.
Damage to the colon due to radiation exposure (chronic radiation proctitis) – Early research suggests that taking vitamin C plus vitamin E might improve some symptoms of chronic radiation proctitis.
Kidney problems caused by dyes used during some X-ray exams – Some research shows that taking vitamin C before and after receiving a contrast agent helps reduce the risk of developing kidney damage. But other research shows that it doesn’t work.
Dental plaque – Chewing gum containing vitamin C appears to reduce dental plaque.
Depression – Early research shows that taking vitamin C along with the antidepressant drug fluoxetine reduces depression symptoms in children and teens better than fluoxetine alone. But taking vitamin C along with the antidepressant drug citalopram does not reduce depression symptoms in adults better than citalopram alone.
Diabetes –Taking vitamin C supplements might improve blood sugar control in people with diabetes. But the results are conflicting. Higher intake of vitamin C from food isn’t linked with a lower risk of developing diabetes.
Damage to the heart caused by the drug doxorubicin – Early research shows that taking vitamin C, vitamin E, and N-acetyl cysteine may reduce heart damage caused by the drug doxorubicin.
Cancer of the lining of the uterus (endometrial cancer) – Higher intake of vitamin C from food might be linked with a lower risk of endometrial cancer. But conflicting results exist.
Cancer of the esophagus – Taking vitamin C along with beta-carotene plus vitamin E does not reduce the risk of developing esophageal cancer. But a higher intake of vitamin C from food is linked with a lower risk of esophageal cancer.
Asthma caused by exercise – Taking vitamin C might prevent asthma caused by exercise.
Gallbladder disease – Taking vitamin C might help to prevent gallbladder disease in women but not men.
Stomach cancer – Higher intake of vitamin C from food is not linked with a lower risk of stomach cancer in most research. Also, taking vitamin C along with other antioxidants doesn’t seem to prevent stomach cancer. But taking vitamin C supplements might prevent precancerous sores in the stomach from progressing to cancer in people at high risk. This includes people previously treated for H. pylori infection.
HIV/AIDS – Taking high or low doses of vitamin C along with other antioxidants doesn’t reduce the amount of HIV in the blood of people with HIV/AIDS.
HIV transmission – Taking vitamin C along with vitamin B and vitamin E during pregnancy and breast-feeding seems to reduce the risk of transmitting HIV to the infant.
High phosphate levels – People with kidney disease who are undergoing dialysis often have high blood phosphate levels. Giving vitamin C by IV seems to reduce phosphate levels in these people.
Hearing loss – Early research shows that vitamin C may improve hearing in people with sudden hearing loss when used with steroid therapy.
Infertility – There is early evidence that women with certain fertility problems might benefit from taking vitamin C daily.
Mental stress – Early research suggests that vitamin C might reduce blood pressure and symptoms during times of mental stress.
• Liver disease not due to alcohol use (nonalcoholic steatohepatitis, NASH) – Taking vitamin C along with vitamin E might reduce liver scarring in people with a type of liver disease called nonalcoholic steatohepatitis. But it doesn’t seem to decrease liver swelling.
Cancer that affects white blood cells (Non-Hodgkin lymphoma) – Higher intake of vitamin C from foods or supplements is linked with a lower risk of developing non-Hodgkin lymphoma in postmenopausal women.
Mouth cancer – Higher intake of vitamin C from food is linked with a lower risk of mouth cancer.
Osteoporosis – Some research shows that vitamin C might improve bone strength. But higher vitamin C blood levels in postmenopausal women have been linked to lower bone mineral densities. More information is needed on the effects of vitamin C on bone mineral density.
Ovarian cancer – Higher intake of vitamin C from food is not linked with a lower risk of ovarian cancer.
Parkinson’s disease – Higher intake of vitamin C from food is not linked with a lower risk of Parkinson’s disease.
Leg pain associated with poor blood flow (peripheral arterial disease) – Higher intake of vitamin C from food is linked with a lower risk of developing poor circulation in women but not men.
Pneumonia – Some research suggests that vitamin C might reduce the risk of pneumonia, as well as the duration of pneumonia once it develops. This effect seems greatest in those with low vitamin C levels before treatment. It’s not clear if vitamin C is beneficial in people with normal vitamin C levels.
Pain after surgery – Taking vitamin C one hour after anesthesia reduces the need for morphine after surgery. This suggests that it might reduce pain. But vitamin C doesn’t seem to improve satisfaction or the need to use the pain-relieving drug paracetamol.
Complications during pregnancy – Taking vitamin C alone during pregnancy might help prevent the amniotic sac from breaking before labor begins. But taking vitamin C with other supplements doesn’t seem to help. Also, taking vitamin C, alone or with other supplements, does not prevent many other pregnancy complications including preterm birth, miscarriage, stillbirth, and others.
Breaking of the amniotic sac before labor begins (premature rupture of membranes; PROM) – Taking vitamin C plus vitamin E starting during the second or third trimester and continuing until delivery seems to help delay delivery in pregnant women whose amniotic sacs broke early.
Bedsores (pressure ulcers) – Some research suggests that taking vitamin C does not improve wound healing in people with pressure ulcers. But other research shows that taking vitamin C reduces the size of pressure ulcers.
Restless legs syndrome – Taking vitamin C alone or in combination with vitamin E seems to reduce the severity of restless legs syndrome in people undergoing hemodialysis. But it’s not known if vitamin C is beneficial in people with restless legs syndrome that is not related to hemodialysis.
Sickle cell disease – Taking vitamin C with aged garlic extract and vitamin E might benefit people with sickle cell disease.
Stroke – Higher intake of vitamin C from food seems to be linked with a reduced risk of stroke. But conflicting results exist. Taking vitamin C supplements doesn’t seem to be linked with a reduced risk of stroke.
Bacterial infection in the nervous system (tetanus) – Taking vitamin C along with conventional treatment appears to reduce the risk of death in children with tetanus.
Urinary tract infections (UTI) – Research suggests that taking vitamin C does not prevent UTIs in older people.
The mental decline caused by reduced blood flow to the brain (vascular dementia) – Higher intake of vitamin C and vitamin E from supplements does not seem to be linked with a reduced risk of vascular dementia in Japanese-American men.
Acne
Chronic fatigue syndrome (CFS)
Constipation
Cystic fibrosis
Dental cavities
Kidney disease
Lyme disease
Tuberculosis
Wounds
Other conditions
Contraindications of Vitamin C
Vitamin C supplementation is contraindicated in blood disorders like thalassemia, G6PD deficiency, sickle cell disease, and hemochromatosis. Avoid taking supplements immediately before or following angioplasty. Diabetic patients should take vitamin C supplements with care as it raises blood sugar levels.
Vitamin C should be used cautiously in oxalate nephropathy or nephrolithiasis as acidification by ascorbic acid increases the chances of precipitation of cysteine, urate, and oxalate stones.
Dosage 0f Vitamin C
Illness
Vitamin C Dosage (mg)
Helps
Common cold
200
prevent
Cataracts
300
prevent
Coronary heart disease
400
prevent
Age-related macular degeneration
500
prevent
Gout
500
prevent
Cardiovascular disease
500
treat
Exercise-induced asthma
500
treat
Lead toxicity
1,000
treat
Sources: The Linus Pauling Institute, Mayo Clinic, and NIH
Side Effects
Adverse effects include headaches, flushing, nausea or vomiting, and dizziness (IV use). There are reports of migraine headaches with a daily dose of 6 g.
Significant amounts of vitamin C can increase the risk of kidney stones and elevate uric acid and oxalate because it acidifies the urine.
Illness
Vitamin C Dosage (mg)
Helps
Common cold
200
prevent
Cataracts
300
prevent
Coronary heart disease
400
prevent
Age-related macular degeneration
500
prevent
Gout
500
prevent
Cardiovascular disease
500
treat
Exercise-induced asthma
500
treat
Lead toxicity
1,000
treat
Sources: The Linus Pauling Institute, Mayo Clinic, and NIH
Childbirth is a process by which a child comes to the world safely. There are many conditions but natural childbirth arose in opposition to the techno-medical model of childbirth that has recently gained popularity in industrialized societies. Natural childbirth attempts to minimize medical intervention, particularly the use of anesthetic medications and surgical interventions such as episiotomies, forceps, and ventouse deliveries and cesarean sections. Natural childbirth may occur during a physician or midwife attended hospital birth, a midwife attended homebirth or unassisted birth.
Different Stages of Childbirth
The Different Stages Of Labor
Labor has 4 stages. Stage 1 lasts between 12 to 19 hours. Here, contractions get increasingly intense and more frequent and your cervix dilates to 10 cm. Stage 2 lasts between 20 minutes to 2 hours. You start pushing and deliver your baby during this stage. Stage 3 lasts 5 to 30 minutes. The placenta is delivered in this stage. Stage 4 indicates the first 2 to 3 hours after birth – time for you to rest, recover and breastfeed.
At last, after such a long wait your due date is approaching. Along with the excitement and sense of anticipation, you must also be feeling a little apprehension. If you are preparing for delivery and looking for information on what the birthing process is going to be like, we have the goods for you.
Labor has three stages, and the first 2 to 3 hours after birth is sometimes considered to be the fourth stage of labor. Let’s take a look at some signs that indicate that labor is beginning and what happens during each stage of labor.
Signs That Childbirth is Beginning
As your due date gets closer, you’ll find that your baby has moved lower and settled into your pelvis. Some women also get a burst of energy as labor approaches and feel an urge to clean or cook (an instinct called nesting). Here are some signs that indicate the start of labor:
Your contractions become stronger and come closer together.
You get lower back pain and cramps that don’t go away.
While you’re pregnant a plug of mucus blocks your cervix. A bit before labor starts, or in the early stage of labor, this plugs comes away and you have a pink or brownish jelly-like discharge. The pink or brownish color is due to the presence of blood. Don’t worry, though. It’s normal to lose a little blood during this process. However, if you start losing more blood it could be a sigh that you need medical attention. Labor starts immediately after this process for some women while it may take a few days for others.
Your water might break. This usually happens during labor but can also happen before labor begins. The water that drains out is the amniotic fluid that protects your baby. If labor doesn’t start after your water breaks, you need medical attention as your baby’s no longer protected and there is a higher risk of infection. You should also seek medical attention if you lose blood or if the water is smelly.
The birth of your baby is a special experience and every delivery is unique. But here’s a general idea of what to expect during the process of childbirth:
1. The First Stage: Onset Of Labor
The first stage begins with the onset of labor and ends when the cervix is fully opened. Your cervix needs to open about 10 cm for your baby to pass through. This is what’s called being “fully dilated.” Your water could break at any time during this stage. This is the longest stage of labor, usually lasting about 12 to 19 hours.
Stage 1 has three phases:
The first phase, known as early labor, encompasses the period from the beginning of labor till the cervix dilates to 3 cm.
The second phase, known as active labor, covers the period where the cervix dilates from 3 cm to 7 cm.
The third phase, known as transition, covers the period where the cervix dilates from 7 cm to 10 cm.
Let’s now take a look at what happens during each phase.
Early Labor Phase
Early labor generally lasts around 8 to 12 hours. During this phase, your cervix will thin and open up to 3 cms. Your contractions will usually be mild and irregular – a contraction might occur between 30 to 45 seconds, with a period ranging from 5 to 30 minutes between each contraction. Your contractions will become increasingly more frequent and stronger during the course of this phase.
What Should You Do?
Try and relax during this phase. It’s not yet time to go to the hospital.
If your labor starts at night, try to get some sleep. If it happens during the day do gentle, simple activities around the house.
Get something to eat and drink. You’ll need all the energy you can muster soon.
Your birth support partner can help you time your contractions and keep you calm.
Active Labor Phase
The active labor phase usually lasts around 3 to 5 hours. Your cervix will dilate to 7 cms during this time. Your contractions will be longer, closer, and more intense. They may last around 45 to 60 seconds with a 3- to 5-minute gap in between.
What Should You Do?
It time to go to the hospital now.
Practicing breathing techniques or relaxation exercises in between contractions can be helpful.
It’s a good idea to switch positions frequently during this phase.
Walking around or having a warm bath may also be helpful.
Keep drinking sufficient water and urinate often.
Your birth support person can track your contraction and offer encouragement. He or she can also help you feel more comfortable (by propping up pillows, distracting you with music etc.) and massage your lower back and abdomen.
Transition Phase
Though this is the shortest phase of the first stage of labor, it is also the most challenging. This phase could last between 30 minutes to 2 hours and your cervix will dilate to 10 cm at the end of this phase. Contractions can be long and intense and may even overlap. A typical contraction may last around 60 to 90 seconds and you may get a gap of 30 seconds to 2 minutes in between. You could experience chills, hot flashes, nausea, or gas during this period.
What Should You Do?
This is a difficult phase and you might need quite a bit of the support at this time.
Focus on your breathing and try to get through it one contraction at a time.
When you feel the urge to push, let your doctor know.
Your birth support partner can offer much-needed encouragement and remind you to relax between contractions during this phase.
2. The Second Stage: Pushing And Delivery
The second stage is when you start pushing and deliver your baby. This generally lasts between 20 minutes to 2 hours. Contractions may last between 45 to 90 seconds with a 3- to 5-minute gap in between. Sometimes, your doctor may make a small cut (known as episiotomy) to make your vaginal opening larger in order to quicken delivery or avoid a tear.
What Should You Do?
Choose a position that you feel comfortable giving birth in. Women give birth in various positions like sitting, kneeling, squatting, or lying back. An upright position like squatting may have some benefits like reducing the duration of this stage. But concentrate on choosing a position that you find easy.
You will need to use all your energy to push forcefully during contractions and rest in between.
When your baby’s head is about to come out, your doctor may ask you not to push but to blow short breaths out your mouth. This is to give the skin and muscles of the area between your anus and vagina time to stretch. It also allows your baby’s head to be born gently and slowly.
After the baby’s head is out, the rest of the baby is generally born in the next couple of contractions. You can expect to hold your baby against you almost immediately.
Your birth support partner can help you relax, encourage you, and give you ice chips to help you through this phase
3. The Third Stage: Out Comes The Placenta
The third stage is the shortest and it involves the delivery of the placenta. This stage can take anywhere between 5 minutes to half an hour. Your doctor may massage your uterus and gently pull the umbilical cord, which will help deliver the placenta. You could experience some shivering after the placenta is delivered, but this is normal and not a cause for concern.
4. The Fourth Stage: Post-Birth Phase
The first 2 to 3 hours after birth make up the fourth stage of labor. You might experience fatigue, chills, tremors, and some discomfort during this stage. You could also feel dizzy if you try to stand up. But the hard work of labor is over and you can now enjoy your baby.
What Should You Do?
Try to get some rest to recover from all the hard work that went into labor.
You can take a warm shower if you wish, but make sure that someone is nearby to help if you feel weak or dizzy.
Placing an ice pack covered with a towel between your legs can help reduce swelling.
Breastfeed your baby and give her plenty of skin to skin contact. Placing your baby against your skin is the best way of keeping her warm and calm.
Have some fluids and something to eat if you feel hungry.
Useful Pregnancy Tips For Normal Delivery
Pregnancy Tips For Normal Delivery
Maintain a daily exercise routine of light to mild exercise, focusing more on kegel and deep breathing exercises, during your entire pregnancy. Keep a tab on your weight, by drinking copious amounts of water and filling up on fresh fruits, leafy greens. Engage in regular perineal massage after the completion of 7th month to ease stress levels and tackle labor efficiently.
During pregnancy, avoid thinking too much about your probability of having a normal delivery or a cesarean section. Try to stay away from too much planning because it is likely that you won’t be able to stick to it.
About 85% of pregnant women do have a fair chance of delivering vaginally, but only about 65% are successful. If you are one of those women who want to have a baby the normal way take a look at some useful pregnancy tips for vaginal delivery.
10 Pregnancy Tips For Vaginal Delivery
1. Regular Exercises
Doing mild exercises throughout pregnancy can help you build not only good stamina but also keep you active during this span. Regular exercises with vitality can strengthen the pelvic muscles. Kegel exercises are particularly helpful. The strong thigh muscles are helpful in combating the stress of labor pains.1
Pelvic stretches and tilts, deep squats, aquatic pregnancy exercises can open your hips and make your pelvic muscles stronger to enable you to have a normal delivery. Keep in mind to exercise under the supervision of an expert as wrongly done exercises can do harm to you and your baby.
You can also try prenatal yoga, which increases flexibility and will help you have breathing control. Yoga will also keep you relaxed and calm.
2. Watch Your Diet
Eat properly and eat rightly. You must keep a tab on your weight, too much weight gain can interfere with your chances of having a normal delivery.
Many times women put on a lot of weight on the excuse of pregnancy by eating fatty foods. Keep your cravings under control. Nutrition is important not only for your health but also for the health and development of your baby.
Food is essential for making you strong and for nourishing your body. A healthy and well-nourished mother is capable of facing the challenges of labor easily and more comfortably. Drink a lot of water and eat a lot of green fresh vegetables and fruits.
3. Keep Away Your Stress
Stay away from stress, anxiety, and too much contemplation. Your current phase requires you to stay cool and composed. There are times when avoiding stress is quite difficult to still to try to be calm.
Read good books about parenting and be in the company of good, friendly people. Steer yourself clear from situations and people that make you anxious or cause you discomfort.
Remember maternal stress can adversely affect the baby’s health and wellness.
4. Practice Breathing Exercises
Breathing exercises are very important as during the process of delivery you need to hold breath from time to time. Proper and sufficient oxygen supply is mandatory for enhancing the growth of the baby.
So, practice meditation and deep breathing exercises regularly. This way you will inch a step closer to having a normal delivery.
5. Educate Yourself
Educate yourself well about the process of delivery and labor. Get information on natural pain management techniques like breathing, relaxation, and other natural labor management coping techniques.
You can ask your doctor to tell you more about delivery or can join prenatal classes to enhance your knowledge about the phenomenon of giving birth.
Prenatal classes that cover labor pain management techniques would be particularly helpful. You can also research online, read good books, and have a confident mind.
6. Regular Massages
You need to have regular massages done after the seventh month of pregnancy. It reduces stress, helps an expectant mother tackle labor efficiently and mitigates joint pains and muscular tensions.
7. Find The Right Support People For Labour
It’s very important to have the right to support people at your birth if you want a drug-free birth.
You might think it will be all wonderful having mom, sisters and all the family to be there to watch your baby be born, but are they going to encourage you and help you get to where you want to go?
Or are they going to collapse into a bawling heap and tell you how awful it all is and a little pain relief can’t hurt? The support people in your labor are more important than you think.
If your support people start to panic, you are more likely to panic too – and that’s when you might be looking for the next exit to the epidural freeway. Be sure your support people are strong because they are going to have to be there for you and not for them.
8. Move Around! Don’t Sit Still!
When you arrive at the hospital, keep moving to stay comfortable. If you’re strapped to a monitor, you’re bound to the bed. Ask ahead of time if your hospital allows intermittent fetal monitoring, which gives you the freedom to get up.
Walk and stretch, sit on a birthing ball, and hop in and out of the birthing tub if it’s available. Use a combo of gravity and hip movement to help the baby come down.
Movement of the hips, belly dancing, hula dancing, squatting, rocking, pelvic tilts and such help maneuver the baby down and through to find the easiest path out of the mother.
9. Visualize The Finish Line
The transition phase, when the uterus is dilating from 7 to 10 centimeters and then it’s time to push, is when most moms-to-be want to call it quits.
Make sure your partner knows you’ll need a good pep talk at this stage. This is absolutely normal, your body is doing what it’s supposed to do, it’s almost over.
Also, try to have an open mind. If you reach the point where natural labor is just not happening, you have to accept what’s good for your child. The goal is a healthy baby.
10. Trust Your Body
Women have been birthing since the beginning of time and while mortality rates during childbirth are much lower than that of our ancestors, their instinctive ways of birthing is much more efficient and less painful than what we commonly experience on our backs, in a bed, at the convenience of doctors.
Have confidence and faith in your amazing birthing body, follow your instincts in labor and allow your body and your baby to do exactly what they know to do.
Labour /Child Birth is the ending of a pregnancy by one or more babies leaving a woman’s uterus by vaginal passage or Caesarean section. In 2015, there were about 135 million births globally. About 15 million were born before 37 weeks of gestation, while between 3 and 12% were born after 42 weeks. In the developed world most deliveries occur in hospital,[8][9] while in the developing world most births take place at home with the support of a traditional birth attendant.
The most common way of childbirth is a vaginal delivery.It involves three stages of labour: the shortening and opening of the cervix, descent and birth of the baby, and the delivery of the placenta. The first stage typically lasts twelve to nineteen hours, the second stage twenty minutes to two hours, and the third stage five to thirty minutes. The first stage begins with crampy abdominal or back pains that last around half a minute and occur every ten to thirty minutes. The crampy pains become stronger and closer together over time. During the second stage pushing with contractions may occur. In the third stage delayed clamping of the umbilical cord is generally recommended. A number of methods can help with pain such as relaxation techniques, opioids, and spinal blocks.
Safe And Natural Labour /Child Birth Control Methods
The American Congress of Obstetricians and Gynecologists (ACOG) guidelines recommend a full evaluation of the maternal-fetal status, the status of the cervix, and at least a 39 completed weeks (full term) of gestation for optimal health of the newborn when considering elective induction of labour. Per these guidelines, the following conditions may be an indication for induction, including:
Abruptio placentae
Chorioamnionitis
Fetal compromise such as isoimmunization leading to hemolytic disease of the newborn or oligohydramnios
Fetal demise
Gestational hypertension
Maternal conditions such as gestational diabetes or chronic kidney disease
Preeclampsia or eclampsia
Premature rupture of membranes
Postterm pregnancy
Induction is also considered for logistical reasons, such as the distance from hospital or psychosocial conditions, but in these instances gestational age confirmation must be done, and the maturity of the fetal lung must be confirmed by testing. The ACOG also note that contraindications for induced labour are the same as for spontaneous vaginal delivery, including vasa previa, complete placenta praevia, umbilical cord prolapse or active genital herpes simplex infection.
Safe And Natural Labour /Child Birth-Control Methods
Temperature and cervical secretion-monitoring method
Calendar-based method
Using fertility tests
Lactational amenorrhoea method (LAM)
Outercourse
Natural birth-control methods can be effective if used accurately. A popular option is to keep track of changes in your body temperature and cervical fluid while tracking your monthly cycle. Using fertility tests can also be useful. Lactational amenorrhoea, outercourse, and herbal medications also help.
Birth-control pills are constantly in the news with various side effects from their prolonged use coming to light every single day. Where does that leave you if you’re not looking to conceive? Natural birth-control methods have been used for generations, yet not all of them are equally effective. So which ones should you opt for?
Should You Even Consider Natural Labour /Child Birth Control Methods?
While natural birth-control methods might not be as effective as commonly used artificial methods like male or female condoms or birth-control pills. But, if any of the modern Fertility Awareness-Based Methods (FABM) are followed accurately, the protection can be as much as 97–99 percent.
What you should know, however, is that if you make an error in your calculations or take a misstep, the protection that may have been 98–99 percent drops to just about 75 percent or lower, depending on how far off your accuracy is.2 While protection in the high 90s is good enough for most, if you need to improve the effectiveness of the method, be doubly sure to follow all the rules. Besides this, you might want to consider a different approach if
You have a medical condition that could pose a risk to the child if you got pregnant
The above-mentioned factors could lower the effectivity of this form of contraception or affect your health adversely. Besides, do remember, while these natural birth-control methods might protect you against conceiving, they do not deflect sexually transmitted diseases. So if you are not in an exclusive monogamous sexual relationship, or are concerned that either of you might be carrying an infection of some kind, you would do well to also use a barrier like a condom.
1. Temperature And Cervical Secretion-Monitoring Method
These options are examples of FABM. The temperature method involves the use of a basal thermometer which indicates a small rise in body temperature after ovulation. Do note that ear and nose thermometers are not accurate enough for this method. The method involves taking your temperature every morning, ideally at the same time, before you get out of bed and especially before you eat or drink anything.
For 3 days in a row, your temperature might be higher than all of the previous 6 days. This increase in temperature is very small, generally around 0.2 C (0.4 F). It’s likely that at this point, you’re no longer fertile.
The cervical secretion-monitoring method, meanwhile, involves keeping a check on the change in the amount and texture of your cervical secretions (cervical mucus) during different times in your menstrual cycle. To do this, gently insert your middle finger into your vagina, pushing it up to around your middle knuckle.
For the first few days after your period, you might notice that your vagina is dry and doesn’t produce a lot of mucus. As your hormonal levels rise to prepare for ovulation, it might turn moist, sticky, white and creamy. This indicates the start of the fertile period of your menstrual cycle. Immediately after ovulation, your cervical mucus is likely to get wetter, clearer, and slippery, resembling the texture of a raw egg white. Eventually, your mucus should return to being thicker and more sticky. 3 days post this, you should no longer be fertile.
Combining these two methods has been found to prevent pregnancy. In fact, one study found that it is an effective option for family planning/birth control. During the fertile days, intercourse must be done with some form of birth control or protection. Alternatively, abstinence may be practiced for those days. Of the women enrolled in the study, only 1.8 in every 100 became pregnant over a 13-cycle window. Here, too, the researchers emphasized that effectiveness depends on adhering to the guidelines for observations/tracking of these parameters.
2. Calendar-Based Method
You could also determine your most fertile days by tracking your menstrual cycle closely. The modern FABM way of doing this is called the Standard Days Method. If you’re someone with a cycle of 26–32 days, this calendar-based method may work for you. What it does is to spot the fertile window, occurring between days 8 and 19 of your cycle. This generally refers to 7 days before your ovulation and 2 days after, when you’re most likely to get pregnant. Once you have zeroed in on the exact dates, you need to either abstain from having sex on these days or use a suitable contraceptive. In one study of the method across the Philippines, Peru, and Bolivia over 13 cycles, researchers found that when used correctly, the method resulted in only a 4.75 percent cumulative probability of conception. It could thus be a sound natural alternative.5
The only caveat here for this method is that if a woman’s cycle is irregular or unpredictable, the accuracy and therefore effectiveness of natural birth-control drops. As such, you could combine this method with the temperature and cervical secretion-monitoring method, both of which are generally considered more effective, as seen also in the pregnancy rates in the studies mentioned.
3. Using Fertility Tests
This approach relies on easy-to-use home kits that generally contain a device that can tell you what your most fertile days are. This is done by measuring the levels of luteinizing hormone or estrogen metabolites in your urine and requires you to record the beginning of her cycle, i.e the first day of your menstruation and continue recording each day until the 6th day when you will be asked to take a urine test first thing in the morning. Depending on the brand of the test, you might have to do a test for 10–20 days. The device will then indicate when your fertility rate is low, high, and at its peak. It will also, on an average, give you a 2-5 day warning before the actual day of ovulation. During this period, it is recommended that you use protection or abstain from sexual intercourse. This method is simple and the use of calibrated measuring tools makes its accuracy good. In general, it is said to result in a 1–3 percent pregnancy rate over a year-long window, when used correctly.
That said, besides being expensive, the warning period might not be enough to prevent pregnancy and doesn’t look at the status of cervical mucus. Hence, it might be ideal to combine this method with the cervical secretion-monitoring method monitoring method to fine-tune your observations. It may also be supplemented by basal body temperature measurement to improve accuracy.8 One study even noted a pregnancy rate of 2.1 percent for every 12 months of correct use of this method. That translates to effective protection 97–99 percent of the time, and 97.9 percent protection in the case of the study.9
4. Lactational Amenorrhoea Method (LAM)
This method applies to breastfeeding mothers who breastfeed exclusively (only feed your baby breast milk) and have babies that are under 6 months of age. Post-childbirth, exclusive breastfeeding leads to the lack of menstruation in women. Both these factors lead to temporary infertility that some women use as a form of contraception.
When used correctly and consistently, less than 2 in 100 women who use this method will get pregnant in the first 6 months. However, do take care to use the method correctly and be sure not to feed your baby other foods because this may reduce your lactation. That said, it’s important to note that this method becomes unreliable when
Breastmilk is substituted with other foods or liquids
Your baby turns 6 months old
You have a period
Additionally, it is possible for you to get pregnant before your periods start again since women generally ovulate 2 weeks before their period.10
5. Outercourse
This form of contraception refers to lovemaking without penetration into a vagina or anus. Partners can be sexual, intimate, and even orgasmic without engaging in intercourse. Hence, no semen, vaginal fluids, or blood is shared between them, making it an effective way to prevent pregnancy.11
6. Herbal Medications
Herbs are also believed to be highly effective at reducing fertility in order to naturally and safely prevent pregnancy. Some herbs may affect the ovary, while others act upon the uterus, affect normal hormone production, or block certain hormones. Some herbs also have the ability to interfere with implantation and are useful as an emergency contraceptive. A few of these herbs are as follows:
Queen Anne’s Lace (Daucus carota): Also known as wild carrot, Queen Anne’s Lace can be taken on as needed basis, making it useful for women who have sex infrequently. Research suggests that terpenoids in the seed block crucial progesterone synthesis in pregnant animals, which disrupts the implantation process, or if a fertilized egg has implanted for only a short period, it will cause the egg to be released without developing.12 To try this method, eat 1 teaspoon of these seeds within 8 hours of unprotected intercourse and continue the course for a week. Be sure to thoroughly chew the seeds for maximum effectiveness.
Neem: Neem can be used in three different forms for birth control -neem leaves, neem oil, and neem leaf extract. Neem oil kills sperm in the vagina within 30 seconds and remains active for five hours. It causes no irritation or discomfort like the chemical based spermicidal foams do. In addition, neem oil acts as a lubricant and it may also offer some protection from vaginal and sexually transmitted diseases. To try this method, use a water-based vaginal lubricant with ten percent neem oil added. Apply before intercourse to give the surface of the vaginal wall time to become coated with the material. If there was no neem lubricant available during intercourse, applying the lubricant soon after intercourse will prevent implantation.13
Papaya: Unripe papaya has been used traditionally to prevent or terminate pregnancies. A ripe papaya cannot be used as it loses the phytochemicals that interfere with hormones. The papaya seeds can kill sperms, hence a daily intake of papaya seeds can decrease the sperm count in a healthy male. According to research, the seeds of Carica papaya have been experimentally found to inhibit spermatogenesis in males.14
There are several other herbs, which have partially or in combination with other natural birth control methods, reported to be similarly effective as a contraceptive. However, we have omitted them merely due to the lack of potential research regarding their efficacy. Do not continue using a herb if you start developing problems and also never increase the dosage of herbs more than the required amount. You should never disregard verified advice from a healthcare provider, regarding safety and efficacy of these natural birth control methods.
7. The Pull-Out Method
Also known as coitus interruptus or withdrawal, the pull-out method is one in which the man withdraws or pulls out his penis from his partner’s vagina before ejaculating. This method requires the man to keep his semen away from the woman’s genitalia while ejaculating. This method prevents fertilization by hindering any contact between the sperm and the egg.
While this is an easy, low-cost method, it relies heavily on the consistency and self-control of the man, lack of which can lead to pregnancy. In addition to this, the method does not take into account pre-ejaculatory fluid which doesn’t usually contain sperm but can sometimes contain a few. It might also pick up any sperm left in the urethra from a previous ejaculation. Hence, it is considered to be one of the least effective natural birth-control methods because it depends on the man’s ability to withdraw before he ejaculates. However, its effectivity goes up to 73 percent if used correctly.
Must-Know Facts About Episiotomy Assocciate Labour
Not all mothers need an episiotomy, a surgical incision that widens the vaginal opening. It is only necessary if the baby is large, in an abnormal position, or is not handling the last minutes of labor well. While the recovery may take upto a month, having warm sitz baths and keeping the area clean, dry can help ensure safe episiotomy aftercare and healing.
If you’re a mother-to-be, you might need an episiotomy. This is a minor cut that widens the vaginal opening to encourage a smooth delivery. But it can be scary if you’re not sure what to expect! Here are nine things every expectant mother should know about an episiotomy.
1. Episiotomy Is Not A Routine Procedure Anymore
Once upon a time, an episiotomy was a routine part of giving birth. But now, the procedure isn’t recommended for everyone. Your doctor will determine if you should get one or not!1 It all depends on your body and baby.
2. Only Some Cases Need One
If your baby is too big for your vaginal opening, an episiotomy may prevent painful tearing. It might also be necessary if your little one’s feet or bottom comes out first. This is an abnormal position, but an episiotomy can make the delivery easier.2 The procedure also helps deliveries that need to happen quickly or require extra instruments.
3. There Are 2 Kinds Of Episiotomies
A midline or median incision is the most common episiotomy. This is a straight vertical cut that goes from the vagina to the anus. It’s also the easiest to repair. There’s also a mediolateral incision which is a diagonal cut. It has less potential of tearing through the anus but is harder to repair. Recovery might be slightly more painful, too.
4. The Procedure Isn’t Painful
Thanks to anesthesia, you won’t feel the actual cuts. The area around the vagina will be numb. After birth, the incisions will be repaired with dissolving stitches. But feeling mild to moderate pain during recovery is perfectly normal. Your doctor will let you know how you can safely relieve the pain.
5. It’s Done Right Before Delivery
An episiotomy is done right before you give birth. When the doctor sees that the baby is about to come out, the cut will be made. It’ll be stitched up after both the baby and the placenta have been delivered.
6. There Are Some Risks
Like all surgeries, an episiotomy presents a few risks. The cut might tear even more during delivery and reach the anus. You might also lose a lot of blood during the process or the cut might become infected. But depending on the situation, the benefits of an episiotomy might outweigh these risks.
7. Recovery Takes A Month
Episiotomy recovery takes up to a month. And since the stitches dissolve, you won’t need to go back to remove them. Instead, take it easy during this time. Bathing in warm water may help you feel more comfortable. If your baby is healthy, you can take the painkillers paracetamol and ibuprofen while breastfeeding. Avoid aspirin, though.
8. Preventing Infection Is Important
Taking care of the healing cut is crucial. This will avoid infections and even more complications. After every trip to the bathroom, clean the area. You can do this by washing it with warm water. And when you empty your bowel, wipe from front to back, away from the cut.
9. Reduce Your Need For An Episiotomy
To lower your chances of needing an episiotomy, focus on making your body stronger before delivery. Kegel exercises can be a huge help.10 You can also massage the perineum, the area under your vagina. Use vegetable-based massage oil for best results.11 And don’t forget about prenatal yoga!
Don’t panic if you need an episiotomy. Your doctor can help you have a successful procedure and delivery. If you have concerns, be sure to ask questions.
Oily skin occurs when the oil glands in your skin start to produce excess oil. It’s a natural process that you cannot stop, but you can take steps to manage and care for oily skin. Oily skin can be uncomfortable and unpleasant, but by having a good skincare routine and being gentle with your skin you can ease the problem.
Oily skin is caused by over-active sebaceous glands, that produce a substance called sebum, a naturally healthy skin lubricant.When the skin produces excessive sebum, it becomes heavy and thick in texture. Oily skin is typified by shininess, blemishes and pimples. The oily-skin type is not necessarily bad, since such skin is less prone to wrinkling, or other signs of aging, because the oil helps to keep needed moisture locked into the epidermis (outermost layer of skin).
The negative aspect of the oily-skin type is that oily complexions are especially susceptible to clogged pores, blackheads, and buildup of dead skin cells on the surface of the skin.Oily skin can be sallow and rough in texture and tends to have large, clearly visible pores everywhere, except around the eyes and neck.
How To Control Oily Skin ,Tips And Natural Remedies
Managing oily skin takes extra effort, but it’s possible. Aim to manage excess sebum instead of trying to dry it out. Start with a cleansing oil to dissolve sebum, dirt, and makeup. Wash it away with an oil-free face wash that doesn’t have fragrance. Apply a face mask to soak up extra sebum, and finish with a moisturizer to avoid dryness. Honey, green tea, papaya, and clay are ideal natural ingredients for oily skin.
Living with oily skin can be a slippery slope. Using a face wash can feel totally pointless, while makeup only makes things worse. And who would want to re-apply mattifying powder every hour? To top it off, oily skin is the perfect breeding ground for acne, something no one ever wants to deal with.
Needless to say, oily skin needs special attention, and the wrong ingredients or habits will just bring on the grease. So the goal should be to control excess sebum, not get rid of it. Drying out your skin will actually encourage sebaceous glands to make more oil. Talk about a catch-22! And to balance things out and get a handle on overactive sebaceous glands here’s a few things you could do.
Wash your face twice a day
Having a good cleaning and skincare routine is the most important thing you can do to care for oily skin. Gently clean your face twice a day, morning and night, with warm water and soap, or a soapless facial cleanser. Use a gentle cleanser at first, as a harsher cleanser can actually increase oil production.
If a normal cleanser does not reduce the oiliness of your skin, consider a cleanser that includes benzoyl peroxide, salicylic acid, glycolic acid, or beta hydroxy acid.
Start with a cleanser with benzoyl peroxide. This chemical is used specifically to treat mild to moderate acne.
A chemical cleanser like this might lead to side-effects, such as drying, redness and scaling. These effects often recede after the first month of using the cleanser.
You may have to try a number of different products to see which one works best for you.
Use your hands to clean your face and do not use a washcloth or loofah. Pat your face dry afterwards — do not rub or irritate the skin.
Be mindful of what touches your face
Although the oiliness of your skin is largely genetic and the oil is produced below the surface of the skin, it’s a good idea to be mindful of what touches your skin. If you have greasy hair and it is falling over your face, some of this greasiness will be transferred to your skin.
If you have grubby hands and keep touching your face, you will be spreading the oil around.
Keep your hair and hands clean and off your face.
Wipe Your Face With A Cleansing Oil
A cleansing oil might seem like the last thing you need but it’s a game changer. It breaks down sebum, dirt, and makeup while adding moisture. It’s no wonder that it’s a staple in Korean skincare and is starting to pop up around the United States. A good option is sea buckthorn berry oil, a remedy proven to control excess sebum.1 You could also try jojoba oil which is believed to mimic sebum on the skin to “trick” sebaceous glands into producing less sebum and help keep oil levels balanced. That said, it’s important to note that there’s no scientific research to support this theory so you’d have to give it a go to see if your skin truly responds well to it.
Limit Washing Your Face To Twice A Day
Oily skin might make you want to scrub your skin clean several times a day. But it’s important to limit washing your face to twice a day and after sweating. Overdoing it will just strip away natural oils and some sebum is needed for healthy, supple skin.
Be sure to cleanse your skin after using a cleansing oil to get rid of any excess oil and gunk. Try and avoid products with salicylic acid or benzoyl peroxide. Although these ingredients fight acne, they’re also quite drying. Consider using them in spot treatments instead.3 This way, you can avoid exposing healthy skin to their harsh effects.
Use A Face Mask 2–3 Times A Week
Since oily skin is more prone to breakouts and acne, treating your skin to a face mask 2–3 times a week will unclog pores and remove trapped oil and dirt. Besides, it’s a relaxing, easy way to give your skin a pick-me-up. Better yet, a mask with oil-absorbing ingredients will handle excess sebum. Additionally, look for face masks that feature hyaluronic acid or alpha hydroxy acid (AHA) for extra oil-banishing properties. Here are a two popular oil-busting face mask ingredients if you’re planning on doing things yourself.
Papaya: This will give you a natural glow. A 2014 study in the Indian Journal of Pharmaceutical Science found that papaya combats both oil and bacteria. It’ll also reduce melanin, the natural pigment behind hyperpigmentation, but won’t leave your skin dry.4 Simply mash up fresh fruit and use as a mask or cleanser.
Clay: Clay is amazing for absorbing extra oil.5 Many commercial products have it, but save your cash and buy cosmetic clay powder from the health store. Mix it with papaya for an instant oil-absorbing mask. However, wear it only for 15 minutes and don’t let it dry out completely.
Egg whites and lemon: A folk remedy for oily skin, lemon and egg whites are believed to tighten pores. To give them a go, combine 1 egg white with 1 teaspoon freshly-squeezed lemon juice and use it as a mask. You could add a cup of mashed strawberries to the mix for a dose of vitamin C. If you’ve got a lemon allergy or sensitive skin, it might be a good idea to skip this remedy.
Always do a patch test when using a new face mask. Just apply a small amount to your neck, back of the ear, or inner wrist. Wait a few hours and look for any irritation..
Don’t Forget To Moisturize
Even oily skin needs to stay hydrated. Otherwise, dryness will make your sebaceous glands work even harder. Use a water-based moisturizer with zero fragrance. Doing so will keep your pores from being burdened with more oil.
Add Honey To Your Skincare Routine
Honey is a rare “one size fits all” remedy. It reduces oil, hydrates the skin, and kills acne-causing bacteria like Propionibacterium acnes and Staphylococcus epidermidis. Add it to your face masks, use it as a spot treatment, or slather some on every other day for a few minutes before washing it off.
Use A Green Tea Toner
Toners help tighten your pores and remove oil. And while you can find several different brands of toners out there, we suggest opting for green tea or a product that contains it as an ingredient. This is because the polyphenols (antioxidants) in it control inflammation, sebum, and bacteria, making it an excellent choice for angry, oily skin. All you have to do is steep green tea leaves in warm water, pour the tea into a spray bottle, and spritz the solution on your face regularly or after cleansing.
Keep Blotting Paper Handy
Anyone with oily skin would know the pain of trying to deal with excessively greasy skin that makes it seem like we’re perpetually sweating. And since constantly powdering your face will only give it a cakey pallor, it might be best to carry blotting paper with you. While these thin, small papers can’t prevent the oil from being produced in the first place, they do a good job at minimizing the shiny, greasiness that oily skin brings with it, especially on a hot summer’s day. So you can blot away at the oiliness whenever you’d like to. The best part? They’re inexpensive and easily available.
Exfoliate With Oatmeal Or Ground Almonds Every Week
This is an important skin care practice to remove dead skin cells, oil, and gunk. And regular exfoliation will prevent sebum in skin cells from getting clogged and breaking out. Natural ingredients like oatmeal and ground almonds will exfoliate your skin without drying it out too much (which we all know will trigger more oil production). Combine either of the two with honey and gently scrub your skin before washing it off. Avoid exfoliating more than 2 times in a week.12
Eat Clean
Although there isn’t enough research to fully understand the benefits of a clean diet on skin, traditional medicine holds that oily skin is worsened by consuming a diet high in greasy fast food. Besides, switching to dark, leafy vegetables as well as fruits, nuts, and whole grains can give your skin the nutrition it needs to stay healthy
Natural Remedies To Treat Itchy Scalp At Home
Dandruff, psoriasis, lice, and fungal infections can give you an itchy scalp. Try tea tree oil, eucalyptus oil, honey, or neem for dandruff. Turmeric, honey, aloe vera, or meditation can help you with psoriasis. Petroleum jelly, tea tree oil, neem, and a lice comb can be your ally against head lice. Lavender oil and tea tree oil can work alongside medication if you have fungal scalp infections.
Do you get that hard-to-resist urge to scratch your head? An itchy scalp or pruritus of the scalp can be annoying as well as embarrassing. So, what’s causing that itch? Many conditions can in fact! Some common ones include dandruff (seborrheic dermatitis), psoriasis, lice, and a fungal infection (tinea capitis). Let’s take a look at these conditions and some natural remedies that can help you deal with them.
Itchy Scalp Due To Dandruff
Did you know that dandruff affects almost 50% of all adults?2 This condition can give you an itchy scalp as well as flake your skin. It is considered to be a mild form of a condition known as seborrheic dermatitis which causes itchy and flaking skin on other parts of the body too. Although we don’t yet know what exactly causes this condition, the growth of a yeast known as malassezia is associated with it. Antidandruff shampoos are usually used to control dandruff. But if you’re looking for a natural remedy, here’s what you can try.
Tea Tree Oil
Tea tree oil has antifungal properties and can be useful in treating dandruff. One study found that using a 5% tea tree oil shampoo daily for 4 weeks significantly reduced itchiness and greasiness in people with mild to moderate dandruff.4
How to: Try adding a teaspoon of tea tree oil to your shampoo and wash 2-3 times a week to clear out your dandruff.
Eucalyptus Oil
1-8, Cineol, a natural compound found in eucalyptus oil, shows antidandruff activity by inhibiting the yeast malassezia.5
How to: Mix around 10 drops of eucalyptus oil in your regular shampoo and massage it into your scalp. Leave it on for a couple of minutes before rinsing, allowing the eucalyptus oil to work its magic.
Neem
According to research, neem extracts are extremely potent against the fungus associated with dandruff.6
How to: Boil neem leaves in water, cool the mixture, and use it to wash your scalp and hair. You can also add a teaspoon of neem oil to your regular shampoo or massage neem oil into your scalp after diluting it in a sesame oil base to get rid of those annoying flakes.
Honey
Now, here’s a sweet remedy for that itchy scalp! Honey has antifungal and antioxidant properties that can help clear dandruff. In one study, participants applied 90% honey diluted in warm water every other day and left it on for 3 hours before rinsing it off with warm water. They experienced great relief. Itching and scaling were both resolved within a week. It was also observed that a weekly application of honey prevented dandruff from recurring.
Itchy Scalp Due To Psoriasis
Psoriasis is a long-lasting skin disorder which results in itchy patches of reddish skin and silvery scales. This condition can affect not just your scalp but your knees, elbows, palms, back, face, and feet too. It occurs due to an issue with your immune system and can be exacerbated by factors like stress, infections, dry skin, and some medications. Your doctor may advise medicines or light therapy to deal with this condition. You can also try home remedies like:
Aloe AloVera
Aloe vera has been valued for its soothing and moisturizing properties for ages. And research indicates that it can help you deal with psoriasis too. During one study, patients suffering from psoriasis applied a cream containing .5% aloe vera extract thrice daily for 5 consecutive days a week for a maximum period of 4 weeks. It was found that this treatment cleared psoriasis plaques significantly and cured 83.3% of those who used it.9
How to: Split open an aloe vera leaf and apply the gel inside to affected areas. Wash off after 20–30 minutes. This can help relieve itching and deal with psoriasis.
Turmeric
The exotic golden spice turmeric is another agent that could help you deal with psoriasis. A study found that when a gel containing turmeric was applied topically it improved psoriasis. It is thought that this is due to the effect of curcumin, a compound present in turmeric, which has been found to inhibit several inflammatory enzymes implicated in psoriasis.
How to: Mix in a little turmeric powder with water to make a paste and apply on affected areas thrice daily. Rinse off after a while. You can also incorporate turmeric in your daily diet to improve your fight inflammation.
Meditation
Stress has been found to worsen psoriasis. So it makes sense that a relaxation technique like meditation can be helpful for some people in dealing with this condition. And research backs this up. One study suggests that meditation can clinically improve the symptoms of psoriasis. Another study also found that people who participated in a mindfulness meditation-based stress reduction intervention while undergoing light therapy healed quicker than those who didn’t.So, taking the time out to meditate might just free you of that itch!
Honey
Another remedy for psoriasis has been sitting on your kitchen shelf all along. According to research, antioxidant-rich, moisturizing honey can help you deal with this condition. In one study, participants with psoriasis applied medical grade honey to areas affected by psoriasis nightly for 2 weeks. It was found to be comparable in efficacy to an aqueous cream commonly recommended for this condition.
Itchy Scalp Due To Head Lice
Could lice be making you scratch your head? These parasites feed on human blood and usually spread through close contact. You can also get lice by sharing things like hairbrushes or hats with someone who has it.14 You can get lotions and sprays to treat head lice. But if you’re wary of strong chemicals and are looking for something natural, here are some home remedies that you can check out.
Lice Comb
You get special combs that have closely spaced flat teeth which you can use to manually comb the lice out of your hair. Though these combs can be used on dry hair, they work best on wet hair which has conditioner applied to it. The lice will find it difficult to move because of the conditioner.
Petroleum Jelly
According to one study, petroleum jelly doesn’t just kill lice by suffocating them, it even works on the eggs, allowing only 6% of them to hatch. Do keep in mind though that this method might not be as effective as using a pesticidal lotion or manually removing the lice.It will take time and repeated effort.
Neem
Lab studies show that neem seed extracts can kill lice.Neem oil has also been traditionally used in some Asian communities to treat lice.
How to: So the next time you’re bothered by these parasites, add a few drops of neem oil to your shampoo when you’re washing your hair.
Tea Tree Oil
How to: Add a few drops of tea tree oil to your shampoo, massage it into your hair, and let it sit for a few minutes. You can also add tea tree oil to your washing machine while you do laundry to disinfect pillow covers or sheets that may be infested with lice.
Diet
Vitamin A, also known as retinoids, benefits the skin by normalizing keratinization, downregulating sebum production which contributes to acne, and reversing and treating photodamage, striae, and cellulite.
Vitamin D and analogs are used to downregulate the cutaneous immune system and epithelial proliferation while promoting differentiation.
Vitamin C is an antioxidant that regulates collagen synthesis, forms barrier lipids, regenerates vitamin E, and provides photoprotection.
Vitamin E is a membrane antioxidant that protects against oxidative damage and also provides protection against harmful UV rays.
Anorexia-Cachexia Syndrome is a common clinical problem characterized by loss of appetite and weight loss or complex metabolic syndrome of involuntary weight loss associated with cancer and some other palliative conditions a consensus definition of cachexia related to either cancer or chronic disease has been proposed, namely: weight loss with or without fat loss, and additional criteria
Causes of Anorexia-Cachexia Syndrome
Although the etiology of cachexia is not well defined, several hypotheses have been explored including cytokines, circulating hormones, neuropeptides, neurotransmitters, and tumor-derived factors. An emerging view is that the anorexia-cachexia syndrome is caused predominantly by cytokines either produced by cancer or released by the immune system as a response to the presence of cancer, as well as other tumor products that induce profound lipolysis or protein degradation
80% of patients with upper gastrointestinal cancers
60% of patients with lung cancer have had substantial weight loss
Cachexia is more common in children and elderly patients and becomes more pronounced as the disease progresses
A systematic review of the literature on cachexia suggests that there is a range of pathways involved and that the interactions between weight loss, nutritional intake and anorexia are not straightforward or predictable.
Diagnostic Criteria of Anorexia-Cachexia Syndrome
Cancer cachexia is not difficult to identify. In North Central Cancer Treatment Group research trials involving more than 2,500 patients, simple criteria for anorexia/cachexia have been used:
A 5-lb weight loss in the preceding 2 months and/or an estimated daily caloric intake of fewer than 20 calories/kg
A desire by the patient to increase his or her appetite and gain weight
The physician’s opinion that weight gain would be beneficial for the patient
Recently, other investigators have attempted to provide more detailed or comprehensive definitions of cachexia. For example, Fearon and others recently suggested that weight loss of greater than 2% might also serve to define cachexia in patients already showing evidence of a low body mass index or wasting of skeletal muscle. These definitions are important in stimulating further discussion of this entity and its pathophysiology.
Interestingly, recent studies also suggest that antineoplastic agents may be contributing to some of the body composition changes observed in cachexia. Artoun and others observed that cancer patients treated with sorafenib (Nexavar) manifest notable degrees of muscle wasting over time, with an 8% decrease in lean tissue at 1 year in contrast to placebo-exposed patients.
Biochemical profile at admission and clinical follow-up.
Initial
At 6 weeks
At 4 months
At 6 months
At 10 months
Reference and unit
Glucose
71
82
110
93
97
65–110 mg/dL
Urea
11
17
18
19
16
10–50 mg/dL
Creatinine
0.24
0.45
0.59
0.6
0.43
0.4–1.2 mg/dL
Sodium (Na+)
151
138
139
141
138
136–145 mEq/L
Potassium (K+)
4.1
3.9
3.56
3.9
3.7
3.5–5.0 mEq/L
Albumin
1.2
2.3
2.9
2.2
3.6
3.4–4.8 g/dL
Cholesterol
108
100
155
143
132
50–200 mg/dL
HDL
44
40
45
43
47
36–65 mg/dL
Non HDL
64
100
110
108
103
Triglycerides
155
137
105
123
141
50–200 mg/dL
Hemoglobin
10.1
12.4
12.8
13.2
14.2
13–18 mg/dL
Leucocytes
5500
4200
8310
6700
7300
4600–10 220 cell/µL
Platelets
204 000
218 000
261 000
231 000
256 000
150 000–450 000/µL
Hormones
Luteinizing hormone (LH)
<0.10
<0.10
<0.1
<0.1
<0.1
1.4–8.6 IU/mL
Follicle stimulating hormone (FSH)
0.20
0.3
0.14
0.1
0.2
1.5–12.4 IU/mL
PRolactin
11.10
13.0
15.52
13.1
12.7
4.1–18.4 ng/mL
Testosterone
<2.5
280
225.8
389
500
280–800 ng/dL
Free T4 (FT4)
0.533
1.52
1.37
1.52
1.65
0.930–1.700 ng/dL
Thyrotropin (TSH)
0.051
<0.005
<0.005
<0.005
<0.005
0.270–4.200 µIU/mL
Growth hormone
<0.1
<0.1
0.02–1.23 ng/mL
IGF-1
13.13
16.9
7.49
20.8
14.7
10–1000 ng/mL
Cortisol
7.83
5.00–25.00 µg/dL
Adrenocorticotropic hormone (ACTH)
3.10
1.4
2.3
7.2–63.3 pg/mL
H1AC
7.3
6.2
4.6
6.5
6.4
4.8–6%
[i] Biochemical profile at admission and at 6 weeks and 4-, 6- and 10-month clinical follow-up. Abnormal results marked with bold.
Leptin and Body Weight Regulation of Anorexia-Cachexia Syndrome
The concept that appetite-restraining signal from adipocytes is integral components of the feedback loop between the periphery and the brain for energy homeostasis gained firm ground with the cloning of the ob gene and its encoded protein, leptin, from adipocytes. Leptin is an afferent signal from the periphery to the brain that regulates adipose tissue mass. The level of leptin is positively correlated with body fat mass, and dynamic changes in plasma leptin concentrations in either direction activate the efferent energy regulation pathways. Leptin reduces appetite and increases energy expenditure and evidently elicits these effects via the central nervous system. In the absence of leptin, such as in ob/ob mice, animals fail to restrain their food intake and become massively obese.
Treatment of Anorexia-Cachexia Syndrome
Potentially treatable factors that contribute to breathing problems should be sought and treated if appropriate. These include
Need for aids, equipment, increased home support, or modification of daily activities to minimize breathlessness.
Treatment all over
The best way to treat cancer cachexia is to cure cancer, but unfortunately, this remains an infrequent achievement among adults with advanced solid tumors. Therefore, the next therapeutic option is to increase nutritional intake and to inhibit muscle and fat wasting by manipulating the metabolic milieu outlined above with a variety of pharmacological agents.
It is essential to identify causes of reduced food intake, such as nausea and vomiting directly related to treatment, oral mucositis, and gastrointestinal obstruction, as well as to utilize appropriate palliative interventions for relieving these conditions.
A detailed discussion of these issues is beyond the scope of this article but should be considered before choosing the treatment suited to the patient. Treatment should be directed at improving the quality of life, and for many patients, this means improving appetite and food intake.
Hypercaloric Feeding
It was hoped that enteral or parenteral nutritional support would circumvent cancer anorexia and alleviate malnutrition. However, the inability of hypercaloric feeding to increase lean mass, especially skeletal muscle mass, has been repeatedly shown.
The place of aggressive nutritional management in malignant disease also remains ill-defined and most systematic prospective studies that have evaluated total parenteral nutrition combined with chemotherapy or radiotherapy have been disappointing.No significant survival benefit and no significant decrease in chemotherapy-induced toxicity have been demonstrated. Indeed, an increase in infections and mechanical complications has been reported.
However, parenteral nutrition may facilitate administration of complete chemoradiation therapy doses for esophageal cancer and may have beneficial effects in certain patients with decreased food intake because of mechanical obstruction of the gastrointestinal tract. Home parenteral nutrition can also be rewarding for such patients. If the gut can be used for nutritional support, enteral nutrition has the advantage of maintaining the gut mucosal barrier and immunologic function, as well as the advantage of having low adverse side effects and low cost.
The effects of caloric intake on tumor development and growth are still being debated. A clear benefit from nutritional support may thus be limited to a specific, small subset of patients with severe malnutrition who may require surgery or may have an obstructing, but a potentially therapy-responsive tumor. A novel approach is to supplement substances such as omega-3 fatty acids that reduce IL-1 and TNF-α production and may improve the efficacy of nutritional support.
Glucocorticoids
Glucocorticoids are widely used in the palliative setting for symptoms associated with cancer. There have been a number of randomized, placebo-controlled trials demonstrating the symptomatic effects of different types of corticosteroids. Most studies have shown a limited effect of up to four weeks on symptoms such as appetite, food intake, the sensation of well-being, and performance status.
Corticosteroids have been shown to have a significant antinausea effect and to improve asthenia and pain control. However, these studies have failed to show any beneficial effect on body weight. Prolonged treatment may lead to weakness, delirium, osteoporosis, and immunosuppression—all of which are commonly present in advanced cancer patients.
Prednisolone, at a dose of 5 mg three times (15 mg) daily, and dexamethasone, at 3 to 6 mg daily, has been shown to improve appetite to a greater extent than placebo. Methylprednisolone given intravenously at a dose of 125 mg daily may improve quality of life. There is no indication that anyone glucocorticoid is superior in its appetite-stimulating ability. When prescribing, it is recommended to begin with an initial one-week trial and continue treatment if there is a response. The entire daily dose may be given in the morning with breakfast or on a divided schedule after breakfast and lunch. This decreases hypothalamic-pituitary-adrenal (HPA) axis suppression and insomnia associated with use later in the day.
Prescribing an intermediate-acting glucocorticoid (prednisone, prednisolone, methylprednisolone) may cause less HPA axis suppression than a long-acting drug (dexamethasone). Peptic ulceration is a concern, particularly in patients at risk. Prophylactic histamine-2 receptor antagonists are prudent when commencing long-term glucocorticoids. The mechanism of action of glucocorticoids on appetite includes the inhibition of synthesis and/or release of proinflammatory cytokines such as TNF-α and IL-1, which decrease food intake directly or through other anorexigenic mediators, such as leptin, CRF, and serotonin. Glucocorticoids can enhance NPY levels in the hypothalamus, which appear to be responsible, at least in part, for the increased appetite and food intake. NPY-induced feeding is known to be dependent on circulating glucocorticoid levels.
Progestational Drugs
Megestrol acetate 40 mg/ml(MA) and medroxyprogesterone acetate (MPA) are synthetic, orally active derivatives of the naturally occurring hormone progesterone. In several clinical trials, these compounds have been found to improve appetite, caloric intake, and nutritional status.
Megestrol has demonstrated a dose-related benefit from dosages ranging from 160 mg (40 mg orally four times daily) to 1600 mg on appetite, caloric intake, body weight gain (mainly fat), and sensation of well-being, with an optimal dosage of 800 mg daily. Increasing dosages from 160 mg of megestrol to 800 mg per day improves response to a level beyond which no further improvement occurs. It is recommended that a patient is started on the lowest dosage (160 mg/day) and the dose be titrated upwards according to the clinical response.
Quality of life measures such as the Karnovsky index may or may not be influenced by progesterone agents. Medroxyprogesterone has similarly been shown to increase appetite and food intake with stabilization of body weight at a dose of 1000 mg (500 mg twice) daily. Although the drug may be used at 500 to 4000 mg daily, side effects increase above oral doses of 1000 mg daily. Medroxyprogesterone can also be given in a depot formulation. Oncologists are increasingly prescribing megestrol or medroxyprogesterone oral suspensions rather than tablets for their patients because of improved compliance and decreased cost.
There is, at present, considerable evidence of the effect of synthetic progestins on appetite and body weight, the two clinical hallmarks most widely identified in the cancer anorexia-cachexia syndrome. However, further issues to be clarified are the optimal treatment duration, the best time to start treatment during the natural history of the disease, and the eventual impact on the overall quality of life.
Both megestrol and medroxyprogesterone can induce thromboembolic phenomena, breakthrough uterine bleeding, peripheral edema, hyperglycemia, hypertension, adrenal suppression, and adrenal insufficiency (if the drug is abruptly discontinued). Although patients rarely need to stop taking these drugs because of adverse effects, these drugs should not be prescribed in cases of tthe hromboembolic/thrombotic disease, heart disease, or for patients at risk for serious fluid retention.The mechanism of action of progestational drugs remains to be clarified but might be related to glucocorticoid activity. Megestrol may induce appetite via stimulation of NPY in the hypothalamus, modulation of calcium channels in the ventromedial hypothalamus (VMH)—a well-known satiety center which reduces the firing tone of VMH neurons—and inhibition of the activity of proinflammatory cytokines such as IL-1, IL-6, and TNF-α.
Serum levels of such cytokines were reported to be decreased in cancer patients after megestrol or medroxyprogesterone treatment.
Cyproheptadine and Other Antiserotonergic Drugs
Cyproheptadine is an antiserotonergic drug with antihistaminic properties that have been shown to have an appetite-stimulant effect in a number of human conditions.
A randomized, controlled trial found mild appetite stimulation in patients with advanced cancer, although it did not prevent progressive weight loss. Considerable evidence, both in humans and experimental animals, suggests that anorexia may be mediated by increased serotonergic activity in the brain. Its blockade, therefore, might be beneficial in reducing symptoms.
Serotonin (5HT) is a known satiating factor. It suppresses food intake when injected into the VMH of animals, where it may play a critical role in anorexia associated with cancer. Cyproheptadine appeared to stimulate appetite and to decrease diarrhea in patients with advanced carcinoid tumors. 5HT3 receptor antagonists, such as ondansetron and granisetron, have entered widespread clinical use as antiemetics for cancer chemotherapy.
Ondansetron improved the ability of patients to enjoy food although it failed to prevent weight loss. Future clinical trials with other antiserotonergic drugs are needed to define the role of the serotonergic system in the development and treatment of cancer cachexia.
Branched-chain Amino Acids
Peripheral muscle proteolysis, as occurs in cancer cachexia, works to metabolize amino acids required for the synthesis of liver and tumor protein. The administration of amino acids may theoretically serve as a protein-sparing metabolic fuel by providing a substrate for both muscle metabolism and gluconeogenesis.
Branched-chain amino acids (BCAA: leucine, isoleucine, and valine) have been used with the aim of improving nitrogen balance, particularly muscle protein metabolism.
It was reported that BCAA-enriched total parenteral nutrition resulted in improved protein accretion and albumin synthesis.BCAA may also serve to counteract anorexia and cachexia by competing for tryptophan, the precursor of brain serotonin, across the blood-brain barrier and thus blocking the increased hypothalamic activity of serotonin.
It is known that increased plasma levels of tryptophan can lead to increased CSF tryptophan concentrations and increased serotonin synthesis during cancer. Oral supplementation of BCAA successfully decreased the severity of the anorexia in cancer patients.
Prokinetic Agents
Many patients with advanced cancer have symptoms of delayed gastric emptying and gastric stasis. Autonomic failure with decreased gastrointestinal motility is a recognized complication of cancer cachexia and is capable of causing anorexia, chronic nausea, early satiety, and constipation leading to the reduced caloric intake.
The prokinetic agent, metoclopramide, 10 mg orally before meals and at bedtimes, may relieve anorexia and early satiety with minimal side effects. It has been the most extensively used drug in patients with cancer for the prevention and treatment of chemotherapy-induced emesis.
Slow-release metoclopramide taken every 12 hours is significantly better than rapid-release metoclopramide taken every six hours, confirming the need for continued gastric stimulation for effective control of chronic nausea and early satiety. The role of other prokinetic agents, including domperidone and potentially erythromycin derivatives that lack antibacterial activity, need to be examined in randomized trials in cancer patients.
Eicosapentaenoic Acid
The polyunsaturated fatty acid, eicosapentaenoic acid (EPA), has been widely studied in animals and has demonstrated inhibition of lipolysis and muscle protein degradation associated with a cachexia model. It countered the metabolic actions of LMF and PIF by interfering with their second-messenger production (cyclic AMP and arachidonic acid, respectively), and resulted in a reversal of tumor-induced cachexia without changes in food intake in animal models.
In a recent open-label study conducted with pancreatic cancer patients, a supplement of fish oil capsules [18% EPA + 12% DHA (docosahexaenoic acid), 12 tablets per day taken orally] was investigated for three months. Patients showed decreased fatigue and a low body weight gain, as well as a reduction of acute-phase protein while taking the capsules. The reduction of acute-phase response (C-reactive protein) was also related to the suppression of IL-6 production. The effect appeared to be specific to the fish-oil supplement because it was not observed in patients receiving another polyunsaturated fatty acid, γ-linolenic acid.
Although nutritional supplementation alone cannot attenuate the development of weight loss in cachectic patients, the inclusion of EPA significantly increased weight gain and lean body mass, leading to an improvement in performance status.
In a randomized, controlled study, patients with advanced cancer who received a mixed fish-oil preparation showed increased survival relative to patients who received placebo. This improvement was observed in both weight-losing and non-weight-losing subgroups of patients.
Cannabinoids
Appetite stimulation and body weight gain are well-recognized effects of the use of marijuana and its derivatives. Dronabinol is the synthetic, oral form of tetrahydrocannabinol (THC), which is the active ingredient responsible for this effect.
Dronabinol and Marinol (in the United States) and Nabilone (in Canada) have been used as antiemetics in cancer,
Several studies of THC in advanced cancer-associated anorexia have shown some improvement in mood and appetite with either no or some improvement in body weight.
Randomized, controlled trials are needed to better determine the efficacy and usefulness of THC in cancer cachexia.
It has been shown that almost 20 percent of the cancer patients receiving chemotherapy along with dronabinol as an antiemetic experienced side effects, such as euphoria, dizziness, somnolence, and confusion resulting in a dose reduction or less frequently in the withdrawal of the treatment. The drug could be taken at bedtime to avoid some psychotomimetic effects and might produce long-lasting appetite stimulation for 24-hour periods. The mechanism by which cannabinoids exert their effect has yet to be clarified. It was postulated that they might act via endorphin receptors, by inhibiting prostaglandin synthesis or by inhibiting IL-1 secretion. Recent studies demonstrate that endogenous cannabinoids are present in the hypothalamus, which may tonically activate CB1 cannabinoid receptors to maintain food intake and form part of the neural circuitry regulated by leptin.
5′-Deoxy-5-Fluorouridine
The fluorinated pyrimidine nucleoside, 5′;-deoxy-5-fluorouridine (5′-dFUrd) has been shown to effectively attenuate the progression of cachexia in mice bearing murine or human cancer cell lines.
5′-dFUrd is a cytostatic agent that is converted upon metabolization into the active 5-fluororacil (5-FUra) by pyrimidine (thymidine and uridine) phosphorylases, which are very active in tumor tissue. Although concomitant inhibition of tumor growth was observed in these models, it was not sufficient to account for the preservation of body weight. 5prime;-dFUrd reversed a progressive weight loss, hypoglycemia, and increased production of acute phase proteins with no change in tumor size or even some tumor growth.
The mechanisms of the anticachectic activity of 5′-dFUrd include inhibition of production of IL-6 and PIF. Chemotherapy could be expected to have a role in cachexia not only by decreasing tumor mass but perhaps also by modulating the production by cancer cells or immune cells of chemical mediators.
Unfortunately, few studies have been conducted with the aim of trying to define the potential symptomatic role of low-toxicity chemotherapy on cachexia, as well as on asthenia or pain. Such clinical studies are warranted and should include 5′-dFUrd.
Emerging Drugs
The reported clinical trials on emerging drugs are generally small. Larger, randomized studies are necessary to assess the efficacy of these drugs in the treatment of cancer cachexia.
Melatonin
Melatonin is the pineal hormone that is able to decrease the level of circulating TNF-α in patients with advanced cancer. In a recent controlled trial of 100 patients with metastatic solid tumors, loss of more than 10 percent body weight was less common among those treated with melatonin (20 mg daily) than among patients in the placebo group.
Addition of melatonin to the chemotherapy regimen of cisplatin plus etoposide improved the response rate and survival rate, and reduced myelosuppression, neuropathy, and cachexia among lung cancer patients in poor clinical condition.
Thalidomide
Initially developed as a sedative and an anti-inflammatory agent, thalidomide was withdrawn from use when its teratogenic effect was recognized. It is now prescribed for new indications, except in susceptible populations (women of child-bearing potential and their spouses, and those with peripheral neuropathy).
Thalidomide also inhibits TNF-α in animals and humans with cancer, AIDS, and other diseases. A significant improvement in well-being and weight gain occurs in AIDS patients with modest doses of thalidomide (300 mg).
It was also reported to improve insomnia and restlessness as well as nausea in advanced cancer patients and it has improved appetite as well, resulting in an enhanced feeling of well-being in one-half to two-thirds of patients studied.
These results together with the recent finding that thalidomide is able to inhibit the growth of the tumor through an inhibition of neoangiogenesis, suggest the unique role of thalidomide both as an anticachectic and antineoplastic agent.
β2-agonists
Beta 2 adrenoceptor agonists may have an important effect on protein metabolism in skeletal muscle, favoring protein deposition even in sedentary populations. It was reported that clenbuterol suppresses the activation of muscle proteolysis through its action on the ubiquitin-dependent proteolytic system during tumor growth in tumor-bearing animals.
Although no controlled trials are reported in cancer patients, it was shown to significantly improve muscle strength after knee surgery when compared with placebo.
Non-steroidal Anti-inflammatory Drugs
Non-steroidal anti-inflammatory drugs (NSAIDs) are very widely used in patients with cancer for the treatment of fever and pain. Ibuprofen, taken at a dose of 400 mg three times daily, has been shown to reduce levels of acute phase proteins, IL-6, and cortisol and to normalize whole-body protein kinetics to some extent in cachectic colorectal cancer patients. It may reduce resting energy expenditure and stabilize weight and quality of life in pancreatic cancer patients.
The related anti-inflammatory agent indomethacin, taken at a dose of 50 mg twice daily, has been shown to stabilize performance status and prolong survival of patients with metastatic solid tumors in a large controlled trial. These agents may, therefore, have some role in the palliation of cachexia and fever, although concern remains about gastrointestinal side effects. NSAIDs act by inhibiting prostaglandin production by the rate-limiting enzymes known as cyclooxygenases, COX-1 and COX-2. The recent discovery and introduction into clinical practice of selective inhibitors of COX-2 (celecoxib and rofecoxib) that are devoid of gastrointestinal toxicity yet maintain a high anti-inflammatory activity suggest that these agents will be therapeutic alternatives to conventional NSAIDs.
These COX-2 inhibitors were recently shown to have anti-angiogenic and anti-tumor activities in animal models.
Others
Pentoxifylline, a methylxanthine derivative, is a phosphodiesterase inhibitor that inhibits TNF-α synthesis by decreasing gene transcription. A randomized, controlled trial in patients with solid tumors, however, showed no increase in appetite or body weight gain among patients taking pentoxifylline (400 mg three times daily for two months) compared with patients receiving placebo.
Hydrazine sulfate inhibits phosphoenol-pyruvate carboxykinase, a key enzyme in gluconeogenesis. It was hoped that interrupting the Cori cycle would normalize some aspects of carbohydrate metabolism in cachectic cancer patients. However, large, randomized, placebo-controlled trials did not show any benefit in advanced lung and colorectal cancer patients. Based on its lack of efficacy and significant neurotoxicity, hydrazine sulfate is not used by mainstream oncologists, although it is still promoted by some alternative medicine practitioners.
Anabolic steroids increase muscle mass in noncancer patients, and this has led to their illicit use for athletic advantage. Nandrolone decanoate treatment resulted in a decrease in weight loss in patients with lung cancer. However, in a large, randomized, controlled trial comparing megestrol acetate versus dexamethasone versus fluoxymesterone for the treatment of cancer cachexia, fluoxymesterone was clearly inferior.
Nutritional, Psychological, and Behavioral Therapies
The management of cachexia in advanced cancer patients should first attempt to maximize oral intake by allowing the patient flexibility in type, quantity, and timing of meals.
Professional teams of oncology physicians, nurses, and dietitians, along with patients and families, can diagnose specific needs and plan individualized treatment for improved nutritional health.
Counseling, which any member of the healthcare team may provide, is an effective and inexpensive intervention and should be combined with other nutritional interventions.
Nursing interventions to counteract cachexia should be aimed at minimizing the negative factors of nausea, vomiting, diarrhea, pain, fatigue, changes in taste, or food preferences that may influence appetite.
Encouraging patient and family interaction and providing emotional and educational support may be helpful. When family members can provide the patient’s favorite foods, food intake usually improves and family bonds are strengthened.
Communication among physicians and other healthcare professionals provides the patient with a multidisciplinary approach to care. The patient record will be an excellent resource to document a plan of care and patient responses to treatment. Psychological distress and psychiatric disorders are common among cancer patients and have a prevalence ranging from 10 to 79 percent of patients depending upon the group studied. These problems are also as common among the family members of people with cancer.
The use of psychological and behavioral interventions in cancer is increasing and recent studies have suggested that some of these techniques may affect the quality of life and, perhaps, survival rates.
Evaluations of relaxation, hypnosis, and short-term group psychotherapy have suggested some benefit with regard to anorexia and fatigue, although the population most likely to benefit from these interventions has not yet been determined.
Anorexia and cachexia may result in a secondary depression, or the depression may be a prime contributor to the anorexia and subsequent weight loss. Benzodiazepines can be helpful for persistent fear and anxiety and antidepressant drugs are increasingly used in depressed cancer patients.
Contraceptive Pill also is known as contraception and fertility control pill is a method or device used to prevent pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth control only became available in the 20th-century Planning, making available, and using birth control is called family planning. Some cultures limit or discourage access to birth control because they consider it to be morally, religiously, or politically undesirable.
Oral contraceptive pills have been associated with increased risk for myocardial infarction, stroke, and venous thromboembolism. Studies have been published recently that suggest that these risks are minimal inappropriately chosen low-risk women. Stroke is a very uncommon event in childbearing women, occurring in approximately 11 per 100,000 women over 1 year. Thus, even a doubling of this risk with oral contraceptive pills would have minimal effect on attributable risk. The estimated risk of myocardial infarction associated with oral contraceptive pill use in nonsmokers is 3 per million women over 1 year. The estimated risk of venous thromboembolism attributable to oral contraceptive pills is less than 3 per 10,000 women per year. Additionally, the literature suggests that there may be an increased risk of breast cancer associated with long-term oral contraceptive pill use in women under the age of 35. However, because the incidence of breast cancer is so low in this population, the attributable risk of breast cancer from birth control pill use is small.
Before taking Contraceptive Pill
The most effective methods of birth control are sterilization by means of vasectomy in males and tubal ligation in females, intrauterine devices (IUDs), an implantable birth control. This is followed by a number of hormone-based methods including oral pills, patches, vaginal rings, and injections.
Less effective methods include physical barriers such as condoms, diaphragms, and birth control sponges and fertility awareness methods. The least effective methods are spermicides and withdrawal by the male before ejaculation. Sterilization, while highly effective, is not usually reversible; all other methods are reversible, most immediately upon stopping them.
Safe sex practices, such as with the use of male or female condoms, can also help prevent sexually transmitted infections. Other methods of birth control do not protect against sexually transmitted diseases. Emergency birth control can prevent pregnancy if taken within the 72 to 120 hours after unprotected sex. Some argue not having sex as a form of birth control, but abstinence-only sex education may increase teenage pregnancies if offered without birth control education, due to non-compliance
Contraceptive, pill Commonly called “the pill,” combined oral contraceptives are the most commonly used form of reversible birth control in the United States.
This form of birth control suppresses ovulation (the monthly release of an egg from the ovaries) by the combined actions of the hormones estrogen and progestin.
If a woman remembers to take the pill every day as directed, she has an extremely low chance of becoming pregnant in a year. But the pill’s effectiveness may be reduced if the woman is taking some medications, such as certain antibiotics.
Besides preventing pregnancy, the pill can make periods more regular. It also has a protective effect against pelvic inflammatory disease (PID), an infection of the fallopian tubes or uterus that is a major cause of infertility in women, and against ovarian and endometrial cancers.
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Birth control pills (also called oral contraceptive pills and the “Pill”) are a type of female hormonal birth control method and are very effective at preventing pregnancy.
The Pills are small tablets that you swallow each day. Most pills contain two types of synthetic (man-made) female hormones: estrogen and progestin. These are similar to the estrogen and progesterone normally made by the ovaries. These pills are called “combination oral contraceptives,” and there are many different kinds.
The hormones in the pills prevent pregnancy by suppressing your pituitary gland, which stops the development and release of the egg in the ovary (ovulation) (see female reproductive anatomy image below). The progestin also helps to prevent the sperm from reaching the egg and changes the lining of the uterus.
www.rxharun.com/birth control pill
Another type of pill contains only one hormone (progestin) and is called either the “progestin-only pill,” or the “mini-Pill.” It works by stopping ovulation and by helping to prevent the male’s sperm from reaching the egg.
Types of Contraceptive Pill
Combination Pills (COCs)
Birth control pills with two hormones — estrogen and progestin — are called combination pills. They’re the most common type of birth control pill. Most combination pills come in 28-day or 21-day packs. You’re protected from pregnancy as long as you take 1 pill every day. You don’t have to take it at the exact same time every day, but doing so helps keep you in the habit of remembering your pill. You can also use alarms, reminders, or birth control apps to help remind you.
28-day packs
Take 1 pill every day for 28 days (four weeks), and then start a new pack on day 29. The last pills in 28-day packs of combination pills do not have hormones in them. How many days you take hormone-free pills are different for different brands. Most commonly you’ll take hormone-free pills for 7 days, but sometimes less. These pills are called “reminder” or “placebo” pills — they help remind you to take your pill every day and start your next pack on time. Even if you don’t take them, you’ll be protected from getting pregnant if you have sex on those days. They may contain iron or other supplements that help you stay healthy. During the time you take these “reminder” pills is when you get your period.
21-day packs
Take 1 pill every day for 21 days (three weeks) in a row. Then don’t take any pills for seven days (fourth week). You’ll get your period during the fourth week while you aren’t taking any pills. It’s important to take every pill in a 21-day pack because there are no reminder (hormone-free) pills. The hormone pills will prevent pregnancy even if you have sex during the week when you don’t take any pills. Start your next pack after not taking your pills for seven days — you may want to use an alarm or reminder to help you stay on track.
91-day packs
Some combination pills have 12 weeks’ worth of hormone pills in a row, followed by up to 1 week of reminder pills. This is so you’ll only have your period once every three months. The hormones will prevent pregnancy even if you have sex during the reminder pill week. Other pill brands can also be used to skip your period by skipping the reminder pills.
There are two different ways to take the pill:
The period option – Take the 21 hormone pills and then the 7 non-hormone pills. You will get your period while you are taking the 7 non-hormone pills. It may be lighter and less crampy than your regular period. You will not be protected from pregnancy if you forget more than one pill in a week
The no-period option – Take the hormone pills continuously, every day. Take the 21 hormone pills and then start a new packet, missing the 7 non-hormone pills. This means you won’t get your period. With this option, you are protected from pregnancy unless you forget more than eight pills in a row. You can do this for as many packets of hormone pills as you like, and then you can take the non-hormone pills to have a period when you want to. You might notice bleeding and spotting at first, but this usually goes away with time or you can take the 7 non-hormone pills to have a period.
Benefits of Contraceptive Pill
Birth control pills have a number of benefits
They protect you 24/7. You don’t have to worry about birth control during intimacy.
They’re effective. They protect against pregnancy better than most other birth control options.
They help regulate your menstrual cycle. This can be helpful for women with irregular or heavy periods.
They’re fully reversible. This means when you stop taking them your cycle will return to normal and you can get pregnant later.
There are also benefits depending on the type of pill. Combination pills may also provide some protection against:
Progestin-only pills have other benefits as well, such as being safer for women who:
can’t tolerate estrogen therapy
are smokers
are older than 35 years
have a history of blood clots
want to breastfeed
Birth control pills are used to treat many different conditions including
Polycystic Ovary Syndrome (PCOS)
Is a hormonal imbalance which causes irregular menstrual periods, acne, and excess hair growth. For girls whose menstrual periods are irregular (too few or not at all), birth control pills work by lowering certain hormone levels to regulate menstrual periods. When hormones are at normal levels, acne and hair growth often improve.
Endometriosis
Most girls with endometriosis have cramps or pelvic pain during their menstrual cycle. Birth control pills are often prescribed continuously to treat endometriosis and work by temporarily preventing periods. Since periods can cause pain for young women with endometriosis, stopping periods will usually improve cramps and pelvic pain.
Lack of periods (“amenorrhea”) from low weight, stress, or excessive exercise
Birth control pills may be prescribed to replace estrogen, which helps to regulate the menstrual cycle. Normal estrogen levels and healthy weight are important for healthy bones. If lack of periods is caused by low weight or an eating disorder, the best treatment is weight gain to a normal healthy weight.
Menstrual Cramps
When over-the-counter medications don’t help with severe cramps, birth control pills may be the solution because they prevent ovulation and lighten periods.
Premenstrual Syndrome (PMS)
Symptoms of PMS such as mood swings, breast soreness, weight gain and bloating, along with acne can occur up to 2 weeks before a young women’s period. Birth control pills may be prescribed to stop ovulation and keep hormone levels balanced. Symptoms may improve, particularly when oral contraceptive pills are prescribed continuously.
Primary Ovarian Insufficiency (POI)
Birth control pills are often prescribed to girls who have ovaries that don’t make enough estrogen because of radiation and/or chemotherapy or a genetic condition such as Turner Syndrome or other conditions. The goal of this treatment is to regulate the menstrual cycle and keep bones healthy.
Heavy Menstrual Periods
Birth control pills can reduce the amount and length of menstrual bleeding.
Acne
For moderate to severe acne, which over-the-counter and prescription medications haven’t cured, birth control pills may be prescribed. The hormones in the Pill can help stop acne from forming. Be patient though, since it takes several months for birth control pills to work.
Guiding pill prescription
The guiding principles when considering which pill to prescribe for an individual woman are to choose a formulation that:
has the lowest dose of oestrogen and progestogen to provide good cycle control and effective contraception
is well tolerated
has the best safety profile
is affordable
offers additional non-contraceptive benefits if desired.
Effective regimens
The first available formulation of the combined oral contraceptive pill contained 50 microgram of ethinyloestradiol for cycle control. However, an association between the pill and venous thromboembolism soon emerged. This was due to the effect of oestrogen on the synthesis of clotting factors.[Rx] To mitigate this risk, and reduce oestrogenic adverse effects, the dose of ethinyloestradiol was reduced to 35 and 30 microgram and more recently 20 microgram without an apparent loss of contraceptive efficacy.[Rx]
The pills available in Australia are mostly in 28-day packs with 21 active and 7 inactive pills, to mimic the menstrual cycle. Some formulations contain 24 active and 4 inactive pills (24/4 regimes) which may reduce the chance of contraceptive failure and breakthrough ovulation.[rx] Extended pill-taking regimens are used by many women to delay or avoid a withdrawal bleed. This is most easily achieved with monophasic regimens in which each active pill contains the same amount of oestrogenand progestogen and the inactive pills are skipped. Typically this is done for three months at a time. Indeed evidence is available to support the safety of continuous use of the contraceptive pill for up to 12 months.[Rx] Another approach is called a ‘menstrually signalled’ regimen. Women take the pill continuously until they experience four days of vaginal spotting or bleeding after which they have a four-day pill break.
Triphasic pills are commonly prescribed in Australia, but have no evidence-based advantage over monophasic pills in relation to their adverse effect profile or cycle control. A quadriphasic combined oral contraceptive pill that contains oestradiol valerate and desogestrel is formulated with an oestrogen step-down and progestogen step-up sequence.[Rx]The pill is a user-dependent method. Its failure rate therefore differs between ‘perfect use’ (0.3% annually) by women who take it consistently and correctly and ‘typical use’ (9% annually) when the pill is used inconsistently or incorrectly.[Rx]
Safety and tolerability
Long-term cohort studies show that, compared to non-users of the combined oral contraceptive pill, users have lower rates of death from any cause. They also have significantly lower rates of death from cancer, cardiovascular disease and other diseases.[Rx]
Non-contraceptive benefits
There is not a great deal of evidence for the benefit of one pill type over another. Although the newer combined oral contraceptives have been marketed on their non-contraceptive benefits, it is important to understand which claims are well substantiated.
Acne and hirsutism
Most women with acne and hirsutism find that their skin improves when they take the combined oral contraceptive pill. This is in part because of a rise in sex hormone binding globulin. Pills containing cyproterone acetate, drospirenone, gestodene or desogestrel are often recommended, but the evidence for a benefit over levonorgestrel-containing pills is limited.
The pills containing cyproterone acetate and ethinyloestradiol appear to improve acne (judged by inflammatory lesions and global assessments) better than those containing levonorgestrel.[Rx] Studies comparing pills containing cyproterone acetate with pills containing drospirenone, gestodene or desogestrel have had conflicting results.[Rx] Women with hirsutism may benefit from pills containing one of the anti-androgenic progestogens, including cyproterone acetate or drospirenone, which have been found to result in improvements in clinical hirsutism scores.[Rx]
Heavy menstrual bleeding
All combined contraceptive pills can reduce the duration and heaviness of menstrual blood loss. Extending the days women take active pills while reducing or eliminating inactive pills can be useful for heavy menstrual bleeding.
The oestradiol valerate with dienogest pill has a quadriphasic regimen which reduces menstrual blood loss through its effect on the endometrium. It has an indication for the management of heavy menstrual bleeding. This pill appears to be more effective at reducing the number of days of bleeding and the amount of blood loss when compared to combinations of ethinyloestradiol and levonorgestrel.[Rx]
Premenstrual syndrome and premenstrual dysphoric disorder
Menstrual-related symptoms are commonly reported, but a proportion of women will experience more severe cyclic symptoms, known as premenstrual syndrome. A further subset of women will experience severe dysphoric symptoms, which have been labelled as a premenstrual dysphoric disorder.
Side Effects of Contraceptive Pill
Birth control pill side effects that should be investigated are:
A: Abdominal/stomach pain
C: Chest pain (as well as shortness of breath)
H: Headaches that are severe
E: Eye problems such as blurred vision or loss of vision
S: Swelling or aching in the legs and thighs (also redness, swelling or pain in the calf or thighs).
Most women have no side effects when taking birth control pills, but some women do experience irregular periods, nausea, headaches, or bloating. Each type of oral contraceptive pill can affect each woman differently.
Spotting or Irregular Periods
Very light bleeding (you just need a panty liner or light day pad) may occur during the first 3 weeks of taking the Pill and may continue for several cycles, but this is not serious. Irregular bleeding is common if you are late taking your pills or you miss a pill. If the bleeding is new and you are sexually active, get checked for Chlamydia infection. If the bleeding becomes heavier.
Nausea
Sometimes a young woman can feel nauseated (sick to her stomach), but the feeling usually goes away if the pill is taken with food or with a bedtime snack. Sometimes a pill with less estrogen is prescribed if the nausea doesn’t go away.
Headaches
Sometimes, young women may complain of headaches when they start taking birth control pills. Most often headaches happen because of stress or other reasons such as skipping meals, not enough sleep, sinus infections, or migraines. If your health care provider thinks your headaches are related to the Pill, he/she may prescribe a different pill with a lower amount of estrogen or may take you off of it completely and watch to see if headaches improve.
Mood changes
Feeling up and down emotionally can sometimes happen to anyone and is unlikely to be caused by the Pill. Exercise and a healthy diet may help, but if they don’t, you should talk with your health care provider and try a different kind of oral contraceptive pill.
Breakouts
Usually, the pill helps cure acne, but a few women feel they get acne from a certain kind of birth control pill.
Sore or enlarged breasts
Your breasts may become tender or may get larger.
Weight
Some teens gain weight and some teens lose weight while taking birth control pills, but most teens stay exactly the same weight. Many times a young woman thinks she has gained 5-10 pounds, but when her weight is actually checked, there is no change. If you think you may have gained weight while taking the Pill talk to your health care provider. Try to remember to watch your portion sizes and eat 5-7 servings of fruits and veggies each day and don’t forget to exercise. Your appetite may increase or stay the same.
What are the possible side effects of birth control pills?
Most women have no side effects when taking the oral contraceptive pill. However, it’s possible to have irregular periods, nausea, headaches, or weight change especially during the first few months. Each type of oral contraceptive pill can affect a young woman differently.
Irregular periods: Spotting (you don’t need to use a regular pad, just a panty shield) or very light bleeding may occur during the first 1-3 weeks of starting the Pill, or if you miss a pill. If the bleeding becomes heavier or lasts more than a few days or the bleeding happens after you have been on the pill for a few months, keep taking the pill and talk with your health care provider.
Nausea: Nausea occasionally occurs when you first start taking the Pill and will often go away in a few days. It is less likely to occur if the Pill is taken after dinner or with a bedtime snack.
Mood changes: Feeling up and down emotionally can sometimes happen to anyone and is unlikely to be caused by the Pill. Exercise and a healthy diet may help, along with talking to a counselor. Make sure you let your health care provider know how you are feeling.
Sore or enlarged breasts: Very occasionally, your breasts may become tender and/or get larger, but usually your breasts will stay the same. Breast tenderness usually goes away after a few months.
Weight change: Some teens gain weight and some teens lose weight while on the Pill, but most stay exactly the same. Try to remember to watch your portion sizes, avoid fast food, and eat 5-13 servings of fruits and vegetables each day. Drink lots of water and don’t forget to exercise! Just in case you were wondering, there are no calories in the Pill.
If you do have side effects, you should talk to your health care provider. If the side effects are very uncomfortable or if they don’t go away after three cycles, your health care provider may switch you to a different pill.
What about serious side-effects?
There’s no doubt at all that the Pill can occasionally cause serious problems like:
deep vein thrombosis. This is now known to be more common in women who are taking high oestrogen Pills and also third-generation Pills containing the progestogens desogestrel and gestodene
heart attacks
strokes.
Fortunately, these events are rare. But they are much more likely to happen if you have certain ‘risk factors’, which include:
being a smoker
having a family history of thrombosis or some similar illness (say, if your mother had a heart attack or a deep vein thrombosis at 40)
being severely overweight
being diabetic (though quite a few non-smoking diabetics do use the Pill, under careful supervision)
high blood pressure
high cholesterol level (hypercholesterolaemia)
past history of phlebitis (vein inflammation) or thrombophlebitis
being immobile for a while (especially when having a surgical operation).
Combined pill/Contraceptive Pill
The combined oral contraceptive pill is usually just called “the pill”. It contains artificial versions of female hormones oestrogen and progesterone, which women produce naturally in their ovaries.
A woman can get pregnant if a man’s sperm reaches one of her eggs (ova). Contraception tries to stop this happening usually by keeping the egg and sperm apart or by stopping the release of an egg (ovulation).
How effective is the Pill at preventing pregnancy?
The Pill is very effective if you take it exactly as you are supposed to – one pill a day, taken at the same time each day. You should also use back-up contraception such as condoms if you have diarrhea or vomiting, or are taking a medication that could change the effectiveness of the birth control pill. Using condoms is always important to decrease your chances of getting a sexually transmitted infection (STI)
Although it’s obvious that the Pill is most effective against pregnancy when it’s taken at the same time every day, perfect use can be difficult for both teens and adults. That’s why it’s often considered 92% effective. This means that if 100 women use the Pill, but don’t take it perfectly, 8 or more women will become pregnant in a year.
Advantages of the combined pill
Advantages of taking the combined pill include:
It usually makes periods shorter, lighter and more regular.
It can improve symptoms that can come with periods such as pain, mood swings and headaches.
It lessens the risk of cancer of the ovaries and uterus.
It can be used to safely skip periods.
It usually improves acne.
Disadvantages of the combined pill
Disadvantages of taking the combined pill include:
You will need to remember to take a pill every day.
Cost can be an issue.
You will need to be able to visit your doctor regularly to renew your prescription.
It can cause side effects such as nausea, breast tenderness, headaches and increased appetite.
It can lead to serious complications such as deep vein thrombosis (blood clots), heart attacks and strokes, but these are not common.
The combined pill does not suit women who have medical conditions such as certain types of migraines, high blood pressure, severe heart conditions or liver disease.
It is not recommended for women who are very overweight, or who smoke and are aged over 35.
Vomiting and severe diarrhoea can stop the combined pill from being absorbed by the body.
Some medication, such as the type used to treat epilepsy, and the herbal remedy St John’s wort, may stop the combined pill from working.
It does not give protection from sexually transmissible infections (STIs).
But can’t it give you a lot of side-effects when you start?
Yes. During the first few packs of the Pill, many women get minor, passing side-effects, such as:
These side-effects usually go away after the first few packs. If they don’t, it’s easy to get rid of them by simply switching to another brand. For a complete list of side-effects, please read the leaflet that comes with your Pills.
THE PILL AND CANCER
Breast cancer
Research shows that even if there is a risk of breast cancer, it is small. Before you start taking the pill, the nurse will ask you if you or anyone in your family has had breast cancer.
Cervical cancer
If you’ve been on the pill for five or more years and you carry certain types of wart virus, you might be more at risk of cervical cancer. Whether you take the pill or not, you should get a cervical smear every three years.
Ovarian cancer
Your risk of ovarian cancer lowers by 50% if you take the pill. Even 30 years after stopping the pill you will still have a lower risk.
Endometrial cancer
This is cancer of the lining of the uterus. Your risk of endometrial cancer lowers by 50% if you take the pill. Even 15 years after stopping the pill you will still have a lower risk.
Who can use the combined pill
If there are no medical reasons why you cannot take the pill, and you don’t smoke, you can take the pill until your menopause. However, the pill is not suitable for all women. To find out whether the pill is right for you, talk to your GP, practice nurse or pharmacist.
You should not take the pill if you:
are pregnant
smoke and are 35 or older
stopped smoking less than a year ago and are 35 or older
are very overweight
take certain medicines (ask your GP or a health professional at a contraception clinic about this)
You should also not take the pill if you have (or have had):
thrombosis (a blood clot) in a vein, for example in your leg or lungs
stroke or any other disease that narrows the arteries
anyone in your close family having a blood clot under the age of 45
a heart abnormality or heart disease, including high blood pressure
severe migraines, especially with aura (warning symptoms)
Vaginal discharge is a mixture of liquid, cells, and bacteria that lubricates and protects the vagina. This mixture is constantly produced by the cells of the vagina and cervix and it exits the body through the vaginal opening. The composition, amount, and quality of discharge vary between individuals as well as through the various stages of sexual and reproductive development. Normal vaginal discharge may have a thinner, watery consistency or a thick, sticky consistency, and may be clear or white in color. Normal vaginal discharge may be large in volume but typically does not have a strong odor, nor is it typically associated with itching or pain. While most discharge represents normal functioning of the body, some changes in discharge can reflect infection or other pathological processes
What infections cause vaginal discharge to change?
There are a number of infections that cause vaginal discharge to change or become unpleasant. Many of these infections can be caused by having sex with someone who has the infection. This graph describes a number of common vaginal infections
Yeast Infection
Is caused by having sex with an infected person? No
What does discharge look like? Thick, white, like cottage cheese
How is the infection treated? Antifungal vaginal creams or pills
Trichomoniasis (“Trick”)
Is caused by having sex with an infected person? Yes
What does discharge look like? Green, yellow, or gray in color; frothy
How is the infection treated? Antibiotics ordered by your doctor
Bacterial vaginosis (Gardnerella or BV)
Is caused by having sex with an infected person? Probably not
What does discharge look like? White discharge that smells fishy
How is the infection treated? Antibiotic pills or vaginal cream ordered by your doctor
Gonorrhea (Clap)
Is caused by having sex with an infected person? Yes
What does discharge look like? Cloudy or yellow, but often no symptoms. If not treated, the infection may spread, causing pelvic inflammatory disease with pelvic pain.
How is the infection treated? Antibiotic pills or shots ordered by your doctor
Chlamydia (Kla-mid-ee-ah)
Is caused by having sex with an infected person? Yes
What does discharge look like? Often no symptoms. If not treated, the infection may spread, causing pelvic inflammatory disease with pelvic pain.
How is the infection treated? Antibiotic pills ordered by your doctor
Causes of vaginal discharge
Non-infective
Physiological
Cervical ectopy
Foreign bodies, such as retained tampon
Vulval dermatitis
Non-sexually transmitted infection
Bacterial vaginosis
Candida infections
Sexually transmitted infection
Chlamydia trachomatis
Neisseria gonorrhoeae
Trichomonas vaginalis
Causes abnormal discharge
According to the causes of infection
Non-infective
Physiological
Cervical ectopy
Foreign bodies, such as retained tampon
Vulval dermatitis
Non-sexually transmitted infection
Bacterial vaginosis
Candida infections
Sexually transmitted infection
Chlamydia trachomatis
Neisseria gonorrhoeae
Trichomonas vaginalis
According to the overall condition
Any change in the vagina’s balance of normal bacteria can affect the smell, color, or discharge texture. These are a few of the things that can upset that balance:
Antibiotic or steroid use
Bacterial vaginosis, a bacterial infection more common in pregnant women or women who have multiple sexual partners
Birth control pills
Cervical cancer
Chlamydia or gonorrhea (STDs), sexually transmitted infections
Diabetes
Douches, scented soaps or lotions, bubble bath
Pelvic infection after surgery
Pelvic inflammatory disease (PID)
Trichomoniasis, a parasitic infection typically contracted and caused by having unprotected sex
Vaginal atrophy, the thinning and drying out of the vaginal walls during menopause
Vaginitis, irritation in or around the vagina
Yeast infections
See the chart below to learn more about what a particular type of discharge might mean.
Types of Abnormal Discharge and Their Possible Causes
Type of Discharge
What It Might Mean
Other Symptoms
Bloody or brown
Irregular menstrual cycles, or less often, cervical or endometrial cancer
Abnormal vaginal bleeding, pelvic pain
Cloudy or yellow
Gonorrhea
Bleeding between periods, urinary incontinence, pelvic pain
Frothy, yellow or greenish with a bad smell
Trichomoniasis
Pain and itching while urinating
Pink
Shedding of the uterine lining after childbirth (lochia)
Thick, white, cheesy
Yeast infection
Swelling and pain around the vulva, itching, painful sexual intercourse
White, gray, or yellow with fishy odor
Bacterial vaginosis
Itching or burning, redness and swelling of the vagina or vulva
Types of abnormal discharge and their possible causes
Any change in the balance of normal bacteria in the vagina can affect the smell, colour, or texture of the discharge. These are a few of the things that can upset the balance:
Type of Discharge
What It Might Mean
Other Symptoms
Bloody or brown
Irregular menstrual cycles, or less often, cervical or endometrial cancer
Irregular vaginal bleeding, pelvic pain
Cloudy or yellow
Gonorrhoea
Bleeding between periods, painful urination
Frothy, yellow or greenish with a bad smell
Trichomoniasis
Pain and itching while urinating
Pink
Shedding of the uterine lining after childbirth (lochia)
Thick, white, cheesy
Yeast infection
Swelling and pain around the vulva, itching, painful sexual intercourse
White, grey, or yellow with a fishy odor
Bacterial vaginosis
Itching or burning, redness and swelling of the vagina or vulva
Warning signs
In girls, a fever or a yellow or green discharge with a fishy odor (because they may have a sexually transmitted disease resulting from sexual abuse)
Severe abdominal or pelvic pain or pain, particularly if it lasts more than 2 hours
Drainage of pus, a fever, or other signs of infection in the reproductive organs
Stool in the vaginal discharge
A bloody discharge after menopause
Looks foamy or like cottage cheese
Is green, yellow, or gray in color
Causes swelling
Causes itching
In women with an abnormal discharge, certain characteristics are cause for concern
Diagnosis of Vaginal Discharge
History Ask the patient about itching, odor, the color of discharge, painful intercourse, or spotting after intercourse.
Yeast causes intense itching with a cheesy, dry discharge.
Gardnerella causes a foul-smelling, thin white discharge.
Trichomonas gives irritation and frothy white discharge.
Foreign body (lost tampon) causes a foul-smelling black discharge.
Cervicitis causes a nondescript discharge with deep dyspareunia
Chlamydia may cause a purulent vaginal discharge, post-coital spotting, and deep dyspareunia.
Gonorrhea may cause a purulent vaginal discharge and deep dyspareunia.
Cervical ectropion causes a mucous, asymptomatic discharge.
Physical Exam
Inspect carefully for the presence of lesions, foreign bodies and odor. Palpate to determine cervical tenderness.
Yeast has a thick white cottage-cheese discharge and red vulva.
Gardnerella has a foul-smelling, thin discharge.
Trichomonas has a profuse, bubbly, frothy white discharge.
Foreign body is obvious and has a terrible odor.
Cervicitis has a mucopurulent cervical discharge and the cervix is tender to touch.
Chlamydia causes a friable cervix but often has no other findings.
Gonorrhea causes a mucopurulent cervical discharge and the cervix may be tender to touch.
Cervical ectropion looks like a non-tender, fiery-red, friable button of tissue surrounding the cervical os.
Infected/Rejected IUD demonstrates a mucopurulent cervical discharge in the presence of an IUD. The uterus is mildly tender.
Chancroid appears as an ulcer with irregular margins, dirty-gray necrotic base and tenderness.
Laboratory
Obtain cultures for chlamydia, gonorrhea, and Strept. You may test the vaginal discharge in any of 4 different ways:
Test the pH. If >5.0, this suggests Gardnerella.
Mix one drop of KOH with some of the discharge on a microscope slide. The release of a bad-smelling odor confirms Gardnerella.
Examine the KOH preparation under the microscope (“Wet Mount”). Multiple strands of thread-like hyphae confirm the presence of yeast.
Mix one drop of saline with some discharge (“Wet Mount”). Under the microscope, large (bigger than WBCs), moving micro-organisms with four flagella are trichomonads. Vaginal epithelial cells studded with coccoid bacteria are “clue cells” signifying Gardnerella.
Differential diagnosis of vulvovaginal symptoms. The parameters listed here can be useful for the rapid diagnosis of vulvovaginal symptoms. It is important to differentiate aerobic vaginitis from atrophic vaginitis. The latter often presents with identical symptoms in women with estrogen deficiency (e.g., postpartum, during the lactation period, in postmenopausal women) and can usually be treated effectively with local application of estriol.
parabasal cells, elevated leukocyte count, no lactobacilli
KOH (whiff) test
positive
negative
often positive
negative
or
Combination therapies for PID (modified and based on 16, 17, 40).
Combinations of active ingredients
Dose
Length of treatment
Azithromycin – can also be used as an alternative to doxycycline (pregnancy!) to treat severe PID.* On the length of treatment: data on the length of treatment required when administering antibiotic therapies is poor and inconsistent. With the exception of single doses and the use of doxycycline to treat chlamydia (at least 14 days), the length of treatment should depend on the clinical condition (rule of thumb: intravenous antibiotic treatment should be discontinued at the earliest 24 hours after significant clinical improvement; length of treatment should be at least 7 days, usually not more than 14 days).
Mild to moderate form
1. Ceftriaxone plusdoxycycline
250 mg i. m.2 × 100 mg/day orally
single dose14 days
Alternatively
2. Amoxicillin/clavulanic acidplusdoxycycline
2–3 × 875 mg/125 mg per day orally2 × 100 mg/day orally
*14 days
Alternatively
3. Ofloxacinplus metronidazole
2 × 400 mg per day orally2 × 500 mg per day orally
*14 days
The first two regimens can be additionally combined with metronidazole to ensure effectiveness against anaerobes (combination 1) or increase effectiveness even further (combination 2). These regimens also treat potentially present BV. The use of azithromycin (off-label) is a possible alternative to doxycycline and ofloxacin, both of which are contraindicated in pregnancy; suggested azithromycin dosage: 1 × 1 g per week [rx].
Severe form
1.Ceftriaxone plusmetronidazoleplus doxycycline
1 × 2,0 g/day2 × 500 mg/day (i. v. or orally)2 × 100 mg/day, orally where possible
**14 days
Alternatively
2. Piperacillin/tazobactamplusdoxycycline
4.0 g/0.5 g every 8 hours i. v.2 × 100 mg/day, orally where possible
*At least 14 days
Alternatively 3. Meropenem
500 mg/every 8 hours i. v.
*
Treatment of Vaginal Discharge
Non Pharmacological Treatment
Ways to Ease Watery Discharge Discomfort
Methods of helping to calm the discharge are common sense, but many women will fail to do them. If the discharge is causing discomfort, consult your doctor. Otherwise, you can try the following to help ease:
Use Baby Wipes – Make use of your purse. Baby wipes are a great way to help clean the vagina and keep the area bacteria-free. These wipes shouldn’t be inserted in the vagina. Simply clean the outside of the vagina to alleviate any smells or wetness that’s causing discomfort. If possible, choose an unscented baby wipe. The fewer chemicals, the better.
Use Pads – I don’t recommend keeping a tampon in to solve watery discharge. But you can use pads to ensure that your undies stay dry. Always offers very thin pads that are comfortable and work to absorb any liquid that may be expelled. These pads don’t come with wings, and they absorb within seconds. This is a great way to stop the wet feeling that leaves you feeling self-conscious and uncomfortable throughout the day.
Change Your Underwear Often – If your underwear is getting wet fast, you’ll want to keep a fresh pair in your purse. This allows you to change your underwear as it gets wet to avoid any discomfort. You’ll also want to change your underwear to ensure that no bacteria buildup occurs. It’s not uncommon for the moist and wet environment to cause bacteria growth in the panties. And this bacterium can lead to infection, which is not fun.
Increase the “Air” – If you can, sleep naked at night without pants or underwear. Place a towel down on the bed to ensure that the bed doesn’t get wet. This airing out allows you to decrease the risk of infection and reduces irritation. An issue of bacteria imbalance will benefit from airing out. The body will sort out the bacteria imbalance on its own in most cases.
Boost Your Immune System With Natural Herbs – Watery discharge isn’t an indicator of health issues, but there’s a small risk that the discharge will transition into an infection. This happens when other symptoms are present, and the discharge will often change colors instead of staying clear.
A few natural herbs and products that can help you boost your immune system to fight off potential infection are:
Vitamin C
D-Mannose
Saraca Ashoka
Cimicifuga Racemosa
You can also try to cleanse the urinary tract with cranberry juice to stop an infection before it progresses. Again, this may be overkill, but it’s never a bad idea to help boost your immune system and clean out the reproductive system.
Watery discharge is common, and there often isn’t a cause for concern. Since the clear discharge is part of the normal menstrual cycle, it often occurs monthly without concern. If you notice a gush of discharge that can soak a tampon, consult with your doctor.
Treatment of Vaginal Discharge
In addition to specific treatment of any organism identified by culture or another test.
summarises some of the recommended treatments for individual infections.
Management of vaginal infections
Bacterial vaginosis
Metronidazole 2 g as a single oral dose, metronidazole 400-500 mg twice daily for five to seven days, intravaginal clindamycin cream (2%) once daily for seven days, or intravaginal metronidazole gel (0.75%) once daily for five days4
The infection often recurs and acidic vaginal jelly (such as Relact from Kora Healthcare) may reduce relapse rates27
Partner notification not needed
Vulvovaginal candidiasis
Vaginal imidazole preparations (such as clotrimazole, econazole, miconazole—various preparations are available including single dose ones), or fluconazole 150 mg orally8
The role of alternative treatments like tea tree oil and yoghurt containing Lactobacillus acidophilus have not been evaluated9
Oral versus vaginal treatment depends on preference
Treatment for candidiasis is available over the counter in the UK
Partner notification not needed
Chlamydia trachomatis
Doxycycline 100 mg twice daily for seven days (contraindicated in pregnancy), azithromycin 1 g orally in a single dose (WHO recommends azithromycin in pregnancy but the British National Formulary advises against its use unless no alternatives are available)13
Cefixime 400 mg as a single oral dose or ceftriaxone 250 mg intramuscularly as a single dose16
Referral to a genitourinary medical unit is encouraged because of the existence of resistant strains of the organism16
A test of cure is not routinely indicated if an appropriately sensitive antibiotic has been given, symptoms have resolved, and there is no risk of reinfection16
Partner notification required
Trichomonas vaginalis
Metronidazole 2 g orally in a single dose or metronidazole 400-500 mg twice daily for five to seven days17
Partner notification required
Readers should refer to BASHH guidelines, the British National Formulary, and local policies for full treatment options, including treatment in pregnancy
Any patient complaining of an itchy vaginal discharge should probably be treated with an antifungal agent (Monistat, Lotrimin, etc.) because of the high likelihood that yeast is present, and
Any patient complaining of a bad-smelling vaginal discharge should probably be treated with Flagyl (or another reasonable substitute) because of the high likelihood that Gardnerella is present
Ectropion, Erosion or Eversion
This harmless condition is frequently mistaken for cervicitis.
Ectropion, erosion or eversion (all synonyms) occurs when the normal squamocolumnar junction is extended outward from its; normal position at the opening of the cervix.
Grossly, the cervix has a red, friable ring of tissue around the os. Careful inspection with magnification (6-10x) will reveal that this red tissue is the normal tissue of the cervical canal, which has grown out onto the surface of the cervix.
Cervical ectropion is very common, particularly in younger women and those taking BCPs. It usually causes no symptoms and need not be treated. If it is symptomatic, producing a more or less constant, annoying, mucous discharge, cervical cauterization will usually eliminate the problem.
When faced with a fiery red button of tissue surrounding the cervical os, chlamydia culture (in high-risk populations) and Pap smear should be performed. If these are negative and the patient has no symptoms, this cervical ectropion should be ignored.
Cervicitis
Inflammation or irritation of the cervix is rarely the cause of significant morbidity. It is mainly a nuisance to the patient and a possible symptom of the underlying disease (gonorrhea, chlamydia).
Some patients with cervicitis note a purulent vaginal discharge, deep dyspareunia, and spotting after intercourse, while others may be symptom-free. The cervix is red, slightly tender, bleeds easily, and a mucopurulent cervical discharge from the os is usually seen.
A Pap smear rules out malignancy. Chlamydia culture and gonorrhea culture (for gram negative diplococci) are routinely performed.
No treatment is necessary if the patient is asymptomatic, the Pap smear is normal, and cultures are negative. Antibiotics specific to the organism are temporarily effective and may be curative. Cervical cautery may be needed to achieve a permanent cure.
Chlamydia
This sexually-transmitted disease is caused by “Chlamydia trachomatis“. It very commonly locates in the cervical canal although it can spread to the fallopian tubes where it can cause PID.
Most women harboring chlamydia will have no symptoms, but others complain of purulent vaginal discharge, deep dyspareunia, and pelvic pain. There may be no significant pelvic findings, but a friable cervix, mucopurulent cervical discharge, pain on motion of the cervix, and tenderness in the adnexa are suggestive.
The diagnosis is often made on the basis of clinical suspicion but can be confirmed with chlamydia culture. Such cultures are frequently performed routinely in high-risk populations.
Treatment is:
Recommended Regimens
Azithromycin1 g orally in a single dose OR
Doxycycline100 mg orally twice a day for 7 days.
Alternative Regimens
Erythromycin base500 mg orally four times a day for 7 days, OR
Erythromycin ethylsuccinate800 mg orally four times a day for 7 days, OR
Ofloxacin300 mg orally twice a day for 7 days, OR
Levofloxacin500 mg orally for 7 days.
Read the CDC Treatment Guidelines for Chlamydia
Foreign Body
Lost and forgotten tampons are the most common foreign body found in the vagina, although other objects are occasionally found. Women with this problem complain of a bad-smelling vaginal discharge which is brown or black in color. The foreign body can be felt on digital exam or visualized with a speculum.
As soon as you suspect or identify a lost tampon or another object in the vagina, immediately prepare a plastic bag to receive the object. As soon as it is retrieved, place it in the bag and seal the bag since the anaerobic odor from the object will be extremely penetrating and long-lasting.
Have the patient return in a few days for a follow-up examination. Normally, no other treatment is necessary, but patients who also complain of fever or demonstrate systemic signs/symptoms of illness should be evaluated for possible toxic shock syndrome, an extremely rare, but serious, complication of a retained tampon.
Gardnerella (Hemophilus, Bacterial Vaginosis)
The patient with this problem complains of a bad-smelling discharge which gets worse after sex. Cultures will show the presence of “Gardnerella Vaginalis,” the bacteria associated with this condition. While this problem is commonly called “Gardnerella,” it is probably the associated anaerobic bacteria which actually cause the bad odor and discharge.
The diagnosis is confirmed by the release of a bad odor when the discharge is mixed with KOH (“whiff test”), a vaginal pH greater than 5.0, or the presence of “clue cells” (vaginal epithelial cells studded with bacteria) in the vaginal secretions.
The treatment is
Metronidazole500 mg orally twice a day for 7 days,
Recommended Regimens (CDC 2002)
ORMetronidazole gel0.75%, one full applicator (5 g) intravaginally, once a day for 5 days,
OR
Clindamycin cream 2%, one full applicator (5 g) intravaginally at bedtime for 7 days.
Alternative Regimens (CDC 2002)
Metronidazole2 g orally in a single dose,
OR
Clindamycin300 mg orally twice a day for 7 days
OR
Clindamycin Ovules100 g intravaginally once at bedtime for 3 days.
Read the CDC Treatment Guidelines for Bacterial Vaginosis
Many (perhaps most) women harboring the gonococcus will have no symptoms, but others complain of purulent vaginal discharge, pelvic pain, and deep dyspareunia. There may be no significant pelvic findings, but mucopurulent cervical discharge, pain on motion of the cervix, and tenderness in the adnexa are all classical.
Gonorrhea
This sexually-transmitted disease is caused by a gram-negative diplococcus. The organism grows easily in the cervical canal, where it can spread to the fallopian tubes, causing PID. It may also infect the urethra, rectum or pharynx.
The diagnosis is often made on the basis of clinical suspicion but can be confirmed with chocolate agar culture or gram stain.
Treatment is: Recommended Regimens (CDC 2002)
Cefixime400 mg orally in a single dose,
OR
Ceftriaxone125 mg IM in a single dose,
OR
Ciprofloxacin500 mg orally in a single dose,
OR
Ofloxacin400 mg orally in a single dose,
OR
Levofloxacin250 mg orally in a single dose,
PLUS, IF CHLAMYDIAL INFECTION IS NOT RULED OUT
Azithromycin1 g orally in a single dose
OR
Doxycycline100 mg orally twice a day for 7 days.
Alternative Regimens (CDC 2002)
Spectinomycin2 g in a single, IM dose. Spectinomycin is expensive and must be injected; however, it has been effective in published clinical trials, curing 98.2% of uncomplicated urogenital and anorectal gonococcal infections. Spectinomycin is useful for the treatment of patients who cannot tolerate cephalosporins and quinolones.
Single-dose cephalosporinregimens (other than ceftriaxone 125 mg IM and cefixime 400 mg orally) that are safe and highly effective against uncomplicated urogenital and anorectal gonococcal infections include ceftizoxime (500 mg, administered IM), cefoxitin (2 g, administered IM with probenecid 1 g orally), and cefotaxime (500 mg, administered IM). None of the injectable cephalosporins offer any advantage over ceftriaxone.
Single-dose quinolone regimens include gatifloxacin 400 mg orally, norfloxacin 800 mg orally, and lomefloxacin 400 mg orally. These regimens appear to be safe and effective for the treatment of uncomplicated gonorrhea, but data regarding their use are limited. None of the regimens appear to offer any advantage over ciprofloxacin at a dose of 500 mg, ofloxacin at 400 mg, or levofloxacin at 250 mg.
Sexual partners also need to be treated.
Infected IUD
Sooner or later, as many as 5% of all intrauterine devices will become infected. Patients with this problem usually notice mild lower abdominal pain, sometimes have a vaginal discharge and fever, and may notice deep dyspareunia. The uterus is tender to touch and one or both adnexa may also be tender.
Treatment consists of removal of the IUD and broad-spectrum antibiotics. If the symptoms are mild and the fever low-grade, oral antibiotics (amoxicillin, cephalosporins, tetracycline, etc.) are very suitable. If the patient’s fever is high, the symptoms significant or she appears quite ill, IV antibiotics are a better choice (cefoxitin, or metronidazole plus gentamicin, or clindamycin plus gentamicin).
If an IUD is present and the patient is complaining of any type of pelvic symptom, it is wisest to remove the IUD, give antibiotics, and then worry about other possible causes for the patient’s symptoms.
IUDs can also be rejected without infection. Such patients complain of pelvic pain and possibly bleeding. On pelvic exam, the IUD is seen protruding from the cervix. It should be grasped with an instrument and gently removed. It cannot be saved and should not be pushed back inside.
PID:
Mild Gradual onset of mild bilateral pelvic pain with purulent vaginal discharge is the typical complaint. Fever <100.4 and deep dyspareunia are common.
Moderate pain on motion of the cervix and uterus with purulent or mucopurulent cervical discharge is found on examination. Gram-negative diplococci or positive chlamydia culture may or may not be present. WBC may be minimally elevated or normal.
Treatment consists of:
Regimen A (CDC 2002)
Ofloxacin400 mg orally twice a day for 14 days
OR
Levofloxacin500 mg orally once daily for 14 days
WITH or WITHOUT
Metronidazole500 mg orally twice a day for 14 days
Regimen B (CDC 2002)
Ceftriaxone250 mg IM in a single dose
OR
Cefoxitin2 g IM in a single dose and Probenecid,1 gorally administered concurrently in a single dose
OR
Other parenteral third-generation cephalosporin(e.g., ceftizoxime or cefotaxime)
PLUS
Doxycycline 100mg orally twice a day for 14 days
WITH or WITHOUT
Metronidazole 500 mg orally twice a day for 14 days.
PID: Moderate to Severe
Severe PID required a hysterectomy to cure.
With moderate to severe PID, there is a gradual onset of moderate to severe bilateral pelvic pain with purulent vaginal discharge, fever >100.4 (38.0), lassitude, and headache. Symptoms more often occur shortly after the onset or completion of menses.
Excruciating pain on movement of the cervix and uterus is characteristic of this condition. Hypoactive bowel sounds, purulent cervical discharge, and abdominal dissension are often present. Pelvic and abdominal tenderness is always bilateral except in the presence of an IUD.
Gram-negative diplococci in cervical discharge or positive chlamydia culture may or may not be present. WBC and ESR are elevated.
Treatment consists of bedrest, IV fluids, IV antibiotics, and NG suction if ileus is present. Since surgery may be required, transfer to a definitive surgical facility should be considered.
Parenteral Regimen A (CDC 2002)
Cefotetan2 g IV every 12 hours
OR
Cefoxitin2 g IV every 6 hours
PLUS
Doxycycline100 mg orally or IV every 12 hours.
Parenteral Regimen B (CDC 2002)
Clindamycin900 mg IV every 8 hours
PLUS
Gentamicin loading dose IV or IM (2mg/kg of body weight) followed by a maintenance dose (1.5mg/kg) every 8 hours. Single daily dosing may be substituted.
Alternative Parenteral Regimens (CDC 2002)
Ofloxacin400 mg IV every 12 hours
OR
Levofloxacin500 mg IV once daily
WITH or WITHOUT
Metronidazole500 mg IV every 8 hours
OR
Ampicillin/Sulbactam3 g IV every 6 hours
PLUS
Doxycycline100 mg orally or IV every 12 hours.
Trichomonas
This microorganism, with its four flagella to propel it, is not a normal inhabitant of the vagina. When present, it causes a profuse, frothy white or greenish vaginal discharge.
When the discharge is suspended in normal saline and examined under the microscope, the typical movement of these large organisms (larger than white blood cells) is obvious. Itching may be present, but this is inconsistent. Trichomonas is transmitted sexually and you may wish to treat the sexual partner, particularly if this is a recurrent trichomonad infection.
Recommended Regimen (CDC 2002)
Metronidazole2 g orally in a single dose.
Alternative Regimen (CDC 2002)
Metronidazole500 mg twice a day for 7 days.
Yeast (Monilia, Thrush)
Vaginal yeast infections are common, monilial overgrowths in the vagina and vulvar areas, characterized by itching, dryness, and a thick, cottage-cheese appearing vaginal discharge. The vulva may be reddened and irritated to the point of tenderness.
Yeast thrives in damp, hot environments and women in such circumstances are predisposed toward these infections. Women who take broad-spectrum antibiotics are also predisposed towards these infections because of loss of the normal vaginal bacterial flora.
Yeast organisms are normally present in most vaginas, but in small numbers. A yeast infection, then, is not merely the presence of yeast, but the concentration of yeast in such large numbers as to cause the typical symptoms of itching, burning, and discharge. Likewise, a “cure” doesn’t mean the eradication of all yeast organisms from the vagina. Even if eradicated, they would soon be back because that is where they normally live. A cure means that the concentration of yeast has been restored to normal and symptoms have resolved.
The diagnosis is often made by history alone and enhanced by the classical appearance of a dry, cheesy vaginal discharge. It can be confirmed by microscopic visualization of clusters of thread-like, branching Monilia organisms when the discharge is mixed with KOH.
Recommended Regimens (CDC 2002)
Intravaginal Agents
Butoconazole2% cream 5 g intravaginally for 3 days,
OR
Butoconazole2% cream 5 g (Butaconazole1-sustained release), single intravaginal application,
OR
Clotrimazole1% cream 5 g intravaginally for 7–14 days,
OR
Clotrimazole100 mg vaginal tablet for 7 days,
OR
Clotrimazole 100 mg vaginal tablet, two tablets for 3 days,
OR
Clotrimazole 500 mg vaginal tablet, one tablet in a single application,
OR
Miconazole2% cream 5 g intravaginally for 7 days,
OR
Miconazole100 mg vaginal suppository, one suppository for 7 days,
OR
Miconazole200 mg vaginal suppository, one suppository for 3 days,
OR
Nystatin 100,000-unit vaginal tablet, one tablet for 14 days,
OR
Tioconazole6.5% ointment 5 g intravaginally in a single application,
OR
Terconazole0.4% cream 5 g intravaginally for 7 days,
OR
Terconazole0.8% cream 5 g intravaginally for 3 days,
OR
Terconazole80 mg vaginal suppository, one suppository for 3 days.
Oral Agent:
Fluconazole150 mg oral tablet, one tablet in single dose.
Reoccurrences are common and can be treated the same as for initial infections. For chronic recurrences, many patients find the use of a single applicator of Monistat 7 at the onset of itching will abort the attack completely. Sexual partners need not be treated unless they are symptomatic.
How to keep your vagina healthy
Maintaining a healthy vagina does not require a lot of effort, but is something you need to do. In order to protect the vagina and prevent the risk of infection, stick to the following guidelines:
Keep it clean and dry
Wear cotton underwear.
Never douche – this removes natural vaginal bacteria.
Always practice safe sex
Eat a healthy diet, especially when taking antibiotics and increase your intake of yogurt with live and active cultures.
Avoid feminine hygiene products in the genital area
Use pads and not tampons.
Keep your blood sugar levels under good control if you have diabetes.
Home Remedies
1. Tea Tree Oil
If you use scented wipes and vaginal deodorants, it’s time to throw them in the trash bin. These products can disrupt the vagina’s pH balance and induce infection and foul odor. To get rid of odors, use natural tea tree oil diluted in water as a vaginal wash.
You Will Need
A few drops of tea tree oil
A cup of water
What You Have To Do
1. Mix three to four drops of tea tree oil in water and use this to rinse the vaginal area.
2. You can also dip a tampon in olive oil, pour two to three drops of tea tree oil on it, and insert the tampon. Leave it in for an hour.
How Often You Should Do This
Wash with the tea tree oil water daily or several times a week. As for the ‘tampon and oil’ treatment, you can repeat it several times a week.
Why This Works
Tea tree oil is both antibacterial and antifungal, and thus will curb the infection while fighting the odor .
Caution
Always do a test patch on your forearm as tea tree oil might not suit everybody.
2. Baking Soda
If you thought baking soda finds its use only in cakes and bread recipes, you are wrong. You will be surprised to see how this tested method helps you to get rid of vaginal odor quickly.
You Will Need
1/2 cup of baking soda
What You Have To Do
1. Add baking soda to your bath and soak your lower body in it for 20-30 minutes.
2. You can also add a teaspoon of baking soda in a glass of warm water and gulp it down.
Why This Works
The vaginal odor intensifies when the pH level of the body goes awry. Baking soda helps bring your pH levels back to normal, thus controlling the excess of bacteria and fungi. This treats the infection and eliminates the crotch odor instantly. You can also use baking soda water as a vaginal wash.
3. Pineapple
This amazing fruit is said to be beneficial for your vaginal health and odor.
You Will Need
Pineapple or pineapple juice
What You Have To Do
Include raw pineapple and pineapple juice in your regular diet.
How Often You Should Do This
You can drink one to two glasses of fresh pineapple juice every day for a few days.
Why This Works
The strong smell of pineapple improves the odor of your vaginal secretions.
4. Hydrogen Peroxide For Bacterial Vaginosis
Hydrogen peroxide is a multipurpose chemical that can be used to treat bacterial vaginosis and remove bad vaginal odor. It is one of the most effective feminine odor remedies.
You Will Need
3% hydrogen peroxide
1 tampon
Water
What You Have To Do
1. Mix equal parts of hydrogen peroxide and water.
2. Dip a tampon in this mixture and insert it into the vagina. Leave it in for not more than 30 minutes.
How Often You Should Do This
You can repeat this every few hours until the foul odor subsides.
Why This Works
The natural disinfecting properties of hydrogen peroxide kill the bad bacteria in the vagina. This leads to an increase in the number of the good bacteria that are naturally present there. Many studies have been conducted, and they all prove the infection-treating capabilities of hydrogen peroxide .
5. Vitamin C With Rose Hips
Rose hips are the seeds of the rose plant, and they contain high levels of vitamin C. Rose hips, by themselves, or in combination with a vitamin C tablet can be used to get rid of vaginal odor.
You Will Need
Vitamin C tablet
Rose hips
1 tampon
What You Have To Do
Insert the tablet with rose hips into the vagina. You can keep it there with the help of a tampon.
How Often You Should Do This
Repeat this every day till the fishy smell from the vaginal discharge goes away.
Why This Works
Vitamin C is an immunity booster and helps remove harmful toxins from the body. The tablet, when used in combination with rose hips, is an effective and safe method to treat bacterial vaginosis, one of the major causes of foul odor in the vagina area . An efficacy study conducted in 2013 also showed that using vitamin C tablets for six days a month for six months can reduce the recurrence of this infection
Who knew betel leaves (paan) could be used to cure the smelly discharge problem? Read on to find out how.
You Will Need
A few betel leaves
Tampon
What You Have To Do
1. Tear the leaves into small pieces and boil them. Simmer for about 10 minutes.
2. Cool the decoction until it reaches lukewarm temperature.
3. Dip the tampon in this liquid and insert it into the vagina.
4. Keep it there for 15 minutes. Remove and discard.
How Often You Should Do This
Repeat this daily for one week. You could also drink this decoction twice a day or use the water as a vaginal wash.
Why This Works
The extract of betel leaves is used in ointments for its antibacterial properties. It also acts as an astringent.
7. Vinegar
Vinegar, especially ACV, is yet another potent remedy that is fail-proof when it comes to fighting vaginal odor.
You Will Need
1 cup of white vinegar or apple cider vinegar
What You Have To Do
1. Mix the vinegar in your bathtub with water and soak in it for 20 minutes.
2. You can also mix two tablespoons of vinegar in 8 oz of water and drink it.
How Often You Should Do This
Soak in vinegar water once daily till the foul smell discharge is treated. Drink vinegar water twice daily.
Why This Works
Vinegar gets rid of the toxins that cause the fishy vaginal odor. It is acidic in nature and is loaded with antibacterial properties that will help kill the odor-causing germs .
Caution
Some people are allergic to vinegar. Step into the bathtub lightly, and if you experience a burning sensation, step out immediately and wash the area
8. Garlic
Many may question the potency of garlic in treating odor, but thanks to its own pungent smell, it works amazingly. Believe us when we say that this is certainly one of the best-known home remedies to kill overpowering vaginal odor.
You Will Need
A garlic clove
A cheesecloth
String
What You Have To Do
1. Peel the fresh garlic clove, and wrap it in a cheesecloth.
2. Attach a small string to it. Insert it into the vagina and leave it there overnight.
3. Remove it in the morning with the help of the string.
How Often You Should Do This
Do it once overnight. The pungent vaginal odor should be gone by the morning. You can repeat if the infection and the bad odor is still there.
Why This Works
Garlic has been used since ancient times to treat infections. Various studies have proved that it has antibacterial activity against a wide range of bacteria .
9. Chlorophyll
Do you remember reading about chlorophyll that plants use to make their own food with the use of sunlight and water? Yes, that very chlorophyll can work wonders in reducing the vaginal smell.
You Will Need
Liquid chlorophyll or chlorophyll tablets
What You Have To Do
1. Drink one tablespoon of chlorophyll diluted with 8 oz of water, and you will never have to visit the doctor to get rid of vaginal odor.
2. You can take one tablet in the night and one in the morning if you cannot find the liquid version in the pharmacy.
How Often You Should Do This
Drink or take the tablet twice a day till the fishy smell from the vagina is gone.
Why This Works
Liquid chlorophyll works as a good deodorant and helps reduce the strong and unpleasant odor . It is easily available with most pharmacists.
10. Yogurt
Yogurt might not be your favorite food, but it can help diminish and reduce vaginal odor considerably. Simply have two cups of unsweetened yogurt a day, preferably with meals, to restore the normal pH of the vagina.
You Will Need
1-2 teaspoons of yogurt
1 tampon
What You Have To Do
1. Dip the tampon in the yogurt and gently insert it into your vagina.
2. Let it be there for an hour or two. Remove and rinse the area.
Alternatively, if you suffer from a very strong vaginal odor, you can also dip cotton pads in the yogurt and gently rub them on the vagina.
How Often You Should Do This
You can repeat the cotton pads method three to four times a day. The tampon method will help you to eliminate the vaginal odor overnight.
Why This Works
A strong vaginal odor is an indication of a yeast infection. The bacteria in yogurt can help fight the infection and reduce the odor as well. It brings the vaginal pH back to normal, and the lactobacillus bacteria present in it will help treat the infection. This is a natural and effective method to remove the fishy smell from your vagina (
11. Herbal Capsules
An alkaline vaginal pH leads to bacterial growth and foul smell. Therefore, it is important to maintain an acidic vaginal pH. One of the best ways to maintain acidic vaginal pH is by consuming homemade herbal capsules for two consecutive weeks.
Here is how to prepare the herbal capsule:
You Will Need
Comfrey root powder – 2 tablespoons
Myrrh gum powder – 2 tablespoons
Slippery elm bark – 2 tablespoons
Goldenseal root powder – 4 tablespoons
Echinacea root powder – 2 tablespoons
Yellow dock root powder – 2 tablespoons
Gelatin capsules – size 00
What You Have To Do
1. Mix all the herbal powders.
2. Fill the size 00 capsules with a teaspoon (~700 mg) of the herbal powder mix.
3. Store in a safe and cool place.
4. Take two capsules thrice a day.
How Often You Should Do This
Take six capsules per day for one or two weeks.
Why This Works
These homemade herbal capsules have antibacterial, antifungal, and antiviral properties, which will help boost your overall health and prevent microbial growth in the vaginal area.
12. Alum
Aluminium potassium sulfate is known as alum. It is widely used to clean water tanks, as a traditional aftershave ointment, and in pickles. Alum is mixed with water to kill bacteria and eliminate body odor or vaginal odor. If the vaginal odor is due to excessive white discharge, alum can be helpful in preventing the odor.
Here is how to use alum to prevent vaginal odor.
You Will Need
Water
Alum
What You Have To Do
1. Mix half a teaspoon of alum with a glass of water and drink it twice a day. This will help manage excess white discharge and vaginal odor.
2. Soak an alum stick in water and rub it gently near the mouth of the vagina. Alum sticks are available in the market. Do this once or twice daily until you get the desired results.
2. Mix one-fourth tablespoon of alum powder in a liter of water and wash your vagina with this water.
How Often You Should Do This
Drink alum water twice a day. Wash your vagina with alum water daily for two weeks.
Why This Works
Alum arrests bacterial growth by preventing bacterial adhesion to the vaginal wall, which is one of the reasons for vaginal odor.
13. Gooseberry (Amla)
One the of the best and effective herbal home remedies to get rid of vaginal odor is to eat gooseberry or amla every day until you get the desired results. Gooseberry has a lot of antioxidants and has anti-inflammatory and antibacterial properties.
You Will Need
2 gooseberries
½ teaspoon roasted cumin powder
A pinch of salt
1 glass water
What You Have To Do
1. Use a mortar and pestle to grind the gooseberries.
2. In a glass of water, add the gooseberry paste, roasted cumin powder, and a pinch of salt. Stir well before drinking. Do this for two weeks.
3. You can also slice a gooseberry, add salt to it and let it dry in the sun for two days. Eat two or three pieces of the dried gooseberry per day for a week.
4. Cut a gooseberry in half and put it in a glass of water and refrigerate it overnight. In the morning, add a little salt and roasted cumin powder and sip this water throughout the day. Do this for two weeks.
5. Juice the gooseberries and consume two tablespoons of the juice first thing in the morning every alternate day for two weeks.
How Often You Should Do This
Follow any of the above mentioned methods for atleast two weeks for effective results.
Why This Works
The juice of the gooseberry contains vitamin C while cumin aids digestion and improves immunity. Both the ingredients help to boost immunity and kill bacterial growth .
14. Neem
Neem leaves (Indian lilac) and neem bark have antimicrobial properties. Neem leaves have been used for ages to cure many skin diseases, smallpox, gut parasites, and wounds. Since vaginal odor can also be due to bacterial overgrowth, neem leaves can be used to treat vaginal odor effectively.
You Will Need
10 neem leaves
1 inch neem bark
1 liter water
What You Have To Do
Wash the neem leaves thoroughly and add them in water. Boil the water until the quantity reduces to half. Use this water to wash your vagina daily. Do this for at least one week.
1. Wash the neem leaves thoroughly and let them soak in water overnight. Use this water to wash your vagina.
2. Wash the neem leaves thoroughly and grind them using a mortar and pestle. Do not add water. Take the neem paste and use your palm to make five small “neem balls”. Gulp one neem ball every morning. Wash it down with water.
3. Put the neem bark in the water and boil it till the water reduces to half. Drink this water the first thing in the morning.
How Often You Should Do This
Wash your vagina with neem water twice daily for two weeks. Drink neem water every morning for two weeks.
Why This Works
Since neem leaves and bark have antimicrobial properties, a daily dose of this herbal medicine will help prevent microbial growth and clean your system from within
15. Fenugreek
The leaves and seeds of fenugreek are both beneficial for women. It helps to maintain hormonal balance, reduces abdominal fat, improves digestion, reduces blood sugar levels, and reduces menstrual cramps . To use fenugreek to eliminate vaginal odor, follow these steps:
You Will Need
1 teaspoon fenugreek seeds
1 liter water
What You Have To Do
1. Boil the fenugreek seeds in water until the quantity of water reduces to half. Cool it and drink it before breakfast every day.
2. Soak the fenugreek seeds in water overnight. Drink it the first thing in the morning every day.
How Often You Should Do This
For best results, drink fenugreek water for two weeks.
Why This Works
Fenugreek water has a subtle bitter-sweet taste. Apart from providing the body with vitamins and minerals, it also aids weight loss. Less fat in the body would lead to less sweat, which is one of the causes of foul vaginal odor.
16. Cranberry
You might be aware that cranberry juice is highly effective in treating urinary tract infection (UTI). Cranberries have antimicrobial and anti-inflammatory properties. Hence, they will help reduce the foul odor of your vagina.
You Will Need
1 cup fresh cranberries
1 liter water
What You Have To Do
1. Soak the cranberries in the water overnight. Sip this water all throughout the day. This will help to flush out toxins and prevent bacterial infections.
2. Blend or juice the cranberries and drink the juice without removing the pulp. Remove the pulp if you have Irritable Bowel Disease.
How Often You Should Do This
Drink a glass of cranberry juice every day to eliminate vaginal odor.
Why This Works
Cranberries are highly effective against bacteria that affect the vagina and urinary tract. Cranberries prevent the adhesion of the bacteria on the vaginal wall, therefore preventing bacterial growth.
17. Turmeric
Turmeric has antimicrobial, anti-inflammatory, and antioxidant properties. It is one of the best home remedies to treat microbial infections and wounds .
Here is how to use turmeric to eliminate vaginal odor.
You Will Need
1 inch turmeric root or 1 teaspoon turmeric powder
1 glass milk
What You Have To Do
1. Wash the turmeric root thoroughly. Peel it and chew on it the first thing in the morning.
2. Add turmeric powder to a glass of warm milk and drink it before going to bed.
3. Wash the turmeric root thoroughly. Peel it and boil it in a liter of water until the quantity of water reduces to half. Use this water to wash your vagina.
How Often You Should Do This
Wash your vagina with this water twice a week.
Why This Works
Turmeric, if consumed in the raw and natural form, helps to kill bacteria and boost immunity. You will see a visible difference in your skin and your vaginal odor.
18. Citrus Fruits
Citrus fruits, such as oranges, grapefruit, sweet lime, lemon, grapes, etc., are excellent sources of vitamin C that boosts immunity. It helps the body to fight against bacterial growth in the vagina. Therefore, eating citrus fruits or drinking fresh citrus fruit juices will help to get rid of vaginal odor.
You Will Need
½ cup green grapes
1 sweet lime or orange
1 liter water
What You Have To Do
1. Eat the citrus fruits.
2. Slice the fruits and toss them into a jar containing a liter of water. Let them soak overnight. Sip this water all throughout the day.
3. Juice the citrus fruits and drink.
How Often You Should Do This
Eat citrus fruits or drink juices daily to eliminate vaginal odor.
Why This Works
Citrus fruit juice or detox water will help to maintain the body’s pH balance and prevent microbial infection and itching in the vagina.
19. Seeds & Nuts
Nuts and seeds have a good amount of vitamin E, which prevents vaginal dryness and itching. Pumpkin seeds and almonds are rich in zinc, which helps to prevent vaginal dryness, itching, bacterial growth and odor. Other nuts, such as walnuts, flax seeds (rich in omega-3-fatty acid and polyestrogen), hazelnuts, and sunflower seeds, are also helpful in regulating the menstrual cycle and preventing vaginal dryness and hormone imbalance .
You Will Need
4 almonds
2 hazelnuts
1 tablespoon flax seed powder
1 cup milk
What You Have To Do
1. Soak the almond seeds in water for four hours.
2. Peel the skin of the almonds and toss into the blender.
3. Toss in the hazelnuts.
4. Pour the milk and give it a spin.
5. Pour out the milk into a cup.
6. Add the flaxseed powder and stir well.
Why This Works
Nuts and milk will help strengthen your bones, improve brain function, scavenge oxygen radicals, and boost immunity.
20. Guava Leaves
Guava leaves contain tannins, antioxidants, antibacterial, and anti-proactive properties. Guava leaves have been used to treat wounds and prevent microbial infections. Here is how to use guava leaves to treat foul vaginal odor.
You Will Need
4-5 guava leaves
1 liter water
What You Have To Do
Throw in the guava leaves into the water and boil the water until it reduces to half.
How Often You Should Do This
Drink this before breakfast every alternate day for two weeks.
Why This Works
Guava leaves have antimicrobial properties that make them one of the best herbal remedies to treat vaginal odor .
21. Lavender Oil
This sweet smelling and mood uplifting oil will help to reduce vaginal itching and irritation. Here is how to use it.
You Will Need
2 drops lavender oil
1 drop mint oil
What You Have To Do
1. Add the oils to your bath water and soak your body in the water for at least 10 minutes.
2. Add the oils to a liter of water and store in a bottle. Refrigerate it. Use cotton to dab this solution on the mouth of your vagina and vaginal area.
How Often You Should Do This
Do this every alternate day for a couple of weeks.
Why This Works
The aroma of this oil will make you feel rejuvenated, smell good all the day long, and curb the problem of vaginal odor.
22. Use Boric Acid
To prevent bacterial growth and vaginal itching, it is important to maintain an acidic pH in the vagina. Lactobacillus (the good bacteria) helps to maintain the acidic pH levels in the vagina. However, menstrual blood and semen increase the pH levels and make it favorable for bacterial growth. Using boric acid, a mild antiseptic, will help to lower the pH levels and prevent bacterial vaginosis,
Here is how to use boric acid to get rid of vaginal odor.
You Will Need
Boric Acid
Gelatin capsules – size “00”
What You Have To Do
1. Fill the gelatin capsules with boric acid and keep them safe in an airtight container. Store it in a cool and dry place.
2. Insert one boric acid filled capsule into your vagina. Keep it overnight.
How Often You Should Do This
Use these capsules for three consecutive nights if you have bacterial vaginosis (use increased amount of boric acid). After that, use these capsules twice a week.
Caution: Do not swallow the boric acid capsules. Make sure you label the container properly. Also, do not try this method if you are pregnant or trying to conceive. Keep the boric acid capsule container away from children.
Why Does My Vagina Smell?
Normally, the vagina consists of the perfect combination of healthy bacteria that maintain the pH in that region. When this balance is altered due to the different reasons listed above like other bacteria and yeast, there is a change in this pH. The number of healthy bacteria goes down, and the other unhealthy bacteria and yeast grow. These cause a change in the vaginal discharge’s color and consistency and also result in the foul smell in your private parts.
Vaginal Odor After Intercourse
It is seen in many women that right after intercourse, they experience a change in their vaginal discharge accompanied by a foul smell. This is because most bacterial and fungal infections are spread through sex . Having vaginal, oral, or anal sex, or any sexual contact involving touching fluids of an infected person can make you contract the infection. These infections cause rashes, abnormal vaginal discharge, and that peculiar fishy smell from your vagina . Wash your vaginal area with cold or lukewarm water before and after having sex. This will prevent any unwanted bacterial growth, itching, and yeast infections. You may also encourage your partner to do so as well.
Vaginal Odor During Pregnancy
Vaginal odor that results due to infections can cause severe complications during pregnancy . If you are planning to get pregnant, it is advisable to get tested for any vaginal infections and treat it as soon as possible.
Extra care needs to be taken during the course of your pregnancy to avoid contracting any infections that result in alterations in your normal vaginal discharge and smell. Consult your doctor in case you notice any strong foul odor.
How To Make Your Vagina Smell Good Fast
It makes sense to pay attention to what you eat and strike off food that triggers the bad odor. Sweet food that contains a lot of sugar or foods rich in yeast can often cause vaginal odor. You should avoid them to reduce the yeast infection, and, in turn, reduce the vaginal odor. Several vegetables like kale and celery and fruits like pineapple and cranberry are said to make your vagina smell good.
Also, remember, panty liners, pads, or any other such lining held in close contact with your private parts can lead to the production of yeast or bacteria, giving way to foul vaginal smell. Avoid the use or limit the use of liners and pads, unless absolutely necessary. The idea is to stay natural and play it safe by visiting your doctor regularly.
Drink Enough Water Daily
Water helps to maintain body’s temperature and cell integrity and flush out the harmful toxins. Dehydration is one of the causes of foul vaginal odor. Therefore, you need to stay hydrated. The amount of water you need to drink will depend on your height, weight, and activity levels. You will require more water if you are highly active.
Avoid Bathing In Hot Water
Hot water kills the body’s natural bacteria. The prolonged use of hot water for bathing will lead to vaginal odor. Take cold water baths or use lukewarm water to bathe. You can also add essential oils, rose petals, or camphor to your bath water.
Avoid High Yeast And Sugar Foods
High yeast and high sugar foods can lead to vaginal odor. Avoid eating bread, cakes, pastries, sweets, alcohol, donuts, etc. Nibble on dark chocolate when you crave for something sweet.
Eat Veggies And Fruits Every Day
Fruits and veggies are loaded with nutrients that help to fight a lot of health problems, including bacterial and yeast infections, heart disease, etc. Eat at least three servings of veggies and two servings of fruits to avoid foul vaginal odor. You can also make smoothies with vegetables or fruits for breakfast. Avoid spicy food and starchy veggies.
Stop Using Soaps And Fragrances
Soaps and fragrances contain chemicals that affect the pH balance of the vagina, which leads to bacterial growth. These chemicals also kill the natural bacteria present in the vaginal area. Therefore, to eliminate vaginal odor, avoid using soaps or fragrances in the vaginal area. Also, do not use water sprays or douches to wash your vaginal area. Water sprays or douches wash away the natural bacteria, leading to vaginal odor.
Wipe The Toilet Seat
The surface of toilet seats is a good place for many pathogenic bacteria. Therefore, always wipe the toilet seat, even if it looks clean, before sitting down on it. Do not flush while sitting on the seat. Be very careful while using public toilets.
Avoid Too Much Oil Or Meat During Periods
Vaginal odor during periods can be avoided by avoiding meat and a lot of oil in your food for the first three days of your period. Consume green leafy veggies, vegetable soup, smoothies, fresh fruits, fresh fruit juices, and fruit detox water. This will help prevent bacterial growth and any extra oil secretion through sweat glands, flush out toxins from the body, and maintain the pH balance.
Say Yes To Soft Panty Liners
Using uncomfortable pads or panty liners can cause vaginal irritation and itching. This may kill the natural vaginal bacteria and help in the growth of harmful bacteria. Switch to a panty liner that is soft and more comfortable for you. This will prevent the growth of harmful bacteria and eliminate vaginal odor.
Change Panty Liners Frequently
Panty liners should be changed after every three to four hours. Using a panty liner for more than four hours will aid bacterial growth, which can lead to foul odor. Also, try not to use tampons as they aid bacterial growth and cause itching and vaginal discomfort.
Change Underwear After Exercising
Sweaty, dark, and covered areas are ideal for bacterial growth. Therefore, change your underwear after exercising. It will help prevent itching, irritation, and foul odor.
Wash Your Underwear Regularly In Warm Water
Make sure to wash your underwear regularly in warm water. Soak your underwear in warm detergent water for 10 minutes before switching the washer on. This will help wash away any bacteria in your underwear. Also, dry your underwear properly before wearing it again.
Shed The Thigh Fat
Extra thigh fat causes extra sweat as the thighs constantly touch each other. This leads to bacterial growth and vaginal odor. Exercise regularly to shed a few pounds from the thigh area to completely eliminate vaginal itching and odor.
Check Your Hormones
Women who are undergoing hormonal changes or suffering from hormonal imbalance may have vaginal secretions that have a foul or fishy odor. Check with your gynecologist to know how these hormonal imbalances can be treated or the underlying reason for vaginal secretions. Use an antibacterial and antifungal powder on your inner thighs to get rid of vaginal odor temporarily.
Play It Safe
Always have safe sex if you suffer from foul vaginal odor. Safe sex will limit bacterial growth and also keep you away from harmful diseases.
Change Your Panties Twice A Day
One of the best ways to get rid of vaginal odor is to change panties twice a day or every 12 hours. Also, wear cotton panties rather than silk or satin. You may wear silk or satin panties, but do not wear them for longer hours. Satin and silk entrap sweat and urine, which leads to bacterial growth, and hence the foul smell. Change to a more comfortable cotton panty before going to sleep every night. Also, buy panties of different types so that the bacteria doesn’t get a favorable condition to grow
Whitening Face Skin to restart life again some health tips that is the practice of using substances, mixtures, or physical treatments to lighten skin color. Skin whitening treatments work by reducing the content of melanin of the skin. Many agents have been shown to be effective in skin whitening; some have beneficial side effects (e.g. are antioxidants,nutrients, or decrease the risk of some types of cancer); some are a significant risk to health (for example, those containing mercury).
Mechanisms of action of Whitening Face Skin
Melanin is the main substance responsible for the color of the skin. Melanin is class of dark polymers generated by the body through the process of melanogenesis. Among the melanin pigmenting the skin and hair, two types can be distinguished based on its chemical composition and biological route of synthesis: the black/brown eumelanin and the red/yellow pheomelanin. The variation of skin color among individuals is mostly because of variation of the content of melanin in the skin. Skin with little or no melanin is almost white. Other factors influence skin color in a lesser degree, including the amount of blood in blood vessels (because of the color of blood), skin thickness and content of carotenoids in skin.
Melanin in synthesized in melanosomes which are organelles produced in melanocytes. Melanocytes are cells dedicated to this function that are present in the skin, hair follicles, and other structures of the body. The synthesis of melanin (also called “melanogenesis” and “melanization”) involves a chain of enzyme-catalyzed chemical reactions and non-enzyme-catalyzed reactions.The main precursor to melanin is L-tyrosine. The first step of melanogenesis is the conversion of L-tyrosine to L-DOPA; this is the first and rate-limiting step and is catalyzed by the enzyme tyrosinase (TYR).Other enzymes involved in the synthesis include tyrosinase-related protein 1 (TRP1) and tyrosinase-related protein 2 (TRP2); TRP2 is also known as “dopachrome tautomerase” (DCT). L-tyrosine is taken by the melanocytes from the intercellular medium, then transported to the melanosomes. L-tyrosine is also synthesized within the melanocytes from L-phenylalanine by the enzyme phenylalanine hydroxylase (PAH).
Melanosomes are transferred to keratinocytes (the most abundant cell type in the skin). Most of the melanin of skin is found in keratinocytes. Additionally, melanocytes interact with keratinocytes through chemical signaling.
Skin whitening agents work by reducing the presence of melanin in the skin. To accomplish this, there are several possible mechanism of actions
Inhibition of the activity of tyrosinase: The catalytic action of tyrosinase is inhibited (slowed or nearly stopped) by the skin whitening agent.
Inhibition of the expression or activation of tyrosinase: The antimelanogenic agent causes that less tyrosinase is generated or that tyrosinase is not activated to its functional form.
Scavenging of the intermediate products of melanin synthesis.
Preventing the transfer of melanosomes to keratinocytes.
Directly destroying existing melanin.
Destroying melanocytes.
Get Enough Sleep for Whitening Face Skin
Sleep is also the main factor that contributes to whitening your skin. A sound sleep along with some morning exercise is believed to make your skin perspire as well as help open your pores. If you want the glowing and fair skin, do not sleep late at night and sleepless should be avoided, thereby paying attention to your sleep. In conclusion, a good sleep is one of the golden rules for beautiful skin.
Cleanse And Moisturize Your Whitening Face Skin
Another tip on how to whiten skin is to cleanse and moisturize your skin well, which aims to remove the make-up layer and other harmful factors such as dirt, oils, bacteria, and so on. Normally, you can use an essential oil or cream and wash off your face with a proper face wash for your own. Skin moisturizing is also an important step to whiten your skin. Do not forget to moisturize your skin every day.
Apply Sunscreen for Whitening Face Skin
Overexposure to sunlight is one of the main causes of dark and dull skin. Therefore, applying a sunscreen is necessary for sunburn avoidance. To protect your skin from harmful effects of sunlight, you should use the sunscreen with an SPF 30 if you are outdoors. For indoor activities, you can apply an SPF 15 product. Remember to reapply at midday.
Exfoliate Your Skin for Whitening Face Skin
Death skin cells also make your skin look darker and duller, thereby needing to remove them to whiten up the shin. In fact, there is a variety of face and body scrubs to exfoliate the skin. You also can rely on natural ingredients that are available in your kitchen to do so. Later on, we will recommend you some effective recipes for skin whitening.
Eat More Fruits And Vegetables for Whitening Face Skin
Like water, fresh fruits and vegetables are also necessary for skin whitening process and they are indispensable in your balanced diet. A glowing study shows that fresh fruits and vegetables, which contain abundant vitamins and minerals good for skin care, can help your skin look more attractive . Therefore, a larger portion of fruits and vegetables in your diet will support the whitening process.
How To Whiten Skin Fast & Naturally At Home
Combining a healthy diet with natural treatments for skin whitening will help your skin be whiter from the inside out. Here are the top healthy diet tips and natural home remedies for skin whitening that you can try following.
I. How To Whiten Skin Fast With Natural Herbs
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Way 1: You can apply licorice extract to your dark skin using a cotton ball prior to going to bed. Leave overnight and the next morning rinse with water. It’s advisable to repeat regularly for best results.
Way 2: You need to prepare 2 to 5 drops of licorice extract, 1 tablespoon of lemon juice, 1 tablespoon of tomato juice, 1 cucumber and 1 tablespoon of sandalwood paste. Blend all the ingredients to make a paste and apply to your dark skin. Leave for around 20 to 30 minutes and rinse it off with water. It is recommended to repeat two times every week for best results.
How To Whiten Skin Fast Using Bearberry Extract
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Way 1: Take full strength bearberry extract and add it to your regular moisturizing or lotion cream. Then, apply to your dark skin and repeat every day for best results.
Way 2: You can dilute bearberry extract in some water. Later apply to your dark skin and repeat two times every day for best results.
How To Whiten Skin Fast Using Almond Oil And Banana Pack
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Firstly, you prepare 1 ripe banana and 1 tsp of almond oil.
Then, mash the banana well until you gain a smooth paste and to it add the almond oil.
Mix well and later apply on your clean face.
Allow it to stay for twenty minutes and finally, wash off well by using water.
How To Whiten Skin Fast Using Mulberry Extract
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You just need to take the mulberry extract and add it to any skin lotion.
Then, apply this mix to the dark skin.
You should repeat two times daily for best results.
How To Whiten Skin Fast Using Sandalwood & Orange Peel Pack
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You prepare 1 tablespoon of orange peel powder and 1 tablespoon of sandalwood powder.
In a glass bowl, mix the two ingredients together and add a little water to it to get a thick consistency.
Then, apply it on clean neck and face, and massage for 5 minutes.
Keep it on for about 15 minutes and wash it off by using water.
How To Whiten Skin Fast Using Milk Cream And Walnut Pack
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You prepare about 4-5 walnuts and 1 tablespoon of milk cream.
Next, soak these walnuts in water for an hour and then, mash them into one thick paste.
To it, add the milk cream and mix well. After this, apply this mixture on your clean neck and face and massage in a soft circular motion for about 5 minutes.
Keep it on for twenty minutes and wash off by using water.
How To Whiten Skin Fast Using Milk And Strawberry Pack
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The first step is to prepare 2 ripe strawberries together with 1 tbsp of raw milk.
Then, make a smooth paste by mashing the ripe strawberries and adding raw milk to it and mixing well.
After this, apply this mixture on your clean face and leave it to stay for twenty minutes. At last, wash off with water.
How To Whiten Skin Fast with Pumpkin Mask
After this, mix all the ingredients milk till you attain a uniform paste.
Now apply this paste to the face and keep it on for around 20 minutes.
Finally, rinse with warm water.
You can try this prior to going to sleep in the night.
How To Whiten Skin Fast with Coconut Milk Whitening Mask
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Firstly, prepare 4 almonds, 2 teaspoons of coconut milk, 1teaspoon of milk powder together with 2 teaspoons of lemon juice.
Next, soak these almonds overnight and peel their skin in the morning, and then grind them to one smooth paste.
Thereafter, add coconut milk, milk powder and lemon juice to it, and mix well.
Now apply this mask on your clean skin and wash with fresh water after 20-30 minutes.
For best results, apply this mask twice to thrice a week.
How To Whiten Skin Fast with Lavender Essential Oil
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Mix about 3 to 4 drops of lavender essential oil with 1 tbsp of carrier oil.
Then, apply this mix onto the skin and keep it on for 20-30 minutes or overnight.
Do this process before you go to bed every night.
How To Whiten Skin Fast with Orange Essential Oil
First of all, take few drops each of orange essential oil and coconut or jojoba oil.
Mix together the two oils and massage onto your area to be treated for 4-5 minutes.
Leave for a couple of minutes and wash by using warm water.
You should do this process every day for 1-2 weeks.
How To Whiten Skin Fast with Neroli Essential Oil
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Firstly, blend several drops of neroli oil and 1 tbsp of carrier oil and next, apply onto your skin.
Massage for a couple of minutes and keep it on for 15 to 20 minutes.
After this, wipe by using a cotton pad or damp cloth.
It’s advised to repeat this method every day for a few days.
How To Whiten Skin Fast with Pineapple & Papaya Face Mask
complexion skin. Follow these instructions below:
Prepare 150g each of fresh papaya and fresh pineapple, together with 1 tbsp of honey.
Place diced pineapple and papaya in one blender and blend until a thick consistency is formed.
Shift thick paste in one bowl and add honey (1tbsp) and mix well.
Then, apply this paste on the face with gently circular rubs. Keep this mask on for 10-15 minutes.
At last, wash the fruit mask by using splashes of cold water.
How To Whiten Skin Fast With Cedarwood Essential Oil
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Mix several drops of cedarwood oil with 1 tbsp of jojoba or bergamot oil and apply on your affected area.
Wash with lukewarm water after a few minutes.
Do this daily till desired results are achieved.
How To Whiten Skin Fast with Avocado And Honey Face Mask
Prepare 1 tablespoon of honey and 1 avocado. Next, scoop the avocado’s flesh and mash it until you attain a thick pulp.
Add a tbsp of honey to it and mix well. Before applying the face pack, you need to cleanse your face by using lukewarm water.
Then, gently apply the paste on face and neck. Wash thoroughly by using splashes of cold water after 8-10 minutes.
How To Whiten Skin Fast with Grape Seed Extract
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Wet your skin at first and take several drops of grape seed extract in the hands and now apply this on your skin.
Massage for about 1-2 minutes and wash with water afterwards.
This process should be repeated every day.
Apple Face Mask
You will need to prepare 1 apple, 1egg yolk and 2 tablespoon milk. Next, skin the apple and then put it in one blender.
Add the milk and mix well. Later add the egg yolk to this and blend once again. Shift the paste in one bowl. After that, apply it on your skin.
Leave the mask to remain for 7-10 minutes and gently wash by using splashes of lukewarm water.
How To Whiten Skin Fast With Sandalwood Face Mask
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Mix 2 tbsp of sandalwood powder with rose water to make a paste.
You need to clean your face by using water before applying the paste. Leave this mask to remain for 15-20 minutes.
Finally, wash your face clean with cold water.
Castor Oil, Cream, And Honey Face Mas
First of all, take 50g of fresh cream, 1 tbsp of castor oil and 1 tbsp of honey and. In a bowl, mix together all the ingredients.
Make sure your face has to be cleaned before applying this face mask.
Then, apply this mask on the face and leave it to remain for 10-15 minutes.
II. Healthy Diet Tips For Skin Whitening
Facial skin is very sensitive and delicate, so it needs to be whitened from the inside out. You should include these skin whitening foods and drinks into your daily diet plan:
Drinks For Skin Whitening
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Option 1: Drink about a glass of the cold milk before you go to bed daily.
Option 2: Drink about a glass of the warm water that is mixed with 1 tsp of the lemon juice & 1 tsp of the pure honey each morning.
Option 3: Boil about a glass of water, then you let it cool down slightly. Next, you add about 5 to 6 mint leaves into it. You cover & let it sit for around 4 minutes. Finally, you drink it daily at any time of a day.
Drink Water Regularly
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Drinking at least eight glasses of water everyday can help push the unwanted urea out of your body. This can improve your blood circulation, which will eventually show in your skin. You can even add a slice of lemon to your water for better results.
Maintain A Healthy And Balanced Diet
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You are what you eat. So, if you eat too much processed food, it will definitely show on your skin.
By maintaining a balanced diet, you will be able to boost your skin’s texture and give your skin a healthy glow. Although it may take some time, having a healthy diet can also whiten your skin gradually. In addition, eating a balanced diet will get all the vitamins and minerals you need.
Lemon Water
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A lot of cosmetic products claim to help you get glowing & healthy skin but they are very expensive. Instead, try applying lime water to get a healthy & glowing skin. Besides benefiting the skin, lime juice and water reduce blackheads, wrinkles, & ageing. Lemon also works as a natural bleach because it contains vitamin C. In addition, the acidity found in it will help to whiten the skin
How To Whiten Skin Fast With Dark Chocolate
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Another way how to whiten skin fast is eating dark chocolate. You just need to consume a few squares of dark chocolate a day, and you will rev up your skin texture & UV resistance. Cocoa polyphenols & flavonoids found in chocolate are known as superb antioxidants, which are useful in whitening the skin. It also helps as one protection against UV rays
Fruits And Vegetables Rich In Vitamin C
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Eating more fruits and vegetables that are rich in vitamin C also is another simple but effective way on how to whiten skin fast at home. To maintain a bright and healthy complexion, most dermatologists will recommend you to consume foods that are rich in vitamin C including cherries, tomatoes, kiwifruit, strawberries, or citrus.
Red And Yellow Fruits
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These red and yellow fruits are rich in carotene and phytochemicals, which assist in anti-oxidation, thus perking up the resistance power of the skin. So you just need to include a wide range of red & yellow vegetables and fruits such as, pumpkins, carrots, and mangoes into your daily diet plan.
Soybean
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One of the best and easiest ways on how to whiten skin fast is consuming soybean. Soybean is a natural food that is best for anti-ageing because it contains the isoflavone that works as a phytoestrogen, which fights ageing. In addition, the antioxidants found in soybean aid in maintaining the luster of the skin. You can try consuming soybean products such as tofu or soybean milk to make your skin whiter.
Papaya
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Papaya is very rich in antioxidants. This fruit also contains a special enzyme that is called papain that can kill the dead cells as well as help you to get rid of almost skin impurities. Taking a glass of papaya milk daily or simply applying this fruit onto your skin will do wonders for it.
Snack
Healthy snack with some nuts will help you in fighting acne because they include selenium & zinc. Snack with almonds and pumpkin seeds will help you in purifying the blood as well as providing you with nutrients that are beneficial to your body. In addition, you can consume fennel seeds that have 2 strong properties such as antioxidants & detoxifiers. These properties can tone your skin as well as improve the blood circulation. Furthermore, eating fennel can also help you in keeping your skin hydrated & moisturized.
III. How To Whiten Skin Fast – Skin Care Tips For Skin Whitening
Limit Your Sun Exposure
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Use a sunscreen with the high SPF. For example, 30 SPF or high.
Wear a wide-brimmed hat
Wear long-sleeved shirts & long pants. Choose cool and swishy fabrics during the summer, so you will not get too hot.
Do not completely stay out of the sunlight. Your body needs vitamin d from the sun exposure in the early morning.
Protect yourself from the harmful rays of the sun.
Regular use of sunscreens when going out.
Stay away from the sunlight between about 9 a.m. & 4 p.m., when the UV rays are quite harmful and strong.
Have A Proper Skin Care Regimen
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Another way on how to whiten skin fast and naturally at home is keeping a proper skin care regimen. You should wash your face about 2 times a day. Then, you need to moisturize the skin regularly to make it supple and smooth. Moisturizing the skin can aid you a lot in the rejuvenation process of your skin. You also need to remember that the dry skin will absorb more heat that can cause it to look darker.
Exfoliate
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Maybe you have heard about the dead skin cells as well as how they love to keep on your face. Just by exfoliating your skin once a week, you can remove dead & dark skin cells and let the new, lighter ones come out on the skin surface. When the new skin is revealed due to exfoliation, you may finally get the lighter skin tone.
Keep It Moisturized
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Option 1: choose coconut oil that is a great moisturizer, which keeps the skin looking glowing & youthful. You spread a little of coconut oil onto your legs and arms after getting out of your shower. Then, you wait about 10 minutes in order that it can absorb into the skin before you wear your clothes on.
Option 2: jojoba oil has moisturizing properties, so it also is a great moisturizer for the skin. In addition, you can choose almond oil or olive oil that can work wonders.
IV. How To Whiten Skin Fast With At Home Natural Treatments
Aloe Vera
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Firstly, you cut the outside layers of one aloe vera leaf. Then you squeeze out the thick.
And you apply the gel on your skin.
You keep it on for about half an hour
Finally, you rinse it off with water.
You should repeat this at least twice per day for two weeks.
You can also buy aloe vera leaves in the market, if you do not plant aloe vera at home.
Oranges
Vitamin C is the most important element in skin care that you can receive in abundance from oranges. In addition, oranges have bleaching properties, which can whiten your skin tone.
In fact, if you drink fresh orange juice regularly, it can greatly improve the whole texture of your skin and supple it. To whiten your skin, you can use the following way.
You make a paste by mixing orange juice (2 tablespoons) with powdered turmeric. And then you apply this paste on your neck and face before bedtime. You can also use it on your legs and hands. Finally, you rinse it off in the next morning. You should do this daily.
How To Whiten Skin Fast & Naturally With Honey
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Honey helps whiten and moisturize your skin. Dry skin, which is a common factor, leads to your uneven skin tone. Antibacterial properties in honey can help fade age acne scars and spots. Regularly applying honey on the face can help to whiten the skin naturally by decreasing acne spots on the face.
You use raw honey to your face; keep it on for about a few minutes. Then you rinse it off with tepid water. This simple way will help eliminate your dead skin cells, make your skin whiter than before. You should practice this once daily.
To make a skin-whitening mask, you mix 1 teaspoon of honey, 1 tablespoon of powdered milk, ½ tsp of almond oil, and lemon juice. Then you mix them together and apply it lightly on your skin. You keep it on for about 10 to 15 minutes. Finally, you rinse it off with cool water. You should repeat this every other day.
There are many healthy and effective ways on how to whiten skin fast and naturally at home, keep reading to learn more!
Yogurt
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You rub yogurt onto your skin gently. You keep it on for about a few minutes. Then you rinse it off with tepid water. You should practice this once daily for some weeks to notice a positive change in your complexion.
Another way, you can mix fresh yogurt (one tablespoon) and ½ tbsp of honey. Then you use this mixture on your neck and face. You keep it on for about 10 to 15 minutes. Finally, you rinse it off with water. You should repeat this daily to make your skin tone better.
You can also combine some tsp of oatmeal and a little lemon juice to yogurt to create a thick paste. Then you use it as a face skin mask. This way will also help make your skin supple.
Gram Flour
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Firstly, you mix a little water with some gram flour or rose water to create a thick paste.
Then you spread it on your face, legs and hands.
You keep it on till the paste dries. Finally, you rinse it off with water.
Lemons
Way 1: You dip one cotton ball in squeezed lemon juice. Then you use it directly on the face skin. You can rub a slice of lemon directly on your skin and let the juice to stick finely to your skin. You keep it on for an hour and then rinse your face with water. You should repeat this once per day. This simple way will surely whiten your skin tone and can also stop the development of spots and scars on your face.
Way 2: You mix lemon juice (3 teaspoons) and turmeric powder (1 teaspoon) or tomato juice to create a paste. Then you apply the paste on your skin and keep it on for 30 minutes. Finally, you rinse it off with water. You should practice this once daily.
Way 3: Alternatively, you mix together lemon juice (1 teaspoon), powdered milk and honey. Then you use it on your skin and then you keep it on for about 15 to 20 minutes before washing it off. You should practice this daily
How To Whiten Skin Fast Using Papaya
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Way 1: you can eat papaya as the fruit. The cleansing properties of papaya can cleanse your skin of impurities, which could be causing your skin to darken.
Way 2: You rub the inside of a papaya on the face. Then you allow it to dry. Finally, you rinse your face with cool water, pat it dry. This way will make your skin whiten. You should practice this daily.
Way 3: You mash one ripe papaya and then mix it with one glass of squeezed lemon juice. You massage this mixture on your face and neck. You keep it on for 30 minutes before rinsing it off with cool water. You should practice this at least once per week to see a visible result in your skin tone.
Cucumber
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Way 1: you put cucumber slices directly on your face skin. And keep them on for about a few minutes, then you take them off. Finally, you wash your skin with tepid water. You should practice this twice daily.
Way 2: you grate a cucumber, and then you mix with honey to create a spot-reducing mask. Then you apply this mask on your neck and face. You keep it on for about 15 to 20 minutes. Finally, you wash it off with cool water. You should practice this twice daily to see effective results.
Way 3: You can also make a mixture by mixing cucumber juice and one teaspoon of lemon juice. You use it on your face. You keep it on for about 15 to 20 minutes or till it dries. Finally, you rinse it off with fresh water. You should practice this once daily.
How To Whiten Skin Fast Using Turmeric
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Way 1: You mix milk cream and turmeric powder to make a thick mixture. Then you practice this mixture on your skin. You let it to dry. Finally, you rinse it off with warm water. You should do this regularly to see the effective result.
Way 2: You mix gram flour (2 teaspoons), turmeric powder (one-half teaspoon) and lemon juice (one teaspoon). Then you apply this mask. You keep it on for about 20 to 25 minutes or till it dries. Finally, you take off the dried mask; you wash your skin with tepid water.
Oatmeal
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Removing old skin cells is the best way to support the development of your new skin cells to make your skin tone better. Oatmeal helps exfoliate your skin, keeping it supple and soft.
Way 1: you mix tomato juice with oatmeal and you practice the mixture on the face. You keep it on for about 20 minutes and then rinse it off with cool water. While washing, rub it lightly in order that the oatmeal can remove the dead skin cells. You should repeat this daily.
Way 2: you mix oatmeal powder (one teaspoon), a pinch of turmeric with lemon juice (a few drops) to create a thick paste. You apply it on your skin and let it dry. You rinse off the dry paste with water. You should practice this once daily.
Milk
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Practice
You take the bowl of warm water and milk. Then you dip your washcloth in this.
Next, you take out and wring the washcloth to eliminate to excessive milk. Now you use this cloth to rub your skin gently.
When the cloth is dry, you dip it again deeply and repeat the process.
You repeat the cycle of soaking and rubbing for about 3-4 times.
You should practice this once per day, preferably after taking bath.
How to Whiten Skin Fast Using Rice Powder
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In Asian countries, women have used rice powder and rice water to whiten their skin. Rice is an abundant source of para aminobenzoic acid which works as a natural sunscreen. A study carried out with rice bran extracts, which has proven its skin lightening, hydrating, and anti aging effects as well on your skin.
You will need:
½- 1 cup of uncooked rice
Warm water
Milk
Practice:
You need to grind the rice into powder.
Then you mix enough milk to the rice powder to create a paste. You can use water to create this paste, when you are allergic to milk.
Next, you apply this rice powder mixture to your face & neck.
You keep it for about 20-30 minutes and then rinse off with warm water.
You should repeat 2-3 times per week.
Citrus Fruits Peels
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You will need:
1 tablespoon of dried orange peel powder
1 tablespoon of yogurt
Practice:
Firstly, you need to grind the orange peels into powder.
Then you mix plain yogurt with the orange peel powder and make a paste.
Next you apply this mixture on your face & neck.
You keep it there for about 20-30 minutes and then rinse off with water.
You should repeat 2-3 times per week.
How To Whiten Skin Fast Using Kojic Acid
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In 1989, kojic acid found in mushrooms is considered as a natural skin lightening agent originated in Japan. Kojic acid has been shown to decrease hyper-pigmentation clinically, as per the American Academy of Dermatologists. This acid stops melanin formation by interfering tyrosinase activity. Dark skin will naturally get better, when the melanin is not produced. Plus, it works as an antioxidant and is best for sensitive or sun damage skin.
Firstly, you have to wash your face properly.
You take ½ – 1 teaspoon of the kojic acid and then you mix this with your gel, cream or lotion.
Finally, you can apply this mixture on your face & neck.
You should practice this twice per day for a maximum of two months.
How to Whiten Skin Fast Using Almond Oil
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Almond oil has various components good for your skin. These include minerals and phytosterols, vitamins B6, B2, E, PP, and unsaturated fatty acids. Vitamin PP is the original name of vitamin B3 or niacin. Almond oil helps you have lighter skin as well as evened out skin complexion. It also protects you from wrinkles, removes blemishes, and makes your skin whiter with radiance.
You need take the sweet almond oil.
Then you warm it up by indirect heat. (You can put the oil into a steel bowl and put the bowl in a bowl (bigger) with hot water. Throw it after sometime.)
Next you massage your face & neck with this oil for about 10-15 minutes.
And then, you press a tissue on your face to eliminate the excess oil.
You should practice this every night before bedtime.
You can repeat this for 2-3 times per day for 15 days, and then one time a week.
Gram Flour Face Mask
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You will need:
1 tablespoon of gram flour
1 tablespoon of milk cream
½ teaspoon of honey
2 – 4 drops of freshly squeezed lemon juice
Practice
You mix all the ingredients to make a paste.
Then you apply this mixture to your face & neck.
You keep it for about 15-20 minutes or until it dries out completely.
You rinse off with warm water.
You should repeat this mask daily for four weeks and then one times a week.
How to Whiten Skin Fast Using Potato Pack
Potato has gentle bleaching properties and if you use this paste regularly, it will reduce marks and whiten your skin. Potato contains amazing skin bleaching properties that can brighten and whiten your skin naturally. Plus, they are full of vitamin A, B6, B1, B2, magnesium, phosphorus, beta carotene, etc to buzz up the health of your skin.
Firstly, you peel skin of one potato and grate it.
Now you combine a little of rose water and then you beat it to create a paste. (You can also add honey or some drops of lemon juice if your skin is oily or dry respectively.)
Finally, you apply it on your skin for 10 – 15 minutes before washing it off with water.
How to Whiten Skin Fast Using Tomatoes
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Tomato has a natural bleaching agent. This is also a skin whitening agent. Tomatoes have astringent and cooling properties and are very rich in vitamin C. Therefore, it is a perfect way on how to whiten skin fast if you have an acne prone or oily skin. The natural acidic element of tomatoes will help to balance the skin pH as well as remove excessive oil. Its antioxidants will prevent the free radicals to give you a more healthy looking skin. The following ways is very useful to whiten skin:
Way 1: you take a small tomato and grind it to get the pulp. Then you apply this pulp on your skin. You keep it for about 10 -15 minutes to dry and then you can use tomato pulp one more times. You should apply this cycle for about 30 minutes. Finally you rinse it off with water.
Way 2: You combine lemon juice (some drops) with tomato juice (1 tablespoon). Then you use this on your face & neck. You keep for about 15 – 20 minutes before washing off.
Way 3: You add buttermilk (4 tablespoons) to tomato juice (2 tablespoons). Then you apply to your face & neck with fingers or a cotton ball. You keep it for half an hour and wash it off. You should follow this especially when your skin has darkened because of sunburn.
Way 4: If you have a complex skin or a mixed skin, you can use tomatoes with avocado. You mash a small tomato with a small avocado’s pulp. Then you apply this mixture on your face. You keep it for about 30 minutes. Finally, you rinse it off with warm water.
Way 5: You can mix 2 tablespoons of yogurt with a small tomato’s pulp. Then you apply this mixture on your skin. You keep it for 20 minutes before washing it off.
If you want to know more about natural solutions for skin care and healthy treatments for skin problems, you can go to our main Skin Care page. After reading the article of top 70 tips on how to whiten skin fast naturally at home, hope that you can find out the best treatment to get rid of your dark and dull skin quickly and easily.
