Doctor in Aditya Hospital
Caesarean Section Procedure
Treatment Of Female Sexual Problems
Termination Of Pregnancy Procedure
Treatment Of Pregnancy Problems
Well Woman Healthcheck
Treatment Of Female Sexual Problems
Treatment Of Medical Diseases In Pregnancy
Treatment Of Menstrual Problems
Intra-Uterine Insemination (IUI) Treatment
Medical Termination Of Pregnancy (Mtp) Procedure
Gynecology Laparoscopy Procedures
Pap Smear Procedure
Urinary Incontinence (Ui) Treatment
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During the natural course of events, a women's body starts its reproductive phase with menarche and at about 50 years of age, attains menopause. This is when the reproductive function ceases and the ovaries stop producing the hormone estrogen and progesterone. In some cases, for various reasons including medical, the ovaries stop functioning earlier, and this is medically termed early or premature menopause. Menopause that occurs before 40 years of age is termed premature menopause; it is due to primary ovarian insufficiency and occurs in 1% of the women. If it occurs between 45 to 50 years, it is termed early menopause.
Causes: Normal ageing, family history, genetic disorders, autoimmune disorders, toxins, and surgery are some reasons that could lead to premature menopause.
Effects: Estrogen and progesterone have a lot of beneficial effects on a women's body. Reduction in their levels leads to some of the below changes:
- Emotional changes like mood swings, irritability, and in some cases depression, especially in premature menopause.
- Irregular cycles before complete cessation of the menstrual cycles.
- General mucosal dryness leading to vaginal dryness, dry skin, dry eyes.
- There also would be urinary incontinence and reduced sex drive due to reduced hormone levels.
- For women who still would want to have children, infertility would be a big cause for concern. This could lead to other emotional issues, worsening the depression.
- Osteoporosis - Bones lose their density and get weak and are more prone to fracture.
- Cardiovascular health - Post menopause, women are more prone to heart attacks and stroke. Though not fully proven, this is believed to be true as the good role that estrogen plays on blood vessels is negated with menopause.
- Accelerated ageing - Menopause leads to accelerated damage of genetic structures, thereby leading to faster ageing. This also leaves a feeling in the women of being less attractive and less desirable.
There is also a good news, that after menopause women are at lesser risk of cancer - especially breast and ovarian.
It is not easy for women to handle premature menopause. The body undergoes some changes much earlier than expected, and it requires a lot of support and caring and comforting to come to terms with it - especially if associated with infertility or chemotherapy for cancer. Emotional issues of not being able to have children and feeling less attractive require frank talks to boost the person's confidence and increase self-worthiness.
It is easier said than done, but one of the key ways to handle premature menopause is an open discussion. In case you have a concern or query you can always consult an expert & get answers to your questions!
While pregnancy is not a pathological condition, it is a happy time that can be marred by various conditions. Debilitating morning or all day sickness, which is usually characterised by nausea, reflux in the gastro esophageal band, heartburn and acidity. This can also turn into vomiting and lead to complications if it does not stop. Persistent, almost daily vomiting can be termed as excessive vomiting in pregnancy, and this is known as Hyperemesis Gravidarum in medical terms. Let us find out more about this condition--
Routine: Hyperemesis Gravidarum usually strikes as a matter of routine at a set time everyday where the patient will either be in unappetising company of acute and painful acidity and nausea, or will also be vomiting.
Severity: The severity of the condition usually decreases as the patient's pregnancy progresses. Usually, this condition strikes around the fourth or fifth week of pregnancy, before becoming better towards the middle of the second trimester. There are cases, though, where it continues to be just as severe till the very end of the pregnancy.
When to take Action: The patient may have to be hospitalised in case too much vomiting takes place, so as to prevent excess loss of water and salt from the body, and resultant weakness which may affect the growth of the foetus. Also, it is best to call the doctor when you have experienced fainting and dizzy spells.
Causes: Hyperemesis Gravidarum or excessive vomiting during pregnancy cannot be attributed to any specific or single cause. Usually, it is known to be a genetic condition passed down by mothers to their daughters. But in most cases, doctors believe that the condition is due to hormonal changes where an increase in the HCG hormone, or Human Chronic Gonadotropin hormone level during pregnancy may lead to a variety of symptoms such as morning sickness or excessive vomiting. This hormone is known to be at its peak during pregnancy.
Risk Factors: It has mostly been seen that women who are carrying twins are at risk of suffering from this condition. Also, women who have suffered from chronic motion sickness in the past report excessive vomiting during pregnancy.
Treatment: The best way to treat this issue is to prevent too much of nausea and vomiting with the help of a bland diet that does not have heavy to digest ingredients. Also, it is best to take small and frequent meals.
Working your way around excessive vomiting during pregnancy is a matter of ensuring that you take rest, fluids and other precautions.
In case you have a concern or query you can always consult an expert & get answers to your questions!
There are three stages of caring for an expecting mother: prenatal, intranatal, postnatal care. This is essential to ensure smooth pregnancy and labour and to keep the mother healthy after giving birth. This care is a combined effort between the doctor and the expectant couple. Here are a few things to keep in mind if you are expecting an addition to your family.
Prenatal care from the moment you realize that you are pregnant, a woman must start taking extra care of her body. This reduces the risks in your pregnancy and at the time of labour. But even before planning a pregnancy, it is important that couples should consult with the doctor, in order to avoid any complications in future. Thus you should ensure that regular check up not just during the pregnancy, but also before the pregnancy is equally important, so that your doctor can rule out complications arising due to factors, such as Thalassemia, Thyroid, Blood Sugar and PCOS, etc.
The main objectives of prenatal care are:
- To maintain the health of the mother
- Detect high risk cases
- Foresee complications and find ways to prevent them
- Reduce anxiety associated with delivery
Thus, an important part of prenatal care is to visit your gynaecologist regularly. These visits will be scheduled according to your age and stage of pregnancy. A few other points to keep in mind are:
- Stop smoking and stay away from passive smoking as well
- Stop drinking alcohol
- Take folic acid supplements and multivitamins
- Avoid contact with toxic chemicals like insecticides etc.
- Ensure your vaccination is up to date
- Avoid X-rays
- Do not start or stop any medication without informing your doctor first
- Eat healthy food and drink plenty of water
- Exercise regularly for half an hour daily
- Get plenty of rest
- Avoid stress
- Educate yourself about childbirth
Intranatal care refers to care given to the mother and baby at the time of delivery. The main objectives here are:
- Smooth delivery without injuring mother or baby
- Preventing complications
- Delivery resuscitation for the baby
There are a number of ways to deliver a baby and whatever you choose, you must ensure the presence of a doctor at your side, while delivering a baby. Your doctor will determine the position of the fetus and help you through your delivery.
Postnatal care is essential for 6-8 weeks after the baby is born. During this period, the mother goes through a number of physical and emotional changes and thus requires rest, nutrition and vaginal care. The main objectives here are:
- Prevent postpartum complications
- Restore mother to optimal health
- Ensure problem free breastfeeding
Sharing responsibility is essential for the health of the mother, after delivery. Get as much sleep as possible and pay attention to what you eat. Do not try and lose your pregnancy weight instantly. Schedule a checkup with your doctor six weeks after delivery to ensure your vagina has healed properly. Additionally abstain from intercourse at this time. With proper care, every stage of your pregnancy can be a beautiful experience.
Many women have concerns about an ectopic pregnancy and we shall be solving all doubts about this dangerous condition right here today. An ectopic pregnancy happens when a fertilised egg implants outside the uterus in a woman’s body. Ectopic, in fact, means ‘out of place’. The fertilised egg usually implants in the fallopian tubes whose actual work is to transport the ovum or egg from the ovaries to the uterus for fertilisation. This is why such pregnancies are also called ‘tubal pregnancies’. Sometimes the fertilised egg can also implant in the cervix or the ovaries of the hapless woman.
Normally pregnancies happen when a fertilised egg attaches itself to the uterine wall to grow and develop. Ectopic pregnancies are a serious condition and can cause internal bleeding and infection and even death of the expecting mother. That’s why knowing the symptoms is so important.
Common symptoms of ectopic pregnancy appear as the pregnancy matures. Initially the woman will have all the usual pregnancy-related symptoms like missing her period and breast tenderness, but soon the other alarming symptoms will start appearing like severe abdominal pain on one side, vaginal bleeding, severe cramps and nausea and vomiting, fainting spells and dizziness.
One should seek a doctor’s advice right away in this condition because ectopic pregnancy can be fatal. Why? Because as the fertilised egg is implanted in a part of a woman’s body which is not built to look after it, the embryo can burst in the fallopian tubes, cervix or wherever it has managed to implant itself. This mini-explosion inside the body is a leading cause of pregnancy-related deaths during the first trimester. This can lead to internal bleeding and infection, which is lethal.
Hence, the earlier an ectopic pregnancy is diagnosed and treated, the better. The only way to deal with an ectopic pregnancy is to abort it. The doctor can do this using either medicines or surgery.
The medicine ‘methotrexate’ can be used to end a tubal pregnancy. Surgery can also be used to remove the embryo.
In some cases, doctors may have to remove the fallopian tube with the implanted embryo. This has a number of repercussions. The woman can become infertile. Even if the fallopian tubes have been scarred during surgery, it becomes difficult for her to get pregnant again.
Ectopic pregnancies are also getting quite common due to a number of factors like an increase in sexually transmitted diseases which cause scarring of tubes and infertility treatments. If a woman is over 30 years of age, has a history of a pelvic inflammatory disease, a surgery in the pelvic area or has had an ectopic pregnancy before, she should be very careful indeed. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
Postpartum is the period after one's labour and delivery. Pregnancy and postpartum are a time when a woman's body changes to a great extent in order to first accommodate the baby and then go through labour and delivery. A vaginal delivery can have many implications when it comes to the postpartum. The same goes for a Caesarean Section or C Section as well. Let us find out what your postpartum care routine should include:
Vaginal Soreness: Deal with vaginal soreness with the help of stool softeners and pain relievers, as prescribed by your gynaecologist. You should also make hygiene a priority at this time. Use a wash cloth and warm water to clean the area every time you urinate. Also, you can use an ice pack if the wound is particularly painful.
Discharge: Vaginal discharge in the postpartum period is called lochia, and it usually carries on for a few weeks after the baby is born. You must use a sanitary napkin during this period and clean up regularly. If your bleeding or discharge is accompanied by fever, then you should contact your gynaecologist immediately.
C-Section Wound: In case there is redness and swelling in the wound, accompanied by symptoms like pain and foul smelling discharge from the vagina, you will need to get in touch with your doctor immediately so that he or she can check for possibility of infections.
Movement: After a C Section, you will need to take as much rest as possible so that the wound heals properly. This includes avoiding making too many trips up and down the stairs as well. It would be a good idea to have a family member or partner around who can help as well. Gentle walks after a week or two are usually recommended for the body to come back to normal gradually.
Kegels: Do kegels or contracting exercises for the strength of the pelvic floor to return, especially after a vaginal delivery. This will help in alleviating pain and burning sensation during urination at this time.
Nutrition: Take special care to eat nutritious and home cooked food, especially if you are breast feeding. This will also help in the healing of the vaginal or C Section wound. Also, a high fibre diet will help in better bowel movements which will lessen the pain while visiting the bathroom.
Taking care of your body in postpartum is a matter of bringing it back to normal gradually even as you deal with the side effects of delivery. Ensure that you are in touch with your doctor.
A uterus has 2 layers the one with a thin layer is known as the endometrium and the thick outer layer is known as myometrium. Menstruation occurs after every 10-14 days post the ovulation. In a normal menstruation cycle, the wall of the endometrium thickens as part of the preparation process of pregnancy. In a normal scenario, the endometrium wall sheds if a woman does not conceive. While doing this the uterus might shed some blood. However, if the bleeding becomes erratic and in higher frequencies, the condition is termed as abnormal uterine bleeding.
Here is a list of reasons for abnormal uterine bleeding:
- Young girls: Any bleeding before the first menstrual cycle is termed as abnormal. The bleeding might happen due to trauma, the intervention of a foreign object, problems related the urinary tract, irritation of the uterus etc. Bleeding might also occur due to sex abuse. A qualified gynaecologist would be able to diagnose the exact cause for this condition.
- Adolescents: After the first menstrual cycle, there could be fluctuation in the subsequent menstrual cycle accompanied with excess bleeding from the uterus. This is a condition which is treatable and normalises once the ovulation and the hormonal cycle stabilises. However, if the bleeding persists in after 3-4 menstrual cycle, a doctor has to be consulted.
- Premenopausal women: There could be a variety of reasons for more than normal bleeding in women between menopause and adolescence. Some of the common reasons are hormonal changes and hormonal therapy for birth control. For women who fail to ovulate regularly can experience conditions such as endometrial polyps, uterine fibroids and uterine adenomyosis leading to excess bleeding from the uterus. Some other common factors of uterine bleeding include cervix infection, pregnancy, cervical cancer, disorders related to clotting, certain illnesses related to the kidney and liver.
- Hormonal birth control: Women taking help of hormonal birth control can experience breakthrough bleeding. This often occurs due to changes in the uterus lining. If the bleeding from the uterus persists for few months at stretch, a different birth control pill should be tried. Bleeding can also occur due to due to irregular consumption of birth control pills. If the situation does not improve, it is wise to consult a doctor to get the condition addressed.
- Menopausal transition: Towards the end of the menstrual cycle, the period timings become irregular. While the secretion of the oestrogen continues the progesterone flow declines. This phase is known as perimenopause. The sudden hormonal changes lead to an excess fluid secretion by the walls of the endometrium. The whole process can lead to an excess bleeding from the uterus. Even using birth control pills during this phase can lead to excess bleeding. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
When the reproductive glands produce scant to no hormones like oestrogen or testosterone, then it is known as hypogonadism. These hormones are important for controlling secondary sex characteristics like development of breasts in women and testes in men and growth in pubic hair. Sex hormones are also required for the roles they play in menstrual cycle in women and sperm production in men.
Hypogonadism is curable with the right medicines.
Types of Hypogonadism
1. Primary hypogonadism: In this type, there are not enough sex hormones in your body because of a problem in your gonads (testis or ovary). In primary hypogonadism, the gonads do receive the message from the brain to produce sex hormones but cannot produce them.
2. Central/Secondary hypogonadism: In this type, the brain is wherein the problem lies. The pituitary gland and hypothalamus located in the brain do not work properly.
What causes Hypogonadism
The causes of hypogonadism can be classified according to their types.
In primary hypogonadism, the causes are:
1. Genetic disorders (for example, Turner syndrome in women and Klinefelter syndrome in men)
2. Autoimmune disorders
4. Kidney and Liver disease
In central hypogonadism, the causes are:
1. Anorexia nervosa
3. Bleeding in the pituitary area
5. Taking certain medicines (for example, glucocorticoids and opiates)
6. Anabolic steroids (alternatives to human testosterone)
8. Genetic problems (example: Kallmann syndrome- unable to start or complete puberty)
11. Hemochromatosis (excessive iron)
12. Nutritional deficiencies
Symptoms associated with Hypogonadism
Symptoms of hypogonadism in females include
1. Lack of menstruation
2. Changes in mood and energy
3. Body hair loss
4. Lack of sex drive
5. Milky discharge from breasts
Symptoms of male hypogonadism include
1. Body hair loss
2. Loss in muscles
3. Abnormal growth in breasts
4. Low libido
If you wish to discuss about any specific problem, you can consult a Gynaecologist.
Low level of testosterone can end up affecting various aspects of a your life. It can affect your libido, your performance in bed along with your motivation and energy. Testosterone replacement therapy can bring the levels back to what they were before and restore his lost confidence, energy and vigour.
Testosterone is a hormone which is mainly produced in the testicles. Testosterone controls bone density, distribution of fat, muscle mass and strength, body and facial hair, red blood cell production, sex drive and production of sperms.
Testosterone levels generally lower with age, especially after 30. Usually, in older men, low levels of testosterone result in androgen deficiency. Androgen deficiency affects the muscle mass, bone density, weight and can drastically change sleep patterns as well. On the other hand, testicle injury, testicular cancer or treatment for it, hormonal disorders, infections, HIV/AIDS, chronic kidney or liver disease, type 2 diabetes and obesity can lead to low testosterone levels as well.
While testosterone replacement therapy (TRT) seems very desirable, there are certain risks and benefits which need to be considered.
Factors to be considered before opting for it
1. Sleep apnea is one of the risk factors of TRT. In this condition, breathing stops and starts repeatedly when you sleep.
2. Acne problems and other skin disorders
3. Swollen breasts. Men with breast cancer should not opt for this treatment.
4. TRT can trigger noncancerous prostate growth.
5. Sperm production is limited or the testicles might shrink
6. Chances of deep vein thrombosis (blood clots in veins) leading to pulmonary embolism (clots burst and lodge into your lungs) are increased.
Benefits of getting a testosterone therapy done
1. Sexual drive, performance and function are improved.
2. Mineral density of the bones gets restored
3. Healthy weight loss, thus improving your body composition
4. Muscle strength and mass improves
5. Mood and energy gets a boost
6. Cognitive functions improve
7. Lessens the risks of type 2 diabetes and cardiovascular diseases
9. Reduces chances of anaemia or improves the condition if you are already suffering from it If you wish to discuss about any specific problem, you can consult a doctor.
Ovarian Cancer, as the name suggests, is a cancer that affects the ovaries. It leads to the abnormal growth of cells, which eventually spreads over to other parts of a woman’s body, such as the stomach, uterus and vagina. The risk of ovarian cancer is greater in women who have experienced the process of ovulation many times in their lifetime. It also includes those women who attain menopause at a much later stage in their lives or those who start ovulation at an early age. The different types of tumors, which develop in ovarian cells are more often than not, benign or non-cancerous and do not spread beyond the ovaries.
Therefore, they can be easily treated by either removing a part or the whole of the ovary. But malign tumors have the ability to spread to other parts of the body and can prove to be fatal.
What are the causes of ovarian cancer
1. Family History: If someone in your close relation like mother, sister or daughter has developed ovarian cancer, then the risk of becoming susceptible to the disease also increases. If any of your close relatives have developed the disease earlier at a young age, then it’s quite likely that it was due to some inherited faulty gene. BCRA1 and BCRA2 are known to be the faulty genes that are connected to ovarian cancer.
2. Age: You become more susceptible to developing ovarian cancer at a postmenopausal stage.
3. Hormone Replacement Therapy (HRT): Women who go for hormone replacement therapy put themselves at a greater risk of developing the disease. Nevertheless, if you stop undergoing the sessions of HRT, your risk of suffering from this fatal condition eventually decreases.
4. Obesity/overweight: This is also one of the important factors behind the increased risks of developing ovarian cancer. So, the more obese you are, greater is the risk involved.
What are the symptoms associated with ovarian cancer?
1. Symptoms at an initial stage include pelvic or abdominal pain, postmenopausal vaginal bleeding or irregular menstruation.
2. Loss of appetite or feeling full quickly
3. Other typical symptoms are diarrhea, constipation, nausea or changes in bowel movements.
4. Feeling of mass pressure at your lower back or pelvis
Treatment available for it
Treatment for ovarian cancer generally consists of a combination of surgery and chemotherapy:
1. Surgery: Treatment usually entails removal of the ovaries, uterus and fallopian tubes, including the surrounding lymph nodes as well as the fatty abdominal tissue, which often gets affected with ovarian cancer. This surgery may help you to retain the ability to conceive.
2. Chemotherapy: Chemotherapy is a procedure that follows a surgery and is performed to destroy the remaining cancer cells, if any. Chemotherapy drugs are either inserted into your vein or directly into the abdominal cavity and if need be, into both. If you wish to discuss any specific problem, you can consult a gynaecologist.
Dilation and curettage is a surgical procedure where the cervix (the lower part of uterus) is dilated and tissues are removed from the inside of the uterus. The procedure is usually done to treat heavy menstrual bleeding or clean the lining of the uterus after an abortion or miscarriage.
During the procedure, the cervix is dilated with medication and a thin surgical instrument is inserted through the vagina. This instrument is then used to scrape (curettage) the uterine tissues.
Reasons for Conducting the Procedure
Dilation and curettage is mostly done to either treat or diagnose certain uterine disorders. Dilation and curettage is recommended if your doctor needs to diagnose conditions such as:
1. Irregular uterine bleeding
2. Postmenopausal bleeding
3. Discovery of unnatural endometrial cells while conducting a common test for cervical cancer
Sometimes, the doctor can take a sample tissue from the uterus and perform tests on it to check for the following conditions:
1. Uterine cancer
2. Uterine polyps (abnormal tissue growth)
3. Endometrial hyperplasia (precancerous thickening of the uterine lining)
Dilation and curettage, when used for therapeutic purposes, is used in the treatment of the following conditions:
1. To clear away molar pregnancy; which is characterized by formation of tumours.
2. To treat heavy bleeding after childbirth; any remaining placenta in the uterus is removed.
3. To remove benign uterine or cervical polyps.
4. To clear away fibroids (benign tumours which form on the uterine wall)
5. To remove any tissue that could have been left behind after an abortion or miscarriage to prevent heavy bleeding or infection
What needs to be considered before opting for it?
The procedure of dilation and curettage is mostly safe. Complications from this procedure are rare, but some factors should always be taken care off.
1. The surgical instrument can perforate or poke a hole in the uterus. Sometimes, perforations can heal on their own; but if any organ or blood vessel gets damaged, then another surgery will be required.
2. The cervix can be damaged during the procedure. The doctor can stitch the wound close, or apply pressure on the wound to stop the bleeding.
3. Sometimes, there might be scar tissues on the wall of the uterus. This can cause irregular, painful or absent menstrual cycles, augment risks of infertility and future miscarriages. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.