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Dr. Sakundala Barathi M

Gynaecologist, Chennai

150 at clinic
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Dr. Sakundala Barathi M Gynaecologist, Chennai
150 at clinic
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I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family....more
I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family.
More about Dr. Sakundala Barathi M
Dr. Sakundala Barathi M is one of the best Gynaecologists in Thiruvottiyur, Chennai. You can visit her at Dr.Barathi's Clinic in Thiruvottiyur, Chennai. You can book an instant appointment online with Dr. Sakundala Barathi M on Lybrate.com.

Lybrate.com has an excellent community of Gynaecologists in India. You will find Gynaecologists with more than 42 years of experience on Lybrate.com. You can find Gynaecologists online in Chennai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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4/17, Udayasuriyan 1st St,Toll Gate,Thiruvottiyur, ChennaiChennai Get Directions
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Got my period today (34 days) looks dark brown colour. Tested salt pregnancy test at 10 am. Found foam on top of my urine. Bit confuse. Please help me.

MBBS
General Physician, Mumbai
Got my period today (34 days) looks dark brown colour. Tested salt pregnancy test at 10 am. Found foam on top of my u...
If two lines have come in the kit than it is positive and foam in urine need not be worried for pregnancy checkup
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I got my periods on 9 July after that I had intercourse on 17 July we used condoms then on 22 august I take 2 tablets of nortesterione a day but on third day I took the dose of morning and night together and I did not got my periods why.

BHMS
Homeopath, Secunderabad
I got my periods on 9 July after that I had intercourse on 17 July we used condoms then on 22 august I take 2 tablets...
Every women should understand that her body is unique and responds to medicines or pills in a different manner at different times. Therefore one should be very cautious about harmonal pills and follow the instructions thoroughly. Irregular usage or increasing / decreasing the dose may disturb the natural rhythm and if these tablets are abused for a long time then it affects the wholes system! Visit a gynaecologist and learn about the tablets and their proper usage and the side effects .Being knowledgable and putting efforts for being healthy (overall health discipline) will empower you.
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I am not having period. So I just want few names of medicine which will make me period immediately.

MBBS, MD - Obstetrtics & Gynaecology, FMAS, DMAS
Gynaecologist, Noida
I am not having period. So I just want few names of medicine which will make me period immediately.
Hello, Please rule out pregnancy first and then if no menses till next 2 weeks then you may opt for a withdrawal bleed with progesterones.
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Menopause- How to tackle it

MBBS (Gold Medalist, Hons), MS (Obst and Gynae- Gold Medalist), DNB (Obst and Gynae), Fellow- Reproductive Endocrinology and Infertility (ACOG, USA), FIAOG
Gynaecologist, Kolkata
Menopause- How to tackle it
Today 18th October is WORLD MENOPAUSE DAY....
Aging is an inevitable phenomenon in our lives. Often our parents or grand-parents say “we are aged now, so it’s just a matter of few years”. But is it really so? French author Jules Renard said “It`s not how old you are, it`s how you are old”. Scientific studies has shown that “we can expect to become old”. There are mainly two reasons for it. One is our life style changes, leading to faster aging of the general population. The second thing is profound improvement in medical care that made it possible to conquer death even at the age of 80 years.In 1000 BC, the life expectancy was only 18 years. By 100 BC, the time of Julius Caesar, it had reached 25 years. In 2005, it was 80 years for women and 75 years for men. And today, you can expect to reach 82 years if you are a male and 85 years if you are a female. Men and women population need to be addressed differently from social, economic and biological points of view. Half of men at 85 and above live with their wives, but only 10% of elderly women live with their husbands. Aging is nothing but a sign of maturity. There are three signs of maturity in each sex. Two of them are common in both men and women; graying of hair and cataract in eye. The third one is unique to each sex. In men, it’s increased size of prostate gland (prostatism) and in female, it’s menopause.

Menopause is unavoidable in a woman’s life. In simplest term, it is the cessation of menstruation permanently at the end of reproductive life. The ovaries stop secreting female sex hormones- mainly estrogen and progesterone. In medical terminology, menstruation should be absent for 12 consecutive cycles to define it as menopause. Though menopause is the stoppage of reproductive function, it has profound effect in almost every organ of the body. Despite our socio-economic improvement, the age of menopause remains relatively the same; average 51 years with range of 45 to 55 years. However, there are some causes that may cause early menopause. If it occurs before 40 years, it’s called premature menopause. This needs medical consultation because it is caused by some serious diseases like genetic causes (may have family history of premature menopause- in elder sisters and mother), smoking, autoimmune disorders (body makes destructive substances against itself) etc. Sometimes premature menopause is the side-effect of some treatments like drugs (especially anti-cancer drugs), radiation and removal of ovaries by surgery. On the other hand, if menstruation continues to occur after 55 years, it’s called delayed menopause. It also deserves consultation with gynaecologists, as it is often caused by diabetes, some tumours and even some cancers. So, if menopause occurs too early or too late, it should never be ignored.

But if menopause occurs in time, do the women should consult gynaecologists? Well. You can find the answers from this article. Most of the women have some common problems after menopause; they become irritable or depressed and sometimes very much emotional and moody. Even suicidal tendency is not uncommon. Often they complain of sudden sensation of excessive warmth, the hot sensation, as if there is something burning on the head, the ears or other parts of the body. This is called “hot flush”, which is often associated with excessive sweating at night, palpitation and anxiety. This happens due to absence of estrogen hormone. These problems can be solved by hormonal drugs. Even non-hormonal drugs also work well. So, timely treatment can give them good quality of life and you don’t have to say “my mother has become intolerable these days”.

Frequently our mothers and grand-mothers complain of having back-pain or pain in the bones. This is due to osteoporosis; the destruction of components of bones and joints. They often get fracture with minor trauma. Again, this is due to deficiency of estrogen and also inadequate calcium intake. So, the treatment of this problem is exercise (at least 30 minutes per day), avoidance of smoking and the drugs that inhibits bone formation and adequate calcium and vitamin D intake. Hormone therapy is also effective and there are many non-hormonal drugs that can prevent destruction of bone. Thus timely medical consultation may stop our mothers saying “I cannot go outside for pain in my knees”.

Cardiovascular disease is the leading cause of death in elderly. Before the age of 40 years, males are more likely to die, than females, due to heart attacks. After 40, the sex difference is lost. This is because of absence of estrogen in women after menopause that alters the composition of fat (especially cholesterol) in blood. Cholesterol get deposited in the wall of blood vessels. Such problems can be avoided by dietary control, control of high blood pressure and diabetes and regular medical checkup.

The worst problemof the menopause is faced by the urinary and reproductive systems, i.e., the private parts of the body. In medical terminology, this is called “pelvic atrophy”. Our women remain very silent of it; most of them do not consult doctors for such problems. There is feeling of increased frequency of urination (women has go to the toilets frequently), burning sensation during urination and sometimes inability to hold the urine until they can reach the toilet or leakage of urine during coughing and sneezing (medically called “urinary incontinence”). The incontinence is not only a medical problem but also a social and hygienic embarrassment, for which many women avoid participation in social activities and even do not want to go outside. Sexuality is a thing that is often ignored both by the elderly people as well as the doctors. Menopause does not mean end of the conjugal life. Often the women may feel decreased libido (the desire) because of low hormone levels. And again there is difficulty in keeping intimacy for problems in the concerned area (due to decreased blood supply), again due to deficiency of estrogens. This may even lead to damage to the private parts and bleeding, while leading the conjugal life. For this, the couples should not suffer silently. There are many treatments that can avoid such urinary and sexual problems. Sometimes, simple counselling and some special exercises may prove to be adequate. Otherwise hormonal drugs (estrogens) can be used. And for this purpose, even we don’t need to take the hormones orally or by injection; simple local use of some creams or jellies help a lot. You will be surprised to know that testosterone may also help some women, because testosterone is not only found in male but is also an important female hormone. Those who want to avoid hormones, can try other non-hormonal agents. Even pregnancy is possible after menopause. There have been many examples of conception, either naturally or by test-tube baby (in vitro fertilization), after menopause. The recent socio-economic trend of delaying the age of marriage and child-birth is making this issue of pregnancy after menopause very much relevant.

Cancer is the second leading cause of death in elderly, after heart attack. Lung cancer is increasing day by day in women and even non-smokers can also have lung cancers. Discharge of blood with cough or vomiting, long-standing cough, chest pain and weight loss needs consultation with chest physician. Breast cancer is a major cause of death in women. This can be avoided by monthly self-breast examination and consultation; if any abnormal swelling or discharge is found. Colo-rectal cancer (cancer of lower part of our digestive tract), recently showed increased incidence in all the age groups. So, if there is any bleeding with stool or passage of black coloured stool, it should never be ignored. Ovarian cancer is showing increased incidences all over the world. Despite significant improvement in cancer management, ovarian cancer is a nightmare of the gynaecologists. Often, even after best possible treatment, patients of ovarian cancer don’t survive beyond one year of diagnosis. So, if you have any problems in digestion, abdominal discomfort, pain and swelling, please don’t just go to medicine shop to take antacids; instead go to your doctor. Post-menopausal bleeding is a medical term, used to describe the condition where there is bleeding through vagina, after menopause. Even if the bleeding is only one drop, it should never be ignored. Though, most causes of such bleeding are not worrisome (due to drugs and ‘’pelvic atrophy”- as mentioned earlier), some cancers may present in this way. Cancer of endometrium (the inner lining of uterus) almost always present with post-menopausal bleeding. Cancer of cervix (the mouth of uterus) is the commonest cancer of reproductive system in our country, which is totally preventable by timely diagnosis by screening (even before actual cancer occurs) and timely HPV vaccination.

“What cannot be cured, must be endured”. We cannot cure the menopause, nor can we avoid it. But definitely we can give our older generation a better quality of life. The first step is obviously making them aware of the menopause and its aftermaths. Second issue is regular health checkup by physicians and gynaecologists, even if they feel no problems as such. But the most important issue is managing their problems. As mentioned above, life-style modifications (like diet, exercise) and non-hormonal drugs play important role. But if we consider the basic problem is menopause, it’s simply deficiency of secretion of female sex hormones from the ovaries. So, if we can artificially introduce those hormones in women, menopausal symptoms can be reduced. This led to emergence of a treatment modality, called HRT (Hormone Replacement Therapy).

Clearly, as discussed earlier, HRT is required in women complaining of menopausal symptoms like “hot flush”, urinary and sexual problems, osteoporosis, and mood depression and also for young women having premature menopause. HRT does not only help to improve these problems, but also has some added advantage like preventing excessive weight gain, problems in oral cavity, eyes and ears and even colorectal cancer. Majority of the women report feeling better and having improved quality of life (social, personal, biological and conjugal) after start of HRT. There are multiple ways to give HRT to a woman. Those include injections (one in 1-3 month), oral tablets, local creams or jellies, skin patches etc. And the drugs include estrogen only, estrogen plus progesterone, tibolone etc.

Now the million-dollar question is, “is HRT absolutely safe?” The answer is difficult to give in one word. After the publication of the reports of the WHI (Women’s Health Initiative) and the MWS (Million Women Study), there have been a great hue and cry regarding safety of HRT. Those study found out many serious side effects of HRT and concluded that HRT should not be used in all the menopausal women. However, subsequently, many flaws of those studies were found out and subsequent review of the WHI study proved that HRT has few side effects. Thrombosis (increased tendency of blood to form clots) is a known side effect of hormonal drugs, but the problem occurs only to those who are at risk of thrombosis due to other causes (like obesity). Breast cancer is definitely a risk factor but the risk is small. So, the women need to continue self-breast examination and yearly checkup by their consultants. Blood fat concentration (cholesterol) may be altered, which needs regular lipid profile checkup. And finally there is increased risk of heart attacks and stroke. But possibility of heart attack is there only if HRT is started in very elderly women (after 60 years) and those who are already have some risks (obesity, smokers, and hypertensive). Even, timely initiation of HRT (before 60 years) can protect the heart and brain against stroke.

Thus HRT is found to have very minimum side-effects and that too at the expense of so many benefits. There are very few women who should not use HRT; those having thrombosis, heart disease or liver disease at present and very high blood fat level (high triglyceride). If the woman has any mass in the breast or post-menopausal bleeding, then HRT should be used only when the diagnosis of the mass or the bleeding is certain. To be on the safe side, before start of HRT, details examination by the consultant doctor is required. This includes checkup of blood pressure, heart, breast, liver and the pelvic organs. The best time to start HRT is as early as after menopause. For premature menopause, the women are relatively younger (before 40, even before 30). So, they should start HRT soon after consultation with doctors, if HRT is suitable for them. For women with natural menopause, HRT should be started before 60 years. Annual visit to the doctor is necessary to detect any side effects and to find whether HRT is needed further or not. HRT need not be continued lifelong. Most of the women can stop it after 5 years. Very few women have to continue it beyond 10 years. Actually, after 2-3 years of HRT, most of the menopausal problems subside and women do not require to continue HRT. However, before stoppage, doctor consultation is required.

In a nutshell, elderly people deserve special care. But that does not mean they should always be in the bed. They should continue their day to day activities. They have the full right to enjoy their life by themselves. What we can do is be supportive to boost up their confidence and self-esteem. That needs social as well as medical attention. Regular touch with physician and gynaecologist cannot be overemphasized. Most of the symptoms can be taken care by life style modifications and drugs. HRT should be used as necessary. HRT is very safe and cost-effective modality. “Not everyone grows to be old, but everyone has been younger than he is now”.

Fistula-In-Ano (Say No to Surgery) - 7 Important Things You Must Know!

M.S. (Ayurveda), Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Delhi
Fistula-In-Ano (Say No to Surgery) - 7 Important Things You Must Know!

Anal fistulas or fistula-in-ano generally cause discomfort due pus or watery discharges and sometimes pain. This is a condition where a nodular swelling appears in area surrounding the anal opening. Intermittent pus discharged is noticed from this nodular swelling. Instead of a nodular swelling; there might be simply an opening in this region. An anal abscess is one of the most common causes for this condition. Here are ten things you should know about these anal fistulas:

  1. It is curable through Ayurveda only: Till date many treatment options are tried to cure Anal Fistula which include Anal Fistula Surgery/ Glu technique/ cutting seton/ Colostomy/ Fistula plug/ VAAFT and many more. But all of these treatment methods have pretty high recurrence rate of about 20-25 %. However with Ksharsutra treatment for Anal Fistula; chances of recurrence are negligible. Other complications generally seen in surgery like bleeding, incontinence (inability to hold stool); are not seen with Ksharsutra Treatment. Clinical trials conducted by Indian Council for Medical Research (ICMR); at AIIMS New Delhi and PGI Chandigarh in 1992 have proved that Ksharsutra treatment is more convenient and more effective than Surgery in the patients of Anal Fistula. 
  2. There are symptoms you can look out for: Some of the symptoms that indicate anal fistulas include appearance of a nodular swelling in area surrounding Anal opening. Intermittent pus discharge is also observed from this swelling. Usually pain subsides and opening closes after the discharges; and patient feels relief. But after certain interval of time again pus accumulates; swelling re-appears with some amount of pain which is again relieved after the discharge. This cycle is repeated at varying interval in the patient of anal fistula.
  3. Medication can only provide temporary relief: Anti biotics and painkiller might give temporary relief from the symptoms. But after some time there will be again pus formation and associated swelling & pain in area surrounding anal opening. 
  4. Anal fistulas can recur after surgical treatment: As discussed above all the treatment options tried by modern medicine (including most recent treatment VAAFT) have high incidence of recurrence (about 20-25%) Whereas there are negligible chances of recurrence after Ksharsutra Treatment for Anal Fistula. . 
  5. Anal fistulas treated by Graded Ksharsutra do not recur: Ayurvedic treatment for anal fistulas is known as Kshar sutra therapy. This involves the use of medicated thread being ligated in Fistula Tract. The medicines present in this thread act as a strong debriding agent and induces healing of Fistula tract. In few weekly sittings of Ksharsutra change; Fistula gets healed completely and it do not recur. Pt. maintains his normal routine life during treatment period. 
  6. Sitz bath can be beneficial: This involves sitting in a tub filled with warm water so that the affected site is submerged. An antiseptic and astringent agent like Triphala decoction may be added to the water if needed. A sitz bath soothes the skin and provides relief from pain. This also helps keep the area clean and thus reduces chances of infection
  7. Oily and spicy foods should be avoided: When dealing with anal fistulas, you should try and take a diet that keeps your stool soft and regular. Hence use of oily and spicy foods should be reduced. Eat plenty of fiber and drink lots of water. Alcohol should also be avoided. 

Comparative Study: 

Ksharsutra vs Surgery in Anal Fistula Patients- 

  1. Ksharsutra is done under Local Anesthesia. Hence complications of General Anesthesia are avoided. Surgical procedures are done under GA with all impending complications of General Anesthesia. 
  2. Ksharsutra being a parasurgical procedure hence no bleeding/ cutting of tissue is involved. Surgery involves cutting/ bleeding. 
  3. No hospitalization or bed rest is required in Ksharsutra Treatment. In Surgery hospitalization is must. 
  4. In Ksharsutra; patient can continue his normal daily routine Surgery may require bed rest. 
  5. Complications like incontinence (inability to hold stool) and recurrence are seen after surgery
  6. Ksharsutra is a safe procedure and these complications are not seen. 
  7. Ksharsutra Treatment is more economical as compared to VAAFT surgery. VAAFT Surgery is comparatively too expensive.

In case you have a concern or query you can always consult an expert & get answers to your questions!

5411 people found this helpful

Hi ma'am, I am 28 years married woman and I am suffering from itching in my vagina from last 15 days, I have tried washing with salt water and also with dettol & savlon I get relief for few minutes and then again the same problem. There is a white cloudy discharge too but without any smell, so ma'am pls suggest me what to do.

MBBS, MD - Obstetrtics & Gynaecology
Gynaecologist, Gorakhpur
First stop using savlon n dettol n salt water for vaginal wash as it kills healthy bacterias and make you more prone for vaginal fungal infections. Use vaginal washes exclusively made for this purpose its avsilable as OTC product. Avoid having sex for a fortnight still if you have problem see a doctor n get yourself examined internally for vaginal infections and get treated for you n your spouse too as you might get reinfected after coitus.
4 people found this helpful
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Hello sir, I got my periods on 30 April n got fresh on 5 may BT yesterday my periods started again after 4 days of fresh. N the flow as normal like asusal. I am afraid please give me any suggestion.

MBBS
General Physician, Chandigarh
Hello sir,
I got my periods on 30 April n got fresh on 5 may BT yesterday my periods started again after 4 days of fr...
With sexual activities your hormones in the body change hence can cause irregular cycles once in a while.
2 people found this helpful
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Me and my wife are planning to have a baby from past two months. But she is not able to conceive what is the reason?

MD - Obstetrtics & Gynaecology, MBBS
Gynaecologist, Gurgaon
Me and my wife are planning to have a baby from past two months. But she is not able to conceive what is the reason?
Hi dear. Infertility or inability to have children is a complex problem and can be due to many reasons. We normally suggest couples to try for atleast 6 months before trying to investigate for infertility. Both the woman and man are responsible for conception and to know the cause of infertility we need to test both. Basic ultrasound and hormone tests for woman as well as semen analysis for the male is needed to know the cause as there are multiple reasons for not conceiving, ranging from hormonal problems, stress, infections etc. So its necessary you visit a infertility specialist in your area for evaluation and treatment. All the best
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