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Friends today I am discussing about a serious problem known as Male infertility. Male InfertilityCauses Causes Not all cases of male infertility or azoospermia (no sperm in the ejaculate) are the same or should be treated in the same way. AZOOSPERMIA CAN BE DIVIDED INTO TWO BROAD CATEGORIES: Obstructive Azoospermia (OA):: OA means that sperm are being produced normally inside the testicle, but there is a blockage or obstruction in the reproductive tubing that is preventing the sperm from flowing to the outside world. Non-Obstructive Azoospermia (NOA): NOA means that the tubes are open, but there is a sperm production problem where either no sperm are produced at all or there is a very low level of sperm production. This level is often so low that the sperm never make it all the way out of the testicle and can only be found inside the testicle during surgery. Causes of Obstructive Azoospermia CAUSES OF OBSTRUCTIVE AZOOSPERMIA CAN BE GENETIC, CONGENITAL, OR ACQUIRED. Vasectomy: The most common cause of obstructive azoospermia, this surgical procedure interrupts the sperm ducts to stop the flow of sperm. Watch this video to learn more about vasectomy and vasectomy reversal. Infection: Obstructive azoospermia can also be caused by infections of the testicles, prostate, or reproductive tract such as epididymitis/orchitis, prostatitis, and venereal diseases such as Chlamydia. These can cause a blockage in the small tubules of the epididymis or the ejaculatory duct. Congenital Conditions: Some men are born missing a portion of the vas deferens that is essentially a genetic situation similar to a vasectomy. Other men are born with a cyst in the prostate that blocks the ejaculatory ducts. Surgical Complications: Surgical procedures performed on the urogenital organs or hernia repair can result in scarring that leads to a blockage. This is more common in pediatric patients because the reproductive tract is so small in children. Causes of Non-Obstructive Azoospermia Non-Obstructive azoospermia can be caused by abnormalities within the testicle or with reproductive hormones that control sperm production. The causes can be genetic, congenital or acquired. Some causes can be treated effectively and others can be bypassed to allow a man to father a child with IVF. Some men have a problem with the production of hypothalamic or pituitary hormones and this is treated by replacing the missing hormones in order to encourage sperm production. Genetic Causes: These include chromosomal abnormalities where the number of chromosomes is not as it should be (called aneuploidy) or parts of the chromosome arms break off and switch locations (called translocations). The most common chromosomal problem causing azoospermia in men is a situation where there is an extra X chromosome. This is called Klinefelter Syndrome. Another genetic cause of azoospermia is a deletion of some of the genes on the Y-chromosome. The Y-chromosome is responsible for giving men their “male” characteristics. When one or more of the genes on this chromosome that is responsible for sperm production are deleted, it can result in azoospermia. Genetic causes of azoospermia are not reversible but most men with genetic issues still produce small amounts of sperm within the testicles that can be used to father normal children. Varicocele: This reversible cause of NOA is characterized by varicose veins around the testicle. This condition is the most common cause of male infertility and is easily fixable. Most varicoceles only cause a minor lowering of sperm count but in some cases the varicocele results in azoospermia. You can learn more about varicocele and varicocele repair here. Hypospermatogenesis: This means that there is sperm production within the testicle but just at lower amounts than normal, and what would be required to see sperm on a routine semen analysis. This is the most common finding on biopsy. Maturation Arrest: In this situation there is a problem in the development of sperm during the maturation phase that causes the testicle to fill with only precursor sperm. This arrest in development can occur at an early or late stage of the sperm maturation process. There is close to a 50% chance of finding some mature usable sperm in this situation. Causes of Male Infertility & Azoospermia Sertoli-Cell Only Syndrome (SCO) or Germ Cell Aplasia (GCA): This is typically a worst-case-scenario cause of NOA. With SCO or GCA, the germ cells that divide and become sperm are missing from the testicle. But even in this situation 15-20% of men with SCO will have some low level of sperm production somewhere within the testicle. One of the most important things we have learned about the testicle in the last 20 years is that sperm production in the abnormal situation is not homogeneous, meaning it is not the same or constant in all areas of the testicle. So, while one area might have scarred tubules with SCO pattern, another area might have some germ cells and some mature sperm. This phenomenon has led to the development of microsurgical sperm extraction techniques that enable the reproductive surgeon to examine the inside of the testicles, specifically the seminiferous tubules, using a microscope. This means there is a greater chance of finding an area that has sperm, and a better chance of becoming a biological father. Testicular Cancer: Sometimes the first sign of testicular cancer or other tumors of the reproductive system is azoospermia or a very low sperm count. This is one of the most important reasons why a male reproductive specialist must examine someone with an abnormal sperm count. By detecting the tumor early, it could save a patient’s life. Medical Treatments: Chemotherapy and radiation therapy used to treat cancer are two types of medical treatment that can cause temporary azoospermia. Most men who undergo these treatments will have sperm production resume within two years following therapy, depending on the type of treatment received. Prescription Drugs: Among the biggest drug-related causes of NOA are testosterone and other anabolic steroids. These can cause sterilization and are a very common and usually reversible cause of azoospermia. Overwhelming Oxidative Stress causes sperm damage There are numerous causes of male infertility but no matter what the etiology, the final common pathway to sperm damage (DNA fragmentation) is through free radical peroxidation leading to overwhelming amounts of oxidative stress on the sperm. Ironically, oxidative stress is necessary for normal sperm function and sperm actually produce free radicals, but when more stress is generated than the system can compensate for, the body is unable to neutralize the toxins which ultimately injure the sperm cell membrane and the sperm DNA. This leads to functional impairment of the sperm cell and, ultimately, infertility. Best Homeopathic Medicines for Oligospermia Many homeopathic remedies have been known to cure Low sperm Count. Some of these are; Agnus Castus: Sexual melancholy. Fear of death. Sadness with impression of speedy death. Absentminded, forgetful, lack of courage. Illusion of smell-herrings, musk. Nervous depression and mental forebodings. Yellow discharge from urethra. No erections. Impotence. Parts cold, relaxed. Desire gone (Selen; Con; Sabal). Scanty emission without ejaculation. Loss of prostatic fluid on straining. Gleety discharge. Testicles, cold, swollen, hard, and painful. Anacardium Orientalis: Fixed ideas. Hallucinations; thinks he is possessed of two persons or wills. Anxiety when walking, as if pursued. Profound melancholy and hypochondriasis, with tendency to use violent language. Brain-fag. Impaired memory. Absent mindedness. Very easily offended. Malicious; seems bent on wickedness. Lack of confidence in himself or others. Suspicious (Hyos). Clairaudient, hears voices far away or of the dead. Senile dementia. Absence of all moral restraint. Voluptuous itching; increased desire; seminal emissions without dreams. Prostatic discharge during stool. Argentum Nitricum: The patient is intellectual strong, patient complaint of memory loss, along with disturbed sense of reasoning. Patient is involved in foolish task, with strange conclusions. Patient experience strange illusions and hallucinations. His mind is full of useless and troublesome thoughts specially at night time, which makes him very anxious. Due to anxiety patients keeps on walking.Melancholia.Weak of memory, It seems time passes very slowly. Dulness of head, mental confusion ; dizziness ; tendency to fall sideways. Caladium: Patient is unable to remember things, he is very forgetful with vague mind. Due to absentmindedness, he keep on searching different things. Concentration is very less due to which he is unable to put his ideas into speech. He has high desire for sex with relaxation of his organ. A state of total impotency. During intimacy there is urethral discharge. at times impotency is due to mental suppression. Severe itching on testcles. Conium Mac: Mental state is full of hysteria with the nervousness. Patient complaint of weakness of muscles with trembling. Patient has very high desire for sex, but due to impotency he is not able to perform. Patient complaints of semen loss during sleep with or without dreams. Ejaculation is very painful- as if cutting with a knife due to acrid semen. Swelling and hardness Lycopodium: There is great desire to be alone. Despondent. Mentally and physically patient is very tired with complaint of chronic fatigue, with great aversion to his work. He is very forgetful, with dread of public appearance. Great Sensitivity, patient cries even when thanked. It is one of the most used medicines for impotency. Genital organ are feeble due to low vitality. Patient marries to live a normal life, but after marriage he finds he is sexually impotent without erections or very weak and short erections as if he is not a man. There is history of gonorrhoeal discharge with warts on male genitals. Patient is not trustworthy; he is very suspicious and find fault in every task. Patient is very timid with low self-confidence.

Friends yesterday I discussed about Azoospermia but today I am discussing about Oligospermia and Fertility. What is oligospermia? Oligospermia is a male fertility issue characterized by a low sperm count. Other aspects of the sexual health of men with this condition are typical. This includes the ability to get and maintain an erection, as well as produce ejaculation at orgasm. Sperm count in your ejaculate can vary throughout your life. A healthy sperm amount is often necessary for fertility. The World Health Organization (WHO) classifies sperm counts at or above 15 million sperm per milliliter (mL) of semen as average. Anything below that is considered low and is diagnosed as oligospermia. Mild oligospermia is 10 to 15 million sperm/mL. Moderate oligospermia is considered 5 to 10 million sperm/mL. Severe oligospermia is diagnosed when sperm counts fall between 0 and 5 million sperm/mL. It’s unclear how many men have low sperm amounts in their semen. This is, in part, because not everyone with the condition is diagnosed. Only men who have difficulty with conceiving naturally and ultimately seek help may be diagnosed. Causes Several conditions and lifestyle factors can increase a man’s risk for oligospermia. Varicocele Enlarged veins in a man’s scrotum can disrupt blood flow to the testicles. This can cause the temperature in the testicles to increase. Any increase in temperature can negatively impact sperm production. About 40 percent of men with low sperm numbers or low sperm quality count have this common issue. Read more about varicocele. Infection Viruses like sexually transmitted infections can reduce the sperm amount in semen. Ejaculation issues While many men with oligospermia have typical ejaculations, some ejaculation problems may reduce sperm count. Retrograde ejaculation is one such issue. This occurs when semen enters the bladder instead of leaving from the tip of the penis. Other things that may interfere with typical ejaculation include: injuries tumors cancer past surgeries Medications Beta blockers, antibiotics, and blood pressure medications may cause ejaculation problems and reduce sperm count. Hormone issues The brain and the testicles produce several hormones that are responsible for ejaculation and sperm production. An imbalance in any of these hormones may lower sperm count numbers. Exposure to chemicals and metals Pesticides, cleaning agents, and painting materials are a few of the chemicals that can reduce sperm count. Exposure to heavy metals, such as lead, can cause this problem, too. Overheating testicles Sitting frequently, placing laptops over your genitals, and wearing tight clothing may all contribute to overheating. An increase in temperature around the testicles may temporarily reduce sperm production. It’s unclear what long-term complications may occur. Drug and alcohol use The use of some substances, including marijuana and cocaine, may reduce sperm counts. Excessive drinking can do the same. Men who smoke cigarettes may have lower sperm counts than men who do not smoke. Weight problems Being overweight or obese increases your risk for low sperm counts in several ways. Excess weight can directly reduce how much sperm your body can make. Weight problems may also interfere with hormone production. How does oligospermia affect fertility? Some men with oligospermia can still conceive despite lower sperm counts. Fertilization may be more difficult, however. It may take more attempts than couples without a fertility issue. Other men with oligospermia may have no problem with conception, despite the low sperm numbers. Some of the most common causes of oligospermia also increase a man’s risk for other fertility issues. This includes sperm motility problems. Sperm motility refers to how “active” sperm are in a man’s semen. Normal activity allows sperm to swim toward an egg for fertilization easily. Abnormal motility may mean the sperm don’t move enough to reach an egg. The sperm may also move in an unpredictable pattern that would prevent them from reaching an egg. Home remedies Men with oligospermia may be able to increase the chances for conception with these techniques: Have sex more frequently If you’re trying to have a baby, increasing your frequency of intercourse can improve your chances of conception, especially around the time your partner is ovulating. Track ovulation Timing sex to ovulation can increase your chances for conception. Work with your partner’s doctor to find the best times for intercourse for conception. Don’t use lubricants Some lubricants and oils can reduce sperm motility and prevent sperm from reaching an egg. If lubricant is needed, talk with your doctor about a sperm-safe option. Treatment Treatment can improve sperm numbers and quality. These treatment options include: Surgery Varicocele often require surgery. During the procedure, your doctor will close off the enlarged veins. They’ll redirect blood flow to another vein. Medication Medications, including antibiotics, treat infections and inflammation. Treatment may not improve sperm numbers, but it may prevent greater sperm count drops. Lifestyle changes Losing weight and maintaining a healthy weight may improve sperm numbers. It may also reduce your risk for many other health conditions. Stop using drugs, alcohol, and tobacco to improve sperm amounts, too. Hormone treatment A variety of medications, injections, and lifestyle changes can restore hormones to a healthy level. When hormone levels recover, sperm numbers may improve. Reproduction assistance If you’re still unable to get pregnant, you and your partner can work with a fertility specialist to explore your options. Outlook Low sperm counts decrease the chances you can conceive naturally with your partner. However, they don’t rule it out entirely. Many men with oligospermia are able to fertilize their partner’s egg, despite lower sperm numbers. Best Homeopathic Medicines for Oligospermia Many homeopathic remedies have been known to cure Low sperm Count. Some of these are; Agnus Castus: Sexual melancholy. Fear of death. Sadness with impression of speedy death. Absentminded, forgetful, lack of courage. Illusion of smell-herrings, musk. Nervous depression and mental forebodings. Yellow discharge from urethra. No erections. Impotence. Parts cold, relaxed. Desire gone (Selen; Con; Sabal). Scanty emission without ejaculation. Loss of prostatic fluid on straining. Gleety discharge. Testicles, cold, swollen, hard, and painful. Anacardium Orientalis: Fixed ideas. Hallucinations; thinks he is possessed of two persons or wills. Anxiety when walking, as if pursued. Profound melancholy and hypochondriasis, with tendency to use violent language. Brain-fag. Impaired memory. Absent mindedness. Very easily offended. Malicious; seems bent on wickedness. Lack of confidence in himself or others. Suspicious (Hyos). Clairaudient, hears voices far away or of the dead. Senile dementia. Absence of all moral restraint. Voluptuous itching; increased desire; seminal emissions without dreams. Prostatic discharge during stool. Argentum Nitricum: The patient is intellectual strong, patient complaint of memory loss, along with disturbed sense of reasoning. Patient is involved in foolish task, with strange conclusions. Patient experience strange illusions and hallucinations. His mind is full of useless and troublesome thoughts specially at night time, which makes him very anxious. Due to anxiety patients keeps on walking.Melancholia.Weak of memory, It seems time passes very slowly. Dulness of head, mental confusion ; dizziness ; tendency to fall sideways. Caladium: Patient is unable to remember things, he is very forgetful with vague mind. Due to absentmindedness, he keep on searching different things. Concentration is very less due to which he is unable to put his ideas into speech. He has high desire for sex with relaxation of his organ. A state of total impotency. During intimacy there is urethral discharge. at times impotency is due to mental suppression. Severe itching on testcles. Conium Mac: Mental state is full of hysteria with the nervousness. Patient complaint of weakness of muscles with trembling. Patient has very high desire for sex, but due to impotency he is not able to perform. Patient complaints of semen loss during sleep with or without dreams. Ejaculation is very painful- as if cutting with a knife due to acrid semen. Swelling and hardness Lycopodium: There is great desire to be alone. Despondent. Mentally and physically patient is very tired with complaint of chronic fatigue, with great aversion to his work. He is very forgetful, with dread of public appearance. Great Sensitivity, patient cries even when thanked. It is one of the most used medicines for impotency. Genital organ are feeble due to low vitality. Patient marries to live a normal life, but after marriage he finds he is sexually impotent without erections or very weak and short erections as if he is not a man. There is history of gonorrhoeal discharge with warts on male genitals. Patient is not trustworthy; he is very suspicious and find fault in every task. Patient is very timid with low self-confidence.

Friends today I am discussing about Male infertility. Many infertile couples have more than one cause of infertility, so it's likely you will both need to see a doctor. It might take a number of tests to determine the cause of infertility. In some cases, a cause is never identified. Infertility tests can be expensive and might not be covered by insurance — find out what your medical plan covers ahead of time. Diagnosing male infertility problems usually involves: General physical examination and medical history. This includes examining your genitals and asking questions about any inherited conditions, chronic health problems, illnesses, injuries or surgeries that could affect fertility. Your doctor might also ask about your sexual habits and about your sexual development during puberty. Semen analysis. Semen samples can be obtained in a couple of different ways. You can provide a sample by masturbating and ejaculating into a special container at the doctor's office. Because of religious or cultural beliefs, some men prefer an alternative method of semen collection. In such cases, semen can be collected by using a special condom during intercourse. Your semen is then sent to a laboratory to measure the number of sperm present and look for any abnormalities in the shape (morphology) and movement (motility) of the sperm. The lab will also check your semen for signs of problems such as infections. Often sperm counts fluctuate significantly from one specimen to the next. In most cases, several semen analysis tests are done over a period of time to ensure accurate results. If your sperm analysis is normal, your doctor will likely recommend thorough testing of your female partner before conducting any more male infertility tests. Scrotal ultrasound. This test uses high-frequency sound waves to produce images inside your body. A scrotal ultrasound can help your doctor see if there is a varicocele or other problems in the testicles and supporting structures. Hormone testing. Hormones produced by the pituitary gland, hypothalamus and testicles play a key role in sexual development and sperm production. Abnormalities in other hormonal or organ systems also might contribute to infertility. A blood test measures the level of testosterone and other hormones. Post-ejaculation urinalysis. Sperm in your urine can indicate your sperm are traveling backward into the bladder instead of out your penis during ejaculation (retrograde ejaculation). Genetic tests. When sperm concentration is extremely low, there could be a genetic cause. A blood test can reveal whether there are subtle changes in the Y chromosome — signs of a genetic abnormality. Genetic testing might be ordered to diagnose various congenital or inherited syndromes. Testicular biopsy. This test involves removing samples from the testicle with a needle. If the results of the testicular biopsy show that sperm production is normal, your problem is likely caused by a blockage or another problem with sperm transport. Specialized sperm function tests. A number of tests can be used to check how well your sperm survive after ejaculation, how well they can penetrate an egg and whether there's any problem attaching to the egg. Generally, these tests are rarely performed and often do not significantly change recommendations for treatment. Transrectal ultrasound. A small, lubricated wand is inserted into your rectum. It allows your doctor to check your prostate and look for blockages of the tubes that carry semen (ejaculatory ducts and seminal vesicles). Treatment Often, an exact cause of infertility can't be identified. Even if an exact cause isn't clear, your doctor might be able to recommend treatments or procedures that will result in conception. In cases of infertility, the female partner also is recommended to be checked. This can help to determine if she will require any specific treatments or if proceeding with assisted reproductive techniques is appropriate. Treatments for male infertility include: Surgery. For example, a varicocele can often be surgically corrected or an obstructed vas deferens repaired. Prior vasectomies can be reversed. In cases where no sperm are present in the ejaculate, sperm can often be retrieved directly from the testicles or epididymis using sperm-retrieval techniques. Treating infections. Antibiotic treatment might cure an infection of the reproductive tract, but doesn't always restore fertility. Treatments for sexual intercourse problems. Medication or counseling can help improve fertility in conditions such as erectile dysfunction or premature ejaculation. Hormone treatments and medications. Your doctor might recommend hormone replacement or medications in cases where infertility is caused by high or low levels of certain hormones or problems with the way the body uses hormones. Assisted reproductive technology (ART). ART treatments involve obtaining sperm through normal ejaculation, surgical extraction or from donor individuals, depending on your specific case and wishes. The sperm are then inserted into the female genital tract, or used to perform in vitro fertilization or intracytoplasmic sperm injection. When treatment doesn't work In rare cases, male fertility problems can't be treated, and it's impossible for a man to father a child. Your doctor might suggest that you and your partner consider using sperm from a donor or adopting a child. Lifestyle and home remedies There are a few steps you can take at home to increase your chances of achieving pregnancy: Increase frequency of sex. Having sexual intercourse every day or every other day beginning at least four days before ovulation increases your chances of getting your partner pregnant. Have sex when fertilization is possible. A woman is likely to become pregnant during ovulation — which occurs in the middle of the menstrual cycle, between periods. This will ensure that sperm, which can live several days, are present when conception is possible. Avoid the use of lubricants. Products such as Astroglide or K-Y jelly, lotions, and saliva might impair sperm movement and function. Ask your doctor about sperm-safe lubricants. Alternative medicine Evidence is still limited on whether — or how much — herbs or supplements might help increase male fertility. None of these supplements treats a specific underlying cause of infertility, such as a sperm duct defect or chromosomal disorder. Some supplements might help only if you have a deficiency. Supplements with studies showing potential benefits on improving sperm count or quality include: Black seed (nigella sativa) Coenzyme Q10 Folic acid Horse chestnut (aescin) L-carnitine Panax ginseng Zinc Talk with your doctor before taking dietary supplements to review the risks and benefits of this therapy, as some supplements taken in high doses (megadoses) or for extended periods of time might be harmful. Coping and support Coping with infertility can be difficult. It's an issue of the unknown — you can't predict how long it will last or what the outcome will be. Infertility isn't necessarily solved with hard work. The emotional burden on a couple is considerable, and plans for coping can help. Planning for emotional turmoil Set limits. Decide in advance how many and what kind of procedures are emotionally and financially acceptable for you and your partner, and determine a final limit. Fertility treatments can be expensive and often aren't covered by insurance. A successful pregnancy often depends on repeated attempts. Some couples become so focused on treatment that they continue with fertility procedures until they are emotionally and financially drained. Consider other options. Determine alternatives — adoption or donor sperm or egg — as early as possible in the fertility process. This can reduce anxiety during treatments and feelings of hopelessness if conception doesn't occur. Talk about your feelings. Locate support groups or counseling services for help before and after treatment to help endure the process and ease the grief if treatment fails. Managing emotional stress during treatment Practice stress-reduction techniques. Examples include yoga, meditation and massage therapy. Consider going to counseling. Counseling such as cognitive behavioral therapy, which uses methods that include relaxation training and stress management, might help relieve stress. Express yourself. Reach out to others rather than holding in feelings of guilt or anger. Stay in touch with loved ones. Talking to your partner, family and friends can be helpful. Best Homeopathic Medicines for Oligospermia Many homeopathic remedies have been known to cure Low sperm Count. Some of these are; Agnus Castus: Sexual melancholy. Fear of death. Sadness with impression of speedy death. Absentminded, forgetful, lack of courage. Illusion of smell-herrings, musk. Nervous depression and mental forebodings. Yellow discharge from urethra. No erections. Impotence. Parts cold, relaxed. Desire gone (Selen; Con; Sabal). Scanty emission without ejaculation. Loss of prostatic fluid on straining. Gleety discharge. Testicles, cold, swollen, hard, and painful. Anacardium Orientalis: Fixed ideas. Hallucinations; thinks he is possessed of two persons or wills. Anxiety when walking, as if pursued. Profound melancholy and hypochondriasis, with tendency to use violent language. Brain-fag. Impaired memory. Absent mindedness. Very easily offended. Malicious; seems bent on wickedness. Lack of confidence in himself or others. Suspicious (Hyos). Clairaudient, hears voices far away or of the dead. Senile dementia. Absence of all moral restraint. Voluptuous itching; increased desire; seminal emissions without dreams. Prostatic discharge during stool. Argentum Nitricum: The patient is intellectual strong, patient complaint of memory loss, along with disturbed sense of reasoning. Patient is involved in foolish task, with strange conclusions. Patient experience strange illusions and hallucinations. His mind is full of useless and troublesome thoughts specially at night time, which makes him very anxious. Due to anxiety patients keeps on walking.Melancholia.Weak of memory, It seems time passes very slowly. Dulness of head, mental confusion ; dizziness ; tendency to fall sideways. Caladium: Patient is unable to remember things, he is very forgetful with vague mind. Due to absentmindedness, he keep on searching different things. Concentration is very less due to which he is unable to put his ideas into speech. He has high desire for sex with relaxation of his organ. A state of total impotency. During intimacy there is urethral discharge. at times impotency is due to mental suppression. Severe itching on testcles. Conium Mac: Mental state is full of hysteria with the nervousness. Patient complaint of weakness of muscles with trembling. Patient has very high desire for sex, but due to impotency he is not able to perform. Patient complaints of semen loss during sleep with or without dreams. Ejaculation is very painful- as if cutting with a knife due to acrid semen. Swelling and hardness Lycopodium: There is great desire to be alone. Despondent. Mentally and physically patient is very tired with complaint of chronic fatigue, with great aversion to his work. He is very forgetful, with dread of public appearance. Great Sensitivity, patient cries even when thanked. It is one of the most used medicines for impotency. Genital organ are feeble due to low vitality. Patient marries to live a normal life, but after marriage he finds he is sexually impotent without erections or very weak and short erections as if he is not a man. There is history of gonorrhoeal discharge with warts on male genitals. Patient is not trustworthy; he is very suspicious and find fault in every task. Patient is very timid with low self-confidence.

Friends today I am discusing about depression, stress and fear . We at Kamla Clinic Railway Road Pathankot treat all chronic problems with holistic medicines without any side effect. Visit or book ur appoint ment by call or whatsapp @ 9463311100. Five to ten per cent of patients visit­ing their GP will be suffering from “clinical” or “major” depression. This means that as a GP, two to three of the patients I see in a normal working day will be experiencing debilitating and disabling symptoms of feeling down, depressed or hopeless and will have little interest or pleasure in doing things. Too many people still think that depres­sion is “all in the mind” and there is a great deal of guilt felt by sufferers that they cannot just snap out of it. Having a “nervous breakdown” still carries a stigma, especially if symptoms are severe enough to need a hospital admission or referral to a psychiatrist. I spend a great deal of my professional life reassuring people that they are not going mad and their symptoms do have a rational explanation. As well as clinical depression, where symptoms are severe enough to affect day to day living, 15 to 30 per cent of my patients will have depressive symp­toms but still manage to continue with work or home life without serious prob­lems. This situation is referred to as “subthreshold” or “mild” depression, depending on the severity and number of symptoms. This is probably the largest group of patients with a psychological problem that I see in my surgery every day. People come with a variety of com­plaints, including a feeling of persistent fatigue, lack of appetite or excess appetite resulting in comfort eating, not being able to look forward to enjoyable events such as holidays or family celebrations, poor sleep, feelings of anxiety and low self­esteem, guilt for “not really being ill”, feelings of not coping, lack of interest in activities or relationships, loss of sex drive and generally feeling cut off from the world. Whilst most of us can exper­ience all of these feelings at some time to a greater or lesser extent, it is when they last for weeks on end that we start to feel unwell and out of balance. It is in these circumstances that the body starts to need a little help to recover. The good mood hormone What causes depression? Most people know that our brain produces a “good mood” hormone called serotonin. If we do not produce enough of it or it gets broken down too quickly, then a low mood results. Quite what triggers off this chemical imbalance is the subject of hot debate by scientists, but its results are only too clear to sufferers of this com­mon condition. There may be an inher­ited element to depression, possibly a genetic factor but scientists are unsure whether depression is due to nature or nurture. I suspect it is a mixture of both. Certainly I come across some people whose brains permanently seem to pro­duce low levels of good mood hormone, meaning they always feel somewhat under par mentally. Treatment In the past, people with symptoms of depression or anxiety were often treated with tranquillizers, or benzodiazepines like diazepam (Valium). This is because depression is really a mixture of feeling low combined with symptoms of anxi­ety. The latter can range from waking up with a sinking feeling or butterflies in the stomach or panic attacks to full blown physical symptoms of acid indigestion, problems with swallowing, diarrhoea, a feeling of tightness in the throat, diffi­culty breathing, weight loss, and a sure­ness that “something serious is wrong with me”. Although tranquillizers may still be used by the medical profession if symptoms of anxiety are very severe, they are now generally recommended only for short term use (up to two weeks at a time). The most common medications for depression these days are antidepressants which help to rebalance the mood hor­mones, commonly selective serotonin reuptake inhibitors (SSRIs) and less often, the tricyclic antidepressants (TCAs). Talking therapies NICE suggests that GPs use either coun­selling or cognitive behavioural therapy (CBT) to treat mild depression. This has been shown to be more effective in the first instance than medication for most sufferers with less troublesome symp­toms. I find the so­called talking therapies extremely use­ful to help people change their sometimes negative way of thinking and such treat­ments can be life changing, helping peo­ple regain normal function without a reliance on tablets. I have worked as a GP in both Dorset and Hampshire and have always been able to refer patients on the NHS, but waiting times for non­urgent cases have become longer and longer over recent years, as more and more people are referred. So although my patients and I can access this invalu­able treatment free of charge, there can be a three to four month wait to see a therapist and sessions may be limited to a certain number rather than what the individual really needs. This can be very frustrating for both client and therapist! Homeopathy’s place It is whilst waiting to see a therapist that I find homeopathy has a place for my patients. It can also be used as a sole treat­ment if patients do not feel that they want to see, or need to see a counsellor or ther­apist but nevertheless want some help to recover from their illness. I would emphasise that I am not suggesting that homeopathy should be used as the only treatment in serious depressive illness where there are feelings of wanting to die or a risk of suicide, or in mental health problems such as bipolar disorder (manic depression), schizophrenia or severe post­natal depression. These are complex and potentially life threatening illnesses and need advice from a psychiatrist along­side the GP and other healthcare pro­fessionals. Homeopathy may have a part to play as an additional or complemen­tary treatment but NOT as a stand alone therapy in these situations. There are so many homeopathic med­icines that can be used to treat the numer­ous symptoms of depression and anxiety that it can be difficult to know where to start. It is important to make sure that your symptoms are not due to another illness such as an underactive thyroid or a stomach ulcer, so please talk to your GP first to make sure of the diagnosis before starting homeopathic treatment. Arsenicum album One of the first medicines that I think of when I see someone with all the symp­toms of anxiety with depression, partic­ularly when there are gastric symptoms of indigestion and diarrhoea, combined with panic attacks, is Arsenicum album. This medicine is based on white arsenic which causes severe gastroenteritis if taken in a toxic dose, which is why it can help similar symptoms when taken in a homeopathic potency. Somebody doing well with Arsenicum will probably be neat, tidy but restless. They may look anxious and drawn and tend to have a fastidious way about them, being able to give a lot of detail to their symptoms. Often I find that such a patient has to tell me all their troubles in a very method­ical but sometimes time consuming way. Arsenicum patients can be convinced that they have a physical illness which is being missed because they feel so ill and may in fact end up having a num­ber of investigations such as endoscopy and colonoscopy before finally accept­ing what is wrong with them. They can feel that they will never be well again. Fear is a prominent symptom, causing apprehension and dread, with an over­whelming feeling that everything will go wrong, and they despair of their recov­ery. These can be patients that I have to try very hard to reassure and I will often use a 30c dose, three to four times a day, with Aconite 30c taken as needed if they are having additional panic attacks. Ignatia Where depression follows from bereave­ment, loss, or a shock, such as witness­ing a fatal road accident, Ignatia can be useful. The symptom picture is typified by emotional ups and downs with mood swings and is often quoted in homeo­pathic reference books as “laughter alter­nating with tears”. Having suffered the loss of my own parents, I know myself the separation feeling that one under­goes when someone close to you dies and I remember being able to talk quite calmly one minute, and then being overcome with tears soon afterwards before becom­ing calm again a few minutes later. Often the sufferer can prove difficult for friends and loved ones to deal with as they are SO up and down, being resist­ant to sympathy and oversensitive to well meaning advice, which may be wrongly taken as criticism. Ignatia patients tend to “bottle things up” and cry and give deep sighs during the course of their con­sultation. It may be hard for them to talk if they are overcome with their miser­able situation and friends can find it well nigh impossible to cheer up such patients. Poor sleep is common and so is the feel­ing of a ball or something stuck in the throat, known conventionally as globus syndrome. I often give a few Ignatia 30c tablets to recently bereaved patients to take when needed, especially around the time of the funeral, and will use a 200c on a weekly or monthly basis for per­sistent depressive symptoms. Natrum muriaticum Another remedy that can bottle things up, but reacts quite differently to the Ignatia patient is Natrum muriaticum. This is one of my most frequently used homeopathic treatments for symptoms of stress, such as those typified by mild depression. I find it very useful when a patient has never been well since a shock or loss and feel as if they have a glass wall between them and the rest of the world. Often they have been unable to cry since bereavement and feel that they have not grieved properly for their loss. They feel worse for sympathy yet are very empa­thetic people. They sometimes build up a barrier emotionally and can appear somewhat cold and distant. They can worry about upsetting people uninten­tionally by saying the wrong thing and also can take things the wrong way. I tend to view these people as the “salt of the earth” type, having a strong sense of duty, but can find themselves being overwhelmed by the responsibility of their work, especially if they are caring for an elderly or sick relative. Such patients can feel that they should be doing more, not less, and feel they must “just get on with it”, and yet feel more and more tired and low in spirit as time goes on. Grudges can build up, with resentment. There may be an increased sensitivity to noise; certain passages of music may move them to those long awaited tears, but without relief from their low mood. I have discovered to my cost that using too high a dose of Natrum mur can cause emotional upset without improving the symptoms of depression so I tend to use a one off dose of 200c when there is a clear history of a defi­nite cause to the illness and a daily 30c dose if the trigger is less clear. Sepia When all energy is drained, and my patient feels that they are unworthy of anybody’s love or attention, I turn to Sepia, a rem­edy which I have written about in the past for its use in the menopause and post­natal depression. I have used this almost exclusively for women who are sad, silent, solitary individuals, completely lacking in zest. Tears are never far away and a feeling of having to keep emotions under control otherwise one will have to scream is typical of the strain that such patients can feel. There is a wish to keep busy but with no incentive to do so and these patients can spend hours sitting motion­less in sadness. Sepia women will often tell me that they love their husbands or partners but cannot manage the physical side of the relationship, which they feel is starting to cause difficulties for their other halves. Sepia usually suits women who tend to feel chilly and they can either feel incred­ibly hungry, being unable to ever feel full or have nausea at the mere smell of food. They often have a sinking, or “all­gone” feeling in the pit of the stomach, espe­cially when they wake, which is not relieved by eating. Older people One area of depression and anxiety I would like to mention is that of the older patient. I am really referring to the over 75s and those perhaps with physical frailty or other health problems and not all “pensioners”, as the media seems to refer to anybody over the age of 60 these days. Depression in this older age group can sometimes give rise to symptoms of forgetfulness and memory loss and lead to a mistaken diagnosis of dementia or Alzheimer’s disease. This is why antide­pressant medication is often given by doctors if such symptoms appear. Unfortunately it can take up to three months for conventional treatment to have a full effect, and because memory problems may affect an older person’s health, and their ability to stay at home to a great extent, doctors tend to treat earlier than later. If you have a sympa­thetic GP, or, even better, one that it is homeopathically trained, it may be pos­sible to try a remedy such as Alumina for a trial period first. This is a homeo­pathic potency of aluminium and is indi­cated where there is confusion about time (“time seems to pass too slowly”), diffi­culty making decisions, unease in the evening (“as if something were going to happen”), involuntary weeping without cause and a dazed feeling, making mis­takes in writing and speaking. All such symptoms are worse in the morning and tend to improve as the day goes on. An alternative to try is Baryta carb, which I have found especially helpful if symptoms are worse with worry or come on after a stroke. Both Alumina and Baryta carb can be given at 30c strength daily. Finding a quiet place Depression is all too often seen as a prob­lem of women, and although it is true that twice as many female patients are treated for anxiety and depression as men, both sexes can be affected. However, it does not have to be the “black dog” that the late Winston Churchill suffered from and does not always need to be treated with medication. Regular exercise can help, as this increases the endorphins produced by the brain, which are responsible for the highs that athletes can experience. Many GPs can refer patients to local “exer­cise on prescription” schemes which often offer a supervised course of gym sessions at a reduced fee. Finding a quiet place, through meditation, painting or walking the dog, can really help rebalance the mind and body; too many patients look blank when I ask them “and what do you do for yourself?” after listening to what they do for others. Look for your own quiet place if any of the above applies to you and please take further advice. It will be worth it, I promise.