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Is male menopause a reality?As opposed to the sudden drop in ovulation and hormonal levels in women, menopause in men is a gradual process. The consequences in men aren't that clear. The health risks, though, are significant and it is important to recognize the symptoms of male menopause early on. Read along to know more. A testosterone level of 300-1200 ng/dL is considered normal in a healthy male. As one ages, the testosterone levels too drop gradually. After 30 years of age, the levels drop by 1% per year. By the time a man crosses 50 years of age, he is in menopause. Look out for the following signs to know if your testosterone levels are dropping : Low Libido : A low sex drive or decrease in inclination to have sex is the first sign of decreasing testosterone levels. Erectile Dysfunction : Testosterone is responsible for releasing nitric oxide that leads to erection. As the levels of testosterone decrease with age, getting an erection and maintaining it for longer periods of time may become difficult. Low Semen Level : The normal amount of semen ejaculated each time varies between 0.1 and 10 mL. This normal level is due to the efficient functioning of the testes, seminal vesicles, and prostate, all of which work under the influence of testosterone. As you age, the testosterone levels drop and the amount of semen ejaculated also drops. Orgasm Troubles : As you age, having an orgasm every time may be a bit difficult due to the dropping testosterone levels. Mood Swings : This happens in men as much as in women! The interesting thing here is that the man who suffers from it is the last one to note it and acknowledge. So, if you find yourself snapping and getting irritated at the smallest of things, get your testosterone levels checked. Depression : When you feel dull and demotivated at all times, and even doing the slightest of activity seems like a chore, it means that your testosterone levels have dropped to a significantly low level. Abdominal Fat : This is again an early sign of decreasing testosterone level. Belly fat is a sign of advancing age. Low testosterone levels are a sign of advancing age. Not all men who have low testosterone levels may show symptoms. In such cases, there is no need for any kind of treatment. Low testosterone may also be due to some other conditions like thyroid disease, excessive alcohol use, sleep apnea, etc. After 30 years of age, the levels of testosterone drop by 1% per year. By the time a man crosses 50 years of age he is in menopause. Identifying and eliminating these causes will restore the testosterone levels to normal. However, if no cause can be attributed to the low testosterone levels, it is a clear indication of normal aging and 'menopause.' As with women, men too have the option of hormone replacement therapy. However, this treatment is controversial. In some men, the testosterone replacement may relive several symptoms, but the risks far outweigh the benefits. An increased chance of heart attack, prostate cancer, and other health problems are associated with testosterone replacement therapy. Herbal supplements for problems associated with decreasing testosterone levels are generally considered safe, but they too have no proven health benefits and are known to increase the risks for prostate cancer. Male menopause isn't as dramatic and abrupt as the menopause in women, but it is a reality. It happens gradually over a period of several years.
Too much of these can be detrimental to healthModeration is the mantra for everything in life. There are a lot of things in our daily life that we do. Excess of these can be detrimental for your health. Let's see how: Television, Laptop, Mobile: That screen is torture for your eyes. Looking at the TV/ laptop/ mobile screen for too long can cause dryness of the eyes. It also makes the mind dull and inactive. Even though you have not done anything much, you feel tired. It is also unhealthy for your social and personal life. Gadgets are meant to add convenience to your life, and not alienate you from real people. These also lead to sedentary lifestyle which further triggers obesity, hypertension, diabetes and other chronic ailments. Travelling: Many of us travel for work, for education. Frequent meetings are a part of work life. Some like to holiday a lot. But too much traveling upsets routine for the body. It changes schedules too often, adds new stressors to an ordinary day. Food options also get limited and sleeping patterns are influenced. If your job demands excessive travel, make sure you consciously put an effort to choose a healthy lifestyle when away from home. Worrying: Worry is unavoidable. Think of a day you did not worry about anything, isn't it difficult? Normal stress is a part of life, but if you are worrying too much, you are weakening your immune system in more ways than one. It makes you weak, susceptible to infections, prone to lifestyle diseases, and also affects your social life and relationships. Vitamin supplements: Supplements are not your daily diet. Have them in moderation and with due consultation from a doctor. Some vitamins get stored in the body when taken in excess quantities. This can result in condition called as hypervitaminosis and various health problems. Exercise: Body is not a mechanical machine that can keep functioning at the click of a switch. Even a machine needs oiling and repairs. If you love to exercise, that's great. But don't do it all day. Too much physical exercise is strain on the body. It can lead to muscle exhaustion, weakness, breakdown and may even damage the kidneys. Sleeping: Sleeping is the rest the body needs but too much of rest means rusting. Oversleeping makes you dull and may even trigger your migraines. It annoys the body clock and may create metabolic disturbances Social Networking: This is not good for your mental health. Those two hundred friends who like and comment are not your world; the one whom you call when you want to cry is your friend. Posting images and sharing updates on social media is fine, but it is more important to talk to those who live with you, who are physically around. Many peer pressures and image issues also arise from excessive social networking and people may tend to live in a 'make believe' world.
Infertility at workplaceSince infertility among the younger age is increasing, it is important that a couple decides an early suitable date to attempt conception. Time and again it has been found that infrequency of intercourse is the cause of delayed pregnancy. It is advisable that the woman has a thorough examination by the gynecologists to identify the ovulation dates and for the man to have a thorough spermatic fluid check.  If both are normal then they could wait for a suitable date later. Should there be a problem the quicker it is attended to better. Also, early in the marriage they should start a fund which could be utilized for matters related to conception. For the male, the main treatment covers his personal sex life and a detailed examination of his spermatic fluid. It is the female who has to undergo many detailed tests and possibly surgeries which are expensive. It is often seen that not only the procedures for both take a toll on their personal and intimate relationship but also severely affect their finances which may come to a point that it does not allow them to complete the treatment as for e.g. the woman undergoing IVF may costs several lakhs of rupees. The treatment of infertility has improved greatly, but interferes severely with the work schedule. Working couples particularly women may have a hard time keeping to their schedules. Depending on their infertility diagnosis, many workplace challenges exist including the need to take time off to undergo tests and other appointments. It is difficult to balance the medical and surgical procedures with daily life and work. This is a difficult issue for many people as they fear their employer may discriminate against them for taking time off from work. Sadly in India there are very few employers who include medical benefits and cost of treatment for infertility. Suggestions have been given on stress dealing with infertility treatment and work. Here are few pitfalls to avoid: Do Your Homework: Review your organization's HR policies so you understand the amount of leave you have and other policies that pertain to your situation. You may be able to arrange for flex time or work from home on the days of your appointments, so that you do not actually miss any work. Be Honest:  Go to supervisor and let her or him know that you will be using your leave time and will give as much notice as possible. Honesty is the best policy. Remember people are inherently curious about the disease of infertility. If you feel the questions are invasive and make you feel uncomfortable, remember you do not have to answer the questions. You can respond nicely and let them know that you appreciate their concern but you are not ready to answer any questions. Your co-workers are asking question because it is human nature to be curious. In conclusion, not everyone needs to know what is happening with your reproductive health. At work place should medical help be available do take advantage of it.  This treatment has nothing to do with your performance at work. Go to work feeling confident that you will be able to perform your job and handle your workload during this time.
Get the couch potato out to playKids in the modern day are increasingly getting lazier and unfit. Watching TV, playing games on consoles and smartphones, and spending time on social networks is eating into time which would otherwise be spent playing outdoors.The lack of exercise comes with a host of problems, which can affect kids in childhood or later on in life. Therefore, parents must encourage kids to exercise by being an example. However, do keep in mind that there is nothing that will bore a kid than treadmills or lifting weights. Playing sports is often the better way to go. Give aerobics a try Aerobic exercises can help kids to stay fit and also can be fun at the same time. The common perception is that aerobics involve dancing a set pattern. However, aerobics is any exercise that increases your oxygen intake. Outdoor activities can include basketball, cycling, soccer, swimming, tennis, walking or running Along with aerobics, children should also do stretching exercises, which help in improving flexibility, allowing muscles and joints to bend and move easily through their full range of motion. Getting your kids excited It is important, however, to communicate with your child the need to exercise. You could encourage them to take part in outdoor games at school as well as in the locality where you stay. You should regulate the number of hours your kid can spend in front of the TV or PC. This way she will look for means to play outside the house. You can also play with them yourself. It will be fun for the both of you, as well as helps you bond with your child. Exercising for at least an hour a day is ideal, and it broken down into chunks of 15 minutes at a time.  
Your bundle of joy comes with bundles of fascinating facts Blue-eyed wonder: Most babies are born blue-eyed. The melanin pigment that decides the color of the eyes is not developed at the time of birth. So the babies are born with blue/light eyes irrespective of the genetic makeup. By the time the baby is 6-7 months old, the pigments start developing and the baby's eye colour changes as per the genetic makeup of the parents. Marked for life: One in every three infant is born with a birthmark! No tears: That is true! New born babies do not shed any tears. The lacrimal duct and the tear glands are well developed but they produce just enough tears for lubrication. Actual tears start appearing after one month of age. Crawling wonders: New research has found that babies can crawl almost as soon as they are born. When left to themselves, they are quite capable of using their limbs and find their way to food i.e. the mother's breast.And we thought that they are tiny helpless creatures! Temperature sensitivity: Babies are much more sensitive to temperature changes and body heat.Though the baby can't throw off the clothes to cool down, it is smart enough to do other things. When the baby is cold, it will move around more and if it is too hot it may just lie still as if sunbathing. Touch therapy: Touch is the most highly developed sensation in babies, even in premature ones. The touch sensation develops from head to toe with the mouth being the most sensitive. No wonder they tend to put everything in their mouths. Short-sighted: Babies are short sighted at birth. Their vision is set to a limit of 8-to-12 inches. They can see people and objects clearly only if they are within this range. Brain size: The brain grows at such a rate in newborns that by the end of the first year,the brain is double the birth size and half its final size! Palmar Grasp: New born babies have a strong grip, as strong as a monkey's. The grip is so strong that if you dangle them on one hand, they can support their own weight. This probably originated from the primitive survival instinct. This strong grasp reduces after a couple of months. Taste buds: Babies have more than 10,000 taste buds situated all over the tongue and even at the roof and sides. As they grow, these extra taste buds disappear.
Algophobia: The fear of painAlgophobia is the fear of pain:  an abnormal and consistent feeling that is far beyond what would be considered normal. The term is derived from the Greek words, Algos meaning pain and Phobos meaning fear. Our bodies are designed in a way that when there is a painful stimulus it reacts. How the body reacts to the pain is an individualistic phenomenon. Some people have a very low threshold for pain, and even the slightest pain evokes a huge response in them. Where as others can withstand a good amount of physical pain before their bodies give in. Some people dread even the tiniest amount of pain. They foresee situations that will cause pain in them. The way they react to even the smallest amount of pain is far more than the normal level of acceptance. Such people are said to be suffering from Algophobia. Algophobia is a learned behaviour, say behavioral psychologists. For example you may have heard from several people how hitting your shin on the furniture in the dark is the worst possible pain ever. So you tend to keep a watch and if it is dark, you move around extra-carefully to avoid bumping into the furniture and getting hurt. This would be considered normal, cautious behaviour. But if the same thought keeps buzzing in your head continuously and you go to extreme lengths to avoid that pain, you could be algophobic. Old people are the ones who have excessive fear. The age factor along with fear of death plays a vital role in old people developing this fear. For example an old lady may hear about all the ailments and pains that afflict old age people and may become apprehensive about it. She may develop irrational fears that more often than not, are also imaginary. She may start experiencing the pains even before anything actually happens to her. It may seem unrealistic to a normal person, but for algophobics pain can be a severely dreaded thing. Therefore they will go to great lengths to avoid pain at all levels, including day-to-day activities. They will not go into the dark, handle tools, avoid lifting heavy objects or even avoid playing any type of contact sports. If a task has a scope for injury and pain, they will avoid it! Frequently a pathological complaint of Hyperalgesia occurs along with algophobia. Hyperalgesia is a condition of increased sensitivity to pain due to damage to the peripheral nerves and pain receptors. Pain in such cases may be directly in the damaged tissues or in the surrounding areas. An interesting fact is that hyperalgesia can occur due to long term use of painkillers especially strong ones like opium and its derivatives. Algophobia is treated with behavioural therapy, psychotherapy and anti-anxiety medications. Hypnotherapy also has shown beneficial effects.  
Accepting your flawsThere are basically two kinds of 'flaws,' one that is physical and the other that is in your personality. A physical 'flaw' like being too short, fat, or darkis never a person's fault. Thus accepting what you are can only boost your self-esteem and confidence. Despite these 'shortcomings,' it is your character and your achievements that stand out in the long run and not the way you look. The first step in creating a better life is accepting if you are wrong! Personality traits and habits are mostly visible to others but not to you. These are those faults that can cause bitterness in relationships or cause problems at work or in our social interactions. Some people lose their temper easily, some are lazy, and some are rude, while some are either introverts or extroverts. If you have flaws that can cause problems for others then the best thing you can do is to change those negative traits in yourself. Character flaws might be natural, but they can affect others negatively. The first thing in making improvements is to analyze yourself. What are you so angry about ? Is it really some other person's fault or that you have had a bad day at the office? Give it a thought and once you find the answers, you will feel relieved. Accept your physical flaws and love yourself for what you are, as this is the key to lasting happiness. Major flaws like alcoholism, splurging money, borrowing money, or addictions are what one should be willing to overcome. If you accept you have any of these major flaws and need help to overcome them, then you need to seek help. There are professionals who can help out, provided you are a willing party to the process. Improvement will come only if you are willing to change. Remember that flaws are easy to acknowledge and to change;the only thing required is the desire within you to do so.
High heels can walk you to the hospital bedHigh heels make a fashion statement which makes us look tall, elegant and good but they cause injuries on a regular basis. High heel shoes have been luxury item once upon a time; today high heels have made themselves a part of every girl's life thanks to supermodels and stars. You will not find any health warning on shoes but they ought to, as they seriously put you at a high risk of numerous health problems. How are high heels and low back painrelated? High heels significantly affect your natural posture and your spine. The natural arch of spine becomes acute when walking in high heels. This poses high risk to the spine getting injured. This not only wears  and tears intervertebral cushions called discs but cause injury to the nerves too.  High heels put strain on muscles of lower back causing pain after a long day of wearing high heels. Nerve trapping, nerve pain and radiculopathy can result from wearing high heels for a long period. This is exhibited     as tingling, numbnessand pain. Arthritis, nerve pain, hammer toes, ingrown toenails and bunions are all common problems due to high heels. Calf muscle shortens and tightens after prolonged use. Jogging, playing, running with high-heeled shoes can tear and rupture calf muscles. What can you do to prevent damage? Firstly ensure your body is in top shape before you start. There is a much less chance of developing low back pain if you are strong and fit. So do activities like swimming, pilates, circuit class, box-exercise and whatever else thatmakes you feel good. Focus on activities that make the abdominal area strong includingyour deep core muscles. Secondly a regular regime of stretching will prevent a lot of problems occurring. Either get involved in a yoga class or make sure you do 10-15 minutes of stretching every day. Stretch your back, your calves and hamstrings especially. Thirdly get sports massage at leastonce-a-month. This will loosen the tightened structures, realign the spine and lengthen the hamstrings, calves and Achillestendon
Top 10 tips for weight maintenanceTIP 1: Stay Calm and PlanDon't worry about your weight excessively. This will only result in stress which can be counter-productive to your pursuit. Remember that you have reached the goal you had to and you are strong enough to sustain it. Take one day at a time. Do not think about how you are going to keep it forever. Just focus on the next day. TIP 2: Health JournalKeep a journal where you note down your eating and exercising patterns. Write down what you eat, plan your meals, drink adequate water, and form an exercise regime. Did you know that you can include an activity within your life as a habit by performing it for 21 days? Do these things not because you have to but because they are good for your health. Slowly, they will become a part of who you are. TIP 3: Being Healthy Is A Lifetime DealOne of the greatest mistakes that people do is to think that once they have lost weight, they can return to their early eating habits. Remember that your health is with you for life. Shift your perspective from 'I have to become thin' to 'I have to be healthy.' Once you do this, you will find it easier to stay healthy for the well-being of your body. TIP 4: Be RealisticWhen you are planning your lifestyle, don't take up unrealistic goals. This is one of the reasons why weight-trainers say that the best way to reduce and sustain right weight is to make it 'your life.' Eat right, sleep well, and drink lots of water. These three, if done properly, can help you to have the right body weight. If you have any rules like 'don't eat cake or pastries ever,' 'quit drinking,' then rethink about them. Are you going to be able to never eat sweets? The primary goal is to make a balance, choose the middle path. TIP 5: Get An Idea Of Your Weight-PatternMany people stop weighing their body once they have reached the ideal weight. They think that the scales are only for the fat ones. A person with such a perspective is only looking for slim bodies and not healthy ones. Remember that your weight is not a judgment of your appearance, but a barometer of your health. So do not stop doing the weekly weight checks. Keep a report of your weight every week and check out the causes for any abnormal changes. TIP 6: Accept Your Limitations And Learn From ThemEveryone has their ups and downs. Don't get discouraged and be angry at yourself if you binged on a donut on a cloudy day. Everyone makes mistakes. It is not the end of your weight maintenance. It is simply a blip. Learn from it. Know what the causes are for it and work on making sure you react to the cause differently next time. TIP 7: Thirst And HungerYour body could confuse your thirst for hunger. So, if you are feeling hungry really soon after your previous meal, then start by drinking a glass of water and check if you feel better. If you do not, then it is time for a light healthy snack. TIP 8: Inspire YourselfWeight maintenance is primarily a psychological task. Till the time you were reaching the ideal weight, you learn everything you had to about being healthy. Now, you have to make sure you don't let obstructions stop you from sustaining this healthy lifestyle. So, join other people who are only in the process of maintaining their weight. Become part of the running blub or catch up with a health conscious friend regularly. TIP 9: Mind Over MatterBalance your eating patterns. If you think that you will be going out for lunch, then have a healthy breakfast and cut down on the dinner. You might be craving for a dessert, so you can have salad for the main course and treat your sweet tooth. Talk to yourself about what you are going to eat. Ask yourself if you really want to eat it because you are hungry or are there any other reasons for it. How would you feel about it after you are done eating? TIP 10: Celebrate Your AchievementsLastly, be proud of your weight maintenance program. Celebrate the fact that you worked hard towards making sure you have a healthy body and invite people who were part of your pursuit. Embrace your body and toast to the next year of a healthy lifestyle.
Bile block - Understanding gallbladder problemsRavi was a young intern working the night shifts in a government hospital when he was asked to examine a patient who had just been brought in. The patient was a 45-year-old, a fat man, who was complaining of pain in the right side of the abdomen along with nausea and vomiting. On inquiry it was revealed that he had eaten a very heavy fat-laden dinner. Remembering what his surgery professor had taught him about cholelithiaisis, Ravi immediately guessed what the diagnosis could be. He, however, sent the patient for a blood test and an abdominal scan. The reports confirmed Ravi’s suspicions- cholelithiasis, gallstones. The gallbladder is a tiny pear shaped organ that lies just below the liver. It is responsible for storing the bile that is produced by the liver for digesting food. It ensures the smooth outflow of the bile from the bile ducts. When the bile components aggregate in the gallbladder, they build up to form gallstones, similar to kidney stones. The gallstones are usually small enough to pass on to the intestines and be eliminated without causing too much trouble. At times, these stones may be big enough to block the outflow of the bile and give rise to a variety of symptoms depending on the size of the stone and severity of the block. The symptoms include -  Intermittent colic. A bloated sensation with constant nausea. Inability to tolerate fats. Vomiting.  Fever with chills if the stone becomes infected. Gall stones though found in both sexes, is more common in females. The risk factors for developing gallstones include - Diabetes. Organ transplant. Diseases like hemolytic anemia, sickle cell anemia. Liver cirrhosis. Failure of the gallbladder to empty properly, e.g., during pregnancy. Rapid weight and nutrition loss due to any reason. Gallstones are confirmed by a blood test to check the liver function and by an abdominal scan. Medications to dissolve the stones, and surgery in case of large stones that do not dissolve with medications, are the treatment options.
Adrenaline rush - Feel it inside!Imagine yourself at a great height, either scaling a dangerous cliff-hanger of a rock face or on a bungee jumping platform. Some of us who have had the pleasure of doing high adventure sports like racing or indulging in perilous activities like giving out an acceptance speech for the first time are well aware of that strange feeling in the solar plexus, the clammy hands and intensely thudding heart, and the rush of blood to the head just as you are about to take the plunge! The heart beats faster than ever, breathing goes rampant, the senses seem to become supercharged, and the fear, the joy, and the excitement meddles with the mind. That’s adrenaline rush! So what do you want to do? Fight? Or flight? Either ways, adrenaline does it for you. Speaking medically, the two small adrenal glands on top of the pair of kidneys release a magic chemical that gives the animals way towards the fight-or-flight response to counter certain high-intensity situations, called adrenaline or epinephrine. The chemical entity is a hormone, a neurotransmitter as well as a medicine and is too complex to explain its behavior. However, when it works the heart pumps out the blood to the excited muscles and all the juices surge up inside the body. There is more to this topic than just the physiological mumbo-jumbo. The hormone acts every day in the normal course of life, but not regularly to the extent when it produces side effects such as shakiness, palpitation, high anxiety, and profuse sweating! Thats kept for special situations like physical threat, excitement, bright lights, noise, and really high temperature – in good or bad ways. Let us surf through some of the rewarding and a few of the nasty situations where the jolting juice takes charge of our body! The Good ones: Countering Stress: In extreme stress conditions like accidents or fracture, the body needs to react fast and is at its highest awareness. Adrenaline keeps the muscles up and kicking to help the victim fight with the stress. High Energy Requirement: In majority of sports, more specifically in contact sports like Rugby, Boxing, Mixed Martial Arts, etc., the player needs to be in his full sense and topmost concentration level. The adrenaline rush runs in the background to keep them at their extreme self. The Push Mode: Often the daily chores aren enough to excite us and we tend to search for some adventure. In such pursuit of excitement, there are times when the road is a dead end or there is only one way forward – the impossible or most difficult one! The hormone pumps the brain both ways with fear and with the push to conquer the fear and proceed. Adventure Sports often sounds fun, but at times when running ahead of a raging bull, or hanging off a cliff, or rafting down the rough waters of a cascade – feels like the heart shall come out and scream!! It is the rush of adrenaline that keeps one ahead of the fear and explore the high-energy fun of winning over it. Life Saving Moments: In cases of life-threatening emergencies such as drug overdose, cardiac arrest, or pulmonary failure, where the heart and lungs suddenly cease to function and the body gets into a shock –– the epinephrine shots are considered as a life-saving medication to bring the patients back to life (only to be used judiciously by a qualified medical practitioner). The important medical use of adrenaline is in treatment of acute anaphylaxis and allergies under medical supervision. The Bad Ones: Disorders of the Adrenal: Tumors and cancers of the adrenal gland can cause hyperactivity of this high-performance hormone affecting the normal functioning of the heart and the blood vessels by increasing heart rate and creating anarchy in the body systems. Over-Stressed Adrenaline Rush: The demand-supply mismatch in the present world scenario requires one to perform at his/her epitome of mental and physical strengths. In that constant urge of performance, the brain and the body is stressed out so intensely that the adrenaline surge symptoms are experienced by the individual even in the absence of threatening situations. Sudden sweating of palms, shortness of breath, pounding heartbeats, or chest pains without a justifiable reason can be a result of constant stress.
Your questions about contraception, answeredFew couples want to have babies as soon as they are married. Most want to enjoy their sex life without having to worry about conceiving a child in the process. If you are in this group, then here are answers to the most commonly asked questions about contraception. What is contraception? Contraceptionis use of various methods to control and prevent the pregnancy. It allows you to choose when you want to have a baby. What are the various methods of contraception? There are two main methods. Temporary contraception: Caps, combined pills, male condoms, female condoms, contraceptive implant, contraceptive injection, contraceptive patch, diaphragms, intrauterine device (IUD), intrauterine system (IUS), natural family planning, progesteron-only pill, vaginal ring. Permanent contraception: Female sterilisation(tubectomy), Male sterilisation (vasectomy). No contraceptive is 100% reliable and some can have side effects. Find out about all the methods listed here, so you can decide which method is right for you. How soon can I conceiveafter stopping the birth control pills? It is difficult to predict exactly how long it will take for a woman to start ovulating again. Some women are fertile as soon as the pills are stopped and others might take couple of months. Once the periods return and are normalised with normal ovulation, you can conceive a child. What if my period doesn't resume after I stop taking oral contraception pills? If you don't get your periods for several months, you may have what's known as post pill amenorrhea. The pill prevents your body from making hormones involved in ovulation and menstruation. When you stop taking the pill, it can take some time for your body to return to normal production of these hormones. Normally, periods should start again within three months of stopping the pill. But some women, especially those who took the pill to regulate their menstrual cycles, may not have periods for many months. If you don't have a period within three months, take a pregnancy test to make sure you're not pregnant, and then see your doctor.
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